Interpersonal relatedness and psychological functioning following traumatic brain injury: implications for marital and family therapists

Recovery from a mild-to-moderate traumatic brain injury (TBI) is a challenging process for injured persons and their families. Guided by attachment theory, we investigated whether relationship conflict, social support, or sense of belonging were associated with psychological functioning. Community-dwelling persons with TBI (N = 75) and their relatives/significant others (N = 74) were surveyed on relationship variables, functional status, and TBI symptom severity. Results from this cross-sectional study revealed that only sense of belonging was a significant predictor of postinjury psychological functioning, although interpersonal conflict approached significance. No relevant preinjury or injury-related variables impacted these relationships, except marital status. Our findings suggest that interventions targeting strengthening the injured persons' sense of belonging and lowering interpersonal conflict may benefit those living with TBI.     

Infertility: Identifications and disruptions with the maternal object

For many women, infertility is the first major crisis of adulthood. Maternal identification provides a template for parenting and infertility disrupts the opportunity to recapitulate this relationship or make reparation for early failures. Supportive work is often useful to address the manifest level of infertility issues; however, psychoanalytic work can broaden the treatment to encompass the unconscious meaning of the wished for child and the psychological effects of the lack of success. In this paper, the theme of disruption of maternal object identification, and its effect on self representation is addressed. Two case examples where pregnancy and infertility remained a dominant theme throughout the treatment are presented. In each of these cases, infertility became a medium for exploration of their internal objects.     

Conceptualization and measurement of the spiritual and psychological dimensions of wellness in a college population

Wellness is commonly conceptualized as having many dimensions, but little effort has been made to evaluate how spiritual and psychological dimensions are related to overall wellness. To explore the relationship between measures of spiritual and psychological wellness and perceived wellness in a college student population, the authors administered a series of survey instruments to 112 undergraduate students under quiet classroom conditions. They used the Life Attitude Profile to measure spiritual wellness, the Life Orientation Test and the Sense of Coherence Scale to measure psychological wellness, and the Perceived Wellness Survey to measure overall wellness. Path analysis performed with a proposed theoretical model revealed that the effect of life purpose on perceived wellness was mediated by optimism and sense of coherence, which had independent effects on perceived wellness beyond that of life purpose. The findings suggested that an optimistic outlook and sense of coherence must be present for life purpose to enhance a sense of overall well-being.     

Frustrated Fertility: Infertility and Psychological Distress Among Women

Using a random sample of 580 Midwestern women, we test the hypothesis that women who have experienced infertility report higher psychological distress. Approximately one third of our sample reports having experienced infertility sometime in their lives, although the majority of the infertile now have biological children. Drawing hypotheses from identity and stress theories, we examine whether roles or resources condition the effects of infertility or whether its effects are limited to childless women. Infertility combined with involuntary childlessness (including biological and social) is associated with significantly greater distress. For women in this category, the risk of distress is substantial.     

A Holistic Approach to the Treatment of the Crisis of Infertility

The purpose of this paper is to discuss the importance of assessing the impact of infertility on couples/individuals and understanding the relevance of the impact in the context of psychological treatment. The assumption is that infertility can have a significant negative impact which can at least be minimized by therapeutic intervention. Three psychological-behavioral categories are posited as the result of several years work with infertile individuals/couples. Detailed case presentations of couples in each category are given so that the total impact of the crisis of infertility and the role of psychological intervention can best be understood.     

Toward a multifaceted understanding of Lareau's “sense of entitlement”: Bridging sociological and psychological constructs

In her influential ethnographic study, Lareau proposed that intensive middle‐class parenting strategies produce in children a “sense of entitlement” that can be used to gain advantages in schools and other institutional settings. In this article, we review both sociological and psychological studies to propose a multifaceted understanding of a sense of entitlement that challenges the assumption that the consequences of entitlement are exclusively positive. We also compare “sense of entitlement” with four psychological constructs—academic entitlement, help‐seeking, interpersonal control, and agentic engagement—that provide critical clues for subsequent empirical efforts. Our study highlights the benefits of bridging sociological and psychological work, not only to connect related disciplines and concepts, but also to assess and refine theory.     

“That's What Makes a Woman”: Infertility and Coping with a Failed Life Course Transition

Becoming a parent remains a key marker for the transition into adulthood, especially for many women. Infertility thwarts this transition. In this research, we investigate one aspect of the gendered nature of adult development within the life course. Specifically, this study examines interview data from 40 infertile women in order to explore how this group of women cope with what they perceive to be a failed life course transition and how it affects their sense of self. We find that this failed life course transition altered these women's relationships with others. Further, this change had a corresponding effect on their self. These women's inability to do gender by being mothers challenges their sense of themselves as normal adult women. Using West and Zimmerman's concept of doing gender, we argue that infertility can be experienced as a failed life course transition among women who desire children. We also demonstrate how this failed transition has a distinctly gendered component.     

Education and health in late-life among high school graduates: Cognitive versus psychological aspects of human capital

Just as postsecondary schooling serves as a dividing line between the advantaged and disadvantaged on outcomes like income and marital status, it also serves as a dividing line between the healthy and unhealthy. Why are the better educated healthier? Human capital theory posits that education makes one healthier via cognitive (skill improvements) and noncognitive psychological resources (traits such as conscientiousness and a sense of mastery). I employ the Wisconsin Longitudinal Study (1957-2005) to test the relative strength of measures of cognitive human capital versus noncognitive psychological human capital in explaining the relationship between education and health outcomes among high school graduates. I find little evidence that noncognitive psychological human capital is a significant mediator, but find a relatively significant role for cognitive human capital, as measured by high school academic performance. It is not just higher educational attainment; academic performance is strongly linked to health in later life.     

An Examination of the Association Between Relationship Mindfulness and Psychological and Relational Well-being in Committed Couples

Relationship mindfulness is the degree to which individuals tend to be mindful during interactions with romantic partners. In this study, we examined both the intrapersonal and interpersonal links between relationship mindfulness and psychological and relationship functioning in a sample of 219 couples who had been in their relationship for at least 1 year. Even when accounting for the general tendency to be mindful, relationship mindfulness was linked with markers of relationship well-being and psychological functioning, both intrapersonally and interpersonally. The findings bring to light the importance of considering relationship mindfulness in clinical work with couples that focuses on addressing deficiencies in relationship or psychological well-being.     

Reconstructing a Sense of Relational Agency in Family Therapy

The concept of agency is relevant in family therapy. As family therapists we approach each family member as a full agent, which means that what each person thinks and feels, makes sense, and that each person contributes in a significant way to the construction of a relationship. A person's sense of relational agency is constructed in relationships through processes of relational influence. Thus, agency is a relational construct and is dependent on bidirectional transactions in a relationship. A person's sense of relational agency refers to the belief a person has about being able to influence another person, that this influence is significant for the other, makes a difference for the other, and contributes to the construction of the relationship. Many family members who enter therapy have lost their sense of relational agency. In this paper we discuss ideas how to reconstruct family members’ sense of relational agency in therapeutic practice.     

Understanding the emotional aspects of infertility: implications for nursing practice

Approximately 10% to 15% of childbearing-age couples experience infertility. Infertility has multiple aspects, including physical, emotional, financial, social, and psychological effects. Although most health care professionals are more aware of problems related to physical aspects of infertility, the difficulties and needs that arise from the emotional aspects are often more significant for couples. Thus, it is crucial that health care professionals, particularly nurses, understand these needs. This article provides some practical information to help nurses do just that.     

What Are the Correlates of Infertility-Related Clinical Anxiety? A Literature Review and the Presentation of a Conceptual Model

Infertility is a major stressor for many couples. Although several reviews addressing psychological distress and depression within infertile couples exist, less emphasis has been placed on infertility-related anxiety. Yet it is important to know whether clinical anxiety is a prevalent problem among infertile couples and what are the characteristics of those suffering from clinical anxiety. The present article summarizes the literature on infertility-related anxiety published between 1997 and 2008 and presents a model of infertility-related clinical anxiety that identifies variables that may distinguish individuals who present with clinical anxiety from those who successfully cope with infertility. This model is intended to inform both research and clinical practice with partners of infertile couples. Methodological shortcomings of infertility research and recommendations for future studies are also discussed.     

Psychological trauma from the perspective of medical history: from Paracelsus to Freud

Psychological traumatisation, as we understand it today, was—in terms of the history of ideas—anticipated by various approaches which have had a lasting impact on modern psychiatry, psychotherapy, and psychosomatic medicine. On the one hand, there is the traditional concept of possession and exorcism with its impressive psychodynamics. On the other hand, there is the theory of the imagination, of an illusion in the sense of a pathogenic infection. Especially the pathological teachings of Paracelsus (sixteenth century) and Johann Baptist van Helmont (seventeenth century)—the latter having advanced the former’s alchemist approach—demonstrate the extent to which demonological, parasitological, and psychological ideas were amalgamated in their “ontological” notion of a disease. Only the introduction of hypnotism in the middle of the nineteenth century made possible a psychological or psychodynamic understanding of psychological trauma in the modern sense. Hypnotism was striving to strictly dissociate from the magical and natural philosophical speculations of mesmerism and its theory was quite compatible with the model representations of scientific medicine. Sigmund Freud was able to tie in his ideas of hysteria and neurosis with this concept and especially to define repression of (infantile) sexuality as the cause of a culturally ineluctable psychological trauma. Finally, a brief survey of medical history is given to explore artificial trauma as a healing factor.     

Sense of School Membership and Associated Academic and Psychological Outcomes in Post-Institutionalized Adopted High School Students

Research highlights lasting cognitive and academic challenges in youth internationally adopted from institutional care. However, there is a lack of research examining internationally adopted students' sense of membership at school and associated academic and psychological outcomes. The current study measured sense of school membership and academic and psychological outcomes in post-institutionalized internationally adopted high school students (n = 29) compared to adolescents internationally adopted from foster care (n = 28) and non-adopted adolescents (n = 32). Post-institutionalized males had a lower sense of school membership than males adopted from foster care or non-adopted males. Group differences in school membership were mediated by academic achievement and psychological well-being.     

“I didn't want to be moved there”: Young women remembering their perceived sense of Agency in the Context of placement instability

In studies of children who have been placed in care, any definition of placement instability that is based only on the number of placements and the number of physical moves may well be incomplete. To understand placement instability, one must also consider the psychological shifts, both cognitive and emotional, that accompany it. In the present study, to explore the psychological shifts associated with placement instability, we conducted semi-structured interviews with 15 young women who had spent time in out-of-home placements as adolescents. Our findings show that the kinds of psychological shifts that these young women had undergone as a result of placement instability depended on how they had perceived that instability, and that in this perception, their sense of their own agency was central. Instability that they had observed only in other girls, instability that was imposed on them by external forces, and instability that they induced by their own actions all resulted in different kinds of psychological shifts. These findings are discussed in light of the empowerment.     

Correlates of wife assault in Hong Kong Chinese families

The objective of this study was the risk factors of wife assault in Hong Kong Chinese families. The sample included 107 battered women from a refuge for battered women. Factor analysis revealed risk factors like dominance, stress, poor anger management, aggressive personality, conflict, lack of empathy, masculine gender role stress, sense of insecurity, relationship distress, and violent socialization. Correlation analysis indicated that dominance, spousal conflict, and sense of insecurity increase the likelihood of carrying out minor physical assault and using psychological aggression, while aggressive personality predicts severe physical assault and injury. The risk factors were explained in terms of traditional Chinese concepts of gender role expectations of men and women and face orientations. The present study provides some evidence relating to the risk factors of wife assault in Chinese families.     

Asian adolescent and young adult adoptees' psychological well-being: Examining the mediating role of marginality

Adolescent adoptees from an ethnic minority background different from that of their adoptive parents can face unique challenges to their psychosocial adjustment that may include, for some, a sense of marginality and low self-esteem. Using a web-based survey design with a sample of 100 internationally adopted Asian adolescent and young adults, the present study examined how feelings of marginality mediate the relationship between ethnic and racial socialization and psychological well-being among Asian adoptees. The results showed that (a) supports for racial socialization decreased adoptees' feeling of marginality and thereby, increased their positive sense of self; and (b) ethnic socialization was not related to feelings of marginality and self-esteem. This study illustrates the importance of providing post adoption services addressing racial socialization issues. Further, adoptive parents should teach their children how to deal with racial prejudice and discrimination, and prepare them by helping them to develop positive coping strategies.     

Sociology as a vocation: Reputations and group cultures in graduate school

Graduate training in sociology involves more than meeting organizationally imposed demands such as satisfying departmental requirements, taking exams, and completing a dissertation. More central is the development of identity through institutional and interactional forces. We examine the experience of graduate students as tied to the social psychological processes associated with professional training. We consider the faculty-student relationship, identifying how student identities as future sociologists are negotiated and constructed within a reputation market linked to status politics. Through this process, graduate students construct frames of interpretation that make sense of a status system in which criteria for evaluation are often variable, uncertain, or undisclosed. To recognize how graduate students fit into their occupational routines, we build upon three core disciplinary constructs: identity, reputation, and group culture. This perspective permits graduate education to be grounded in sociological understandings, underlining the role of a sociological imagination. We propose strategies that sociology departments might follow to facilitate the professional socialization of graduate students, emphasizing the establishment of group culture and presentational norms. In the absence of these changes, we offer advice to graduate students on navigating their current programs.     

The role of psychological factors on teenagers who become parents out-of-wedlock

This paper presents the role of psychological factors in teenagers who become parents out of wedlock. It talks on the normative adolescent psychological development, emphasizing the developmental thrust towards separation, but juxtaposes the deviant psychological development of teenagers who are unable to gain control of their childbearing. The different experiences of female and male teenagers and the meaning of parenthood are cited. The pre-existing, intrinsic, psychological dynamics that predispose these vulnerable teenagers to early childbirth includes unmet early dependency needs; the desire to appear as adults, while simultaneously wanting to remain as children; denial of parenthood risk; and denial of the demands of babies. Furthermore, male teenagers perceive fatherhood as an attainment of some psychological sense of manhood. While for both males and females, the unconscious acceptance of dependency on the government to provide for the basic needs of their children and themselves can be a way of psychologically gratifying their own needs. The impact of early childhood experiences, role of parents as models, family experiences, social class, changing societal sexual mores, urban living, education and a sense of future are explicated. The influence of cognitive challenges and of specific psychiatric illness is also discussed. This study concludes that social policy integrate an understanding in the crafting of domestic policy on teenage parenthood.     

The Social Construction of Infertility

Health and illness are not objective states but socially constructed categories. We focus here on infertility, a phenomenon that has shifted from being seen as a private problem of couples to being seen as a medical condition. Studying infertility provides an ideal vantage point from which to study such features of health care as inter‐societal and cross‐cultural disparities in health care, the relationship between identity and health, gender roles, and social and cultural variations in the process of medicalization. Infertility is stratified, both globally and within Western societies. Access to care is extremely limited for many women in developing societies and also for marginalized women in some highly industrialized societies. We also discuss the ways in which responses to infertility are influenced by the process of self‐definition. The experience of infertility is profoundly shaped by varying degrees of pronatalism and patriarchy. In advanced industrial societies, where voluntary childfree status is acknowledged, many women experience infertility as a ‘secret stigma’; in other cultures, where motherhood is normative for all women, infertility may be impossible to hide. In the West, acceptance of the medical model is virtually hegemonic, but in other societies medical interpretations of infertility coexist with traditional interpretations.