Self Disclosure

While online, some people self-disclose or act out more frequently or intensely than they would in person. This article explores six factors that interact with each other in creating this online disinhibition effect: dissociative anonymity, invisibility, asynchronicity, solipsistic introjection, dissociative imagination, and minimization of authority. Personality variables also will influence the extent of this disinhibition. Rather than thinking of disinhibition as the revealing of an underlying "true self," we can conceptualize it as a shift to a constellation within self-structure, involving clusters of affect and cognition that differ from the in-person constellation.

Background: Informal caregivers of palliative patients took part in existential behavioral therapy (EBT), a group intervention comprising mindfulness exercises to reduce psychological distress and improve quality of life. Objectives: This study examined which aspects of EBT were perceived as helpful during the first year of bereavement and how mindfulness was understood and transferred into daily life. Design: Sixteen problem-centered, semi-structured interviews were evaluated with content analysis. Results: Two main categories were found: social support and self-regulation. Social support includes sense of belonging as well as emotional, cognitive, and practical help experienced from others. Mindfulness and acceptance, a clear focus on the positive, and orientation toward the future were helpful strategies of selfregulation; these were also part of the EBT intervention. Mindfulness was understood as permitting emotions and acceptance of one's inner processes, even if they were not pleasant, and was found to be helpful to stop ruminative thinking. Conclusions: The categories considered as being helpful parallel core elements of EBT and recent grief theories. The intervention was found to be supportive and met the needs of the participants. The interviewees appreciated the continuity of EBT support from palliative care into bereavement.

Most studies of HIV disclosure in Africa have focused on disclosure to spouses and sexual partners, and particularly among women. Few have examined disclosure to family, friends, and others. Understanding the reasons for disclosure and nondisclosure and how these reasons differ by disclosure target is needed for effective prevention interventions. Using a case study design and content analysis, this study explored whether the reasons for disclosure decisions differ by the nature of the relationship to the disclosure target. Semistructured interviews were conducted with 40 HIV clients in Kampala, with even stratification by gender and age. Most (95%) respondents reported disclosing to someone; among these, 84% disclosed to family members, 63% to friends, 21% to workplace colleagues, and 18% to others. Of the 24 participants who had a spouse, 13 (54%) reported disclosing to a spouse. The most common reasons for disclosure were to receive support (76%), associated with disclosure to family members; relationship ties (76%), associated with disclosure to all target types; explaining change in behavior or appearance (61%), associated with disclosing to family and friends; and HIV prevention (50%), associated with disclosure to spouse/partner and friends. The most common reasons for nondisclosure were: fear of abandonment, particularly among young women disclosing to spouse/partner; inaccessibility to the disclosure target; and not wanting to worry/upset the disclosure target. This exploratory analysis suggests that reasons for disclosure and nondisclosure differ depending on the targets of disclosure, highlighting the need for tailoring interventions for improving disclosure decisions making and outcomes.

There is little doubt that family factors can influence involvement in delinquency, although the full nature and extent of their influences remain unclear. In recent decades, testosterone has been increasingly implicated as a contributor to adolescent offending. The present study sought to determine whether two important types of familial factors--parental socioeconomic status and amicable parent-child relationships--are interacting with testosterone (and possibly other androgens) to affect delinquency. A large sample of North American college students self-reported their involvement in eight categories of delinquency along with self-ratings of various androgen-promoted traits (e.g., muscularity and low-deep voice), parental social status, and the quality of the relationships they had with parents. In both sexes, parent-child relationships and androgens were significantly associated with delinquency but parental social status was not. Factor analysis revealed that the authors' m...

Difficulties in identification of Latinos from secondary datasets have often been addressed by the use of a Spanish surname list. To evaluate the sensitivity and specificity of the 1980 U.S. Census Spanish surname list in correctly identifying Latino ethnicity, we conducted a cross-sectional survey of adult members of a prepaid health plan in the San Francisco Bay Area. We compared a randomly selected list of 1345 Spanish surnames and 717 non-Spanish surnames from health plan membership lists with their self-identified race and ethnicity obtained by telephone interviews. The sample was stratified according to surname group (Spanish or non-Spanish), sex, age, and county. Compared with self-identified ethnicity, a Spanish surname was 88.4% sensitive in identifying Latino men and 70.4% sensitive in identifying Latina women. The non-Spanish surname list was 94.1% sensitive and 95.0% specific in correctly identifying non-Latinos. Although the overall negative predictive value was 97.8%, ...

Most research concerning the implications of self-disclosure on trauma's aftermath has focused on the salubrious effects disclosure may foster for the primary victim. However, the manner in which recipients of disclosure are symptomatically affected by it remains unexamined. Of particular interest are spouses who are often the primary support providers and are therefore susceptible to secondary traumatization. Assessing posttraumatic stress symptoms (PTSS) and self-disclosure among traumatized veterans and their wives, the current longitudinal study begins to fill this gap in the literature. A total of 220 couples consisting of Israeli veterans, of whom 128 were former prisoners of war (ex-POWs) and 92 were combatants, and their wives were examined. PTSS and self-disclosure of both partners were assessed 30 and 35 years after the war using the Posttraumatic Stress Disorder Inventory (PTSD-I; Solomon et al., 1993) and the Self-Disclosure Index (SDI; Miller, Berg, & Archer, 1983),...

Expressive writing, which involves disclosing one's deepest thoughts and feelings about a stressful life event by using a first-person perspective, has been linked to gains in health and well-being, though effect sizes range widely. Assuming a third-person perspective is a natural and effective way of coping with highly distressing events. Therefore, the current study examined whether a distanced, third-person approach to expressive writing might be more beneficial than a traditional, first-person intervention for high baseline levels of event-linked intrusive thinking. Randomly assigned participants wrote expressively about traumatic life events by using a first-person or third-person-singular perspective. Linguistic analyses showed that assuming a first-person perspective is linked to higher levels of in-text cognitive engagement, whereas a third-person perspective is linked to lower cognitive engagement. However, in a context of higher levels of intrusive thinking, third-pers...

The relationship between television (TV) viewing and overweight in children is likely to be influenced by the quality of measures used. We systematically reviewed studies related to overweight in children that had included a measure of TV exposure. Literature searches were conducted in MedLINE, PsychInfo, SportDiscus and ISIWeb of Science. Methods of assessing TV viewing were evaluated, including the type of measure, the administration procedure and reported psychometric properties. The majority of studies assessed TV viewing using self-report surveys and very few studies used direct observation. The validity or reliability of measures was often not examined. The majority of tools that were evaluated were compared with another self-report measure or an objective measure of physical activity. TV viewing measures should be selected that are specific to the research question, the study design, as well as methodological feasibility. However, it is recommended that measures of TV viewing be used only if they have psychometric data to support their validity and reliability. Selecting measures that are valid and reliable enables us to examine with greater accuracy the influence of TV viewing on childhood overweight, as well as the efficacy of interventions designed to reduce TV viewing in children.

To cite this article: Int J Dent Hygiene 5, 2007; 82-86 Airila-Månsson S, Bjurshammar N, Yakob M, Sö der B. Self-reported oral problems, compared with clinical assessment in an epidemiological study. Abstract: Objectives: To study self-reported oral problems in relation to periodontal clinical findings in an epidemiological investigation. Materials and methods: 1676 individuals, 828 men and 848 women, participated. The clinical examination comprised the number of remaining teeth excluding third molars, plaque index (PLI), gingival index (GI), bleeding on probing (BOP%), calculus index (CI) and the number of teeth with pocket depth (PD) ‡5 mm. Participants answered a questionnaire concerning smoking and snuffing habits and described in their own words any oral problems present. Analysis of variance (anova), unpaired t-test and chi-squared test were the statistical methods used. Results: The questionnaire was completed by 99.4% of participants. Problems of the teeth and mouth were reported by 28.9% of respondents comprising 31.8% females and 26.2% males. The

This study examined associations between self-rated health and combinations of social participation and trust among ageing people in three living areas of Finland (N ¼ 2815, 66% response rate). Social participation and trust combinations were: low social capital (low participation/low trust), traditionalism (low/high), ''the miniaturisation of community'' (high/ low) and high social capital (high/high). The highest rate of good self-rated health was found among the high social capital group, but after adjusting for background variables, statistical significance remained only in the urban area. High social capital measured at an individual level may thus promote health among ageing people. r

Personal humorous remarks may be avoided in certain conversations out of fear of introducing and reinforcing undesirable assumptions. Teases directed at others and self-targeted humor are perhaps the most vulnerable in this regard. Unless participants know each other well, a tease intended as kidding could be heard as an insult, and a self-directed remark could be read as a confession. When humor is not expected, speakers may have to rely more heavily on presentational cues, such as prior humorous context or exaggeration to mark humorous intent, or pretense.

We conducted a qualitative evaluation of a semi-structured, client-led support group that addressed drug use recovery issues and was assisted by a psychological consultant. Seven regular group members and their counselors were interviewed about the effect of the assisted self-help group on drug use and the clients' quality of life, and these interviews were content analyzed. In addition, the psychological consultant made group process observations for each session of the first three months. Clients reported group strengths as: Feeling supported and understood, being able to speak freely without fear of staff reprisals, obtaining information/feedback, improved mood, and decreased drug use. With the provision of professional support and guidance, this group shows promise as an adjunct to standard outpatient drug abuse treatment by allowing for some degree of client independence and extending the scarce resource of professional counseling.

Therapy is a paid intimate relationship that thrusts clients and therapists into navigating personal and professional boundaries. When, where, why, and how is it appropriate and ethical for family therapists to be transparent, and when is it damaging? Theorists take varied stances from Haley's position of tight boundaries around therapist disclo-sureFwhether in treatment or trainingFto the narrative viewpoint that therapists should be transparent about models of therapy, personal values, and life experiences that inform their practice and beliefs. However, these positions are not research based, and theorists who support disclosure offer few guidelines other than general statements. This article examines the history of ideas about disclosure in six major family therapy models, and the dangers and possibilities of transparency. It looks at the research on self-disclosure in individual therapy and whether and how it could apply to family therapy. Guidelines are proposed that take into account the multiple social identities of therapists and clients, and issues of safety and transparency.

Youths with a homosexual orientation face different developmental challenges during adolescence than those faced by heterosexual youths or individuals who recognize their homosexual orientation later in life. We discuss the impact of "coming out," or defining a homosexual orientation, on the development and identity formation of youths who come out during adolescence. The process of coming out is presented as entailing four broad dimensions: recognizing oneself as lesbian or gay; exploring one's sexual orientation through the gay and lesbian community; disclosing one's sexual orientation to others; and becoming more comfortable with one's sexual orientation. Some of the major challenges faced by these youths are described, and future directions for research efforts are discussed.

This study was designed to compare the factor structure of Need for Closure Scale (NFCS) as it emerges from three European samples (Croatia, Italy and The Netherlands) to the structure emerging from a USA sample, and to test the invariance of the structure of the scale both across three European contexts and across European and US samples. This comparison was conducted to examine the generalizability of results obtained with the NFCS across cultures.

Little research has been done on pain assessment in critical care, especially in patients who cannot communicate verbally. To describe (1) pain indicators used by nurses and physicians for pain assessment, (2) pain management (pharmacological and nonpharmacological interventions) undertaken by nurses to relieve pain, and (3) pain indicators used for pain reassessment by nurses to verify the effectiveness of pain management in patients who are intubated. Medical files from 2 specialized healthcare centers in Quebec City, Quebec, were reviewed. A data collection instrument based on Melzack's theory was developed from existing tools. Pain-related indicators were clustered into nonobservable/subjective (patients' self-reports of pain) and observable/objective (physiological and behavioral) categories. A total of 183 pain episodes in 52 patients who received mechanical ventilation were analyzed. Observable indicators were recorded 97% of the time. Patients' self-reports of pain were recorded only 29% of the time, a practice contradictory to recommendations for pain assessment. Pharmacological interventions were used more often (89% of the time) than nonpharmacological interventions (<25%) for managing pain. Almost 40% of the time, pain was not reassessed after an intervention. For reassessments, observable indicators were recorded 66% of the time; patients self-reports were recorded only 8% of the time. Pain documentation in medical files is incomplete or inadequate. The lack of a pain assessment tool may contribute to this situation. Research is still needed in the development of tools to enhance pain assessment in critically ill intubated patients.

A hierarchical biometric model is presented of the origins of comorbidity among substance dependence, antisocial behavior, and a disinhibited personality style. The model posits a spectrum of personality and psychopathology, united by an externalizing factor linked to each phenotype within the spectrum, as well as specific factors that account for distinctions among phenotypes within the spectrum. This model fit self-report and mother-report data from 1,048 male and female 17-year-old twins. The variance of the externalizing factor was mostly genetic, but both genetic and environmental factors accounted for distinctions among phenotypes within the spectrum. These results reconcile evidence for general and specific causal factors within the externalizing spectrum and offer the externalizing factor as a novel target for future research.

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Therapy is a paid intimate relationship that thrusts clients and therapists into navigating personal and professional boundaries. When, where, why, and how is it appropriate and ethical for family therapists to be transparent, and when is it damaging? Theorists take varied stances from Haley's position of tight boundaries around therapist disclo-sureFwhether in treatment or trainingFto the narrative viewpoint that therapists should be transparent about models of therapy, personal values, and life experiences that inform their practice and beliefs. However, these positions are not research based, and theorists who support disclosure offer few guidelines other than general statements. This article examines the history of ideas about disclosure in six major family therapy models, and the dangers and possibilities of transparency. It looks at the research on self-disclosure in individual therapy and whether and how it could apply to family therapy. Guidelines are proposed that take into account the multiple social identities of therapists and clients, and issues of safety and transparency.

This study used a feminist developmental framework to test the hypothesis that internalizing conventional ideas about femininity in two domains-inauthenticity in relationships and body objectification-is associated with diminished sexual health among adolescent girls. In this study, sexual health was conceptualized as feelings of sexual self-efficacy (i.e., a girl's conviction that she can act upon her own sexual needs in a relationship) and protection behavior (i.e., from both STIs and unwanted pregnancy). A total of 116 girls (aged 16-19) completed measures of femininity ideology, sexual self-efficacy, sexual experiences, and protection behavior. Results revealed that inauthenticity in relationships and body objectification were associated with poorer sexual self-efficacy and sexual self-efficacy, in turn, predicted less sexual experience and less use of protection. Further, the two components of femininity ideology were associated with different forms of protection. The importance of a feminist developmental framework for identifying and understanding salient dimensions of sexual health for female adolescents is discussed.

This study examines the correlates of self-diagnosis of chronic medical and mental health conditions in under-served minority populations. The Behavioral Model for Vulnerable Populations was employed to compare the predisposing and enabling characteristics of two groups: the first group consisted of individuals who self-reported their medical conditions without a presumptive or definitive physician diagnosis, while the second group consisted of individuals who self-reported their medical conditions with a presumptive or definitive physician diagnosis of their condition. The sample consisted of 287 African American and Latino heads of household. This sample was obtained from a geographically defined random sample of 418 households from three urban public housing communities in Los Angeles County, California. This study was a cross-sectional, face-to-face, semistructured interview survey. Using logistic regression techniques and controlling for demographic characteristics, the results...

Background: Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients. Methods: We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36) and self-rated health was measured by Diabetes Symptom Checklist -Revised (DCS-R).

Title. Item selection and content validity of the Critical-Care Pain Observation Tool for non-verbal adults. Aim. This paper is a report of the item selection process and evaluation of the content validity of the Critical-Care Pain Observation Tool for non-verbal critically ill adults. Background. Critically ill patients experience moderate to severe pain in the intensive care unit. While critical care clinicians strive to obtain the patient's selfreport of pain, many factors compromise the patient's ability to communicate verbally. Pain assessment methods often need to match the communication capabilities of the patient. In non-verbal patients, observable behavioural and physiological indicators become important indices for pain assessment. Method. A mixed method study design was used for the development of the Critical-Care Pain Observation Tool in 2002-2003. More specifically, a four-step process was undertaken: (1) literature review, (2) review of 52 patients' medical files, (3) focus groups with 48 critical care nurses, and interviews with 12 physicians, and (4) evaluation of content validity with 17 clinicians using a self-administered questionnaire. Results. Item selection was derived from different sources of information which were convergent and complementary in their content. An initial version of the Critical-Care Pain Observation Tool was developed including both behavioural and physiological indicators. Because physiological indicators received more criticism than support, only the four behaviours with content validity indices >0AE80 were included in the Critical-Care Pain Observation Tool: facial expression, body movements, muscle tension and compliance with the ventilator. Conclusion. Item selection and expert opinions are relevant aspects of tool development. While further evaluation is planned, the Critical-Care Pain Observation Tool appears as a useful instrument to assess pain in critically ill patients.

The contributions of eight authors to this issue of In Session are discussed, with emphasis on who discloses what to whom, in what ways, and for what reasons. The primary conclusions concern the varieties of selfdisclosure, the motives for self-disclosure, the appropriate outcome variable in studying self-disclosure, the value of evidence, the importance of the context, and the crucial role of the relationship. Self-disclosure, properly used, can be a significant contributor to successful psychotherapy.

Underreporting of energy intake is a pervasive problem and resistant to improvement, especially among people with overweight and obesity. The goal of this study was to investigate whether the use of a personal digital assistant (PDA) for dietary self-monitoring would reduce underreporting prevalence and improve the validity of selfreported energy intake. Adults with overweight and obesity (nϭ61, 92% women, mean age 48.2 years, mean body mass index 32.3) were provided with a PalmZire 21 (Palm, Inc, Sunnyvale, CA) loaded with Calorie King's Diet Diary software (version 3.2.2, 2002, Family Health Network, Costa Mesa, CA). Subjects participated in a 24-week in-person behavioral weight control program and were asked to self-monitor their diet and exercise habits using the PDA. Basal metabolic rate and physical activity level were estimated at baseline. Energy intake from 7-day electronic food records were collected within the first month of the weight-control program. As subjects were actively losing weight, Bandini's adjustments were used to correct self-reported energy intake for weight loss. In this group, where 41% of the subjects were categorized as low-energy reporters, the use of a PDA did not improve validity of energy reporting when compared to what is reported in the literature.

Objective: This study investigated the effect of child witness demeanor (defined as crying) on mock jurors' decisions in a simulated First-Degree rape trial. Method: One hundred and thirty-three undergraduates serving in the role of mock jurors read a trial summary in which the primary independent variable was the demeanor of the alleged child victim (i.e., calm, teary, hysterical crying). In addition to reading the summary, participants viewed pencil drawings of the witnesses that were presented as "courtroom drawings." Results: The results showed that the teary condition led to more guilty verdicts and a greater belief in the alleged victim than the other demeanor conditions. Conclusions:Findings from this study indicate that demeanor can impact the perception of a child who is an alleged sexual assault victim in court. However, it is not simply the case that any display of demeanor will lead to a positive outcome for the alleged victim. Instead, it appears that too little or too much emotion from the alleged child victim negatively affected credibility in the eyes of the mock jurors.

The study was designed to develop and validate a self-report questionnaire on food neophobia in French children. We evaluated food neophobia in a specific cultural context, examining an age group that has hardly been studied (5-to 8-year-olds). The questionnaire items were based on methods known for changing neophobic behavior (imitation, information, flavor principle and external stimulation) in order to diversify food presentation situations. In addition, we used colored pictures of food for seven items. Thirteen items that referred to acceptance of unfamiliar food were selected out of 25 items tested in an earlier stage. Six hundred and three children filled out the food neophobia questionnaire and a food task used to check its predictive validity was given to 503 of them. A factor analysis emphasized the one-dimensional structure of the questionnaire. Results showed satisfactory internal consistency and good test-retest reliability. The children's choices and their willingness to try new types of food were significantly correlated with the questionnaire scores. Food neophobia conceived as a personality trait was discussed. r

Questionnaires are relied upon by clinicians, researchers, and social services to assess child molesters' (CMs') offense-supportive beliefs (or cognitive distortions). In this study, we used an experimental procedure to evaluate whether extrafamilial CMs underreported their questionnaire-assessed beliefs. At time one, 41 CMs were questionnaire-assessed under standard conditions (i.e., they were free to impression manage). At time two, CMs were questionnaire-assessed again; 18 were randomly attached to a convincing fake lie detector (a bogus pipeline), the others were free to impression manage. The results showed that bogus pipeline CMs significantly increased cognitive distortion endorsements compared to their own previous endorsements, and their control counterparts' endorsements. The findings are the first experimental evidence showing that CMs consciously depress their scores on transparent questionnaires.

Purpose: This study investigated changes in psychosocial variables related to exercise, eating, and body image during a weight reduction program and evaluated their association with weight loss in middle-aged overweight and obese women up to 1 yr after intervention. Methods: The 136 participants (age, 48.1 Ϯ 4.4 yr; weight, 30.6 Ϯ 5.6 kg·m Ϫ2 ) who completed the 4-month lifestyle weight reduction program (86% retention), losing Ϫ6.2 Ϯ 4.6% (P Ͻ 0.001) of their initial weight, were followed up for 12 additional months. Of these, 82% completed 16-month assessments (weight change, Ϫ5.5 Ϯ 7.7%, P Ͻ 0.001). Psychosocial variables were assessed by validated instruments in standardized conditions at baseline and after the intervention (4 months). Results: Compared with 4-month assessments, body weight did not change at 16 months (P Ͼ 0.09). Changes in eating restraint, disinhibition, and hunger; exercise, self-efficacy, and intrinsic motivation; body shape concerns; and physical self-worth were associated with weight change at 4 months (P Ͻ 0.001, except hunger, P Ͻ 0.05). Baseline-adjusted 4-month scores in all psychosocial variables also predicted weight change from baseline to 16 months (P Ͻ 0.01), except hunger (P Ͼ 0.05). After controlling for 4-month weight change and other covariates, increases in exercise intrinsic motivation remained predictive of weight loss at 16 months (P Ͻ 0.05). Multiple linear regression showed that eating variables were significant and independent correlates of short-term weight change, whereas changes in exercise variables were stronger predictors of longer term weight outcomes. Conclusions: Results highlight the importance of cognitive processes during weight control and support the notion that initial focus on diet is associated with short-term weight loss, while change in exercise-related motivational factors, with a special emphasis on intrinsic sources of motivation (e.g., interest and enjoyment in exercise), play a more important role in longer term weight management.

Objective To describe the prevalence of maternal physical and emotional health problems six to seven months after birth.Design Statewide postal survey, incorporating the Edinburgh Postnatal Depression Scale, distributed to women six to seven months after childbirth.Participants All women who gave birth in a two-week period in Victoria, Australia in September 1993 except those who had a stillbirth or known neonatal death.Results The response rate was 62.5% (n= 1336). Respondents were representative of the total sample in terms of mode of delivery, parity and infant birthweight; young women, single women and women of nonEnglish speaking background were under-represented. One or more health problems in the first six postnatal months were reported by 94% of the women; a quarter had not talked to a health professional about their own health since the birth. Of women reporting health problems, 49% would have liked more help or advice. The most common health problems were tiredness (69%), backache (435%), sexual problems (26.%), haemorrhoids (24.%) and perineal pain (21%); 16.% of women scored as depressed. Compared with spontaneous vaginal births, women having forceps or ventouse extraction had increased odds for perineal pain (OR 4.9 [95% CI 3.–6.]), sexual problems (OR 2.6 [95% CI 1.–3.]), and urinary incontinence (OR 1.81 [95% CI 1.–2.1). These differences remained significant after adjusting for infant birthweight, length of labour and degree of perineal trauma.Conclusion Physical and emotional health problems are common after childbirth, and are frequently not reported to health professionals despite the fact that many women would like more advice and assistance in dealing with them.

Self-reports of behavior are the most commonly used method for collecting outcome data in health education programs, but they are subject to a variety of sources of measurement error. Problems of measurement in some recently reported education program evaluations are identified, and a model is proposed to identify systematically the major influences for accuracy of self-reported measures of behavior. Several methodologic studies on the skill aspect of selfreport form completion are briefly described, and eight steps to promote more accurate self-repon of health behaviors are proposed.

j Abstract Background Coping styles utilized by family caregivers of persons with schizophrenia have been implicated in the mental health of those caregivers and in the course of schizophrenia. We tested the relation between caregivers' coping efficacy, defined as the caregiver's perceptions of how successful they were in modifying their relative's behavior, and caregiver's psychological distress as well as criticisms and positivity toward their relatives diagnosed with schizophrenia. Method We sampled 31 dyads of Mexican American caregivers and their relative with schizophrenia or schizoaffective disorder and used multiple methods of measurement including caregiver interviews, interactions between caregivers and their relatives, and clinician interviews with patients. Results Coping efficacy accounted for significant variance beyond patient symptoms and caregiver burden to: (a) caregiver psychological distress (b = )0.35, P < 0.05), and (b) caregiver positivity, that is, caregivers' expressions of praise, approval or affection toward their ill relatives (b = 0.47 P < 0.01). Conclusions Caregivers' coping efficacy has heuristic value for research on the alleviation of caregiver psychological distress and the promotion of family caregiver behaviors associated with a benign course of illness.

Although there is developmental research on the prevalence of offline self-disclosure in pre-adolescence and adolescence, it is still unknown (a) how boys' and girls' online selfdisclosure develops in this period and (b) how online and offline self-disclosure interact with each other. We formulated three hypotheses to explain the possible interaction between online and offline self-disclosure: the displacement, the rich-get-richer, and the rehearsal hypothesis. We surveyed 690 pre-adolescents and adolescents (10-17 years) at three time points with half-year intervals in between. We found significant gender differences in the developmental trajectories of self-disclosure. For girls, both online and offline self-disclosure increased sharply during pre-(10-11 years) and early adolescence (12-13 years), and then stabilized in middle and late adolescence. For boys, the same trajectory was found although the increase in self-disclosure started 2 years later. We found most support for the rehearsal hypothesis: Both boys and girls seemed to use online self-disclosure to rehearse offline self-disclosure skills. This particularly held for boys in early adolescence who typically have difficulty disclosing themselves offline. Against this backdrop, it is striking that research has largely ignored online selfdisclosure during adolescence. Even the most basic questions have not been investigated: For example, how does the development of online and offline self-disclosure vary for boys and girls in different developmental periods? Do gender differences, which are consistently found for offline self-disclosure, also hold for online self-disclosure? The main aim of our study is to provide initial answers to these questions. By comparing the prevalence of online and offline self-disclosure, we are able to investigate how boys' and girls' online and offline self-disclosure develops during pre-adolescence and adolescence and how both types of self-disclosure interact with each other.

Perfectionistic self-presentation is proposed as a deleterious interpersonal style that has an influence in clinical contexts that involves promoting a public image of perfection and avoiding displays and self-disclosures of imperfections. A sample of 90 clinical patients taking part in a clinical interview were assessed in terms of their levels of perfectionistic self-presentation and trait perfectionism and their affective, cognitive, and physiological reactions. Perfectionistic self-presentation dimensions were associated with (1) greater distress before and after the interview, (2) negative expectations and greater threat prior to the interview, and (3) post-interview dissatisfaction. Analyses of physiological data found that perfectionistic self-presentation was associated with higher levels of heart rate when discussing past mistakes, and, as expected, the need to avoid disclosing imperfections predicted higher levels of and greater change in heart rate when discussing past mi...

Objective To evaluate the reproducibility and validity of the School-Based Nutrition Monitoring (SBNM) secondary level student questionnaire. Design Reproducibility was evaluated using a test-retest study design by administering the questionnaire on the same day (morning and afternoon, nϭ254) and, when appropriate, 9 to 14 days apart (nϭ259). Validity was assessed by comparing foods selected on the questionnaire with foods reported from a single 24-hour recall covering the same referent period (yesterday) in 209 students. Subjects/setting Eighth grade students in middle schools from central Texas were used: male and female, approximately 75% white, for the reproducibility study, with 15% Hispanic, 6% African American; for the validation study, approximately 38% white, 41% Hispanic, and 17% African American. Statistical analysis Spearman rank order correlation, statistic, and percentage agreement were used for both reproducibility and the validation. Results For the reproducibility study, agreement for questions about food intake "yesterday" were 70% to 98%, with statistics ranging from 0.54 to 0.93 and correlations between 0.66 and 0.97. Questions on recent physical activity had high agreement (66% to 89%) as did "usual" physical activity items, weight loss, and food selection behaviors. Nutrition knowledge items showed relatively weaker reliability: agreements ranged from 47% to 92%, with statistics between 0.30 and 0.56. Attitude questions had weaker agreement (50% to 87%), statistics (0.27 to 0.52), and correlations (0.33 to 0.63). For the validation study, correlation coefficients ranged from 0.32 for breads to 0.68 for milk and beans. Percentage agreement ranged from 38% for breads to 89% for gravy. Applications/conclusions Most questions on the SBNM secondary questionnaire were found to have acceptable reproducibility, whereas validation of food choice behaviors showed results similar to or better than other dietary assessment instruments for this age group. This questionnaire is a useful epidemiologic tool for surveillance, assessing broad intervention effects among groups or providing needs assessment data on selected nutrition and physical activity-related constructs.

Aim. This paper is a report of an analysis of the concept of HIV disclosure. Background. There is a growing interest among healthcare providers and researchers in HIV disclosure as an effective HIV prevention and early disease management initiative. However, the concept still remains unclear. Conceptual clarity is important for providing an expanded theoretical definition and understanding of attributes of HIV disclosure. This information is useful in constructing better HIV disclosure measures in HIV/AIDS nursing practice and research. Data sources. A computer search of the following databases was conducted to capture the meaning and processes of HIV disclosure among HIV-positive individuals: PubMed, CINAHL and PSYCINFO. Only English language journals were used. Publication dates of the literature review ranged from 1999 to 2009. The following key words were used: HIV disclosure, self-disclosure, disclosure and serostatus disclosure. Methods. The Walker and Avant (2005) concept analysis model (Strategies for Theory Construction in Nursing, Pearson Prentice Hall, River, NJ, 2005) was used to guide the analysis process, which was completed in 2009. Results. The concept analysis revealed that HIV disclosure is a complex process characterized by the following attributes: experiencing an event, communicating something, timing, and contextual environment, protecting someone, relationship status and improving something or being therapeutic. In addition, the process of HIV disclosure varies across time. Conclusion. The proposed HIV disclosure attributes provide nursing scholars and researchers with new directions on how to reframe research questions, develop measurement tools to reflect better the diversity and fluidity of the process of HIV disclosure among HIV-positive individuals. Policy implications include the need to develop approaches that protect individual and public rights.

Anxiety is difficult to detect in patients receiving mechanical ventilation because clinical signs are confounded and patients often cannot respond to validated anxiety measures. Most patients can respond to the single-item Faces Anxiety Scale. To assess the validity of the Faces Anxiety Scale, the frequency and severity of state anxiety, and correlates of anxiety in intensive care patients. A research assistant made a single clinical judgment of anxiety in the range of 1 to 10 on the basis of patients&#39; nonverbal responses (ie, nods) to 9 questions about mood and their physical and behavioral signs. Patients then responded to the Faces Anxiety Scale. Demographic, clinical, and pharmacological data were obtained from the patients&#39; charts. Mean age of the 106 patients was 61 years; 62% were men. Admission diagnoses were cardiovascular in 26% of patients, respiratory in 26%, trauma in 18%, neurological in 12%, gastrointestinal in 12%, and other in 6%. At the time of anxiety ass...

The present study examined the efficacy of group cognitive-behavioral therapy (CBT) in the treatment of childhood anxiety disorders. Thirty high-anxious children (aged 9-12 years) were assigned to either (a) group CBT ðn ¼ 10Þ; (b) a psychological placebo intervention (i.e., emotional disclosure [ED]; n ¼ 10), or (c) a no-treatment control condition ðn ¼ 10Þ: Therapy outcome measures (i.e., children's self-report of anxiety disorders symptoms, depression, and trait anxiety) were obtained three months before treatment, at pretreatment, and at posttreatment. Results showed that levels of psychopathological symptoms remained relatively stable during the three months preceding treatment. Most importantly, pretreatment-posttreatment comparisons indicated that CBT was superior to ED and the notreatment control condition. That is, only in the CBT condition significant reductions of anxiety disorders symptoms, trait anxiety, and depression were observed. These findings can be taken as further evidence for the efficacy of CBT in the treatment of childhood anxiety disorders. r