Race, Culture, and Ethnicity: Implications for a Community Intervention

We present an overview of research on African American families and emphasize in this discussion limitations of approaches used in the past to study African American families. We also discuss and identify challenges for designing and implementing community, family-based programs targeting competence-promoting behaviors in African American families. In addition, we attempt to accomplish the following objectives: (1) identify themes in studies of African American families, including bias in prior research; (2) discuss ways in which prior approaches and conceptual models guiding studies of African Americans have created challenges for the development and implementation of community-based intervention and research programs; and (3) present the Parents Matter! Program as an example of a community-based prevention effort that attempted to overcome many of the challenges created by prior research efforts.     

建立风险管理机制防范医疗纠纷的探讨

"医疗风险无处不在".针对医疗纠纷的起因及医疗风险管理的办法阐述了国内外医疗风险管理的现状,提出医疗风险管理的建议,使医疗风险管理规范化、制度化、社会化.     

Social skills and sex‐role functioning in borderline personality disorder: relationship to self‐mutilating behavior

This study compared the social skills functioning and sex role affiliation of female inpatients diagnosed with borderline personality disorder who engaged in self‐mutilating behavior (n?=?30) with female patients with borderline personality disorder who did not engage in such behavior (n?=?18). Patients with borderline personality disorder who engaged in self‐mutilating behavior were found to have relatively poorer skills in communicating non‐verbal emotional information to others and in receiving and interpreting such information from others. In terms of sex role orientation, patients who engaged in self‐mutilating behavior were significantly more likely than non‐mutilators to be typed as undifferentiated using the Bem Sex Role Inventory. These participants were less likely to identify with either masculine or feminine sex roles. Patients who did not self‐mutilate were found to be significantly more likely than those who did self‐mutilate to identify with the masculine sex role.     

Long‐term Self‐monitoring of Weight: A Case Study

The aim of this study was to examine the self‐monitoring of weight on a daily basis over a long period of time in order to understand the process of weight regain. An obese female client measured her weight every morning over a period of 10 years. The subject made a total of 2081 weight measurements. Thus, her weight was measured on 67% of all possible days. After the initial weight loss a pattern of gradual weight gain was observed. The subject gained weight during August and September, and at the end of December, in particular. Furthermore, her weight increased slightly at the weekends. This case study highlights the advantage of self‐monitoring of weight on a daily basis. Individual patterns of weight change possibly associated with season and weekly variation may be crucial when obese subjects try to maintain their weight after weight loss. However, it may take several months or even years to detect the weekly and yearly rhythms or other patterns in the data. Thus, self‐control of weight is problematic, since patterns in the weight regain process are difficult to detect. This may be one reason why self‐control of weight is so difficult.     

Are fear-avoidance beliefs related to the inception of an episode of back pain? A prospective study

Abstract

Fear-avoidance beliefs and catastrophizing have been implicated in chronic pain and theoretical models have been developed that feature these factor in the transition from acute to chronic pain. However, little has been done to determine whether these factors occur in the general population or whether they arc associated with the inception of an episode of neck or back pain. The aim of this study was to evaluate prospectively the effects of fear-avoidance beliefs and catastrophizing on the development of an episode of self-reported pain and associated physical functioning. To achieve this, we selected a sample of 415 people from the general population who reported no spinal pain during the past year. At the pretest a battery of questionnaires was administered to assess beliefs about pain and activity and it featured the Pain Catastrophizing Scale and a modified version of the Fear-Avoidance Beliefs Questionnaire. One year later outcome was evaluated by self-reports of the occurrence of a pain episode as well as a self-administered physical function test. The results showed that scores on both fear-avoidme and cabstrophizing were quite low. During the one year follow-up, 19% of the sample suffered an episode of back pain. Those with scores above the median on fear-avoidance beliefs at the pretest had twice the risk of suffering an episode of back pain and a 1.7 times higher risk of lowered physical function at the follow-up. Catastrophizing was somewhat less salient, increasing the risk of pain or lowered function by 1.5. but with confidence intervals falling below unity. These data indicate that fear-avoidance beliefs may be involved at a very early pint in the development of pain and associated activity problems in people with back pain. Theoretically. our results support the idea that fear-avoidance beliefs may develop in an interaction with the experience of pain. Clinically, the results suggest that catastrophizing and particularly fear-avoidance beliefs are important in the development of a pain problem and might be of use in screening procedures.     

Assessing reinforcers under progressive schedule requirements.

Recent research findings suggest that reinforcing stimuli may be differentially effective as response requirements increase. We extended this line of research by evaluating responding under increasing schedule requirements via progressive‐ratio schedules and behavioral economic analyses. The differential effectiveness of preferred stimuli in treating destructive behavior maintained by automatic reinforcement also was examined. Results showed that one of two stimuli was associated with more responding under increasing schedule requirements for the 4 participants. Furthermore, stimuli associated with more responding under increasing schedule requirements generally were more effective in treating destructive behavior than stimuli associated with less responding. These data suggest that progressive‐ratio schedules and behavioral economic analyses may be useful for developing a new technology for reinforcer identification. From a clinical perspective, these results suggest that two reinforcers may be similarly effective for low‐effort tasks and differentially effective for high‐effort tasks.     

Functional analysis and treatment of self-injury associated with transitions.

We applied functional analysis methodology to the assessment and treatment of 2 individuals' self‐injurious behavior (SIB), which was reported to be occasioned by transitions from one activity or location to another. A structural (task) analysis of activity transitions identified at least three separate components that might influence behavior either alone or in combination: (a) termination of a prechange activity, (b) initiation of a postchange activity, and (c) movement from one location to another. Results of preference and avoidance assessments were used to identify activities to which participants were exposed in varying arrangements during transitions in a functional analysis. Results of 1 participant's functional analysis indicated that his SIB was maintained by avoidance of having to change locations, regardless of the activity terminated prior to the change or the activity initiated following it. The 2nd participant's analysis revealed the same function but also an additional one: avoidance of certain task initiations. This information was used to identify transition contexts during intervention and to design treatment procedures appropriate for a given context and behavioral function. A procedure involving advance notice of an upcoming transition had no effect on SIB, and differential reinforcement of alternative behavior (DRA) had limited effects in the absence of extinction. Sustained decreases in SIB were observed when DRA was combined with extinction and response blocking. Further extensions of functional analysis methodology to the assessment of problem behavior in situations characterized by multiple or protracted stimulus changes are discussed.     

Self‐esteem and its relationship to bullying behaviour

From the rapidly growing literature on bullying, it is increasingly recognised that peer relationship problems as manifested in being bullied are associated with low self‐esteem. However, the literature on self‐esteem in relation to children who bully others is controversial. The objective of this paper is to elucidate further our understanding of the relationship between self‐concept and bullying behaviour. Data from a nationwide study of bullying behaviour carried out in Ireland during 1993‐1994 have been reviewed. The relevant results from 8,249 school children aged 8 to 18 years are presented. The paper examines the global and dimensional nature of self‐esteem and how it relates to children and adolescents who either have been victimised or bullied others. A distinction is made between “pure victims,” “pure bullies,” and children and adolescents who were both bullied and who bullied others. In other words, pure victims were those who had not bullied others, and pure bullies had not themselves been bullied. Those who were both bullied and bullied others were subdivided further into victims who bully occasionally, sometimes, and frequently and bullies who are victimised, occasionally, sometimes, and frequently. The results show that children of both primary and post‐primary age who were involved in bullying as victims, bullies, or both had significantly lower global self‐esteem than did children who had neither bullied nor been bullied. However, the pure bullies, in contrast to the pure victims, placed the same value on their physical attractiveness and attributes and on their popularity as did their peers who had not bullied others or been bullied. The bully‐victims of all ages had the lowest self‐esteem of the subgroups in the study. Also, the more frequently children were victimised or bullied others, the lower was their global self‐esteem. The typology and frequency of bullying and the age of the children when they were involved in bullying influenced the status of the specific domains of self‐esteem. There were, e.g., significant differences in anxiety between the pure bullies of post‐primary age and their peers who had not bullied others or been bullied. The post‐primary children who bullied most frequently were the least anxious. The results indicate that high self‐esteem protects children and adolescents from involvement in bullying. Thus, in view of the strong relationship between self‐esteem and bullying that has been found in the present paper, it is recommended that top priority be given by parents and teachers to preventing and reducing feelings of poor self‐worth among children and adolescents. Aggr. Behav. 27:269–283, 2001. © 2001 Wiley‐Liss, Inc.     

青少年抑郁情绪的发展轨迹:界定亚群组及其影响因素

本研究意在分性别考察中国青少年抑郁情绪的发展轨迹及其影响因素。785名男生和859名女生参加了3轮追踪研究,初始测量阶段的年龄跨度为10~16岁,平均年龄分别为12.99±1.84和12.96±1.87岁。采用流调中心抑郁量表(CES-D)简版测量青少年的抑郁情绪。模型拟合的结果显示男女生的抑郁情绪在10~19岁时段皆呈线性增长趋势,其中男生分为两个亚群组,人际关系解释了部分变异;女生分为4个亚群组,学业压力和人际关系均解释了部分变异。     

Why Young Men Drive Dangerously: Implications for Injury Prevention

Why is risk consistently underestimated, and why do young men in particular take exceptionally high risks and think of themselves as invulnerable? Two explanatory paths are proposed. The first is that risk taking in young males has been shaped by evolutionary forces to provide a fitness value. The second pathway is through myth and the other narrative forms that affirm the ego's immortality and invulnerability. Because of its evolutionary base, risk taking is emotionally driven: Emotions are preverbal and irrational, which means that persuasive prevention cannot be more than weakly successful. Three prevention challenges emerge from this analysis: to determine what it is that young drivers fear, to attach affectively experienced fears to defined driving behaviors, and to devise injury-prevention programs that acknowledge that young males' risk taking is not "stupid," but driven by adaptive needs that are as significant to today's young adults as they were to our distant ancestors.