Is it diabetes mellitus or Munchausen's syndrome?

John Henryism Active Coping, Acculturation, and Psychological Health in Korean Immigrants

This study aimed to explore the levels of John Henryism (JH) active coping and its association with acculturation status and psychological health (specifically perceived stress, acculturative stress, anxiety, and depression) in Korean immigrants to the United States. In 102 Korean immigrants, JH active coping was measured by the JH Scale; acculturation by the Bidimensional Acculturation Scale; perceived stress by the Perceived Stress Scale; acculturative stress by the Social, Attitudinal, Familial, and Environmental Scale; anxiety by the State Anxiety Subscale of the Spielberger State-Trait Anxiety Inventory; and depression by the Center for Epidemiological Studies Depression Scale. The levels of JH active coping in this sample of Korean immigrants appear to be lower than the levels reported in other racial groups. Independent of demographic factors, JH active coping was a significant predictor of higher acculturation status and better psychological health as indicated by lower levels of perceived stress, acculturative stress, anxiety, and depressive symptoms.

Exploring moderating effects of John Henryism Active Coping on the relationship between education and cardiovascular measures in Korean Americans

OBJECTIVE

John Henryism Active Coping (JHAC) is defined as a strong behavioral predisposition to cope with stressors in an effortful and determined manner. The well-known inverse relationship between socioeconomic status (SES) and blood pressure (BP) has been hypothesized to be stronger for individuals who have high JHAC than those with low JHAC, suggesting that JHAC may place people with low SES at higher cardiovascular risk. Previous studies testing this hypothesis have presented mixed findings; therefore, this study was conducted to test the JHAC hypothesis by examining the main and interaction effects of SES and JHAC on cardiovascular risk (measured by BP and arterial stiffness [AS]).

METHODS

The sample was 102 Korean Americans (aged 21-60years). Measures included age, sex, body mass index, smoking, SES (measured by income and education), JHAC (measured by the 12-item JHAC Scale), BP, and AS.

RESULTS

In terms of the SES measures, only education was significantly related to systolic BP (p=0.003), diastolic BP (p=0.001), and AS (p<0.000). The interaction effects of education and JHAC on systolic BP and AS were also significant (p=0.019 and p=0.018, respectively), indicating that the inverse relationships of education to systolic BP and AS were more prominent in subjects with lower JHAC scores.

CONCLUSION

Contrary to the JHAC hypothesis, JHAC may be associated with low cardiovascular risk in people with low education in certain groups. Studies are recommended to examine potential beneficial effects of JHAC on cardiovascular health in a larger sample and to identify their mechanisms.

The deceit continues: an updated literature review of Munchausen Syndrome by Proxy

OBJECTIVE

This article presents an updated review of the literature of Munchausen Syndrome by Proxy (Factitious Disorder by Proxy, MBP).

METHOD

Four hundred fifty-one cases of MBP were analyzed from 154 medical and psychosocial journal articles.

RESULTS

Typical victims may be either males or females, usually 4 years of age or under. Victims averaged 21.8 months from onset of symptoms to diagnosis. Six percent of victims were dead, and 7.3% were judged to have suffered long-term or permanent injury. Twenty-five percent of victims' known siblings are dead, and 61.3% of siblings had illnesses similar to those of the victim or which raised suspicions of MBP. Mothers were perpetrators in 76.5% of cases, but as knowledge of MBP grows a wider range of perpetrators is identified. In a small number of cases, MBP was found to co-exist with secondary gain or other inflicted injury.

CONCLUSION

Although published cases form a non-random sample, they add to knowledge about MBP and validate claims that it occurs. More knowledge about non-medical aspects of MBP, and more pooling of data, is desirable.