Marina Doucerain, Norman Segalowitz, and Andrew G. Ryder
This article discusses the importance of clear and precise conceptualizations of acculturation as well as the need for consistencies in definition, operationalization, and measurement. More specifically, it argues for an expanded acculturation research toolkit that does not rely too heavily on self-report acculturation scales. The article begins with an overview of the state of affairs with respect to acculturation conceptualizations and methods, paying particular attention to the unidimensional, bidimensional, and multidimensional frameworks of psychological acculturation. It then considers ways in which commonly used definitions and methods of acculturation can be used more intelligently. It also describes alternative methods for researchers interested in moving beyond self-report rating scales, a tiered approach to acculturation research, and method-specific health considerations. Finally, it offers some recommendations aimed at helping the field of acculturation and health research move forward.
Multimethod and mixed methods are well suited to prevention research in global health; however, their application has not yet been adequately discussed or demonstrated. This chapter illustrates key opportunities and challenges through focusing on using multimethod and mixed methods for investigating prevention involving migration. It summarizes one large study focused on labor migrants and HIV/AIDS risk and protection to illustrate how innovative strategies combining different forms of knowledge in multimethod and mixed methods can generate more robust and useful findings. Multimethod and mixed methods in prevention research in global health should strategically utilize multiple study elements (investigators, theories, methods, and data) that are most responsive to the central research problems and questions, through existing and new synergies, so as to most appropriately address the key preventive intervention characteristics and contribute to the overall completeness of the knowledge.
Jill A. Stoddard, Christopher Barmann, Eric Lenze, and Julie L. Wetherell
By the year 2050, the number of adults over the age of 60 will reach an estimated two billion, representing the fastest-growing segment of the population. Although anxiety and mood disorders are common among older adults, consensus is lacking as to the most appropriate treatments. In an effort to optimize treatment strategies for older adults, this chapter focuses on a thorough review of outcome literature investigating the use of pharmacotherapy and psychotherapy within three treatment domains: combination, sequential, and augmentation. The preponderance of evidence has lent support to the notion that combining psychosocial and medical treatments results in better outcomes for older adults with anxiety and mood disorders. However, there is a clear need for additional randomized, controlled trials further investigating optimal treatment strategies addressing mental health in late life.
Kristian E. Markon
Comorbidity models have become central to psychopathology theory and research, not only because they have clarified our understanding of how and why disorders co-occur but also because they have clarified our understanding of what the disorders are. This chapter reviews basic types of comorbidity models, recurring issues in comorbidity modeling, and discuss emerging issues in the area. Using recent epidemiological, repeated-measures data on depression and anxiety as an example, two different models of comorbidity are compared, one in which comorbidity arises due a shared liability dimension (i.e., a reflective or latent variable model) and another in which comorbidity arises as an epiphenomenon of correlated symptoms (i.e., a formative or network model). This comparison, relatively novel in the literature, illustrates a number of issues that are encountered in comorbidity modeling, and clearly demonstrates how questions pertaining to comorbidity can shape our understanding of psychopathology constructs.
Gary Elkins and Michelle Perfect
This article significances the importance of the process of hypnosis in health-compromising behaviors as they represent a major source of preventable disease, and for this reason they have been the focus of increased attention among health care professionals. Hypnosis is frequently sought, and has been applied to two significant health risk behaviors: nicotine dependence and obesity. There is a great need for interventions to modify the behaviors associated with nicotine dependency and obesity, and effective hypnosis treatments have the potential both to save lives and to improve the health care of many individuals who are at risk. This chapter underscores that the quality of evidence supporting the use of hypnosis interventions for health-compromising behaviors has been varied. It states that rigorous clinical trials need to be conducted to examine the effects of multimodal interventions, where hypnosis is one of many components.
M. Robin DiMatteo, Tricia A. Miller, and Leslie R. Martin
This essay examines issues relevant to the accurate assessment of patient adherence to recommendations for health behavior change and/or the management of medical conditions, including long-term chronic diseases. Both conceptual and methodological issues are discussed. The importance of accurate assessment in both clinical practice and research is examined, as well as the consequences of conceptual and measurement biases. The role of assessments of current adherence in predicting future behavior is examined, as is the essential distinction between assessing adherence as a behavior and assessing the predictors and consequences of adherence. The potential challenges of various approaches to assessing adherence accurately are examined, focusing particularly on self-report; measurement scales for adherence are presented; and innovative techniques are discussed for assessing adherence using technologically based formats. Effective communication is emphasized as the most important and salient element relevant to adherence assessment, linking patient adherence assessment with effective communication in the clinical setting.
Maria E.A. Armento and Melinda A. Stanley
Older community-dwelling adults generally do not receive mental health care in equal proportion to need, and this reflects a global phenomenon. A number of studies have begun to look at the effectiveness of treatment for late-life depression and anxiety in non-mental health settings where older adults receive services, in particular primary care and community-based service settings. Mental healthcare in non-traditional settings has the possibility of increasing reach and accessibility of treatment for older adults. Continued research is needed to expand this care through continued implementation in primary care and community settings and, potentially, beyond. As this area continues to broaden, so does the possibility of reaching many older adults who are experiencing anxiety and depression, thereby increasing their overall quality of life.
Joyce P. Lee, Richard M. Lee, and Alisia G. T. T. Tran
This chapter investigates the phenomenon of foreigner objectification, or the labeling (implicit or otherwise) of members of racial/ethnic minority groups as foreigners regardless of citizenship, migration status, or length of residence. As the majority of research on foreigner objectification has emerged out of the United States, the chapter focuses on the foreigner objectification experiences of two rapidly growing US racial/ethnic groups: Latinos/as and Asian Americans. It first contextualizes foreigner objectification within the larger literature on attitudes toward racial/ethnic minority groups. It then discusses how foreigner objectification has been measured in psychological research and examines the limited but growing literature on the association between foreigner objectification and mental and physical health.
Ian A. James
There is an increasing interest in the use of cognitive-behavioural therapy (CBT) for people with dementia, with RCT protocols currently being developed for the treatment of anxiety. Because anxiety, and other psychiatric conditions, may be contributing factors in ‘behaviours that challenge’ (BC), such work is important. However, overall CBT is less well developed in the treatment of BC. This chapter first examines the nature of BC and then looks at the key CBT principles being used to reduce problematic behaviours. While this initial section is short on an evidence base, there already exists a healthy literature on the use of CBT for carers. As this chapter will show, when working with people with severe dementia, the therapeutic work is often conducted via professional carers and staff. The research with carers is diverse in focus, looking at maintaining carers’ well-being and/or providing support to reduce both the incidences of BC and the likelihood of institutionalization of the person with dementia.
Nancy A. Pachana
Clinical geropsychology benefits from a global perspective in a variety of ways. Gerontological theories and interventions may find new applications and expressions when tested in different cultural settings, and the sharing of datasets internationally expands their utility. Importantly, the training of health professionals, and particularly mental health professionals, to cope with increasing numbers of geriatric patients globally, is lagging. In this chapter, some of the ways in which clinical geropsychology has matured into an international field are explored, with reference to the chapters in this Oxford Handbook of Clinical Geropsychology where appropriate.