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Biomedical subjects

J A Flaherty

Publications and source records attributed to J A Flaherty.

At least 37 records · Page 2Linked to original sources

Psychosocial assets and mental health of minority medical students.

In this study, black, white, and Hispanic medical students are compared in terms of their psychosocial assets and mental health status when they entered medical school and after a year of medical training. The data show that the minority students entered medical school with some distinct advantages over the white students. The minority students reported greater social supports, higher self-esteem, lower anxiety, and more internal locus of control. After one year, however, the blacks manifested slightly lower self-esteem and higher levels of hostility and external locus of control. The Hispanics continued to report higher self-esteem and greater social supports but showed increased external locus of control and higher alcohol consumption. Policy implications for improvements in pre-entrance enrichment programs are discussed.

Black or African American↗

Alcohol-related problems of future physicians prior to medical training.

Time 1 data are presented from an ongoing longitudinal study of drinking patterns and problems of future physicians from medical school entrance through 2.5 years of training. The data in this report address the prevalence and psychosocial correlates of alcohol-related problems experienced prior to medical school training. A group of 167 students (91% of the cohort) was surveyed. Self-report questionnaires included: alcohol-related problems (the MAST), earlier parent-child relationships, personality characteristics (external locus of control, self-esteem, dependency, masculinity-femininity), life events, social supports, motivations for drinking and symptomatic distress. The male students manifested a higher mean level of alcohol problems, and the sexes differed at the trend level when the MAST was scored to distinguish "problem" from "nonproblem" drinkers (with 18.4% of the students reporting 5 or more problem points and 7.4% reporting 4 problem points). The significant correlates of alcohol problems included: perceived lack of earlier maternal affectivity (for men) and perceived lack of earlier paternal affectivity (for women), and lack of emotional support (for men). Moreover, escape motives for men were the motives most highly correlated with alcohol problems. Symptomatic distress (anxiety and hostility) was significantly correlated with alcohol-related problems in men but not women. Future reports will depict the psychosocial experiences and alcohol-related problems manifested by this cohort during medical training.

Adult↗

Mental health attitudes and practices of Soviet immigrants.

A survey of mental health knowledge, attitudes and help-seeking practices was conducted with 415 Soviet immigrants to Israel. The purpose of the study was two-fold: to provide data for mental health services and outreach programs designed for this immigrant group and to obtain a "proxy window" into these attitudes and behaviors in the Soviet Union itself. The results show that almost 20% of the immigrants reported consultation to formal agents in Israel and about half of these reported similar consultation in the USSR. An almost equal proportion consulted the family. Univariate and multivariate analysis show that demoralization, marital status, and religiosity were significantly associated with help-seeking. The second part of the survey explored Soviet immigrant attitudes to mental illness and the mentally ill by means of case vignettes and social situations, respectively. The respondents were able to detect abnormal behavior, but did not label it as psychopathology. Their overall tolerance of such behavior was low. These attitudes did not change over time nor seem to be influenced by reported abuses of psychiatry in the USSR.

Adult↗

Somatic symptoms among older Soviet immigrants: an exploratory study.

This exploratory study investigates the overlap of somatization and depressive symptoms among older Jewish-Soviet immigrants to the United States. It has been suggested that this group has depression often masked by somatic complaints. In order to test this hypothesis fifty-five respondents completed the Symptom Checklist 90, PERI Demoralization Scale and the Social Support Network Inventory. The somatization subscale was found to be significantly higher among older Soviet immigrants than in a depressed group, yet the depression subscale was significantly lower. Compared to a group of normal controls both the depression and somatization subscales were significantly elevated. Somatization, depression, and demoralization were elevated in Soviet immigrants. The results of this study are discussed in the context of the available literature on cross-cultural psychiatry and somatization. The clinical relevance of these findings is highlighted.

Acculturation↗

"Tragic man" and "tragic woman": gender differences in narcissistic styles.

The narcissistic personality style is assumed to be highly prevalent in contemporary society, but little epidemiologic attention has been directed to its relative occurrence among different segments of the population. This study addresses gender differences in the manifestation of narcissistic personality traits and their differential association with low self-esteem and dysphoric mood. A Narcissistic Traits Scale was developed and administered along with measures of self-esteem and depressive symptomatology to a population of medical students. The data show no sex differences in overall narcissistic styles but demonstrate sex differences in the prevalence of given traits and in their differential association with low self-esteem and dysphoric mood. The clinical and research implications of these findings are discussed, along with suggestions for future research utilizing more representative community samples.

Adolescent↗

Developing instruments for cross-cultural psychiatric research.

The growth of cross-cultural psychiatry is now occurring at a time when psychiatry in general is emphasizing diagnostic clarity and the use of quantifiable and reliable methods of collecting clinical and research data. It is now imperative that cross-cultural psychiatry also examine its methods for developing instruments for use in cross-cultural research. This paper outlines a method for developing instruments designed in one culture for use in a second, and particular attention is given to cross-cultural validity or equivalence. Five types of equivalence are enumerated and defined: content, semantic, technical, criterion, and conceptual equivalence. These concepts are illustrated by examples from the authors' experience in research on internal migrants in Peru.

Cross-Cultural Comparison↗

The process of acculturation: theoretical perspectives and an empirical investigation in Peru.

World-wide migratory patterns have led to an increasing interest in acculturation processes and their psychosocial and psychiatric sequelae. This paper reviews alternative theoretical approaches to the study of acculturation and identifies gaps in the current knowledge base. We then present empirical research on acculturation processes experienced by both Indian rural to urban migrants and White-Mestizo non-migrants in Lima, Peru. The study examined overall acculturation and five sub-dimensions: language use, customs, sociability, perceived discrimination and ethnic identity. The data show that second generation migrants are more highly acculturated across sub-areas and perceive less ethnic discrimination than first generation migrants. The first generation varied in acculturative level across sub-dimensions as a function of their age at the time of migration. Contrasts between the migrant and dominant group depicted a two-way process of culture change, but a process characterized by an inequality in the content exchanged in each direction. Socio-demographic correlates of acculturation were also found. These results are discussed in terms of the potential psychological consequences of alternative acculturative adaptations within the Peruvian social-structural context.

Acculturation↗

Adult psychosocial assets and depressive mood over time. Effects of internalized childhood attachments.

This paper discusses contrasting assumptions in psychiatric epidemiological research regarding the relative significance of childhood and adult social experiences as etiological factors in adult psychopathology. It delineates a set of hypotheses that relate internal parental representations to subsequent depressed mood and to psychosocial assets assumed to mediate the relationships between parental representations and mood states. These hypotheses were prospectively tested using a cohort of medical students surveyed at medical school entrance and 7 months later. The data show that earlier paternal affectivity perceived at time 1 is inversely predictive of time 2 depressed mood, holding time 1 mood constant, whereas earlier maternal and paternal overprotection perceived at time 1 are directly predictive of time 2 depressed mood, holding time 1 mood constant. In addition, parental representations at time 1 are significantly linked to particular personality characteristics at time 1 and 2. However, it is not clear whether these personality characteristics are antecedents or consequences of depressed mood. The paper concludes with a discussion of theoretical and methodological issues involved in the retrospective assessment of remote social experiences as etiological factors in adult psychopathology.

Child Development↗

The role of recent life events and social support in the control of diabetes mellitus. A pilot study.

This study evaluated objectively the relationship between recent life events, social support systems, and blood glucose control in diabetic patients using both short-term [fasting blood sugar (FBS)] and long-term [glycosylated hemoglobin (Hgb A-1C)] measures of control. We found that a higher number of life events was associated with a higher percentage of abnormal FBS and Hgb A-1C results, and that improved social support was associated with a smaller percentage of abnormal Hgb A-1C scores. These pilot findings are discussed in connection with a biopsychosocial approach to the understanding and management of diabetes mellitus.

Adult↗

Childhood relationships, adult coping resources and depression.

Underlying the design of most adult epidemiologic stress-distress studies is the assumption that only social factors deriving from individuals' current environments or very recent pasts impact on their mental health status. The present study examined the link between perceived early parent-child relations and adult depressive symptomatology. It was hypothesized that perceived dysfunctional early parent-child relationships correlate with adult depressive symptomatology and adult internal personality resources (level of autonomy-dependency and internal-external locus of control) mediate this relationship. A cohort of students beginning medical school was administered self-report questionnaires measuring the above variables (final N = 153, 73% response rate). Using correlational and regression analysis, hypothesis 1 was supported and hypothesis 2 was partially supported. The authors discuss alternative causal interpretations of the correlational findings, and recommend future studies of the social origins of psychopathology which embrace a total life cycle model. These studies should ideally reflect interdisciplinary theoretical perspectives and encompass long-term prospective research designs or greater attention to the construction and validation of instruments for improved retrospective assessments.

Adaptation, Psychological↗

Effects of childhood relationships on the adult's capacity to form social supports.

Social supports have been viewed as central to psychological well-being, but little attention has been directed to the capacity to form supportive relationships. Psychoanalytic perspectives suggest that the quality of adult relationships is derived from earlier childhood attachment experiences. The authors tested this thesis by correlating medical students' perceptions of their earlier relationships with their parents with the perceived quality of their current social support networks. The data suggest the need for a more complex and psychodynamically relevant conceptualization of social supports, which has implications for therapeutic interventions to ameliorate support deficits.

Adult↗

Sex differences in drinking among medical students: patterns and psychosocial correlates.

Societal changes in sex roles have led to an increased interest in the comparative drinking behaviors of men and women and in their psychosocial antecedents. The differential prevalence and psychosocial correlates of alcohol consumption in a cohort of 107 men and 46 women first-year medical students are addressed. Self-report questionnaires assessed quantity, frequency and variability in the consumption of beer, wine and distilled spirits; early parent-child relationships; internal-external locus of control; interpersonal dependency; social supports; and depressive symptomatology. From analyses of variance, the data show that the men consume beer more frequently and in greater quantities. The sexes do not differ in the consumption of wine or distilled spirits. In addition, several psychosocial variables relate to drinking patterns in opposite directions for men and women. Heavier drinking among women is significantly associated with perceived childhood parental warmth and low depressive symptomatology. The opposite is true for men, although these relationships are much weaker. Future research should address sex differences in the symbolic meaning and implications of alcohol use in different socioeconomic and occupational groups.

Adult↗

A supportive care clinic: maintaining the chronic psychiatric patient.

A comprehensive investigation into the social support networks of a group of chronic psychiatric patients attending a Supportive Care Clinic was conducted. The results suggest that these patients, while exhibiting weaker support systems than the general population, do have a significant amount of personal support in addition to that received from the treatment center. Furthermore, they perceive the "support" aspect of the Clinic as the most helpful feature as compared to personal growth or medication. The results of these findings are discussed in terms of their practical utility for the ambulatory care of chronic psychiatric patients.

Adult↗