Associations between childhood adversity and daily suppression and avoidance in response to stress in adulthood: can neurobiological sensitivity help explain this relationship?

Background and objectivesAlthough it has been postulated that psychological responses to stress in adulthood are grounded in childhood experiences in the family environment, evidence has been inconsistent. This study tested whether two putative measures of neurobiological sensitivity (vagal flexibility and attentional capacity) moderated the relation between women's reported exposure to a risky childhood environment and current engagement in suppressive or avoidant coping in response to daily stress.Design and methodsAdult women (N = 158) recruited for a study of stress, coping, and aging reported on early adversity (EA) in their childhood family environment and completed a week-long daily diary in which they described their most stressful event of the day and indicated the degree to which they used suppression or avoidance in response to that event. In addition, women completed a visual tracking task during which heart rate variability and attentional capacity were assessed.ResultsMultilevel mixed modeling analyses revealed that greater EA predicted greater suppression and avoidance only among women with higher attentional capacity. Similarly, greater EA predicted greater use of suppression, but only among women with greater vagal flexibility.ConclusionChildhood adversity may predispose individuals with high neurobiological sensitivity to a lifetime of maladaptive coping

Cultural syndromes: Socially learned but real

While some of mental disorders due to emotional distress occur cross-culturally, others seem to be much more bound to particular cultures. In this paper, I propose that many of these “cultural syndromes” are culturally sanctioned responses to overwhelming negative emotions. I show how tools from cultural evolution theory can be employed for understanding how the syndromes are relatively confined to and retained within particular cultures. Finally, I argue that such an account allows for some cultural syndromes to be or become mental disorders and also steers clear of some of the anti-realist trappings associated with a social constructivism of cultural syndromes

Exploring Resilience Models in a Sample of Combat-Exposed Military Service Members and Veterans: A Comparison and Commentary

Background: The term resilience is applied in numerous ways in the mental health field, leading to different perspectives of what constitutes a resilient response and disparate findings regarding its prevalence following trauma. Objective: illustrate the impact of various definitions on our understanding and prevalence of resilience, we compared various resilience definitions (absence of PTSD, absence of current mental health diagnosis, absence of generalized psychological distress, and an alternative trauma load–resilience discrepancy model of the difference between actual and predicted distress given lifetime trauma exposure) within a combat-exposed military personnel and veteran sample. Method: In this combat-trauma exposed sample (N = 849), of which approximately half were treatment seeking, rates of resilience were determined across all models, the kappa statistic was used to determine the concordance and strength of association across models, and t-tests examined the models in relation to a self-reported resilience measure. Results: Prevalence rates were 43.7%, 30.7%, 87.4%, and 50.1% in each of the four models. Concordance analyses identified 25.7% (n = 218) considered resilient by all four models (kappa = .40, p \u3c .001). Correlations between models and self-reported resilience were strong, but did not fully overlap. Conclusions:The discussion highlights theoretical considerations regarding the impact of various definitions and methodologies on resilience classifications, links current findings to a systems-based perspective, and ends with suggestions for future research approaches on resilience

Religious faith and psychosocial adaptation among stroke patients in Kuwait: A mixed method study

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2012 Springer Science+Business Media.Religious faith is central to life for Muslim patients in Kuwait, so it may influence adaptation and rehabilitation. This study explored quantitative associations among religious faith, self-efficacy, and life satisfaction in 40 female stroke patients and explored the influence of religion within stroke rehabilitation through qualitative interviews with 12 health professionals. The quantitative measure of religious faith did not relate to life satisfaction or self-efficacy in stroke patients. However, the health professionals described religious coping as influencing adaptation post-stroke. Fatalistic beliefs were thought to have mixed influences on rehabilitation. Measuring religious faith among Muslims through a standardized scale is debated. The qualitative accounts suggest that religious beliefs need to be acknowledged in stroke rehabilitation in Kuwait

Risk Coping Measures against Different Types of Shocks: Empirical Evidence from Vietnam Household Living Standard Survey

Income variability and additional medical consumption should be major shocks for farm households in developing countries. This paper investigates risk coping measures against these different types of shocks using Vietnamese Living Standard Measurement Study. Estimating results suggest that productive fixed assets are used for medical shock, while non-productive assets such as consumer goods are disposed for coping with income shock. This can be interpreted by nature of shocks, loan interest rate for coping shocks, and households' time preference under liquidity constraint. Consumer goods could be accumulated for precautionary motive and heavy debt of sickness may result in loss of productive fixed assets.income and sickness shock, risk coping measures, assets, Vietnamese farm household

Preliminary study comparing parent and child functioning by intervention for adolescent idiopathic scoliosis

OBJECTIVE: The purpose of this study is to assess whether there are significant differences between pre-surgical and bracing patients with Adolescent Idiopathic Scoliosis (AIS) in parent and child functioning including pre-operative pain, pre-operative anxiety, parent pain catastrophizing, and parent protectiveness over child's pain symptoms. METHODS: Eligible patients were recruited from the Boston Children's Hospital Orthopedics Department. Retrospective chart reviews were conducted to identify patients aged ten through seventeen with AIS who were recommended for brace treatment or spinal fusion surgery. The study included thirty-five participants and their parents, seventeen pre-surgical participants and eighteen bracing participants. REDcap questionnaires were sent to parents and their children to fill out. The questionnaires included the following measures of interest for this study: Adult Responses to Children's Symptoms (ARCS), the Pain Catastrophizing Scale (PCS), the Multidimensional Anxiety Scale for Children (MASC), and the Numeric Rating Scale (NRS) for pain. One-way ANOVAs were used to determine if there were statistically significant differences between the two groups on the following variables: age and sex of the child, sex of the parent, race and ethnicity of the parent and child, degree of curvature of the spine (Cobb angle), and on the above mentioned parent and child measures. RESULTS: The group demographics were representative of the typical AIS population. Significant differences in age, Cobb angle, and sex of the child were determined between groups and represent potential confounding factors. There was a significant difference between groups for PCS magnification and a trend towards significance for PCS helplessness and the total PCS score. Other measure differences were statistically insignificant. CONCLUSIONS: Potential differences in parent and child measures were assessed to investigate parent and child functioning in the context of two medical interventions used to treat AIS. Bracing treatment and spinal fusion surgery were chosen with the intent to determine if the severity of an intervention has adverse effects on parent and child functioning. It is important to consider these results in a preliminary context due to the small sample size. Nonetheless, the results suggest that pre-surgical patients and their families are affected differently by the additional stressors and life-altering factors that come with spinal fusion surgery. There seems to be greater emphasis placed on their child's pain as well as a sense of helplessness. Both factors may have adverse effects on their child's ability to cope with the stress of surgery, which may also translate into a more difficult recovery period

Suicide Education to Support Caregivers in their Abilities to Care for Suicidal Individuals

Purpose: Suicide is a preventable act of lethality yet still remains a public health concern. Suicide can affect individuals from a variety of backgrounds and does not discriminate against age, gender, ethnicity, income, or occupation. Efforts to prevent suicide often focus on supporting the suicidal individual however there is a lack of available resources that focus on supporting those closest such as caregivers. Caregivers can play a pivotal role in their loved one’s trajectory towards recovery. The purpose of this project was to provide caregivers with a suicide toolkit that encompasses basic education, approaches to supporting a loved one who is suicidal, and community resources on prevention. Methods: This quality improvement project included information on evidenced based approaches, and local resources on suicide prevention. A total of twenty caregivers were included in this project that were divided into two separate groups: group A and group B. Ten caregivers were assigned to group A and asked to provide input as to what they felt a toolkit should encompass based on identified needs, this feedback was then used in part to develop a suicide toolkit. Group B consisted of a second set of ten caregivers who were asked to complete a pre and post questionnaire following the review of the suicide toolkit that was developed by the DNP student to see whether or not scores improved. Results: Eight out of ten caregivers from group A provided input for toolkit development. Four common themes emerged from this feedback that were included in the development of the toolkit. Ten caregivers in group B completed the pre and post questionnaire following the review of the toolkit and the means between these groups were compared and showed a slight improvement but not to the proposed 25% goal set forth. Conclusion: Post questionnaire scores showed improvement in comparison to pre questionnaire scores however several questions reflected no improvement in scores. This data may suggest that providing a toolkit alone does not elicit specific improvements in knowledge, confidence, competence, and perceived caring abilities, rather it can be a component of treatment. Several limitations are discussed including a small sample size used and little to no additional participant identifiers. Future recommendations include increasing the sample size and changing the phrasing of the questionnaire to better reflect caregiver experiences

Homestead forestry and rural development : a socio-empirical study of Bangladesh : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Development Studies at Massey University, New Zealand

This thesis is concerned with the role of homestead forests in the development of poor, labour surplus economies. The term 'homestead forest' refers to the collection of vegetation - trees, plants, herbs, creepers and others - which almost all rural households in Bangladesh grow, for their own use as well as for sale, using the land in and around their homesteads and dwellings. The term 'development' encompasses economic, social, cultural and ecological aspects of countries. The thesis therefore examines the role of homestead forests in this wider context. It starts by reviewing the existing theoretical literature on development drawing on the works of sociologists, social anthropologists, development economists, geographers and others. It argues that many of the theories do not fit the particular conditions of the very poor agriculture-dependent economies such as Bangladesh. This study therefore advances the hypotheses that of 'non-conventional' approaches involving the development of the resources of homestead forests in the rural areas would go a long way towards assisting the poor, landless masses of Bangladesh. An extensive survey of the many and varied uses of homestead forests is undertaken to support these hypotheses on the basis of direct observation and experience. To give further content to the hypotheses, village surveys were undertaken in carefully selected areas of Bangladesh. With the help of scientifically formulated questionnaires the situation of the rural people of the selected villages was examined. This helped to identify the many causes of poverty and helplessness among the rural poor. The methods of survival were also focused on in these surveys of the rural people. It became clear that homestead forests play a major role in the lives and livelihoods of the rural people. The question why the large scale forestry development programmes did not help the rural poor also figured in this investigation. It was found that the large scale commercial types of forests deny access to the majority of the rural people, while homestead forests, being directly owned and controlled by the people, provide them with much needed support. It is true that such support, however valuable, is still inadequate. It is also unevenly distributed among the rural people. The survey therefore looked at the distributional aspects of homestead forestry resources within the survey villages. The findings confirm the need to strengthen this valuable resource base in rural Bangladesh if widespread poverty, and its inevitable concomitant, social and political unrest and instability are to be attacked. The study ends with a number of recommendations to make the changes necessary for more efficient utilization of the homestead forestry resources for the benefit directly of the poor and, indirectly, the rest of society as well

Self-efficacy for coping. Utility of the Cancer behavior inventory (Italian) for use in palliative care

Background: Newer models of palliative and supportive cancer care view the person as an active agent in managing physical and psychosocial challenges. Therefore, personal efficacy is an integral part of this model. Due to the lack of instruments in Italian to assess coping self-efficacy, the present study included the translation and validation of the Italian version of the Cancer Behavior Inventory-Brief (CBI-B/I) and an initial analysis of the utility of self-efficacy for coping in an Italian sample of palliative care patients. Methods: 216 advanced cancer patients who attended palliative care clinics were enrolled. The CBI-B/I was administered along with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), the Mini Mental Adjustment to Cancer Scale (Mini-MAC), the Cancer Concerns Checklist (CCL), and the Hospital Anxiety and Depression Scale (HADS). The Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ratings of functional capacity were completed by physicians. Results: Factor analysis confirmed that the structure of the CBI-B/I was consistent with the English version. Internal consistency reliability and significant correlations with the EORTC QLQ-C30, Mini-MAC, and HADS supported the concurrent validity of the CBI-B/I. Differences in CBI-B/I scores for high versus low levels of the CCL and ECOG-PS supported the clinical utility of the CBI-B/I. Conclusions: The CBI-B/I has strong psychometric properties and represents an important addition to newer model of palliative and supportive care. In order to improve clinical practice, the CBI-B/I could be useful in identifying specific self-efficacy goals for coping in structured psychosocial intervention