Paul Arntson

The Social Support Function in Epilepsy Self-Help Groups:

The nature of self-help groups is discussed and considered with special reference to those composed of epileptics. Results of a preliminary survey of epilepsy self-help group members are presented, and effects relating to stigmatization, reasons for participation, asserted curative factors, and formal-only versus informal participation in the self-help group process are examined. Societal reaction to people with epilepsy is viewed as a major contributor to problems associated with this disability.

Adult survivors of childhood cancer and their parents: Experiences with survivorship and long-term follow-up

To compare the perspectives of adult childhood cancer survivors and their parents in terms of: (1) parental involvement in the survivors healthcare, (2) thoughts and discussion about their own or their sons/daughters childhood cancer, (3) concern about the survivors current health status, and (4) perceived benefits of follow-up care. Forty-two adult survivors and their parents completed a semistructured audio-taped interview via the phone responding to a parallel set of questions. Thirty-eight percent of survivors reported that one of their parents attended the adult survivor clinic with them; in 41% of patient-parent dyads the parent expressed more concern than their child about the childs health status; 45% of the parents reported thinking about the cancer experience more often than their child. The results suggest that some parents continue to worry about their childs health status into adulthood, and in turn may choose to stay involved in their adult childs healthcare. Additional research is needed to understand the survivorship needs of the adult survivor and their family. Including parents in important healthcare decisions and discussions may be a consideration when caring for this unique population of patients.

Pediatrician-Parent Communication in a Continuity-of-care Setting

This study investigated pediatrician-parent communication by content, analyz ing medical encounters in a setting providing continuity of care. Thirty-eight encounters between middle class families and three senior pediatricians were au dio-taped, transcribed, and analyzed for content. The categories of medical com munication coded from the interactions were related to each familys medical and demographic characteristics. Five patterns of results emerged: (1) There was a highly stylized active-passive role relationship, with doctors asking twice as many questions and making twice as many commands as the parents did. (2) A strong reciprocity norm existed between pediatricians and parents for the communication of affect. (3) The higher the experience, income, and educational levels of the parents, the shorter the encounters were, the less frequently symptoms were dis cussed, and the more frequently medication and professional treatment were men tioned. (4) Parents discussed health more in terms of organicity of causes than did pediatricians who, more frequently, raised environmental factors. (5) The more the family had a history of past illnesses, the more frequently the doctors made affect comments during the encounters. Comparing the results to findings drawn from an emergency clinic documented the importance of sustained relationships between practitioners and patients.

Shared Decision Making: Fertility and Pediatric Cancers

Childhood cancer is a familial disease; no family member escapes unscathed from the impact of a young person’s cancer diagnosis, treatment, and follow-up procedures. As new treatment options unfold and more children survive, families are faced with multiple critical decisions at the time of diagnosis. This chapter will address one of the goals of oncofertility research – to improve the decision making competencies of family members confronting the news of a child’s cancer diagnosis plus the additional information that the treatment may or will affect the child’s future fertility. We will bring together key constructs and research from family systems theory and the shared decision making model in order to understand better how families whose children are newly diagnosed with cancer can make informed choices about the future fertility of their children while immediately confronting a potentially life-threatening illness. To accomplish this purpose, the chapter will unfold in the following manner: first, we will briefly articulate the current state of childhood cancer and fertility preservation. Second, we will explicate a systems approach to family communication and decision making. Third, we will summarize the recent evolving work on shared decision making in health care. Fourth, the current state of childhood cancer and fertility preservation options will be described as a highly stressful context into which a family systems approach and shared decision making models must be integrated for immediate and long-range successful health care outcomes. In doing so, we will review the recent research that has investigated how families and health care professionals do and want to make decisions about fertility preservation when children are diagnosed with cancer. We will conclude by summarizing what we now know about shared decision making by families and health care professionals concerning fertility preservation for children with cancer and what we still need to know. As family members and health professionals confront this situation together, the desired outcome is a shared decision-making process that involves parent(s),

Hypergraphia in epilepsy: is there a specificity to temporal lobe epilepsy?

The purpose of this investigation was to determine the specificity of hypergraphia to temporal lobe epilepsy using the paradigm developed by Sachdev and Waxman (1981). One hundred and thirty-eight patients were sent a standard stimulus letter and the response rates were examined for the patient groups with temporal lobe epilepsy (N = 80), and without (N = 31), and mixed seizure types (N = 13). For those patients who responded, additional analyses involved the number of words per response and the presence/absence of any qualitative indices of the postulated interictal behavioural syndrome of temporal lobe epilepsy. The results were interpreted in the light of the contemporary definitions of hypergraphia and were related to the larger literature concerned with personality and behavioural change in temporal lobe epilepsy.

The effect of predispositions toward verbal behavior on interaction patterns in dyads

A self‐report instrument, a test of Predispositions toward Verbal Behavior, was designed to measure the cognitive orientation that persons hold toward the extent of their verbal participation in social settings. A word association task was devised to test correspondence among self reports of verbal activation, interaction patterns, and subsequent social attributions. Results showed a significant linear trend among levels of verbal activation and (1) duration of verbal responses, (2) number of words per response, and subjects’ subsequent impressions of (3) their own verbal activity and (4) interviewer understanding of what they had said.

Identification in interpersonal relationships: One foundation of creativity

This article attempts to meld theories of identification with interrelational existentialism to allow for better explanations of collaborative creativity. It argues that the Burkean theory of identification is Freudian based and therefore de‐emphasizes interpersonal and subjective conceptions of communication. On the other hand, Burkean theory once corrected provides a praxis useful to existential criticism. The study argues that existential interpersonal communication stimulates an ontological understanding that sometimes results in creative dialogue and/or individual creativity. It sets out a series of probes useful in the analysis of authentic dialogic communication.

The seventh of march address: A mediating influence

Rhetorical criticism aids in historical revision. In this study, audience analysis reveals that Websters Seventh of March Address was much more effective than earlier histories suggest. The standard interpretations of the address rely on biased sources and ignore relevant facts. While historical revision has reinterpreted the speech in light of more accurate factual analysis, it has ignored the support rhetorical criticism can provide. Analysis shows an audience more open to conservative appeals than earlier historical review indicated. And investigation of Websters strategies shows them uniquely attuned to his audience.

Physician-Patient Communication and Decision Making

A major goal of our research program is to increase citizens’ competencies to make health care decisions concerning their own lives [1]. One of the most important decisions they can make concerns when and how to use prescription drugs. Their ability to make competent drug treatment decisions can be greatly influenced by how physicians and patients discuss the use of drugs. Information about prescriptions is most salient during the consultation when medications are introduced by physicians in order to solve health problems. Furthermore, a high percentage of the population relies on doctors for health information. Yet, before recommending how physicians and patients can most functionally discuss the risks, benefits, and use of prescriptions, we must conduct research that describes the current state of communication and decision making about drugs. This research will then provide a credible data base from which to suggest possible improvements.

Sex Role Socialization: Children's Enactments of Their Parents' Behaviors in a Regulative and Interpersonal Context.

The purpose of this study was to examine the differential effects of regulative and interpersonal contexts, together with the sex of the parent, on the perceptions and role playing responses of boys and girls. One hundred and six kindergarten children described and role‐played a series of four pictures constructed to place a mother and father figure with a child in a regulative and interpersonal context as defined by Bernstein. We found sex‐of‐subject‐by‐context and sex‐of‐parent‐by‐context interaction effects for length of utterance when children role‐played the parent figure in the pictures. When subjects also role‐played the child in the picture, we found two main effects for utterance length: one for sex of parent, and one for critical context. The children indicated that mothers would mention more specific punishments than fathers, and that the child in the pictures would counter the responsibility for his/her actions more with the mother figure than with the father figure. Taken together, these resu...