Quality of life in transplant patients, compared to other stressful health situations in pulmonary patients

Transplantation may imply severe biopsychosocial impairments. In order to know the quality of life of patients one year after transplantation, 58 subjects were compared to three different groups of patients (stabilized and acute COPD patients, and lung cancer patients in a surgery unit). Patients filled in two questionnaires: EORTC QLQ-C30 (quality of life) and HAD (anxiety and depression). The quality of life dimensions with inter-group differences were physical, role, emotional and cognitive functioning, global health status, and a number of symptoms (fatigue, dyspnea, insomnia and appetite loss). There were differences in depression, and but not in anxiety. Transplant and surgical patients showed better quality of life and affective status than chronic pulmonary patients. Discriminant analysis showed that the transplant group was the best described group. We conclude that patients, one year after transplantation, show similar quality of life as asymptomatic hospitalised patients, somewhat better than chronic patients in a stabilized stage of the disease, and much better than severe chronic patients.     

Evaluating differential predictions of emotional reactivity during repeated 20% carbon dioxide-enriched air challenge

The present study explored psychological predictors of response to a series of three 25 second inhalations of 20% carbon dioxide-enriched air in 60 nonclinical participants. Multiple regression analyses indicated that only anxiety sensitivity physical concerns predicted self-reported fear, whereas both physical anxiety sensitivity concerns and behavioural inhibition sensitivity independently predicted affective ratings of emotional arousal. In contrast, the psychological concerns anxiety sensitivity dimension predicted ratings of emotional displeasure (valence), and both psychological anxiety sensitivity concerns and behavioural inhibition sensitivity independently predicted emotional dyscontrol. No variables significantly predicted heart rate. These data are in accord with current models of emotional reactivity that highlight the role of cognitive variables in the production of anxious and fearful responding to somatic perturbation, and help further clarify the particular predictors of anxiety-related responding to biological challenge.     

Brazilian-Portuguese empathy quotient: evidences of its construct validity and reliability

Empathy is the ability to read other's mind and understand their intentions. This paper examines the psychometric properties of the Brazilian-Portuguese version of a short form of the empathy quotient (EQ, 15 items). The EQ-15 was administered to 237 participants from the general population from Jo?o Pessoa, Brazil. Confirmatory factor analyses supported the tripartite model with cognitive, emotional and social empathy factors. In line with other studies, gender differences were only observed for the first two factors, with female participants scoring higher on both, which suggests that the social factor might not constitute a truly dimension of empathy. Strong evidence for convergent and discriminant validity was only observed for the cognitive factor. The poor psychometric parameters of the emotional and social factors are argued to reflect the complexity and contrasting ideas of their items. The possibility of elaborating specific items for the emotional and social factors is also discussed.     

An Analysis of Thoughts,Behaviours, and Emotions in Daily Decision-Making

Cognitive theory and naturalistic decision-making models were utilized to examine the relationship between thoughts, behaviours, and emotions in daily decision-making. An experimental survey using vignettes examined the effects of investment of cognitive and behavioural effort in hypothetical vignettes on emotional responses to uncertain negative outcomes. For each vignette, this negative outcome was either surprising or distressing. Further, the type of uncertainty was an alteration, inclusion, or cancellation pertaining to the original vignette, yielding six conditions in the within-groups design. Participants (N = 335, 220 females) responded to each vignette by choosing a behavioural effort option (low or high), following which they elaborated the reason for their choice (high or low cognitive effort). They also responded to the predetermined negative outcome on an affective scale (emotional response). Results showed that (a) emotional responses to vignettes varied, based on the type of uncertainty in the scenario; (b) surprising outcomes elicited higher emotional distress; (c) behavioural effort positively predicted emotional distress when the type of uncertainty was alteration or inclusion; and (d) strategies involving high cognitive effort predicted investment of high behavioural effort in the vignette. Implications of examining behavioural, cognitive, and emotional processes leading to daily decisions are discussed in the context of coping with uncertainty.     

Factors associated with self-efficacy in persons with chronic illness

Change of lifestyle may be necessary for persons with chronic illnesses in order to manage their health situation and reduce symptom distress. Success in changing lifestyle partly depends on a person's self-efficacy beliefs. This cross-sectional study explores social support, physical activity, and illness perceptions in relation to self-efficacy in a sample with morbid obesity and in a sample with chronic obstructive pulmonary disease (COPD). The linear regression analyses showed that higher physical activity and less emotional response to illness were directly associated with higher self-efficacy among persons with obesity, while more social support; fewer perceived consequences from illness; and more understanding of the illness were directly associated with higher self-efficacy among persons with COPD. The results indicate that obese persons are likely to benefit from increasing physical activity and from receiving emotional support. Persons with COPD may be empowered by being able to utilize cognitive coping strategies and by receiving social support.     

The contribution of anxiety and depression to fatigue among a sample of Australian university students: suggestions for university counsellors

Responses to the Zung Self-Rating Anxiety Scale (SAS: Zung, W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12, 371–379), the Self-Rating Depression Scale (SDS: Zung, W. (1973). From art to science: The diagnosis and treatment of depression. Archives of General Psychiatry, 29, 328–337) and the Fatigue Severity Scale (FSS) developed by Krupp and colleagues (Krupp, L.B., LaRocca, N.G., Muir-Nash, J., & Steinberg, A.D. (1989). The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46, 1121–1123) were collected from 200 Australian university students to explore the links between these three disorders. Reliability data were satisfactory for all three scales and there were no significant gender or age-related differences between total scale scores. Factor analyses revealed a 5-factor solution for the SAS, a 6-factor solution for the SDS and a single factor for the FSS. There were 8 major and meaningful correlations found and these were entered into a regression of the SAS and SDS factor scores upon the single factor of the FSS. Fatigue factor scores were most powerfully predicted by psychomotor agitation, pain and resultant fatigue and cognitive and emotional arousal factor scores from the SAS and SDS. These data argue for an arousal/anxiety-fatigue-depression progression in disease that may be developmental or accumulative, with extreme levels of psychomotor arousal, resultant muscle fatigue and pain, plus concurrent elevated emotional state and cognitive arousal contributing to an eventual depletion of physical resources, leaving the individual in extreme fatigue. Implications for diagnosis and treatment by counsellors are discussed.     

Characteristics of Family Interaction of Individuals with Hikikomori (Prolonged Social Withdrawal) From the Viewpoint of Behavior Theory

The cognitive behavioral approach for families of individuals with hikikomori (IWH) places importance on assessing family interaction from a behavior theory. However, there is no gold standard method for the assessment of family interaction of IWH. Additionally, the characteristics of the family interactions of IWH have not been clarified. This study aims to (a) develop the Family Interaction Scale for Hikikomori (FIS‐H) using parent‐reported data, and (b) clarify the characteristics of hikikomori cases. First, the FIS‐H factor structure was examined. Second, to examine the reliability and validity of the FIS‐H and the characteristics of hikikomori cases, parents of IWH (hikikomori‐group) and unaffected parents (without‐group) completed the FIS‐H and the Relationship Happiness Scale. Based on data from 146 parents, the FIS‐H preliminary version consisted of four factors with a total of 12 items (Study 1). The reliability and validity of the FIS‐H were also confirmed to be acceptable using data from 246 hikikomori‐group participants. The hikikomori‐group had higher FIS‐H scores than did the without‐group (Study 2). These results show that it is important to appropriately assess family interactions.     

Components of Mindfulness in Patients with Chronic Pain

Methods of mindfulness are gaining increasing popularity within the behavioral and cognitive therapies and appear helpful for a range of clinical problems. The purpose of this study was to examine cognitive and behavioral processes underlying mindfulness. One hundred fifty patients seeking treatment for chronic pain completed a battery of questionnaires, including the 15-item Mindful Attention Awareness Scale (MAAS; Brown and Ryan, J Pers Soc Psychol 84:822–848, 2003). Preliminary analyses supported reliability and validity of the MAAS for patients with chronic pain. A confirmatory factor analysis provided incomplete support for a singe factor structure from the items of the MAAS. In turn, an exploratory factor analysis yielded a four-factor solution: Acting with Awareness, Present Focus, Responsiveness, and Social Awareness. Correlation and regression analyses indicated that the Acting with Awareness and Present Focus subscales were significantly related to measures of patient emotional, physical, and social functioning. Further research that explores and validates models of mindfulness-based processes is recommended.     

Vocal indicators of facilitative interpersonal skills

The facilitative interpersonal skills (FIS) method uses simulations of difficult client moments as a test of helpers' ability to remain therapeutic in therapeutically stressful situations. A total of 135 participants completed the FIS task as part of a training in helping skills and provided verbal responses that were assessed by trained raters for interpersonal skills. Audio recordings of these verbal responses were then analysed acoustically for fundamental frequency (F0), spectral slope and F0 range. Mean F0 and F0 range were more highly associated with trained raters' ratings of FIS for female participants than for male participants, although F0 range was associated with FIS of both males and females. The results suggest that F0 is associated with FIS for females, especially the FIS items that are indicative of emotional expression and verbal fluency. Findings are discussed as possibly indicating that some expression of higher F0 in response to distressed client situations may be part of interpersonal skills, such that more skilled therapists respond to stressful client situations with a higher F0.     

Friendship closeness inventory: development and psychometric evaluation

This study developed a psychometrically sound measure of closeness in Australian men's (n = 59) and women's (n = 77) same-sex friendships, the Friendship Closeness Inventory. Subscales were developed to measure both masculine and feminine styles of closeness in three domains of Emotional Closeness, Behavioural Closeness, and Cognitive Closeness. The inventory was subjected to reliability checks which supported the reliability of each scale, and factor analyses which supported the 3-factor design. Correlations among ratings on subscales suggested that the affective, behavioural, and cognitive dimensions are distinguishable but related components of friendship. Group comparisons indicated that women rated themselves closer to their same-sex friends on the affective dimension than men. Researchers have suggested that sex-role socialisation may partly account for sex differences in self-ratings of emotional expressiveness in friendships. There were no significant differences between men's and women's ratings on the behavioural and cognitive aspects of friendships. The cognitive element may need further exploration in further scale development as it measures only one aspect of cognitive closeness: the perceived influence of friends. Pending further validation, the inventory appears potentially useful for research exploring affective, behavioural, and cognitive elements of young men's and women's friendships.     

Family Poverty and Trajectories of Children’s Emotional and Behavioural Problems: The Moderating Roles of Self-Regulation and Verbal Cognitive Ability

Socio-economic disadvantage is strongly associated with children’s emotional (internalising) and behavioural (externalising) problems. Self-regulation and verbal cognitive ability have been related to children’s emotional and behavioural resilience to socio-economic disadvantage. Despite being inter-related, self-regulation and verbal cognitive ability have not been examined jointly as promoting resilience in young children. This study investigated the roles of self-regulation and verbal cognitive ability in children’s emotional and behavioural resilience to family socio-economic disadvantage from early to middle childhood (ages 3, 5, and 7 years; N?=?16,916; 49 % girls). Using multivariate response growth curve modelling, we found that the relationship between socio-economic disadvantage and internalising problems was stronger for children with lower verbal cognitive ability. Also, poor children with high and low levels of self-regulation showed a widening gap in both emotional and behavioural problems over time. Poor and non-poor children alike benefited from self-regulation, but poor children appeared to be more vulnerable to low self-regulation. Self-regulation and verbal cognitive ability seem to be important protective factors for young children growing up in poor families.     

The Impact Message Inventory–Circumplex (IMI–C): A Replication Study of Its Circumplex Structure in a Dutch Sample

The 56-items Impact Message Inventory–Circumplex (IMI–C) has been developed to describe the interpersonal styles of target persons in terms of the 2-dimensional interpersonal circle, divided in 8 subscales (octants). The IMI–C is based on the assumption that a target person's interpersonal styles can validly be measured by assessing the internal (cognitive and emotional) reactions of the IMI–C respondent (e.g., therapists), interacting with the target person (e.g., psychotherapy patients). This replication study tested the circumplexity of a computer-delivered Dutch IMI–C. The computer-delivered Dutch IMI–C approached circumplexity in a large clinical sample (N = 812) of psychotherapy and psychiatric patients, after removing 3 items from the Submissive octant scale. These 3 items clearly disturbed the IMI–C circumplex structure. It is concluded that, even with the inevitable problem of nested data, circumplexity was approached sufficiently to justify the interpretation of the IMI–C at the octant level, provided that the 3 troublesome Submissive items are removed from the calculations of octant scores. Our replication test of the Dutch IMI–C circumplexity might be an impetus for researchers in the United States to invest in the further validation of the original American version.     

Cognitive behavioural treatment for chronic fatigue syndrome in a rehabilitation setting: effectiveness and predictors of outcome

Cognitive behavioural therapy (CBT) was combined with graded exercise therapy (GET) for patients with chronic fatigue syndrome (CFS) in an uncontrolled implementation study of an inpatient multidisciplinary group therapy. During the intake procedure, 160 CFS patients completed a questionnaire on fatigue related measurements, physical impairment, depression, somatic and psychological attributions, somatic focus, and sense of control over symptoms. Pre-treatment physical activity level was measured with an actometer. At baseline, post-treatment and 6-month follow-up individual strength, subjective fatigue and physical impairment, were reassessed. Large effect sizes were found on subjective fatigue (1.2 post-treatment; 1.2 follow-up) and physical impairment (−.9 post-treatment; −.9 follow-up), Clinically significant improvement was found in 33.8% of the participants at post-treatment and 30.6% at follow-up. Individual strength at post-treatment was predicted by level of physical activity before treatment, and by sense of control over symptoms and physical activity at follow-up. Clinically significant improvement in subjective fatigue was predicted by not receiving a disablement insurance benefit, shorter duration of fatigue, higher sense of control over symptoms and, at follow-up by more pre-treatment physical activity. In conclusion, the intervention was effective for CFS patients. Cognitive behavioural factors that perpetuate fatigue symptoms are also predictors of treatment outcome.     

Reason and emotion In psychotherapy: Thirty years on

Summary In summary, then, in 1962 RET displayed important features still current. These include the interrelatedness of cognitive, emotive and behavioural processes, the important role that cognition plays in psychological problems, its humanistic view of the self and the futility and dangers of self-rating. The emphasis on perpetuation rather than acquisition processes of emotional disturbance holds good now as it did then, and the core view of therapeutic change is essentially the same now as it was in 1962, despite further, more recent elaborations. Also, one can find the beginnings of a model of psychological health in 1962 that has been more fully developed since that time. Significant change has occurred in RET since 1962 that updates several of Ellis's original ideas. These include the distinction between interpretations (or inferences) and evaluations, the primacy of musts in accounting for psychological disturbance, the clear distinction between healthy and unhealthy negative emotions and the greater role accorded to force and energy in the change process. Aspects of psychoanalytic theory, as well as conditioning theory featured in 1962 no longer appear, and a greater emphasis is placed on biological aspects of emotional disturbance now than thirty years ago. Finally, a greater range of cognitive, imaginal, emotive and behavioural methods are found in current RET literature than inReason and Emotion in Psychotherapy where Ellis restricts himself to illustrating a few cognitive and behavioural techniques. RET, then, has grown and developed over the past thirty years. In large part, this reflects the theory's flexibility and the competent people who have worked to make RET one of the most viable and widely used cognitive-behaviour therapies. Of these, I modestly include myself! This article was originally presented as an Inaugural Lecture at Goldsmiths' College, University of London, on December 8, 1992.     

Frustration Discomfort Scale (FDS). A Psychometric Study of the Italian Version

The Frustration Discomfort Scale (FDS, Harrington 2005a) was developed as a multidimensional measure of frustration intolerance. Frustration intolerance plays an important role in behavioral and cognitive model of emotional problems (Harrington 2006). The aim of this study is to translate the original English version of FDS into Italian and to assess the validity and reliability of the Italian version for application among Italian population. The Italian version of FDS-R, with the Hospital Anxiety and Depression Scale were administered on-line to 497 subjects aged from 18 to 66 years old. The exploratory factor analysis suggested a solution with four factors, plus a general factor. The factor analysis supports a multidimensional model of frustration intolerance but the distribution of the items is different. The internal consistency appears optimal for all four factors (range .637–.866). Despite encouraging evidence, the factor structure and other features of the FDS-R are yet to be firmly established.     

中国父母关爱行为的多维度测量研究

运用问卷法,对北京905名中小学生及其父母进行了问卷测量,并用验证性因素分析对父母关爱行为的维度结构进行了检验.数据分析结果表明,与西方研究者所使用的单维度关爱结构不同,中国父母的关爱行为具有多维度结构,除了情感关爱之外,物质关爱(包括行为关爱和饮食关爱两种)也作为独立的维度单独存在.此外,数据分析显示,中国父母在情感关爱和饮食关爱上有较高的水平表现,小学生父母在情感、物质层面上的关爱表现水平要高于中学生父母,父母的情感关爱表现水平与其受教育程度之间存在着正向关联.并且,父母不同维度的关爱行为与不同年龄段及不同性别儿童的发展之间,展现出了不同的关联程度,因此也从另一侧面支持了父母关爱行为的多维度结构.     

The Complex Interplay Between Trait Fatigue and Cognition in Multiple Sclerosis

Cognitive impairments are frequent in patients with Multiple Sclerosis (MS). Yet, the influence of MS-related symptoms on cognitive status is not clear. Studies investigating the impact of trait fatigue along with anxio-depressive symptoms on cognition are seldom, and even less considered fatigue as multidimensional. Moreover, these studies provided conflicting results.Twenty-nine MS patients and 28 healthy controls, matched on age, gender and education underwent a full comprehensive neuropsychological assessment. Anxio-depressive and fatigue symptoms were assessed using the HAD scale and the MFIS, respectively. Six composite scores were derived from the neuropsychological assessment, reflecting the cognitive domains of working memory, verbal and visual learning, executive functions, attention and processing speed. Stepwise regression analyses were conducted in each group to investigate if trait cognitive and physical fatigue, depression and anxiety are relevant predictors of performance in each cognitive domain. In order to control for disease progression, patient’s EDSS score was also entered as predictor variable.In the MS group, trait physical fatigue was the only significant predictor of working memory score. Cognitive fatigue was a predictor for executive functioning performance and for processing speed (as well as EDSS score for processing speed). In the healthy controls group, only an association between executive functioning and depression was observed.Fatigue predicted cognition in MS patients only, beyond anxio-depressive symptoms and disease progression. Considering fatigue as a multidimensional symptom is paramount to better understand its association with cognition, as physical and cognitive fatigue are predictors of different cognitive processes.     

Development and validation of a Christian-based Grief Recovery Scale

The purpose of this study was to develop and validate a Christian-based Grief Recovery Scale (CGRS) which was used to measure Christians recovering from grief after a significant loss. Taiwanese Christian participants were recruited from churches and a comprehensive university in northern Taiwan. They were affected by both the Christian faith and Chinese cultural beliefs. The CGRS is developed through replicated factor analyses in three stages. The final version of the CGRS retains 35 Likert-type items and consists of six factors: spiritual well-being; recovering meaning and sense of control; ongoing physical and emotional responses; reassuring faith; strongly missing a deceased loved one; and life disturbance. The evidence for CGRS reliability and validity is highlighted. Implications for research and counselling practice are suggested.     

Paying attention to distress: What's wrong with rumination?

We explored the notion—derived from conceptualisations of mindfulness—that what makes attention to distress harmful is negative judgement about it. In Study 1 we examined factors of Nolen-Hoeksema's Ruminative Response Scale (RRS). A “Brooding” scale included items describing negative judgements of experience, and a “Reflection” scale, comprised items describing analysis of thoughts and feelings without obvious judgement. Correlations of Reflection with depression and thought suppression were lower than those for Brooding, but still significant, perhaps because all items implied some judgement. In Study 2, items were reworded to de-emphasise evaluative judgements (RRS-nonjudging) and compared to the original RRS. Although the factor structures of the original and RRS-nonjudging versions were essentially identical, the RRS-nonjudging Reflection scale was uncorrelated with depression and thought suppression, and was more highly correlated with emotional processing than was the original Reflection scale.     

Cognitive and functional deterioration in patients with severe COPD

The objective of this study was to examine the association among the duration of COPD, degree of hypoxemia, and neurological abnormalities including cognitive functioning. Fifty-four patients with severe COPD and 24 age- and sex-matched controls, were included in the study. All patients and controls were administered pulmonary function tests, standardized Mini-mental State Examination (MMSE), Blessed Dementia Scale (BDS), Physical Self-maintenance Scale (PSMS), Modified Activities of Daily Living scale (MADL), Instrumental Activities of Daily Living scale (IADL), Cornell Scale for Depression in Dementia (CSDD), Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR). In addition, detailed physical and neurological examinations were performed. Sixty-four percent of patients with COPD showed abnormalities in MMSE, predominantly in recent memory, construction, attention, language, and orientation domains. Functional abnormalities were correlated with cognitive abnormalities. Although COPD patients did not show significant depression compared to controls, 77.7%. of the patients showed subjective and objective cognitive disturbance and 72.2% of the patients were classified as questionable or mild dementia. In conclusion, patients with COPD show significant cognitive and functional impairments that cannot be explained just by coincidence or by depression.