Small Unit Leader Perceptions of Managing Soldier Behavioral Health and Associated Factors

This investigation explored squad leaders’ perceptions of their roles managing subordinate soldiers’ behavioral health (BH) needs. The data were obtained through an anonymous survey of 458 squad leaders (i.e., small unit leaders who oversee 4–10 soldiers). More than 80% of squad leaders perceived management of soldier BH needs before, during, and after treatment as their responsibility, and felt comfortable and capable of executing these roles. Latent class analysis was used to determine groups of “most active,” “moderately active,” and “least active” leaders. Multinomial logistic regression was used to compare the least and most active classes. The most active leaders were more likely to report high BH knowledge, dedication to a common purpose, and low levels of “associative” stigma. These results should inform leader management of soldier BH. Future research should examine active leader characteristics and whether evidence-based training can increase support for preventing and managing BH issues.     

Self-Stigma in Substance Abuse: Development of a New Measure

Little attention has been paid to the examination and measurement of self-stigma in substance misuse. This paper aims to fill this gap by reporting on the development of a new scale to measure self-stigma experienced by people who are misusing substances, the Substance Abuse Self-Stigma Scale. Content validity and item refinement occurred through an iterative process involving a literature search, focus groups, and expert judges. Psychometric properties were examined in a cross-sectional study of individuals (n?=?352) receiving treatment for substance misuse. Factor analyses resulted in a 40-item measure with self devaluation, fear of enacted stigma, stigma avoidance, and values disengagement subscales. The measure showed a strong factor structure and good reliability and validity overall, though the values disengagement subscale showed a mixed pattern. Results are discussed in terms of their implications for studies of stigma impact and intervention.     

The job demand-control(-support) model and physical health outcomes: A review of the strain and buffer hypotheses

Abstract

This review of the Job Demand-Control (JDC) model and the expanded Job Demand-Control-Support (JDCS) model and employees' physical health, focuses on the two prevalent views on these models. According to their view on the models researchers study different hypotheses: (a) the (iso)strain hypothesis, stating that the highest level of ill health is expected when the job is characterized by high demand and low control (and low social sup port), ot (b) the buffer hypothesis, predicting that control (and social support) can buffer the potential negative effects of high demands on physical health. It is argued that these hypotheses reflect theoretical distinct models, and that the practical implications associated with these models differ.

The review of 51 studies on the JDC(S) model reveals that the “strain” hypothesis predominates in studies of all-cause mortality, cardiovascular disease (CVD) related and specific non-CVD related health outcomes. In contrast, the “buffer” hypothesis is most prevalent in research on self-reported (psycho)somatic complaints. For the strain hypothesis as well as the buffer hypothesis the results are equivocal. Working in a high (iso)strain job appears to be associated with an elevated risk for cardiovascular disease and negative pregnancy outcomes, and increased (psycho)somatic complaints. Conclusions on other physical outcomes seem premature, considering the limited number of studies. The buffer hypothesis is supported in the few studies on CVD endpoints and in some studies on (psycho)somatic complaints.

A comparison of the validity of the two hypotheses is problematic, because they are mostly applied to a different set of outcomes. Furthermore, the analyses employed in the testing of the two hypotheses are of a different nature (non-linear versus linear).

The main recommendation for future research is to examine the validity of the strain and the buffer hypothesis concurrently, and to further explore the nature of the relationships.     

Fear of routine dental treatment in adults: Its nature and management

Abstract

The fear of dental treatment in adults can be characterised in several ways, loosely related, such as anticipating being afraid, avoiding dental check-ups and seeking treatment only under general anaesthesia. Defined thus, at least a quarter of adults are highly afraid of dentistry. The feared experiences are many, including most frequently, pain. Several studies have shown that anxious patients experience less pain during treatment than they expect. It remains to be confirmed that these are typical experiences because other studies show that local anaesthesia can fail to protect patients from sudden pain in 13% of treatments on average. Expectations of pain are highly resistant to change, the result probably of several influences including distortion in recall of pain-free treatment, intermittent experience of sudden severe pain, expecting pain in order to reduce its impact, and uncertainty about treatment. It has yet to be shown that experience free of discomfort can reduce these expectations. However, relaxation instructions and information about pain management and stop signals can reduce pre-treatment fear. To prevent the onset and the maintenance of anxiety: the prevention of pain is essential; controlled behavioural studies of the treatment of pain and other experiences such as panics are needed. Finally, the need for new instruments to assess all aspects of fear of dentistry is described.     

Perfectionism and health: A mediational analysis of the roles of stress,social support and health-related behaviours

This study tested a model derived from personality theory in which perceived stress, perceived social support, health-risk and health-promotion behaviours mediate the relationship between perfectionism and perceived physical health. A sample of 538 undergraduate students completed a web-based survey assessing multi-dimensional perfectionism, perceived stress, perceived social support, health behaviours, physical health and a scale tapping elements of the five-factor model of personality. Analyses that account for the effects of traits from the five-factor model (e.g., neuroticism, conscientiousness and extraversion) indicated that socially prescribed perfectionism was associated with poorer physical health and this association was fully mediated by higher levels of perceived stress and lower levels of perceived social support. Self-oriented perfectionism was related complexly to health such that it was related to poorer health via higher levels of perceived stress, but was also related to better health via higher levels of perceived social support. Our findings illustrate the need for considering key mediators of the link between perfectionism and poor health outcomes.     

Zapotec sacred places,enduring and/or ephemeral: Reverence,realignment and commodification at an archaeological-tourist site in Southern Mexico

The abundant and rightfully famous archaeological ruins of Mexico, besides attesting to the grand achievements of pre-Columbian Mesoamerican culture, also serve as foci for the preservation and/or reaffirmation of contemporary indigenous religion and identity. Additionally, those same ancient ruins have been, in many instances, tidied up and reconfigured variously as outdoor classrooms and museums for the dissemination of a narrative of Mexican national identity, as the country's premier tourist attractions, and thus as sites eventually prized far more as engines of economic development than as educational or religious contexts. Where indigenous peoples are often imagined as passive victims in this commodification of their sacred sites, the case study featured in this article, namely, the twentieth century management of the internationally renowned Zapotec site of Mitla, Oaxaca reveals a native community playing a very active role, arguably the lead role, in the exploitation of the economic potential of its famed ruins. Indeed, the Mitleyenos' entrepreneurially astute reconfiguration of their local sacred geography, a realignment that balanced unprecedented economic challenges with on-going devotional commitments, suggests that the designation of various sites and buildings as ‘sacred’, albeit an extremely pressing matter, is also much more contingent and more transient than is generally assumed.     

The sense of diachronic personal identity

In this paper, I first consider a famous objection that the standard interpretation of the Lockean account of diachronicity (i.e., one’s sense of personal identity over time) via psychological connectedness falls prey to breaks in one’s personal narrative. I argue that recent case studies show that while this critique may hold with regard to some long-term autobiographical self-knowledge (e.g., episodic memory), it carries less warrant with respect to accounts based on trait-relevant, semantic self-knowledge. The second issue I address concerns the question of diachronicity from the vantage point that there are (at least) two aspects of self—the self of psycho-physical instantiation (what I term the epistemological self) and the self of first person subjectivity (what I term the ontological self; for discussion, see Klein SB, The self and its brain, Social Cognition, 30, 474–518, 2012). Each is held to be a necessary component of selfhood, and, in interaction, they are appear jointly sufficient for a synchronic sense of self (Klein SB, The self and its brain, Social Cognition, 30, 474–518, 2012). As pertains to diachronicity, by contrast, I contend that while the epistemological self, by itself, is precariously situated to do the work required by a coherent theory of personal identity across time, the ontological self may be better positioned to take up the challenge.     

Goal disturbance,coping, and psychological distress in partners of myocardial infarction patients: Taking account of the dyad

Abstract

This study aims to explore the relationship between goal disturbance and levels of psychological distress in partners of myocardial infarction (MI) patients. Furthermore, the role of partner and patient coping behaviour in the context of goal disturbance is explored. Forty dyads were interviewed and completed questionnaires 1 month (T1) and 4 months (T2) post MI. All patients were men. Patients and partners do not differ on anxiety or depression scores, however, patients experience significantly more higher order goal disturbance at T1. Partners reporting more goal disturbance also show increased distress at T1. More use of approach coping by partners contributes to explained variance in their goal disturbance. Partner avoidant coping is moderated by patient avoidant coping. Approaches to reduce distress in partners should thus take account of goal disturbance and coping behaviours within the dyad.     

Abstract

Although Aristotle did not mention it, integrity can be understood in an Aristotelian framework. Seeing it in these terms will show that it is an executive virtue which concerns the existential well being of an agent. This analysis is not offered as an exegesis of Aristotle's text, but as an attempt to use an Aristotelian framework to understand a virtue deemed important today. This account will have the benefit of solving some problems relating to motivational internalism and, as such, will contribute to that recent current of thought which has been highlighting the importance of virtue thinking in moral theory. I will distinguish moral judgement from decision and show that moral judgement is dependent upon virtue more strongly than it is upon impartial rationality. I will suggest that integrity is the virtue to which moral judgement gives expression and is the virtue which links judgement to decision so as to overcome akrasia.