The Depression Anxiety Stress Scale-21: Spanish Translation and Validation with a Hispanic Sample

The English-language version of the Depression Anxiety Stress Scale-21 (DASS-21) was professionally translated into Spanish and field-tested among 98 bilingual Hispanic adults. Participants who were diagnosed with an anxiety disorder on the Anxiety Disorders Interview Schedule-IV completed the DASS-21, the Beck Depression Inventory-II, and the Beck Anxiety Inventory. Results indicated strong indices of internal consistency and expected patterns of discriminant, convergent, and structural validity. A confirmatory factor analysis compared a model fit of a first order 1-factor model, a first order 3-factor model, and a second order factor model. The latter 2 models were significantly better than the 1-factor model. Psychometric data were comparable to those of an English version. Clinicians and researchers in need of a brief, Spanish-language, screening measure of general psychopathology may want to consider this newly translated DASS-21.     

Guidelines for Writing Letters to Patients

Patient letters provide a permanent record of the genetic counseling that was provided and are unique in medical care; rarely do other health care providers send summaries written specifically to their patients and families. We surveyed genetic counseling training program directors and found that while the acquisition of patient letter-writing skills was considered important, there were no specific guidelines made available to students. To develop letter-writing guidelines, we evaluated patient letters, reviewed references on professional correspondence, surveyed the medical literature, and worked with a writing consultant. The guidelines we subsequently developed and present here include a format for writing patient letters, suggestions on presenting medical information in understandable terms, and wording considerations. These patient letter-writing guidelines are intended to serve as a guide for teaching students this important skill and as a resource for practicing health care professionals.     

Personality Dysfunction and the Management of Chronic Medical Illness: A Community Health Sample

The purpose of this study was to determine the influence of personality disorders on perceived health status, self-efficacy for management of the chronic illness, and physician perception of patient health. A total of 607 patients with self-identified chronicillness(es) volunteered to participate in the study. Out of this sample, 147 had collaborative physician data indicating a chronic illness. The final sample was 143 due to incomplete data. Results suggested that maladaptive personality characteristics, as measured by the Short-Form of the Coolidge Axis II Inventory (SCATI), were related to a number of important factors that influence self-management of chronic illnesses. When the personality constellations were broken into 3 groups (normal, subclinical, and clinical) significant differences were found on the 3 groups of dependent variables (Subjective Health, Self-Efficacy, Physician Appraisal) for the different personality disorders. These data provide useful information on several factors that influence effective disease management. Clinical implications and directions for future research are provided.     

Subjectivity and sexual difference: New figures of the feminine in Irigaray and Cavarero

This paper argues that the metaphors of breath and voice as employed in the recent works of Luce Irigaray and Adriana Cavarero yield a reconceptualization of subjectivity as unique, embodied and relational. When interpreted in light of Cavarero's reorientation of the question of subjectivity from a what to a who, this newly configured notion of subjectivity can serve as the basis for a non-essentialist politics of sexual difference.     

Psychosocial variables, external barriers, and stage of mammography adoption.

Guided by H. Triandis's (1980) theory of behavior and the transtheoretical model, the study purpose was to examine differences in psychosocial variables and external conditions by stage of mammography adoption. Sampled from a statewide population, participants (N=509) were women aged 51-80. They had been contacted by telephone, screened for eligibility (e.g., no history of cancer or recent mammogram), and interviewed 3-6 months later. Higher utility beliefs, social influences, and practitioner interactions about mammography were associated with improved stage of adoption, as were lower negative affect and external barriers regarding mammography. Higher decisional balance scores, with and without negative affect toward mammography were associated with improved stage. Controlling for variables reflecting pros and cons, negative affect toward mammography further distinguished among stages. A richer set of pros and cons measures could explain screening more fully.