Biomedical subjects

Jennifer Boyd Ritsher

Publications and source records attributed to Jennifer Boyd Ritsher.

10 recordsLinked to original sources

PubMed2005

Cultural factors and the International Space Station.

The American and Russian/Soviet space programs independently uncovered psychosocial risks inherent in long-duration space missions. Now that these two countries are working together on the International Space Station (ISS), American-Russian cultural differences pose an additional set of risk factors. These may echo cultural differences that have been observed in the general population of the two countries and in space analogue settings, but little is known about how relevant these are to the select population of space program personnel. The evidence for the existence of mission-relevant cultural differences is reviewed and includes cultural values, emotional expressivity, personal space norms, and personality characteristics. The review is focused primarily on Russia and the United States, but also includes other ISS partner countries. Cultural differences among space program personnel may have a wide range of effects. Moreover, culture-related strains may increase the probability of distress and impairment. Such factors could affect the individual and interpersonal functioning of both crewmembers and mission control personnel, whose performance is also critical for mission safety and success. Examples from the anecdotal and empirical literature are given to illustrate these points. The use of existing assessment strategies runs the risk of overlooking important early warning signs of behavioral health difficulties. By paying more attention to cultural differences and how they might be manifested, we are more likely to detect problems early while they are still mild and resolvable.

Astronauts↗

PubMed2004

Internalized stigma predicts erosion of morale among psychiatric outpatients.

Stigma in society causes harm to people with severe mental illness (SMI) and internalized stigma represents its psychological point of impact. We evaluated the extent of internalized stigma in a sample of outpatients with SMI, using the Internalized Stigma of Mental Illness (ISMI) Scale, developed with consumer input. About a third of the sample reported high levels of internalized stigma. We tested whether internalized stigma predicted increased depressive symptoms and reduced self-esteem at 4-month follow-up, controlling for baseline levels. Depression was predicted by Alienation, Stereotype Endorsement, Social Withdrawal Scales and total ISMI score. Reduced self-esteem was predicted by Alienation. ISMI results were stronger than those for the widely used Devaluation-Discrimination Scale. The finding that alienation further reduces morale speaks to the difficulty of pulling oneself out of this type of vicious cycle without assistance.

Ambulatory Care↗

PubMed2004

Association of Rorschach and MMPI psychosis indicators and schizophrenia spectrum diagnoses in a Russian clinical sample.

In this study, I investigated the relationships among psychological test variables and schizophrenia spectrum diagnoses in a Russian sample of 180 psychiatric patients. Schizophrenia is understood somewhat differently in Russia than in the West. Analyses compared Rorschach (SCZI, PTI; Exner, 2001) and MMPI (Berezin, Mitroshinkov, & Sokolova, 1994) psychosis indicators (Sc, Sc3, Sc6, and BIZ) and 3 diagnostic systems: (a) Russian traditional, (b) the Russian-modified International Classification of Diseases (9th ed. [ICD-9]; Ministerstvo Zdravokhraneniya SSSR, 1982), and (c) the nonmodified ICD-10 (World Health Organization, 1992; comparable to the Diagnostic and Statistical Manual of Mental Disorders [4th ed.], American Psychiatric Association, 1994). Results showed modest support for the SCZI and PTI but not the MMPI indicators. While the field awaits further evidence, psychologists should proceed with caution when using the Rorschach and MMPI to assess for psychosis among Russians.

Adolescent↗

PubMed2004

Hearing voices: explanations and implications.

Integrating information on voice hearing from multiple disciplines and perspectives, we review current explanatory models and their implications for intervention strategies. Far from always signifying a mental illness, voice hearing may result from other causes, including drug side effects, brain lesions, and culturally-sanctioned phenomena. Accordingly, a wide range of assessment, intervention, and self-management strategies are available and appropriate. We conclude that by offering a diversity of treatment options, eliciting patients' causal theories, and incorporating these into an individualized treatment strategy, clinicians are likely to help clients control the distressing aspects of the voices, minimize stigma and discrimination, and make meaning of the experience.

Adaptation, Psychological↗

PubMed2003

Internalized stigma of mental illness: psychometric properties of a new measure.

The study evaluated the Internalized Stigma of Mental Illness (ISMI) scale, designed to measure the subjective experience of stigma, with subscales measuring Alienation, Stereotype Endorsement, Perceived Discrimination, Social Withdrawal and Stigma Resistance. The ISMI was developed in collaboration with people with mental illnesses and contains 29 Likert items. The validation sample included 127 mental health outpatients. Results showed that the ISMI had high internal consistency and test-retest reliability. Construct validity was supported by comparisons against scales measuring related constructs with the same methodology. As expected, the ISMI had positive correlations with measures of stigma beliefs and depressive symptoms, and it had negative correlations with measures of self-esteem, empowerment and recovery orientation. Factor analyses of the joint set of items from the ISMI and each scale supported the distinction between constructs. Having a validated measure of internalized stigma may encourage clinicians to include stigma reduction as a verifiable treatment goal in addition to symptom reduction.

Adaptation, Psychological↗

PubMed2002

Internal validity of an anxiety disorder screening instrument across five ethnic groups.

We tested the factor structure of the National Anxiety Disorder Screening Day instrument (n=14860) within five ethnic groups (White, Black, Hispanic, Asian, Native American). Conducted yearly across the US, the screening is meant to detect five common anxiety syndromes. Factor analyses often fail to confirm the validity of assessment tools' structures, and this is especially likely for minority ethnic groups. If symptoms cluster differently across ethnic groups, criteria for conventional DSM-IV disorders are less likely to be met, leaving significant distress unlabeled and under-detected in minority groups. Exploratory and confirmatory factor analyses established that the items clustered into the six expected factors (one for each disorder plus agoraphobia). This six-factor model fit the data very well for Whites and not significantly worse for each other group. However, small areas of the model did not appear to fit as well for some groups. After taking these areas into account, the data still clearly suggest more prevalent PTSD symptoms in the Black, Hispanic and Native American groups in our sample. Additional studies are warranted to examine the model's external validity, generalizability to more culturally distinct groups, and overlap with other culture-specific syndromes.

Adult↗

PubMed2002

Relationship of treatment orientation and continuing care to remission among substance abuse patients.

OBJECTIVES: The authors examined whether continuing outpatient mental health care, the orientation of the treatment program (12-step, cognitive-behavioral, or eclectic), and involvement in self-help groups were linked to substance abuse patients' remission status two years after discharge. METHODS: The data were from a cohort of 2,805 male patients who were treated through one of 15 Department of Veterans Affairs substance abuse programs. Remission was defined as abstinence from illicit drug use and abstinence from or nonproblem use of alcohol during the previous three months. The relationships of the three variables to remission were tested with regression models that controlled for baseline characteristics. RESULTS: About a quarter of the study participants (28 percent) were in remission two years after discharge. Intake characteristics that predicted remission at two years included less severe substance use and psychiatric problems, lower expected disadvantages and costs of discontinuing substance use, and having abstinence as a treatment goal. No significant relationship emerged between treatment orientation and remission status two years later. Involvement in outpatient mental health care during the first follow-up year and participation in self-help groups during the last three months of that year were associated with a greater likelihood of remission at the two-year follow-up. CONCLUSIONS: The results extend previously published one-year outcome findings showing that cognitive-behavioral and 12-step treatment programs result in similar remission rates. Patients who enter intensive substance abuse treatment with polysubstance use, psychiatric symptoms, or significant emotional distress have more difficulty achieving remission. Routinely engaging patients in continuing outpatient care is likely to yield better outcomes. The duration of such care is probably more important than the number of sessions.

Adult↗

PubMed2002

Perinatal Bereavement Grief Scale: distinguishing grief from depression following miscarriage.

The study evaluated the Perinatal Bereavement Grief Scale (PBGS), the first scale designed to measure grieffollowing reproductive loss in terms of yearning for the lost pregnancy and lost baby. Participants included 304 women interviewed by telephone I to 3 times within 6 months aftermiscarriage. The PBGS had high internal consistency and test-retest reliability. It showed convergent validity with measures of attachment and investment in the child and divergent validity against measures of social desirability and depressive symptoms, supporting the conceptual distinction between grief and depression. Cross-cultural validity was acceptable whether tested by language (Spanish vs. English) or ethnicity (Hispanic vs. other). This measure of yearning enables study of the epidemiology and prognostic value of this key feature of mourning.

Abortion, Spontaneous↗

PubMed2002

Psychiatric comorbidity, continuing care and mutual help as predictors of five-year remission from substance use disorders.

OBJECTIVE: In a cohort of 2,595 male patients in VA intensive treatment programs for substance use disorders (SUD), we tested whether psychiatric comorbidity, outpatient care and mutual help group attendance during the first two follow-up years predicted remission status at Year 5, controlling for covariates. METHOD: Logistic regression modeling of longitudinal data was used to test the hypotheses. RESULTS: Dual diagnosis patients were less likely to be in remission at Year 5 than SUD-only patients. Outpatient care was at best only weakly related to Year 5 remission status. By contrast, mutual help involvement substantially improved the chances of substance use remission at Year 5 for both SUD-only and dual diagnosis patients. Mutual help involvement did not, however, offset the poorer prognosis for dual diagnosis patients. CONCLUSIONS: Because mutual help groups specifically targeted to individuals with comorbid substance use and psychiatric disorders are currently rare, further research is recommended to investigate whether they are more effective than standard SUD mutual help groups in facilitating the recovery of persons with dual diagnoses.

Adult↗

PubMedDate not supplied

Positive psychological effects of space missions.

Being in space is a powerful experience that can have an enduring, positive impact on the psychological well-being of astronauts and cosmonauts. We sought to examine the frequency, intensity and distribution of such salutogenic experiences among persons who have flown in space, using a questionnaire we developed based on the scientific literature and first person accounts. All participants reported positive effects of being in space, but the degree of change varied widely, and some experiences were particularly common. Three of our five predicted attitude-behavior relationships were supported by the data. Response patterns did not vary according to demographics or time in space. Cluster analysis yielded two groups of participants. One group was generally more reactive and also placed a higher priority on perceptions of space than did the other group. We conclude that positive experiences are common among space travelers and seem to cluster into meaningful patterns that may be consequential for Mars missions. We consider the possible selection, training, and monitoring issues raised by our findings.

Aerospace Medicine↗