Spiritual Assessment in African-Americans: A Review of Measures of Spirituality Used in Health Research

Background A number of instruments have been developed for investigating relationships between spirituality and health, and have been used to assess spirituality in African-Americans. Yet, the cultural appropriateness for African-Americans of these instruments has not been investigated to date. Objectives To evaluate the construct validity and reliability of spirituality measures used in health research from 1982 to 2005. Method Systematic review of the literature. Results Thirty five studies and five measures of spirituality met the inclusion criteria. Most of the spirituality measures were developed in primarily Caucasian-American samples. African-Americans were represented in 71% of the studies (n = 25) using spirituality measures in health research. Distinct cultural attributes of African-American spirituality were omitted in most of the spirituality measures. Two studies were retrieved in which psychometric evaluation was conducted in entirely African-American samples. Discussion Spirituality is a significant cultural experience and belief that influences the health behaviors of African-Americans. The lack of a culturally appropriate measure of African-American spirituality is a major limitation of studies investigating spirituality and health in this population. Development of a culturally appropriate and sensitive measure of spirituality in African-Americans is suggested to strengthen the quality of research in this area.     

Mental causation as multiple causation

The paper argues that mental causation can be explained from the sufficiency of counterfactual dependence for causation together with relatively weak assumptions about the metaphysics of mind. If a physical event counterfactually depends on an earlier physical event, it also counterfactually depends on, and hence is caused by, a mental event that correlates with (or supervenes on) this earlier physical event, provided that this correlation (or supervenience) is sufficiently modally robust. This account of mental causation is consistent with the overdetermination of physical events by mental events and other physical events, but does not entail it.

The Effect of Professional Partnership on the Development of a Mutual-help Organization

The effects of partnership between Schizophrenics Anonymous (SA, a mutual-help organization) and the Mental Health Association in Michigan (MHAM, a professionally staffed advocacy organization) on SA's growth and development were explored. Following the initiation of a formal partnership, SA groups were more available throughout the state, more likely to be associated with formal mental health settings, and less likely to have leaders who had been participants in other SA groups. Groups with consumer leaders had significantly greater longevity than groups with professional leaders. Changes in the organizational structure and process of SA were also identified. SA leaders reported that SA moved from a collective to a more bureaucratic structure. As a result, there was greater consistency, administrative capacity, and response capacity. This enhanced capacity came with costs reported by SA leaders. The leadership role of SA members became less defined. SA members expressed concerns about the more hierarchical structure of SA's organization, decreased consumer control, increased professional involvement in SA, and an excessive focus on group development as opposed to group maintenance. Mental Health Association in Michigan staff reported that MHAM was also impacted by the partnership, both with regard to internal functioning and external perception. Implications for effective partnerships between mutual-help and professional organizations are discussed.     

Understanding How Participation in a Consumer-Run Organization Relates to Recovery

The goal of this study was to examine how different types of participation in a consumer-run organization (CRO) are related to recovery. More specifically, this study uses structural equation modeling to examine the relative impact of empowering and socially supportive participation experiences on progress towards recovery among 250 CRO members from 20 CROs. An empowering participation experience refers to involvement in leadership roles and contribution to organizational functioning. A socially supportive participation experience refers to social involvement in mutually supportive friendships with intimacy and sharing. Results indicate that both types of participation are associated with recovery, although a socially supportive participation experience maintains a stronger relationship with recovery than an empowering participation experience. Findings are consistent with the idea that CROs should encourage both types of participation. Drawing from over ten years of experience supporting CROs, the discussion section explores several strategies CROs can use to foster empowering and socially supportive participation experiences.     

Does personality moderate the relationship between stress and health behavior? Expanding the nomological network of the five-factor model

The present study tested the hypothesis that personality would moderate the stress to health behavior relationship. Using a community sample, 706 adults (Mean age = 37 years) were administered a set of five-factor model adjective rating scales, measures of stress and distress (i.e., negative life stress, physical symptom intensity, negative mood), health behaviors, as well as a demographic questionnaire. Using hierarchical multiple regression, Openness to Experience, Extraversion, and Neuroticism were found to moderate the stress to health behavior relationship. Supplementary analyses were conducted to determine if the five-factors would also moderate a life event to distress relationship. While several main effects were found, Conscientiousness was found to buffer the stress to distress connection. The factors that may influence both moderator models, suggestions for integration, and future research are discussed.     

Ego involvement moderates the assimilation effect of affective expectations

Based on the affective expectations model and research on mental effort mobilization, two experiments manipulated affective expectations (no expectations versus positive expectations) and ego involvement (low versus high) and assessed participants’ affective reactions to hedonically neutral stimuli. In Experiment 1, evaluations were more positive when participants had positive expectations about neutral photos—but only when ego involvement was low. High ego involvement neutralized this affective expectation assimilation effect. Experiment 2 replicated these findings for experienced mood after reading a hedonically neutral short essay. Furthermore, high ego involvement led to longer response latencies in the affect ratings in Study 1. The findings support the idea that high ego involvement resulted in relatively high mental effort that was necessary to detect discrepancies between affective expectations and stimuli’s real affective potential and therefore moderated the assimilation effect to affective expectations.

Physical activity in infants with Down syndrome receiving a treadmill intervention

Despite the recognized relevance of physical activity in the development and health of children, assessment of physical activity levels (PA-level) in infancy is limited, especially in infants with Down syndrome (DS). Increasing PA-level using a treadmill training (TMT) intervention may benefit infants with motor delays. The purpose of this study was to investigate whether a higher intensity, individualized TMT protocol (HI) would elicit immediate and short-term higher PA-level in infants with DS than a lower intensity, generalized training protocol (LG).Thirty infants with DS were randomly assigned to the LG or the HI group. Training was terminated when the infants could walk three steps independently. Activity monitors were placed on infants’ trunks and legs for a 24-h period every other month during the intervention phase, and at set intervals 1-year post-independent walking onset. Data were analyzed to separate sedentary-to-light activity (Lowact) and moderate-to-vigorous activity (Highact).Overall our results demonstrate that infants receiving the HI TMT had higher levels of Highact than infants in the LG group, factoring out the activity produced by the intervention itself. Infants in the LG group spent more time in Lowact than the HI group. In addition, these results seemed to be retained during the post-intervention follow-up. Despite these exciting results, more work is needed to understand the relationship of the intensity of TMT on PA-level in infants with DS, and whether PA-level and TMT are related to motor milestone achievement and/or health benefits.     

Do the wrong thing: How toddlers tell a joke from a mistake

We investigated whether 19–36-month-olds (1) differentiate mistakes from jokes, and (2) understand humorous intentions. The experimenter demonstrated unambiguous jokes accompanied by laughter, unambiguous mistakes accompanied by the experimenter saying, “Woops!”, and ambiguous actions that could either be a mistake or a joke, accompanied by either laughter or, “Woops!” Toddlers were asked to try. Nineteen- to 36-month-olds differentiated jokes and mistakes by copying unambiguous jokes and correcting unambiguous mistakes. Only 25–36-month-olds differentiated mistakes and humorous intentions by copying ambiguous actions marked by laughter, and correcting those marked by, “Woops!” Understanding humorous intentions precedes understanding intentions behind pretense, lying, and false beliefs, thus may be a first step in understanding that others can intend to do the wrong thing.     

The Medical Offset Effect: Patterns in Outpatient Services Reduction for High Utilizers of Health Care

Psychosocial intervention has been found to be related to subsequent reductions in health care use. Studies generally measure this “offset effect” by combining medical use categories into one outcome variable, such as outpatient doctor visits. However, using a general outcome variable may obscure more specific patterns of reduction. In an effort to identify potential “targets” for mental health intervention, outpatient care for health screening, illness visits, laboratory/X-ray, and urgent care were considered. Health care use reductions were most prominent for high utilizers and were found across a number of different types of outpatient care. With high utilizers, those who participated in MFT showed significant reductions of 68% for health screening visits, 38% for illness visits, 56% for laboratory/X-ray visits, and 78% for urgent care visits.     

Untangling the Debate: The Ethics of Human Enhancement

Human enhancement, in which nanotechnology is expected to play a major role, continues to be a highly contentious ethical debate, with experts on both sides calling it the single most important issue facing science and society in this brave, new century. This paper is a broad introduction to the symposium herein that explores a range of perspectives related to that debate. We will discuss what human enhancement is and its apparent contrast to therapy; and we will begin to tease apart the myriad intertwined issues that arise in the debate: (1) freedom & autonomy, (2) health & safety, (3) fairness & equity, (4) societal disruption, and (5) human dignity.