Family therapy in primary health care: Skills training and outcome evaluation

Some of the theoretical tenets of family therapy such as emphasis on the activation and utilization of existing family resources and the importance it accords to context appear to have a good fit with primary health care's commitment to empowering individuals in their struggle against ill health and the circumstances in which it occurs. This paper explores the possibility of teaching a problem-solving approach to family therapy to nurses in a South African primary health care system. Training consisted of conceptual, pragmatic, and self-growth exercises, and trainees' conceptual and performance skills were compared to the skills of a group of untrained nurses.We thank Bukelwa Selema, co-trainer on the program, for her contributions to joining effectively with the nurses and enriching the experiential process. We also thank Dr. P.J. Beukes, Dr. J.H. Olivier, Dr. G.M. Louw, Matron L.C. Langley and other staff in the Soweto primary health care system for their support. In particular, we are grateful to nursing sisters Martha Nkoane and Millicent Matomela, who roleplayed clients on the videotaped training modules. We are also grateful to Edcent Williams, who was one of the videotape raters, and Mike Spruce, Ricky Snyders, Nico Cloete, Ricky Mauer, and Brenda Radebe for their inputs at various stages of designing and implementing the programme.     

Experienced closeness and distance among family members

This study looks at experienced emotional closeness among family members using a projective measure, the Family Paper Sculpture. Results support the hypothesis that, in a non-clinical population, experiences of extreme closeness and extreme distance may be different manifestations of the same underlying process. Some support is found for the hypothesis that families in which relationships are experienced as very close or very distant at one point in time may experience those same relationships as extreme in the opposite direction at another point in time. Global coding of taped family interactions supports the hypothesis that extremes of experienced closeness are associated with more conflict, less ability to resolve differences, and less warmth and support among family members. It is suggested that the experience of being very close, varying through time with the experience of being very distant, may be associated with disappointed attempts to achieve closeness with autonomy.worked on this research while a graduate student in psychology at the University of Houston-Clear Lake.David C. Bell, PhD, completed work on this report while at Texas A & M University. He is presently working on a book about connection and dependency.The studies reported here were supported by grants from the National Institute for Mental Health and the Hogg Foundation for Mental Health. The authors would like to thank David Gutterman, Sheila Jones, Judy Nunn, and Theresa Rourke for coding the global scales.     

Sports specific metacognitions and competitive state anxiety in athletes: A comparison between different sporting types

This study investigated the relationship between sport related metacognitions with state anxiety dimensions, and compared how sporting categories affected these variables, among an online sample of athletes (N = 187). A MANOVA revealed there were significant differences between sporting types in metacognitive beliefs relating to the utility of rumination and arousal, the need to control thoughts, and levels of somatic anxiety. Correlations and multiple regressions showed that that in contrast to the relationships with self-confidence, cognitive and somatic state anxiety were positively associated with specific dysfunctional metacognitive beliefs, but negatively related to metacognitive processes. Overall, these findings highlight that: (a) athletes might adopt metacognitions to meet the different cognitive demands of sport types; and (b) metacognitions are in part responsible for the occurrence of state anxiety and self-confidence during competitions. The findings of this study have implications toward how researchers and sports practitioners approach the comprehensive nature of competitive anxiety.     

Caregiver perspectives of risk and protective factors influencing early childhood development in low-income,urban settings: A social ecological perspective

This qualitative study explored caregivers' perceptions of factors influencing early childhood development in low-income, urban South African settings, from a social ecological perspective. Individual interviews were conducted with 15 caregivers of 3–5-year-old children; a reflexive thematic analysis approach was adopted. In the family and home context, caregivers spoke about their role in developing, nurturing, providing, protecting and disciplining their children. Risks included low socioeconomic status, dysfunctional relationships and caregiver mental health; resources related to early learning and social support. In the preschool/school context, caregivers discussed the value of early learning, and priorities for selecting early childhood care and education settings. Community risks included violence and crime; resources mentioned were social support, community programmes and infrastructure. The social ecological model provides a holistic and contextually relevant perspective for understanding multiple factors (risks and protective factors) influencing early childhood development in low-income South African settings.     

A sequential exploratory diagnostic model using a Pólya-gamma data augmentation strategy

Cognitive diagnostic models provide a framework for classifying individuals into latent proficiency classes, also known as attribute profiles. Recent research has examined the implementation of a Pólya-gamma data augmentation strategy binary response model using logistic item response functions within a Bayesian Gibbs sampling procedure. In this paper, we propose a sequential exploratory diagnostic model for ordinal response data using a logit-link parameterization at the category level and extend the Pólya-gamma data augmentation strategy to ordinal response processes. A Gibbs sampling procedure is presented for efficient Markov chain Monte Carlo (MCMC) estimation methods. We provide results from a Monte Carlo study for model performance and present an application of the model.     

Implicit Learning in a Simple Cued Reaction-Time Task

Implicit learning tasks usually involve the learning of complex rules. While this does reduce the likelihood of subjects becoming aware of the relationship to be learned, it also raises the possibility of explaining improved performance in terms of explicit processes. The current experiments are an attempt to develop a task which shows evidence of implicit learning, but which involves the learning of a very simple rule and so avoids these alternative explanations. In two experiments, we exposed subjects to learning trials in which a target letter (or shape) was immediately preceded by a cue letter (or shape) in otherwise random nine-letter (or 15-shape) sequences. In a test phase, subjects responded more quickly to cued than uncued targets if the learning phase had involved reliable cue–target pairings, but not following random control pairings. This was true of subjects who were classified as aware and those classified as unaware of the cue–target relationship.     

Self-Efficacy and Causal Attributions: Direct and Reciprocal Links

This study examines Bandura's (1986, 1997a) propositions that self-efficacy provides information from which causal attributions are made and that causal attributions, in turn, influence formation of subsequent self-efficacy expectations. We developed a conceptual rationale for and empirically tested 2 sets of hypotheses pertaining to direct and reciprocal links between self-efficacy and causal attributions. Effects of causal attributions and subsequently formed self-efficacy on subsequent task performance were also investigated. Results support the existence of direct and reciprocal links between self-efficacy and causal attributions. We found interactive effects between self-efficacy and performance feedback on causal attributions, and a mediating effect of causal attributions on the formation of subsequent self-efficacy beliefs. Causal attributions and subsequent self-efficacy also significantly predicted subsequent performance.     

Support for the Death Penalty: A Gender-Specific Model

Research on the public's level of death penalty support (DPS) has neglected gender-specific models. While most previous work has shown that women have lower DPS than men, it is not clear whether traditional models of DPS will work for a sample restricted to women. The greater intolerance of the death penalty among women may overshadow or reduce the impact of traditional predictors of DPS among women. The present paper performs the first systematic gender-specific analysis of DPS. It uses national data from the 1990 General Social Survey. Measures of three variable sets were employed: symbolic orientations (e.g., political conservatism, authoritarianism); crime salience (e.g., victimization, fear); and demographic controls. The results of a stepwise logistic regression analysis showed that political conservatism has a direct effect on the DPS of both men and women. For women only, authoritarianism also had a direct effect on DPS. Further analysis showed that for women, six variables exert an indirect effect on DPS through political conservatism and five through authoritarianism. Only three indirect effects were found for men. However, none of the 16 variables analyzed had a significant gendered effect. Indicators of traditional models of DPS were found to work as well for women as they did for men.