Fragments of a Case of Psychosis: From Institutional Sheltering to Psychoanalytical Experience

This article describes a psychoanalytical experience that took place in an institution for mental health, located in Rio de Janeiro, Brazil. There, an art workshop was created in an attempt to welcome and shelter psychotic patients. This work space later proportioned a ''setting'' for the practice of psychoanalysis with psychotic patients. In the clinical case, herein examined, the author dedicates special attention to the relation that exists between certain psychotic aspects and the process described by Jacques Lacan as: the ''foreclosure of the name of the father''.     

Psychometric evaluation and normative data for a Swedish version of the Patient Health Questionnaire 15‐Item Somatic Symptom Severity Scale

The lack of an available Swedish version of the Patient Health Questionnaire 15‐Item Somatic Symptom Severity Scale (PHQ‐15) motivated the present psychometric evaluation of such a version as well as providing normative data for the PHQ‐15. Data from 3,406 individuals who took part in the Västerbotten Environmental Health Study in Sweden were used. The respondents constitute a random sample, aged 18 to 79 years, stratified for age and sex. They responded to a Swedish translation of the PHQ‐15 as well as the Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the Shirom Melamed Burnout Questionnaire for assessment of convergent validity. The distribution of PHQ‐15 scores was positively skewed and mesokurtic in shape, and the internal consistency of the PHQ‐15 was satisfactory. Correlation coefficients between PHQ‐15 score and the measures of anxiety, depression, stress and mental/physical exhaustion indicate satisfactory validity. Normative data for PHQ‐15 scores as well as for categories of somatic symptom severity are provided. The favorable psychometric properties of the Swedish version of the PHQ‐15 suggest use of this instrument for quantification of somatization in Swedish and similar populations, and has the advantage of available normative data.     

Entertainment–Education? A Fotonovela? A New Strategy to Improve Depression Literacy and Help‐Seeking Behaviors in At‐Risk Immigrant Latinas

Research shows high risk for depression among immigrant Latinas known to increase during the acculturation process. Several barriers such as stigma and low health literacy result in an under-utilization of needed treatment among these women. In response, this study replicated the effectiveness of a Spanish language fotonovela, a form of Entertainment–Education (E–E), designed to increase depression literacy, decrease stigma, and increase help-seeking knowledge and behavior in Latinos. Specifically, this study evaluated a fotonovela delivered in a multifaceted approach to health education used by promotoras. A pretest–posttest randomized control group experimental design with 142 immigrant Latinas at risk for depression was employed. Results indicate significant posttest improvements in depression knowledge, self-efficacy to identify the need for treatment, and decreased stigma in experimental as compared to control group participants. Findings support the application of E–E health literacy tools such as fotonovelas, delivered in multifaceted approaches to health education used by promotoras, to Latinas at risk for mental health concerns.     

Health beliefs and breast examination behaviors: Analyses of linear structural relations

Abstract

A survey of 619 Detroit-area women was conducted in order to understand why women do or do not perform breast self-examination and obtain or not obtain professional breast examinations. The survey assessed these behaviors and women's beliefs about (a) their susceptibility to breast cancer, (b) the seventy or seriousness of breast cancer, (c) the benefits of breast examinations and (d) the costs or disadvantages of the examinations. Separate sets of questions measured seventy of breast cancer when it is treated (a) late (seventy-late) and (b) promptly (seventy-early). Predictions were derived by combining the health belief model with the theory of subjective expected utility. Path analysis supported most predictions of the combined theory. As predicted, high severity-late increased perceived benefit, high seventy-early decreased benefit, and perceived benefit mediated the effects of seventy on behavior. Implications for understanding health decisions, measuring health beliefs, and modifying health behaviors are discussed.     

Shock tactics to counter AIDS: The australian experience

Abstract

The use of shock tactics to motivate people to learn more about AIDS and to take appropriate protective action characterised the approach adopted by the national health authorities in Australia during 1987. The rationale underlying this approach is critically examined, particularly in the light of results obtained from surveys of community concern and knowledge about AIDS in the state of South Australia before the campaign and after it had been in progress for some five months. Contrary to expectations no significant increases in either personal or social concern were found; in fact, among older respondents personal concern had decreased significantly. Levels of knowledge about AIDS, in general, remained unchanged, apart from an increase in acceptance of the safety of blood transfusions from a very low to a somewhat higher level. Among a minority of respondents (29%) who approved of the campaign and also believed they had been influenced by it, personal and social concern about AIDS, but not knowledge, was significantly greater than among others. The view that fear-inducing techniques can be used to bring about increases in knowledge about AIDS was not supported, although some positive effects on the social attitudes of respondents most affected by the campaign are suggested.     

Training in health psychology: An international look

With the progression of health psychology as a new field in psychology specific training programs are more and more needed. A survey of the training situation of health psychology in Northern America, Europe, Australia, and New Zealand highlighted a lack of formalized training programs in most countries except the United States and Canada, as well as an enormous variety between countries on standards of training, and on the differentiation of health psychologists from clinical psychologists.

For the qualification of health psychology as an independent psychological discipline a plea is made for international standardization of quality control and suggestions for the content of formalized training programs in health psychology are given.     

What do people think about changes in health behaviors? Differential perceptions of consequences of increases and decreases in health behaviors

Most health decision-making models posit that cost-benefit analyses underlie decisions to make changes in health-related behavioral practices. In a series of studies, participants imagined either increasing or decreasing the frequency of a variety of health behaviors and estimated the consequences of those changes. In Studies 1 and 2, individuals consistently estimated that increasing a health behavior produced greater consequences than did decreasing the behavior by an equivalent amount. The results of Study 3 demonstrated that this effect is due to differences in how individuals judge the impact of health behavior changes which involve not engaging in the behavior at all versus other types of changes. Taken together, these findings suggest that perceptions of the outcomes afforded by health behavior changes depend on both the behavioral frequency and direction of changes in behavior an individual is considering. This asymmetry has the potential to help explain patterns of behavior in a range of important health domains and may impact the effectiveness of behavior change interventions.     

Predicting uptake of a routine cervical smear test: A comparison of the health belief model and the theory of planned behaviour

Abstract

This paper reports on a study carried out to identify predictors of uptake of cervical screening among 142 women (59% response rate) in inner London. Two social cognition models were used: The Health Belief Model (HBM; Becker, 1974) and the Theory of Planned Behaviour (TPB; Ajzen, 1991) and in addition anticipated affect following non-attendance for screening was assessed. The TPB emerged as by far the superior model for predicting screening intentions, explaining 51% of the variance in comparison with only 4% explained by the HBM variables. However, neither model was able to predict a significant amount of variance in uptake of screening three months later. Possible reasons for the poor prediction of this type of behaviour are discussed.     

Psychology,health and health care

This article traces the development of the World Health Organization's emphasis on psychological and behavioural factors in health and notes its encouragement of recognition of these factors by member states. The article further outlines the reasons for this increasing recognition and stresses the important role of psychological and behavioural factors in the maintenance of health and prevention of illness.     

Personality and attitudinal correlates of healthy and unhealthy lifestyles in young adults

Abstract

The relationship between healthy lifestyle and personality and attitudinal variables was analyzed with data collected from 809 men and 996 women aged 18–30 years in England, Belgium, Finland and Norway as part of the European Health and Behaviour Survey. A health practices index was constructed on the basis of performance of sixteen behaviours including smoking, alcohol consumption, exercise, sleep time and a variety of dietary and preventive practices. Scores on the health practices index were higher in women than men, but in both sexes the index was normally distributed. Consistently healthy practices were positively correlated with extraversion and optimism, and negatively associated with neuroticism, psychoticism and chance locus of control beliefs. These effects were maintained after controlling for social desirability, but together accounted for only a modest proportion of the variance in the health practices index. The results are discussed in relation to the factors characterising health conscious and unhealthy lifestyles.