Cognitive organization of disease concepts in Singapore

Abstract

This research investigates illness cognition and its relationship to the use of different types of medicine in three ethnic groups in Singapore. Four hundred and twenty-nine Chinese, Malay, and Indian Singaporeans rated 24 diseases as to their similarity. Multidimensional scaling (MDS) indicated three dimensions. Regression of these dimensions against 17 disease attributes suggested that these dimensions represented spiritual/psychological causation, disease severity, and viral causation. When the dimensions were related to the use of, preference for and perceived effectiveness of different types of medicine it was found that Indian medicine tended to be used, preferred and perceived to be most effective for diseases low in severity whereas Chinese medicine was viewed most favourably for diseases perceived to be low in spiritual/psychological causation as well as those not seen as virally caused. Malay medicine tended to used, preferred and perceived as most effective for conditions believed to be non-serious and not caused by a virus. Western medicine was most likely to be used, preferred, and seen as most effective for diseases viewed as serious as well as those believed to be virally caused.     

Cross-Sectional and Longitudinal Associations between Leisure Time Physical Activity,Mental Well-Being and Subjective Health in Middle Adulthood

Previous studies have shown that participation in leisure time physical activity is related to better mental well-being and subjective health. However, the associations between different types of leisure time physical activities and different dimensions of mental well-being have rarely been studied. In addition, longitudinal research, analyzing possible causal relations between these variables, is lacking. To investigate these research questions, data gathered at ages 42 and 50 (present N = 303) for the Finnish Jyväskylä Longitudinal Study of Personality and Social Development were used. Physical activity was assessed as frequency of participation at ages 42 and 50, and at age 50 also as frequency of participation in different types of physical activities. Mental well-being was captured by emotional, psychological and social well-being and subjective health by self-rated health and symptoms. Cross-sectionally, different types of physical activities were related to different dimensions of well-being. Walking had positive associations with psychological and social well-being, rambling in nature with emotional and social well-being, and endurance training with subjective health. Rambling in nature was also positively related to subjective health but only among men. Longitudinally, mental well-being predicted later participation in leisure-time physical activity, whereas no longitudinal associations between subjective health and physical activity were found. The results suggest that leisure time physical activities are related to current mental well-being and subjective health in midlife. Across time, good mental well-being seems to be a resource promoting engagement in physical activity.

     

The Relationship of Participation in Sports and Physical Activity to Body Objectification, Instrumentality, and Locus of Control Among Young Women

The primary purposes of this study were to assess the possible relationship of sports participation during high school to body self-objectification, instrumentality, and locus of control, and to explore the possibility that different sports might be differentially related to psychological variables according to the perceived stereotypical masculinity or femininity of the sport. Two studies were reported herein. In the first, using 195 male and female students, we examined perceptions of sports according to emphasis on physical appearance and perceived masculinity/femininity. These findings were used in Study 2, which included 437 college women, to describe sports participation along dimensions of both extent of participation and the nature of the sports in which the individual participated. Extent of participation in physical fitness activity was also assessed. Participation in sports and/or physical activity was associated with higher scores on the body shame subscale of McKinley and Hyde's (1996) Objectified Body Consciousness Scale, which indicates greater internalization of cultural standards of female beauty. Body shame was also related to participation in more "feminine" sports (those focusing more on female appearance). Physical activity was also consistently related to both instrumentality and locus of control. Further research is needed to understand the relationship of sports and physical exercise activities to body self-objectification and other indicators of psychological functioning among women.     

Development and validation of the Maladaptive Daydreaming Scale (MDS)

This study describes the development of the Maladaptive Daydreaming Scale (MDS), a 14-item self-report instrument designed to gauge abnormal fantasizing. Our sample consisted of 447 English-speaking individuals from 45 different countries. A 3-correlated-factors model best presented the underlying dimensions Yearning, Kinesthesia and Impairment, capturing related rewarding experiences as well as psychological impairment of maladaptive daydreaming. MDS scores were associated with obsessive–compulsive behavior and thoughts, dissociative absorption, attention deficit, and high sense of presence during daydreaming, but less with psychotic symptoms. The MDS and its subscale demonstrated good validity, sound internal consistency and temporal stability and discriminated well between self-identified individuals with and without maladaptive daydreaming. Considering the instrument’s high sensitivity and specificity levels, it seems an excellent measure for future investigation of MD that will, hopefully, shed light on the etiology and psycho-biological mechanisms involved in this mental condition, as well as on the development of effective MD treatment methods.     

Anxiety sensitivity cognitive concerns drive the relation between anxiety sensitivity and symptoms of depression

Depression is typically treated as a homogeneous construct despite evidence for distinct cognitive, affective, and somatic symptom dimensions. Anxiety sensitivity (AS; the fear of consequences of anxiety symptoms) is a cognitive risk factor implicated in the development of depressive symptoms. However, it is unclear how lower order AS dimensions (i.e. physical, cognitive, and social concerns) relate to depressive symptom factors. Confirmatory factor analysis, followed by structural equation modeling, were conducted to examine the factor structure of depression and to then examine the relations between these factors and the lower order factors of AS. This study was conducted in a sample of 374 adults (M age = 35.5, 54.3% female) with elevated levels of psychopathology (89.2% meeting criteria for at least one DSM-5 diagnosis, 25.6% primary depressive disorder). In this study a two-factor model of depression, composed of Cognitive and Affective/Somatic factors, was superior to one- and three-factor solutions. AS cognitive concerns were related to both cognitive and affective/somatic symptoms of depression. Neither of the other AS dimensions was related to depression symptom dimensions. These findings provide a better understanding of the relations between AS and depression symptoms.     

The relationship between anxiety sensitivity and latent symptoms of emotional problems: A structural equation modeling approach

A large body of research suggests that common and specific psychopathology dimensions underlie the symptoms that occur within mood and anxiety disorders. As of yet, it is unclear precisely how the facets of Anxiety Sensitivity (AS), or fear of the symptoms of fear and anxiety, relate to these latent factors. Using data from 606 adolescents participating in the baseline phase of a longitudinal study on risk factors for emotional disorders, we modeled the facets of AS as measured by the Anxiety Sensitivity Index-Expanded Form (ASI-X) and related these facets to a hierarchical model of latent symptoms of psychological distress. Results suggest that one facet of AS is associated with a broad General Distress factor underlying symptoms of most emotional disorders while others relate to intermediate-level and conceptually-meaningful narrow factors representing aspects of psychological distress specific to particular emotional disorders.     

Gender Conceptualizations in Female High School Seniors: Relationships with Global Self-Worth and Multiple Measures of Body Image

This study was conducted to determine if gender-role conceptualizations in adolescent girls were related to their global self-worth and several dimensions of their body image. Self-report surveys were administered to 335 predominantly Caucasian Grade 12 girls from religiously-based high schools in the midwestern part of the United States. It was hypothesized that adolescent females?? gender-typing of themselves as well as their gender-related attitudes towards others would be significantly, and possibly divergently, related to their perceptions of themselves and their physical bodies. Obtained data were analyzed using multivariate canonical correlation procedures. The results of these analyses revealed support for the predicted overall relationship between gender conceptualizations and self-perceptions, but also indicated some differences in the way in which the two dimensions of gender-role conceptualizations (personal and attitudes towards others) were associated with adolescents?? perceptions of themselves. Specifically, girls exhibiting more egalitarian gender-related attitudes towards others scored higher on global self-worth and lower in body appearance orientation. In addition, higher self-endorsement on the masculine subscales was linked with higher global self-worth, lower social physique anxiety, and higher use of competence to evaluate the physical body. In contrast, high self-endorsement on the feminine subscales exhibited mixed links to the set of self-perceptual variables.     

Effects of excessive Internet use on undergraduate students in Pakistan.

This study was undertaken to investigate the positive and negative effects of excessive Internet use on undergraduate students. The Internet Effect Scale (IES), especially constructed by the authors to determine these effects, consisted of seven dimensions namely: behavioral problems, interpersonal problems, educational problems, psychological problems, physical problems, Internet abuse, and positive effects. The sample consisted of 200 undergraduate students studying at the GC University Lahore, Pakistan. A set of Pearson Product Moment correlations showed positive associations between time spent on the Internet and various dimensions of the IES indicating that excessive Internet use can lead to a host of problems of educational, physical, psychological and interpersonal nature. However, a greater number of students reported positive than negative effects of Internet use. Without negating the advantages of Internet, the current findings suggest that Internet use should be within reasonable limits focusing more on activities enhancing one's productivity.     

The association between psychological distance and construal level: evidence from an implicit association test

According to construal level theory (N. Liberman, Y. Trope, & E. Stephan, in press; Y. Trope & N. Liberman, 2003), people use a more abstract, high construal level when judging, perceiving, and predicting more psychologically distal targets, and they judge more abstract targets as being more psychologically distal. The present research demonstrated that associations between more distance and higher level of construal also exist on a pure conceptual level. Eight experiments used the Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998) to demonstrate an association between words related to construal level (low vs. high) and words related to four dimensions of distance (proximal vs. distal): temporal distance, spatial distance, social distance, and hypotheticality. In addition to demonstrating an association between level of construal and psychological distance, these findings also corroborate the assumption that all 4 dimensions of psychological distance are related to level of construal in a similar way and support the notion that they all are forms of psychological distance.     

Cluster Analysis of the Yale Global Tic Severity Scale (YGTSS): Symptom Dimensions and Clinical Correlates in an Outpatient Youth Sample

Tic disorders are heterogeneous, with symptoms varying widely both within and across patients. Exploration of symptom clusters may aid in the identification of symptom dimensions of empirical and treatment import. This article presents the results of two studies investigating tic symptom clusters using a sample of 99 youth (M age = 10.7, 81% male, 77% Caucasian) diagnosed with a primary tic disorder (Tourette’s disorder or chronic tic disorder), across two university-based outpatient clinics specializing in tic and related disorders. In Study 1, a cluster analysis of the Yale Global Tic Severity Scale (YGTSS) identified four symptom dimensions: predominantly complex tics; simple head/face tics; simple body tics; and simple vocal/facial tics. In Study 2, these clusters were shown to be differentially associated with demographic and clinical characteristics. Findings lend support to prior research on tic phenomenology, help to organize treatment goals, and suggest symptom dimensions of tic disorders for further evaluation.     

Appraised psychological workload, musculoskeletal symptoms, and the mediating effect of fatigue: a structural equation modeling approach

The aim of the present study was to test two structural models of the relationship between appraised psychological workload and musculoskeletal symptoms from the neck, shoulder, and upper and lower back with different aspects of perceived fatigue as mediating variables. In this cross-sectional study a questionnaire survey was conducted among employees at three Swedish assembly plants (n= 305). The proposed models were tested for one general fatigue dimension--lack of energy--and four specific fatigue dimensions--physical discomfort, physical exertion, lack of motivation, and sleepiness--using structural equation modeling. The results indicate that the role of perceived fatigue in the relationship between appraised workload and musculoskeletal symptoms is different for different aspects of fatigue. The general fatigue dimension, lack of energy, does not mediate the relationship. As regards the specific fatigue dimensions, the relationship is partially mediated by physical discomfort and lack of motivation but not by physical exertion or sleepiness. Appraised psychological workload has a unique effect on musculoskeletal symptoms not mediated by fatigue.     

A multidimensional scaling analysis of own- and cross-race face spaces

We examined predictions derived from Valentine’s (1991) Multidimensional Space (MDS) framework for own- and other-race face processing. A set of 20 computerized faces was generated from a single prototype. Each face was saved as Black and White, changing only skin tone, such that structurally identical faces were represented in both race categories. Participants made speeded “same-different” judgments to all possible combinations of faces, from which we generated psychological spaces, with “different” RTs as the measure of similarity. Consistent with the MDS framework, all faces were pseudo-normally distributed around the (unseen) prototype. The distribution of faces was consistent with Valentine’s (1991) predictions: despite their physical identity to the White faces, Black faces had lower mean inter-object distances in psychological space. Other-race faces are more densely clustered in psychological space, which could underlie well-known recognition deficits.     

Incremental associations between facets of anxiety sensitivity and posttraumatic stress and panic symptoms among trauma-exposed adults

The present investigation examined incremental associations between anxiety sensitivity (AS) subfactors (e.g. physical, psychological, and social concerns) and posttraumatic stress and panic symptoms among trauma-exposed adults. These effects were examined above and beyond other theoretically relevant factors, including negative affectivity and number of types of trauma exposures. The 239 participants were selected from a university- and community-based sample (129 women; mean age = 23.0 years; SD = 9.6, range = 18-65), all of whom endorsed exposure to traumatic life events. The AS psychological concerns and AS physical concerns lower order factors evidenced distinct associations with posttraumatic stress symptoms and panic-relevant symptoms, respectively. Specifically, the AS psychological concerns facet was significantly incrementally predictive of posttraumatic stress-relevant avoidance symptoms. The AS physical concerns facet was significantly incrementally predictive of panic-relevant symptoms, including anxious arousal, body vigilance, and perceived control over anxiety-related events. Results are discussed in the context of the relevant theoretical literature pertaining to shared vulnerability and comorbidity between posttraumatic stress and panic.     

Do similar patient and spouse perceptions of myocardial infarction predict recovery?

The present study examines whether the degree of congruence between the patient's and the partner's perceptions of myocardial infarction (MI) has an influence on a range of recovery outcomes in the patient. The MI perceptions of 70 Portuguese couples in which the male had suffered a first heart attack were assessed at 3 months after discharge from hospital, using the Illness Perception Questionnaire (IPQ). Several dimensions of patient recovery were assessed at 3, 6 and 12 months post-MI, using standardised measures of psychological well-being, return to work, disability, social functioning, sexual functioning, and indices of lifestyle changes. The degree of congruence in each couple's illness perceptions was assessed and related to each outcome measure. The results suggest that the degree of congruence between patients and partners in their illness perceptions was related to different dimensions of recovery at 3, 6 and 12 months. The results revealed that in couples who had similar positive perceptions of the identity and consequences of the MI, patients showed (a) better physical and psychological functioning, (b) better sexual functioning, and (c) less impact of MI on social and recreational activities. Also, similar positive perceptions of timeline were associated with lower levels of disability, and similar positive cure/control beliefs were linked with greater dietary changes. Separate analyses showed that these effects were not confounded with marital functioning. This study provides clear evidence that the degree of match/mismatch between the patient's and partner's perceptions of the MI is associated with a range of recovery outcomes.     

II—Control Variables and Mental Causation

I introduce the notion of a 'control variable' which gives us a way of seeing how mental causation could be an unproblematic case of causation in general, rather than being some sui generis form of causation. Psychological variables may be the control variables for a system for which there are no physical control variables, even in a deterministic physical world. That explains how there can be psychological causation without physical causation, even in a deterministic physical world.     

Symptom patterns in late luteal-phase dysphoric disorder

The symptom patterns of 180 women with prospectively confirmed late luteal-phase dysphoric disorder (LLPDD) were examined using a careful application of factor and cluster analytic techniques. Factor analysis of premenstrual change scores on 33 common premenstrual syndrome symptoms yielded four orthogonal factors that were consistent across two sets of menstrual cycle data. These were a negative affect dimension with concomitant behavioral changes, physical symptoms, agitation, and positive arousal. Cluster analysis of factor scores grouped patients into one of five symptom patterns, the most common of which is a general distress cluster, characterized by symptoms across all dimensions. The LLPDD symptom groups identified are remarkably consistent with those of earlier studies using both normative and clinic samples, and consideration of symptom pattern differences in future research may greatly increase our understanding of this disorder.     

Psychological Adaptation of Chinese Sojourners in Canada

Psychological adaptation during acculturation was studied among 68 Chinese sojourners (students and visiting scholars from China and Hong Kong), 28 Chinese immigrant and Chinese-Canadian students, 30 Chinese students and scholars in China, and 33 non-Chinese Canadian students. Each participant completed questionnaires pertaining to various aspects of their lives and personalities, including: health beliefs and behaviours; problems and ways of coping; social contact and acculturation attitudes; psychological and physical health; and subjective adaptation. The Chinese sojourners reported lower English fluency, lower ease of making friendships, more adaptation and communication problems, and lower subjective adaptation than non-Chinese Canadian, or Chinese-Canadian students. The Chinese sojourners experienced less desired and actual contact, more contact incongruity, more separation and less assimilation than Chinese-Canadian students. The Chinese sojourners reacted to their problems with less wishful thinking and self-blame, and more tension reduction, and the seeking of informational support than non-Chinese Canadian students. There were significant differences between groups in health concept and health causation, and believed and utilized health ways. Health causation, and believed and utilised health ways were the most important factors influencing the Chinese sojourners' health status. The Chinese sojourners experienced more problems, but tended to use fewer health ways after-arrival than pre-departure. The Chinese also experienced poorer health, especially poorer psychological health after-arrival than pre-departure. The longitudinal and cross-sectional analysis of the Chinese sojourners' Cawte scores supported the U-curve hypothesis.     

The experience of psychological therapies for people with multiple sclerosis: A mixed-methods study towards a patient-centred approach to exploring processes of change

Psychological therapies are effective for managing multiple sclerosis (MS) symptoms such as depression, pain and fatigue. Cognitive behavioural therapy (CBT), mindfulness and other theory-led approaches have been applied and were found to have moderate effects. The present study adopts a patient-led approach to investigate people with MS' (PwMS) experiences of psychological therapies and the change processes they identify. In this naturalistic, mixed-methods design, semistructured interviews were conducted and three questionnaires were administered to 20 PwMS at two different times. Qualitative data collection and analysis followed the interpretative phenomenological analysis (IPA) guidelines, and quantitative data were analysed using paired t tests. Four superordinate themes described the participants' experiences of change as related to their psychological therapy: from despair to relief; from feeling their body as alien to becoming acquainted with an unpredictable new body; from helplessness to empowerment; and from punishment to forgiveness. Quantitative results showed that physical function and general health perception improved, and anxiety was significantly reduced. Despite seeking help from diverse psychological therapy modalities, the analysis revealed common themes that the participants found significant in their therapy stories. Following a patient-centred approach, the development of psychological therapies for PwMS should focus on their relationships, everyday lives, body perception, losses, shame and guilt. PwMS also need to be understood and acknowledged beyond their condition.     

Relations between physical activity, weight discrepancies, body-cathexis, and psychological well-being in college women

This study examined the relations between physical activity, weight discrepancies, body-cathexis, and indicators of psychological well-being in college women. Factor analysis and zero-order correlation, and partial correlation analyses show that physical activity was not directly related to psychological well-being, however, physical activity did reduce weight discrepancies and improved body-cathexis. When specific body types were examined, there were distinctive patterns of satisfaction with body parts and processes depending on whether the women's body types conformed to or deviated from idealized weights and heights.