Intersectionality in Clinical Medicine: The Need for a Conceptual Framework

Intersectionality has become a significant intellectual approach for those thinking about the ways that race, gender, and other social identities converge in order to create unique forms of oppression. Although the initial work on intersectionality addressed the unique position of black women relative to both black men and white women, the concept has since been expanded to address a range of social identities. Here we consider how to apply some of the theoretical tools provided by intersectionality to the clinical context. We begin with a brief discussion of intersectionality and how it might be useful in a clinical context. We then discuss two clinical scenarios that highlight how we think considering intersectionality could lead to more successful patient–clinician interactions. Finally, we extrapolate general strategies for applying intersectionality to the clinical context before considering objections and replies.     

表情对婴儿面孔图式效应的调节及其机制

婴儿面孔图式效应是促进早期亲子关系形成的一种先天本能反应, 该效应一直被认为主要是受婴儿面孔结构的影响。但近年来表情对该效应的影响开始得到关注, 在以成人面孔为基线的条件下, 婴儿面孔图式效应量会因表情不同而有所变化, 表现出中性婴儿面孔图式效应最强的现象。鉴于目前对该现象的成因及其神经机制知之甚少, 所以本项目拟先建立一套婴儿与成人同面孔多表情图片系统; 然后以此为基础, 分别考察面孔表情不确定性是否会调节成人对不同表情婴儿面孔的偏好和注意偏向, 并探究其相应神经机制, 促进养育脑研究在我国的开展。     

儿童社交回避行为：成因、测量方式及适应功能

社会退缩行为是指儿童在社会情境中抑制自己参与同伴互动并表现出独处的行为。根据不同的社交动机,社会退缩行为包含多种亚类型,其中社交回避行为这一亚类型指儿童总是表现出主动避免各种社交场合的行为。总体而言,社交回避是目前研究最少的一种,其形成的主要原因可能是由于儿童本身较高的抑郁感所致,而研究者已开始尝试以间接和直接的方式测量其水平。来自以变量为中心和以个体为中心的研究分别表明,社交回避儿童面临着最高的适应风险。鉴于这一研究领域的广泛前景,未来的研究亟需关注社交回避影响儿童适应的过程机制及其年龄发展特点,测量工具的进一步开发,直接的跨文化比较以及社交回避的干预方案开发。     

Migration for love? Love and intimacy in marriage migration processes

According to Australian regulations, the right to marriage migration applies only to genuine relationships. Marriage migration couples must demonstrate to state agents the authenticity of their romantic attachments in order to achieve a positive outcome in their applications. This article examines how love and intimacy in the context of Australian immigration regulations are interpreted by Thai women who originate from a non-Western culture. Drawing on interviews and ethnographic work with 15 Thai women marriage migrants, this article illustrates the ways in which the practical actions of caring and sharing are mobilized as important strategies for expressing real love and intimacy in marriage migration processes. Thus, although these women narrate their migration experiences as based on love and intimacy, such narratives are not free from global economic and structural inequalities. Women's constructions of love and intimacy presented here can transform over time in response to new personal experiences, changing social contexts and fluctuating circumstances in the processes of marriage migration.     

Studying the role of cognitive control in reasoning: evidence for the congruency sequence effect in the ratio-bias task

In this study, we investigated whether control of the conflict between incongruent heuristic and analytical answer options in a reasoning task is modulated by the presence of conflict on previous trials. In two experiments, we found that the incongruency of the previous trial has a significant effect on the control exhibited on the current trial. Our data also showed that this adaptation effect is modulated by the incongruency of the previous series of trials. These results demonstrate the same control adaptation effects for a reasoning task as observed for standard response interference tasks. Coinciding control effects in the two research areas suggest that cognitive control might be an important mechanism underlying performance on reasoning tasks. Based on these results we argue that the study of cognitive control in reasoning could potentially facilitate the refinement of empirical predictions and provide a new tool to explore the exertion of top-down control in human thinking.     

Identification complexity and conflict: how multiple identifications affect conflict across functional boundaries

We integrate insights from the social identity complexity and dual identification literature to explore the influence of workplace identification on cross-functional conflicts at work. We propose that patterns of identification across multiple identity targets will affect the development of cross-functional conflicts within an organization. We test our hypotheses in a two-wave study of 156 military personnel over a period of 4 months, finding support for our propositions. Specifically, we find that less complex patterns of identification (defined as dominant identification with a single workplace identity) are associated with higher increases in process, task and relationship conflict during cross-functional working, compared to complex patterns of identification (identification with two or three targets) and weak identification. These findings have important implications for cross-functional working, and also provide new insights into the role of identification complexity in shaping workplace outcomes.     

Clarifying the dynamic interrelation of conflicts between the work and home domain and counterproductive work behaviour

This study investigates the daily relationship between experiencing home–work conflict (HWC) and an employee’s performance of counterproductive work behaviour (CWB) directed towards the individual (CWBI) and CWB directed towards the organization (CWBO). Moreover, we examine whether these relationships are buffered by family supportive supervisor behaviour. Finally, we investigate whether CWBs directed towards the individual and the organization are related to feelings of work–home conflict (WHC). We examined the daily diary data using multilevel path analyses. We found support for a significant positive relation between HWC and same as well as next-day CWB enacted towards the individual, and same-day CWB directed towards the organization. General levels of family supportive supervisor behaviour buffered an employee’s daily relationship between experiencing HWC and enacting counterproductive work behaviour towards the individual, and are directly and negatively related with enacting CWB towards the individual and the organization. Furthermore, daily CWB enacted towards the individual was significantly positive, whereas CWB enacted towards the organization was significantly negatively related to WHC. Future research would benefit from examining buffering effects on the resource-depleting relationship between counterproductive work behaviour enacted towards the individual and WHC.     

Psychosocial impacts of communal conflicts in a sample of secondary school youths from two conflict communities in south east Nigeria

In Nigeria, communal conflicts arise due to misunderstanding from ownership of land for farming, oil deposits, solid minerals or water for fishing activities. It may also arise in defence of community pride and properties or even in defence of the people involved in the conflict. The General Health Questionnaire (GHQ-12), The Short Screening Scale for Post traumatic stress disorder, The Generalized Anxiety Disorder Scale (GAD-7) and the Beck Depression Inventory (BDI-2) were used to assess psychosocial impacts of communal conflicts among 560 secondary school youths from two communities in south east Nigeria. Result revealed various forms of psychosocial impacts of communal conflicts among the youths.     

Intimate relationship quality,self-concept and illness acceptance in those with multiple sclerosis

Lower levels of Intimate Relationship Quality (IRQ) have been found in those with Multiple Sclerosis (MS) compared to the general population. This study examined an MS sample to see whether IRQ was positively associated with self-concept, whether IRQ was positively associated with MS illness acceptance and whether IRQ was predicted by self-concept and illness acceptance. In this cross-sectional study, 115 participants with MS who were in an intimate relationship completed an online survey advertised on MS related websites. The survey assessed demographic variables, MS illness variables and levels of IRQ, self-concept and illness acceptance. Results revealed that IRQ was significantly positively associated with self-concept and with illness acceptance. Multiple hierarchical linear regression analysis revealed that, after controlling for illness duration and level of disability, self-concept significantly predicted IRQ but illness acceptance did not significantly predict IRQ. This study addressed several gaps and methodological flaws in the literature and was the first known to assess predictors of IRQ in those with MS. The results suggest that self-concept could be a potential target for individual and couple psychological interventions to improve IRQ and contribute to improved outcomes for those with MS.     

Examining the relation between adolescent social anxiety,adolescent delinquency (abstention), and emerging adulthood relationship quality

Background and Objectives: Social anxiety symptoms and delinquency are two prevalent manifestations of problem behavior during adolescence and both are related to negative interpersonal relationships in adolescence and emerging adulthood. This study examined the relation between social anxiety and delinquency in adolescence and the interplay between adolescent social anxiety and delinquency on perceived relationship quality in emerging adulthood. Design and Methods: In a 10-year long prospective study (T1, n = 923; T2, n = 727; Mage T1 = 12; 49% female), we examined competing hypotheses using regression analyses: the protective perspective, which suggests social anxiety protects against delinquency; and the co-occurring perspective, which suggests social anxiety and delinquency co-occur leading to increased negative interpersonal outcomes. Results: In adolescence, the relation between social anxiety and delinquency was consistent with the protective perspective. In emerging adulthood, consistent with the co-occurring perspective, ever-delinquents (but not delinquency abstainers) with higher social anxiety reported less perceived best friend, mother, and father support compared to delinquents with lower social anxiety. There was no interaction between anxiety and delinquency in predicting perceived conflict. Conclusion: This study highlights the importance of examining the relation between social anxiety and delinquency with regards to different interpersonal outcomes.