The health preoccupation diagnostic interview: inter-rater reliability of a structured interview for diagnostic assessment of DSM-5 somatic symptom disorder and illness anxiety disorder

Somatic symptom disorder (SSD) and illness anxiety disorder (IAD) are two new diagnoses introduced in the DSM-5. There is a need for reliable instruments to facilitate the assessment of these disorders. We therefore developed a structured diagnostic interview, the Health Preoccupation Diagnostic Interview (HPDI), which we hypothesized would reliably differentiate between SSD, IAD, and no diagnosis. Persons with clinically significant health anxiety (n = 52) and healthy controls (n = 52) were interviewed using the HPDI. Diagnoses were then compared with those made by an independent assessor, who listened to audio recordings of the interviews. Ratings generally indicated moderate to almost perfect inter-rater agreement, as illustrated by an overall Cohen’s κ of .85. Disagreements primarily concerned (a) the severity of somatic symptoms, (b) the differential diagnosis of panic disorder, and (c) SSD specifiers. We conclude that the HPDI can be used to reliably diagnose DSM-5 SSD and IAD.     

The effectiveness of positive psychology interventions in enhancing positive behaviors and family relationships in Hong Kong: A community-based participatory research project

This paper describes a program of brief, universal, positive psychology-based interventions to increase targeted behaviors that enhance family relationships, developed and delivered to over 1500 participants using a community-based participatory approach. The cluster-randomized design combined interventions based on one of three themes (gratitude, hope, or open-mindedness) in one of two structures (intervention, or intervention with planning). The latter structure supplemented with materials and exercises derived from the Health Action Process Approach model of behavior change. Planning was more effective in increasing attitude and intention to perform behaviors, frequency of the targeted behaviors, and family health and happiness (Cohen’s ds: 0.10–0.16, p < 0.05), particularly in the theme targeting open-mindedness. Qualitative data supported effectiveness. This project was a first effort to develop a large-scale preventive psychological intervention in an understudied culture with the goal of maximizing acceptability and utilization by involving community stakeholders in every stage of the design.     

Building Resilience in Families,Communities, and Organizations: A Training Program in Global Mental Health and Psychosocial Support

This article describes the Summer Institute in Global Mental Health and Psychosocial Support, a brief immersion training program for mental health, health, and allied professionals who work with populations that have endured severe adversities and trauma, such as domestic and political violence, extreme poverty, armed conflict, epidemics, and natural disasters. The course taught participants to apply collaborative and contextually sensitive approaches to enhance social connectedness and resilience in families, communities, and organizations. This article presents core training principles and vignettes which illustrate how those engaging in such interventions must: (1) work in the context of a strong and supportive organization; (2) appreciate the complexity of the systems with which they are engaging; and (3) be open to the possibilities for healing and transformation. The program utilized a combination of didactic presentations, hands‐on interactive exercises, case studies, and experiential approaches to organizational team building and staff stress management.     

Associations of spontaneous self-affirmation with health care experiences and health information seeking in a national survey of US adults

Objective: Self-affirming – such as by reflecting on one’s strengths and values – reduces defensiveness to threatening information, reduces negative effects of stereotype threat and promotes prosociality. These outcomes may promote physical health, highlighting a need to examine the role of self-affirmation in medical and health contexts.

Design: Data were collected as part of the nationally representative, cross-sectional, 2013 Health Information National Trends Survey. Items were completed by 2731 respondents.

Main Outcome Measures: Respondents answered questions about spontaneous self-affirmation tendencies, perceptions of providers and health care, involvement in medical appointments, health information seeking and engagement in medical research.

Results: Spontaneous self-affirmation was associated with more positive perceptions of communication with one’s provider, better perceived quality of care, greater likelihood of asking questions in a medical appointment, greater information seeking for oneself and multiple indices of surrogate information seeking (i.e. seeking information for others). Four of eight significant associations remained significant when controlling for optimism. The associations of self-affirmation with aspects of the patient–provider relationship were not modified by factors likely to be associated with stereotype threat (e.g. race or BMI).

Conclusion: Spontaneous self-affirmation was related to positive outcomes in health contexts. Experimental research is needed to further explore the causal nature of these associations.     

Le droit à la protection de la santé dans l’alinéa 11 du Préambule de 1946 : les impacts en termes de solidarité

The right to health protection is recognized as a constitutional objective. This includes guaranteeing an equal access to health care without any discrimination. The implementation of this right is a difficult task due to geographical and socioeconomic inequalities. In many situations, the public health sector is experiencing financial crises. The problems concerning health access seem to be mounting and could jeopardise the principle of solidarity which is the foundation of the health system.     

Attachment relationships and physical activity in adolescents: The mediation role of physical self-concept

ObjectivesBased on the integration of attachment and physical self-perception perspectives, the present study examined links between adolescents' engagement in physical activity and their attachment relationships with mothers, fathers, and friends, respectively, and assessed the potential mediation role of physical self-perception in this link.Design and methodsUsing a cross-sectional design, questionnaire data was obtained from 767 adolescents (49% boys, M_age = 12.92, SD = .86) and structural equation modeling was used to examine relationships among variables.ResultsAttachment security with parents and friend was associated with higher levels of physical activity. There was partial support of the mediation role of physical self-perception, as adolescents who were securely attached to mother and friend perceived themselves as having better physical condition, which in turn predicted greater engagement in physical activity. The mediation role of physical self-perception between mother attachment and PA was stronger for female adolescents. Secure attachment to father had a direct positive effect on physical activity. The direct effect was strongest for male adolescents.ConclusionsOur findings highlight the importance of relationship-based intervention strategies to enhance and maintain healthy regular physical activity among adolescents.     

Attitudes to the early Church and the Age of Conversion in late medieval Scotland

The conversion of Scotland, in the fifth, sixth and seventh centuries, was carried out largely by Gaelic-speaking missionaries from Ireland. When Scotland was largely Gaelic-speaking it was freely acknowledged that the conversion had come mainly from Ireland. But in the later Middle Ages, as Gaelic retreated from the Lowlands and became increasingly seen there as barbaric and uncivilised, new historical models were developed in Scottish hagiography which portrayed missionaries as civilised Lowlanders penetrating and pacifying the barbaric Highlands. In the course of this process the ancient Picts disappeared from view. This rewriting of history could not overcome the known facts about St Columba, however, and on the eve of the Reformation Roderick MacLean, a Gaelic-speaking bishop (with Lutheran sympathies), wrote elaborate and sophisticated Latin poems proclaiming the achievements of Columba and Iona.     

Organizational climate in Spanish Public Health Services: Administration and Services Staff

The main goal of this research is to explore the organizational climate perceived by administrative and healthcare personnel working in Spanish healthcare services, analyzing the differences according to their health specialization, sex, age and professional status. The sample was made up of 3,787 individuals working in the administrative and healthcare services of the Public Health System of the Principality of Asturias, 88.7 % were working in specialist care and 11.3 % in primary care. Mean age was 51.88 (standard deviation of 6.28); 79.9 % were women and 20.1 % men. The organizational climate was assessed with the CLIOR scale. The organizational climate perceived is moderately positive, with a global mean of 3.03 on a scale of 1 to 5 points. The differences are statistically significant (p < .01) according to specialty, age and profession. A better working climate is perceived in primary care than in specialist care, and among older as compared to younger workers. The results indicate that the working climate perceived by administration and services staff employees in the Spanish healthcare context is moderately positive, with a better perceived climate in primary care than in specialist care.     

Using risk model judgements to better understand perceptions of synergistic risks

Numerous scientific studies show that risk factors can interact to synergistically increase the likelihood of certain adverse and life‐threatening outcomes. Yet, the extent to which individuals know that specific risk factor combinations present ‘synergistic risks’ is unclear and little is known about the determinants of such knowledge. This is largely because epistemological progress concerning this topic has been frustrated by a reliance on metrics that have latterly been judged to be of questionable validity. To address this issue, this paper presents two studies that assess an alternative approach (i.e., risk model judgements) which requires respondents to judge the risk for a factor combination relative to, rather than in isolation from, the risk attributable to each constituent factor. Results from both studies indicate that risk model judgements overcome the drawbacks of traditional metrics. More importantly, the results provide epistemological insights into what can determine whether an individual understands that a factor combination presents a synergistic risk; these determinants include experiential and intuitive insights into the effects of combining specific risk factors, domain‐specific judgemental experience and exposure to effective learning opportunities. These findings can be utilized in interventions aimed at helping individuals to make better decisions concerning multiple risk factors.