bluuebunny/crossref_metadata_2025 huggingface dataset:
MiR-146a Regulates Neutrophil Extracellular Trap Formation That Predicts Adverse Cardiovascular Events in Patients With Atrial Fibrillation
Authors: Arroyo Ana B. , de los Reyes-García Ascensión M. , Rivera-Caravaca José M. , Valledor Patricia , García-Barberá Nuria , Roldán Vanessa , Vicente Vicente , Martínez Constantino , González-Conejero Rocío
Published: February 2018

Objective—

Atrial fibrillation (AF) patients experience adverse cardiovascular events (ACEs) despite anticoagulant therapy. We reported that rs2431697 of miR-146a, a negative regulator of inflammation, predicts ACEs in patients with AF. The relationship between neutrophil extracellular traps and thrombogenesis is known. Thus, our aim was to evaluate the role of neutrophil extracellular trap compounds as prognostic markers of ACEs in AF and to study whether miR-146a affects NETosis.

Approach and Results—

We included 336 steadily anticoagulated AF patients with a median follow-up of 7.9 years (interquartile range, 7.3–8.1) and 127 healthy subjects. The reviewed ACEs included stroke (ischemic/embolic), acute coronary syndrome, acute heart failure, and global or vascular death. We quantified cell-free DNA and NE (neutrophil elastase) at diagnosis. Rs2431697 was genotyped. Neutrophils from human and mice were seeded to analyze shed cell-free DNA and H3cit (citrullinated histone 3) after activation. In human plasmas, higher NE levels (>55.29 ng/mL), but not cell-free DNA, were independently associated with higher risk of all-cause mortality (hazard ratio, 2.24; 95% CI, 1.36–3.68), cardiovascular mortality (hazard ratio, 4.77; 95% CI, 1.11–20.47), and composite cardiovascular events (hazard ratio, 1.84; 95% CI, 1.01–3.76). In patients, NE levels were associated with rs2431697 (TT: 51.82±2.73 versus CC: 40.01±3.05 ng/mL;
P
=0.040). In vitro, both human (TT for rs2431697) and miR-146a
−/−
mice neutrophils yielded higher levels of cell-free DNA and H3cit than CC or wild-type cells, respectively.

Conclusions—

NE activity can provide new ACE prognostic information in AF patients. These findings provide evidence of a potential role of miR-146a in neutrophil extracellular trap generation and cardiovascular risk in AF.
Long-Term Clinical Comparison of Procedural End Points After Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation
Authors: Lee Kwang-No , Roh Seung-Young , Baek Yong-Soo , Park Hee-Soon , Ahn Jinhee , Kim Dong-Hyeok , Lee Dae In , Shim Jaemin , Choi Jong-Il , Park Sang-Weon , Kim Young-Hoon
Published: February 2018

Background:

Pulmonary vein isolation (PVI) is effective for maintenance of sinus rhythm in 50% to 75% of patients with paroxysmal atrial fibrillation, and it is not uncommon for patients to require additional ablation after PVI. We prospectively evaluated the relative effectiveness of 2 post-PVI ablation strategies in paroxysmal atrial fibrillation.

Methods and Results:

A total of 500 patients (mean age, 55.7±11.0 years; 74.6% male) were randomly assigned to undergo ablation by 2 different strategies after PVI: (1) elimination of non-PV triggers (group A, n=250) or (2) stepwise substrate modification including complex fractionated atrial electrogram or linear ablation until noninducibility of atrial tachyarrhythmia was achieved (group B, n=250). During a median follow-up of 26.0 months, 75 (32.2%) patients experienced at least 1 episode of recurrent atrial tachyarrhythmia after the single procedure in group A compared with 105 (43.8%) patients in group B (
P
value in log-rank test of Kaplan–Meier analysis: 0.012). Competing risk analysis showed that the cumulative incidence of atrial tachycardia was significantly higher in group B compared with group A (
P
=0.007). With the exception of total ablation time, there were no significant differences in fluoroscopic time or procedure-related complications between the 2 groups.

Conclusions:

Elimination of triggers as an end point of ablation in patients with paroxysmal atrial fibrillation decreased long-term recurrence of atrial tachyarrhythmia compared with a noninducibility approach achieved by additional empirical ablation. The post-PVI trigger test is thus a better end point of ablation for paroxysmal atrial fibrillation.
Interaction of Body Mass Index on the Association Between N‐Terminal‐Pro‐b‐Type Natriuretic Peptide and Morbidity and Mortality in Patients With Acute Heart Failure: Findings From ASCEND‐HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure)
Authors: Bhatt Ankeet S. , Cooper Lauren B. , Ambrosy Andrew P. , Clare Robert M. , Coles Adrian , Joyce Emer , Krishnamoorthy Arun , Butler Javed , Felker G. Michael , Ezekowitz Justin A. , Armstrong Paul W. , Hernandez Adrian F. , O'Connor Christopher M. , Mentz Robert J.
Published: February 2018

Background

Higher body mass index (
BMI
) is associated with lower circulating levels of N‐terminal‐pro‐b‐type natriuretic peptide (
NT
‐pro
BNP
). The Interaction between
BMI
and
NT
‐pro
BNP
with respect to clinical outcomes is not well characterized in patients with acute heart failure.

Methods and Results

A total of 686 patients from the biomarker substudy of the
ASCEND
‐
HF
(Acute Study of Clinical Effectiveness of Nesiritide in Decompensated
HF
) clinical trial with documented
NT
‐pro
BNP
levels at baseline were included in the present analysis. Patients were classified by the World Health Organization obesity classification (nonobese:
BMI
<30 kg/m
2
, Class I obesity:
BMI
30–34.9 kg/m
2
, Class
II
obesity
BMI
35–39.9 kg/m
2
, and Class
III
obesity
BMI
≥40 kg/m
2
). We assessed baseline characteristics and 30‐ and 180‐day outcomes by
BMI
class and explored the interaction between
BMI
and
NT
‐pro
BNP
for these outcomes. Study participants had a median age of 67 years (55, 78) and 71% were female.
NT
‐pro
BNP
levels were inversely correlated with
BMI
(
P
<0.001). Higher
NT
‐pro
BNP
levels were associated with higher 180‐day mortality (adjusted hazard ratio for each doubling of
NT
‐pro
BNP,
1.40; 95% confidence interval, 1.16, 1.71;
P
<0.001), but not 30‐day outcomes. The effect of
NT
‐pro
BNP
on 180‐day death was not modified by
BMI
class (interaction
P
=0.24).

Conclusions

The prognostic value of
NT
‐pro
BNP
was not modified by
BMI
in this acute heart failure population.
NT
‐pro
BNP
remains a useful prognostic indicator of long‐term mortality in acute heart failure even in the obese patient.

Clinical Trial Registration

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00475852.
Programming Cardiac Resynchronization Therapy for Electrical Synchrony: Reaching Beyond Left Bundle Branch Block and Left Ventricular Activation Delay
Authors: Varma Niraj , O'Donnell David , Bassiouny Mohammed , Ritter Philippe , Pappone Carlo , Mangual Jan , Cantillon Daniel , Badie Nima , Thibault Bernard , Wisnoskey Brian
Published: February 2018

Background

QRS
narrowing following cardiac resynchronization therapy with biventricular (BiV) or left ventricular (LV) pacing is likely affected by patient‐specific conduction characteristics (
PR
, qLV,
LV
‐paced propagation interval), making a universal programming strategy likely ineffective. We tested these factors using a novel, device‐based algorithm (Sync
AV
) that automatically adjusts paced atrioventricular delay (default or programmable offset) according to intrinsic atrioventricular conduction.

Methods and Results

Seventy‐five patients undergoing cardiac resynchronization therapy (age 66±11 years; 65% male; 32% with ischemic cardiomyopathy; LV ejection fraction 28±8%;
QRS
duration 162±16 ms) with intact atrioventricular conduction (PR interval 194±34, range 128–300 ms), left bundle branch block, and optimized
LV
lead position were studied at implant.
QRS
duration (
QRS
d) reduction was compared for the following pacing configurations: nominal simultaneous BiV (Mode I: paced/sensed atrioventricular delay=140/110 ms), BiV+Sync
AV
with 50 ms offset (Mode
II
), BiV+Sync
AV
with offset that minimized
QRS
d (Mode
III
), or
LV
‐only pacing+Sync
AV
with 50 ms offset (Mode
IV
). The intrinsic
QRS
d (162±16 ms) was reduced to 142±17 ms (−11.8%) by Mode I, 136±14 ms (−15.6%) by Mode
IV
, and 132±13 ms (−17.8%) by Mode
II
. Mode
III
yielded the shortest overall
QRS
d (123±12 ms, −23.9% [
P
<0.001 versus all modes]) and was the only configuration without
QRS
d prolongation in any patient.
QRS
narrowing occurred regardless of
QRS
d,
PR
, or
LV
‐paced intervals, or underlying ischemic disease.

Conclusions

Post‐implant electrical optimization in already well‐selected patients with left bundle branch block and optimized
LV
lead position is facilitated by patient‐tailored BiV pacing adjusted to intrinsic atrioventricular timing using an automatic device–based algorithm.
Polygenic Risk for Depression Increases Risk of Ischemic Stroke
Authors: Wassertheil-Smoller Sylvia , Qi Qibin , Dave Tushar , Mitchell Braxton D. , Jackson Rebecca D. , Liu Simin , Park Ki , Salinas Joel , Dunn Erin C. , Leira Enrique C. , Xu Huichun , Ryan Kathleen , Smoller Jordan W.
Published: February 2018

Background and Purpose—

Although depression is a risk factor for stroke in large prospective studies, it is unknown whether these conditions have a shared genetic basis.

Methods—

We applied a polygenic risk score (PRS) for major depressive disorder derived from European ancestry analyses by the Psychiatric Genomics Consortium to a genome-wide association study of ischemic stroke in the Stroke Genetics Network of National Institute of Neurological Disorders and Stroke. Included in separate analyses were 12 577 stroke cases and 25 643 controls of European ancestry and 1353 cases and 2383 controls of African ancestry. We examined the association between depression PRS and ischemic stroke overall and with pathogenic subtypes using logistic regression analyses.

Results—

The depression PRS was associated with higher risk of ischemic stroke overall in both European (
P
=0.025) and African ancestry (
P
=0.011) samples from the Stroke Genetics Network. Ischemic stroke risk increased by 3.0% (odds ratio, 1.03; 95% confidence interval, 1.00–1.05) for every 1 SD increase in PRS for those of European ancestry and by 8% (odds ratio, 1.08; 95% confidence interval, 1.04–1.13) for those of African ancestry. Among stroke subtypes, elevated risk of small artery occlusion was observed in both European and African ancestry samples. Depression PRS was also associated with higher risk of cardioembolic stroke in European ancestry and large artery atherosclerosis in African ancestry persons.

Conclusions—

Higher polygenic risk for major depressive disorder is associated with increased risk of ischemic stroke overall and with small artery occlusion. Additional associations with ischemic stroke subtypes differed by ancestry.
Reproductive, pathogenic and genotypic characterisation of five Meloidogyne graminicola populations from the Philippines on susceptible and resistant rice varieties
Authors: Cabasan Ma. Teodora Nadong , Kumar Arvind , Bellafiore Stéphane , De Waele Dirk
Published: February 2018

Five populations ofMeloidogyne graminicolaisolated from different rice-growing areas in the Philippines were characterised. The populations showed little phenotypic variability of second-stage juveniles and female perineal pattern. Differences in reproduction amongM. graminicolapopulations were not observed on mature resistantOryza glaberrimavarieties ‘TOG5674’, ‘TOG5675’, ‘RAM131’ and ‘CG14’, or on susceptibleO. sativavarieties ‘IR64’ and ‘UPLRi-5’. In all infected rice varieties, plant growth and yield-contributing traits showed no differences among the populations. A search onM. graminicolapopulations from the Philippines for single-nucleotide polymorphism on the sequences of Internal Transcribed Spacer (ITS) of rDNA genes and mtDNA indicated only few points of heteroplasmy. Nematode reproduction and disease induction of the fiveM. graminicolapopulations in the Philippines exerted the same level of aggressiveness and virulence. The absence of resistance-breaking populations ofM. graminicolais important for the maintenance of durability of resistance to this important rice pathogen.
Nomenclatural notes on Piper Linn. (Piperaceae) from India II
Authors: MUKHERJEE PRASANTA KUMAR
Published: February 2018

In continuation of the taxonomic study of the genus Piper from India (Mukherjee, 2017), eighty-four Piper names, reported from India, are considered here for their typification, identity, and nomenclature. The scrutiny led to the recognition of twenty-four species. Thirty-five synonyms are proposed as new ones out of sixty-one treated here. Lectotypes are designated for almost all the species recognised here together with their synonyms or basionyms. Holotypes are mentioned when applicable. Of particular mention are P. hookeri and P. sylvaticum with confused identities and lacking proper typification. Corrections are suggested to earlier lectotypifications for P. hymenophyllum and P. rhytidocarpum. Extension of distribution to India from Myanmar are recorded for three species: P. acutistigmum, P. leptostachyum and P. pothoides.
An unusual new species of Canthidium (Coleoptera: Scarabaeidae: Scarabaeinae) from Oaxaca, Mexico
Authors: KOHLMANN BERT , ARRIAGA-JIMÉNEZ ALFONSINA , RÖS MATTHIAS
Published: February 2018

In this paper we describe Canthidium quercetorum new species (Coleoptera: Scarabaeidae: Scarabaeinae), a species that inhabits dry oak forest in the Mexican state of Oaxaca, between 2100 and 2300 m above sea level. Photographs and an illustration of the habitus and a distribution map are provided. The unusual distribution and ecology of this species are discussed. An updated key for the genus in Mexico and the United States of America is also presented.
A new humicolous Parhydraena d’Orchymont, 1937 from South Africa (Coleoptera, Hydraenidae)
Authors: BILTON DAVID T.
Published: February 2018

Parhydraena d’Orchymont, 1937 currently includes 19 species, 17 of which are endemic to South Africa (Perkins 2009; Bilton 2014). Most species of the genus are fully aquatic, but a few, together with members of other genera of Parhydraenini, occupy moist habitats rich in organic debris (Perkins 2009). These so-called humicolous habitats (Perkins & Balfour-Browne 1994) occur both beside water and elsewhere, and have been colonised a number of times by primarily aquatic hydraenid lineages, particularly in Africa and Australasia (e.g. Perkins & Balfour-Browne 1994; Perkins 2004a, 2004b; Perkins 2009; Hernando & Ribera 2017). Within Parhydraena the toro group (sensu Perkins 2009) comprises four (sub)humicolous species which share a broad habitus, a marked constriction between the pronotum and elytral shoulders, and short legs and maxillary palpi. Whilst phylogenetic relationships within Parhydraena remain unclear in the absence of molecular data, the toro group as currently defined may not be monophyletic, given the differences in aedeagal anatomy observed amongst its members (see Perkins 2009). The most morphologically divergent species described to date is P. toro Perkins, 2009, whose simplified aedeagal anatomy differs considerably from all other known members of the genus. P. toro appears to be narrowly endemic to the inselberg of Table Mountain and surroundings, occurring in damp litter in Afromontane forests and beside seepages and streams (Perkins 2009; DTB pers. obs.). Here I describe a new species from a cool, high-altitude gully in the western end of Hex River Mountains, which closely resembles P. toro in external and aedeagal morphology and shares its humicolous microhabitat.
Contributions of Different Time-Scale Variations to Tropical Cyclogenesis over the Western North Pacific
Authors: Cao Xi , Wu Renguang , Bi Mingyu
Published: February 2018

The present study investigates relative contributions of different time-scale variations of environmental factors to the tropical cyclone (TC) genesis over the western North Pacific (WNP) during July–August–September–October (JASO). Distinct from previous studies that are concerned with large-scale spatial patterns during a certain period, the present study focuses on local and instantaneous conditions of the TC genesis. Analysis shows that the contribution of convection and lower-level vorticity to the TC genesis is mainly due to intraseasonal and synoptic variations. The contribution of vertical wind shear is largely related to synoptic variations. The contribution of midlevel specific humidity is almost 2 times more from intraseasonal variations than from synoptic variations. The contribution of sea surface temperature (SST) to the TC genesis is mainly due to interannual and intraseasonal variations. The barotropic energy for synoptic-scale disturbances during the TC genesis comes mainly from climatological mean flows over the southwest quadrant and from intraseasonal wind variations over the northeast quadrant of the WNP, respectively. The contribution of interannual variations to the TC genesis is enhanced over the southeast quadrant of the WNP. More TCs form under weak easterly and westerly vertical shears, respectively, during El Niño developing and decaying JASO. The contribution of interannual variations of SST tends to be larger during El Niño decaying than during developing JASO.
Decadal Variability of Eddy Kinetic Energy in the South Pacific Subtropical Countercurrent in an Ocean General Circulation Model
Authors: Rieck Jan K. , Böning Claus W. , Greatbatch Richard J.
Published: February 2018

The eddy kinetic energy (EKE) associated with the Subtropical Countercurrent (STCC) in the western subtropical South Pacific is known to exhibit substantial seasonal and decadal variability. Using an eddy-permitting ocean general circulation model, which is able to reproduce the observed, salient features of the seasonal cycles of shear, stratification, baroclinic production, and the associated EKE, the authors investigate the decadal changes of EKE. The authors show that the STCC region exhibits, uniquely among the subtropical gyres of the world’s oceans, significant, atmospherically forced, decadal EKE variability. The decadal variations are driven by changing vertical shear between the STCC in the upper 300 m and the South Equatorial Current below, predominantly caused by variations in STCC strength associated with a changing meridional density gradient. In the 1970s, an increased meridional density gradient results in EKE twice as large as in later decades in the model. Utilizing sensitivity experiments, decadal variations in the wind field are shown to be the essential driver. Local wind stress curl anomalies associated with the interdecadal Pacific oscillation (IPO) lead to upwelling and downwelling of the thermocline, inducing strengthening or weakening of the STCC and the associated EKE. Additionally, remote wind stress curl anomalies in the eastern subtropical South Pacific, which are not related to the IPO, generate density anomalies that propagate westward as Rossby waves and can account for up to 30%–40% of the density anomalies in the investigated region.
Proportion of Indicator Common Variance Due to a Factor as an Effect Size Statistic in Revised Parallel Analysis
Authors: Xia Yan , Green Samuel B. , Xu Yuning , Thompson Marilyn S.
Published: February 2018

Past research suggests revised parallel analysis (R-PA) tends to yield relatively accurate results in determining the number of factors in exploratory factor analysis. R-PA can be interpreted as a series of hypothesis tests. At each step in the series, a null hypothesis is tested that an additional factor accounts for zero common variance among measures in the population. Integration of an effect size statistic—the proportion of common variance (PCV)—into this testing process should allow for a more nuanced interpretation of R-PA results. In this article, we initially assessed the psychometric qualities of three PCV statistics that can be used in conjunction with principal axis factor analysis: the standard PCV statistic and two modifications of it. Based on analyses of generated data, the modification that considered only positive eigenvalues ([Formula: see text]) overall yielded the best results. Next, we examined PCV using minimum rank factor analysis, a method that avoids the extraction of negative eigenvalues. PCV with minimum rank factor analysis generally did not perform as well as [Formula: see text], even with a relatively large sample size of 5,000. Finally, we investigated the use of [Formula: see text] in combination with R-PA and concluded that practitioners can gain additional information from [Formula: see text] and make more nuanced decision about the number of factors when R-PA fails to retain the correct number of factors.
Mortality and Cause of Death in Younger Homeless Veterans
Authors: Schinka John A. , Leventhal Katherine C. , Lapcevic William A. , Casey Roger
Published: February 2018

Objectives:

Increased mortality has been documented in older homeless veterans. This retrospective study examined mortality and cause of death in a cohort of young and middle-aged homeless veterans.

Methods:

We examined US Department of Veterans Affairs records on homelessness and health care for 2000-2003 and identified 23 898 homeless living veterans and 65 198 non-homeless living veterans aged 30-54. We used National Death Index records to determine survival status. We compared survival rates and causes of death for the 2 groups during a 10-year follow-up period.

Results:

A greater percentage of homeless veterans (3905/23 898, 16.3%) than non-homeless veterans (4143/65 198, 6.1%) died during the follow-up period, with a hazard ratio for risk of death of 2.9. The mean age at death (52.3 years) for homeless veterans was approximately 1 year younger than that of non-homeless veterans (53.2 years). Most deaths among homeless veterans (3431/3905, 87.9%) and non-homeless veterans (3725/4143, 89.9%) were attributed to 7 cause-of-death categories in the International Classification of Diseases, 10th Revision (cardiovascular system; neoplasm; external cause; digestive system; respiratory system; infectious disease; and endocrine, nutritional, and metabolic diseases). Death by violence was rare but was associated with a significantly higher risk among homeless veterans than among non-homeless veterans (suicide hazard ratio = 2.7; homicide hazard ratio = 7.6).

Conclusions:

Younger and middle-aged homeless veterans had higher mortality rates than those of their non-homeless veteran peers. Our results indicate that homelessness substantially increases mortality risk in veterans throughout the adult age range. Health assessment would be valuable for assessing the mortality risk among homeless veterans regardless of age.
The built environment and trip chaining behaviour revisited: The joint effects of the modifiable areal unit problem and tour purpose
Authors: Yang Liya , Hu Lingqian , Wang Zhenbo
Published: February 2018

Empirical research that examines the built environment and travel behaviour has frequently found inconsistent results, which can be attributed to the modifiable areal unit problem (MAUP) and to different treatments of travel purposes. This study considers these two important issues simultaneously in investigating the association between the built environment and travel behaviour in Beijing, China. Using tours as the analysis unit of travel, this study classifies three tour purposes: subsistence, maintenance and recreation, and identifies seven different spatial units to address the MAUP. Based on data from the 2010 Beijing Comprehensive Travel Survey, this study uses logistic regressions to estimate the primary tour mode and tour complexity. The results identify the ‘ideal’ unit at which the built environment has the greatest association with tours of specific purposes. Such results inform how urban planning and transportation policies can effectively influence travel.
Motivation for the Pastoral Profession in the Netherlands
Authors: Zondag Hessel J.
Published: February 2018

Expectancy theory has been utilized by organizational psychology to explore the expectations and valuations of individuals in various professions. This study employs expectancy theory to clergy, investigating pastors' personal motivations, or values, for assuming pastoral ministry and the subsequent expectation that these values will be honored by their activities within the pastorate. The responses of 235 pastors from Catholic and Protestant denominations on a 24-item questionnaire devised to gauge pastoral motivation and adapted to assess pastoral expectations were factor analyzed and correlated in this exploratory study. The analysis yielded four robust factors. The first two motives found to be dominant were the pursuit of a Christian Way of Life and Anthropocentric Altruism. Anthropocentric Egoism and Theocentric Egoism, although secondary motivations, were theoretically meaningful in the understanding of pastoral motivations and expectations. The impact of expectations upon pastoral well-being and resilience against burnout is discussed.
Response to “A Winnicottian Redescription of Christian Spiritual Direction Relationships: Illustrating the Potential Contribution of Psychology of Religion to Christian Spiritual Practice”
Authors: Haynes Laura A
Published: February 2018

In this response to Hardy's article, I argue that redescribing the spiritual in psychological terms as a methodology for integration between the two is workable to the degree that these areas overlap, but is reductionistic in that it tends to minimize the supernatural aspect of the spiritual. Redescribing the spiritual direction relationship of directee and director as Winnicottian potential space appears to reduce negating the human-human relationship while tending to negate intervention that is radically divine. Hardys suggests that spiritual directors alter their primary or sole focus on the Divine in order to focus on transference-countertransference in the directee-director relationship. I argue that this shift in focus significantly alters an ancient and proven genre of counseling. Therefore, I suggest possible ways to integrate director-directee play in the potential space with radically Divine agency.
Spiritual Directors and Clinical Psychologists: A Comparison of Mental Health and Spiritual Values
Authors: Howard Nicholas C. , McMinn Mark R. , Bissell Leslie D. , Faries Sally R. , Vanmeter Jeffrey B.
Published: February 2018

We surveyed a total of 315 spiritual directors, psychologist members of the Christian Association for Psychological Studies (CAPS), and psychologist members of the American Psychological Association (APA) to determine their respective values on ten mental health themes derived from Jensen and Bergin (1988), and three spirituality scales drawn from the writings of John of the Cross. All three groups endorsed the value of expressing feelings, personal autonomy and maturity, and integrating work and leisure. CAPS psychologists and spiritual directors endorsed more than APA psychologists the values of spirituality, forgiveness, and the three John of the Cross scales. Spiritual directors reported greater endorsement of the self-awareness and growth theme than did psychodynamic psychologists who, in turn, reported greater endorsement than cognitive-behavioral psychologists. The results are examined in light of the pre-Enlightenment paradigm and value system in which spiritual direction and Christian theology are rooted.
Solitude, Silence, and the Training of Psychotherapists: A Preliminary Study
Authors: Vanmeter Jeffrey B. , McMinn Mark R. , Bissell Leslie D. , Kaur Mahinder , Pressley Jana D.
Published: February 2018

The spiritual disciplines of silence and solitude have long been practiced within the contemplative Christian tradition as a means of character transformation and experiencing God. Do these disciplines affect the use of silence in psychotherapy for Christian clinicians in a graduate training program? Nineteen graduate students in clinical psychology were assigned to a wait-list control condition or a training program involving the disciplines of solitude and silence, and the groups were reversed after the first cohort completed the spiritual disciplines training. One group, which was coincidentally comprised of more introverted individuals, demonstrated a striking increase in the number of silent periods and total duration of silence during simulated psychotherapy sessions during the period of training. The other group, more extraverted in nature, did not show significant changes in therapeutic silence during the training. These results cause us to pose research questions regarding the interaction of personality characteristics and spiritual disciplines in training Christian psychotherapists.
Professional use of the Internet: Legal and Ethical Issues in a Member Care Environment
Authors: Rosik Christopher H. , Brown Roger K.
Published: February 2018

Advances in communication technology have outpaced the development of accompanying legal standards and ethics codes. Therapists and physicians who utilize the Internet to provide services may knowingly or inadvertently create a professional relationship that is beholden to ambiguous legal and ethical guidelines. This article will examine these concerns with particular reference to member care professionals. Issues such as confidentiality, competence, consent, and jurisdiction will be addressed and several recommendations will be presented that can help mission organizations and member care professionals promote ethical practice and reduce legal liability when providing online services.
Interpersonal Forgiveness from an Eastern Orthodox Perspective
Authors: Gassin Elizabeth A.
Published: February 2018

In the last 15 years, Christian and secular psychologists in the western tradition have written much about interpersonal forgiveness and reconciliation. The eastern Christian tradition (i.e., the Orthodox Church) has not had much of a voice in this discussion. In order to promote dialogue and assist clinicians in their ministry to Orthodox Christians, this article proposes some basic elements of an Orthodox view of interpersonal forgiveness and reconciliation, links those elements with eastern theology and anthropology, and compares them with concepts from western Christian and secular psychology.
The Pleistocene Mind: A Critical Review of Evolutionary Psychology, and an Introduction to Intelligent Design Psychology
Authors: Grace Christopher R.
Published: February 2018

Researchers and scientists in evolutionary psychology, a new theoretical perspective within the field of psychology, have proposed striking insights into human behavior based on our long evolutionary past. These insights and proposals have gained support over the past decade among psychologists, but they have also been roundly criticized. According to proponents, the field of evolutionary psychology seeks to synthesize modern evolutionary theory with the latest psychological findings, informed by the field of evolutionary biology. This new field of evolutionary psychology claims to have discovered insights about our universal human nature, pointing to our supposed millions of years of evolution during the Pleistocene era as the main designer of our minds. Evolutionary psychologists point to such universal phenomenon as feelings of shame, cheater-detectors, standards for female beauty, mate selection, and child abuse by step-fathers as evidence for specialized brain circuits that were designed by evolution. Adapted to a life on the savannas, the human mind is composed of these functionally specialized circuits, and to fully understand behavior today we must understand the pressures of savanna life. Critics of this new discipline, including philosophers, scientists, and evolutionary biologists, have responded with serious counterpoints. This article provides a brief overview of the field and the arguments brought against EP, including evaluating both the empirical evidence and the theoretical underpinnings. Implications for those favoring a theistic world-view are also discussed, and an introduction is given to a new field called Intelligent Design Psychology.
Spiritual Direction in the Orthodox Christian Tradition
Authors: Rogers F. Gregory
Published: February 2018

This essay examines the practice of spiritual direction in the Orthodox Christian tradition. Spiritual direction is first defined as leading the believer to the knowledge of God. A historical sketch of the practice of direction is followed by an outline of the process of spiritual transformation as seen in the Orthodox tradition. The role of the Orthodox spiritual director is analyzed along with the duties of the disciple. An analysis of the indicators of spiritual maturity notes the importance of the attainment of dispassion and the development of virtue. Conventional psychotherapeutic methods are compared with Orthodox spiritual direction, noting circumstances under which the Orthodox spiritual director would make a referral to a mental health professional.
Thirty Years of Integrative Doctoral Training: Historic Developments, Assessment of Outcomes, and Recommendations for the Future
Authors: Johnson W. Brad , Mcminn Mark R.
Published: February 2018

Integrative clinical psychology doctoral programs explicitly blend religious faith with professional training. During the past thirty years, there has been a steady increase in the number of integrative programs in the United States, yet the mission-relevant training outcomes of these programs remain largely unknown. In this article, we review published literature relative to integrative doctoral programs and offer an assessment of the training outcomes recently reported by those integrative programs currently accredited by the American Psychological Association (APA). We briefly summarize the distinctive strengths and relative weaknesses of integrative programs and consider the primary challenges they now face. We conclude with several specific recommendations designed to help integrative doctoral programs thrive in the future.
Maintaining Personal Resiliency: Lessons Learned from Evangelical Protestant Clergy
Authors: Meek Katheryn Rhoads , Mcminn Mark R. , Brower Craig M. , Burnett Todd D. , Mcray Barrett W. , Ramey Michael L. , Swanson David W. , Villa Dennise D.
Published: February 2018

Despite the prominence of clergy in providing human services, and the work-related stressors they experience, clergy health and coping responses have rarely been the focus of psychological research. We report two studies. In the first, we evaluated responses of 398 senior pastors to three open-ended questions regarding personal coping, structural support for their work, and remediation efforts in times of distress. In the second study, Christian mental health professionals and Christian education professionals identified Protestant Christian clergy who exemplify emotional and spiritual health. Twenty-six participated in individual 30-minute interviews. Respondents emphasized the importance of being intentional in maintaining balance in life and developing healthy relationships. They also value a vital spiritual life, emphasizing both their sense of calling into ministry the importance of spiritual disciplines, and an ongoing awareness of God's grace. We suggest ways that Christian mental health professionals can support pastors in preventive and remedial roles.
Shedding Light on Theophostic Ministry 2: Ethical and Legal Issues
Authors: Entwistle David N.
Published: February 2018

Theophostic Ministry (TPM), developed by Ed Smith (1997, 2000), is reviewed and critiqued regarding ethical and legal issues. Since its introduction in 1995, interest in Theophostic Ministry has grown rapidly and the method has been applied to a wide range of mental health disorders. As currently employed, however, TPM may pose numerous ethical and legal issues. These issues include the adequacy of TPM training methods, debatable claims that it utilizes divine guidance, unsubstantiated claims of guaranteed healing and superiority of method, widespread use of Theophostic Ministry interventions without adequate empirical scrutiny or support, concerns regarding whether Theophostic Ministry should be considered a counseling intervention or a ministry, and concerns about the openness of TPM's founder to critique. Taken together, these issues constitute serious concerns regarding compliance with professional codes of ethics and legal guidelines.
After Postmodernism: Perspectivism, a Christian Epistemology of Love, and the Ideological Surround
Authors: Watson P. J.
Published: February 2018

Postmodernism liberates the integration of psychology and Christianity from the domination of modernism, but also leads to a vertiginous relativism. A movement beyond postmodernism seems essential. For Christians, such a movement might build upon the “future objectivity” of Friedrich Nietzsche's postmodern perspectivism. Writings of the French social theorist René Girard suggest how this “objectivity” might be assimilated within a Christian metanarrative about Truth. His theory more specifically implies that the Bible commands an epistemology of love that is non-authoritarian, critical, and integrative. Methods compatible with an epistemology of love have been developed within an ideological surround model of the relationship between psychology and religion. An epistemology of love supplies a metaperspective for seeing and then telling a coherent metanarrative about the challenges of integration after postmodernism.
Reflective Judgment: Seminarians' Epistemology in A World of Relativism
Authors: Dale Janet L.
Published: February 2018

In a culture marked by pluralism and relativism are evangelical Christian leaders with their faith-based conclusions intellectually strong? How do their assumptions about revealed knowledge affect their ability to solve important ill-structured (ambiguous and controversial) issues of life and ministry? The reflective judgment model and its semi-structured interview (RJI), based on 20 years of research, were used to assess the problem-solving ability of students preparing for ministry. The 38 male students were enrolled in an accredited seminary with an epistemology of revealed knowledge. Differences between entering and graduating students' RJI mean scores were not statistically significant, nor were their mean scores significant between religious and secular dilemmas. Further, students' scores did not decrease significantly as their references to faith increased. Recommendations for higher education are offered to help seminarians develop reflective judgment so they can adequately respond to ill-structured problems.
Suicide Acceptability and Religious Well-Being: A Comparative Analysis in African American Suicide Attempters and Non-Attempters
Authors: Anglin Deidre M. , Gabriel Kamieka O. S. , Kaslow Nadine J.
Published: February 2018

This study was designed to examine the relationship between suicide acceptability and religious well-being, and to investigate the differences that may exist between African American suicide attempters and non-attempters on these two concepts. Two hundred low-income, African Americans were administered self-report questionnaires measuring suicide acceptability and religious well-being. Findings indicated that suicide acceptability was negatively related to religious well-being for both suicide attempters and non-attempters. There was also a significant difference between these two groups on suicide acceptability and religious well-being. Results were consistent with previous research that suggests that African Americans who attempt suicide endorse higher levels of suicide acceptability and lower levels of religious well-being than do their nonattempter counterparts. These findings have important implications for culturally-competent community programming and community mental health programs that serve low-income ethnic minority populations.
A Confirmatory Test of the Factor Validity of Scores on the Spiritual Well-Being Scale in a Community Sample of African Americans
Authors: Utsey Shawn O. , Lee Angela , Bolden Mark A. , Lanier Yzette
Published: February 2018

This study examined a five-factor model of the Spiritual Well-Being Scale (SWBS; Ellison, 1983) proposed by Miller, Fleming, and Brown-Anderson (1998). A confirmatory factor analytic procedure was conducted to determine whether the Miller et al. model fit the data for the current sample of African Americans. For comparative purposes, several alternative SWBS models were included in the study's design. The findings indicated that none of the SWBS models provided an adequate fit to the data for the current sample. Implications for future use of the SWBS with African American populations are discussed.
Seeking Forgiveness: Considering the Role of Moral Emotions
Authors: Bassett Rodney L. , Bassett Kelly M. , Lloyd Matthew W. , Johnson Jason L.
Published: February 2018

Sandage, Worthington, Jr., Hight, and Berry (2000) pointed out that most of the research on forgiveness has focused on the process of granting forgiveness rather than seeking forgiveness. Therefore, in this project, college students were asked to recall a recent event from their past where they harmed someone with whom they had a relationship. They were then asked to rate their feelings following the transgression such that it was possible to determine the extent to which they experienced sorrow or guilt (Narramore, 1984). Participants also indicated how they responded to the situation. In addition, a few weeks later, these same students were invited to respond to a dispositional measure designed to tap their general tendencies toward experiencing sorrow or guilt. One of the particularly interesting findings from this study was that the efforts to measure sorrow seemed to split into two factors. One of these sorrow factors seemed to predict healthy patterns of seeking forgiveness while the other factor did not.
Kicking the Patient: Immediacy in the Consulting Room
Authors: Mangis Michael W
Published: February 2018

A case is presented of an adolescent with a history of substance abuse. The case is discussed from the perspective of Time Limited Dynamic Psychotherapy (TLDP). The patient's Cyclical Maladaptive Pattern (CMP) involved remaining attached to significant others by avoiding all conflict and seeking to please them as much as possible out of a fear of abandonment. The therapist became “hooked” into counter-transference enactment–kicking the patient–thus playing the role of the rejecting adult figure that fails her. The patient and therapist were then able to break out of this cyclical pattern and forge a new kind of relationship. This experience led to the patient developing a healthier relational pattern in her life and, hopefully, may lead to her experience of God being able to break free from her expectations as well.
Spirituality, Religiosity, Shame and Guilt as Predictors of Sexual Attitudes and Experiences
Authors: Murray Kelly M. , Ciarrocchi Joseph W. , Murray-Swank Nichole A.
Published: February 2018

This study examines the relationship among levels of spirituality, religiosity, shame, and guilt on sexual attitudes and experiences. A convenience sample that included graduate and undergraduate students (N = 176; mean age = 37) completed a five-factor measure of personality as well as measures of spirituality, religiosity, shame, guilt, and sexual attitudes and experiences. Spirituality was negatively correlated with sexual permissiveness, and engaging in high risk sex. The moral emotion of shame increased when people had multiple sex partners within the past three months while those more spiritual or connected to God were less likely to have had sex after use of alcohol and/or drugs. Also, the more often someone attended religious services the less likely they were to have had multiple partners within the past three months. A sense of alienation from God predicted shame and guilt, but shame and guilt themselves did not predict sexual practices. These findings suggest that sexual attitudes and experiences are related to both spirituality and religious practices independently of personality, whereas they have no relationship to shame and guilt.
Emotion as an Integrative Topic: An Analysis of Faithful Feelings
Authors: Beck James R.
Published: February 2018

Emotion is a topic of great interest to both academic disciplines involved in the integration enterprise. Biblical studies and theology address the topic because of its vital role in understanding the nature of God and the nature of human functioning. Psychology addresses the topic of emotion because of the central role emotion plays in psychological development, wellbeing, psychopathology, and clinical interventions. To form an integrative approach to emotion, scholars from both sides of the equation need to bring the best, most up-to-date data to the conversation. A new book, Faithful Feelings, represents a major contribution to the discussion of emotion from the discipline of biblical studies. This article analyzes its potential contribution to scholars in psychology working on the subject of emotion from the standpoint of relevance, scope, and depth.
Sexual Orientation, Mental Health, Gender, and Spirituality: Prejudicial Attitudes and Social Influence in Faith Communities
Authors: McLeland Kelly C. , Sutton Geoffrey W.
Published: February 2018

This study examined how the attitudes of conservative American Protestants attending Midwestern churches might vary as a function of religious beliefs, gender, and exposure to scenarios of people from stigmatized groups who were asking for spiritual care. Results of the 2 (scenario gender) x 2 (scenario sexual orientation) x 2 (scenario mental health issue) x 2 (participant gender) MANOVA revealed significance for sexual orientation bias (Λ = .79, F (2, 88) = 11.94, p < .001, η2 = .21) and participant gender bias (Λ = .91, F (2, 88) = 4.13, p = .02, η2 = .09. Follow-up ANOVA's revealed different effects depending on whether participants reported personal or perceived group attitudes. We discuss the results in terms of social comparison theory and projection.
Who Cares? Generativity and the Moral Emotions, Part 2: A “Social Intuitionist Model” of Moral Motivation
Authors: Leffel G. Michael
Published: February 2018

Part 1 in this three-part series proposed a new direction for theory and research in the “psychology of ultimate concerns” (Emmons, 1999) to be organized around Erik Erikson's (2000) socio-moral and motivational views of generative care (less stage- and age-related). The present article takes the next step, suggesting that further development of “project eudaimonia” (Flanagan, 2007) requires a more systematic model of the sources of moral motivation by which persons are moved to care, and processes whereby persons might “expand” (Stern, 2004) their motive and capacity for generative care, i.e., to take care of the strengths-development of cared for others (Erikson, 2000). The purpose of this article is to introduce a specific model of moral motivation, a “Social Intuitionist Model” of moral motivation (SIM motivation) that derives from Haidt's (2001) model of moral judgment. The article first describes Haidt's original model; second, it expands the SIM into a model of moral motivation; and third, it discusses the implications of the model for the relational spirituality paradigm. The SIM motivation encompasses six domains or sources of moral motivation and related developmental processes: tuning-up moral intuitions, amplifying moral emotions, expanding moral virtues, integrating moral values, sharpening moral reasoning, and strengthening moral will. In particular, this model highlights the critical roles played by three implicit-procedural domains of motivation: moral intuitions, moral emotions, and moral virtues. This article series extends the author's recent proposal for a moral motive approach to emotion and transformation in the relational spirituality paradigm (Leffel, 2007a, 2007b, 2007c).