The Trauma Related Shame Inventory: Measuring Trauma-Related Shame Among Patients with PTSD

This article proposes a new measurement instrument of trauma-related shame. The purpose of this study is to investigate the psychometric properties of the scores derived from the Trauma Related Shame Inventory (TRSI) by means of generalizability theory (G-theory). The psychometric analyses are based on a sample of 50 patients in treatment for Post-traumatic Stress Disorder (PTSD). The results provided supporting construct validity evidence for the interpretation of TRSI as a homogeneous construct. The 24-item version of internal and external referenced shame yielded generalizability and dependability coefficients of .874 and .868, respectively. The distinction between shame and guilt was supported by a high generalizability coefficient of .812 for the difference scores between TRSI and guilt cognition scale. Further validity evidence was provided by a positive relationship between TRSI and a) self-judgment subscale in Self-Compassion Scale (SCS; Neff Self and Identity 2:(3), 223–250, 2003) and b) Beck Depression Inventory (Beck Steer and Brown 1996a) when controlled for guilt. The results of the present study provided promising support for using the 24-item version of TRSI in both clinical research and practice.     

The relationship among the transtheoretical model of behavioral change,psychological distress,and diet attitudes in obesity: Implications for primary care intervention

Obesity is prevalent but undertreated in primary care. Family practice volunteer outpatients (N=454) were administered the Stage of Change for Weight (URICA), the Brief Symptom Inventory (BSI), and the Diet Readiness Test (DRT) to assess the relationship between these variables and obesity. The body mass index (BMI) was used to classify obesity revealing 197 patients with elevated BMI's. There was no significant difference between the obese and the nonobese on any of the psychological measures. The obese reported significantly more difficulty setting diet goals and less control over their eating, ate more to emotional situations, and exercised less than the nonobese. The obese sample (46.7%) reported being in the Action stage of change for weight management. Implications for intervention in primary care include targeting attitudes (DRT) and dispelling physician attitudes that obese individuals have increased levels of psychological distress. Addressing Stage of Change for weight management can facilitate tailoring the appropriate intervention when used in concert with the DRT variables.     

VA Puget Sound Telemental Health Service to rural veterans: a growing program

The VA Puget Sound Health Care System Telemental Health program connects veterans with psychologists, psychiatrists, and social workers via live clinical video teleconferencing. Providers deliver care to veterans in rural Veteran Affairs medical centers, community-based outpatient clinics and residences, and thus, increase access to specialty mental health care for rural and medically underserved veteran communities.     

Projection in surrogate decisions about life-sustaining medical treatments.

To honor the wishes of an incapacitated patient, surrogate decision makers must predict the treatment decisions patients would make for themselves if able. Social psychological research, however, suggests that surrogates' own treatment preferences may influence their predictions of others' preferences. In 2 studies (1 involving 60 college student surrogates and a parent, the other involving 361 elderly outpatients and their chosen surrogate decision maker), surrogates predicted whether a close other would want life-sustaining treatment in hypothetical end-of-life scenarios and stated their own treatment preferences in the same scenarios. Surrogate predictions more closely resembled surrogates' own treatment wishes than they did the wishes of the individual they were trying to predict. Although the majority of prediction errors reflected inaccurate use of surrogates' own treatment preferences, projection was also found to result in accurate prediction more often than counterprojective predictions. The rationality and accuracy of projection in surrogate decision making is discussed.     

Relationships among parental reports of child, parent, and family functioning.

Most children with psychosocial problems do not present for treatment in mental health settings. They are managed by primary care physicians. Children with psychosocial problems often have parents and/or families with psychosocial distress. The present study measured associations between parental reports of child, parent, and family functioning in individuals in the general population. Participants were 226 parents of children, aged 2-16 years, who presented for routine primary care. Parents reported on the psychosocial functioning of themselves, their child, and their family. All correlations of measures were significant, ranging from .55 to .23. Similar to data from psychiatric samples, the psychological functioning of children, parents, and families were significantly correlated. Unlike in psychiatric settings, child mental health problems were not as closely related to parent or family distress as parent and family distress were related to each other and to child behavior problems.     

Alcohol-aggression expectancies and dispositional rumination moderate the effect of alcohol consumption on alcohol-related aggression and hostility

Alcohol consumption increases aggression, but only in some drinkers. This study extends previous work to show how expectancies for alcohol-induced aggression and dispositional rumination moderate the link between alcohol consumption and alcohol-related aggression and hostility in a sample of 285 men and women. Alcohol-aggression expectancies and quantity of alcohol interacted to predict alcohol-related hostility and aggression. Trait rumination moderated the effect of alcohol consumption on aggressive acts. Finally, women who ruminated were more likely to report alcohol-related aggression than were men who ruminated. These results suggest that alcohol expectancies for aggression and rumination constitute two important cognitive facilitators of alcohol-related aggression and hostility, and that gender plays an important role in these relations.     

Alcohol‐aggression expectancies and dispositional aggression moderate the relationship between alcohol consumption and alcohol‐related violence

Alcohol consumption increases aggression, but only in some drinkers. This study examines how expectancies for alcohol‐induced aggression and dispositional aggression moderate the link between alcohol consumption and alcohol‐related violence, building on previous studies that have employed limited measures of alcohol‐related violence and included few women. A sample of 212 men and women reported their alcohol consumption, alcohol‐aggression expectancies, dispositional aggression, and incidents of alcohol‐related aggressive acts. Alcohol‐aggression expectancies and quantity of alcohol consumed interacted to predict alcohol‐related aggression. Alcohol‐aggression expectancies covaried with alcohol‐related aggressive acts, particularly in heavier drinkers. Dispositional aggression also correlated with alcohol‐related aggression among heavier drinkers. These results help identify that alcohol might increase aggression only among heavy drinkers who expect alcohol to increase aggression or who are dispositionally aggressive. Aggr. Behav. 32:517–527, 2006. © 2006 Wiley‐Liss, Inc.