Foundations of psychosocial dynamic personality theory of collective people

Psychodynamic profiles of major depressive disorder and generalized anxiety disorder in China

Traditional clinical diagnoses relying on symptoms may overlook latent factors that illuminate mechanisms and potentially guide treatment. The Operationalized Psychodynamic Diagnosis (OPD) system may compensate for symptom-based diagnosis by measuring psychodynamic profiles underlying mental disorders through conflicts and structure axes. However, OPD has not been widely adopted in China, and it remains unclear whether OPD can be used as an effective approach to distinguish between depression and anxiety. The current study aims to adopt the OPD system to investigate the psychodynamic profiles of major depressive disorder (MDD) and generalized anxiety disorder (GAD) in China, targeting patients with "pure" symptoms without comorbidity. We recruited 42 MDD patients, 32 GAD patients, and 31 healthy controls (HC), and assessed their self-report depression and anxiety symptoms, along with their underlying psychodynamic profiles through OPD interviews. Overall, both MDD and GAD patients showed more prominent conflict issues and lower levels of structure than HC. The MDD and GAD groups yielded different conflict profiles and conflict processing modes when processing their second conflicts. Importantly, the multi-dimensional psychodynamic profiles achieved machine learning classification of clinical groups with an accuracy of 0.84, supporting successful distinction of MDD and GAD patients. In conclusion, the OPD demonstrated sensitivity in revealing distinct psychodynamic profiles underlying "pure" depression and anxiety clinical populations in China. This work calls for future incorporation of OPD as a tool to investigate psychodynamic formulations underlying mental disorders, compensating for traditional symptom-based diagnostic approaches to guide precise individualized interventions.

Values and their relationship with emotion processing and physical and psychological symptoms among Jewish and Arab breast cancer survivors

Introduction

Individuals from different cultures differ in their values, which encompass belief systems that individuals develop based on their culture, and play a pivotal role in shaping their perspectives. These values may affect emotion processing (EP): the recognition, interpretation, expression and response to bodily sensations, translated as emotions. These varying values may contribute to distinct emotional experiences, impacting physical and psychological symptoms in breast cancer (BC) survivors.

Methods

This cross-sectional study investigated how EP including acceptance, expression (avoidance and approach coping), and awareness, may mediate the relationship between conservation values and symptoms of pain, fatigue, and depression among Arab (n = 62) and Jewish (n = 179) women BC survivors in Israel. Conservation values include tradition, conformity, and security.

Results

Depression and fatigue were negatively correlated with acceptance of emotions, and positively correlated with avoidance and conservation levels. Emotion processing mediated the relationship between conservation and fatigue and depression. Arab women reported higher levels of various values, emotional acceptance, pain, fatigue, and depression symptoms compared to Jewish women. Conservation was higher in Arab women and correlated with both approach and avoidance coping which was not the case in Jewish women. Avoidance coping had a positive relationship with fatigue in the Jewish, but not the Arab women. Similarly, approach coping was negatively related to depression in Jewish, but not in Arab women.

Discussion

Cultural differences are important for understanding the experience of cancer in individuals from different cultures. Future interventions for more conservative BC survivors should take culture into account.

The association between parenting styles, maternal self-efficacy, and social and emotional adjustment among Arab preschool children

Parenting styles and parental self-efficacy are major factors that affect the overall adjustment of children. The current study examined parenting styles and maternal self-efficacy and their association with social-emotional adjustment among Arab preschool children living in Israel. Parenting Styles Questionnaire, Maternal Self-Efficacy Questionnaire, and Adjustment Questionnaire were administered to 420 Arabic-speaking mothers of 3- to 4-year-old children. After employing multiple regression analyses, the results indicated that parenting styles and the overall adjustment of children were significantly correlated. More precisely, a significant association between authoritative parenting style and higher levels of social-emotional adjustment among preschool children was found. Furthermore, maternal self-efficacy was significantly correlated to the overall adjustment of children. In this regard, higher maternal self-efficacy is associated with increased social-emotional adjustment among preschool children. The findings of our study show the applicability of these constructs found relevant across numerous cultures in a unique sample of Arab children living in Israel. Lastly, this study supports intervention programs that promote authoritative parenting style and parental self-efficacy in Arab communities.

Dark Triad and COVID-19 vaccine hesitancy: the role of conspiracy beliefs and risk perception

With the spread of the Coronavirus Disease-2019 (COVID-19) pandemic, the mass vaccination plan represents the primary weapon to control the infection curve. Unfortunately, vaccine hesitancy also spread out worldwide. This led to exploring the critical factors that prevent vaccination from improving the efficacy of vaccine campaigns. In the present study, the role of the Dark Triad (psychopathy, Machiavellianism, and narcissism) in vaccine hesitancy was investigated, considering the sequential mediating effects of conspiracy beliefs and risk perception. Via a cross-sectional design, the study was conducted with 210 participants surveyed using an online questionnaire to assess the Dark Triad, vaccine hesitancy, conspiracy beliefs, risk perception, and a set of demographic and socio-cultural control variables. Results showed that conspiracy beliefs and risk perception fully mediated the association between the Dark Triad and vaccine hesitancy. This finding suggested that albeit personality accounts for individual differences in human behaviour, vaccine hesitancy is also affected by irrational and false beliefs that, in turn, weaken the risk perception associated with COVID-19. Implications and future research directions were discussed.

Adaptation and validation of the Johnson-Lecci scale to assess anti-white bias among black UK minority group members

The present study (total N = 901) set out to construct and validate a culturally sensitive instrument to examine anti-White bias among Black UK minority group members. Our novel measure of anti-White bias-which we called the AWB scale-was based upon the Johnson-Lecci scale (JLS; 2003) a questionnaire designed to measure anti-White attitudes among Black Americans. Studies 1 and 2 provided converging evidence for the AWB's four-factor dimensionality, its structural characteristics, its temporal stability and its external validity in Black UK samples, attesting to the consistency of minorities' experience of anti-majority bias in two very different societal contexts. Moreover, Study 3 evidenced our measure's utility for understanding reactions to various relevant contemporary societal events. Theoretical contributions to the literature on intergroup bias are delineated and compared with majority-to-minority prejudice.

A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study

Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a 'deficit-based' discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants' knowledge of their context, needs, resources and strengths. We conducted an exploratory sequential mixed methods study, which included 10 focus groups (5 men's, 5 women's) and 296 quantitative in-person surveys. Participants with diagnosed diabetes were randomly drawn from the patient list of the largest healthcare service organization (survey response rate: 93%). Prominent and interconnected themes emerged from focus group discussions, including: diet, physical activity, and social, economic, mental/psychological and political stress. The discussions raised the need for adapting diabetes management approaches to incorporate participants' communal, physical and psychological well-being, and socioeconomic/political realities. The connections between these factors and diabetes management were also reflected in multivariable analyses of the survey data. Women (OR: 2.03; 95% CI: 1.09-4.63), people with disabilities (OR: 2.43; 95% CI: 1.28-4.64), and unemployed people (OR: 2.64; 95% CI: 1.28-5.44) had higher odds of economic barriers to diabetes management. Furthermore, female sex (OR: 2.26; 95% CI: 1.25-4.09), unemployment (OR: 4.07; 95% CI: 1.64-10.10), and suboptimal glycemic control (OR: 1.20, 95% CI: 1.03-1.41 per 1-unit increase in HbA1c) were associated with moderate-to-severe depressive symptoms. A pro-active, team-based healthcare approach incorporating Indigenous/minority participants' knowledge, experience, and strengths has the potential to improve individuals' diabetes management. Healthcare services should be structured in ways that enable providers to listen to their patients, address their key concerns, and foster their strengths.

Foundations for an Arab/MENA Psychology

Arab/Middle Eastern and North African (MENA) American psychology is a field rooted in ethnic studies and multicultural psychology. Although its study is relatively nascent in U.S. psychology, it has slowly been growing since the 1990s. The events of 9/11 resulted in an increase in psychological research on the Arab/MENA population in the United States, providing empirical evidence to inform the historical and social foundations for an Arab/MENA psychology. This article seeks to identify key elements and factors present in an Arab/MENA psychology focusing on issues of identity and recognition, discrimination, cumulative racial-ethnic trauma, acculturation, and cultural values, such as hospitality and generosity, morality, family centricity, honor and shame, religiosity, and communication style.

Palestinian Refugee Youth in Jordan: Parental Practices, Neighborhood Cohesion and Assistance, and Adolescent Wellbeing

In this study, a total of 335 Palestinian refugees (M = 15.5 years, SD = 1.05, 49% males), recruited from four United Nations Relief and Work Agency (UNRWA) schools at the Al-Baqa'a and Jabal Al-Hussein refugee camps in Jordan, rated their neighborhood physical environment and neighborhood support and cohesion, separately rated their mothers' and fathers' parenting on several dimensions, and reported on their adjustment to these circumstances (internalizing symptoms, self-concept clarity, and norm breaking). Living in more dangerous physical environments was associated with higher levels of refugee youths' internalizing symptoms and norm breaking, but effects were not significant when parenting was considered. Our study showed that higher levels of psychological control-disrespect (significantly for fathers and marginally for mothers) and marginally, higher levels of maternal harsh punishment were associated with more teen internalizing symptoms. In addition, fathers' greater psychological control and lower levels of support had a marginally significant effect on teens' greater norm breaking. For behavioral control, only mothers' greater behavioral control was associated with refugee youths' greater self-concept clarity but not with paternal behavioral control. Thus, fathers' psychological control and mothers' behavioral control had the biggest association with adolescent outcomes.

Palestinian Refugee Youth in Jordan: Parental Practices, Neighborhood Cohesion and Assistance, and Adolescent Wellbeing

In this study, a total of 335 Palestinian refugees (M = 15.5 years, SD = 1.05, 49% males), recruited from four United Nations Relief and Work Agency (UNRWA) schools at the Al-Baqa’a and Jabal Al-Hussein refugee camps in Jordan, rated their neighborhood physical environment and neighborhood support and cohesion, separately rated their mothers’ and fathers’ parenting on several dimensions, and reported on their adjustment to these circumstances (internalizing symptoms, self-concept clarity, and norm breaking). Living in more dangerous physical environments was associated with higher levels of refugee youths’ internalizing symptoms and norm breaking, but effects were not significant when parenting was considered. Our study showed that higher levels of psychological control–disrespect (significantly for fathers and marginally for mothers) and marginally, higher levels of maternal harsh punishment were associated with more teen internalizing symptoms. In addition, fathers’ greater psychological control and lower levels of support had a marginally significant effect on teens’ greater norm breaking. For behavioral control, only mothers’ greater behavioral control was associated with refugee youths’ greater self-concept clarity but not with paternal behavioral control. Thus, fathers’ psychological control and mothers’ behavioral control had the biggest association with adolescent outcomes.

Internalized Stigma among Bedouin and Jews with Mental Illness: Comparing Self-Esteem, Hope, and Quality of Life

The aim of this study was to assess the differences in internalized-stigma, self-esteem, hope, and quality of life in individuals with mental illness from two diverse cultures (Bedouins and Jews) and to examine the relationships between self-stigma and self-esteem, hope, and quality of life in participants from both cultures. Two hundred participants with mental illness in Israel were assessed on the Internalized Stigma of Mental Illness (ISMI) scale. The Arab Bedouin participants tended to internalize stigma to a greater extent than the Jewish participants. Overall, there was a significant negative correlation between self-stigma, self-esteem, and hope and between alienation and quality of life in both groups although the correlation was stronger among the Arab Bedouin participants. By contrast, the associations between self-stigma and quality of life were only significant for two of the self-stigma dimensions (alienation and discrimination) among the Jewish participants. These results contribute to a better understanding of the role internalized stigma may play in the life of people with mental illness from diverse cultures. They may help design culturally appropriate intervention programs for people with mental illness.

Migrant Caregivers of Older People in Spain: Qualitative Insights into Relatives' Experiences

The traditional structure of families is undergoing profound changes, causing the so-called “crisis of family care.” This study describes the experiences and emotions of the family member who hires migrant caregivers for the older people. This is a qualitative study using a phenomenological design with nine women participants between 53 and 72 years of age. The data collection was carried out through two in-depth interviews and a focus group. There were three major topics: (1) the women in this study recognized that they were not able to take care of the family member directly, due to their responsibilities as female workers and mothers. The fact that migrant caregivers were chosen was conjunctural, where economic reasons were more important. (2) The family members supported the caregivers by teaching them about care and also resolving conflicts produced by culture shock. (3) Trusting the caregiver was a gradual process; the family members felt a complex set of emotions (insecurity, gratitude for the help, moral obligation). In conclusion, they wanted a caregiver who would provide the elder dependent with the love and compassion that they, as daughters, would provide if they had time to do so. The family became the caregiver’s managers and assumed the responsibility of training and helping them.

Individuals With Type 2 Diabetes: An Exploratory Study of Their Experience of Family Relationships and Coping With the Illness

PURPOSE

The purpose of this qualitative study is to explore familial patterns that may be related to type 2 diabetes (T2DM) and to patients' ways of coping with the illness.

METHODS

A purposive sample of 32 Israeli Jewish (n = 12) and Arab (n = 20) individuals with T2DM were recruited from a community population and interviewed about their familial experiences and their illness. Interview data were analyzed using Colaizzi's phenomenological method.

RESULTS

Many participants, particularly from the Arab society, reported familial patterns that suggest fused relationships and emotional cutoff. They described highly close and positive family relationships, on one hand, but demonstrated unwillingness to share their difficulties with their family members, on the other hand. Precipitating stressful or traumatic events and day-to-day stress appeared as leading perceived causes of the illness. Maintaining an appropriate lifestyle, stress reduction, and family support were the main coping strategies with the illness.

CONCLUSIONS

The findings suggest a possible avenue in which fusion with family members and inability to attenuate emotional distress by sharing difficulties with others may contribute to the development of T2DM. Assessment of such family dynamics and ways of coping with stress could lead to more appropriately nuanced treatment for individuals with T2DM and prediabetes.

Images of alcoholism among adolescents in individualistic and collectivistic geographies

Aim

This article compares adolescents' images of alcoholism in two different drinking geographies, namely Helsinki (Finland) and Turin (Italy), with the aim to better understand the persisting variance in youth drinking within Europe.

Design

Altogether 28 focus group interviews were conducted at schools among 15-year-old pupils (N=145). To assure reliable qualitative comparison across language boundaries, we applied a structured qualitative focus-group methodology called the Reception Analytical Group Interview (RAGI).

Conclusions

Collectivist images of alcoholism can be considered more protective in terms of alcohol-related risk behaviour as they 1) emphasise interpersonal responsibility, 2) enhance the value of norms and traditions, and 3) highlight causes of alcoholism which are beyond the control of the individual (that is, contextual, social and inherent in the substance), making the attitude towards alcohol more cautious. A greater emphasis on the individual competence may correspondingly result in a lower perception about the risks of drinking.

“The wound is still open”: the Nakba experience among internally displaced Palestinians in Israel

Purpose

While the 1948 Nakba represents the most significant crisis in the history of the Palestinian people, its psychological effects on its survivors in Israel have yet to be explored. The purpose of this paper is to examine the subjective experience and the psychological implications of the Nakba ordeals and the ensuing uprooting among the internally displaced Palestinians living in Israel.

Design/methodology/approach

Qualitative semi-structured in-depth interviews were conducted with ten internally displaced Palestinians who experienced the Nakba as youngsters. The interview transcripts were analyzed thematically in line with accepted practice in phenomenological research in psychology.

Findings

Participants had experienced a wide range of traumatic events intertwined with protracted daily struggles and accumulated losses. These experiences resulted in pronounced psychological distress and immense inner pain that was perpetuated throughout their lives, rendering the Nakba an unresolved traumatic experience.

Research limitations/implications

This paper describes the psychological outcome of the Nakba among a small sample of elderly survivors. Further urgent research is needed to collect valuable untapped information from this aging and dwindling community.

Originality/value

Although more than six decades have elapsed since the tragic events, the current research paper constitutes a pioneering effort to document the subjective experience of the Nakba. The current research findings counterbalance 60 years of public and academic disregard of this tragic period.

Expression of emotions related to the experience of cancer in younger and older Arab breast cancer survivors

OBJECTIVES

Researchers have suggested that older adults express less negative emotions. Yet, emotional expression patterns in older and younger breast cancer survivors, have barely been examined. This study aimed to explore types and intensity of negative and positive emotional expression related to the breast cancer experience by younger and older Arab breast cancer survivors.

DESIGN

Participants were 20 younger (aged 32-50) and 20 older (aged 51-75) Muslim and Christian Arab breast cancer survivors (stages I-III), currently free of disease. Data were gathered through in-depth semi-structured interviews. Mixed methods analyses were conducted, including: (1) frequency analysis of participants' emotional expressions; (2) content analysis of emotional expressions, categorized according to negative and positive emotions.

RESULTS

Three emotional expression modalities were revealed: (1) Succinct versus comprehensive accounts; (2) expression of emotions versus avoidance of emotions; (3) patterns of expression of positive emotions and a sense of personal growth. Younger women provided more detailed accounts about their illness experiences than older women. Older women's accounts were succinct, action-focused, and included more emotion-avoiding expressions than younger women.

CONCLUSIONS

Understanding the relationships between emotional expression, emotional experience, and cancer survivors' quality of life, specifically of those from traditional communities, is necessary for developing effective psycho-social interventions.

Introduction to Three Cross-Regional Research Studies on Parenting Styles, Individuation, and Mental Health in Arab Societies

This is a general introduction to the series of three articles that follows. The study intended to examine cross-regional differences concerning parenting styles, adolescent-family connectedness, and mental health in eight Arab societies. Three questionnaires were administered to 2,893 Arab adolescents in eight Arab societies: Parental Authority Questionnaire, Multigenerational Interconnectedness Scale, and Psychological State Scale. The results of the analysis are presented in the following reports. The strength of our study is in the size and diversity of the sample, whereas its limitation is that all the study results are based on adolescents' self-report. To validate our results, more research is needed using other measures such as parents' self-report and observations of parents and adolescents.

Adolescent-Family Connectedness among Arabs

The Multigenerational Interconnectedness Scale was administered to 2,893 Arab adolescents in eight Arab societies. Results show that adolescent-family connectedness differs significantly across the Arab societies. Arabs scored higher in emotional, financial, functional, and total connectedness than Americans. Female adolescents were more connected than male adolescents in all three kinds of connectedness. A low but significant effect of urbanization was found on emotional and financial connectedness. First-born adolescents scored higher in financial connectedness. Further studies that employ additional tools such as interviews, observations, and parents' self-report are needed.

Being or Becoming: Toward an Open-System, Process-Centric Model of Personality

Mainstream personality psychology in the West neglects the investigation of intra-individual process and variation, because it favors a Being over a Becoming ontology. A Being ontology privileges a structural (e.g., traits or selves) conception of personality. Structure-centric models in turn suggest nomothetic research strategies and the investigation of individual and group differences. This article argues for an open-system, process-centric understanding of personality anchored in an ontology of Becoming. A classical Confucian model of personality is offered as an example of a process-centric approach for investigating and appreciating within-person personality process and variation. Both quantitative and qualitative idiographic strategies can be used as methods of scientific inquiry, particularly the exploration of the Confucian exemplar of psychological health and well-being.

The Epidemiology of Major Depressive Episode in the Iraqi General Population

OBJECTIVE

To assess the prevalence, symptom severity, functional impairment, and treatment of major depressive episode (MDE) in the Iraqi general population.

METHODS

The Iraq Mental Health Survey is a nationally representative face-to-face survey of 4,332 non-institutionalized adults aged 18+ interviewed in 2006-2007 as part of the WHO World Mental Health Surveys. Prevalence and correlates of DSM-IV MDE were determined with the WHO Composite International Diagnostic Interview (CIDI).

FINDINGS

Lifetime and 12-month prevalence of MDE were 7.4% and 4.0%, respectively. Close to half (46%) of the 12-month MDE cases were severe/very severe. MDE was more common among women and those previously married. Median age of onset was 25.2. Only one-seventh of 12-month MDE cases received treatment despite being associated with very substantial role impairment (on average 70 days out of role in the past year).

CONCLUSIONS

MDE is a commonly occurring disorder in the Iraqi general population and is associated with considerable disability and low treatment. Efforts are needed to decrease the barriers to treatment and to educate general medical providers in Iraq about the recognition and treatment of depression.

Perceptions of complementary medicine integration in supportive cancer care of Arabs and Jews in Israel: a cross-cultural study

CONTEXT

There is a dearth of studies on how cultural background influences patients' attitudes and choices regarding complementary and traditional medicine (CTM) integration.

OBJECTIVES

To explore Arab and Jewish patients' perspectives regarding CTM use and its possible integration within conventional cancer care.

METHODS

This was a cross-cultural study. We developed a 27-item questionnaire that evaluates patients' perceptions regarding CTM integration in supportive cancer care. The questionnaire was administered to a convenience sample of patients receiving cancer care in community and hospital oncology centers.

RESULTS

Of the 770 respondents (response rate 88%), 324 defined their religion as Muslim, Christian, or Druze (henceforth, regarded as Arabs) and 446 were Jews. Respondents in the two groups differed significantly in terms of age, gender, marital status, number of children, education, religiosity, and prevalence of cancer types (excluding breast cancer). Although Arab respondents reported less use of CTM for cancer-related outcomes (39.6% vs. 52.1%; P = 0.001), they expressed greater support than Jewish respondents for optional CTM consultation if provided within conventional oncology care (P < 0.0001). Respondents in both groups stated that their primary expectation from the oncologist concerning CTM was to participate in formulating a CTM treatment plan to be provided within the oncology department. Compared with Arab respondents, Jews expected CTM consultations to focus on improving daily functioning and coping, reducing chemotherapy side effects, and providing spiritual support.

CONCLUSION

Although quality of life-related expectations are more pronounced among Jewish respondents, both groups share the expectation from their health care providers to be actively involved in construction of a tailored integrative CTM treatment plan.

Cultural Boundary of Expectancy Theory-Based Performance Management: A Commentary on DeNisi and Pritchard's Performance Improvement Model

We consider Chinese cultural, psychological and social factors that are likely to place boundaries on the applicability of DeNisi and Pritchard's motivational framework and discuss how these cultural barriers play out at each of the links in their model. We conclude with a summary and a discussion of some of the broader implications of applying models of work motivation to a Chinese economy in transition.

Women supporting patients, men curing cancer: gender-related variations among Israeli Arab practitioners of traditional medicine in their treatment of patients with cancer

The use of complementary traditional medicine (CTM) is prevalent among patients with cancer. An understanding of cultural and religious values is needed to design an effective patient-centered supportive treatment program. To examine gender-related demographic and professional characteristics; treatment goals and approaches; and attitudes toward integration among Arab practitioners of CTM. Male and female Arab CTM practitioners treating patients with cancer were located by snowballing through practitioner and clientele networks. Participants underwent semi-structured, in-depth interviews which were analyzed thematically, with a focus on gender-related issues. A total of 27 Arab CTM practitioners participated in the study (17 males, 10 females). Female practitioners were found to be treating women exclusively, with male practitioners treating both genders. Female practitioners tend to be younger, unmarried, urban-based and non-Muslim. Male practitioners set out to "cure" the cancer, while female practitioners focus on symptoms and quality of life. Male practitioners employ a more schematic and structured therapeutic approach; female practitioners a more eclectic and practical one. Male practitioners employ a collectivist approach, involving family members, while female practitioners interact exclusively with the patient. Finally, male CTM practitioners see integration as a means for recognition, increasing their power base. In contrast, female practitioners perceive integration as a foothold in fields from which they have previously been shut out. A number of gender-related issues can have a significant impact on CTM therapy among Arab patients. Further research is needed in order to understand the implications of these differences.

Between the empowered self and the social costs: Arab abused women's perceptions of their relationship with social workers in community health clinics in Israel

Abused women seek help from medicine services extensively. Qualitative interviews were conducted with 12 married Arab-Israeli abused women about their relationships with social workers in community health clinics. Analysis reveals that women's evaluation of the impact of encounters with social workers is bipolar. On one pole are the difficulties and stressors derived from the cultural limitations that are placed on their ability to bring changes. On the other pole are the benefits--awareness in coping with repressive social powers and empowerment as competent choosers. The discussion elaborates the conflicts and paradoxes inherent in the nature of the interventions with abused women in a collectivistic culture.

An integrated view of cultural perceptions of cancer among Arab people in Israel

The aim of this study was to review published studies on the cultural aspects of screening and care of Arab cancer patients living in Israel. The literature published from the beginning of recording, available up to December 2012, was systematically reviewed. Fifteen studies on perceptions of cancer screening and five studies on different aspects of coping with cancer were identified. Non-attendance of screening for early detection of breast or colorectal cancer was reported to be associated with higher personal barriers (the health belief model) and higher cultural and social barriers. Perceptions of cancer risk, causes, outcomes and personal responsibility were widespread from traditional to more modern biomedical views, and sometimes integrated. Among breast cancer patients, effects of a collective and family centred way of life and strong support by one's spouse were evident, followed by a change towards closer spousal relations. Religious coping strategies were the most prevalent among breast cancer patients and were related to better well-being. An integration of traditional and modern perceptions of cancer, attitudes towards screening and coping with cancer were evident. More research is needed in order to advance a culturally competent care of cancer patients and of interventions that encourage screening for the early detection of cancer.

Being within or being between? The cultural context of Arab women's experience of coping with breast cancer in Israel

BACKGROUND

Coping with cancer is affected by cultural norms, beliefs, and perceptions. To date, only a few studies have examined how Arab women cope with breast cancer and how the illness affects their lives. We aimed to study how Arab women perceive and ascribe meaning to their illness and its personal, familial, and social implications and to examine their coping strategies within the religious and traditional cultural context.

METHODS

The study was qualitative. Participants were 20 Muslim and Christian Arab women with breast cancer (stages I-III) from northern Israel, aged 20-50 years. Participants were between 1 and 5 years after chemotherapy and radiotherapy. In-depth, semi-structured interviews were conducted and later transcribed.

RESULTS

Four main themes emerged: (i) "Family Comes First": The Woman and Her Family; (ii) To Expose or not to Expose? That's the Dilemma; (iii) Faith in God as a Source of Coping; and (iv) Constructing New Meanings Following Recovery from Cancer. Findings stressed a duality in participants' cancer coping experience according to the traditional cultural norms of concealment, while simultaneously encountering more open Western attitudes through interactions with healthcare providers and Jewish women receiving treatment alongside them.

CONCLUSIONS

Healthcare professionals should be aware of the unique implications of cancer in the context of the traditional Arab culture intertwined with modernization processes. This context calls for interventions that consider the understandings depicted in the present study.

The Relationship Between Mental Health, Cultural Identity and Cultural Values in Non-English Speaking Background (NESB) Australian Adolescents

In Australia, acculturating adolescents from a non-English speaking background (NESB) face two important challenges: developing a cultural identity and establishing a set of cultural values. These challenges are achieved by balancing a native and Australian orientation. It was expected that NESB adolescents who did not achieve these tasks would experience poor mental health. This study focused on adolescents because a significant relationship between cultural identity, cultural values and mental health in this group will highlight a need for sensitivity to such cultural and developmental issues. Two hundred and sixty-three NESB adolescents completed questionnaires that assessed cultural identity (Australian and native), cultural values (individualism and collectivism), state mental health (depression, anxiety and stress) and trait mental health (positive affectivity [PA] and negative affectivity [NA]). Results indicated that high Australian pride and high native pride are associated with lower depression, anxiety, stress and NA, and higher PA. Results also indicated that adolescents high on individualism and collectivism reported lower depression and stress, and higher PA. Furthermore, adolescents with a separated cultural identity (high native pride and low Australian pride) reported the highest levels of depression, but adolescents with separated cultural values (high collectivism and low individualism) reported the lowest levels of depression and anxiety. We concluded that cultural identity and cultural values are differentially related to mental health, and such relationships, albeit moderate, emerge during adolescence.

Menopausal symptoms among healthy, middle-aged Omani women as assessed with the Menopause Rating Scale

OBJECTIVE

The aim of this study was to analyze the prevalence and severity of climacteric symptoms and associated risk factors among a cohort of healthy, middle-aged Omani women.

METHODS

In this cross-sectional study, 472 healthy Omani women between 40 and 60 years old from the representative regions of Omani society were surveyed using the Menopause Rating Scale. The scores obtained were plotted against their demographic data and menopausal stage.

RESULTS

Overall, 39.6% of the participants were premenopausal, 15.2% were perimenopausal, and 43.6% were postmenopausal. The Menopause Rating Scale scoring showed that somatic and psychological symptoms occurred more frequently than did urogenital symptoms in all three stages. Muscle and joint pain was the most common symptom (73.3%), followed by mental and physical exhaustion (47.2%) and anxiety (46.6%). An increase in the mean scores for both somatic and psychological symptoms and their severity was observed when the following factors were present: progression of menopausal stage (mean ± SD, 22.5 ± 2.6, 3.6 ± 2.9, 4.5 ± 3.2), old age (4.2 ± 3.2) versus young age (2.9 ± 2.6), single (4.3 ± 3.3) versus married (3.3 ± 2.9), illiterate (3.9 ± 3.1) versus educated (2.7 ± 2.6), and sexually inactive (4.4 ± 3.4) versus sexually active (3.1 ± 2.7).

CONCLUSIONS

Omani women were found to exhibit highly atypical symptoms of menopause. Increased severity of symptoms was found to be related to age, advanced stage of menopause, and lower educational level.

Phenomenology and outcome of factitious disorders in otolaryngology clinic in Oman

The phenomenology of factitious disorders from the Arab part of the world has been lacking in the medical literature and few reports have emerged from otolaryngology. Using an observational prospective case series study (n = 19) with long-term follow-up (two to six years), the present study reports the magnitude and mode of clinical profile of factitious disorders in a tertiary care hospital in Oman, an Arab-Islamic country. The outcome was operationalized as prognosis following culturally sensitive intervention akin to confrontation technique. The present observation suggests the prevalence of factitious disorders in the otolaryngology tertiary care setting was 0.2%. Approximately 42.1% (n = 8) had hemorrhagic factitious disorders, 15.8% (n = 3) were those who feigned for multiple surgical interventions. Approximately 15.8% (n = 3) presented neurological factitious disorders while the remaining 26.3% (n = 5) clinical profile suggested minor feigned illnesses. Objective "evidence factitia" was present in 68.4% (n = 13) of the cases. On subsequent follow-up, nine patients with chronic forms became asymptomatic, three patients had fewer episodes, four patients were unchanged, and three patients were lost to follow-up. The prognosis was good in patients who did not have associated psychiatric illnesses as compared to those with psychiatric disorders. Factitious disorders are often incorrectly diagnosed, with all consequences in terms of adverse sequels. The observed good prognostic outcomes are discussed in the context of socio-cultural patterning and the factors that may shape the presentation of factitious disorders in Oman.

Personality and chronic fatigue syndrome: Methodological and conceptual issues

Among clinical psychologists, consulting physicians, scientific researchers and society in general an image has emerged of patients with chronic fatigue syndrome (CFS) as perfectionist, conscientious, hardworking, somewhat neurotic and introverted individuals with high personal standards, a great desire to be socially accepted and with a history of continuously pushing themselves past their limits. The aim of this article is to (a) give a concise review of the main recent studies on personality and CFS, (b) address the major methodological problems in the study of personality in CFS and (c) discuss some of the conceptual assumptions that seem to limit the research on personality and CFS. The results of the reviewed studies range from no evidence of major differences between the personalities of patients with CFS and controls, to evidence of severe psychopathology and personality disorder in patients with CFS. Although personality seems to play a role in CFS, it is difficult to draw general conclusions on the relation between personality and CFS. It is argued that this is partially due to the diversity and heterogeneity in study methods, patient populations, control groups and CFS case definitions. Personality should be regarded as an important factor to be studied in CFS. However, additional studies are needed, not focusing exclusively on personality disorder, or personality considered on a general trait level. In recent developments in personality research, the continually evolving life narrative that makes sense of, and gives direction to, an individual's life is also regarded as an important aspect of personality. New insights into personality and CFS might be gained by systematically studying the self-narratives of patients with the syndrome.

Addressing the Challenges and Opportunities for Today's Youth: Toward an Integrative Model and its Implications for Research and Intervention

This article calls for, and proposes some tenets of, model building in adolescent psychosocial development. Specifically, it is suggested that there is a need for a model that draws from the risk-protection approach, from which many prevention science approaches are drawn, and the applied developmental science perspective, from which many positive youth development approaches are drawn. The model to be built, and the integration it proposes, is based in the overlap between protective factors and developmental assets (drawn from the applied developmental science and positive youth development perspectives), as well as on the complementarity of the intrapersonal mechanisms proposed within the two perspectives. The article also poses important questions for future research and presents an empirical agenda for addressing these questions in the service of building and testing a model of adolescent psychosocial development and of integrating the prevention and positive youth development approaches to intervention and policy.

Parenting styles and mental health of Palestinian-Arab adolescents in Israel

The relationship between three parenting styles (authoritarian, permissive, and authoritative) and the mental health of Arab adolescents was tested. It was hypothesized that parenting style toward boys would differ from that towards girls, psychological adjustment of girls would differ from that of boys, and that the authoritarian style applied within the authoritarian Arab society is not associated with poor psychological adjustment. The Parental Authority Questionnaire, Child Attitude Toward Parents, Lipsitt's Self-Concept Scale for Children, Rosenberg Self-Esteem Scale and the Psychological State Scale were administered to 431 Arab adolescents. Sex comparison revealed that the parenting style with regard to girls tends to be more authoritative and less authoritarian than with regard to boys. Girls scored higher than boys on identity disorder, anxiety disorder, and depression scales, whereas boys scored higher than girls on the behavior disorder scale. There was no significant relationship between the authoritarian parenting style and the mental health measures. A significant positive relationship exists between the authoritative parenting style and the mental health of children. Among boys, the permissive parenting style was associated with negative attitudes towards parents, lower self-esteem and increased identity, anxiety, phobia, depressive, and conduct disorders. It seems, therefore, that the effect of parenting style is culturally and gender dependent rather than universal.

Construct Validity of the Relationship Profile Test: Impact of Gender, Gender Role, and Gender Role Stereotype

Research supports the construct validity of the Relationship Profile Test (RPT; Bornstein & Languirand, 2003), a 30-item, self-report measure of destructive overdependence (DO), dysfunctional detachment (DD), and healthy dependency. In this investigation, we assessed the relationships of gender, gender role, and gender role stereotype ratings to RPT subscale scores. In Study 1, we replicated earlier patterns of gender differences in RPT scores, assessed cross-sample consistency in gender difference effect sizes, and provided preliminary nonclinical norms for the RPT subscales. Study 2 showed that--as expected--DO items are perceived as stereotypically feminine, whereas DD items are perceived as stereotypically masculine. In Study 3, we examined the relationships of RPT subscale scores to masculinity, femininity, and androgyny scores. We discuss the theoretical, empirical, and clinical implications of these findings.

Individuation Among Bedouin Versus Urban Arab Adolescents: Ethnic and Gender Differences

Three scales assessing individuation (Objective Measure of Ego-Identity Status [OMEIS], Separation-Individuation Test of Adolescence [SITA], and Multigenerational Interconnectedness Scale [MIS]) were administered to 40 female and 38 male Bedouin Arab adolescents and to 39 female and 38 male urban Arab adolescents in Grade 12. It was hypothesized that Bedouin Arab adolescents and female adolescents would manifest less individuation than urban Arab adolescents and male adolescents, respectively. Results from the OMEIS revealed that the identity foreclosed mean of the Bedouin adolescents was higher than that of the urban adolescents. As for the SITA, significant differences were found between Bedouin and urban Arabs in terms of dependency denial, separation anxiety, teacher enmeshment, peer enmeshment, and rejection expectancy. Significant gender differences were found in regard to dependency denial, and a borderline difference was found for separation anxiety. Significant effects of ethnicity and gender were found on the financial interconnectedness subscale of the MIS. The results support the present hypotheses concerning ethnicity differences and indicate that urbanization seems to narrow the differences in individuation between male and female adolescents.