PubMed · 515887
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M Williams. 1979. Crisis intervention: a social work method.. https://doi.org/10.1300/j010v05n01_03
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The bed nucleus of the stria terminalis (BNST) was lesioned in adult male Wistar rats (n = 9) and its involvement in coping behavior during forced swim stress examined. Rats remain immobile longer in the second of two swim tests, a phenomenon known as learned despair. Results revealed that, compared to sham-operated controls (n = 8), BNST-lesioned animals displayed immobility significantly earlier and for longer durations in the second swim test. Rats with BNST lesions also showed significantly reduced escape behavior in the form of fewer numbers of jumps and dives compared to controls. Mobility deficits were not due to general motor impairment as revealed by an open field test. Results suggest that the BNST may modulate coping behavior especially during uncontrollable stress.
BACKGROUND: Variability in methods and deficits in design have contributed to conflicting findings about adult psychosocial functioning after childhood cancer. We did a controlled study of psychosocial outcomes in adult survivors of childhood acute lymphoblastic leukaemia (ALL) and Wilms' tumour to address previous methods limitations. METHODS: We assessed 102 survivors of childhood ALL and Wilms' tumour, who had been free from relapse for 5 years and were aged 19-30 years, and 102 unrelated healthy controls. We used standard measures of adult psychiatric disorder, interpersonal and social-role performance, and intellectual ability to assess past and current functioning. FINDINGS: Cancer survivors had no increased rates of psychiatric disorder. Mean scores of cancer survivors were significantly higher (indicating poorer functioning) than those of controls for love/sex relationships (mean difference 0.87 [95% CI 0.53-1.22]), friendships (0.37 [0.07-0.67]), non-specific social contacts (0.40 [0.20-0.60]), and day-to-day coping (0.35 [0.14-0.57]). Cancer survivors were more likely than controls to have a combination of deficits in love/sex relationships and friendships (ALL survivors odds ratio 10.83 [95% CI 3.87-30.82], Wilms' tumour survivors 4.85 [1.43-16.47]), which was associated with more recent treatment (p=0.005). Poor coping was associated with lower intellectual ability scores (p=0.018). INTERPRETATION: Childhood ALL and Wilms' tumour have long-term effects on interpersonal functioning and coping, probably mediated by different mechanisms. Prospective studies with each of these tumour groups are needed with similar adolescent and adult outcome measures.
Clinical studies are beginning to clarify how spirituality and religion can contribute to the coping strategies of many patients with severe, chronic, and terminal conditions. The ethical aspects of physician attention to the spiritual and religious dimensions of patients' experiences of illness require review and discussion. Should the physician discuss spiritual issues with his or her patients? What are the boundaries between the physician and patient regarding these issues? What are the professional boundaries between the physician and the chaplain? This article examines the physician-patient relationship and medical ethics at a time when researchers are beginning to appreciate the spiritual aspects of coping with illness.