Co-occurrent use of cigarettes, alcohol, and coffee in healthy, community-living men and women

Previous studies have examined intra-individual aggregation in the use of cigarettes, alcohol, and coffee by examining the co-occurrent use of any pair of these three substances. A recent literature review failed to find a single investigation that studied use of all three in the same sample. In the present study, co-occurrent use of all three of these substances was examined in crossvalidated subsamples of 226 male and 245 female healthy, community-living, middle-class Americans. A log-linear analysis was used to compare the proportion of smokers, ex-smokers, and nonsmokers categorized as users of more or less amounts of coffee and alcohol. Although most of the intercorrelations were not strong, the results indicate that for both sexes, smokers and ex-smokers were more likely than nonsmokers to drink greater amounts of alcohol and coffee. Furthermore, for smokers, ex-smokers, and nonsmokers, a majority of individuals who reported drinking more alcohol also reported drinking more coffee. Interestingly, the coffee and alcohol consumption levels of ex-smokers resembled those of smokers more than those of nonsmokers. Also, ex-smokers reported drinking more wine and decaffeinated coffee than either smokers or nonsmokers. Finally, the number of cigarettes smoked per day (daily quantity) was positively related to total alcohol and coffee consumption in men, but not in women. Further studies are recommended to examine the role of individual differences in the development, maintenance, and modification of these three appetitive habits and their co-occurrence.     

New directions for the education of clinical psychologists: The primary care setting,the VA's PRIME program,and the in-depth generalist model

As part of this special issue on psychology in primary care settings, we describe the Department of Veterans Affairs' (VA's) new approach to education for practice in the primary care setting and we concurrently address some general issues related to the education of clinical psychologists for practice in this setting. In this article we argue that the primary care psychologist, in parallel with the generalist in medicine, must have a strong generic background in clinical psychology in order to gain the broad range of clinical skills necessary to function effectively as an in-depth generalist (IDG) who is capable of addressing the variety of psychological issues that emerge in the primary care setting. The IDG model of professional practice, which we believe is best suited for primary care/managed care settings, requires extensive training in generic clinical skills and increased time devoted to its implementation at both the predoctoral and the postdoctoral levels.     

Pedagogy for Inter‐Religious Education

Inter‐religious education has become a major concern as globalization proceeds. To develop a satisfactory model for it remains a challenge. This article proposes a paradigm based on the notion of self‐transcendence as articulated by the philosopher‐theologian, Bernard Lonergan. The approach provides a standpoint where the learner achieves a level of freedom by which he/she is enabled to decide responsibly what religious or non‐religious viewpoint to adopt.     

Type A behavior, attentional style, and symptom reporting among adult men and women

Type A behavior and its components (measured on the JAS) were examined in relation to attentional style and symptom reporting in 294 healthy adult men and women. The results showed that for both men and women the JAS Type A, Job Involvement, and Hard Driving factors were all associated with self-reported attentional effectiveness as measured by the Nideffer Test of Attentional and Interpersonal Style. However, a fourth JAS factor, Speed and Impatience, was associated with Nideffer measures of cognitive overload. For both men and women, the Type A, Speed and Impatience, and Hard Driving factors were all positively associated with the number of medical and psychological symptoms reported on the Cornell Medical Index. In addition, acute psychological distress (Hopkins SCL-90R) was associated with Type A behavior for men and with Speed and Impatience for both sexes. Attention differences did not account for the observed positive relationships between Type A factors and symptom reporting with one exception; attentional overload (internal) appeared to partially explain the relationships between symptom reporting and Speed and Impatience in women. In summary, Type As described themselves as having a broader attentional focus and reported more naturally occurring physical and psychological symptoms than did Type Bs.     

Zambia: multi‐faith religious education?

As countries’ populations become more religiously diverse, a need to review the religious education syllabus that operates is often perceived. One such country is Zambia, which was not only traditionally religiously diverse but has become even more so with the advent of Christianity, Islam and Hinduism and other non‐African faiths. This article therefore explores the feasibility of adopting a multi‐faith approach to religious education in Zambia in the light of such increasing religious diversity. In doing so, special reference is made to parallels with what is happening elsewhere, especially in England, for the Zambian religious education situation had a somewhat similar shape as that of England. Among the issues which this paper raises are: what kind of multi‐faith religious education, that preserves its integrity, is likely to enhance social harmony in Zambia, as well as, how might such a religious education be effectively introduced and implemented?     

Adapting Mindfulness-based Stress Reduction for the Treatment of Obsessive-compulsive Disorder: A Case Report

Obsessive-compulsive disorder (OCD) is an illness characterized by intrusive and distressing thoughts, images, or impulses (i.e., obsessions) and by repetitive mental or behavioral acts (i.e., compulsions) performed to prevent or reduce distress. Efficacious treatments for OCD include psychotropic medications and exposure and response prevention (EX/RP). The following case report presents an individual diagnosed with OCD who refused treatment with medication or EX/RP and was treated using an adapted Mindfulness-Based Stress Reduction (MBSR) program. After an 8-week adapted MBSR program, the endpoint evaluation revealed clinically significant reductions in symptoms of OCD as well as an increased capacity to evoke a state of mindfulness. Discussion includes generalizability of these findings, potential mechanisms of action, and the role of an adapted MBSR in the treatment of OCD.     

Do Geographic Regions with Higher Suicide Rates also have Higher Rates of Nonfatal Intentional Self‐Harm?

Fatal and nonfatal intentional self‐harm events in eight U.S. states were compared using emergency department, hospital, and vital statistics data. Nonfatal event rates increased by an estimated 24.20% over 6 years. Case fatality ratios varied widely, but two northeastern states' total event rates (fatal plus nonfatal) were very high (New Hampshire 206.5/100,000 person years; Massachusetts 166.7/100,000). Geographic context did not uniformly impact the likelihood of self‐harm across event types. The state‐level public health burden posed by such acts cannot, therefore, be accurately estimated from either mortality or morbidity data alone.