Medical hermeneutics: Where is the “text” we are interpreting?

The present paper is a commentary on an article by Drew Leder [1]. Leder identifies a series of texts in the clinical encounter, emphasizes the central role of interpretation in making sense of each of these texts, and articulates ordering principles to guide the interpretive work.The metaphor of clinical work as textual explication, however, creates the expectation that there is a text somewhere to be found. Such an expectation invites doctors and patients to search for the text and runs the risk of conceptualizing patients as more static than they are. If one is to use the textual metaphor, one must appreciate the radical extent to which the clinical encounter is a mutually produced and shifting entity. The qualities of mutuality and indeterminacy are not those one usually associates with texts. One might ultimately be better served by a different metaphor based more directly on uncertainty.     

Medicine as business and profession

This paper analyzes one dimension of the frequently alleged contradiction between treating medicine as a business and as a profession, namely the incompatibility between viewing the physician patient relationship in economic and moral terms. The paper explores the utilitarian foundations of economics and the deontological foundations of professional medical ethics as one source for the business/medicine conflict that influences beliefs about the proper understanding of the therapeutic relationship. It, then, focuses on the contrast and distinction between medicine as business and profession by critically analyzing the classic economic view of the moral status of medicine articulated by Kenneth Arrow. The paper concludes with a discussion of some advantages associated with regarding medicine as a business.     

Measuring the impact of informal caring

A factor-analysis of caregiving impact appraisals amongst a community-derived sample of informal carers of elderly people revealed two negative (care work strain and relationship dissatisfaction) and two positive (care work satisfaction and care lifestyle satisfaction) scales. Validity was assessed by means of concurrent correlations with levels of assistance with daily living tasks provided by carers and levels of behaviour problems exhibited by elderly dependents. Criterion validity was considered in relation to two important carer outcomes; willingness to care and a standardized measure of strain. Each of the four scales was significantly associated with concurrently assessed willingness to care. Care work strain and relationship dissatisfaction were associated with concurrently measured strain symptomology. Evidence of 6-month predictive validity was obtained for the care work strain scale.     

Lesbian,gay, and bisexual youth in community settings: Personal challenges and mental health problems

Studied 194 lesbian, gay, and bisexual youth aged 21 and younger who attended programs in 14 community centers to determine the personal challenges they face due to their sexual orientation and their responses to these stresses. First awareness of sexual orientation typically occurred at age 10, but disclosure to another person did not occur until about age 16. There was much variability in sexual behavior, and many youths reported both same-sex and opposite-sex sexual experiences. Although most had told at least one family member about their sexual orientation, there remained much concern about family reactions. Suicide attempts were acknowledged by 42% of the sample. Attempters significantly differed from nonattempters on several milestones of sexual orientation development, social aspects of sexual orientation, parents' knowledge of sexual orientation, and mental health problems. The following organizations participated in this project and are thanked for their assistance: Affirmations (Detroit), the Atlanta Gay Center, Baltimore Gay and Lesbian Community Center, Boston Alliance of Gay and Lesbian Youth, Gay Alternative Youth (Pittsburgh), the Gay and Lesbian Youth Association of Dallas, Gay Youth Alliance — San Diego, the Gay and Lesbian Community Services Center of Los Angeles, Horizons Community Services (Chicago), the Indianapolis Youth Group, the Lesbian and Gay Community Services Center of Cleveland, Lavender Youth Recreation and Information Center (San Francisco), Outright (Denver), and Sexual Minority Youth Assistance League (Washington, DC). The following individuals associated with these groups are gratefully thanked for their help: Danny Barutta, Adriene Corbin, Tom Eversole, Chris Gonzalez, Bill Gripp, Rory Lopez, Phil Rector, Jamie Schield, Cheryl Schwartz, Jan Stephenson, Sterling Stowell, Amy Vitro, and Aubrey Wertheim. Gene Thomas is thanked for helping with data collection, as are Michael LaFlam, Patrick McNamara, and Mark Shiner, who processed the surveys. We also thank Rainer Silbereisen for his comments. This project was supported by funds from the Center for the Study of Child and Adolescent Development of the College of Health and Human Development at Pennsylvania State University.     

Relationship Satisfaction: Impact and Consequences for Women's Emotional Health and Treatment

This study uses feminist theory to examine the variables of relationship length and relationship satisfaction as predicators of both self-esteem and emotional functioning for women. Using a national sample of data gathered from 1,257 female survey respondents this study found significant relationships between emotional functioning, self-esteem, and self-reported relationship satisfaction which was supported by regression testing and path analysis. In addition, a significant negative relationship was noted between a woman's self-esteem and her with-holding of verbalized displeasure or disagreement with her partner. Implications for women in therapy were discussed.     

Self-concept of African-American male youth: Self-esteem and ethnic identity

The role of perceived efficacy, parent support, and community involvement in the self-esteem and ethnic identity of 68 African-American male youth were investigated in this research. The results provided support for the distinctiveness of ethnic identity and self-esteem. A sense of mastery was positively associated with both self-esteem and ethnic identity. Parent support was associated with self-esteem, while community involvement and an appreciation of African-American heritage were positively related to ethnic identity. Implications for future research and the evaluation of prevention and support programs for youth are discussed.     

小学儿童对虚假话语间接意义的理解

探讨了小学儿童对隐含在虚假话语中间接意义的理解特点。结果发现：（１）一年级儿童不能理解虚假话语的非字面意义,三年级儿童才基本上能够理解。（２）小学低年级儿童不能理解虚假话语的间接意义的主要原因是他们不能根据话语与事实不符和说话者知道事实真相来判断说话者说虚假话语的有意性和推论隐含的意义。部分原因可能在于他们没有意识到说话者了解事实真相,因而不知道说话者是故意使用虚假话语的。     

The relationship between qualitative and quantitative research: Lessons from feminist psychology

The dominant methodological approach in psychological research has involved the use of quantitative methods within a positivist framework. In this article we argue that both qualitative and quantitative methods have their strengths and limitations, depending on the research question under investigation. We examine some of the advantages of qualitative methods, paying particular attention to the value of such methods for feminist researchers. We challenge the positivist assumption that all research should be apolitical and value-free, arguing that the political context in which all research studies take place plays an important role in decisions about the appropriate research methods to use. Despite the value attached to qualitative methods by feminist researchers, there may be projects for which quantitative methods, or a combination of qualitative and quantitative techniques, are more suitable. We draw on examples from our research on the transition from school to the job market for young people, and a study of 16- to 19-year-old first time mothers to illustrate these points, examining the practical implications of our arguments for applied social psychology research.     

Cultural specificity of support sources,correlates and contexts: Three studies of African-American and Caucasian youth

Levels and correlates of parental support, peer support, partner support, and/or spiritual support among African American and Caucasian youth were examined in three contexts: adolescent pregnancy (Study 1), first year of college (Study 2), and adolescence and young adulthood (ages 15–29; Study 3). Partially consistent with a cultural specificity perspective, in different contexts different support sources were higher in level and/or more strongly related to adjustment for one ethnic group than the other. Among pregnant adolescents, levels of spiritual support were higher for African Americans than Caucasians; additionally, peer support was positively related to well-being only for African Americans whereas partner support was positively related to well-being only for Caucasians. Among college freshmen, family support was more strongly related to institutional and goal commitment for African Americans than Caucasians; conversely, peer support was more strongly related to institutional and goal commitment among Caucasians. Among 15 to 29-year-olds, levels of parental support and spiritual support were higher among African Americans than Caucasians; additionally, spiritual support was positively related to self-esteem for African Americans but not for Caucasians. Implications and limitations of the research are discussed. The third study was supported by National Institute of Mental Health Grant RO1 MH40963. We thank Monica Greene, Shea Lyda, Wendy Stevenson, and the many undergraduate students who contributed to the three research projects. We also acknowledge the very thoughtful and helpful comments of the anonymous reviewers and the editor, Edison Trickett.     

人际关系适应特征的情境评价方法研究

本研究运用情境评价法对人际关系适应特征进行了实验研究 ,结果表明 :1以 Schutz提出的人际关系六因素为评价标准 ,采用情境评价法比问卷形式能更有效地揭示人际适应特征 ;2在情境评价中 ,以合作为主的情境设置比以竞争为主的情境设置更利于反映出人际适应特征 ;3情境评价采用定向、组织、交流和问题解决等阶段的过程设计符合情境评价的实际进程 ,有助于分阶段展开被试的行为特征 ,提高情境评价的可控性和准确性。