Cuban health psychology: A priority is the primary health care system

Cuban health psychology has experienced a great expansion during the last 25 years, both in the number of psychologists and in range of activities in the field. Today, psychologists are integrated at all levels of the national health system, an achievement which is particularly interesting in that Cuba is a developing country. In a position isolated from trends in international psychology, Cuba has developed a role for psychologists within the field of health which is adapted to its situation as a poor and socialistic country. Priority is given to preventive and community-based psychology within primary health care facilities. Psychologists in primary health care serve a composite client-group, with high priority given to pregnant women and to children. The work of these psychologists covers a wide range of health problems—-physical as well as mental—and focuses upon individuals as bio-psycho-social units. Their responsibilities include health promotion, disease prevention, consultation and treatment, rehabilitation, research and education. This report is based on a 2½ month long field study in Cuba, where Cuban health psychology, particularly as it relates to primary health care, was explored.     

Coping variables as predictors of perioperative emotional states and adjustment

Abstract

Surgery, regardless of its kind and severity, can be regarded as a major stress situation for any patient. High preoperative emotional arousal may negatively influence adaptation during surgery and, consequently, rate of postoperative recovery. In a series of previous studies, our research group analyzed the influence of dispositional and actual coping on subjective and objective stress indicators before, during, and after surgery. The present study investigates the influence of the dispositional coping variables vigilance and cognitive avoidance on actual surgery-related coping, state anxiety, and indicators of intra- and postoperative adjustment. The sample consisted of 42 male and 42 female patients undergoing elective maxillofacial surgery under general anaesthesia. Dispositional coping was measured on the dimensions vigilance and cognitive avoidance with the Mainz Coping Inventory. Actual surgery-related coping was assessed by means of a newly constructed inventory containing items to measure the four dimensions avoidance, vigilance, positive restructuring, and seeking social support.

Self-reported state anxiety was differentiated according to the cognitive, affective, and somatic components. The patients' adaptation was assessed by measuring doses of the narcotic agents used for induction of anaesthesia, the intraoperative status, and the amount of postoperative (analgesic and psychotropic) medication. Significant effects of coping mode, gender, and time of measurement were observed on the cognitive, affective and somatic component of state anxiety, the indicators of intraoperative adaptation and on postoperative medication. Also, patients' actual coping behavior could partly be predicted by dispositional coping. Results indicate that actual coping behavior and gender should be taken into account when trying to predict adaptation and developing psychological preparatory intervention programs.     

Health problems and quitting among female "temps"

The current study focused how individual contract preference among female agency "temps" was related to perceptions of the job, and to somatic complaints and distress and quitting. The effort reward model by (Siegrist, 1996) was used as a general, theoretical framework guiding the choice of relevant job features. The mediating role of job perceptions on the relationship between contract preference and the outcomes was tested, controlling for several possible confounding factors. Data came from questionnaires, answered by 227 female employees, together with records of turnover provided by the employing agency. Results supported a model where contract preferences appeared to be negatively related to both health outcomes, and the relation was mediated by perceptions of work load and social support. Contract preferences were strongly related to intentions to quit, but not to actually leaving the job within 6 months.     

Problem-oriented sessions: Presentation of a method for therapeutic work within a narrow time frame

Abstract

A method of problem-orientation has been developed as a delimited psychotherapeutic procedure comprising four sessions with a psychotherapist. The distinguishing feature of this method is the distinct time frame, within which the therapist grasps the patient's current situation and difficulties. The sessions are disengaged from considerations about the need for further treatment. The therapist appeals to die reflective part of the patient and attempts to awaken their curiosity about themselves in order to explore inner associations concerning core problems. The four problem-oriented sessions are offered during the initial telephone contact to the person who wishes to gain a greater understanding of their own part in their difficulties and who is able, already in the introductory telephone conversation, to embark upon an exploratory dialogue about these problems. The sessions are strongly characterized by this short-term perspective; the intensity increases and attention is sharpened. The stance adopted by the therapist during die sessions is one of balancing a non-appraising, empathic and confirmatory listening aimed at making connections with reality and a faith in the patient's resources and capacity to maintain a sense of responsibility for their life; an approach which limits the patient's tendency to regress. Transference is not interpreted explicitly but is used by the therapist to understand the patient. Supervision is an important and essential component, whereby the therapist receives help in increasing understanding of that which is played out during the sessions and also of their own counter-transference. This understanding constitutes the foundation of the therapist's tentative formulations of that which is central in the patient's problems.     

Dialogue in a learning process: problematization of gender and gender equality in higher education

The overall aim with the study was to describe the knowledge building that was developed in a group of students who were trained nurses enrolled in a Swedish higher education programme. With a point of departure in an interactive research approach, the authors applied the dialogue seminar as method and pedagogical model. When the students in close to practice talks, shared their thoughts about how gender and gender equality could be experienced and understood, the dialogue seminar became useable. At the analysis of the stories which the students shared at the dialogue seminars, it became clear that most of the students had an ambivalent approach to gender equality. When they reflected on gender relations, they brought out the hierarchical and separate gender relations which they experienced as existing within healthcare. Furthermore, their professional lives seemed to be embedded in gender-related practices. An important conclusion is that the students’ reflections oscillated between critical reflection on conditions and critical reflection on processes within their own practice in healthcare. Another finding was that the students’ reflections in dialogue form became important in a learning process, not least in the light of that gender relations and gender equality only to a limited degree had been included in their nurse’s education at the basic level.     

Early processing of emotional faces in children with autism: An event-related potential study

Social deficits are one of the most striking manifestations of autism spectrum disorders (ASDs). Among these social deficits, the recognition and understanding of emotional facial expressions has been widely reported to be affected in ASDs. We investigated emotional face processing in children with and without autism using event-related potentials (ERPs). High-functioning children with autism (n = 15, mean age = 10.5 ± 3.3 years) completed an implicit emotional task while visual ERPs were recorded. Two groups of typically developing children (chronological age-matched and verbal equivalent age-matched [both ns = 15, mean age = 7.7 ± 3.8 years]) also participated in this study. The early ERP responses to faces (P1 and N170) were delayed, and the P1 was smaller in children with autism than in typically developing children of the same chronological age, revealing that the first stages of emotional face processing are affected in autism. However, when matched by verbal equivalent age, only P1 amplitude remained affected in autism. Our results suggest that the emotional and facial processing difficulties in autism could start from atypicalities in visual perceptual processes involving rapid feedback to primary visual areas and subsequent holistic processing.     

Trait anger moderates the impact of anger-associated rumination on social well-being

In this study, we examined whether people’s social well-being is influenced by hostile versus nonhostile goals that people report pursuing when experiencing anger-associated rumination. Moreover, we investigated the impact of trait anger and trait anger rumination on the relationship between anger rumination and perceived social well-being. Participants were 93 students who were equipped with hand-held computers for 28 days to assess anger-related rumination and its social consequences in daily life. Results showed that hostile goal pursuit per se did not affect perceived social well-being. However, impairment of social well-being following hostile rumination was moderated by trait anger. Findings are consistent with recent cognitive models of trait anger and anger rumination.     

Discrimination of human and dog faces and inversion responses in domestic dogs (Canis familiaris)

Although domestic dogs can respond to many facial cues displayed by other dogs and humans, it remains unclear whether they can differentiate individual dogs or humans based on facial cues alone and, if so, whether they would demonstrate the face inversion effect, a behavioural hallmark commonly used in primates to differentiate face processing from object processing. In this study, we first established the applicability of the visual paired comparison (VPC or preferential looking) procedure for dogs using a simple object discrimination task with 2D pictures. The animals demonstrated a clear looking preference for novel objects when simultaneously presented with prior-exposed familiar objects. We then adopted this VPC procedure to assess their face discrimination and inversion responses. Dogs showed a deviation from random behaviour, indicating discrimination capability when inspecting upright dog faces, human faces and object images; but the pattern of viewing preference was dependent upon image category. They directed longer viewing time at novel (vs. familiar) human faces and objects, but not at dog faces, instead, a longer viewing time at familiar (vs. novel) dog faces was observed. No significant looking preference was detected for inverted images regardless of image category. Our results indicate that domestic dogs can use facial cues alone to differentiate individual dogs and humans and that they exhibit a non-specific inversion response. In addition, the discrimination response by dogs of human and dog faces appears to differ with the type of face involved.     

Race differences in psychopathology and disparities in treatment seeking: Community and jail-based treatment seeking patterns

Whites in community samples utilize mental health services at a much higher rate than African Americans (Kessler, et al., 2005). Is this also the case among those in jails? In this study of jail inmates (229 African American, 185 White) there were no race difference in the overall need for mental health treatment (63% of participants had significant symptoms on the Personality Assessment Inventory) but race differences in the level and types of symptoms were evident. Additionally, while Whites were more likely to report pre-incarceration treatment there were no differences in treatment seeking or access to mental health programs while in jail, implying that if barriers to treatment in the community were removed (cost/insurance, location/transportation, time) racial disparities in treatment utilization may be reduced.     

Sozialmedizinische Begutachtung der beruflichen Leistungsfähigkeit

The ?Interview for the Evaluation of Psychosocial Dimensions of Performance Capability“ represents a potentially suitable instrument for the assessment of performance capability in various contexts. Regarding time expenditure, it is very viable and can be applied without special training. Test statistics for subscales derived from factor analysis are satisfying. The modified scales should be subject to further studies of validity and reliability. However, the instrument is already suited as a tool for the assessment of performance capability, represents an algorithm for decision-making and is related to the concepts of the International Classification of Functioning (ICF).