The everyday dynamics of rumination and worry: precipitant events and affective consequences

ABSTRACT

Rumination and worry are two perseverative, negatively valenced thought processes that characterise depressive and anxiety disorders. Despite significant research interest, little is known about the everyday precipitants and consequences of rumination and worry. Using an experience sampling methodology, we examined and compared rumination and worry with respect to their relations to daily events and affective experience. Participants diagnosed with Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), co-occurring MDD–GAD, or no diagnosis carried an electronic device for one week and reported on rumination, worry, significant events, positive affect (PA), and negative affect (NA). Across the clinical groups, occurrences of everyday events predicted subsequent increases in rumination, but not worry. Further, higher momentary levels of rumination, but not worry, predicted subsequent decreases in PA and increases in NA. Thus, in these clinical groups, rumination was more susceptible to daily events and produced stronger affective changes over time. We discuss implications for theory and clinical intervention.     

Delineating paternalism in pediatric care

Theoretical Medicine and Bioethics - Paternalism in the medical care of children is appropriate and ethically justifiable. However, dilemmatic disagreement by paternalistic agents as to which...     

How We Institute Our Psychoanalytic Education: Reply to Commentaries

In reply to Altman's and Schellekes's questions and discussion, the author explores in more depth his own theoretical-technical point of view in order to clarify—chiefly in the light of a modern application of Ferenczi's and Heimann's way of thinking—the rationale for the selection of clinical facts in his paper.     

Does youth psychotherapy improve academically related outcomes? A meta-analysis

To better understand the impact of psychotherapy on youth academic performance, the authors located and examined 83 studies of youth psychotherapy that contained 102 treatment comparisons. Results revealed a d = 0.46 overall effect size, with a d = 0.50 effect size for mental health outcomes, and a d = 0.38 effect size for academically related outcomes. Academically related outcomes were further categorized into teacher-rated classroom behavior (d = 0.26), academic achievement (d = 0.36), environmentally related outcomes (d = 0.26), and self-reported academically related outcomes (d = 0.59). Each of these effect sizes differed significantly from zero, and the 4 academically related categories were homogeneous. Participant racial and ethnic diversity and age were explored as moderators. The results point to psychotherapy benefiting student academics, regardless of age. Ethnically diverse participant groups in the studies fared better academically than did nondiverse groups. Implications discussed include counseling psychologists maintaining a holistic view of youth and of working more closely with educators.     

Life satisfaction among Iranian and American graduate students

This study aimed to find out if there were differences in the life satisfaction of Iranian students (who came to the United States after the Iranian revolution in 1979) as compared with American students. It also aimed at identifying students' perceptions of some of the variables, like social network, competence and stress, that affect the quality of their lives. Ninety-four Iranian students who were attending the University of California Los Angeles, the University of Southern California, and California State University, Long Beach, during the academic year of 1986-87 participated in this study. Multivariate analysis of variance was employed to compare the scores of the two groups, Iranians and Americans, on fifteen life satisfaction subscale scores. The results indicated that for both Iranians and Americans, perceptions of life satisfaction correlated significantly with perception of competence, social network, and hopes for the future. American subjects showed more satisfaction with their competence than Iranians. The Iranians, however, reported greater availability of social network resources than Americans. The results also indicated that both groups are tolerating the stress in their lives relatively well and that both are optimistic about their futures with regard to most aspects of their lives. Implications of these findings for cross-cultural counselling and the usefulness of a multivariate concept of life satisfaction are discussed.     

Sexual assault history and use of health and mental health services

A history of sexual assault may be associated with increased current use of mental health and medical services because of the psychologically and physically disruptive consequences of assault. To test this hypothesis, we estimated rates of mental health and medical services use among 2560 randomly selected community residents, 343 of whom had been sexually assaulted. Sexual assault was associated with seeking both forms of care. Controls for demographic variables, psychiatric diagnosis, health status, and insurance suggested that assault increases use indirectly, through poor mental and physical health. Uninsured, assaulted respondents were especially likely to consult medical providers. Respondents assaulted during childhood were particularly likely to seek mental health care. Assault was more common among mental health service users than nonusers, and among women using medical services compared to female nonpatients. The high prevalence of assault among service users underscores the need for providers to recognize and treat sexual assault-related problems.     

Job-search persistence during unemployment: a 10-wave longitudinal study

Dynamic predictors of job-search intensity over time are examined in a large 10-wave longitudinal study of unemployed individuals. Two sets of variables relevant to the examination of job search from a dynamic, self-regulatory perspective--core self-evaluations (T. A. Judge, A. Erez, & J. E. Bono, 1998) and the theory of planned behavior (I. Ajzen, 1991)--were used to guide our examination. Results suggest core self-evaluation is related to average levels of job-search intensity over time. Job-search intentions mediated the relationship between subjective norms and job-search self-efficacy in the prediction of job-search intensity in the following 2 weeks. Both Time 1 and cumulative job-search intensity predict reemployment. This repeated-measures study contributes to research on job search that has been primarily cross-sectional or included few time waves.     

Depression and God: The Effects of Major Depressive Disorder on Theology and Religious Identity

Major depressive disorder (MDD) has deep roots in brain function. Recent physiological research ties brain areas involved with depression to areas that process emotions. Among the research surveyed, a link was found between the activity levels of the prefrontal cortex (PFC), the orbitofrontal cortex (OFC), and parts of the anterior cingulate cortex (ACC). These links prove to be useful in understanding how an individual might have problems processing emotional experiences. This relates directly to how a person interacts in a religious environment. Religious leaders should share the physicians’ mantra of primum non nocere, which means “first, do no harm.” Skewed views of God can emerge from "gaps in understanding" related to topics such as sin, substance abuse, divine intimacy, and end-of-life questions.