Stress and family support as predictors of distress and rejection in people who care for a relative with schizophrenia

Relatives (N=121) of adult schizophrenia patients were interviewed to investigate predictors of their level of psychological distress and of rejecting attitudes toward the sufferer. The relatives' total stress, particularly that associated with poor communication skills in the sufferer, predicted several measures of their psychological distress, and the same variables plus turbulence of sufferer behavior (i.e., violence and disruptiveness) predicted rejection of the sufferer by the relative. In each case, adequacy of family support moderated the influence of the stressors, although this effect was more marked for distress outcomes than for rejection. The results have important implications for the sorts of professional and peer support which relatives may need to encourage their performance of this potentially burdensome role. In addition, the results fit a classic stress management model and provide a feasible alternative to the Expressed Emotion Model of the relationship between relatives' rejection and patients' illness severity.     

Spirituality,quality of life,and depression in older people with dementia

ABSTRACT

This study aimed to observe dementia’s role in the relationship between spirituality, quality of life, and depression in aging. The sample included 61 participants between 65 and 98 years old, separated into two groups: participants diagnosed with dementia (N = 31) and control participants (N = 30). There was no significant difference in spirituality between demented and control participants; however, different patterns of correlation were observed between spirituality, depression, and quality of life in these groups. Although the level of spirituality did not differ despite dementia, this pathology would appear to play a role in the relationship between spirituality, quality of life, and depression.     

Subjective quality of life of surgically treated glioma patients undergoing polychemotherapy

25 patients with glioma were questioned as to how they apprehended and appreciated their state of health and their psychosocial situation 1 1/2 years (s = 4 months) after the start of their postoperative polychemotherapy. In their opinion, their health was relatively good, that is, they claimed to suffer little pain, few complaints, little feeling of inadequacy, few fears for the future. They regarded the mode of treatment as being somewhat more inconvenient. Such an unexpectedly positive response, in view of the poor prospect, raises the question as to its provenance. A significant cause is seen in the organic psycho-syndrome, and its significance is made the subject of the concluding discussion, with reference to adaptation mechanisms and specifics of the illness.     

Avoidance and personal and occupational quality of life in French people with driving anxiety

Driving anxiety can have a significant impact on one’s quality of life, particularly for those who experience intense levels. However, to date there are limited data about the perceived impact of driving anxiety on occupational life, and driving anxiety remains under-researched in France. To address this gap, an online survey assessing self-reported driving anxiety, how it manifests and its links with some aspects of personal and occupational life was designed. The survey was administered in France to respondents who identified as experiencing driving anxiety. Responses were obtained from 304 people aged 18 years or older. In the sample, 32.2%, 44.7% and 23% respectively reported mild, moderate and extreme levels of driving anxiety. In the extremely anxious group, males were under-represented, whereas people aged 35–44 and unlicensed drivers were over-represented. People who were unemployed (excluding students and retired people), reported that their anxiety had been a barrier to getting a job and a high percentage of these respondents had also previously considered leaving a position because of their anxiety. Respondents also reported their anxiety had a negative impact on their perceived quality of life in general. People who categorised as extremely anxious reported a negative impact four times higher than those in the mildly anxious group.The results highlight for the first time the perceived impact of driving anxiety on daily and occupational life in a French population. Further, the results demonstrate the importance of distinguishing between moderately and extremely anxious drivers as the intensity level has differential impacts on personal and work life quality.     

Single-item vs multiple-item measures of health-related quality of life

Many survey instruments measure health-related quality of life. Researchers can choose from instruments ranging in length from one to several hundred items. A small sample of 35 chronically ill adults self-administered the Short-form General Health Survey of the Medical Outcomes Study, a 20-item health-related quality-of-life measure with established reliability and validity. One specific item on the MOS questionnaire can serve as a single-item measure of health-related quality of life. This one item correlated positively and significantly with the over-all score for health-related quality of life. The results of this analysis support the use of this single-item measure of health-related quality of life when multiple-item instruments are not suitable due to limitations of resources or sample size.     

Psychological predictors for health-related quality of life and disability in persons with chronic obstructive pulmonary disease (COPD)

Objective: Individuals with chronic obstructive pulmonary disease (COPD) exhibit low physical and mental health-related quality of life (HRQL) and high susceptibility to disability. We investigated the influence of psychological factors on HRQL and disability in COPD individuals recruited from the general population. In line with Leventhal’s common sense model, we expected psychological factors to be associated with HRQL and disability even after controlling for medical status.

Methods: Individuals with COPD (n = 502; 59.7 years old; GOLD grades were I: 3%, II: 17%, III: 34%, IV: 46%) were assessed through an online survey administered via COPD patient organisations in Germany. Individuals filled in the Short Form Health Survey (SF-12), COPD Assessment Test, Patient Health Questionnaire (modules: GAD-2, PHQ-15, PHQ-9), Brief Illness Perception Questionnaire, a questionnaire that assesses causal illness attributions, and the internal illness-related locus of control scale of the ‘KKG questionnaire for the assessment of control beliefs about illness and health’. Multiple linear regressions were calculated.

Results: The investigated factors explained high variances (disability = 56%, physical HRQL = 28%, mental HRQL = 63%, p ≤ .001). Better mental health, more optimistic illness perceptions, attribution to psychological causes, and stronger internal locus of control were associated with lower disability and better HRQL. Comorbid somatic symptoms contributed to high disability and low quality of life.

Conclusion: Psychological factors, such as illness perception, attribution and internal locus of control, were associated with disability and HRQL. These factors should be considered when designing treatments for individuals with COPD, and adequate interventions should be provided to enhance illness understanding and self-management skills.     

Subjective measures of awareness and implicit cognition

In this article, we examine whether artificial grammar learning is implicit according to a subjective criterion of awareness based on confidence ratings. In four experiments, participants discriminated between grammatical and ungrammatical sequences in both the same (Experiment 1) and a novel (Experiments 2-4) vocabulary and indicated their confidence in each decision. Replicating earlier studies, confidence judgments reported on a continuous scale (50%-100%) were only weakly related to accuracy, suggesting that learning was implicit. In contrast, confidence judgments reported on a binary scale (high vs. low) revealed that confidence was related to accuracy. We show that participants are better able to place their phenomenal states on a binary scale, as compared with a continuous scale.     

Optimism, promotion pride, and prevention pride as predictors of quality of life

The relationship between optimism and two potential sources of optimistic beliefs--promotion pride (based on a history of success in promotion regulation) and prevention pride (based on a history of success in prevention regulation)--was explored. Optimism was more strongly related to promotion pride than prevention pride (controlling for neuroticism), consistent with past work showing that anticipating success increases eagerness motivation but decreases vigilance motivation. This suggests that the psychology of prevention regulators is not captured well by the existing literature on optimism. Although prevention pride does not predict self-reports of well-being, it does predict adaptive functioning independent of optimism, neuroticism, and promotion pride. Promotion pride uniquely predicted a sense of purpose in life or goal directedness. Both promotion and prevention pride predicted active coping. It is argued that promotion and prevention pride tell us something unique and important about the role of successful self-regulation in determining quality of life.     

A comparison of projective and objective fear-of-success and sex-role orientation measures as predictors of women's performance on masculine and feminine tasks

This study compared projective and objective measures of fear of success (FOS) with each other and with a measure of sex-role orientation as alternative predictors of 309 college women's achievement behavior on masculine and feminine tasks. Neither the sex role nor the FOS measures predicted substantial performance differences on the masculine or feminine tasks, although the objective FOS scales and the Bem Sex Role Inventory did predict subjects' stated investment in the task and attributions for success in a manner generally consistent with FOS theory. In addition, the objective FOS scales showed strong relationships with achievement motivation and sex-role orientation, while TAT (Thematic Apperception Test) FOS was unrelated to either of these variables. The results provide partial support that objective FOS scales tap actual avoidance tendencies characteristic of traditionally feminine women, while the TAT measure reflects, at most, an ambivalence over success which may be equally characteristic of high achieving, nontraditional women and low achieving, traditional women.The research reported here was supported by Grant 1 R03 MH 28835-01 from the U.S. Department of Health, Education and Welfare.     

Health-related quality of life among people living with hiv disease in small communities and rural areas

Abstract

While many studies have examined the life quality of HIV-infected persons in large metropolitan areas, few studies have investigated quality of life issues among persons living with HIV disease in America's small and rural communities. In the present study, 78 people living with HIV/AIDS in small and rural communities (i.e., populations <25,000) reported on their health-related quality of life. Many respondents reported decreased social, emotional, functional, and physical well-being. Results revealed that participants' emotional well-being and the quality of their relationship with their doctor were related to their overall quality of life. The majority of participants (73%) expressed interest in participating in a telephone-linked support group involving other people living with HIV designed to improve quality of life.     

Therapist attitudes and countertransference as predictors of professional quality of life and burnout among psychotherapists

This study aimed to examine the role of attitudes towards psychotherapy and countertransference dimensions as predictors of professional quality of life and burnout among psychotherapists in Iran. Participants were 259 psychotherapists who worked in mental health centres in Tehran (Iran), and they completed the Professional Quality of Life questionnaire, the Therapist Response Questionnaire and the Therapist Attitudes Scale. Professional quality of life was associated with countertransference dimensions and attitude towards psychotherapy. This study concludes that psychotherapists can benefit from working on their specific countertransference issues and re-evaluating their basic attitudes towards psychotherapy to achieve the highest levels of professional satisfaction. Culture may play a role in a specific therapist's attitude and difficulties in addressing certain aspects of countertransference.     

Trauma and posttraumatic stress disorder in people with schizophrenia

This study evaluated the hypothesis that trauma and posttraumatic stress disorder (PTSD) severity would be positively associated with schizophrenia symptoms. Forty-seven clients with schizophrenia were assessed for schizophrenia severity and for lifetime trauma history and PTSD symptoms in 2 independent symptom interviews; 35 (74%) participants reported at least 1 event in which there was threat of harm or life threat and subjective distress, and 6 (13%) had current PTSD. Trauma across the life span was associated with greater severity of PTSD. Within the total sample, PTSD symptoms were associated with greater emotional distress, but not with schizophrenia-specific symptoms. Distress among clients with schizophrenia and PTSD suggests the need for routine assessment of PTSD and development of PTSD interventions in this population.     

Subjective health complaints and health related quality of life in a population of health care workers

The aim of this study was to assess whether Subjective Health Complaints (SHC), demands and coping are associated with health-related quality of life in a population of health care workers. One hundred and nineteen employees in two nursing homes for the elderly filled in a questionnaire on health, exercise, psychological factors, and work conditions. Main outcome measures were SHC and quality of life measured by SF-36. High level of SHC was associated to low health-related quality of life. Low coping and high demands were related to low scores (low quality of life), and high coping and low demands to high scores on mental health. Pseudoneurological complaints (e.g. tiredness, sadness), high demands and low coping were associated with low mental health. The expected negative association between SHC and health-related quality of life was found. There was a positive association between coping and quality of life.     

Validation of physical activity habit strength with subjective and objective criterion measures

ObjectivesA German version of the Self-reported Habit Strength Index (SRHI) for both sports and everyday physical activity (PA) was validated against subjective and objective criterion measures of PA.Design and methodData were obtained from 260 participants (21.4% women) in study 1 and 86 participants (58.1% women) in study 2. Both studies assessed habit strength for PA (sports and everyday PA) by the SRHI and PA by the Baecke Questionnaire (Sport, Leisure and Work Index) as subjective criterion measure, as well as by accelerometry (Step Activity Monitor or GTM1 Actigraph) as objective criterion measure. Bivariate correlations as well as path analyses were computed for the associations between the SRHI scores and subjective and objective criterion measures of PA.ResultsHighest associations for subjective criterion measure were found for habit strength for sports and the Sport Index in both studies. The Leisure Index was predicted by habit strength for sports and everyday PA. For objective criterion measures, habit strength for sports was most significantly associated with total PA in study 1 and moderate intense PA in study 2. Habit strength for everyday PA was a significant predictor of moderate intense and total PA in study 1 and low intense PA in study 2.ConclusionThe present studies replicated high internal consistencies of the SRHI for sports and everyday PA and could partially confirm their validity with subjective and objective criterion measures. The SRHI for sports seems to be more robust than the SRHI for everyday physical activity.     

Coping and quality of life after tumor surgery: personal and social resources promote different domains of quality of life

Personal and social resources facilitate the adaptation to critical life events. The present study investigates whether general self-efficacy beliefs and received social support elevate cancer patients' physical, emotional, and social well-being directly, or whether these effects are rather mediated by active or meaning-focused coping. Gastrointestinal, colorectal, and lung cancer patients were approached at 1 month and at 6 months after surgery (N=175). Structural equation models indicate that self-efficacy at 1 month after surgery exerted a positive direct effect on all three domains of health-related quality of life at 6 months after surgery, but indirect effects through active and meaning-focused coping were also observed. Initial received support elevated later emotional well-being, but not the other two quality of life domains. This effect was not mediated by coping. Results suggest the development of interventions to increase optimistic self-beliefs and coping skills in tumor-surgery patients.