An Exploration of Family Problem-Solving and Affective Involvement as Moderators Between Disease Severity and Depressive Symptoms in Adolescents with Inflammatory Bowel Disease

Little is known about how family functioning relates to psychosocial functioning of youth with inflammatory bowel disease (IBD). The study aim was to examine family problem solving and affective involvement as moderators between adolescent disease severity and depressive symptoms. Participants were 122 adolescents with IBD and their parents. Measures included self-reported and parent-reported adolescent depressive symptoms, parent-reported family functioning, and physician-completed measures of disease severity. Disease severity was a significant predictor of adolescent-reported depressive symptoms, but not parent-reported adolescent depressive symptoms. Family affective involvement significantly predicted parent-reported adolescent depressive symptoms, while family problem-solving significantly predicted adolescent self-report of depressive symptoms. Neither affective involvement nor problem-solving served as moderators. Family affective involvement may play an important role in adolescent emotional functioning but may not moderate the effect of disease severity on depressive symptoms. Research should continue to examine effects of family functioning on youth emotional functioning and include a sample with a wider range of disease severity to determine if interventions aimed to enhance family functioning are warranted.     

Student perceptions of school efforts to facilitate student involvement, school commitment, self-determination, and high school graduation

This study examined the relationship between student perceptions of school efforts to facilitate student involvement, school commitment, self-determination skills, and ontrack indicators for graduation in 10th grade and actual graduation outcomes two years later. The participants were 154 primarily minority students in a large, urban school district. Student perceptions of higher levels of school efforts to facilitate student involvement was related to an increased likelihood that students had passed a state high stakes assessment and were on-track for graduation at the end of 10th grade and an increased likelihood of actual graduation. Implications for facilitating student involvement in educational planning are discussed.     

Context effects in recognition memory: the role of familiarity and recollection

A variant of the process dissociation procedure was coupled with a manipulation of response signal lag to assess whether manipulations of context affect one or both of the familiarity and search processes described by the dual process model of recognition. Participants studied a list of word pairs (context+target) followed by a recognition test with target words presented in the same or different context, and in the same or different form as study (singular/plural). Participants were asked to recognize any target word regardless of changes to form (inclusion), or to only recognise words that were presented in the same form (exclusion). The standard context reinstatement effect was evident even at the short response lags. Analyses of the estimates of the contributions of familiarity and search processes suggest that the context effect demonstrated here can be attributed in part to the influence of familiarity on recognition, whereas the effect on recollection was less clear.     

Investment in body image among patients diagnosed with or at risk for malignant melanoma

We examined investment in body image among 48 patients diagnosed with, or at risk for malignant melanoma (MM), as well as factors hypothesized as related to increased investment, such as gender, perceived stress, mood, fatigue, and personality characteristics. Investment in body image was evaluated using the Measure of Body Apperception [Carver, C. S., Pozo-Kaderman, C., Price, A. A., Noriega, V., Harris, S. D., Derhagopian, R. S., Robinson, D. S., & Moffat, F. L. Jr. (1998). Concern about aspects of body image and adjustment to early state breast cancer. Psychosomatic Medicine, 60, 168–174]. Results showed that women reported more concerns about physical appearance than men, and patients with MM exhibited more concerns about body integrity than at-risk patients. Concerns about body integrity were related to more compulsive personality characteristics, whereas concerns about appearance were associated with more histrionic personality characteristics. Body image investment was related to poorer adjustment as indicated by heightened symptoms of fatigue and stress. This study suggests that further research on investment in body image in this patient population is warranted.     

Talking about Homosexuality: The Views of Mainline Protestant Clergy

Homosexuality is one of the most divisive issues within mainline Protestantism today. In this article we portray the many sides of mainline Protestantism's debates about homosexuality through the lens of statements clergy made about the issue in early 2000. In interviews with 62 mainline Protestant clergy across the United States, 40 volunteered their views on homosexuality without being prompted. We describe the frames through which clergy understand and articulate issues related to homosexuality in the midst of contentious denominational debate about the subject. The majority of clergy who discussed homosexuality focused on the issue in their churches instead of in society at large, and in their denominations rather than in their own congregations. Moreover, virtually none of the clergy interviewed took hard and fast stands on the issue of homosexuality. Most approach the issue in a pragmatic, rather than prophetic, way. Our interviews also show that pastors who choose to speak on homosexuality tend to frame the issue in terms of the diffuse notion of "homosexuality," rather than talking about gay men and lesbians as people.     

Talking to children about family therapy: a qualitative research study

In an exploratory study a number of children were interviewed some time after family therapy. Their responses were analysed using grounded theory methodology. Outcomes indicate that for children, family therapy is potentially a complex arena in which ambiguities and ambivalences are present. The children's position in the therapeutic session is discussed in terms of their role in the 'therapeutic circle'.     

The Use of Self of the Therapist

This article explores how the Satir model facilitates the development of the self of the therapist, which Virginia Satir strongly advocated. Discovering and developing creative ways to externalize the internal hidden processes of people, she invited therapists to work on their own unresolved issues in their training through various methods such as: family of origin, family reconstruction, ingredients of an interaction, and parts party. Her goal was to increase self-esteem, foster better choice making, increase responsibility, and facilitate personal congruence through a therapeutic process. Although very relevant in the training and professional development of therapists, there has been little exploration or research of this topic.     

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.