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PubMed2002

Criminal responsibility or lack of cultural awareness? The Andrea Yates story.

Physicians and other mental health professionals in our state should continue, based on Tennessee's child abuse statutes, to report possible abuse and neglect when indicated even if the behavior is considered culturally normal. In addition, professionals attempting to serve diverse populations must incorporate an understanding of culture, traditions, religious beliefs and other information specific to family interactions. They should include family history of mental illness into the design of their individual treatment plans. Providers should form working partnerships with communities in order to become successful. Ultimately, the solution offered by professionals and the process of problem resolution or treatment should be consistent with, or at least tolerable to, the natural supportive environments that reflect patients' values and their "help-seeking behaviors." The consequences of not understanding and not responding to these influences appropriately can be profoundly deleterious. This may have been a contributing factor with Andrea Yates.

Crime↗
PubMedDate not supplied

Do "helpers at the nest" increase their parents' reproductive success?

"Helpers at the nest," usually offspring of a preceding litter who contribute by feeding the young to increase the reproductive success of a breeding pair, are known in many species of birds and mammals. Although similar behaviors were described by ethnological observations in several human societies, there is a lack of data on their existence and role. This study of 794 reproductive life histories of post-menopausal Berber women of Southern Morocco aims to provide such information. Results show that the presence of "probable helpers" in the household is related to higher fertility scores and is associated with improved survival of offspring to sexual maturity. In contrast to sparse observations from other human societies, there is no indication that child caretaking would be specific to eldest daughters. Although the association between offspring survival and helping patterns seems highly probable, there is no confirmation that child caretaking per se is the relevant variable. Contrary to nonhuman helpers at the nest, workloads of children range from housekeeping to light agricultural tasks, and are not focused on assisting younger siblings. The improvement of reproductive success is probably the result of multiple interactions, among which the network of kinship would play a role at both the levels of economy and reciprocal assistance.

Adolescent↗
PubMed2006

Identifying signs and symptoms of intimate partner violence in an oncology setting.

Domestic violence (DV), or intimate partner violence (IPV), is a prevailing problem in public health. Often, healthcare providers may be the first people that victims of DV will approach to reveal their problem or seek assistance. IPV is a pattern of control using assault and intimidating behaviors that has devastating effects on individuals, their families, and communities. Oncology nurses need to become familiar with common indicators of DV so that signs and symptoms of abuse can be identified when assessing patients in an oncology setting. Standards of oncology nursing practice support that the psychosocial impact of cancer on patients and their families or significant others needs to be considered at all stages of diagnosis and treatment. The psychosocial impact of other personal situations or concerns, such as IPV, can add to the complexity of cancer management. Routine screening for signs and symptoms of psychosocial distress helps identify patients who require additional interventions. Oncology nursing practice is based on a holistic approach to patient care, which supports that identification of physical and psychosocial needs are equally important. Oncology nursing provides many unique opportunities to help patients cope with cancer. Routine nursing assessment for signs and symptoms of abuse will provide an opportunity to assist patients with cancer to manage not only the life-threatening aspects of their diagnosis but also the life-threatening aspects of IPV.

Adaptation, Psychological↗
PubMed2006

A multisite study of Air Force outpatient behavioral health treatment-seeking patterns and career impact.

This study examined 1,068 cases of active duty Air Force service members seen in eight Air Force outpatient mental health clinics during a 1-year period. Age, gender, rank, marital status, special duty status, diagnostic category, treatment completion, and recommendations to the member's unit were examined across referral sources (i.e., self-referred, supervisor-referred, or commander-directed). Results showed significant differences across all variables, with self-referred members being more likely to be older, single, higher ranking, and without special duty status, as well as to have a less significant axis I diagnosis. Self-referred members were less likely to have confidentiality broken and to have career-affecting recommendations made. The implications of these findings, in terms of targeting interventions to increase self-initiated help-seeking behavior, and recommendations for future research are discussed.

Adolescent↗
PubMed2000

Cultural psychology of surprise: holistic theories and recognition of contradiction.

The authors tested the hypothesis that East Asians, because of their holistic reasoning, take contradiction and inconsistency for granted and consequently are less likely than Americans to experience surprise. Studies 1 and 2 showed that Korean participants displayed less surprise and greater hindsight bias than American participants did when a target's behavior contradicted their expectations. Studies 3 and 4 further demonstrated that even when contradiction was created in highly explicit ways, Korean participants experienced little surprise, whereas American participants reported substantial surprise. We discuss the implications of these findings for various issues, including the psychology of conviction, cognitive dissonance, and the development of science.

Adult↗
PubMedDate not supplied

Children and adolescents' internal models of food-sharing behavior include complex evaluations of contextual factors.

This study examined internal representations of food sharing in 589 children and adolescents (8-19 years of age). Questionnaires, depicting a variety of contexts in which one person was asked to share a resource with another, were used to examine participants' expectations of food-sharing behavior. Factors that were varied included the value of the resource, the relation between the two depicted actors, the quality of this relation, and gender. Results indicate that internal models of food-sharing behavior showed systematic patterns of variation, demonstrating that individuals have complex contextually based internal models at all ages, including the youngest. Examination of developmental changes in use of individual patterns is consistent with the idea that internal models reflect age-specific patterns of interactions while undergoing a process of progressive consolidation.

Adolescent↗
PubMed1991

Cognitive-behavioral therapy in patients with ankylosing spondylitis in a German self-help organization.

A cognitive-behavioral treatment program for pain control was administered to 22 subjects with a diagnosis of ankylosing spondylitis (AS) in a self-help setting of the German Rheumatism League. A sample of 17 AS subjects from the same setting served as waiting-list controls. The program consisted of training in progressive muscle relaxation, cognitive restructuring, attention related techniques and pleasant activity scheduling, and was aimed at an improvement of self-control strategies. Ratings of pain severity, anxiety, depression, psychophysiological complaints, and sleep disturbances were used to evaluate the outcome. Follow-up assessments were conducted six months post treatment. A significant interaction between treatment condition and assessment period was demonstrated. Further analyses indicate a beneficial effect of the treatment in all outcome measures apart from general symptoms during pain attacks at the follow-up assessment. Reductions of pain intensity, anxiety, and psychophysiological symptoms were maintained at 12 month follow-up. Although pain reduction was statistically significant, it did not exceed 14% in the pain diary. The more important aspect of the treatment appears to be emotional stabilization and increased feelings of well-being.

Adaptation, Psychological↗
PubMed1998

[Grief among the psychiatric outcare-patients].

The aim of the study is to describe the features of bereavement and the life situation among the bereaved psychiatric outcare-patients. The impact of social support on stress and adaption has been indicated in previous studies. Social support of the patients belongs to the nursing care. The possibilities of the family-centered nursing to support the relatives in bereavement will also be discussed. The sample consisted of new patients' in psychiatric outcare (N = 32). The ground of the need to the care was the dead of their relative. The information has been gathered of the care records and it has been analysed by the content analysis. Following contents have been described: The features of the bereavement and the relations to the relatives. The features of the bereavement consisted of following categories depressive behavior, anxiety, hate and fear, self-destructive behavior and feelings of guilt. Relations to the other relatives consisted of following categories: Rejected by the relatives and disappointed in the relationship. The results indicated, that the patients did not receive social support in their daily life. The family-centered nursing will allow the social support also to the relatives after the dead of the patient.

Ambulatory Care↗
PubMed1991

Participatory management: Maintaining staff performance in a university housing cooperative.

To apply behavior analysis to normal adults in non institutional settings, we may have to encourage their participation in the design and implementation of behavioral technology. This study evaluates a technology by which the members of a student housing cooperative manage their own staff with a minimum of supervision by one of the program designers. This staff management system consisted of prompts, self-reports, spot checks, and contingent rent reductions. Six resident staff members performed substantially more of their assigned tasks when this system was used. In addition, the management system was acceptable to the members, was affordable, and maintained high levels of staff performance during a 5-year follow-up. Participation by the members in the design and implementation of this system appears to have been useful in helping the behavior analysts to develop an unusually durable management system.

Journal Article↗
PubMed2003

Delay in presentation in the context of local knowledge and attitude towards leprosy--the results of qualitative fieldwork in Paraguay.

OBJECTIVE: The primary objective of our research was to explore help-seeking behavior in the context of knowledge, attitude, and practice as factors contributing to delay in presentation in leprosy. The secondary objective was to demonstrate the value of basic qualitative research methods in this context. METHODOLOGY: Fieldwork was based at the Hospital Mennonita Km 81, the referral center for leprosy services in Paraguay. We adopted exclusively qualitative methods for fieldwork, effectively carrying out a rapid assessment of factors contributing to delay. We relied on multiple sources of information and the use of multiple methods to ensure the validity of our findings. RESULTS: Our findings linked delay in presentation to traditional beliefs, lack of awareness of the early symptoms of leprosy, stigma, seeking help from natural healers, and to interactions with the health services. Traditional beliefs diminish the importance of the early symptoms of leprosy. Stigma has an impact on decisions to seek help. Natural healers have maintained their traditional status in society; their preferred treatments for leprosy are ineffective. Only rarely do natural healers refer to the health services. Once presented to the health services, some individuals affected by leprosy experienced lengthy delays in diagnosis and start of treatment. DISCUSSION: To address the traditional values of a society and provide effective public health initiatives is a clearly a major challenge for program organizers and for health education. Increased awareness of leprosy and sensitivity to its social consequences among health service practitioners is a further priority.

Attitude to Health↗
PubMedDate not supplied

Self-reported stress: findings from the 1985 National Health Interview Survey.

The National Health Interview Survey's 1985 Health Promotion and Disease Prevention Questionnaire included questions on the amount of stress experienced in the past 2 weeks, the effect of stress on health, thoughts about seeking help for personal or emotional problems, and actual help-seeking behaviors. This report examines responses to these questions and analyzes self-reported levels of stress by sex and other respondent characteristics. In 1985, an estimated 34 million people aged 18 years and older experienced "a lot" of stress in the 2-week period preceding the interview. Women were more likely than men to report a lot of stress (23 percent versus 18 percent), and respondents 65 years of age or older were more likely than younger respondents to report "almost no" stress. An estimated 21 million people (13 percent) believed that, over the past year, stress had "a lot" of effect on their health. Seventeen percent of the population considered seeking help in the past year for personal or emotional problems from family, friends, helping professionals, or self-help groups. Sixty-nine percent of those who thought about seeking help reported that they actually did seek help. In terms of health practices, men and women who reported higher levels of stress than others of their sex also were more likely to report that they rarely or never ate breakfast, slept 6 or fewer hours per night, were physically less active than their peers, or drank more alcoholic beverages than usual in the 2 weeks prior to the survey.

Adolescent↗
PubMed2004

Stigma and help seeking related to depression: a study of nursing students.

The stigmatization of people with mental illnesses and its effect on help-seeking behaviors have been identified by the Surgeon General and the President's New Freedom Commission on Mental Health as significant issues on the nation's health care agenda. Negative perceptions regarding depression and its treatment contribute to the 30,000 suicides committed annually in the United States. Nurses have the potential to exert tremendous influence toward overcoming this problem, contingent on their attitudes toward depression and its treatment. As nurses and future nurses, students enrolled in both a basic and degree-completion baccalaureate program comprised a sample that represented the influence of the educational process. This descriptive, correlational study measured attitudes toward an individual with depression, described in a vignette, and personal help-seeking intention, and examined the effects of personal variables on help-seeking intention. Students who believed depression was not under personal control were more likely to endorse help seeking for themselves. Individuals who were women, older, upperclassmen, and Catholic reported greater acceptance of seeking psychological help. The role of the psychiatric-mental health nursing class and rotation were identified as improving stigmatizing attitudes and increasing help-seeking intention.

Adolescent↗
PubMed1977

Self-concept and delinquency proneness.

Contrary to the theory of the homeostatic model of self-concept, i.e., the expectancy that engaging in anti-social or pro-social behavior results typically in shifts in the self-concept (Graf, 1968; Deitz, 1970 shifts did not occur. Subjects, 12- 14-year-old boys enrolled in junior high school, delinquent prone (DP) and non-delinquent prone bright (NDPB), reacted to manipulation by engaging in reparative behavior as indicated via an aggression module in a fashion generally expected but the expected shift from chronic self-images did not occur. Both DP and NDPB viewed themselves similarly on self concept. The authors postulated that if shifts would occur for the delinquent prone it would be after they left school with its accompanying identification with a sub-culture outside the school setting.

Adolescent↗
PubMed1984

The inventory of socially supportive behaviors: dimensionality, prediction, and gender differences.

The nature of social support as measured by the Inventory of Socially Supportive Behaviors (ISSB) was explored in the study. The results of a principal components analysis suggest that it is appropriate to use the ISSB as a global measure of a unidimensional construct. The components that emerged were interpretable, however, and are consistent with the types of social support that have been cited in the literature. Males and females do not differ in overall social support as measured by the ISSB, but females report receiving more emotional support than males do. Social network variables predicted ISSB scores for males but not for females. The network variable that predicted social support most strongly was the number of people a respondent felt close to and could confide in or turn to for help in an emergency. The meanings and implications of these findings are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

Allocare in a nocturnal primate: data on the spectral tarsier, Tarsius spectrum.

Non-maternal infant care in many of the small-bodied New World primate species has been hypothesized by some researchers to be related to the high infant/adult weight ratio found in these species. The spectral tarsier, Tarsius spectrum, an Old World primate, has one of the highest infant/adult weight ratios of any primate, with infants weighing between 20-33% of adult weight at birth. On the basis of the hypothesized relationship between allocare and the infant/adult weight ratio, it is predicted that the spectral tarsier will also exhibit extensive allocaretaking behaviour. The results of this study indicate that although spectral tarsiers show care by male and female subadults as well as adult males, it is extremely limited compared to the extensive allocaretaking behavior observed in New World primate species such as Aotus and Callicebus. Spectral tarsier subadult females provide substantially more allocare to infants than do subadult males or adult males. Female subadults were observed sharing food, transporting, grooming, playing, alarm calling, baby-sitting and maintaining physical contact with infants more than other age/sex classes. Although the amount of allocare exhibited by adult males and subadult males was much less than that exhibited by female subadults, the data suggest that adult and subadult male spectral tarsiers do play a small part in the care and socialization of the infant. Adult males and subadult males were both observed occasionally engaging in allocaretaking behaviors such as grooming and playing, as well as frequently patrolling and defending the territory's boundaries. The results from this study suggest that although a high infant/adult weight ratio may be a prerequisite for selection to favor extensive allocare, it is not a causal factor. Additional research is needed in order to understand better the selective pressures involved and the costs and benefits of providing allocare to subadults and adult male spectral tarsiers.

Animals↗
PubMed1990

Perceptions of general and specific therapist behaviors.

In the process of developing a two-part therapist rating scale, we obtained questionnaire responses from a large sample of subjects who had undergone one of a variety of psychotherapies. Our data support the importance of perceived therapist care as a strong correlate of patient satisfaction, and patients seemed able to discriminate clearly between psychodynamic and cognitive-behavioral therapies. In the first (nonspecific) questionnaire, we derived five dimensions (Care-Concern, Directive-Control, Critical-Confronting, Understanding, and Charisma) from principal-components analyses, with the first two dimensions being relatively independent of each other. A multiple-regression analysis revealed that combined scale scores accounted for 50% of the variance of patient satisfaction ratings, with the Care dimension accounting for most of this effect. In the second questionnaire, data were analyzed from respondents who had undergone therapy with known cognitive-behavioral or psychodynamic therapists; but, in a minority of subjects who were recruited through the media, we depended on detailed descriptive vignettes to allocate them to one or another of these "specific" types of psychotherapy. Six scales emerged, three characterizing cognitive-behavioral therapies (Behavioral Task Orientation, Organization, and Cognitive Focus) and three representing psychodynamic therapies (Transference, Inner Conflict, and Relationship). Subjects' ratings on all scales strongly discriminated between the two broad modalities of therapy, suggesting that patient reports may provide valid measures of therapist styles. We conclude that questionnaires such as the one we are developing may provide economical measures for assessing therapist consistency when comparing different modalities of psychotherapy.

Adult↗
PubMed1995

Advocacy and empowerment: dichotomous or synchronous concepts?

An examination of the concept of advocacy in the nursing literature reflects diverse and sometimes conflicting usage. It may denote a set of behaviors not associated with any specific ethical basis, an approach grounded in a justice ethics, or a philosophical basis for nursing. Although some conceptualizations of advocacy are incongruent with empowerment, others that reflect an existential, relational ethics are indeed synchronous with empowerment. Furthermore, the centrality of mutuality and the nurse-patient relationship to both advocacy and a unitary-transformative approach to caring is consistent with the conditions under which empowerment can occur.

Ethics, Nursing↗