The main purpose of this study was to reach a deeper understanding of factors influencing the attitudes toward organ donation and other procedures with the dead body. From a survey of 400 inhabitants of Uppsala, a city in the middle of Sweden, concerning attitudes toward transplantation issues, 38 individuals with different attitudes toward donation of their own organs were selected for follow-up interviews. From the interviews, more than 600 statements concerning motives and reactions to medical procedures with the dead body were listed. These statements were summarized in 20 motive categories, in which 17 the nature of the motives were negative to organ donation and three promoting such a procedure. The categories were then analyzed and interpreted within a frame of reference of psychodynamic defense theory. In several cases it was possible to relate them to common death anxiety defenses. Six different motive complexes were extracted. These are called (1) illusion of lingering life; (2) protection of the value of the individual; (3) distrust, anxiety and alienation; (4) respecting the limits set by Nature or God; (5) altruism; and (6) rationality. Individuals not willing to donate their own organs were judged as either (a) reacting out of strenthened death anxiety defenses, or (b) as having a special outlook on life, where the idea of what is 'natural' was emphasized. The adverse reactions of the positive attitude group were seen as initial reactions perceived as derivations of common death anxiety defenses and weakened when confronted with altruistic and fact-stressing arguments. In the 'undecided group' of 14 persons, 11 arrived at a definite opinion. Seven decided for organ donation when their mistaken beliefs were corrected or when they took time to work through their initial uneasiness, while 4 persons actually were clearly negative. Three still remained uncertain. The stability of these attitudes seems to be high, often being experienced as a part of one's philosophy of life.
In some studies, shyness and anxiety have protected at-risk boys from developing delinquency. In others, shyness and withdrawal have increased risk. We argue that this is because behavioral inhibition, which is the protective factor, has been confounded with social withdrawal and other constructs. Our study addresses 3 major questions: (1) is behavioral inhibition, as distinguished from social withdrawal, a protective factor in the development of delinquency; (2) does the protective effect depend on whether disruptiveness is also present; and (3) does inhibition increase the risk of later depressive symptoms even if it protects against delinquency?
The subjects were boys from low socioeconomic status areas of Montreal, Quebec. Age 10- to 12-year predictors were peer-rated inhibition, withdrawal, and disruptiveness; age 13- to 15-year outcomes were self-rated depressive symptoms and delinquency. Eight age 10- to 12-year behavioral profiles were compared with 4 age 13- to 15-year outcome profiles.
Inhibition seemed to protect disruptive and nondisruptive boys against delinquency. Disruptive boys who were noninhibited were more likely than chance to become delinquent; disruptive boys who were inhibited were not. Inhibition did not increase the risk for depression among disruptive boys. Among nondisruptive boys, only nondisruptive-inhibited boys were significantly less likely than chance to become delinquent. However, withdrawal was not protective. Disruptive-withdrawn boys were at the greatest risk for delinquency or delinquency with depressive symptoms.
Inhibition and social withdrawal, although behaviorally similar, present different risks for later outcomes and, therefore, should be differentiated conceptually and empirically.
Comment In: Arch Gen Psychiatry. 1997 Sep;54(9):785-99294368
This paper reviews definitions of obesity and evidence concerning risk factors for becoming obese. Modifiable aetiological factors, including diet and physical activity, are described, and possible interactions with genetic predisposition are addressed. The impact of obesity on health and quality of life is then considered. Although epidemiological studies have not observed linear associations between increasing weight-for-height and decreasing longevity, there is a consensus that excess mortality occurs at extremely high body mass index values. Compromised quality of life is also observed at this end of the obesity distribution, and is manifested as decreased psychological well-being, less social integration, and stigmatisation.
This study was undertaken to understand food insecurity from the perspective of households who experienced it. The results of group interviews and personal interviews with 98 low-income households from urban and rural areas in and around Québec City, Canada, elicited the meaning of "enough food" for the households and the range of manifestations of food insecurity. Two classes of manifestations characterized the experience of food insecurity: (1) its core characteristics: a lack of food encompassing the shortage of food, the unsuitability of both food and diet and a preoccupation with continuity in access to enough food; and a lack of control of households over their food situation; and (2) a related set of potential reactions: socio-familial perturbations, hunger and physical impairment, and psychological suffering. The results substantiate the existence of food insecurity among Québecers and confirm that the nature of this experience is consistent with many of the core components identified in upstate New York. This study underlines the monotony of the diet, describes the feeling of alienation, differentiates between a lack of food and the reactions that it engenders, and emphasizes the dynamic nature of the experience.
The paper presents a snapshot of the city-village connections in the city of Yakutsk and an anthropological account of the dynamics of the relationship between the city and villages around it. Demographic changes that started in the 1980s, prompted by a decline in agriculture, initiated an exodus of the rural population from the countryside into the city of Yakutsk. This paper explores the migration dynamics of the rural population to the city. Two conflicting aspects of the relationship between the city and village are the focus of this paper: treating village people as close kin and as outsiders. I examine the image of ulusnik [a villager] and consider rationales behind the stigma attached to it and a social role of the Other which is imposed on the people from the countryside.
In this article, the authors examine some of the benefits and challenges associated with conducting research on hard-to-reach/hidden populations: in this instance, sex workers. The population studied was female and male sex workers working in different sectors of the sex industry in a medium-size Canadian metropolitan area. The authors describe the need for close community-academic cooperation, given the hidden and highly stigmatized nature of the target population that was investigated and the local context in which the research project was embedded. The authors discuss the main benefits and challenges of the research collaboration for the various parties involved, including the community partner organization, indigenous research assistants, and academic research team. They conclude with a discussion of strategies to help overcome the main challenges faced during the research endeavor.
Shame is a recurrent theme in the context of sexually abused women. Sexual abuse is taboo and shameful, and so is shame. Shame affects the development of a person and relationships, and is mentally painful. It is often covert. One aim of the present study was to explore whether and how women exposed to sexual abuse during childhood verbally express unacknowledged overt and covert shame, when interviewed about their physical and mental health, relations and circumstances relating to the sexual abuse. Another aim was, if shame was present, to describe the quality of the shame expressed by the women. A mainly qualitative approach with semi-structured interviews was used. Ten women attending self-help groups for women who were sexually abused during childhood were recruited as informants. The interviews were analysed for verbal expressions of shame by identifying code words and phrases, which were first sorted into six shame indicator groups and then categorized into various aspects of shame. The frequency of the code words and phrases was also counted. The findings clearly reveal that the affect of shame is present and negatively influences the lives of the informants in this study. It was possible to sort the code words and phrases most often mentioned into the indicator groups 'alienated', 'inadequate' and 'hurt', in the order of their frequency. It is obvious that shame affects the lives of this study's informants in negative ways. One important clinical implication for professionals in health care and psychiatric services is to acknowledge both sexual abuse and shame in order to make it possible for patients to work through it and thereby help them psychologically to improve their health.
This article discusses the conceptual history of marginalization, suggesting its use as a framework within which to understand some of the causal relationships between the high rate of attrition of new nursing graduates from professional nursing and the difficulties incurred during their transition from student to professionally practicing nurse. The application of marginalization in this article focuses on the vulnerability and alienation that these newly graduated nurses experience during their introduction to acute-care practice. The article further suggests that they are both inadequately prepared by their undergraduate education to enter into the full scope of their new role as professional practitioners, and ineffectually orientated to an oppressive workplace culture that they are expected to sustain.
The involvement of family members in psychiatric care is important for the recovery of persons with psychotic disorders and subsequently reduces the burden on the family. Earlier qualitative studies suggest that the participation of family members can be limited by how they experience the professionals' approach, which suggests a connection to the concept of alienation. Thus, the aim of this study was in a national sample investigate family members' experiences of the psychiatric health care professionals' approach. Data were collected by the Family Involvement and Alienation Questionnaire. The median level and quartiles were used to describe the distributions and data were analysed with non-parametric statistical methods. Seventy family members of persons receiving psychiatric care participated in the study. The results indicate that a majority of the participants respond that they have experiencing a negative approach from the professionals, indicating lack of confirmation and cooperation. The results also indicate that a majority of the participants felt powerlessness and social isolation in the care being provided, indicating feelings of alienation. A significant but weak association was found between the family members' experiences of the professionals' approach and their feelings of alienation.
A conceptual framework showing the household and social implications of food insecurity was elicited from a qualitative and quantitative study of 98 households from a heterogeneous low income population of Quebec city and rural surroundings; the study was designed to increase understanding of the experience of food insecurity in order to contribute to its prevention. According to the respondents' description, the experience of food insecurity is characterized by two categories of manifestations, i.e., the core characteristics of the phenomenon and a related set of actions and reactions by the household. This second category of manifestations is considered here as a first level of consequences of food insecurity. These consequences at the household level often interact with the larger environment to which the household belongs. On a chronic basis, the resulting interactions have certain implications that are tentatively labeled "social implications" in this paper. Their examination suggests that important aspects of human development depend on food security. It also raises questions concerning the nature of socially acceptable practices of food acquisition and food management, and how such acceptability can be assessed. Guidelines to that effect are proposed. Findings underline the relevance and urgency of working toward the realization of the right to food.