Evaluating Attributions for an Illness Based Upon the Name: Chronic Fatigue Syndrome, Myalgic Encephalopathy and Florence Nightingale Disease

In recent years, considerable discussion has occurred about stigma surrounding the name given to an illness currently known as chronic fatigue syndrome (CFS). Although patients and medical personnel have expressed varying opinions on this issue, no studies have evaluated how beliefs about the illness change based upon the type of name used for diagnostic purposes. Proposals have been put forth to rename the illness with an eponym (a famous patient's or researcher's name) or with a less trivial sounding, more medically based type of name. In this study, attributions about CFS were measured in three groups of medical trainees. All groups read the same case study of a person with classic symptoms of chronic fatigue syndrome, with the only difference being in the type of name given. Trainees then were asked to provide attributions about certain aspects of the illness, including its cause, severity, and prognosis. Results suggested that, across name conditions, most trainees appeared to consider the symptom complex of CFS a serious illness resulting in poor quality of life. In addition, findings indicated that the name, chronic fatigue syndrome, may be regarded less seriously than the Myalgic Encephalopathy name with respect to some important aspects of the illness. In this study, specialty of medical trainee also played a role in how the illness was perceived.     

Not all narrative shifts function equally

Readers of narratives keep track of narrative events and the information associated with these events. Does some of this associated information help structure the processing of and memory for the narrative? In three experiments, we examined the role of basic event building blocks (character, time, and location) in event indexing during text comprehension. These three experiments dealt with perceived coherence, perceived cohesion, and on-line processing, respectively. The results indicated that characters are more likely to serve as event indexes. Although the findings with respect to indexing were similar in all three experiments, interesting differences emerged as a function of the level of text comprehension examined (coherence, cohesion, or on-line processing).     

Neighborhood deprivation affects children's mental health: environmental risks identified in a genetic design

The possibility that neighborhood conditions affect children's development has captured much attention because of its implications for prevention. But does growing up in deprived neighborhoods matter above and beyond a genetic liability to behavior problems, if genetically vulnerable families tend to concentrate in poor neighborhoods? A nationwide study of 2-year-old twins shows that children in deprived neighborhoods were at increased risk for emotional and behavioral problems over and above any genetic liability. Environmental factors shared by members of a family accounted for 20% of the population variation in children's behavior problems, and neighborhood deprivation accounted for 5% of this family-wide environmental effect. The results suggest that the link between poor neighborhoods and children's mental health may be a true environmental effect, and demonstrate that genetic designs are environmentally informative and can be used to identify modifiable risk factors for promoting child health.     

The influence of self-efficacy on alcohol use among American Indians

The influence of self-efficacy (general and substance use) on alcohol use among 114 American Indian and Native Alaskan adults was examined. Analysis of variance was performed to assess differences between alcohol use groups (nonuse, low use, and medium-high use). Low general self-efficacy (GSE) was associated with higher alcohol use. High substance use self-efficacy (SSE) was associated with higher alcohol use. Moreover, low GSE was associated with higher SSE. Results indicate that alcohol use may be in response to feelings of powerlessness within one's life and may be sustained by perceived feelings of control over use. The study suggests that the concept of self-efficacy appears to relate to empowerment issues and, as such, would have important applications for use with minority individuals.     

Are self-enhancing cognitions associated with healthy or unhealthy biological profiles?

Self-enhancement is variously portrayed as a positive illusion that can foster health and longevity or as defensive neuroticism that can have physiological-neuroendocrine costs. In a laboratory stress-challenge paradigm, the authors found that high self-enhancers had lower cardiovascular responses to stress, more rapid cardiovascular recovery, and lower baseline cortisol levels, consistent with the positive illusions predictions and counter to the predictions of the defensive neuroticism position. A second set of analyses, replicating the "illusory mental health paradigm" (J. Shedler, M. Mayman, & M. Manis, 1993), also did not support the defensive neuroticism hypothesis. The association between self-enhancement and cortisol was mediated by psychological resources; analyses of the cardiovascular results provided no definitive mediational pathway. Discussion centers on the potential stress-buffering effects of self-enhancing beliefs.     

Portrait of the self-enhancer: well adjusted and well liked or maladjusted and friendless?

Research has variously portrayed self-enhancement as an indicator of narcissistic defensiveness or as a concomitant of mental health. To address this controversy, the present study used multiple measures of self-enhancement along with multiple measures and judges of mental health, comprehensively assessing their relationship. The results indicated that self-enhancement is positively associated with multiple indicators of mental health and with a more favorable impact on others. Discussion centers on a reconciliation of discrepant portraits of the self-enhancer.     

Anxiety sensitivity in six countries

In the present study, the Anxiety Sensitivity Index-Revised (ASI-R; ) was administered to a large sample of persons (n=2786) from different cultures represented in six different countries: Canada, France, Mexico, The Netherlands, Spain, and the United States. We sought to (a) determine the factor structure and internal consistency of the ASI-R and (b) examine the correlations of the measure with psychiatric symptoms and personality dimensions in a single European non-English speaking country (The Netherlands). Partially consistent with the original hypothesis, the underlying structure of the anxiety sensitivity construct was generally similar across countries, tapping fear about the negative consequences of anxiety-related physical and social-cognitive sensations. Lower-order factors were moderately to strongly correlated with one another and showed good internal consistency. The observed lower-order ASI-R factors correlated with established psychiatric symptoms and with the personality trait of neuroticism. Partial correlations indicated that both factors are useful in accounting for variance in symptom measures. We discuss the results of this investigation in relation to the cross-cultural assessment of the anxiety sensitivity construct.     

Prevention of eating disorders and obesity via the internet

Internet technology has been expanding rapidly and has had a dramatic impact on how people communicate, learn and share information. This article presents applications of internet technology to the psychological domain, particularly in the prevention and treatment of eating disorders and obesity. Information regarding advantages and disadvantages of computerized interventions are discussed and several examples of randomized controlled trials with this technology are presented. The studies presented are not meant to be comprehensive of psychological interventions in general, but are examples of computerized applications from the eating disorder and obesity literatures. Ethical considerations and areas for future direction are also discussed.     

Increasing attendance at colorectal cancer screening: testing the efficacy of a mailed, psychoeducational intervention in a community sample of older adults.

This article describes a trial of a psychoeducational intervention designed to modify negative attitudes toward flexible sigmoidoscopy screening and thereby increase screening attendance. The intervention materials addressed the multiple barriers shown to be associated with participation in earlier studies. Adults ages 55-64 (N = 2,966), in a "harder-to-reach" group were randomized either to receive an intervention brochure or to a standard invitation group. Attitudes and expectations were assessed by questionnaire, and attendance at the clinic was recorded. Compared with controls, the intervention group had less negative attitudes, anticipated a more positive experience, and had a 3.6% higher level of attendance. These results indicate that psychoeducational interventions can provide an effective means of modifying attitudes and increasing rates of screening attendance.