47 research outputs found

    Spiritually Integrated Treatment of Depression: A Conceptual Framework

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    Many studies have found an inverse correlation between religious/spiritual involvement and depression. Yet several obstacles impede spiritually integrated treatment of depressed individuals. These include specialization and fragmentation of care, inexperience of clinicians and spiritual care providers, ideological bias, boundary and ethical concerns, and the lack of an accepted conceptual framework for integrated treatment. Here I suggest a framework for approaching these obstacles, constructed from a unified view of human experience (having emotional, existential, and spiritual dimensions); spirituality seen as a response to existential concerns (in domains such as identity, hope, meaning/purpose, morality, and autonomy in relation to authority, which are frequently distorted and amplified in depression); a rationale for locating spiritually oriented approaches within a clinician's assessment, formulation, and treatment plan; and recognition of the challenges and potential pitfalls of integrated treatment

    Accountability as a Key Virtue in Mental Health and Human Flourishing

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    We propose that accountability plays an implicit, important, and relatively unexamined role in psychiatry. People generally think of accountability as a relation in which one party is held accountable by another. In this paper, we examine accountability as a virtue, drawing on philosophy, psychiatry, and psychology to examine what it means to welcome being accountable in an excellent way that promotes flourishing. When people manifest accountability as a virtue, they are both responsive to others they owe a response, and they are responsible for their attitudes and actions in light of these relationships. Psychiatric treatment often aims to correct disordered forms of accountability, including difficulties with empathy and self-regulation. Both the process of treatment and the practice of professionalism depend on relationally responsible accountability. We examine accountability as an overlooked complement to healthy autonomy. Whereas acting autonomously in congruence with one’s values is characteristic of mental health, accountability that is interpersonally responsive and responsible is vital to successful treatment as well as professionalism in psychiatry. We review components of accountability and developmental aspects of the virtue; highlight the role of accountability in healthy functioning; and describe implications for psychiatric assessment, treatment, and professionalism. We aim to catalyze awareness of accountability as intrinsic to mental health care and human flourishing

    Accountability: Construct Definition and Measurement of a Virtue Vital to Flourishing

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    Embracing accountability to others for one’s responsibilities within relationships is important for flourishing, yet underexamined. An interdisciplinary team defined the construct of accountability and developed an 11-item single-factor Accountability Scale. In national samples with US census demographic representation (total N = 1257), we conducted psychometric analyses using methods from classical test theory (exploratory and confirmatory factor analyses) and item response theory. The Accountability Scale demonstrated internal consistency, construct validity, test-retest reliability, and incremental validity. Accountability correlated positively with relational variables (agreeableness, empathy) responsibility-oriented variables (conscientiousness, self-regulation), virtues (gratitude, forgiveness, limitations-owning humility), relational repair, perceived meaning presence, and flourishing, inversely with symptoms (personality disorders, temper, anxiety, depression), and weakly with searching for meaning and social desirability. Accountability scores superseded demographic variables, conscientiousness, and agreeableness to predict relational repair, perceived presence of meaning in life, and flourishing. We offer the accountability construct and scale to advance human flourishing research and applied work

    Theodicy and End-of-Life Care

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    Acknowledgments The section on Islamic perspective is contributed by information provided by Imranali Panjwani, Tutor in Theology & Religious Studies, King's College London.Peer reviewedPublisher PD

    The potential for an independent source of Younger Dryas tree-ring radiocarbon data from the Lake Ontario region, North America, and its palaeoenvironmental context

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    Tree rings are the gold standard for the calibration of radiocarbon dates into calendar years with limited error due to their annual record of radiocarbon content in the atmosphere. Currently, the tree-ring 14C data used in the International Radiocarbon Calibration curve (IntCal13) are from multiple sources back to ~ 10 ka cal BP for the northern hemisphere. However, the source for tree-ring calibration data prior to ~10 ka cal BP, including the Younger Dryas (YD) and most of the Early Holocene (EH) chronozones, is limited to central Europe. Substantial quantities of logs found in the lowlands of Lake Ontario in North America, dating from 12.1 to 11.2 ka cal BP, have great potential for providing unique YD-EH tree-ring 14C data from a new, previously unrepresented, geographic location and for adding a new perspective to ongoing debates such as the timing of the YD/EH transition in continental North America. Preliminary fieldwork yielded over 43 logs, predominantly spruce (Picea spp.), found buried in alluvial strata over 0.2 hectares of the floodplain at Bell Creek near Fulton, NY. Dendrochronological analysis of 32 spruce logs from this collection has produced several chronologies, one 183 years in length and a second of 147 years with a possible crossdate yielding a chronology of 260 years. Ongoing survey of the site suggests that there is high preservation potential in the same stratigraphic units in an additional ~2 hectares of floodplain, and sample collection with subsequent analysis will increase the chronology’s sample depth, extend its length, and potentially provide a robust, independent Younger Dryas – Early Holocene 14C record. Initial assessments of climatic, hydrological, environmental, and isostatic variations and events over time from the tree rings and their stable isotopes, as well as pollen, macrofossil, and sediment analyses and isostatic modeling indicate substantial changes in the Bell Creek Valley and surrounding lowlands both during the YD and into the mid-Holocene. These changes include significant alterations in the rate, volume, and direction of stream flow, and transition from a boreal riparian environment on a low-order river to a wetlands, then back to a riparian environment with much less streamflow and occasional flooding, similar to the Bell Creek Valley today

    Climatic history of the northeastern United States during the past 3000 years

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    Many ecosystem processes that influence Earth system feedbacks – vegetation growth, water and nutrient cycling, disturbance regimes – are strongly influenced by multidecadal- to millennial-scale climate variations that cannot be directly observed. Paleoclimate records provide information about these variations, forming the basis of our understanding and modeling of them. Fossil pollen records are abundant in the NE US, but cannot simultaneously provide information about paleoclimate and past vegetation in a modeling context because this leads to circular logic. If pollen data are used to constrain past vegetation changes, then the remaining paleoclimate archives in the northeastern US (NE US) are quite limited. Nonetheless, a growing number of diverse reconstructions have been developed but have not yet been examined together. Here we conduct a systematic review, assessment, and comparison of paleotemperature and paleohydrological proxies from the NE US for the last 3000 years. Regional temperature reconstructions (primarily summer) show a long-term cooling trend (1000 BCE–1700 CE) consistent with hemispheric-scale reconstructions, while hydroclimate data show gradually wetter conditions through the present day. Multiple proxies suggest that a prolonged, widespread drought occurred between 550 and 750 CE. Dry conditions are also evident during the Medieval Climate Anomaly, which was warmer and drier than the Little Ice Age and drier than today. There is some evidence for an acceleration of the longer-term wetting trend in the NE US during the past century; coupled with an abrupt shift from decreasing to increasing temperatures in the past century, these changes could have wide-ranging implications for species distributions, ecosystem dynamics, and extreme weather events. More work is needed to gather paleoclimate data in the NE US to make inter-proxy comparisons and to improve estimates of uncertainty in reconstructions

    Spiritually Integrated Treatment of Depression: A Conceptual Framework

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    Many studies have found an inverse correlation between religious/spiritual involvement and depression. Yet several obstacles impede spiritually integrated treatment of depressed individuals. These include specialization and fragmentation of care, inexperience of clinicians and spiritual care providers, ideological bias, boundary and ethical concerns, and the lack of an accepted conceptual framework for integrated treatment. Here I suggest a framework for approaching these obstacles, constructed from a unified view of human experience (having emotional, existential, and spiritual dimensions); spirituality seen as a response to existential concerns (in domains such as identity, hope, meaning/purpose, morality, and autonomy in relation to authority, which are frequently distorted and amplified in depression); a rationale for locating spiritually oriented approaches within a clinician's assessment, formulation, and treatment plan; and recognition of the challenges and potential pitfalls of integrated treatment
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