Patient Perspectives on the Learning Health System: The Importance of Trust and Shared Decision Making

We conducted focus groups to assess patient attitudes toward research on medical practices in the context of usual care. We found that patients focus on the implications of this research for their relationship with and trust in their physicians. Patients view research on medical practices as separate from usual care, demanding dissemination of information and in most cases, individual consent. Patients expect information about this research to come through their physician, whom they rely on to identify and filter associated risks. In general, patients support this research, but worry that participation in research involving randomization may undermine individualized care that acknowledges their unique medical histories. These findings suggest the need for public education on variation in practice among physicians and the need for a collaborative approach to the governance of research on medical practices that addresses core values of trust, transparency, and partnership.     

The location problem for color subjectivism

According to color subjectivism, colors are mental properties, processes, or events of visual experiences of color. I first lay out an argument for subjectivism founded on claims from visual science and show that it also relies on a philosophical assumption. I then argue that subjectivism is untenable because this view cannot provide a plausible account of color perception. I describe three versions of subjectivism, each of which combines subjectivism with a theory of perception, namely sense datum theory, adverbialism, and the virtual color proposal, and argue that each version faces serious objections. Considering these three theories of perception to be exhaustive of those available to the subjectivist, I conclude that subjectivism is untenable and that the scientifically motivated argument for this view is unsound. I then offer the diagnosis that the philosophical assumption on which this argument relies is mistaken.     

Peer Leadership in Sport: Links with Friendship,Peer Acceptance,Psychological Characteristics,and Athletic Ability

The purpose of this study was to replicate and extend the work of Glenn and Horn (1993) Glenn, S. D. and Horn, T. S. 1993. Psychological and personal predictors of leadership behavior in female soccer athletes. Journal of Applied Sport Psychology, 5: 17–34. [CSA][Taylor & Francis Online] , [Google Scholar] by examining relationships between peer leadership in sport and social, psychological, and ability characteristics. The sample consisted of 71 female and 67 male high-school soccer players and their coaches. Players completed questionnaires measuring social (peer acceptance and friendship quality) and psychological (perceived competence, instrumentality, and expressiveness) variables, and leadership behavior for self and teammates. Coaches assessed each player on leadership behavior and soccer ability. For female athletes, all psychosocial variables were predictive of self-ratings of leadership, while coach and teammate ratings were related to ability only. For male athletes, all psychosocial variables and ability were related to self-ratings and teammate ratings of peer leadership, while coaches' ratings were related primarily to ability. These results are discussed with regard to social exchange theory and commonalities among peer relationship variables (acceptance, friendship, leadership).     

Psychological Skills Do Not Always Help Performance: The Moderating Role of Narcissism

Psychological skills are typically viewed as beneficial to performance in competition. Conversely, narcissists appear to thrive in competitive environments so should not need psychological skills to the same degree as less narcissistic individuals. To investigate this moderating hypothesis high-standard ice-skaters completed measures of narcissism, psychological skills, and anxiety before performing their competition routine during training. A week later, participants performed the same routine in competition. Performance was operationalized as the difference between competition and training scores. Moderated regression analyses revealed that narcissism moderated the relationship between psychological skills and performance. Psychological skill effectiveness depends on an individual's degree of narcissism.     

Impact of emotional approach coping and hope on PTSD and depression symptoms in a trauma exposed sample of Veterans receiving outpatient VA mental health care services

Abstract

The present investigation evaluates the relationship between coping style, dispositional hope, and posttraumatic stress disorder (PTSD) and depression symptom severity in a trauma-exposed Veteran sample. Specifically, we evaluated the adaptive value of emotional avoidant and approach coping strategies and perceptions of hope in a sample of 209 trauma-exposed Veterans receiving outpatient mental health care at a VA facility. Participants completed a life events questionnaire and inventories assessing coping, dispositional hope, and PTSD and depression symptom severity. Hierarchical regression analyses were conducted controlling for relevant demographic variables. Greater levels of emotional avoidance and lower levels of emotional expression were significantly associated with increased PTSD and depression symptom severity. Dispositional hope was positively associated with depression symptoms only and perceptions of hope moderated the association between emotional avoidance coping and depression symptoms. Findings highlight the value of emotional coping strategies and perceptions of hope in posttraumatic adjustment. Specifically, employing coping techniques that encourage emotional expression may promote improved adjustment among trauma-exposed individuals, while reduced perceptions of hope and the use of avoidant coping strategies may place individuals at greater risk for depression following exposure to traumatic events.     

Intimate Partner Violence among West African Immigrants

Although the number of African immigrants arriving to the United States has increased significantly, there has been little investigation regarding their experiences of intimate partner violence or coping strategies. This study used focus groups and individual interviews to explore intimate partner violence among 32 heterosexual West African immigrants. Results suggest that although cultural expectations influence their coping strategies, West African–born men and women face different realities, with women reporting multiple instances of abuse and a sense of frustration with the existing options for assistance. Although participants discussed multilevel support structures within the immediate West African community to address intimate partner violence, all of these options maintained a gender hierarchy, leaving women dissatisfied. Challenges and barriers to partner violence resolution and coping strategies are identified. Results are examined in terms of their implications for addressing the needs of this underserved population. Implications for future research and services are discussed and highlighted.     

Validity of the Global Assessment of Relational Functioning (GARF) When Used By Community-Based Therapists

Construct validity of the Global Assessment of Relational Functioning (GARF) was assessed using a health services research approach, a mode of study that captures the naturalistic practice of health service providers. A sample of 395 couple/family cases with GARF scores assigned pre- and post-therapy by 222 community-based marriage and family therapists yielded these results: 1) pretreatment GARF scores were negatively correlated with severity of client problems; 2) GARF change scores were positively correlated with client reported changes in functioning; 3) GARF change scores were positively correlated with therapist-reported client change; 4) GARF change scores were positively correlated with client satisfaction; 5) pretreatment GARF scores were negatively correlated with number of therapy sessions; and 6) pretreatment GARF scores and client diagnoses showed no relationship. Given these results the GARF appears to have construct validity in community settings, and is a promising brief assessment tool for relational functioning.     

Workplace Mobbing: Family Dynamics and Therapeutic Considerations

Workplace mobbing is an underreported and understudied public health problem with significant health consequences on victims, intimate relationships, and families. Family and systemic dynamics influence the victim's response and recovery from in mobbing. Effective therapy with victims of mobbing, their significant others, and families requires familiarity with family and systemic dynamics. Various therapeutic considerations and interventions are described and illustrated in a case example.     

An investigation of schizotypy in injecting amphetamine users

A fully dimensional view of psychiatric disorder conceptualises schizotypy as both a continuous personality trait and an underlying vulnerability to the development of psychotic illness. Such a model would predict that the structure of schizotypal traits would closely parallel the structure of schizophrenia or psychosis. This was investigated in injecting amphetamine users (N = 322), a clinical population who have high rates of acute psychotic episodes and subclinical schizotypal experiences. Schizotypy was assessed using the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE), and psychotic symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). Using confirmatory factor analysis, O-LIFE subscale scores were mapped onto latent variables with their more clinical counterparts from the BPRS. A four-factor model comprising positive schizotypy, disorganisation, negative schizotypy, and disinhibition provided the best model fit, consistent with prior research into the structure of schizotypy. The model provided a good fit to the data, lending support to the theory that schizotypy and psychotic symptoms map onto common underlying dimensions.