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J. Hamil. University of North Carolina at Pembroke.

To offset the potential reductionistic effects of recoding terbinafine 250 mg online spray for fungus gnats, we have incorporated a discussion of the qualitative data into the results order terbinafine 250 mg with mastercard fungus gnats soil. The integration of qualitative and quantitative procedures was intended to enhance the theory development objective of the research discount 250mg terbinafine visa antifungal on lips. The use of an interdisciplinary team throughout the research process enhanced the quality of the study. Issues of bias, misinterpretation, and other matters that could affect the validity and reliability of the data were discussed. One of the principal investigators read all 216 interview transcripts and served as a second blind coder for each interview. Having one researcher read and code every interview provided for continuity in the operational definitions of variables. To insure that there was both a male and a female perspective on the data, the second coder was a woman. The sample was selected purposively to include participants not often included in other studies in lasting relationships; namely, people of color, blue-collar participants, and same-gender couples. The goal was not to test theory but to develop an understanding of a subject--psychological intimacy among an older group of diverse partners in lasting relationships--that has not received much attention by researchers. The sample fit with the goal of this exploratory study. The study of psychological intimacy in human relationships is a highly complex and dynamic process. Defining intimacy is a challenge, as is the importance of specifying the operational parameters. Wedefined psychological intimacy as the sense that participants had of their relationships as a place in which they could share personal thoughts and feelings about themselves and their relationships not expressed customarily with others. In this definition, positive communication was a quintessential component of psychological intimacy. We focused on cognitive themes about the meaning of relationships to individual partners rather than on specific interpersonal behaviors. The sample consisted of heterosexual and same-gender couples in relationships that had lasted approximately 30 years. A chi-square analysis of all research variables with the independent variable revealed that social and demographic factors such as age, race, education, income, and religion did not have significant relationships to psychological intimacy in recent years. That finding is important to the process of understanding factors that contribute to the quality of psychological intimacy in committed relationships that last for many years. It may also suggest that factors within relationships are more important than are socioeconomic and demographic factors in shaping psychological intimacy between partners in these relationships. In the chi-square analysis, several factors were associated significantly with reports of psychological intimacy in recent years, defined as the last 5 to 10 years of these relationships. They were the quality of communication between partners, minimal relational conflict, conflict management style of partners, couple decision-making, relational equity, quality of sexual relations, importance of sexual relations, and physical affection. These data are similar to findings reported in previous studies that have explored psychological intimacy (Berscheid & Reis, 1998), although those studies tended to focus on younger participants. Phi coefficients were then computed to determine the strength of the associations between the dependent variable and each of the independent variables. Based on the substantial correlation between communication and psychological intimacy ([phi] =. In this study, it is appropriate to consider psychological intimacy as psychologically intimate communication. Based on the statistically significant relationships of the above variables with psychological intimacy, along with their identification in previous research as important factors in shaping intimacy (Kurdek, 1998; Swain, 1989; Howard, Blumenstein, & Swartz. The first model included the sexual orientation of couples (heterosexual, lesbian, or gay male) as an independent variable. The results pointed to five factors predictive of psychological intimacy in these lasting relationships. They were minimal levels of relational conflict (B = -2. The fifth factor was sexual orientation of couples: more lesbians reported their relationships as psychologically intimate i n recent years than did heterosexuals (B = 1. To assess the significance of gender over sexual orientation on reported psychological intimacy, gender was substituted for sexual orientation in a second model. The four factors that contributed significantly to psychological in the first model did not change substantially in this second model, and the gender of participants had a moderate effect on the results (B =. That finding is compatible with those of Parks and Floyd (1998), who argued that gender role identification of males and females is not as powerful a factor in shaping intimacy in friendship relationships as may be assumed. This study focused selectively on a sample of 108 heterosexual and same- gender partners in 216 relationships that had lasted an average of 30 years. The results suggested that factors within relationships themselves had a more powerful effect in shaping the meaning of psychological intimacy than did social and demographic factors. Perhaps, a reason that these relationships endured was that these factors nurtured a sense of psychological intimacy that contributed to relational stability. The data offer hypotheses for exploration and testing in future research on lasting relationships. In addition to the factors that had a shaping effect on psychological intimacy in recent years, subtle differences were found between lesbian and other participants. Differences based on gender and sexual orientation suggest a subtle interacting dynamic of these factors on psychological intimacy in relationships that last. We suggest that a mutually reinforcing dynamic between two women committed to personal and relational development may explain the subtle yet important differences between lesbian couples and the other couples in this study. We hope that these findings and our observations about them will be helpful to other researchers engaged in the study of lasting relationships. Source: Sex Roles: A Journal of ResearchBerscheid, E. Sexual exclusivity versus sexual openness in gay male male couples. Psychological merger in lesbian couples: A joint ego psychological and systems approach.

David: How do you feel about the way your mother has responded? Alexandra: Well discount terbinafine 250mg with mastercard antifungal diet, I became bitter and even more resentful towards her for how she responded purchase terbinafine 250mg without prescription antifungal oral medication side effects. I just felt even more hopeless and unworthy purchase terbinafine 250 mg antifungal undercoat, and naturally the eating disorder became worse because of that. I have grown, I think, and I have let go of a lot of anger and resentment towards my mother. David: I want to mention here that Alexandra is 15 years old. Her Peace, Love and Hope eating disorders site is here in the Eating Disorders Community. Alexandra: In the beginning I lost about ten pounds, but after that, bulimia only caused me to gain a few pounds of water weight, but I never lost anymore actual weight after that. Unfortunately, with eating disorders, especially with bulimia, since those that suffer just from bulimia do not reach a dangerously low weight, it is almost easy to hide the disordered eating behaviors ( eating disorder symptoms ), so no one suspected there was a problem. Before starting towards recovery, I definitely did feel that I would be failing my eating disorder and also that I did not deserve help. I had to give it a shot, though, because I knew that I would not survive much longer eventually realize that you have nothing to prove, hon. There is nothing good about being successful at dying. I know how competitive the world of eating disorders is, but you have to learn that nothing good comes from being competitive over something that will wreck your body and mind. David: Some of the audience questions center around medical advice. Alexandra, have you made any efforts towards recovery from bulimia and anorexia? Alexandra: I can only give my opinion on medical related questions. No matter what, and I know this is hard to do for sufferers, see your doctor when in doubt. About me making any efforts towards recovery, definitely. Every day, I work harder to break free from purging and starving. I think the root of that is learning to accept yourself for you, not a sick person or a "broken" one or one that suffers from an Eating Disorder, but you as yourself as a person. You have to learn over time to accept yourself no matter what, instead of constantly finding flaws and believing that there is one true "perfect" person out there that you must attain. Alexandra: Because I am only 15 and still unable to drive, I am not seeing a therapist. I have brought the issue up with my mother, about seeing someone just to "talk," and she was none-too-pleased with the idea. So, currently I am fighting on my own and with the support of friends. I want to make a note here that you really cannot fully recover on your own or just from support from your family and friends. You eventually will need professional help at some point or another, as you are battling against your own mind and are unable to distinguish between what is too much, too little, etc. What was the main thing that helped you accept life and enjoy it, rather than giving in to the eating disorder? I think that when I started to come out of the extreme purging and fasting behaviors I started to feel more energized, and then, I was able to see life in a different light. I began ever so slowly to see that I did not need to blame myself for everything under the sun, and that if I tried to get rid of my pain by purging and starving, that I was not solving anything and instead just adding onto my problems. It was really a combination of things that helped me to start recovering. When I did eat, it was nice to not immediately think "Dear God, how am I going to get rid of this? Alexandra: I began to try and recover about a year and a half ago, when I was 14. It has to be something the person wants, and at that time I finally started wanting to end this battle. David: Was there something that happened in your life or thinking that triggered a change in your attitude - making you want to recover? My throat hurt constantly and I was breaking down crying everyday in my room from what was going on in my head. I always knew deep down that I could not continue on like this. Before I started to recover, I was cutting myself and contemplating suicide, and I knew that I had to do SOMETHING, anything, to help this situation. I had been told always almost the same thing by other people who I had met, that also had suffered or had recovered -- "do whatever you can to try and get better. Although I was unsure of either of those things at the time, I decided to give this recovery gig a shot. I heard you never really recover, that you can always relapse. You have to take your own health as first priority and realize that people will always react as they want to. Personally, I really do believe that you can fully recover. One of my good friends is in her early forties and recently fully recovered from a lifelong addiction to bulimia and alcohol. It took her a long, long time, but she has not relapsed in over a year and has no relapse-related thoughts.

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Many patients suffer a generalized form of social phobia discount 250 mg terbinafine amex fungus killing trees, in which they fear and avoid most interactions with other people buy cheap terbinafine 250 mg on line antifungal medicine for skin. This makes it difficult for them to go to work or school cheap 250 mg terbinafine fast delivery anti fungal wash for dogs, or to socialize at all. Social phobias occur equally among men and women, generally developing after puberty and peaking after age 30. A person can suffer from one or a cluster of social phobias. Derived from the Greek, agoraphobia literally means "fear of the marketplace. It causes its victims to fear being alone in any place or situation from which he or she thinks escape would be difficult or help unavailable if he or she were incapacitated. People with agoraphobia avoid streets, crowded stores, churches, theaters and other crowded places. Normal activities are restricted by this avoidance, and people with the disorder often become so disabled they literally will not leave their homes. If people with agoraphobia do venture into phobic situations, they do so only with great distress or when accompanied by a friend or family member. Most people with agoraphobia develop the disorder after first suffering a series of one or more spontaneous panic attacks. The attacks seem to occur randomly and without warning, making it impossible for a person to predict what situations will trigger the reaction. The unpredictability of the panic attacks "trains' the victims to anticipate future panic attacks and, therefore, to fear any situation in which an attack may occur. As a result, they avoid going into any place or situation where previous panic attacks have occurred. Agoraphobia victims also may develop depression, fatigue, tension, alcohol or drug abuse problems and obsessive disorders. These conditions are treatable with psychotherapy and with medication. Psychiatrists and other mental health professionals use desensitization techniques to help people with phobic disorders. They teach patients deep muscle relaxation techniques, and work to understand what provoked the anxiety. As the sessions progress, the object or situation that provokes the fear no longer has its hold on the person. Panic disorder, while it often accompanies phobias such as agoraphobia, can occur alone. People with panic disorder feel sudden, intense apprehension, fear or terror, that can be accompanied by heart palpitations, chest pain, choking or smothering sensations, dizziness, hot and cold flashes, trembling and faintness. But psychiatrists diagnose panic disorder when the condition has become chronic. People with generalized anxiety disorder suffer with unrealistic or excessive anxiety and worry about life circumstances. Patients with this disorder often feel "shaky," reporting that they feel "keyed up" or "on edge" and that they sometimes "go blank" because of the tension they feel. The behaviors that are a part of obsessive-compulsive disorder include obsessions (which are recurring, persistent and involuntary thoughts or images) which often occur with compulsions (repetitive, ritualistic behaviors -- such as hand washing or lock checking -- which a person performs according to certain "rules"). Often beginning in adolescence or early adulthood, obsessive and compulsive behaviors frequently become chronic. Some investigators believe these disorders result from a traumatic experience in childhood that has been consciously forgotten, but surfaces as a reaction to a feared object or stressful life situation, while others believe they arise from imbalances in brain chemistry. Several forms of medication and psychotherapy are highly effective in treating anxiety disorders, and research continues into their causes. Like depression, schizophrenia afflicts persons of all ages, races and economic levels. It effects up to two million Americans during any given year. Its symptoms frighten patients and their loved ones, and those with the disorder may begin to feel isolated as they cope with it. The term schizophrenia refers to a group of disorders that have common characteristics, though their causes may differ. The hallmark of schizophrenia is a distorted thought pattern. The thoughts of people with Schizophrenia often seem to dart from subject to subject, often in an illogical way. Patients may think others are watching or plotting against them. Often, they lose their self-esteem or withdraw from those close to them. Persons suffering schizophrenia sometimes hear nonexistent sounds, voices or music or see nonexistent images. Because their perceptions do not fit reality, they react inappropriately to the world. Patients react in an inappropriate manner or without any visible emotion at all. Though the symptoms of schizophrenia can appear suddenly during times of great stress, schizophrenia most often develops gradually, and close friends or family might not notice the change in personality as the illness takes initial hold. Theories about the causes of schizophrenia abound, but research has not yet pinpointed what causes the disease. In recent years, laboratory findings have suggested strongly that schizophrenia is passed on genetically from generation to generation. Some studies have found abnormal levels of some chemicals in the blood and urine of people with schizophrenia. One study has suggested that the alignment of cells in a particular area of the brain goes awry before birth. Schizophrenia cannot be cured, but it can be controlled.

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