Spiritual Development in the Fourth Quarter of Life

SUMMARY

Spirit, the activating or essential principle influencing a person, and body interpenetrate each other but do not dominate each other in predictable ways. Normal aging is neither a failure of the human spirit nor a failure in the body's Biology. The spirit becomes more apparent as a result of spiritual development.

The fourth quarter of life covers age 75 to 100 years. Prior to age 75, the human spirit undergoes significant developmental events: a crisis of meaning which may result in conversion or more commonly stripping or shedding; transitions, including loss of clearly defined roles and loss of the sense that the individual's life makes a difference.

One motif applied by our culture to old age is the “iconic illusion”; however, it is evident that in some respects this motif has limited application to the fourth quarter of life. “Meaning making” is, in fact, enhanced in the fourth quarter of life, given reasonable levels of cognitive health. The desire and ability to make sense out of existence, to draw together an understanding of a meaningful life trajectory, is best done in the fourth quarter of life. The dominant sense of time in the fourth quarter of life particularly facilitates spiritual development.     

The Effects On and Of Depression - An Exploratory Study of Rehabilitation and Secondary Prevention in Coronary Artery Disease

Forty consecutive participants in a comprehensive, behaviourally oriented coronary rehabilitation and secondary prevention program were followed for three years. Changes in depression (as measured with the Beck Depression Inventory) as well as the influence of baseline levels of depression on achieved changes in lifestyle behaviour and on rehabilitation and secondary prevention effects were analyzed. Subjects with moderate levels of baseline depression experienced short-term reductions of depression, which was maintained at the 12-month follow-up. Clinically depressed subjects experienced less positive results, with smaller immediate reductions as well as relapse to baseline levels after 12 months, specifically in non-physical, cognitive-affective depression symptoms. There were, however, no differences in lifestyle changes or in hospital treatment between groups with different pre-treatment depression levels. These results are discussed in relation to earlier research on the detrimental effects of depression on the prognosis of coronary artery disease.     

Intraclass Correlation Associated with Therapists: Estimates and Applications in Planning Psychotherapy Research

It is essential that outcome research permit clear conclusions to be drawn about the efficacy of interventions. The common practice of nesting therapists within conditions can pose important methodological challenges that affect interpretation, particularly if the study is not powered to account for the nested design. An obstacle to the optimal design of these studies is the lack of data about the intraclass correlation coefficient (ICC), which measures the statistical dependencies introduced by nesting. To begin the development of a public database of ICC estimates, the authors investigated ICCs for a variety outcomes reported in 20 psychotherapy outcome studies. The magnitude of the 495 ICC estimates varied widely across measures and studies. The authors provide recommendations regarding how to select and aggregate ICC estimates for power calculations and show how researchers can use ICC estimates to choose the number of patients and therapists that will optimize power. Attention to these recommendations will strengthen the validity of inferences drawn from psychotherapy studies that nest therapists within conditions.     

Therapist Awareness of Client Resistance in Cognitive-Behavioral Therapy for Generalized Anxiety Disorder

Clients' resistance relates negatively to their retention and outcomes in psychotherapy; thus, it has been increasingly identified as a key process marker in both research and practice. This study compared therapists' postsession ratings of resistance with those of trained observers in the context of 40 therapist–client dyads receiving 15 sessions of cognitive-behavioral therapy for generalized anxiety disorder. Therapist and observer ratings were then examined as correlates of proximal (therapeutic alliance quality and homework compliance) and distal (posttreatment worry severity) outcomes. Although there was reasonable concordance between rater perspectives, observer ratings were highly and consistently related to both proximal and distal outcomes, while therapist ratings were not. These findings underscore the need to enhance therapists' proficiency in identifying important and often covert in-session clinical phenomena such as the cues reflecting resistance and noncollaboration.     

Intolerance of Uncertainty Mediates the Relation Between Generalized Anxiety Disorder Symptoms and Anger

Previous research has shown that individuals with generalized anxiety disorder (GAD) report elevated anger compared with nonanxious individuals; however, the pathways linking GAD and anger are currently unknown. We hypothesized that negative beliefs about uncertainty, negative beliefs about worry and perfectionism dimensions mediate the relationship between GAD symptoms and anger variables. We employed multiple mediation with bootstrapping on cross-sectional data from a student sample (N = 233) to test four models assessing potential mediators of the association of GAD symptoms to inward anger expression, outward anger expression, trait anger and hostility, respectively. The belief that uncertainty has negative personal and behavioural implications uniquely mediated the association of GAD symptoms to inward anger expression (confidence interval [CI] = .0034, .1845, P_M = .5444), and the belief that uncertainty is unfair and spoils everything uniquely mediated the association of GAD symptoms to outward anger expression (CI = .0052, .1936, P_M = .4861) and hostility (CI = .0269, .2427, P_M = .3487). Neither negative beliefs about worry nor perfectionism dimensions uniquely mediated the relation of GAD symptoms to anger constructs. We conclude that intolerance of uncertainty may help to explain the positive connection between GAD symptoms and anger, and these findings give impetus to future longitudinal investigations of the role of anger in GAD.     

具有类属知识性的思维:群体区别判断过程中的复杂性、有效性、有用性和实质性

类属性思维(stereotypes)在一定的程度上是对群体区别正确反映的类属信仰.类属性思维比我们一般假想的更为复杂.首先,我们在本论文中探讨了在立体性的类属性思维EPA理论框架之下的多维度,即类属性思维的三维度:评估、激活和准确度.同时还特别讨论了类属性思维与具体集体共识的表征特点的图腾信仰之间的密切关系.其次,对于作为人类信仰一部分的类属性思维准确性莫衷一是的研究,我们进行了全面综述,并且本文还仔细考查文化类属性思维,个体类属性思维,个体与群体的判断,准确性评判的标准,和原分析的数据等等,同时进一步表明类属性思维和客观现实性有密不可分的关系.最后,我们指出类属性思维对解释群体和民族的区别非常重要,特别是人的感知的实质性寓于实在的客观群体本身(“感知的同一性”).我们认为,类属性思维的过程,对于高度的实体性和感知的实质性的群体来说,具有深刻影响,况且群体或部落(民族)的图腾也是其群体或民族的实体性的外在表现.尽管我们不可能解决同类属性思维的过程有关的所有争论,但我们所强调的观点是:类属性思维是人类相互影响和生存的有效类属性识别.     

The Impact of Childhood Physical Abuse and Age of Sexual Initiation on Women's Maladaptive Posttraumatic Cognitions

Child abuse survivors often exhibit long-standing maladaptive beliefs. Sexual risk-taking could contribute to the maintenance of such beliefs by reinforcing cognitions that originally resulted from child abuse. In this study, 64 community women, most with elevated posttraumatic stress disorder symptoms, completed measures of childhood abuse, sexual risk-taking, and posttraumatic cognitions. Age of first consensual sexual intercourse mediated the relationship between childhood physical abuse and maladaptive posttraumatic cognitions in adulthood. Thus, age of sexual intercourse initiation might play an important role in women's recovery from childhood physical abuse. Clinicians should consider the possible impact of women's sexual history when challenging their cognitions during trauma-based cognitive behavioral therapy. Further, decreasing risky sexual behavior might partially protect against the negative effects of trauma.     

Associations of general religiousness and specific religious beliefs with coping appraisals in response to Hurricanes Katrina and Rita

An emerging scientific literature is investigating the construct of “compassionate love,” love that is “centered on the good of the other,” a construct empirically linked to physical and mental health. We evaluated effects of an 8-week, 16-hour programme for physicians, nurses, chaplains, and other health professionals, using nonsectarian, spiritually based, self-management tools. Participants were randomised to intervention (n = 30) or wait-list (n = 31). Pretest, post-test, 8- and 19-week follow-up data were gathered on six measures of prosocial qualities. Favorable treatment effects (p<0.05) were found for compassionate love (d = 0.49), altruistic actions (d = 0.33), perspective-taking (d = 0.42), and forgiveness (d = 0.61). Treatment adherence fully mediated effects on compassionate love. Furthermore, stress reduction mediated treatment effects on compassionate love, perspective-taking, and forgiveness; each also mediated gains in caregiving self-efficacy. This encouraging evidence suggests that nonlaboratory psychospiritual interventions can boost compassionate love to benefit the recipients and the larger society.     

Religious upbringing and current religiosity in Spanish nursing and medicine students

The influence of religious education in the family upon current spiritual and religious tendencies was assessed in a sample of 599 Spanish nurse and medicine students using a religiosity scale and answers to a series of belief/disbelief statements. Results showed that nursing and medicine students were equally low-religious, with no differences in religiosity total scores between participants coming from religious families; however, medical students coming from nonreligious families showed higher religiousness than the corresponding nursing trainees. This distinction appeared both across religiosity items and in a variety of responses to belief/disbelief of Christian/secular assertions. Regression analysis showed that religious family background was a consistent predictor of religious beliefs at young adulthood, and its influence was higher for medical students. In addition to establish religious upbringing as an important factor modulating enduring religiosity, these findings provide distinctions between nurse and medical trainees, and reproduce, in a Spanish mainly catholic sample, the structure of religiosity factors previously found on North American mainline protestants.     

Hispanic use of juramentos and Roman Catholic Priests as auxiliaries to abstaining from alcohol use/misuse

This self-administered mail survey study conducted along the US–Mexico border replicates and expands on research conducted in Florida regarding the prevalence of juramento use as an intervention technique for alcohol misuse. Juramentos are pledges to abstain from alcohol use for a time determined by the user. The pledge is usually to the Virgin of Guadalupe and is often done in the presence of a Roman Catholic Priest. As in Florida, the majority of Priests along the border reported they were familiar with the practice of juramentos and had already witnessed at least one. The majority of Priests who had done juramentos viewed them as effective. Since the vast majority of Priests indicated that they would begin or continue witnessing juramentos, this makes juramentos and Roman Catholic Priests a viable culturally sensitive aide for treatment among Hispanics, in particular those of Mexican descent.