A perceived control intervention for at-risk older adults

Models of event causation and affective processes were used to design an experimental intervention for older adults. Ss were 2 at-risk populations, recently disabled and recently bereaved, each with matched nonrisk controls. Ss were randomly assigned to a placebo-contact group, a no-contact control group, or a 4-session, 10-week intervention focused on enhancing perceived control. Dependent variables assessed were personal mastery, psychological well-being and distress, positive and negative affect, and measures of daily events and activities. The intervention was nested within a 16-month longitudinal assessment of stress and adaptation processes in a large sample of community residents. The intervention had mixed effects on reports of personal mastery, but it significantly increased engagement in desirable activities and significantly decreased psychological distress and negative affect. Effects tended to be short-lived, however. Effects of the intervention tended to be particularly significant for the disabled group.     

THE DOCTRINE OF THE TRINITY AS A MODEL FOR STRUCTURING THE RELATIONS BETWEEN SCIENCE AND THEOLOGY

Abstract. A strategy for deeding systematically with such complex relationships as those between science and theology is presented after a brief overview of the historical record and illustrated in terms of the concept of divinity. The application of that strategy to the title relationships yields a multilogical/multilevel solution which presents certain analogies to or isomorphisms with the doctrine of the Trinity. These concern mainly the multilogical/multilevel character of both conceptualizations and the relational and contextual reasoning required to conceive them. Furthermore, certain characteristics of the doctrine facilitate the dialogue between theologians and scientists on account of their similarity with such scientific concepts as diversity in unity, multiplicity of relationships, nonseparability, and nonclassical logic.     

The Diagnostic Interview Schedule for Children (PC-DISC v.3.0): Parents and Adolescents Suggest Reasons for Expecting Discrepant Answers

To identify reasons for discrepancies between parent and child reports of child/adolescents's psychiatric symptoms, parents and adolescents (51 pairs) were asked to guess what the other would answer to questions from the PC-DISC about the adolescent's psychiatric symptoms, and to explain why they expected disagreement when the answer they provided for the other was different from their own. Adolescents' explanations for expecting (1) parental denial of symptoms the adolescent reported were: the parent was unaware of, forgot about, assumed the adolescent could not have, or trivialized the symptom; and (2) parental report of symptoms the adolescent denied were: the parent misread or exaggerated the adolescent's symptom, had too high expectations for the adolescent's behavior, put a negative label on or did not trust the adolescent. Parents' reasons for expecting their children to (1) deny symptoms the parents reported were: the adolescent did not remember how s/he felt, lied, did not recognize or minimized the importance or frequency of the symptom; and (2) report symptoms the parents denied were: the adolescent lied, exaggerated the importance of or interpreted the symptom differently.Support for this work was provided by National Institute of Drug Abuse grant number DA-05585 (Dr. Cottler, P.I.), and National Institute of Mental Health grants numbers MH-31302 (Dr. R. C. Cloninger, P.I.) and MH-17104 (Dr. Cottler, P.I.).Address all correspondence, including reprint requests, to Michelle Bidaut-Russell, Ph.D, MPH, MPE, Department of Psychiatry, Box 8134, Washington University School of Medicine, 4940 Children's Place, St. Louis, Missouri 63110.     

The word "bioethics": its birth and the legacies of those who shaped it

Extensive historical sleuthing reveals that the word "bioethics" and the field of study it names experienced, in 1970/1971, a "bilocated birth" in Madison, Wisconsin, and in Washington, D.C. Van Rensselaer Potter, at the University of Wisconsin first coined the term; and André Hellegers, at Georgetown University, at the very least, latched onto the already-existing word "bioethics" and first used it in an institutional way to designate the focused area of inquiry that became an academic field of learning and a movement regarding public policy and the life sciences. A further comparison of the Potter and the Hellegers/Georgetown understandings of bioethics and the relative acceptance of the two views will appear in the March 1995 issue of this journal.     

Predicting the Everyday Life Events of Older Adults

Predicting the everyday life events of people is a relatively unexplored topic, although several major theoretical approaches deal with related issues. The dispositional approach would assign a causal role to personality, while the situational approach would locate causation in the person's environment. Variations on these two extreme themes invoke an interactionist interpretation. Beyond this, a genuinely transactional approach focuses on the enduring person-environment relationship established as people deal with major and everyday life events. This study investigated a wide range of predictors of daily positive, negative, and ill-health events over time in a sample of 206 older adults. Results showed that personality variables played only a minor role in predicting daily events, although an interaction between extraversion and social network size was significant. Background demographic variables and the major stressors of recent conjugal bereavement and physical disability played a role in daily event occurrences. Overall, the strongest degree of predictability of events came from the events themselves: The high degree of event stability over time indicated the value of a genuinely transactional model in understanding the occurrence of everyday events.     

Development of a structured psychiatric interview for children: Agreement between child and parent on individual symptoms

To test the reliability of children's reporting as compared with that of their mothers, a highly structured psychiatric diagnostic interview was used with 307 subjects, ages 6 through 16. Another interviewer gave each mother a similar interview about the child. Responses of each mother-child pair to 168 questions were compared using the kappa statistic. Highest agreement was found on questions concerning symptoms that are concrete, observable, severe, and unambiguous. Mothers tended to report significantly more behavioral symptoms, and children more subjective symptoms. Reasons for low kappas and asymmetrical reporting of symptoms are discussed.     

An examination of the effectiveness of multiple summary scoring procedures of the BNBAS in detecting group differences

The Brazelton Neonatal Behavioral Assessment Scale is the most widely used and accepted tool in the study of the behavior of the human newborn; yet there remains some controversy over the most appropriate way to score the results. The present research compares three a priori methods of scoring. The sample consisted of 43 infants: (a) 11 preterms, (b) 10 fullterms in intensive care, (c) 7 fullterms with sick mothers, and (d) 15 healthy fullterms. BNBAS exams administered to these four groups of infants were scored using the Als (1978), Lester, Als, and Brazelton (1982), and Jacobsen, Fein, Jacobsen, and Schwartz (1984) clusters. The data from these three methods were analyzed by means of one-way ANOVAs for group differences. In addition, a factor analysis on the BNBAS scores was also completed. These three approaches all detected differences between medically at-risk and healthy infants on those items assessing motor maturity and orientation. These results suggest that at this time no one scoring system can capture the richness of behavior of the newborn and address the question by researchers, clinicians, and parents.     

Arousal and the Relationship Between Positive and Negative Affect: An Analysis of the Data of Ito,Cacioppo, and Lang (1998)

Research on positive and negative emotional states has supported several models of how those states relate to each other. Many studies suggest that they are independent, the bivariate view, while others suggest that they are inversely correlated, the bipolar view. Other research has shown that stress is a major moderator of the relationship; the affects become coupled under conditions of high stress, a contextual model, but are relatively independent otherwise. To expand the range of tests of this dynamic model of affect, we reanalyzed a data set initially reported by Ito, Cacioppo, and Lang (1998) on affect-eliciting picture stimuli. In that study, arousal was assessed separately from positive and negative affect, allowing investigation of a source of interaffect relationships different from stress, per se. Arousal interacted with positive and negative affect, showing both bivariate and bipolar relationships, and effects similar to stress. Affective reactions to the stimuli became more inversely correlated when the affects were high and interacting with higher arousal. The data supported the dynamic model of affect and suggest the need for further analyses of the linkages between stress, arousal, and reduced levels of emotional complexity.     

Biparental failure in the childhood experiences of borderline patients

The purpose of this study was to assess the role of biparental abuse and neglect in the development of borderline personality disorder (BPD). A semistructured research interview was used to blindly assess the childhood experiences of biparental abuse and neglect reported by 358 borderline inpatients and 109 axis II controls. Eighty-four percent of borderline patients reported having experienced some type of biparental abuse or neglect before the age of 18; 55% reported a childhood history of biparental abuse; 77% reported a childhood history of biparental neglect. These experiences were also reported by a substantial percentage of Axis II controls (biparental abuse or neglect [61%], biparental abuse [31%], and biparental neglect [55%]). However, borderline patients were significantly more likely than axis II controls to report having been verbally, emotionally, and physically but not sexually abused by caretakers of both sexes. They were also significantly more likely than controls to report having caretakers of both sexes deny the validity of their thoughts and feelings, fail to provide them with needed protection, neglect their physical care, withdraw from them emotionally, and treat them inconsistently. It was also found that female borderlines who reported a previous history of neglect by a female caretaker and abuse by a male caretaker were at significantly higher risk for having been sexually abused by a noncaretaker. Taken together, the results of this study suggest that biparental failure may be a significant factor in the etiology of BPD. They also suggest that biparental failure may significantly increase a preborderline girl's risk of being sexually abused by someone other than her parents.