The Effects of Social Anxiety on the Development of Romantic Relationships in Adolescence

The present study sought to investigate the ways in which social anxiety impedes the development of romantic relationships across adolescence. Previous research has demonstrated a natural progression for romantic associations during adolescence in which teens transition from same- to mixed-sex peer groups, and finally to dyadic relationships with romantic partners (Connolly, Furman, Konarski, 2000; Dunphy, 1963). This model of development was the basis for the present investigation. Social anxiety was examined in terms of how it impacted affiliations at the same- and mixed sex peer group levels, and ultimately the formation of romantic relationships. This project involved administering a series of questionnaires and rating scales to students enrolled in the 9th through \2l grades. Participants included 457 adolescents (196 males, 261 females) recruited from public high schools in the state of Maine. The questionnaires assessed social anxiety, peer acceptance, heterosocial competence, gender composition of adolescent peer networks, dating history, and relationship quality with significant others in the adolescent's life. Higher levels of social anxiety were expected to be associated with impairment at each of these three levels. Given the proposed developmental progression, the effects of anxiety were theorized to be most pronounced within the older cohort of adolescents. Moreover, gender was expected to affect the pattern of results. Social anxiety is most prevalent among females (LaGreca, 1998; LaGreca & Lopez, 1998), who are also thought to progress along the proposed developmental trajectory more quickly than their male counterparts. Therefore, social anxiety was expected to impact the females to a greater degree at each of the three levels. Correlation coefficients, multivariate analyses of variance, and regression analyses were used to evaluate the data. Overall, despite some discrepant findings, the results supported the hypotheses. Social anxiety was affiliated with problems in the same-sex peer group, the mixed-sex clique, and, for older adolescents, romantic relationships. As expected, social anxiety affected females the most at each level. There seems to be a maladaptive pathway that socially anxious teens are following that is markedly different than their non-anxious counterparts.

PARENT-CHILD RELATIONSHIP QUALITY AND THE INFLUENCE ON SOCIOMETRIC VERSUS PEER-PERCEIVED POPULARITY

The purpose of this study was to compare factors in the parent-child relationships of peer perceived popular adolescents to those of sociometrically popular adolescents. Factors included autonomy, relatedness, and idealization. Participants were 71 8th grade adolescents. Results showed similarities in parent-child relationships between perceived popular and sociometrically popular adolescents for autonomy, relatedness, and idealization. Results suggest that future research should explore other factors, such as affection from mother and father and levels of psychological control behavior to differentiate perceived popularity from sociometrically popular adolescents.

Three-agent Peer Evaluation

I show that every rule for dividing a dollar among three agents impartially (so that each agent's share depends only on her evaluation by her associates) underpays some agent by at least one-third of a dollar for some consistent profile of evaluations. I then produce an impartial division rule that never underpays or overpays any agent by more than one-third of a dollar, and for most consistent evaluation profiles does much better.

Kitty Aschenbach als Anitra, Szenenfoto, Ganzfigurbildnis, in: Henrik Ibsen: Peer Gynt

Signatur des Originals: S 36/F02627

Kitty Aschenbach als Anitra, Szenenfoto, Ganzfigurbildnis, in: Henrik Ibsen: Peer Gynt

Signatur des Originals: S 36/F02628

Toni Impekoven als Peer Gynt, Rollenbild, in: Henrik Ibsen: Perr Gynt

Signatur des Originals: S 36/F04668

Arno Hassenpflug als Peer Gynt, Rollenbild, Brustbild, in: Henrik Ibsen: Peer Gynt

Signatur des Originals: S 36/F10756

Leopold Biberti als Peer Gynt, Rollenbild, Hüftbild, in: Henrik Ibsen: Peer Gynt

Signatur des Originals: S 36/F11454

Leopold Biberti als Peer Gynt, Rollenbild, in: Henrik Ibsen: Peer Gynt

Signatur des Originals: S 36/F11455

Agnes Straub als Åse, {[N.N.], Szenenfoto, Doppelbildnis, in: Henrik Ibsen: Peer Gynt

Signatur des Originals: S 36/F11832

Cultural competence in an HIV dedicated dental clinic: Application of the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS)

This dissertation investigated perspectives on cultural competence among African-American women patients, staff, and the administrator of a dental clinic serving people living with HIV/AIDS; and evaluated the role of the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS) in advancing the provision of culturally competent care in the clinic. ^ The study was qualitative with data collection via focus groups and individual interviews with a sample of African-American women patients, and individual interviews with a sample of staff and the clinic administrator. Transcripts were coded and themes identified using the software program ATLAS.ti. A cultural audit template was developed and applied to evaluate cultural competency. ^ Among attitudes and behaviors that contributed to the provision of culturally competent care at the clinic were respect and empathic communication. Formal cultural competency was not featured strongly in the methods by which the staff learned to work with diverse populations. Instead cultural competence among the staff was based on thoughtful hiring practices, natural aptitude and a climate that encouraged learning through informal sharing of experiences. The staff and administrator felt that an African-American dentist would be an asset in improving culturally competent care at the clinic. Previous research and national policy also promote the provider-patient racial/ethnic concordance to improve care. In this study, however, the patients were happy with the care provided regardless of the race/ethnicity of the staff, probably reflecting the well developed cultural competence skills of clinic staff overall. ^ The clinic administrator was unaware of the CLAS standards although the clinic was implicitly operated under their mandates. This occurred because the clinic is supported by federal funding and the CLAS standards were incorporated into the requirements. Incorporation into and monitoring of the CLAS standards in federally funded programs therefore appears to be an effective means for ensuring that they are implemented. ^ This study illustrates that cultural competence, though not universally understood, can be systematically investigated to identify what constitutes appropriate care and the factors that support or inhibit it. Among important elements of culturally competent care are respect and empathic communication. ^

An analysis of the effects of a peer mentor program and other factors on HIV patients' retention in care and clinical outcomes at Thomas Street Health Clinic, Houston Texas

Research examining programs designed to retain patients in health care focus on repeated interactions between outreach workers and patients (Bradford et al. 2007; Cheever 2007). The purpose of this study was to determine if patients who are peer-mentored at their intake exam remain in care longer and attend more physicians' visits than those who were not mentored. Using patients' medical records and a previously created mentor database, the study determined how many patients attended their intake visit but subsequently failed to establish regular care. The cohort study examined risk factors for establishing care, determined if patients lacking a peer mentor failed to establish care more than peer mentor assisted patients, and subsequently if peer mentored patients had better health outcomes. The sample consists of 1639 patients who were entered into the Thomas Street Patient Mentor Database between May 2005 and June 2007. The assignment to the mentored group was haphazardly conducted based on mentor availability. The data from the Mentor Database was then analyzed using descriptive statistical software (SPSS version 15; SPSS Inc., Chicago, Illinois, USA). Results indicated that patients who had a mentor at intake were more likely to return for primary care HIV visits at 90 and 180 days. Mentored patients also were more likely to be prescribed ART within 180 days from intake. Other risk factors that impacted remaining in care included gender, previous care status, time from diagnosis to intake visit, and intravenous drug use. Clinical health outcomes did not differ significantly between groups. This supports that mentoring did improve outcomes. Continuing to use peer-mentoring programs for HIV care may help in increasing retention of patients in care and improving patients' health in a cost effective manner. Future research on the effects of peer mentoring on mentors, and effects of concordance of mentor and patient demographics may help to further improve peer-mentoring programs. ^

The association of peer victimization and/or bullying perpetration and body dissatisfaction in elementary students from the healthy passages baseline study

This is the first U.S. study to investigate the association between peer victimization and/or bullying perpetration and body image dissatisfaction in American elementary school students. The study used data collected from the Healthy Passages baseline cohort of 5152 ethnically diverse fifth grade students from Alabama, Texas, and California. The overall prevalence of body dissatisfaction in our fifth grade sample was 50%. Students who were dissatisfied with their bodies were 23% more likely to be involved in peer victimization than students who were satisfied with their bodies (OR = 1.23; 95% CI = 1.02, 1.48). No significant associations were found between bullying status or bully-victim status and body dissatisfaction. Other factors that contributed significantly to a student's body image status were BMI, level of self-worth, level of household income, gender, pubertal timing and support received from adults (other than parents). It is noteworthy that those who were dissatisfied were heavier, came from lower income homes and were more likely to be male. Additional longitudinal studies are needed to confirm these associations, especially among large ethnically and socio-economically diverse samples. ^

Is family medicine meeting the HIV/AIDS challenge? A national survey of family physicians' beliefs, clinical competence, and experience regarding HIV disease

A national sample of family physicians was surveyed to (1) assess family physicians' beliefs about the human immunodeficiency virus (HIV) and individuals at risk for infection, their clinical competence regarding HIV-related issues, and their experiences with HIV disease; (2) present conclusions to the American Academy of Family Physicians (AAFP) to effect the development of an early clinical care protocol and a continuing medical education curriculum; and (3) collect base-line data for use in the evaluation of an early clinical care protocol and a continuing medical education curriculum, in the case that such programs are developed and disseminated. After considering retired or deceased respondents, of the 2,660 physicians surveyed, 1,678 (63.7%) responded. The resulting sample was representative of the active members of the AAFP. About 77% of the respondents were unable to accurately identify the universal precautions for blood and body fluids to prevent occupational transmission of HIV or hepatitis B virus (HBV). Residency trained and board certified physicians expressed fewer "external constraints," such as fear of losing patients, obviating them from providing treatment to individuals with HIV disease (p =.004 and p $<$.001, respectively). These physicians also manifested fewer "internal constraints" to the provision of HIV treatment, such as fear of becoming infected (p $<$.001 and p =.012, respectively). Residency trained physicians also expressed a greater comfort with discussing sexually-related topics with their patients than did non-residency trained physicians (p $<$.001). There were 67.1% of the physicians surveyed who reported never providing treatment to an individual with HIV disease. Residency trained and board certified physicians expressed a greater likelihood to provide treatment to HIV-infected patients (p $<$.001) than non-residency trained and non-board certified physicians.^ Among the various primary care specialties, family medicine is especially vulnerable to the current challenges of HIV/AIDS. These challenges are augmented by the epidemiologic pattern that characterizes AIDS. For the past several years, we have seen AIDS in this country assume a similar pattern to that seen in most other countries; HIV is becoming increasingly prevalent in the heterosexual population as well as in locations removed from metropolitan centers. This current phase of the epidemic generates greater pressures upon primary care physicians, particularly family physicians, to become better acquainted with the means to provide early care to HIV/AIDS patients and to prevent HIV/AIDS among their patients. Family medicine is especially appropriate for providing care to HIV patients because family medicine involves treatment to all age groups and conditions; other primary care specialties focus on limited patient populations or specific conditions. Family physicians should be armed with the expertise to confront HIV/AIDS. However, family physicians' clinical competence and experience with HIV is not known. The data collected in this survey describes their competencies, attitudes, and experiences. ^

THE DEVELOPMENT OF COMMUNITY COMPETENCE THROUGH A NEIGHBORHOOD ORGANIZATION (LOS ANGELES, MEXICAN-AMERICAN)

This investigation focused on how people cope with the demands of their environment in a competent manner. It sought to assess the effects of learning competent coping behaviors on self-reported well-being. The study chose a community-evolved, organized effort on the part of a group of neighborhoods to build competence in the Mexican-American community of East Los Angeles. This network was a citizen-action organization called the United Neighborhoods Organization. UNO was selected because it concentrated on developing community leaders by using spiritual beliefs and family values as shared community resources. Neighborhood leaders were encouraged to engage in risk-taking and confrontation maneuvers. They were also taught problem-solving skills and provided with social support.^ A survey instrument was developed to assess sociodemographic characteristics, acculturation history and status, willingness to engage in risk-taking and confrontation and self-perceived general well-being. The study relied on eight months of daily participant-observation of the organization, the East Los Angeles environment and the interaction between the two. At the end of the observation period, a sample of 150 UNO participants were given the survey questionnaire as was a matched group of 150 non-UNO participants who were ELA residents.^ The study sample was mostly women, in their middle age years who had lived in the area from 5 to more than 30 years. Significantly more single persons were found in the UNO group. The sample was almost equally divided into English and Spanish speaking respondents. Acculturatively almost all the sample fell in the Very Mexican and Mostly Mexican types. The survey found a trend of association between participating in UNO and reporting feeling well. A statistically significant association was found among UNO participants between taking risks and reporting feeling well, regardless of a tendency for all the sample to minimize risk. A trend was seen for married UNO participants to report feeling well. Slightly more UNO participants were willing to engage in confrontation and a substantial proportion of the participants who were confronters reported feeling well in comparison to their counterparts. Ethnic pride was positively associated with participation in UNO and showed a trend in the expected direction with reported self-perceived well-being. ^