Adjustment to hemodialysis treatment through behavioral controls

The present study was conducted to examine the hypothesis that compliant chronically ill patients, typically described as adjusted, reinforce more positive social environments using behavioral controls than noncompliant patients, typically described as maladjusted. Specifically, it is hypothesized that diet-compliant chronic hemodialysis patients emit significnatly more active involvement-in-treatment behaviors and more social behaviors than diet-noncompliant chronic hemodialysis patients. Subjects, who ranged in age from 30 to 77 years, were outpatients at a kidney center. Behavioral observations were conducted to assess the occurrence or frequency of (1) four involvement-in-treatment behaviors that are routinely taught to all patients and (2) two social behaviors, which were patient verbalizations and smiles. The results showed that compliant patients emitted significantly more involvement-in-treatment behaviors and smiles than noncompliant patients. Results support the proposed control framework that compliant, in contrast to non-compliant, chronically ill patients have recourse through positive behavioral controls when adjusting to the stresses of illness. It was proposed that through these controls, compliant patients reinforce positive environments rather than simply respond to life circumstances as given.     

Satisfaction and Stressors in a Religious Minority: A National Study of Orthodox Jewish Marriage

The paucity of mental health studies with Orthodox Jews makes culturally competent counseling care unlikely. In this large‐scale investigation of marriage among Orthodox Jews, most respondents reported satisfaction with marriage and spouse, although satisfaction was highest among recently married couples. The most significant stressors were finances, communication, physical intimacy/sexuality, time pressures, and in‐law conflicts. Counseling interventions are discussed. La escasez de estudios sobre salud mental en poblaciones de judíos ortodoxos limita la posibilidad de ofrecer un cuidado de consejería culturalmente competente. En esta investigación a gran escala sobre el matrimonio entre judíos ortodoxos, la mayoría de los participantes indicaron satisfacción con su matrimonio y esposo/a, aunque la satisfacción fue mayor entre las parejas recién casadas. Los elementos estresantes más significativos fueron las finanzas, la comunicación, el contacto íntimo/sexualidad, la falta de tiempo, y los conflictos con la familia política. Se discuten intervenciones para la consejería.     

Integrative Therapy in Cases of Pregnancy Following Infertility

This article describes, through several case studies, the use of an integrative therapeutic approach with women who achieved pregnancy after long periods of infertility. Our therapeutic approach includes both verbal and no verbal interventions (relaxation, holding, etc.,) which draws upon the therapist's maternal skills. Our approach includes a focus on both the transference and the real relation with the therapist. The therapist needs to help the patient work though the extensive range of feelings toward the fetus (anger, fear, ambivalence, etc.) that the patient developed while struggling to become pregnant.     

Decision behavior with changing signal strength

The Theory of Signal Detectability (TSD) has nearly replaced classical notions of the threshold because of its ability to separate sensory and decision processes in weak-signal detection and recognition paradigms. The primary emphasis of recent work has concentrated on the sensory rather than the decision aspects and almost all work has been exclusively at one signal strength. We propose a model to describe behavior at different signal strengths based on subjective rather than objective distributions. The model predicts performance at a constant likelihood ratio (LR) criterion (even though subjective distributions are the basis for determining cutoff criteria) unless the observer adopts a Subjective Neyman-Pearson (SNP) objective. Results from an experiment in visual discrimination suggest that some observers in fact operate at constant objective LR's as signal strength is varied randomly over a wide range. The objective LR's of the other subjects changed dramatically with signal strength, but this behavior is consistent with the use of a Subjective Neyman-Pearson (SNP) decision rule and the linear relation between subjective and objective log LR's found in the studies of subjective probability.     

The relationship between religion and cardiovascular outcomes and all-cause mortality in the women's health initiative observational study

Some studies suggest that religiosity may be related to health outcomes. The current investigation, involving 92,395 Women's Health Initiative Observational Study participants, examined the prospective association of religious affiliation, religious service attendance, and strength and comfort from religion with subsequent cardiovascular outcomes and death. Baseline characteristics and responses to religiosity questions were collected at enrollment. Women were followed for an average of 7.7 years and outcomes were judged by physician adjudicators. Cox proportional regression models were run to obtain hazard ratios (HR) of religiosity variables and coronary heart disease (CHD) and death. After controlling for demographic, socioeconomic, and prior health variables, self-report of religious affiliation, frequent religious service attendance, and religious strength and comfort were associated with reduced risk of all-cause mortality [HR for religious affiliation = 0.84; 95% confidence interval (CI): 0.75–0.93] [HR for service attendance = 0.80; CI: 0.73–0.87] [HR for strength and comfort = 0.89; CI: 0.82–0.98]. However, these religion-related variables were not associated with reduced risk of CHD morbidity and mortality. In fact, self-report of religiosity was associated with increased risk of this outcome in some models. In conclusion, although self-report measures of religiosity were not associated with reduced risk of CHD morbidity and mortality, these measures were associated with reduced risk of all-cause mortality.     

Creativity,Loss, and Character. Balakirev: The Man Who Had at One Time All of Music in His Hands,But…

For many centuries, the professional literature has discussed the complicated relationship between creativity and psychopathology. Creative people reproduce their feelings using their creative skills, and it is only natural that one's mental state may influence art. This article describes a special type of creativity that is associated with early loss and bereavement. In this form, creative work plays an important role in coping with loss, especially traumatic loss, in early development. Those who are bereaved, especially when young, may use creative work as a transitional object linking them to a deceased loved one, usually a parent or sibling. This article also describes the life, creativity, character, and illness of one of the most famous Russian musicians of the late 19th century: Miliy Balakirev. Balakirev's use of musical creativity as a method of coping with the loss and the consequent effects on his psychological state during his lifetime is apparent in his letters, friend's memories, and biographies.     

Multicultural Counseling and the Orthodox Jew

The cultural diversity literature largely ignores the effects of religion, and especially Judaism, on counseling and psychotherapy. The author reviews the meager and mostly anecdotal accounts relating to Orthodox Jews in the literature of several related disciplines, including counseling, social work, psychology, and psychiatry. The objective is to identify the barriers, institutional and personal, that must be overcome before the Orthodox Jew can receive adequate mental health care and to suggest recommendations for clinical practice.