Applied & preventive psychology : journal of the American Association of Applied and Preventive Psychology最新文献

A growing body of research derived from terror management theory [e.g., Solomon, S., Greenberg, J., & Pyszczynski, T. (1991). A terror management theory of social behavior: The psychological functions of self-esteem and cultural worldviews. In M. P. Zanna (Ed.), Advances in experimental social psychology: vol. 24 (pp. 93–159). New York: Academic Press] suggests that the human struggle with the awareness of inevitable death can greatly impact people's physical and psychological well-being. The current article reviews converging lines of research that investigate the role of terror management processes in physical and mental health. Specifically, we present research that elucidates the role of death concerns in (1) conscious threat-focused defenses, (2) self-esteem striving, (3) depression, (4) anxiety disorders, (5) discomfort with the physicality of the body and (6) neuroticism. We conclude that terror management theory builds upon the work of other existential scholars and mental health perspectives to provide a broad conceptual and empirically based account of how deeply rooted existential fears manifest in ways that prove both psychologically and physically problematic. We also suggest how future research and social interventions can be employed to help individuals manage basic fears in ways that do not compromise their psychological and physical health.

This paper introduces the concept of modularity as an approach to therapeutic protocol design and application. Modularity is defined in terms of four key properties, and a detailed example of a modular psychotherapy protocol is presented. By explicitly outlining clinical strategies and algorithms, modular design of psychotherapy protocols provides a promising framework for testing many of the assumptions underlying traditional therapy protocols. Modular design also offers numerous potential advantages in terms of design efficiency (reusability of modules, ease of updating or reorganizing protocols) and effectiveness (e.g., greater adaptability for applied contexts, increased therapist satisfaction). Finally, preliminary evidence for the efficacy of modular protocols is encouraging, and suggests that such design should preserve and could even enhance the efficacy of existing therapy protocols.

For people with mental illness, diminished quality of life and loss of personal goals does not result solely from the symptoms, distress, and disabilities caused by their psychiatric disorder. Quality of life and personal goals are also hindered by people who embrace the stigma that accompanies mental illness and mental health care. This paper reviews evidence of the impact of mental illness stigma and strategies for seeking to ease its impact. To achieve these goals, we (a) describe the ways in which stigma harm people with mental illness, (b) summarize models that explain the development and maintenance of these stigmatizing effects, and (c) review strategies that have been shown to decrease the impact of stigma. Concerns about stigma are on the political agendas of many mental health advocacy groups. It has recently also become the focus of extensive research. Our goal in this paper is to balance the practical concerns raised by mental health advocates against data that support or contradicts specific assertions.

Many psychotherapeutic traditions have conceptualized clinical levels of anxiety as resulting from the avoidance of threatening or emotional material. In this paper, we examine behavioral models of avoidance of emotions and emotional material, integrating findings that support established behavioral theories of emotional avoidance and anxiety, and that extend these theories to further explain the intense, intrusive, and interfering nature of clinical anxiety. Research on the suppression and avoidance of emotional material suggests that emotional avoidance and thought suppression may not only hinder the learning process and maintain anxious responding, but may also (a) paradoxically heighten anxious responding to threatening cues and (b) interfere with emotion functionality, thereby further impeding adaptive responding. Findings are discussed in terms of future research and implications for clinical treatment of anxiety disorders.

Multilevel modeling is an excellent way to analyze nested or clustered data of the type commonly collected through investigations into the linkages between psychological functioning and relationship processes. This article describes two especially relevant applications of multilevel modeling. The first application, growth curve analysis, is already familiar to many researchers and involves modeling individuals’ change trajectories over time and relating the derived change parameters to person-level characteristics or phenomena. The purpose of this paper is to emphasize a second application, multilevel process analysis, which involves modeling within-subject characteristics other than change over a representation of time. Multilevel analysis of within-subject processes is particularly well-suited for hypotheses common to clinical psychology investigations, yet has received substantially less attention in the literature than its growth curve counterpart. Types of research questions and methodologies that can be addressed within the multilevel process analysis framework are described. Finally, aspects of multilevel process analysis are demonstrated with daily diary data collected from wives who reported on their marital happiness and depressed mood for 3 weeks.

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by a wide range of physiological symptoms. Patients with this disorder frequently present with a number of psychiatric symptoms, report histories of severe trauma, and show illness-related behavior disproportional to their physical discomfort. The present article reviews the diagnosis, correlates, and associated features of IBS. Multiple models of the etiology of IBS are presented as well as a review of the available research on the efficacy of psychosocial treatments. It is concluded that the demonstrated efficacy of psychosocial treatments for IBS may largely be attributable to the effects of non-specific treatment factors. Experimental controls that will allow for the evaluation of the specific efficacy of prescriptive and structured psychosocial treatments for IBS over and above the effects of non-specific factors are recommended.