Psychological Dysfunction in Southeast Asian Refugees as Mediated by Sense of Coherence

Investigated Antonovky's (1979, 1987) construct of sense of coherence (i.e., an individual's belief that the world was comprehensible, manageable, and meaningful) as the internal psychological mechanism mediating the effects of external stressors (generalized resistance deficits) and resources on psychological dysfunction (measured by depression, anxiety, and psychosocial dysfunction) in 2,234 Vietnamese, Cambodian, Laotian, Hmong, and Chinese-Vietnamese refugees. Generalized resistance and deficits significantly predicted sense of coherence as well as psychological dysfunction. The amount of variance accounted for increased significantly when the mediating effect of sense of coherence was tested using a path analysis. Sense of coherence significantly reduced the predictive power of generalized resistance and deficits in the psychological dysfunction models. Results support the hypothesized mediating role of sense of coherence. Thus, interventions aiming to enhance Southeast Asian refugees' functioning may gain in effectiveness by targeting and promoting their sense of coherence.     

From psychosocial equilibrium to catastrophic breakdown: Cyprus 1955–1974

The recent history of Cyprus presents an example of a society in which a centuries-long peaceful coexistence of diverse populations gave way to violence and murderous hate, with devastating end results. This paper tries to understand and describe the process by which Cypriot society slid from a position of psychosocial equilibrium and integration towards one of disintegration, fragmentation and catastrophic breakdown. This paper draws from work by social anthropologists, sociologists, historians and others, and from my own personal experience. To these I applied insights afforded by psychoanalysis to identify and explore the psychic processes and states of mind that characterized a psychosocial disintegrative process. I came to see external political events and internal psychological processes as inseparably intertwined and dynamically interdependent, each emanating from and catalysing the other. The factual details of the process described are of course unique in their local specificity, but the psychic phenomena that characterized it are not: at both the individual and group levels they are replicated in other societies undergoing similar processes of self-destruction.     

Rigorous results,cross-model justification,and the transfer of empirical warrant: the case of many-body models in physics

This paper argues that a successful philosophical analysis of models and simulations must accommodate an account of mathematically rigorous results. Such rigorous results may be thought of as genuinely model-specific contributions, which can neither be deduced from fundamental theory nor inferred from empirical data. Rigorous results provide new indirect ways of assessing the success of models and simulations and are crucial to understanding the connections between different models. This is most obvious in cases where rigorous results map different models on to one another. Not only does this put constraints on the extent to which performance in specific empirical contexts may be regarded as the main touchstone of success in scientific modelling, it also allows for the transfer of warrant across different models. Mathematically rigorous results can thus come to be seen as not only strengthening the cohesion between scientific strategies of modelling and simulation, but also as offering new ways of indirect confirmation.     

Parent training for young Norwegian children with ODD and CD problems: Predictors and mediators of treatment outcome

Participants were 121 children, aged 4–8 years referred for conduct problems, and their mothers. A parent training intervention was implemented in two outpatient clinics in Norway. Treatment responders were defined as children scoring below a cut-off on the Eyberg Child Behavior Inventory, a score below an optimal cut-off for children in day-care and school as reported by teachers, in addition to a 30% reduction or greater in observed negative parenting. Self-reported parenting practices were explored as potential mediators. The results of logistic regression analyses showed that high levels of maternal stress, clinical levels of ADHD, and being a girl predicted a poorer outcome in conduct problems at home, while pretreatment clinical levels of ADHD predicted a poorer outcome as perceived by the teachers. Harsh and inconsistent parental disciplining emerged as significant partial mediators of changes in conduct problems, highlighting the importance of altering parenting practices to modify young children's conduct problems.     

The Role of the Family in the Course and Treatment of Bipolar Disorder

ABSTRACT— Bipolar disorder is a highly recurrent and debilitating illness. Research has implicated the role of psychosocial stressors, including high expressed-emotion (EE) attitudes among family members, in the relapse–remission course of the disorder. This article explores the developmental pathways by which EE attitudes originate and predict relapses of bipolar disorder. Levels of EE are correlated with the illness attributions of caregivers and bidirectional patterns of interaction between caregivers and patients during the postepisode period. Although the primary treatments for bipolar disorder are pharmacological, adjunctive psychosocial interventions have additive effects in relapse prevention. Randomized controlled trials demonstrate that the combination of family-focused therapy (FFT) and pharmacotherapy delays relapses and reduces symptom severity among patients followed over the course of 1 to 2 years. The effectiveness of FFT in delaying recurrences among adolescents with bipolar disorder and in delaying the initial onset of the illness among at-risk children is currently being investigated.     

Psychological Follow-up of Presymptomatic Genetic Testing for Spinocerebellar Ataxia Type 2 (SCA2) in Cuba

Presymptomatic testing for spinocerebellar ataxia type 2 (SCA2) in Cuba started five years ago. We have now investigated the psychological impact of test results on 150 individuals at 50% risk for SCA2. In a prospective study, psychological instruments were used to evaluate depression, anxiety and family functioning (1) before testing and (2) one year after disclosure of the test result. One year after, anxiety and depression levels decreased both in carriers and non-carriers, but anxiety decreased significantly more in carriers. Pathological levels of anxiety were seen mostly in members of dysfunctional families, but decreased more in them than in other consultands. Presymptomatic testing thus seems to have been especially beneficial for these testees, possibly due to a greater gain from the psychosocial support received. It would be pertinent to evaluate now the impact of other psychosocial variables and perform longer-term longitudinal studies.     

Disclosure of Genetics Research Results after the Death of the Patient Participant: A Qualitative Study of the Impact on Relatives

When a gene mutation is identified in a research study following the death of the study participant, it is not clear whether such information should be made available to relatives. We report here an evaluation of the impact on relatives of being informed of study results that detected pathogenic BRCA2 mutations in a male relative, now deceased, who had early onset (under the age of 55) prostate cancer. The breast and ovarian cancer risk was unknown to the living relatives. Qualitative analysis of interviews with thirteen relatives indicated that those who had a higher risk perception, resulting from an awareness of cancer family history or experiential knowledge of cancer in their family, tended to adjust more easily to the results. All participants believed that genetics research results of clinical significance should be fed back to relatives. Those who were fully aware of the BRCA2 results and implications for themselves felt they had benefited from the information, irrespective of whether or not they had elected for genetic testing, because of the consequent availability of surveillance programs. Initial anxiety upon learning about the BRCA2 result was alleviated by genetic counselling. Factors influencing those who have not engaged with the information included scepticism related to the relative who attempted to inform them, young age and fear of cancer. Those who had not sought genetic counselling did not attempt further dissemination, and some were not undergoing regular screening. Implications for informed consent in genetics research programs, and the requirement for genetic counselling when research results are disclosed, are discussed. Names have been changed to protect the privacy of study participants.     

The Relationship Between Agentic and Communal Personality Traits and Psychosocial Adjustment to Breast Cancer

Agency, communion, unmitigated agency (UA), and unmitigated communion (UC) are related to psychosocial health outcomes in nonclinical and medical populations. This study examined the relationship between these personality traits and emotional and interpersonal well-being, as up to 50% of women experience difficulties in psychosocial adjustment after being diagnosed with breast cancer. Seventy-four women newly diagnosed with breast cancer completed baseline assessment measures within 2 weeks prior to their first chemotherapy treatment or at the beginning of their hormonal therapy. Findings indicate that (1) agency and UA are important correlates of emotional and interpersonal adjustment and should be considered when attempting to identify women at high risk for psychosocial distress, and (2) UC deserves increased attention in behavioral medicine research, given its strong relationship with emotional distress in a breast cancer population. Thus, evidence continues to accumulate regarding the important relationship of these personality traits to psychosocial outcomes in medical populations.     

皮质醇日常节律与儿童问题行为及心理社会因素的关系

HPA轴(下丘脑?垂体?肾上腺皮质轴, hypothalamic-pituitary-adrenal cortex axis)是人体应对压力的重要神经内分泌系统, 其终产物皮质醇常作为测量压力的生物学指标。目前的研究多通过皮质醇日常节律表示静息状态下HPA轴的活动, 而日常节律因其较高的稳定性和可靠性成为儿童生理健康评估的最佳指标。儿童期迅速发育的神经内分泌系统与儿童的行为相互作用, 并受到多种心理社会因素的影响。以往研究主要关注皮质醇日常节律与儿童问题行为及心理社会因素的关系, 未来研究应讨论逆境条件下影响儿童成长的危险性因素和保护性因素, 并探索环境对儿童行为影响可能存在的内分泌机制。