Life Meaning Following Combat Among Air Force Security Forces Personnel

An active duty Air Force ground combat unit (n = 189) completed surveys about trauma and combat exposure, mood symptoms, and meaning in life. Two dimensions of deployment-related traumas were assessed: combat (e.g., firing weapons, being fired upon) and aftermath (e.g., seeing dead bodies, injury). Results of regression analyses indicated that Airmen who experienced more intense combat reported less presence of meaning in life, although the significant interaction with gender suggested declines in meaning in life were especially pronounced among males with higher combat intensity. In contrast, more intense aftermath exposure was associated with slightly stronger meaning in life, with no differences by gender. Intensity of combat exposure might differentially affect perceived meaning in life for male versus female combatants.     

Determination of problems in patients with post‐laryngectomy

The purpose of this study is the determination of the physical and psychosocial problems of total and partial laryngectomies. A total of 25 patients, who were operated with the diagnosis of larynx carcinoma in 2010 at Gazi University Faculty of Medicine Otolaryngology Department, were included in the study. They were evaluated with the help of the Personal Information Form (PIF) and the Determination Form of Post Laryngectomy Problem (DFPLP) for the problems they encountered after the operation. Total laryngectomy (TL) was performed on 76% of patients. It was determined that patients undergoing total laryngectomy experienced some physical and psycho‐social problems such as problems in sleep (31.6%), smell (52.6%), taste (36.8%), and difficulty in swallowing solid foods (36.8%). Furthermore in patients with TL surgery whilst 47.4% of them think that their sexual lives were affected rather negatively, this rate was determined as 33.3% in patients with partial laryngectomy surgery (PL). The psychosocial score averages of the patients who had smell and taste disorders were significantly lower (p < 0.05). The patients, who underwent a laryngectomy operation, experienced many physical, social, and psychological problems. Thus, medical personnel also need to pay attention to these concomitant problems that occur during the treatment of the primary disease and the application of necessary supplementary treatments such as voice prosthesis, pre‐op and post‐op counseling, and anti‐depressants seems significant in terms of increasing the life quality of the patients.     

Guilt as a Source of Narcissistic Gratification

This article takes as its starting point a paper by Hugo Bleichmar presented at the 2003 Joseph Sandler Research Conference on Depression. The author argues in favour of viewing depression in a broad perspective. The Freudian prototype of “guilty depression” represents only one of many pathways leading to depressive states. Psychoanalytic understanding of depression should represent a multidimensional approach, characterised by interacting determinants, both internal and external. In clinical practice, this would imply an attitude of greater freedom and flexibility in the analyst. The paper compares the psychoanalytic account of depression with that given by the cognitive approach. It is argued that within a diverse research field, where depression is studied from different angles—as a disorder of the brain and in terms of cognitive deficits—the contribution of psychoanalysis is that depression is most usefully studied at the level of psychological causation. The psychoanalytic understanding of depressive states in terms of unconscious interpretation and meaning of experience represents a distinct contribution. Implications of viewing depression as an “illness” are discussed.     

An Exploratory Assessment of Sales Culture Variables: Strategic Implications Within the Banking Industry

Growing, or even simply sustaining, profitability in today's rapidly changing environment is a daunting task. Today's firm must contend with increasing competition, changing customer requirements, and unprecedented technological change. Further, changing government regulations, such as the recent wave of deregulation, have dramatically changed the way business has traditionally been done in certain industries. In such a turbulent environment many firms have discovered that a total organizational sales effort is necessary. For many firms, this means a paradigm shift that involves strengthening their sales culture.

The purpose of this study is to empirically examine the sales culture (SC) concept and discuss its importance in contemporary business strategy. First, we will discuss market orientation from a corporate culture perspective. Second, the sales culture component of a market orientation will be defined and examined. Third, an exploratory investigation of constructs associated with sales culture will be investigated using an example taken from an industry that is experiencing rapid change, the banking industry. Finally, strategic implications, limitations and suggestions for future research will be shared.     

Marital role strain,illness intrusiveness,and their impact on marital and individual adjustment in end-stage renal disease

Abstract

A marital role theory approach was used to investigate individual psychosocial well-being and marital adjustment in 89 end-stage renal disease (ESRD) patients and their spouses. Four different patient groups were selected according to a continuum of clinical milestones in the treatment of ESRD, including pre-dialysis (n=17), incenter dialysis (n=18), home dialysis (n=19), and posttransplant patients (n=17). A nephrology clinic control group (n=18) was also included. Standardized instruments were employed to investigate marital role strain (Marital Role Questionnaire, KDS-15), marital adjustment (Locke-Wallace Marital Adjustment Test), subjective well-being (Affect Balance Scale, Rosenberg Self-Esteem Inventory), and psychopathology (Symptom Checklist 90-R). Hierarchical multiple regression analyses provided strong and consistent support for the major hypotheses relating elevated marital role strain to compromised marital adjustment and individual well-being. Further analyses demonstrated that increased perceived intrusiveness of ESRD was significantly related to greater marital role strain, poorer marital adjustment, and decreased individual well-being. This is consistent with the idea that perceived intrusiveness may be an important mediator of marital role strain and of coping with chronic illness. “Objective” intrusiveness, defined in terms of patient group, was not significantly related to marital or individual well-being. These findings support a dyadic approach to the psychosocial study of chronic illness.     

Impact of social support on health status and life satisfaction in people with a spinal cord injury

Abstract

Purpose: Assessment of the impact of received social support on functional health status and life satisfaction in people with spinal cord injury (SCI). Design: Respondents were 176 people with SCI between 18 and 65 years of age and living in the community. Mean time after injury was 3.6 years. Problem-oriented and emotion-oriented support, received from family members, friends and relatives, and professionals were assessed with the Sources of Social Support Inventory. Health status was assessed with the Sickness Impact Profile 68 and life satisfaction with the Life Satisfaction Questionnaire. Structural equation modelling with LISREL V8 was used to study relationships of different types and sources of social support with health status and life satisfaction.Results: Emotion-oriented support led to better psychological functioning and to greater life satisfaction. In addition, emotion-oriented support from the family led to greater satisfaction with relationships and emotion-oriented support from friends and acquaintances led to less satisfaction with social life. Problem-oriented support was not clearly related to health status and life satisfaction; there was only a negative relation between problem-oriented support and satisfaction with social life. Support, problem-oriented or emotion-oriented, from health-care professionals showed no relationships with health status or life satisfaction.Conclusions: Emotion-oriented support from family members and friends was most important for people with SCI. Greater problem-oriented support appears to be related to poorer life satisfaction.     

What are the positive consequences of illness?

Abstract

Fifty five people, either currently sick or having recovered from their illness, were recruited if they reported positive consequences of illness. They were questioned about their experiences of illness, 41 by semi-structured interview and 14 by open-ended questionnaire and responses were classified into 17 categories. The categories were similar but slightly more extensive than previous accounts of positive consequences reported in the literature. The content of the interviews and questionnaires was used to construct a 66 item questionnaire about positive consequences of illness which was then completed by 97 patients. A principal components analysis indicated a large first factor accounting for 27% of the variance. Endorsement of items varied between 87% and zero for chronic lung disease patients attending pulmonary rehabilitation. However, all patients endorsed at least one item and the median number of items endorsed was 31. Positive consequences of illness are highly varied and more common than often realised, and this has implications for the concept and measurement of quality of life.     

The dimensional structure of benefit finding in multiple sclerosis and relations with positive and negative adjustment: A longitudinal study

Benefit finding is a meaning making construct that has been shown to be related to adjustment in people with MS and their carers. This study investigated the dimensions, stability and potency of benefit finding in predicting adjustment over a 12 month interval using a newly developed Benefit Finding in Multiple Sclerosis Scale (BFiMSS). Usable data from 388 persons with MS and 232 carers was obtained from questionnaires completed at Time 1 and 12 months later (Time 2). Factor analysis of the BFiMSS revealed seven psychometrically sound factors: Compassion/Empathy, Spiritual Growth, Mindfulness, Family Relations Growth, Lifestyle Gains, Personal Growth, New Opportunities. BFiMSS total and factors showed satisfactory internal and retest reliability coefficients, and convergent, criterion and external validity. Results of regression analyses indicated that the Time 1 BFiMSS factors accounted for significant amounts of variance in each of the Time 2 adjustment outcomes (positive states of mind, positive affect, anxiety, depression) after controlling for Time 1 adjustment, and relevant demographic and illness variables. Findings delineate the dimensional structure of benefit finding in MS, the differential links between benefit finding dimensions and adjustment and the temporal unfolding of benefit finding in chronic illness.     

Social support,social integration,and health-related quality of life over time: Results from the Fitness and Arthritis in Seniors Trial (FAST)

The present study tested whether baseline perceived social support and social integration predicted baseline and follow-up measures of health-related quality of life for 364 older adults with osteoarthritis. The findings are secondary analyses of a randomized controlled trial of an exercise intervention. Multiple regression analyses indicate that perceived social support was related to baseline measures of functioning in psychological (depressive symptoms, social functioning, and life satisfaction) and physical domains (self-rated disability, observed physical function, and perceived health), after accounting for demographic and clinical status factors. At 18-month follow-up (additionally controlling for exercise intervention and baseline outcomes), social support significantly predicted changes in psychosocial functioning, but was unrelated to changes in self-reported and observed physical health. The findings indicate that social support is an important predictor of long-term psychosocial outcomes, but is less important than baseline clinical status for physical health endpoints in this cohort of older adults. In contrast, social integration was not a consistent predictor of outcomes.     

Socio-economic health inequalities: Their origins and implications

Abstract

Evidence attests to substantial variations in health contingent on socioeconomic position. It is argued that these effects cannot be dismissed as artefact nor can they be explained, in the main, by either social selection or an unequal distribution of accepted behavioural risk factors among different social groups. The most likely explanation would seem to be social causation. However, it is continuing social and material inequality that appears most implicated; accounts which locate the effects in childhood social and material causes are far less compelling. The persistence of socioeconomic health differentials into the materially better-off social strata and the possible determining role of relative as well as absolute living standards suggest that psychological, in addition to material, variables are likely to be involved. Isolating the key psychological variables and identifying the nature of their influences will not be easy tasks, although social relations, psychological stress, uplifts, and control have emerged as possible candidates. However, psychological mediators of this sort most probably constitute surface rather than basic causes. Socio-economic inequality, it is contended, remains the basic cause, and, as such, the proper target for intervention. Psychological interventions are unlikely to yield much in the way of dividends in this context and indeed could inadvertently contribute to victim blaming.