Inhibition of the LH Surge by Restraint Stress in Cyclic Rats: Studies on the Role of GABAA and GABAB Receptors

There is evidence that stress can alter the activity in the brain of gamma-aminobutyricacid (GABA), a neurotransmitter that has been implicated in the regulation of LH secretion. In the present study the role of GABA in the restraint stress-induced inhibition of the LH surge was investigated in the intact cyclic rat. Intracerebroventricular (icv) administration of the GABAA receptor agonist muscimol (0.1, 0.5 or 1 μg) 5 min before the presumed onset of the pro-oestrous LH surge (at 0900 h) caused a dose dependent suppression of the surge. A single dose of the GABAB receptor agonist baclofen (1 μg; icv) injected at 0855 h postponed the onset of the LH surge, and repeated injections at 0855 and 1130 h suppressed the surge. These data indicate that GABA-ergic activity in the brain can inhibit the LH surge in the cyclic rat via GABAA and GABAB receptors. Pro-oestrous rats were subjected to 5 hrs of restraint starting at 0855 h. Pretreatment with the GABAA receptor antagonist bicuculine (1 μg; icv) at 0840, 0940 and 1040 h or pretreatment with the GABAB receptor antagonist phaclofen (10 μg; icv) at 0840 h were ineffective in preventing the restraint-induced inhibition of the LH surge. The results suggest that GABAA and GABAB receptors are not involved in the inhibitory effect of restraint stress on the LH surge.     

Community Gender Norms Change as a Part of a Multilevel Approach to Sexual Health Among Married Women in Mumbai,India

Inequitable gender norms in societies and communities negatively contribute to women’s sexual and reproductive health. While the need for change in gender norms is well recognized, the task is highly challenging in terms of intervention design, implementation and assessment of impact. This paper describes a methodology for identification of gender norms, the design of community level intervention, community participation and the assessment of intervention impact in a low income, predominately Muslim community of 600,000 people in Mumbai, India. Formative research focused on in‐depth interviews with women, men and couples yielding gender normative statements and assessment of community resources to facilitate change. A Gender Equity Scale (GES) based on this formative research was developed and administered annually for a three‐year period to random, cross‐sectional samples in the intervention and control communities, and to community based, non‐governmental organizations (NGO) staff and Imams (religious leaders) in the intervention community. NGO staff disseminated gender oriented messages to their female constituency through their regular outreach activities and through special events and festivals in the community. Imams disseminated gender messages through lectures on social issues for men attending Friday prayers. The results showed that the NGO staff and Imams, assumed more gender equitable attitudes across time. The intervention was associated with a significant improvement in attitudes towards gender equity in the intervention relative to the control community. Men showed a dramatic change in more positive gender attitudes, while women lagged behind in their GES scores. The meaning of these results are explored and the implications assessed for the generalizability of the methodology for other countries, cultures and communities.     

Introduction to Multi-Level Community Based Culturally Situated Interventions

This introduction to a special issue of the American Journal of Community Psychiatry is the result of a symposium at the Annual Meeting of the Society for Applied Anthropology, 2006, that brought together anthropologists and psychologists involved in community based collaborative intervention studies to examine critically the assumptions, processes and results of their multilevel interventions in local communities with local partners. The papers were an effort to examine context by offering a theoretical framework for the concept of “level” in intervention science, and advocating for “multi‐level” approaches to social/behavioral change. They presented examples of ways in which interventions targeted social “levels” either simultaneously or sequentially by working together with communities across levels, and drawing on and co‐constructing elements of local culture as components of the intervention. The papers raised a number of important issues, for example: (1) How are levels defined and how should collaborators be chosen; (2) does it matter at which level multilevel interventions begin; (3) do multilevel interventions have a greater effect on desired outcomes than level‐specific interventions; (4) are multilevel interventions more sustainable; (5) are multilevel interventions cost effective to run, and evaluate; (6) how can theories of intervention be generated and adapted to each level of a multilevel intervention; (7) how should intervention activities at each level coordinate to facilitate community resident or target population empowerment? Many of these questions were only partially addressed in the papers presented at that time, and are more fully addressed in the theoretical papers, case studies and approach to evaluation included in this collection.     

Youth Action Research for Prevention: A Multi-level Intervention Designed to Increase Efficacy and Empowerment Among Urban Youth

Youth Action Research for Prevention (YARP), a federally funded research and demonstration intervention, utilizes youth empowerment as the cornerstone of a multi-level intervention designed to reduce and/or delay onset of drug and sex risk, while increasing individual and collective efficacy and educational expectations. The intervention, located in Hartford Connecticut, served 114 African-Caribbean and Latino high school youth in a community education setting and a matched comparison group of 202 youth from 2001 to 2004. The strategy used in YARP begins with individuals, forges group identity and cohesion, trains youth as a group to use research to understand their community better (formative community ethnography), and then engages them in using the research for social action at multiple levels in community settings (policy, school-based, parental etc.) Engagement in community activism has, in turn, an effect on individual and collective efficacy and individual behavioral change. This approach is unique insofar as it differs from multilevel interventions that create approaches to attack multiple levels simultaneously. We describe the YARP intervention and employ qualitative and quantitative data from the quasi-experimental evaluation study design to assess the way in which the YARP approach empowered individual youth and groups of youth (youth networks) to engage in social action in their schools, communities and at the policy level, which in turn affected their attitudes and behaviors.     

Building Interdisciplinary/Intersectoral Research Partnerships for Community-Based Mental Health Research with Older Minority Adults

Community-based research often brings investigators from different disciplinary backgrounds together with community representatives to conduct research on topics of mutual concern. This paper describes a case example that illustrates an interdisciplinary/intersectoral study of depression and barriers to mental health care among older adults and illustrate the factors central to implementing a successful research partnership. It will address the following conditions that facilitate and challenge interdisciplinary/intersectoral research: (1) achieving commonality of purpose in study design and research and referral approaches; (2) ensuring the ability to develop, field-test and implement psychometrically rigorous and culturally and qualitatively appropriate instruments; (3) building effective management structures for interdisciplinary/intersectoral research partnerships; and (4) identifying, training and supporting qualified researchers to carry out a mental health study with older ethnically diverse adults. The paper concludes with strengths and limitations of the approach.     

Empirical support for the gender‐as‐culture hypothesis.

This investigation provided a test of the gender‐as‐culture, or ‘two cultures’, hypothesis proposed by Maltz and Borker (1982) to explain male/female differences in language use. Analysis of previous empirical investigations located 16 language features that had consistently been shown to indicate communicator gender and these were tested within the framework of the four dimensions of intercultural style proposed by Gudykunst and Ting‐Toomey (1998): direct versus indirect, succinct versus elaborate, personal versus contextual and instrumental versus affective. Study 1 provided preliminary evidence supporting the hypothesized language‐feature‐by‐dimension relationships (e.g., male directives were rated more direct and female uncertainty verbs more indirect). In Study 2, respondents rated multiple exemplars of the 16 language features, as well as 16 contrasting foil sentences, on all four dimensions, finding that nearly all of the variables fell on the hypothesized intercultural dimensions. In Study 3, respondents rated four sets of naturally occurring target sentences and matching foil sentences, representing all language variables, on their appropriate intercultural dimensions in order to establish dimensional polarity. Results across the three studies supported the hypothesized language feature‐by‐stylistic dimension relationship for 15 of the 16 variables: The 6 male language features were rated as more direct, succinct, personal, and instrumental, whereas 9 of the 10 female features were perceived as more indirect, elaborate, and affective. The findings demonstrate that gender preferences for language use function in ways that are consistent with stylistic preferences that distinguish national cultures.     

Anticipatory Processing and Post‐Event Processing in Social Anxiety Disorder: An Update on the Literature

Two repetitive thinking processes that have been proposed in prominent maintenance models of social anxiety disorder (SAD) are anticipatory processing and post‐event processing. Research into these two processes has steadily increased over the last 20 years. This review highlights the main lines of existing research on anticipatory processing and post‐event processing, including studies on the nature of these processes, their association with social anxiety, the predictors, and consequences of these processes, as well as how these processes respond to treatments for SAD. The review also highlights some of the conceptual and methodological issues that have prevented the literature on anticipatory processing and post‐event processing from being more integrated and focused. Finally, the review draws together some new directions in terms of theory and research to further advance the field.     

Multilevel Perspectives on Community Intervention: An Example from an Indo-US HIV Prevention Project in Mumbai, India

This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels.     

Community, Culture and Sustainability in Multilevel Dynamic Systems Intervention Science

This paper addresses intertwined issues in the conceptualization, implementation and evaluation of multilevel dynamic systems intervention science (MDSIS). Interventions are systematically planned, conducted and evaluated social science-based cultural products intercepting the lives of people and institutions in the context of multiple additional events and processes (which also may be referred to as interventions) that may speed, slow or reduce change towards a desired outcome. Multilevel interventions address change efforts at multiple social levels in the hope that effects at each level will forge synergistic links, facilitating movement toward desired change. This paper utilizes an ecological framework that identifies macro (policy and regulatory institutions), meso (organizations and agencies with resources, and power) and micro (individuals, families and friends living in communities) interacting directly and indirectly. An MDSIS approach hypothesizes that change toward a goal will occur faster and more effectively when synchronized and supported across levels in a social system. MDSIS approaches by definition involve “whole” communities and cannot be implemented without the establishments of working community partnerships This paper takes a dynamic systems approach to science as conducted in communities, and discusses four concepts that are central to MDSIS—science, community, culture, and sustainability. These concepts are important in community based participatory research and to the targeting, refinement, and adaptation of enduring interventions. Consistency in their meaning and use can promote forward movement in the field of MDSIS, and in community-based prevention science.