Chronic sorrow: A content analysis of parental differences

Sixty-eight mothers and 64 fathers of children with a neural tube defect responded to a questionnaire about chronic sorrow. Mothers reported a mood state change in very intense category from more pessimistic at time of diagnosis to more optimistic at current time. Fathers, although indicating a mood change in the very intense category to more optimistic, also had more pessimistic responses. Parental similarities and differences were also reported in both times and events that triggered the sorrow response. Categories across times and events were primarily related to health care, school/development concerns and social significance. Clinical and research implications of these findings are discussed.     

Experimental assessment of tinnitus aurium

A 32-year-old male volunteer with an eight year history of chronic unilateral tinnitus (ear-ringing) participated in a behavioral assessment strategy that included a series of measurement and modification procedures. A psychophysical matching technique was employed throughout a planned combination of procedures to assess and manipulate the intensity or loudness of tinnitus responses. Following baseline assessment, measurements were conducted at varying times of the day, concomitant with exposure to music, during progressive relaxation training, and under conditions of caffeine consumption. The value of careful assessment to describe cues and conditions associated with tinnitus and its reduction are discussed with implications for behavior treatment design and evaluation.     

助推手卫生的行为干预策略

保持手卫生是感染防控的重要策略,但是如何提高其依从性成为预防传染性疾病和减少医疗机构获得性感染的一大挑战。以行为科学为基础的手卫生助推干预以更“隐性”的方式将洗手转变为一种可自动触发的行为习惯,弥补了以知识分享和健康宣教为主的传统手卫生干预策略的诸多局限性。基于影响机制的不同,手卫生助推干预策略可分为提供决策信息、优化决策选项、影响决策结构、提醒决策方向4个大类的框架体系。多模式助推策略的有效性也已在实践中得到印证,但目前还非常缺乏在中国社会文化情境下开展的助推洗手行为的干预研究,今后可尝试基于行为科学理论有针对性地在医院、学校和社区等公共场所开展此类干预研究和实践,为感染防控、疾病预防和改善公共健康做出相应的贡献。     

Linguistic features of dysfluencies in Parkinson Disease

PurposeThe purpose of this study was to examine dysfluency characteristics of individuals with Parkinson Disease (PD) relative to linguistic features of grammatical class and position within word. Few studies have reported dysfluency characteristics of PD relative to these characteristics. Those that do report on these characteristics include one case study and a study of six individuals with PD. No previous research is known to have examined dysfluency related to grammatical class and position within words for a large sample of individuals with PD.MethodDysfluencies from 32 individuals with PD were analyzed according to position within a word and grammatical class.ResultsParticipants produced significantly more dysfluencies in the initial position of words compared to medial or final positions, and a significantly higher percent dysfluency for content words versus function words.ConclusionEffects of linguistic features of grammatical class and position within a word on dysfluencies are present within a population with PD and are similar to the linguistic features associated with developmental stuttering. Clinical implications of the effect of linguistic features on speech dysfluencies in PD are discussed.     

Enhancing the care of children with chronic diseases through the narratives of patient,physician, nurse and carer

We tested the hypothesis that a narrative approach may enhance a bio‐psycho‐social model (BPS) in caring for chronically ill children. Forty‐eight narratives were collected from 12 children with six different medical conditions, their mothers, physicians, and nurses. By a textual analysis, narratives were classified on their predominant focus as disease (biological focus), illness (psychologic focus), or sickness (social focus). Sixty‐one percent of narrative’ text were classified as illness, 28% as disease and 11% as sickness. All narratives had a degree of illness focus. Narratives by patients and physicians on the one hand, and nurses’ and mothers’ on the other were disease focused. Narratives were also evaluated with respect to the type of medical condition: Illness was largely prevalent in all but Crohn’s disease and HIV infection, the latter having a predominance of sickness most probably related to stigma. Narrative exploration proved a valuable tool for understanding and addressing the needs of children with complex conditions. Narrative approaches allow identification of the major needs of different patients according to health conditions and story tellers. In the narratives, we found a greater illness and disease focus and surprisingly a low sickness focus, except with HIV stories. Narrative medicine provides a tool to strengthen the BPS model in health care.     

Is it acceptable for a physician to break confidentiality in the case of sexually transmitted diseases? A mapping of young Kuwaiti's views

IntroductionConfidentiality is essential for the establishment of trust between physicians and their patients.ObjectivesThe circumstances under which it is acceptable to young Kuwaiti for a physician to break confidentiality to protect the spouse of a patient with a sexually transmitted disease (STD) were examined.MethodA sample of 263 young Kuwaiti indicated the acceptability of breaking confidentiality in 48 scenarios that were all possible combinations of five factors: disease severity, time taken by the physician to discuss with the patient, the patient's intent to inform the spouse about the disease, the patient's intent to adopt protective behaviors, and the decision to seek the advice of an expert in infectious diseases before breaking confidentiality.ResultsThrough cluster analysis, four qualitatively different positions were found: Quite never acceptable (6% of the sample, mostly males), Depends on husband's willingness to inform (3%), Depends on husband's protective behavior (29%, mostly females), and Quite always acceptable (32%). The remaining participants did not express any clear view.ConclusionIn Kuwait, students’ trust in the medical profession is, therefore, not likely to be seriously undermined if, from time to time, and in well-specified cases, individual physicians decide to break confidentiality when facing dilemmas of the kind examined in the current study.     

Understanding the role of configural processing in face emotion recognition in Parkinson’s disease

This investigation examined whether impairment in configural processing could explain deficits in face emotion recognition in people with Parkinson’s disease (PD). Stimuli from the Radboud Faces Database were used to compare recognition of four negative emotion expressions by older adults with PD (n = 16) and matched controls (n = 17). Participants were tasked with categorizing emotional expressions from upright and inverted whole faces and facial composites; it is difficult to derive configural information from these two types of stimuli so featural processing should play a larger than usual role in accurate recognition of emotional expressions. We found that the PD group were impaired relative to controls in recognizing anger, disgust and fearful expressions in upright faces. Then, consistent with a configural processing deficit, participants with PD showed no composite effect when attempting to identify facial expressions of anger, disgust and fear. A face inversion effect, however, was observed in the performance of all participants in both the whole faces and facial composites tasks. These findings can be explained in terms of a configural processing deficit if it is assumed that the disruption caused by facial composites was specific to configural processing, whereas inversion reduced performance by making it difficult to derive both featural and configural information from faces.     

Regression II. Development through regression

As shown in our previous paper (‘Regression I. Experimental approaches to regression’, JAP, 65, 2, 345-65), the common mechanism of regression can be described as reversible dedifferentiation, which is understood as a relative increase of the proportion of low-differentiated (older) systems in actualized experience. Experimental data show that regression following disease (chronic tension headache) is followed by adaptation and an increase in system differentiation in that experience domain which contains systems responsible for that adaptation. The results of mathematical modelling support the idea that reversible dedifferentiation can be one of the mechanisms for increasing the effectiveness of adaptation through learning. Reversible dedifferentiation, which is phenomenologically described as regression, is a general mechanism for restructuring the organism-environment interactions in situations where behaviours that were effective in the past become ineffective. Reversible dedifferentiation has evolved as a component of adaptation when new behaviours are formed and large-scale modifications in the existing behaviours are required in the face of changes in the external and/or internal environment. Thus, the authors believe that this article provides evidence for Jung’s view that regression is not only a ‘return’ to past forms of thinking, affects and behaviour, but that regressive processes provide a significant impetus for psychological growth and development.     

Building cardiovascular disease competence in an urban poor Ghanaian community: A social psychology of participation approach

This paper describes conceptual, methodological, and practical insights from a longitudinal social psychological project that aims to build cardiovascular disease (CVD) competence in a poor community in Accra, Ghana's capital. Informed by a social psychology of participation approach, mixed method data included qualitative interviews and household surveys from over 500 community members, including people living with diabetes, hypertension, and stroke, their caregivers, health care providers, and GIS mapping of pluralistic health systems, food vending sites, bars, and physical activity spaces. Data analysis was informed by the diagnosis‐psychosocial intervention‐reflexivity framework proposed by Guareschi and Jovchelovitch. The community had a high prevalence of CVD and risk factors, and CVD knowledge was cognitive polyphasic. The environment was obesogenic, alcohol promoting, and medically pluralistic. These factors shaped CVD experiences and eclectic treatment seeking behaviours. Psychosocial interventions included establishing a self‐help group and community screening and education. Applying the “AIDS‐competent communities” model proposed by Campbell and colleagues, we outline the psychosocial features of CVD competence that are relatively easy to implement, albeit with funds and labour, and those that are difficult. We offer a reflexive analysis of four challenges that future activities will address: social protection, increasing men's participation, connecting national health policy to community needs, and sustaining the project.     

Treating a Chronically Depressed Adolescent Female Using the Cognitive Behavioral Analysis System of Psychotherapy: A Case Study

A case is presented of an adolescent female with double depression who was treated using the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). CBASP is designed to teach a social problem-solving procedure called Situational Analysis (SA). Generalized treatment effects were measured through monitoring of diagnostic status, two administrations of the Minnesota Multiphasic Personality Inventory-Adolescent, weekly administrations of the Child Depression Inventory, and acquisition performance ratings on the SA task. The results showed that CBASP appeared to be an effective treatment. The double depressive disorder remitted, and the patient learned to identify behavioral consequences as well as target and attain her interpersonal goals. CBASP can be effective for adolescents, although modifications of the adult form of the therapy may be necessary.