Psychosocial Inquiry Research Articles

Beyond the angers of populism: a psychosocial inquiry

This article offers a model of psychosocial inquiry in an analysis of the sources of the passionate desire for the UK to leave the EU. It proceeds from separate consideration of the ‘monocular’ modes of both societally- and psychologically-focussed approaches, towards bringing them together in a more ‘binocular’ vision. Firstly, familiar societal explanations are considered, in the perceived losses of material security, of national sovereignty and of indigenous community. It is noted that this level of explanation cannot account for the variations amongst Leave-supporting individuals in the intensity of their anger with the ‘establishment’. Secondly, a depth-psychological approach is explored, noting the contribution of theories of ‘othering’ and focussing on how pro-Brexit anger can be understood as a narcissistic rage against the ‘otherness’ of authority, as represented both by Parliament and the British elites, and by European institutions. Thirdly, a psychosocial ‘binocularity’ is outlined, in which societally-generated anxieties can be seen to interact with the intra-psychic vector of the narcissistic defence. That defence in turn can be seen to have become more prominent in late-modern societies due to cultural changes which have impacted adversely on the capacity for basic trust, so in historical context the psychic dimension folds back into the societal.

Alienation and Digital Labour—A Depth-Hermeneutic Inquiry into Online Commodification and the Unconscious

At the core of this paper is a psychosocial inquiry into the Marxist concept of alienation and its applications to the field of digital labour. Following a brief review of different theoretical works on alienation, it looks into its recent conceptualisations and applications to the study of online social networking sites. Finally, the authors offer suggestions on how to extend and render more complex these recent approaches through in-depth analyses of Facebook posts that exemplify how alienation is experienced, articulated, and expressed online. For this perspective, the article draws on Rahel Jaeggi’s (2005) reassessment of alienation, as well as the depth-hermeneutic method of “scenic understanding” developed by Alfred Lorenzer (e.g. 1970; 1986).

Factors Associated With Family-Centered Involvement in Family Practice—A Cross-Sectional Multivariate Analysis

The importance of a family-centered approach in family practice has been emphasized. Knowledge about factors associated with higher family-centered involvement seems beneficial to stimulate its realization. German office-based family physicians completed a questionnaire addressing several aspects of family-centered care. Logistic regression was used to identify associations with the involvement overall and in different domains: routine inquiry and documentation of family-related information, family orientation regarding diagnosis and treatment, family-oriented dialogues, family conferences, and case-related collaboration with marriage and family therapists. We found significant associations between physicians’ family-centered involvement and expected patient receptiveness, perceived impact of the family’s influence on health, self-perceived psychosocial family-care competences (overall and concerning concepts for family orientation, psychosocial intervention in family conferences, and the communication of the idea of family counseling), advanced training in psychosocial primary care (PPC), personal acquaintance with family therapists (regarding case-related collaboration), and rural office environment. Increased emphasis on the family’s influence on health in medical education and training, the provision of concepts for a family-centered perspective, and versatile skills for psychosocial intervention and inquiry of patient preferences, as well as the strengthening of networking between family physicians and family therapists, might promote the family-centered approach in family practice.

L'interazione come tecnica d'indagine psicosociale: il Focus Group

- The article deals with the focus group as a psycho-social action-research technique which is primarily based on the possibilities offered when a certain number of participants find themselves discussing of the same topic. Starting with the definitions which is possible to find in the literature, and making a comparison with other techniques of psycho-social inquiry, such as the interview and the questionnaire, the present paper offers some cues of reflection on the focus group and an example for its use.

Population-Attributable Risk of Suicide Conferred by Axis I Psychiatric Diagnoses in a Hong Kong Chinese Population

Population-Attributable Risk of Suicide Conferred by Axis I Psychiatric Diagnoses in a Hong Kong Chinese Population

Population-Attributable Risk of Suicide Conferred by Axis I Psychiatric Diagnoses in a Hong Kong Chinese Population

This study was conducted to determine the population-attributable risk (PAR) of completed suicide among Hong Kong Chinese with axis I psychiatric diagnoses. With a case-control psychological autopsy method, 150 suicide decedents aged 15-59 were compared for axis I psychiatric diagnoses and psychosocial variables with 150 randomly selected age- and gender-matched persons living in the community. In the presence of other, non-disease-related social risk factors (unemployment and unmanageable debt), past suicide attempt independently accounted for 44% of the PAR of suicide, followed by current major depressive disorder (27%), schizophrenia spectrum disorders (22%), and substance use disorder or pathological gambling (16%). Other diagnoses (such as anxiety and phobic disorders, dysthymia, adjustment disorders, and past major depressive episode) accounted for 24% of PAR. Psychiatric morbidity remains the major risk factor for suicide in Hong Kong despite well-developed psychiatric services. Mental health policy should be refined to target clinical groups at high risk of suicide.

Clinical evaluation study of the German network of disorders of sex development (DSD)/intersexuality: study design, description of the study population, and data quality

BackgroundThe German Network of Disorders of Sex Development (DSD)/Intersexuality carried out a large scale clinical evaluation study on quality of life, gender identity, treatment satisfaction, coping, and problems associated with diagnoses and therapies in individuals with disorders of sex development (DSD). DSD are a heterogeneous group of various genetic disorders of sex determination or sex differentiation, all of which are rare conditions. In about half of all cases the molecular genetic diagnosis is unknown and diagnosis rests on clinical features.Methods and designThe multi-centre clinical evaluation study includes short-term follow-up in some and cross-sectional assessments in all age and diagnostic groups fitting the criteria of DSD. Recruitment was from January 2005 until December 2007 in whole Germany and, additionally, in 2007 in Austria and German-speaking Switzerland. The study consists of a psychosocial inquiry for children, adolescents and their parents, and adults with standardized instruments and the collection of DSD-specific medical data by the attending physician. The main goal was the description of clinical outcomes and the health-care situation of individuals with DSD using a broad generic definition of DSD including all conditions with a mismatch of chromosomal, gonadal and phenotypical sex. 439 children and adolescents, their parents and adults with DSD participated.DiscussionThe clinical evaluation study represents the most comprehensive study in this clinical field. The paper discusses the study protocol, the data management and data quality as well as the classification used, and it describes the study population. Given the lack of large datasets in rare conditions such as DSD and often biased results from small scale clinical case series, the study aims to generate concrete hypotheses for evidence-based guidelines, which should be tested in further studies.

Medically Unexplained Symptoms Presenting at Secondary Care—A Comparison of White Europeans and People of South Asian Ethnicity

To assess whether, among new out-patients at secondary care medical clinics, people of South Asian origin have a higher proportion of medically unexplained symptoms, and receive different care compared to white Europeans. A retrospective case note study was performed in a district general hospital with a high proportion of ethnic minorities in the local population. We examined the notes of 100 people each of South Asian and white European origin who were in the 20-39 years age range and attending as new medical out-patients. We recorded the presenting symptoms, investigation results, and management plan, and from this we classified them as either explained by recognized organic disease or medically unexplained. We also recorded the number of investigations and whether psychosocial factors were mentioned in the letter to the referring doctor. Complete data were available for 93 people of South Asian origin and 98 white Europeans. The proportion of each who had medically unexplained symptoms was 52% and 49% respectively. The mean number (SD) of investigations in each was 1.8 (1.5) and 1.7 (1.6). Psychosocial factors were mentioned in correspondence of 42% and 45% respectively. The prevalence of medically unexplained symptoms, in this UK clinic, is similar among younger adults of South Asian and white European origin. South Asians undergo similar investigation and psychosocial inquiry to their white counterparts, suggesting that younger South Asians are managed similarly to white Europeans with respect to this aspect of medical care.

Electronic medical record use and physician–patient communication: An observational study of Israeli primary care encounters

Objectives Within the context of medical care there is no greater reflection of the information revolution than the electronic medical record (EMR). Current estimates suggest that EMR use by Israeli physicians is now so high as to represent an almost fully immersed environment. This study examines the relationships between the extent of electronic medical record use and physician–patient communication within the context of Israeli primary care. Methods Based on videotapes of 3 Israeli primary care physicians and 30 of their patients, the extent of computer use was measured as number of seconds gazing at the computer screen and 3 levels of active keyboarding. Communication dynamics were analyzed through the application of a new Hebrew translation and adaptation of the Roter Interaction Analysis System (RIAS). Results Physicians spent close to one-quarter of visit time gazing at the computer screen, and in some cases as much as 42%; heavy keyboarding throughout the visit was evident in 24% of studied visits. Screen gaze and levels of keyboarding were both positively correlated with length of visit ( r = .51, p < .001 and F(2,27) = 2.83, p < .08, respectively); however, keyboarding was inversely related to the amount of visit dialogue contributed by the physician ( F(2,27) = 4.22, p <. 02) or the patient ( F(2,27) = 3.85, p < .05). Specific effects of screen gaze were inhibition of physician engagement in psychosocial question asking ( r = −.39, p < .02) and emotional responsiveness ( r = −.30, p < .10), while keyboarding increased biomedical exchange, including more questions about therapeutic regimen ( F(2,27) = 4.78, p < .02) and more patient education and counseling ( F(2,27) = 10.38, p < .001), as well as increased patient disclosure of medical information to the physician ( F(2,27) = 3.40, p < .05). A summary score reflecting overall patient-centered communication during the visit was negatively correlated with both screen gaze and keyboarding ( r = −.33, p < .08 and F(2,27) = 3.19, p < .06, respectively). Discussion The computer has become a ‘party’ in the visit that demanded a significant portion of visit time. Gazing at the monitor was inversely related to physician engagement in psychosocial questioning and emotional responsiveness and to patient limited socio-emotional and psychosocial exchange during the visit. Keyboarding activity was inversely related to both physician and patient contribution to the medical dialogue. Patients may regard physicians’ engrossment in the tasks of computing as disinterested or disengaged. Increase in visit length associated with EMR use may be attributed to keyboarding and computer gazing. Conclusions This study suggests that the way in which physicians use computers in the examination room can negatively affect patient-centered practice by diminishing dialogue, particularly in the psychosocial and emotional realm. Screen gaze appears particularly disruptive to psychosocial inquiry and emotional responsiveness, suggesting that visual attentiveness to the monitor rather than eye contact with the patient may inhibit sensitive or full patient disclosure. Practical implications We believe that training can help physicians optimize interpersonal and educationally effective use of the EMR. This training can assist physicians in overcoming the interpersonal distancing, both verbally and non-verbally, with which computer use is associated. Collaborative reading of the EMR can contribute to improved quality of care, enhance the decision-making process, and empower patients to participate in their own care.

Surviving Cancer and Family Costs: Examining the Needs of Spouses

Aggressive cancers are devastating diseases that leave fractured lives in their wake. Many of these cancers are treated with bone marrow transplantation (BMT), an option that can potentially cure one's cancer but may leave the patient with reduced functioning years after the cancer diagnosis ceases to be a threat. Most BMT research attention is focused on keeping the cancer patient alive. When the focus shifts to psychosocial inquiry, the patient remains at the center of studies as researchers work to determine how one recovers from life-threatening illnesses and how to reduce the long-term complications. When social supports are discussed, family and spouses tend to be viewed as a resource of support. Few studies have examined how the patient's treatment and recovery influence the life satisfaction of spouses and family members. This study addresses this gap by focusing on the quality of life of transplant spouses.

Social problems in Pakistani psychiatric patients.

The paper presents a case register-based descriptive survey of social problems of general hospital psychiatric patients in Pakistan. 47.2% of psychiatric patients had a social problem. Problems with primary support group occurred in 33.4%, 14.2% had relational problems and 7.8% had problems relating to bereavement or death. Social problems were more common in females and patients who had adjustment disorder or depression. Psychiatric patients had more social problems than those who were diagnosed as having a physical problem only. Female depressed patients experienced problems with their in-laws more frequently than other types of social problem. The implications are that: i) some DSMIV categories require changing to make them more internationally applicable; ii) specific psycho-social inquiry during psychiatric diagnostic interviews is essential; iii) grief counselling and family therapy are important psychotherapeutic needs of Pakistani psychiatric patients; iv) these, in turn, indicate priorities in mental health professional training curricula.

Psychosocial problem disclosure by primary care patients

The vast majority of psychologically distressed primary care patients present exclusively somatic concerns at the outsets of their visits. However, it is not known how often such patients subsequently disclose psychosocial problems to their primary care physicians (PCPs) and what variables predict such disclosures. Our objectives were to measure, among psychologically distressed primary care patients, the frequency of disclosure of psychosocial problems (disclosure), the effects of prior psychosocial inquiry (prior inquiry) by PCPs and various patient variables on disclosure, and the effect of disclosure on mental health problem recognition (recognition) by PCPs. The study was based in the practices of 69 community-based PCPs and involved 308 adult patients with 28-item General Health Questionnaire scores of 5 or greater, indicating significant psychological distress. Disclosure occurred during 51% of visits overall and 67% of visits with prior inquiry. The odds of disclosure were increased by prior inquiry ( p<0.001), greater physician–patient familiarity ( p<0.001) and greater severity of patient psychological distress ( p<0.001). Prior inquiry and physician–patient familiarity had a negative interaction ( p<0.05) of smaller size than either variable's main effect, so that their combined effect on disclosure exceeded the effect of either variable alone but was less than multiplicative. The estimated odds ratio for recognition given disclosure was 24.13 (95% confidence interval, 11.28–51.63) after adjustment for the effects of significant covariates. We conclude that if PCPs inquire, most psychologically distressed, somatically presenting patients will disclose psychosocial problems. Inquiry is particularly productive with unfamiliar patients. PCPs can engender a substantial increase in psychosocial disclosure simply by adding one or two questions about mood or interpersonal problems to their clinical interviews.

Psychosocial Aspects of Chronic, Clinically Unconfirmed Vulvovaginitis

Women with chronic symptoms of vulvovaginitis referred to a university vulvovaginitis clinic were assessed on psychological and social (including sexual) variables to determine whether differences existed among women with unconfirmed vulvovaginitis, women with confirmed vulvovaginitis, and healthy controls. Eighty-three consecutive women with chronic symptoms of vulvovaginitis and 32 asymptomatic control women completed clinical examinations, cultures, and the following psychological tests or questionnaires: the Brief Symptom Inventory, the Center for Epidemiologic Studies--Depression Scale, the Dyadic Adjustment Scale, a sexual behavior and response questionnaire (Campion), and a study questionnaire. Statistical analyses (chi 2 and analysis of variance) were performed on the confirmed and unconfirmed vulvovaginitis and control groups of women. Women with confirmed and unconfirmed vulvovaginitis scored higher than control women on several psychological variables, but women with unconfirmed vulvovaginitis were found to be significantly more emotionally distressed on psychological tests and to report more discomfort during sexual intercourse than both women with confirmed vulvovaginitis and healthy controls. Psychosocial inquiry is important in the clinical assessment and management of such women.

Father Presence and Ritual Homosexuality: Paternal Deprivation and Masculine Development in Melanesia Reconsidered

Does father absence co-occur with homosexuality? The early Freud and certain later American psychoanalytic writers thought so; their perspectives were no doubt grounded in the folk models and epistemology of our culture. Recent work on ritualized homosexuality in Melanesia (Herdt [ed.] 1984) sheds new light on the question. Surprisingly, where these cultural practices occur, fathers are present in customary sleeping arrangements. This finding is documented and its implications are explored in this study. A long history of psychosocial inquiry into the nature of homosexuality has revolved around the differing influences of mothers and fathers in its determination. What began in the latter part of the 19th century as a discourse on the origins of inversion took as its watershed the Three Essays on the History of Sexuality (1905), wherein

Work with parents of abused and neglected children

THIS COMMUNICATION is based on the experience with 19 families whose abused or neglected children were hospitalized at the Children’s Department, Ullevaal Hospital, over a period of one year. The work with the families was limited to the duration of the child’s stay in the hospital, and did not differ in any qu~i~tive way from other parental or family coun~ling in the area of child care, preventive health services, child guidance or adult psychiatric social work. The aims were: 1) to establish a relationship with the parents; 2) to conduct a psychosocial inquiry; 3) to attain a psychosocial diagnosis of the family; 4) to decide on a plan of treatment; and 5) to motivate parents for cooperating in treatment. Before any constructive work with the family could take place, we found they had to experience a relationship characterized by sufficient trust to enable them to participate adequately in a psychosocial inquiry into the current family situation. Thereafter, through cooperation of the inte~~fession~ team, evaluation led to formulation of a family diagnosis and adoption of a treatment plan. Such a plan included a wide spectrum of measures from long-term support to such extreme and authoritative interventions as taking the child into care. An important aim also was to motivate parents to further cooperation with community resources such as kindergarten, municipal health and social centres, child guidance clinics, foster homes or children’s homes. This discussion is limited to the development of the relationship with the parents, the psychosocial inquiry, and motivation of the parents. In conclusion, the important question of the relationship and personal reactions of the team to the parents they encountered is examined.

Book Review: British Immigrants and Australia: A Psycho-social Inquiry

Book Review: British Immigrants and Australia: A Psycho-social Inquiry

British Immigrants and Australia: A Psycho-social Inquiry.

British Immigrants and Australia: A Psycho-social Inquiry.

Reviews

BRITISH IMMIGRANTS AND AUSTRALIA: A Psycho‐social Inquiry. Alan Richardson. Canberra: Australian National University Press, 1974. xix + 210 pp. $8.95.

Clinical Sociology: Social Rehabilitation of Schizophrenia in China and Implications for Aging Research

This article illustrates a clinical sociology approach to psychosocial inquiry and a heuristic analytical grid as a methodological guide. Key concerns of clinical sociology including the notion of self, individual–society relationship, a priority on experience and meaning (including implicit language), action/intervention, and other theoretical and methodological issues are reviewed. The heuristic analytical grid is depicted in seven themes: the individual, the society, the time dimension, “levels” or types of communication, social representation (of mental health/illness), intervention, and organizational dimension of (medical) intervention. Relevance to the study of gerontology is indicated by highlighting the similarities between the study of personal experience of psychiatric rehabilitation and the study of aging. Implications for research and clinical practice are discussed.

A Methodology of Psycho-Social Inquiry

Journal Article A Methodology of Psycho-Social Inquiry Get access Seba Eldridge Seba Eldridge University of Kansas Search for other works by this author on: Oxford Academic Google Scholar Social Forces, Volume 15, Issue 3, March 1937, Pages 440–443, https://doi.org/10.2307/2570615 Published: 01 March 1937