Adult urinary incontinence: Assessment,intervention, and the role of clinical health psychology in program development

Urinary incontinence (UI) is a disorder receiving little attention from clinical health psychologists. This paper establishes the importance of addressing the issue of UI within the clinical and research practices of clinical health psychologists. Over 10 million Americans suffer from loss of bladder control. Incontinence affects over half of older individuals in long-term care institutions, about one-third of hospitalized elderly, and up to 30% of Americans over the age of 60 living at home. Because of social stigma and misconceptions attached to urinary incontinence, it is estimated that less than half of those affected see a physician about their condition. Since UI is generally associated with medical, social, psychological, and economic consequences, a multidisciplinary perspective is important because these factors are integral in the selection of appropriate treatment. Definitions of UI, its incidence and costs, and brief reviews of treatment and management techniques are presented. Psychological sequelae and treatments are presented as a foundation for developing further treatment and research approaches. Guidelines for collaboration and consultation by clinical health psychologists with medical professionals in the area of UI are also discussed.     

Testing for developmental continuity or discontinuity: Class inclusion and reversal shifts

Often the data in cognitive development consist of continuous cross-sectional increases in the proportion of children who respond in one of two ways to a diagnostic task. Such developmental trends are, however, ambiguous with reference to the course of individual, longitudinal development because they could be the result of either saltatory or gradual ontogenetic change. The present research tested a nonlongitudinal procedure for discriminating between these two alternatives. This procedure involves the administration of several equivalent versions of the diagnostic task at weekly intervals to children within a given age level in order to obtain a frequency distribution of the number of “successes” produced by each child. A bimodal distribution is interpreted as indicating saltatory ontogenetic change, while a unimodal distribution is taken to indicate gradual change. This method was applied to Piaget's class-inclusion problem and to the optional-shift task by administering four versions of each task to a range of different age-level samples. The optional-shift task produced clearly unimodal, bell-shaped distributions at all tested age levels, results which were interpreted to indicate a gradual ontogenetic increase in the probability of making reversal shifts. On the other hand, the frequency distributions for the class-inclusion task, at the appropriate age levels, were distinctly bimodal, and therefore consistent with a discontinuous ontogenetic transition. The capacity of the repeated-measures method to produce reliable within-task results and to differentiate between tasks was thus demonstrated.     

Revisionist practical theology and the meaning of public discourse

The author asks how practical theology can help a pluralist public by encouraging a public discussion of value issues. The aim of practical theology is to allow practice to inform theory; he seeks to allow the pastoral and religious praxis of the Christian life and the social, cultural, and political praxis of the wider society to inform each other, and thus practical theology. He begins by stating his assumptions, i.e., his way of understanding the issue of human responsibility in American society, and goes on to suggest religious and theological resources for responding to his questions. He distinguishes three realms comprising our society and suggests that there are value questions demanding discussion that may be differentiated in each as well as appropriate ways of discussing these questions.He is a Roman Catholic priest and has publishedBlessed Rage for Order: The New Pluralism in Theology.     

The Intersections of Gender,Class, Race,and Culture: On Seeing Clients Whole

The author explores the multiple and dynamic intersections of gender with race, culture, and class in psychosocial identity formation to minimize the risk of homogenizing or polarizing our understanding of these characteristics.     

The effect of dimension content on observation and ratings of job performance

Recent theory and research in the performance appraisal area (e.g., Denisi, Cafferty, & Meglino, 1984; Feldman, 1986; Ilgen & Feldman, 1983; Williams, Denisi, & Blencoe, 1985) have suggested that providing information regarding the performance dimension to be rated will cause raters to select appropriate observational schemata and, as a result, produce higher quality ratings. A study was conducted to determine if giving raters dimension-relevant information prior to performance observation would affect their attention processes and rating quality. Prior to watching a videotape of an instructor giving a lecture, 156 subjects were given either: 1) correct information, 2) incorrect information, or 3) no information regarding dimensions of performance they would subsequently be asked to rate. The results indicated that giving prior information regarding dimension content affected subjects' attention processes. Further, raters receiving no information and those receiving misinformation prior to performance observation produced less accurate ratings compared to expert raters. Ratings produced by subjects receiving correct information did not differ significantly from experts' ratings. These results are discussed in terms of both their practical and theoretical implications.     

Unweighting infants reveals hidden motor skills

We investigated the role of rate limiting factors in development using walking as a model system. The achievement of bipedal posture and locomotion are among the most significant achievements in an infant's first year, with poor balance and weak muscles long proposed as the rate limiting factors. Compensating for either may reveal upright motor skill that has not yet emerged in the infant's natural repertoire. To probe this question, we unweighted prewalking infants and measured their performance in various standing and walking behaviors while unweighted compared to baseline. Our secondary objective was to determine if the influence of unweighting was related to infants’ locomotor experience. Infants stood unsupported for longer durations with 20% or 40% unweighting. Infants took more independent steps and more steps with one hand held with 40% unweighting. No differences in transition to/from standing were observed. Locomotor experience was related to the influence of unweighting during cruising and walking with a push toy. This is the first report of more advanced motor skills—longer periods of unsupported standing and the emergence of independent walking—revealed by unweighting infants. We interpret our observations to suggest that the refinement of motor control needed to support bipedal posture and locomotion precedes the functional emergence of these skills in infants. In other words, the musculoskeletal components required for walking are slower to develop than the neurological factors – and consequently may be the rate limiters. We further suggest that training regimens including unweighting should be explored in infants with motor delays.     

Negative Stereotyping of Obesity in Children: The Role of Controllability Beliefs

This study investigated the extent of negative stereotyping of obesity (compared to negative stereotyping of height) in children and its relationship with the perception of obesity as controllable. Questionnaires measuring negative stereotyping and controllability beliefs about weight (and height) were completed by 96 children from Grades 4 to 6. Consistent negative stereotyping of obesity was found for both child and adult targets, regardless of the child's own gender, age, or weight, Likewise, children uniformly believed obesity to be largely under volitional control. The degree of controllability assigned to obesity was positively correlated with the extent of negative stereotyping. It was concluded that control beliefs may provide a vehicle for changing the strong negative attitudes displayed toward fat people.     

Whole of community suicide prevention forums for Aboriginal Australians

It is well known that Aboriginal Australians are at increased risk of suicide. Contributors to suicide differ for Indigenous and non-Indigenous populations (Westerman, 2003; 2019). This study evaluated whole of community suicide prevention forums conducted across six locations. Attendees were youth (N = 136), service providers (N = 225), and community members (N = 158). The content of the forums was empirically based and, for service providers and community members, covered knowledge of suicide, and depression specific to Aboriginal people, skills relating to working with depressed and suicidal Aboriginal people, and intentions to help an Aboriginal person who is suicidal. Content for youth attendees focused on knowledge of suicide and depression, coping skills, intentions to help a friend, and beliefs about suicide. While the results demonstrated significant gains across most domains, there was a potentiating effect with some skills increases becoming more significant over each phase. This demonstrates that a whole of community approach to Indigenous suicide prevention is required, and that clinical and cultural skills require a longer-term approach for impact and sustainability.     

“Mistakes Can be Beautiful”: Creative Engagement in Arts Integration for Early Adolescent Learners

In this study we explored students’ perspectives and experiences engaging in an arts integration learning model during middle school through a pluralistic lens of creative engagement in learning. The sample included N = 86 students in Grades 6–7 attending schools in fringe rural and urban locales from small and mid-sized cities in the Pacific Northwest. We used a grounded theory approach to explore how creative engagement takes shape for the early adolescent learner. Our conceptual framework integrated intrapsychological (inward) processes with interpsychological (outward) exchange in the social environment of an arts integrated classroom. Schools involved in the study were part of a larger mixed-methods research investigation and received intensive support for school-wide arts integration development. We found that students valued opportunities in arts integration for (a) choice, (b) the expression of their unique interpretations, (c) taking risks and making mistakes, (d) recognizing and applying their Studio Habits of Mind, and (e) enhancement of motivation and engagement in learning. The need for competency, belonging, and autonomy were important conditions of the learning environment and the need for meaning-making was paramount in the process of creative engagement.     

Emotional self-regulation in preschoolers: The interplay of child approach reactivity, parenting, and control capacities

This study examined whether child temperamental approach reactivity moderated the association between 2 factors, parenting and child control capacities and child emotional self-regulation. Participants (N = 113) were 3- and 4-year-olds (M = 48 months, SD = 5.78) and their mothers. Emotional self-regulation was measured as observed persistence and frustration and as maternal report of compliance. Parental approach, avoidance, control, and warmth were observed during play and a frustrating wait. Child approach reactivity and control capacities (inhibitory control and soothability) were assessed via maternal report. Results suggested that maternal approach during the wait was associated with persistence and frustration, whereas maternal warmth during the play was associated with compliance. These effects, and those of child control capacities, depended on the level of child approach. The implications of reactivity-control interactions and parent-child goodness-of-fit for emotional self-regulation are discussed.