Bioterrorism as a public health threat

The threat of bioterrorism, long ignored and denied, has heightened over the past few years. Recent events in Iraq, Japan, and Russia cast an ominous shadow. Two candidate agents are of special concern--smallpox and anthrax. The magnitude of the problems and the gravity of the scenarios associated with release of these organisms have been vividly portrayed by two epidemics of smallpox in Europe during the 1970s and by an accidental release of aerosolized anthrax from a Russian bioweapons facility in 1979. Efforts in the United States to deal with possible incidents involving bioweapons in the civilian sector have only recently begun and have made only limited progress. Only with substantial additional resources at the federal, state, and local levels can a credible and meaningful response be mounted. For longer-term solutions, the medical community must educate both the public and policy makers about bioterrorism and build a global consensus condemning its use.     

A major threat to children's mental health: Psychological maltreatment.

Psychological maltreatment appears to be more prevalent and potentially more destructive than other forms of child abuse and neglect. However, it receives little attention from the public or professional sector and is seldom the target of research or intervention. This article reviews the literature and concludes that psychological maltreatment is the core issue in child maltreatment and poses a serious mental health threat that should be brought to the forefront of psychology's efforts in policy development, research, intervention, and prevention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Compensatory self-inflation: A response to the threat to self-regard of public failure.

Hypothesized that because public evaluative situations are most likely to encourage conditional self-regard, an overevaluation of self-image as a way to compensate for the threat of failure (compensatory self-inflation) is likely to occur if a failure is public but not if it is private. 76 female undergraduates either succeeded or failed on a test of social sensitivity, and the outcome was either known or not known to others. Half of the Ss were subsequently required to evaluate the positive and negative aspects of the test on a social attitudes questionnaire. The favorability of self-image of all the Ss was then assessed. The self-images of Ss who evaluated the test were not affected by the outcome manipulation. Compared with these Ss, among Ss who did not evaluate the test, favorability of self-image was increased after public failure and decreased after private failure. The hypothesis that compensatory self-inflation occurs after public but not private failure was confirmed. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived threat as a major factor in tolerance for experimentally induced cold-water pain.

In Study 1, 12 undergraduates informed only of the normal physiological reactions to hand immersion in cold water and 12 Ss informed that they were participating in a "study of the perception of novel stimuli" showed much greater tolerance and reported significantly less pain than did 12 controls given no pretesting message. Therefore, giving Ss the chance to ascribe uncomfortable sensations to a nondamaging process increased tolerance. Study 2, with 5 graduate students, showed that repeated exposure to cold-water immersion (employed to demonstrate safety of the procedure) did not reduce the reported sensation of pain, indicating that the increased tolerance following assurances of safety was directly due to decreased threat and not to decreased sensation. Findings support the distinction between pain sensation and emotional-motivational reaction leading to escape or avoidance. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is behavior modification a major menace to patients' rights?

Comments on S. Feshback's (1976) and P. Perlin's (1976) questions about the ways that behavior modification programs (BMPs) have been and should be administered and argues that they both err in assuming that BMPs are the most important sources of dangers to which they alert their readers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adopting a public health approach to the delivery of evidence-based parenting interventions.

A public health perspective to the delivery of parenting programs has the potential to greatly increase the impact of evidence-based psychological interventions targeting parents and families. However, a population-level benefit is unlikely to be achieved unless sustained programmatic efforts are undertaken to further increase the reach of efficacious interventions. In addition, such programs need to be adapted to local circumstances, be delivered in a culturally relevant manner, and be used in a sustained way by adoptee organisations if the potential benefits of these interventions are to be realised. The multilevel Triple P system of parenting interventions is used as an example to illustrate the benefits and challenges involved in delivering a comprehensive system of parenting interventions, services, and programs. Practical implications for large-scale implementation and possible future directions for research are identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Leprosy. The beginning of an end to a public health problem?

Incidence rates of leprosy seem to be falling in most countries around the world, despite the HIV epidemic. Among the reasons for the declining rates are changing socioeconomic conditions and high BCG vaccination coverage. The numbers of people disabled by leprosy, however, are more important than incidence rates of leprosy per se. The issue of the disabled will remain a public health problem for many decades to come.     

Triple P-Positive Parenting Program as a public health approach to strengthening parenting.

Parenting programs have considerable potential to improve the mental health and well-being of children, improve family relationships, and benefit the community at large. However, traditional clinical models of service delivery reach relatively few parents. A public health approach is needed to ensure that more parents benefit and that a societal-level impact is achieved. The Triple P-Positive Parenting Program is a comprehensive, multilevel system of parenting intervention that combines within a single intervention universal and more targeted interventions for high-risk children and their parents. With Triple P, the overarching goal is to enhance the knowledge, skills, and confidence of parents at a whole-of-population level and, in turn, to reduce the prevalence rates of behavioral and emotional problems in children and adolescents. The distinguishing features of the intervention and variables that influence its effective implementation are discussed. Self-regulation is a unifying concept that is applied throughout the entire system (e.g., to interactions between children, parents, service providers, and agencies involved in delivering the intervention). Challenges and future directions for the development of public health approaches to parenting are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Population-based needs assessment. Bringing public health to midwifery practice

Midwives are accustomed to individualizing their care of women on the basis of an assessment of each client's health status. By expanding their focus of care to encompass treatment of a population group, midwives and other providers can adopt a public health perspective through use of a community needs assessment. The first steps in diagnosing and treating the health problems of a group require the same rigorous and systematic examination of health indicators as does treatment of an individual. This article outlines the needs assessment process, identifies basic sources of information, and describes ways in which results can be presented.     

Styles of coping with threat: Implications for health.

We explored individual differences in health-seeking behavior and health status in a primary care population. Specifically, we compared high monitors (those who typically scan for threat-relevant information) with low monitors (those who typically ignore threat-relevant information), while controlling for depression. Overall, high monitors came to the physician with less severe medical problems than did low monitors. Nevertheless, high monitors reported equivalent levels of discomfort, dysfunction, and distress compared with low monitors. Furthermore, during the week following their visit, high monitors expressed less symptom improvement in both physical and psychological problems than did low monitors. Finally, high monitors demanded more tests, information, and counseling during their visit than did their low monitoring counterparts, yet desired a less active role in their own care. The theoretical and practical implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)