The association between adolescents' attitudes toward suicide and their psychosocial background and suicidal tendencies.

The present study examined the relationship between adolescents' attitudes toward suicide and their psychosocial background. It also evaluated the association between attitudes toward suicide and the subjects' own suicidal tendencies. A questionnaire assessing these issues was administered to 525 Israeli adolescents. Results indicated that significantly more females, nonreligious adolescents, those exposed to suicidal behavior, and those with increased suicidal risk held more accepting attitudes. Ethnic origin, socioeconomic status, and living in intact/nonintact families were not associated with adolescents' attitudes toward suicide.     

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.     

Pharmacotherapy of paraphilias in the next millennium

Paraphilias are psychiatric disorders of abnormal sexual behavior whose prevalence has markedly increased during the last decade. Treatment modalities currently used fall into three categories: surgical castration, psychotherapy, and pharmacotherapy. The pharmacological interventions consist of antiandrogens that either completely reduce testosterone secretion and/or antagonize the action of testosterone at the level of the receptor, and psychotropic drugs, namely antidepressants. Cyproterone and medroxyprogesterone acetates are the two antiandrogens more commonly used. They are only effective in relatively high doses, but have a substantial number of severe side effects which has considerably limited their use. Psychotropic drugs may be effective solely in men with a definite obsessive-compulsive disorder component. Because of the erratic results and lack of permanent eradication of the paraphilic manifestations their use in paraphilias is highly controversial. Long-acting gonadotropin-releasing hormone (GnRH) agonist analogues are the most potent antiandrogens, and selectively abolish testosterone secretion in a totally reversible fashion. They are administered parenterally once every 1 to 3 months, and have the fewest side effects. Long-acting GnRH analogues, together with psychotherapy, are highly effective in controlling selected paraphilias (pedophilia, exhibitionism, and voyeurism), and are the most promising mode of therapy in the next millennium. There is an urgent need for good methodological research; carefully designed double-blind controlled studies with a large number of subjects in order to validate or not the use of the various pharmacotherapies.     

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.