Narcissistic Implications in Gambling Disorder: The Mediating Role of Emotion Dysregulation

Gambling Disorder (GD) is a complex psychopathology involving a numbers of cognitive, behavioral, emotional and neurobiological determinants. Previous research suggests that GD may frequently co-occur with Narcissistic Personality Disorder. However, there is still a lack of study investigating Pathological Narcissism (PN) in both its vulnerable and grandiose facets among clinical population. Moreover, emotional dysregulation is commonly thought to underlie GD albeit research on this topic remains poor. The present study aims to investigate the role of both vulnerable and grandiose narcissism in relation to GD as well as the mediator role played by emotion dysregulation in such link. We administered to a sample of addicted gamblers (n = 74) and a sample of heathy controls (n = 105), the South Oaks Gambling Screen (SOGS), the Pathological Narcissism Inventory (PNI) and the Difficulties in Emotion Regulation Scale (DERS). Differences across groups emerged on the scores obtained on the PNI and DERS. Moreover, we found positive associations between SOGS scores and both PNI and DERS. Also, strategic addicted gamblers showed higher levels of vulnerable narcissism compared to others. Finally, emotion dysregulation difficulties appeared to fully mediate the relationship between grandiose narcissism and GD severity. Grandiose and vulnerable narcissism appear important variables involved in GD. Also, emotion regulation deficits seem to account for GD and to explain the pathways by which grandiose narcissism leads to GD. Clinical implications and future directions are discussed.     

Bringing Two Worlds Together: A Collaborative Interview With JoEllen Patterson

JoEllen Patterson is Professor in the Marital and Family Therapy Program at the University of San Diego. She is also an Associate Clinical Professor of Family Medicine and Psychiatry at the University of California, San Diego, directing a medical family therapy clinic embedded in a Family Medicine residency (equivalent to General Practice in New Zealand). She also works in Pediatrics and Reproductive Medicine at UCSD. At present her work involves training family therapy students and family medicine residents to do interdisciplinary work using a biopsychosocial model. Research suggests that our bodies are influenced by our mental health; our immune systems and cardiovascular systems seem especially susceptible to mind‐body interplay. JoEllen is particularly interested in how family functioning influences the mind‐body system. In 2003, JoEllen Patterson received a Fulbright Senior Scholars award to visit the Wellington School of Medicine and Health Sciences, and the Child, Adolescent and Family Service in Lower Hutt, New Zealand. She spent two weeks between the clinical service and the academic department, teaching, consulting and advising. I was lucky enough to arrange this posting and to spend time with her during it.     

The dual role of the action researcher

This article aims to provide more insight into advantages and challenges of conducting action research with the intention to improve health care. Action research is distinctive in the sense that the researcher has a dual role as both researcher and implementer of the program studied. The article is based on two Norwegian action-oriented studies that aimed to explore the potential role of online self-help groups for breast cancer patients and adolescents with mentally ill parents respectively. We argue that action research can contribute both to the generation of knowledge, as well as a greater sense of ownership to the program among those who are intended to use it. Nonetheless, a potential conflict between the researcher's pursuit of data, and ethical considerations became apparent in the contexts studied here. Bearing these challenges in mind, we still conclude that action research offers an important contribution for the further development of health care services.     

Stressful Life Events and Physical and Psychological Health: Mediating Effects of Differentiation of Self in a Spanish Sample

The pathways between differentiation of self and health remain only partly elucidated. This cross‐cultural study sought to test Bowen's hypothesis about the associations between differentiation, stressful life events, and physical and psychological health, in a sample of 466 Spanish adults. Results show that people with higher levels of differentiation were less prone to physical ailments (e.g., heart disease, cancer, or blood disorders) and psychological symptoms (e.g., depression or anxiety). Further, differentiation mediated the association between stress (i.e., perceived negativity of stress in the past year and number of stressful events across the lifetime) and physical and psychological health. The current research provides cross‐cultural empirical evidence for the links between differentiation and mind and body health in a Mediterranean culture.     

The Body in Mind: Mead's Embodied Cognition

This article highlights the role played by the body in the work of George Herbert Mead. For Mead, the social emergence of mind depends on human physiology. This is revealed through a detailed exploration of three thematic domains in his work: the organism–environment dyad, perception, and the manipulatory stage of the act. From this, I argue that Mead saw the body as constitutive of cognition and central to the development of mind and self. Present-day research supports this view and demonstrates Mead's relevance for understanding embodied cognition.     

Emerging adulthood among former system youth: The ideal versus the real

Recent research has indicated that emerging adulthood, the late teen years and early twenties, is a distinct developmental period, which occurs gradually and is often filled with exploration, stress, uncertainty and a lack of a distinct role in life. Few studies, however, have examined how emerging adulthood tenets are experienced by young people involved with social service systems. With this in mind, fifty-nine young adults, ages 18 to 25, participated in in-depth interviews regarding their perspectives on transitioning to adulthood and adulthood. Participants were struggling with emotional difficulties, and shared a childhood history, which included a mood disorder diagnosis and utilization of public mental health and social services (e.g., child welfare, juvenile justice, and/or public welfare). The study sought to understand whether or not young adults with mental health and social service histories experience similar (or different) dimensions of mainstream emerging adulthood developmental theory during the late teens and early twenties. Theoretical thematic analysis indicated support not only for the theory of emerging adulthood, but also aspects unique to this sub-population. Implications for practice, policy and research are discussed.     

The Stress Role: A Conceptual Development

The concept of the stress role (a temporary role assumed by actors experiencing unusual or critical stress) is developed in this paper. It is hypothesized that the stress role is a patterned, regularly occurring set of rights, obligations, and expectations which accords special latitude to stressed actors, specifies appropriate behavior toward the stressed, and releases the actors from culpability for atypical role performances during the stressful period. The stress role and similar disabling, adjective-type roles are proposed as examples of "role riders." This paper identifies the stress role norms and outlines the process by which one acquires, occupies, and relinquishes the role. The legitimacy of assuming the stress role is addressed and the timetables, or containment norms, of the stress role are developed. Finally, the functions of the stress role for the actor and for society are discussed. The propositions and concepts introduced here are based on data from in-depth interviews with a random sample of reentry university women, as well as from the growing body of stress and social-support research.     

Self-leadership and stress among college students: Examining the moderating role of coping skills††

Abstract

Objective: Stress remains a major health concern among college students today. Consequently, research on student stress is imperative, from both an organizational and an individual perspective. This research study explores the moderating role of coping skills on the relationship between self-leadership and stress among college students. Participants: Data from 643 full-time undergraduate students attending a 4-year public university in the mid-Atlantic region were collected in February 2017 and analyzed using a moderated regression model. Results: The results indicate self-leadership practices do reduce student stress levels and that this relationship is moderated by student coping skills. Conclusion: The findings from this study deepen our understanding of how self-leadership practices may decrease student stress and showcases self-leadership as an effective tool for reducing college student stress.     

The evaluation of a mind/body intervention to reduce psychological distress and perceived stress in college students

The authors examined the effect of a 6-week mind/body intervention on college students' psychological distress, anxiety, and perception of stress. One hundred twenty-eight students were randomly assigned to an experimental group (n = 63) or a waitlist control group (n = 65). The experimental group received 6 90-minute group-training sessions in the relaxation response and cognitive behavioral skills. The Symptom Checklist-90-Revised, Spielberger State-Trait Anxiety Inventory, and the Perceived Stress Scale were used to assess the students' psychological state before and after the intervention. Ninety students (70% of the initial sample) completed the postassessment measure. Significantly greater reductions in psychological distress, state anxiety, and perceived stress were found in the experimental group. This brief mind/body training may be useful as a preventive intervention for college students, according to the authors, who called for further research to determine whether the observed treatment effect can be sustained over a longer period of time.     

Ethical uneasiness and the need for open-ended reflexivity: the case of research into older people with a wish to die

This article focuses on research ethics in highly intimate research with possible impact on life and death. In order to stimulate an open-ended dialogue about research ethics, we reflect on four ethical challenges that came up during our research into older people with a wish to die. Drawing on our experiences, we discuss (1) the possibly confirming influence of our research on the death wish (moral experience of whether or not to disregard responsibility); (2) the suggested duty to intervene (moral experience of whether or not to compromise the person’s autonomy); (3) the researcher’s authority and power over the data (moral experience of threatening a person’s self-narrative) and (4) the dilemma of intimacy (moral experience of encountering the tragic). For guidance in addressing these challenges, we draw upon work on research ethics from phenomenological and care ethics scholars, as well as from those writing about relational ethics in health research. We suggest that being open about ethical uneasiness is important, because in most cases of a grey area, there are only open-ended answers needing an enquiring mind, rather than clear and fixed guidelines. Acknowledgement of ethical uneasiness and open-ended reflexivity are indispensable to constitute a morally good research practice.     

Social Psychopathy,Social Distress,Family Breakdown,and Custody Disputes in the 1990s: Implications for Mental Health Professionals

The decade of the 1990s will probably contain more challenges to the role of the mental health practitioner in child custody cases than ever before in history. Because of increasing social stress and family disintegration, custody disputes are destined to become more frequent, bitter, and traumatic for all parties. Mental health professionals, in particular, need to develop a coherent structure regarding their own participation in this process. Issues of moral changes among our leadership and our citizenry are examined and guidelines for the behavior of the mental health practitioner in the courtroom are formulated and illustrated as they pertain to custody decisions. Parlicular attention is paid to custody decisions as an a11 rather than a science, the role of empirical research, the need to anticipate certain unintended circumstances, the need for the application of mental health principles on an individual case-by-case basis, the nature of the mental health professional’s expertise, and the problems with the concepts of “parental unfitness” and the use of psychiatric diagnosis as a way of defining such alleged unfitness.     

Chomsky Versus Mead

G. H. Mead's model of language and mind, while perhaps understandable at the time it was written, now seems inadequate. First, the research evidence strongly suggests that mental operations exist prior to language onset, conversation of gestures, or social interaction. Second, language is not just significant symbols; it requires syntax. Third, syntax seems to be part of our bioinheritance, that is, part of our presocial mind/brain—what Noam Chomsky has called our language faculty. Fourth, this means syntax probably is not learned nor a social construction that is internalized as a cultural template. Fifth, this suggests a basic reversal of the prevailing model of symbolic interaction, mind, language, and perhaps the self as well, although there has not been the time or space to engage that topic here. Therefore, symbolic interaction may turn out to be a more Chomskyan than Meadian process. Given the bioinheritance of our mind/brain we are able to engage in symbolic interaction; it does not appear that symbolic interaction creates our mind or the basic computational algorithms of language .     

Black feminist theory in maternal health research: A review of concepts and future directions

Black maternal health and well-being has become a necessary focal point for health researchers due to higher rates of maternal mortality and morbidity for Black women. However, what is often absent from this scholarship within medical sociology is Black Feminist Theory as a framework for understanding Black women's health and well-being. Drawing on Black feminist and maternal health scholarship, I argue that integrating Black feminist approaches in maternal health research expands our understandings of what processes and mechanisms are impacting the health and well-being of Black mothers, while also highlighting the importance of maternal health research that solely centers Black women. Specifically, I focus on three concepts of Black Feminist Theory as it relates to Black maternal health research: (1) examining Black women's standpoint as credible, (2) acknowledging the historical context of multiple systems of oppression against Black women, and (3) incorporating a perspective that acknowledges both disadvantages, as well as empowerment, in the lives of Black women. I end this review with a discussion of future directions for sociological research in maternal health, including the importance of acknowledging how Black mothers are both impacted by, and resisting, social structures that may add nuance to our current understandings of Black maternal health and well-being.     

Problem drinking patterns among African Americans: the impacts of reports of discrimination, perceptions of prejudice, and "risky" coping strategies

This research builds on a series of recent studies that have reported independent effects of personal experiences of racial discrimination on poor mental health outcomes. We suggest that for one mental health outcome, problem drinking, discrimination experiences have an impact not only via abridged socioeconomic attainment and the frustrations associated with institutionally limited opportunity structures, but also by directly increasing the likelihood of problem drinking. Moreover, we argue that personal experiences with discrimination help to foster a set of beliefs about the utility of drinking as a means of reducing stress that in the alcohol literature is referred to as "escapist" drinking. Escapist drinking is proposed as an intervening mechanism that is associated with a higher probability of alcohol-related mental health problems. Using data from the 1999-2000 National Survey of Black Workers, we find that, independent of socioeconomic attainment, personal reports of discriminatory experiences have direct influences on problem drinking. Consistent with our hypotheses, we also find that the effects of personal reports of discrimination are at least partially mediated by the endorsement of beliefs that drinking provides an effective coping mechanism. We conclude that racial impacts on mental health outcomes reflect more than the "simple" effects of constrained socioeconomic attainment.     

Black women’s mental health matters: Theoretical perspectives and future directions

Despite recent sociological research exploring how stratification systems impinge on the health of socially disadvantaged populations, Black women’s mental health is rarely a topic of investigation among scholars of medical sociology, sociology of race and racism, or sociology of gender. In this review, we incorporate perspectives from sociology, social psychiatry, psychology, and social work to develop a transdisciplinary intersectional model of Black women’s mental health. We also present critical interventions in the extant literature. First, though stress exposure is generally associated with poor mental health, more research is necessary to ascertain the gendered-racialized stressors to which Black women are exposed, owing to their racial and gender oppression. Second, we admonish mental health scholars to incorporate other status dimensions (e.g., nativity, sexual orientation, age) to provide a more nuanced depiction of Black women’s psychological health. Third, the unique and enduring relationship between the U.S. punishment system and the mental health of Black women should be further explicated in future research. Last, we envision a body of work on Black women’s mental health that captures the ways in which they cope with societal level marginalization, as these forms of resilience and resistance may be mental health protective.     

A Life-course Perspective on the "Gateway Hypothesis"

Drawing on stress and life-course perspectives and using panel data from 1,286 south Florida young adults, we assess three critical questions regarding the role of marijuana in the "gateway hypothesis." First, does teen marijuana use independently (causally) affect subsequent use of more dangerous substances? Second, if so, does that effect apply to the abuse of other illicit substances, as defined by the DSM-IV, or only to the use of such substances? Finally, does any causal effect of teen marijuana use survive beyond adolescence, or is it a short-term effect that subsides as adolescents transition to adulthood? Our results indicate a moderate relation between early teen marijuana use and young adult abuse of other illicit substances; however, this association fades from statistical significance with adjustments for stress and life-course variables. Likewise, our findings show that any causal influence of teen marijuana use on other illicit substance use is contingent upon employment status and is short-term, subsiding entirely by the age of 21. In light of these findings, we urge U.S. drug control policymakers to consider stress and life-course approaches in their pursuit of solutions to the "drug problem."     

Family systems functioning,family health roles,and utilization of physical health services

The purpose of the study reported here is to determine the relationship between family systems functioning, family health role, and family utilization of health services. The research is based in the Circumplex Model of Marital and Family Systems (Olson, Sprenkle, & Russel, 1979). Family functioning variables include family level of cohesion, family adaptability, and family type, as measured by FACES II. Family health role (i.e., leadership role and acceptance of sick role) and utilization of health services are measured by scales of the investigator-developed Family Health Questionnaire. The sample consists of 140 parents of 70 families, composed of two parents with children under 25 years of age living at home. Analysis reveals significant relationships between the family level of adaptability and acceptance of the sick role, in conjunction with significant gender and gender interaction effects. There are no significant differences between family cohesion levels or family typologies with the health variables.Su An Arnn Phipps is an Assistant Professor at the University of Oklahoma College of Nursing Graduate Program, Tulsa, 700 N. Greenwood, Tulsa, OK 74106. Her research interests include family systems functioning and family physical health, couples' infertility experience, and fathers' role(s) in family health. She received her Ph.D. from Oklahoma State University in Family Relations and Child Development.     

The 'negotiated night': an embodied conceptual framework for the sociological study of sleep

Sleep is essential for our health and well‐being but it has, historically, been the subject of little sociological study. Yet sleep is not, as common sense would have us believe, ‘asocial inaction’. Like our waking lives, it is a time of interaction. The sociology of sleep presently exists in a state similar to the early stages of development of the sociology of the body, waiting for something like Frank's (1991 ) typology of body action, which served as a heuristic guide through which action and its multifaceted components could be understood. This paper argues that one productive analytical framework is to adapt Watson's (2000 ) ‘male body schema’ for the sociological investigation of sleep. This revolves around four interrelated forms of embodiment: normative (opinions and perceptions about healthy sleep behaviour); pragmatic (‘normal’ as related to social role); experiential (feelings related to sleep); and visceral (the biological body and sleep). The possibilities this model provides for the sociology of sleep is illustrated in the paper through the analysis of a case study of sleep negotiation between a couple.     

Associations of Bisexual-Specific Minority Stress and Health Among Cisgender and Transgender Adults with Bisexual Orientation

Among sexual minorities, bisexuals are at the greatest risk for poor health due in part to prejudice and stigma. This research examined associations of bisexual-specific minority stress and health among cisgender (non-transgender) and transgender adults with bisexual orientation. Participants were 488 adults (378 cisgender women, 49 cisgender men, 61 transgender individuals), age 18 to 66 years, with bisexual orientation based on identity and/or attractions to multiple genders. Participants completed an online survey. Hierarchical linear regression analyses were conducted with sexual minority stress and bisexual-specific minority stress as the predictors and physical health, measured by the 36-Item Short Form Survey (SF-36), as the outcome. Models controlled for demographic variables. Moderation analyses were conducted to test for gender differences. Greater bisexual-specific minority stress significantly predicted poorer overall physical health (β = ?0.16), greater pain (β = ?0.16), and poorer general health (β = ?0.25) above and beyond the effects of sexual minority stress. Gender moderated the association between bisexual-specific minority stress and health, such that bisexual-specific minority stress predicted overall physical health and role limitations for transgender individuals but not for cisgender women. Addressing bisexual-specific minority stress is necessary to improve the health and well-being of bisexual individuals.     

RESEARCH ON INTERNATIONAL MIGRATION WITHIN SUB-SAHARAN AFRICA: Foci, Approaches, and Challenges

This article reviews the state of research on international migration within sub-Saharan Africa. It examines the international migration systems that have emerged on the subcontinent, especially in Southern and Western Africa, as well as issues pertaining to gender and migration and to migrants' incorporation in host societies. Special attention is given to conflict-induced migration and to implications of international migration for health, with a particular emphasis on the HIV/AIDS epidemic. Despite the large volume and diversity of international migration in the subcontinent, the literature on the subject remains scarce and disconnected from the body of international migration research in other settings. The review identifies causes of this mismatch and discusses ways to mainstream the subcontinent's migration problematique .