Race-Related Differences in the Experiences of Family Members of Persons with Mental Illness Participating in the NAMI Family to Family Education Program

Families play an important role in the lives of individuals with mental illness. Coping with the strain of shifting roles and multiple challenges of caregiving can have a huge impact. Limited information exists regarding race-related differences in families’ caregiving experiences, their abilities to cope with the mental illness of a loved one, or their interactions with mental health service systems. This study examined race-related differences in the experiences of adults seeking to participate in the National Alliance on Mental Illness Family-to-Family Education Program due to mental illness of a loved one. Participants were 293 White and 107 African American family members who completed measures of problem- and emotion-focused coping, knowledge about mental illness, subjective illness burden, psychological distress, and family functioning. Multiple regression analyses were used to determine race-related differences. African American caregivers reported higher levels of negative caregiving experiences, less knowledge of mental illness, and higher levels of both problem-solving coping and emotion-focused coping, than White caregivers. Mental health programs serving African American families should consider targeting specific strategies to address caregiving challenges, support their use of existing coping mechanisms and support networks, and increase their knowledge of mental illness.     

Trait anxiety and trait anger measured by ecological momentary assessment and their correspondence with traditional trait questionnaires

Ecological momentary assessments (EMA) of anxiety and anger/hostility were obtained every 25–30 min over two 24-h periods, separated by a median of 6 months, from 165 employees at a university in the Northeast. We used a multilevel trait-state-error structural equation model to estimate: (1) the proportion of variance in EMA anxiety and anger/hostility attributable to stable trait-like individual differences; (2) the correspondence between these trait-like components of EMA anxiety and anger/hostility and traditional questionnaire measures of each construct; and (3) the test–retest correlation between two 24-h averages obtained several months apart. After adjustment for measurement error, more than half the total variance in EMA reports of anxiety and anger/hostility is attributable to stable trait-like individual differences; however, the trait-like component of each construct is only modestly correlated with questionnaire measures of that construct. The 6-month “test–retest” correlations of latent variables representing the true 24-h EMA average anxiety and average anger are quite high (r ? 0.83). This study represents the longest follow-up period over which EMA-based estimates of traits have been examined. The results suggest that although the trait component (individual differences) of EMA momentary ratings of anxiety and anger is larger than the state component, traditional self-report questionnaires of trait anxiety and anger correspond only weakly with EMA-defined traits.     

Spirituality Predicts Health and Cardiovascular Responses to Stress in Young Adult Women

The primary focus of this study was to investigate the roles of spirituality and religiosity in self-reported physical health, and to determine whether there is an association between an individuals spirituality and cardiovascular responses to two stressors. Fifty-two females participated in both a betrayal interview and a structured interview, during which blood pressure and heart rate were monitored. Spirituality, as assessed by the Spiritual Well-being Scale, was associated with perceived stress, subjective well-being, and medication use. The Existential Well-being subscale predicted fewer physical health symptoms and was associated with lower mean heart rate and decreased heart rate reactivity. The Religious Well-being subscale was associated with reduced systolic blood pressure reactivity in response to the structured interview. These findings suggest that spirituality may have a salutary effect on health, even in a fairly young sample. While previous studies have predominantly reported that religion, as well as spirituality, have a health protective effect, this study did not find strong support for that conclusion. Religiosity in this age group may still be undergoing developmental maturity, which may explain the lack of relationships to health.     

Disjunctive logic programming with types and objects: The DLV system

The paper presents DLV⁺, a Disjunctive Logic Programming (DLP) system with object-oriented constructs, including classes, objects, (multiple) inheritance, and types. DLV⁺ is built on top of DLV (a state-of-the art DLP system), and provides a graphical user interface that allows one to specify, update, browse, query, and reason on knowledge bases. Two strong points of the system are the powerful type-checking mechanism and the advanced interface for visual querying.DLV⁺ is already used for the development of knowledge based applications for information extraction and text classification.     

An Enduring Somatic Threat Model of Posttraumatic Stress Disorder Due to Acute Life‐Threatening Medical Events

Posttraumatic stress disorder (PTSD) occurs in 12–25% of survivors of acute life‐threatening medical events such as heart attack, stroke, and cancer, and is associated with recurrence of cardiac events and mortality in heart attack survivors. This article reviews the current state of knowledge about PTSD after such events, and proposes an Enduring Somatic Threat (EST) model of PTSD due to acute life‐threatening medical events to address underappreciated differences between PTSD due to past, discrete/external traumatic events (such as combat) and PTSD due to acute manifestations of chronic disease that are enduring/internal in nature (such as heart attack and stroke). The differences include the external versus internal/somatic source of the threat, the past versus present/future temporal focus of threatening cognitions, the different types and consequences of avoidance behavior, and the different character and consequences of hyperarousal. Although important differences between the two types of PTSD exist, the EST model proposes that the underlying fear of mortality maintains PTSD symptoms due to both discrete/external and ongoing/somatic events. Finally, this article offers a research agenda for testing the EST model, with a particular focus on areas that may improve cardiovascular prognosis and health behaviors in survivors of heart attack and stroke.     

Understanding Psychological Safety in Health Care and Education Organizations: A Comparative Perspective

Psychological safety plays a vital role in helping people overcome barriers to learning and change in interpersonally challenging work environments. This article focuses on two such contexts—health care and education. The authors theorize differences in psychological safety based on work type, hierarchical status, and leadership effectiveness. Consistent with prior research, the authors employ cross-industry comparison to highlight distinctive features of different professions. The goal is to illuminate similarities and differences with implications for future psychological safety research. To do this, the authors review relevant literature and present analyses of large data samples in each industry to stimulate further research on psychological safety in both sectors, separately and together.     

Wisdom in clinical reasoning and medical practice

Exploring informal components of clinical reasoning, we argue that they need to be understood via the analysis of professional wisdom. Wise decisions are needed where action or insight is vital, but neither everyday nor expert knowledge provides solutions. Wisdom combines experiential, intellectual, ethical, emotional and practical capacities; we contend that it is also more strongly social than is usually appreciated. But many accounts of reasoning specifically rule out such features as irrational. Seeking to illuminate how wisdom operates, we therefore build on Aristotle’s work on informal reasoning. His account of rhetorical communication shows how non-formal components can play active parts in reasoning, retaining, or even enhancing its reasonableness. We extend this account, applying it to forms of healthcare-related reasoning which are characterised by the need for wise decision-making. We then go on to explore some of what clinical wise reasoning may mean, concluding with a case taken from psychotherapeutic practice.

Consistent occupational preferences and satisfaction,self concept,self acceptance and vocational maturity

This study explored the differences on variables of satisfaction, self-concept, self-acceptance, and vocational maturity between freshmen students who made congruent and incongruent occupational choices. The variables were operationally defined by the College Student Satisfaction Questionnaire, the Tennessee Self-Concept Scale, the Berger scales, and the Vocational Development Inventory. Congruent and incongruent current occupational choice groups were defined operationally using the Self Directed Search. The analysis of variance of the scale scores did not reveal the main effect of congruence to be significant. However, a second analysis using a more rigorous definition of congruence revealed the main effect of congruence to be significant for four satisfaction variables. Findings suggest that subjects in the congruent male group tend to report better maintenance of personal stability and greater satisfaction than subjects in the incongruent female group.     

Acoustic analysis of affective prosody during right-sided Wada Test: a within-subjects verification of the right hemisphere's role in language

A within-subjects study of the affective characteristics of voice was carried out in patients undergoing a Wada Test (WT). All patients became densely aphasic after the left-sided WT and lost the ability to impart affect into speech after the right-sided WT. The affective changes in voice induced by the Wada test were acoustically analyzed by computer-assisted techniques and compared to data obtained pre-Wada and post-Wada. The statistical results, using a one-way analysis of variance for repeated measures, confirmed robustly the current view that the right hemisphere modulates dominantly the affective components of language. The results are also evaluated in light of recent clinical and acoustical data regarding the organization of language in speakers of tone languages, thus, allowing the authors to address issues concerning universal principles of brain-language-behavioral relationships.