Illness perception in people with chronic obstructive pulmonary disease

Illness perception (IP) concerns how patients evaluate living with a disease. To get a broader understanding of IP in patients with chronic obstructive pulmonary disease (COPD), we investigated whether breathlessness is an important precursor of IP and whether IP in its turn is related to mental health, physical health and global quality of life (QOL). One hundred and fifty‐four patients with COPD participated in a cross‐sectional survey. Participants underwent pulmonary function testing, provided socio‐demographic and clinical information, and completed the following standardized instruments: Brief Illness Perception Questionnaire, Respiratory Quality of Life Questionnaire, Short‐Form 12 Health Survey and the Quality of Life Scale. Multiple regression analyses were performed. A high IP score indicates that a patient believes that his/her illness represents a threat. Participants with a high score on the IP dimensions consequences, identity, concern and emotional representation, experienced more breathlessness. High scores on the IP dimensions consequences, identity and concern were associated with impaired physical health and high scores on the IP dimensions consequences, identity and emotional representation were associated with impaired mental health. Impaired global QOL was associated with high scores on the IP dimensions consequences, identity, concern, coherence and emotional representation. The strength of the associations between breathlessness and physical/mental health and global QOL decreased when certain dimensions of IP were included as predictors, indicating that IP to some extent acts as a mediating factor. These findings may have practical implications of patient counselling by helping COPD patients to cope with their disease by restructuring their personal models of illness.     

Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction--the Swedish version

When people's health is threatened, they generally develop illness perceptions to make sense of their illness. The Illness Perception Questionnaire (IPQ-R), developed by Moss-Morris et al (2002), has been widely used in many countries to measure such representations. However, since studies in this crucial research area are lacking in Sweden a Swedish version of IPQ-R was validated with a focus on the seven subscales: timeline acute/chronic, timeline cyclical, consequences, personal control, treatment control, illness coherence and emotional representations. Using confirmatory factor analysis, the aim of the present study was to validate the internal structure of the Swedish version in a sample of 202 persons (144 men and 58 women) who had been diagnosed with myocardial infarction four months earlier. Additionally, inter-correlations among the seven subscales and external concurrent validity were also investigated. The results of confirmatory factor analysis revealed that, in line with the English version of the IPQ-R, the specified seven-factor model had a satisfactory fit. One item was however not considered reliable and was therefore excluded from the instrument. The internal consistency (Cronbach's alpha coefficients) and the inter-factor correlations were relatively similar to those reported in the validation study of the original English IPQ-R. In tests of concurrent validity, the seven IPQ-R subscales were, as hypothesized, mainly associated with external variables. To conclude, the Swedish version of the IPQ-R's seven dimensions, with one item removed, (total 37 items) was found to be a reliable and valid measure of illness perception.     

Psychological and Somatic Factors in Patients Undergoing Coronary Artery Bypass Graft Surgery: Towards Building a Psychological Framework

The present study explored the relationships between psychological and somatic factors in patients undergoing Coronary Artery Bypass Graft surgery (CABG). The data-analysis of previous work was extended by adding somatic factors, including feelings of disability, somatic complaints and fatigue. The focus was on their relationships with psychological factors, including anxiety, depression and neuroticism. Prior to surgery and six months postoperatively, 217 patients completed self-report questionnaires. Using the method of structural equation modeling (SEM), the structure of relationships between the somatic, psychological and background factors (i.e., gender, age and medical factors) was explored. A model was developed providing a good fit and accounting for a substantial amount of variance. The structure of relationships revealed that somatic factors lead to anxiety and depression in the preoperative period, whereas anxiety and depression lead to somatic factors in the postoperative period. The structure further strengthened the key position of neuroticism and its overall negative prognostic implications.     

Illness perceptions in dialysis patients and their association with quality of life

The present study explored illness perceptions of end stage renal disease (ESRD) patients on both haemodialysis (HD) and peritoneal dialysis (PD) treatment, and their associations with quality of life. Leventhal's self-regulation model (SRM) was used as a theoretical framework. Illness perceptions and quality of life were assessed with the IPQ-R and the SF-36 in 91 HD and 42 PD patients participating in the NECOSAD-study. Compared to HD patients, PD patients experienced more personal control and had a better understanding of the illness. Illness perceptions explained from 17 to 51% of the variance in quality of life scores. Perception of more symptoms, more consequences and lower personal control were associated with lower well-being. The concept of illness perceptions is useful in understanding the impact of ESRD and of dialysis treatment on quality of life. Interventions aimed at providing more knowledge about ESRD and dialysis, and provision of skills to coping with the illness and its consequences may improve quality of life in dialysis patients.     

单纯糖耐量受损的冠心病患者临床及冠脉造影特点分析

入选空腹血糖正常并通过冠脉造影（CAG）确诊为冠心病（CAD）的患者104例行糖耐量试验（OGTT ）,将糖耐量正常（NGT ）者、单纯负荷后2h 血糖受损者（I-IGT ）与同期合并糖尿病（DM ）并通过 CAG 确诊为 CAD 的患者38例对照。结果,（1）DM 组甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（LDL-C）、载脂蛋白（Apo）、高敏-C 反应蛋白（hs-CRP）、尿微量白蛋白、尿酸（UA）高于 NGT 组（P＜0．05或 P＜0．01）,且 I-IGT 组体质量指数（BMI）最大,与 NGT组及 DM 组比较有统计学意义（P＜0．01）;（2）I-IGT 、DM 组冠状动脉病变支数、重度狭窄、闭塞、弥漫性病变、病变总积分、右冠状动脉病变比例均高于 NGT 组（P＜0．05或 P＜0．01）;（3）DM 组三支病变、弥漫性病变、冠状动脉病变总积分均高于 I-IGT 组（P＜0．05）。因此,空腹血糖正常的 CAD 患者均应行 OGTT 检查,以降低糖耐量异常的漏诊率;I-IGT 患者发生心血管疾病的危险性增加,且随着糖代谢异常的加重而加剧,应及早干预。     

Illness perceptions and coping explain well-being in patients with Huntington's disease

This study sought to investigate the contribution of illness perceptions and coping mechanisms to the explanation of well-being of patients with Huntington's disease (HD). We investigated the Leventhal et al. assumption of the Self-regulation Model that coping mediates the relationship between illness perceptions and patients’ well-being. Illness perceptions, coping, and well-being in 77 HD patients were assessed with validated questionnaires; motor performance and cognitive performance were assessed with Huntington's disease-specific measures. The assumption that illness perceptions influence HD patients’ well-being via coping was not supported. The results indicate that both coping and illness perceptions made a major contribution to the explanation of variance in HD patients’ psychosocial well-being. Variance in their physical well-being was explained by illness perceptions mainly. The need to conduct further research on the interrelationships between illness perceptions, coping, and well-being in this patient category is discussed.     

Impaired tactual perception in children with Down's syndrome

Using standardized neuropsychological tests, tactual finger discrimination, graphaesthesia and stereognosis were studied in a group of 11 children aged 7–11 years with Down's syndrome (DS). All tasks were solved without visual control. The performance was subnormal in each test and the results of the stereognosis test were particularly poor. It was ascertained that the DS children could understand test instructions. Moreover, under visual control all objects used in the stereognosis test were handled correctly. The results suggest that tactual perception is subnormal in children with DS. The pathogenesis of the somatosensory abnormalities should be explored.     

The perception of available social support is related to reduced cardiovascular reactivity in phase II cardiac rehabilitation patients

Objective  Numerous studies have observed a relationship between social support (SS) and post coronary event survival. Laboratory research suggests one mechanism regulating this relationship may be exaggerated cardiovascular reactivity (CVR). What has not been as well explored is (1) whether the SS-CVR relationship holds up for a heart diseased sample, and (2) whether this relationship is evidenced only in supportive environments or can be found as a function of generalized perception of being socially supported. Thus, the purpose of this study was to examine the relationship of perceived SS and a locally supportive presence to CVR to a speech-induced stressor in post coronary event patients. Method  Forty-one Phase II cardiac rehabilitation patients participated in a research protocol that consisted of BP and HR measurement during two identical affective stress interviews where local support was systematically varied by presence or absence of a friendly small pet dog. Perception of SS was assessed by completion of psychosocial questionnaire packet that included measures of SS, anger expression and pet attachment. Results  Repeated measures ANCOVAs revealed that patients who believed they had greater SS available to them during difficult times exhibited significantly less CVR for MAP (p<.007) and DBP (p<.024). No significant main effects for local support (pet presence) and no interactions between local and perceived support were found. Conclusions  These findings are of interest as they: (a) demonstrate an association between reduced CVR and higher (amounts of) SS in a clinical sample; (b) demonstrate this effect in a sample medicated to dampen CV levels and surges; (c) suggest that perceived amount of SS provides an ameliorative influence on CVR independent of situational support; (d) suggest that for certain conditions pet-models of support may be ineffective at establishing an local support presence.     

The Illness Perceptions and Treatment Beliefs of Individuals with Severe Haemophilia and their Role in Adherence to Home Treatment

The majority of individuals in the UK with severe haemophilia treat themselves at home with clotting factor. The aim of this study was to examine patient's beliefs about their haemophilia, their beliefs regarding treatment with clotting factor and to assess whether relationships existed between these factors and adherence to home treatment. Patient beliefs were assessed by posting individuals with severe haemophilia A and B ( n = 104) the Illness Perceptions Questionnaire (IPQ) and the Beliefs about Medicines Questionnaire (BMQ). The final analysis was based on 65 questionnaires yielding a response rate of 63%. Adherence to the frequency and to the amount of each clotting factor dose was assessed for individuals treating prophylactically and the amount of each clotting factor dose for those only treating 'on-demand'. Adherence scores were calculated by comparing individual patient treatment records with recommended regimens. Regression analysis indicated that perceptions of illness identity and treatment necessity explained a significant amount of the variance in adherence to frequency of prophylactic infusions and that illness identity was associated with the adherence to the amount of each prophylactic dose. Further regression analysis also showed that the amount of each dose of clotting factor administered on-demand was associated with perceptions regarding the necessity of treatment. Analysis with a combined measure of adherence to dose amount indicated that patients treating on-demand or with prophylaxis who under treated, recorded significantly lower perceptions of illness consequence than individuals who were fully adherent or who over-treated. The results suggest that assessing illness perceptions, especially beliefs regarding identity , consequence and necessity of treatment, may play a valuable role in identifying which individuals are least likely to adhere to treatment.     

The factorial structure of individual differences in visual perception

Although at first glance the way we perceive the world is similar for most individuals and resembles a veridical interpretation of the environment, the persistent individual differences found in many perceptual processes continue to inspire and confuse researchers. Despite numerous attempts to map out the reliable factors and correlates of individual variance in perception, the factorial structure of vision has remained elusive. The current article reviews recent developments in the study of individual differences in perception with a focus on work that has applied latent variable techniques for analysing performance across multiple visual paradigms. As this overview reveals, studies that have attempted to answer the question whether one general or several specific factors best describe vision tend to reject the monolithic view. Some general notes are also provided regarding pitfalls that should be taken into account when designing such research in the future.     

Embodied perception with others’ bodies in mind: Stereotype priming influence on the perception of spatial environment

It has been shown that spatial perception is not only a function of optical variables but also a function of people’s physiological potential. When this potential is reduced, either due to age or fatigue, individuals have been observed to report hills steeper and distances longer. Two studies have demonstrated that the experience of an actual reduction in capacities is not necessary. After being primed with the elderly category, young participants estimated the gradient of various pathways and that of a hill steeper (Study 1) and distances across a grassy field longer (Study 2) than their non-primed counterparts. The activation of a social category has often been found to result in stereotype-congruent behaviors. The present findings indicate that, in addition to this well-documented behavioral mimetism, this activation also leads to perceptual mimetism. I suggest that it helps facilitate social interactions by investing the partners with a shared vision of their environment.     

Socioeconomic Differences in Psychosocial Factors Contributing to Coronary Heart Disease: A Review

Psychosocial factors have been shown to play an important role in the aetiology of coronary heart disease (CHD). A strong association between CHD and socioeconomic status (lower-level education, poor financial situation) has also been well established. Socioeconomic differences may thus also have an effect on psychosocial risk factors associated with CHD, and socioeconomic disadvantage may negatively affect the later prognosis and quality of life of cardiac patients. The aim of this study was to review the available evidence on socioeconomic differences in psychosocial factors which specifically contribute to CHD. A computer-aided search of the Medline and PsycINFO databases resulted in 301 articles in English published between 1994 and 2007. A comprehensive screening process identified 12 empirical studies which described the socioeconomic differences in CHD risk factors. A review of these studies showed that socioeconomic status (educational grade, occupation or income) was adversely associated with psychosocial factors linked to CHD. This association was evident in the case of hostility and depression. Available studies also showed a similar trend with respect to social support, perception of health and lack of optimism. Less consistent were the results related to anger and perceived stress levels. Socioeconomic disadvantage seems to be an important element influencing the psychosocial factors related to CHD, thus, a more comprehensive clarification of associations between these factors might be useful. More studies are needed, focused not only on well-known risk factors such as depression and hostility, but also on some lesser known psychosocial factors such as Type D and vital exhaustion and their role in CHD.     

Lifestyle effects of group health education for patients with coronary heart disease

Abstract

In the present study, effects of a health education (INFO) and a PsychoEducational Prevention (INFO + PEP) Programme were Investigated in three hospitals. These programmes were offered to groups of coronary heart disease (CHD) patients and their partners alter discharge from hospital. The INFO was offered to 127 CHD patients in addition to FIT (i.e. standard medical care and physical training). The PEP was offered to 90 Patients in, addition to the INFO and FIT. A control group of 122 patients received only FIT. The INFO and the PEP consisted of four weekly two-hour group sessions each. In addition, the PEP was followed by seven telephone follow-up contacts.

On average, patients improved their lifestyles during the first three months. Between three and twelve months an extra improvement was found for eating habits, whereas there was a relapse for smoking and a sedentary lifestyle. In the short term, angina pectoris and a longer period of heart complaints were parallelled with a decrease in the risk of maintaining unhealthy eating habits, whereas in the long term a longer period of heart complaints a younger age and unemployment predicted a lower risk of maintaining unhealthy eating habits In the short term living with a partner and in the long term female gender were predictive of continued smoking behaviour In the short term, older age, a first CABG and a specific hospital setting decreased the risk of a continued sedentary lifestyle.

The FIT + INFO + PEP had a favourable short-term effect on eating habits. For smoking and a sedentary lifestyle, however, there were negative effects. In the short term patients in the FIT +INFO and those in the FIT +INFO+PEP had significantly more problems in quitting a sedentary lifestyle than those in the FIT intervention in the long term, patients in the FIT + INFO had significantly more problems in stopping smoking compared to these in the FIT.     

Quality of Life in Patients with Recurrent Vasovagal or Unexplained Syncope: Influence of Sex, Syncope Type and Illness Representations

Health-related quality of life (QoL) is reduced in patients with recurrent vasovagal (VVS) or unexplained (US) syncope. Little is known regarding these patients’ QoL as pertains to their capacity to attain their life goals. Factors influencing QoL, such as sex, syncope type and illness representations have not been studied. Our objective is to examine the relationship between illness representations and QoL, as well as possible sex and syncope type differences. One hundred and four patients undergoing tilt-table testing (TTT) for recurrent syncope were interviewed one month before TTT, using questionnaires. Data were analysed using ANCOVAs, a-priori Helmert contrasts for illness representations, and regressions. Patients with US had a poor QoL compared to those with VVS [F(1, 91) = 10.46; p < 0.01], particularly in men (p < 0.01). Patients with higher perceived syncope severity showed an impoverished QoL relative to those with less severe perceptions [F(1, 91) = 5.47; p < 0.05]. A hierarchical regression revealed that illness representations mediate the impact of lifetime number of syncope on QoL. In conclusion, QoL is reduced in these patients, and is influenced by illness representations. Helping patients change their perceptions about their syncope may be an efficient way to promote QoL.     

Perfectionism Dimensions and Dependency in Relation to Personality Vulnerability and Psychosocial Adjustment in Patients with Coronary Artery Disease

The present study sought to illuminate self-criticism and personal standards dimensions of perfectionism and dependency as specific cognitive-personality vulnerability factors that might contribute to a better understanding of numerous psychosocial problem areas that are relevant to coronary artery disease (CAD). One hundred and twenty-three patients diagnosed with clinically significant CAD completed self-report questionnaires. Zero-order correlations and factor analysis results revealed that self-criticism was primarily related to personality vulnerability (aggression/anger/hostility, Type D negative affectivity) and psychosocial maladjustment (depressive symptoms, worry, avoidant coping, support dissatisfaction), whereas personal standards was primarily related to adaptive coping (problem-focused coping, positive reinterpretation) and dependency was primarily related to worry. Hierarchical regression results demonstrated the incremental utility of self-criticism, personal standards, and dependency in relation to (mal)adjustment over and above aggression/anger/hostility, negative affectivity, and social inhibition. Continued efforts to understand the role of perfectionism dimensions and dependency in CAD appear warranted.     

Social perception in children with fetal alcohol spectrum disorder

Although the profile of social cognitive difficulties is well recognized in children with certain neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), this profile is not as well established in other clinical pediatric populations. The objective of the present study is to examine patterns of social perception in children with fetal alcohol spectrum disorder (FASD) compared to typically-developing (TD) control children. A total of 56 children between 8 and 12 years of age—35 with FASD and 21 TD—completed the Reading the Mind in the Eyes Task – Children’s Version (RMET-C). The RMET-C accuracy scores were compared between groups and also by item difficulty and emotional valence. The relation between cognitive functioning, age, FASD severity, and RMET-C performance was also investigated. The children in the FASD group did not perform as well as the children in the TD group on the RMET-C Total score and Easy items, as well as the Positive, Negative, and Neutral emotional valence items. When age and IQ were investigated, there was a significant effect of age on the Positive items in the TD group, with scores increasing with age. With regard to FASD severity, children with alcohol-related neurodevelopmental disorder were outperformed by children with full/partial fetal alcohol syndrome on the Positive and Negative items. Overall, these results further the understanding of the social cognitive profile in children with FASD and how this profile relates to other childhood-onset neurodevelopmental disorders.     

Global and local pitch perception in children with developmental dyslexia

This study investigated global versus local pitch pattern perception in children with dyslexia aged between 8 and 11 years. Children listened to two consecutive 4-tone pitch sequences while performing a same/different task. On the different trials, sequences either preserved the contour (local condition) or they violated the contour (global condition). Compared to normally developing children, dyslexics showed robust pitch perception deficits in the local but not the global condition. This finding was replicated in a simple pitch direction task, which minimizes sequencing and short term memory. Results are consistent with a left-hemisphere deficit in dyslexia because local pitch changes are supposedly processed by the left hemisphere, whereas global pitch changes are processed by the right hemisphere. The present data suggest a link between impaired pitch processing and abnormal phonological development in children with dyslexia, which makes pitch pattern processing a potent tool for early diagnosis and remediation of dyslexia.     

自闭症谱系障碍者的视运动知觉

视运动知觉是人脑对外界物体的运动特性的知觉。视运动知觉异常是自闭症谱系障碍者的一种常见表现, 其检测光流、二阶运动、协同性运动、生物运动及运动速度的能力异于健康控制组, 且过度迷恋重复性运动物体。该群体视运动知觉异常的原因探析集中于背侧/M细胞通路特定假设、复杂性假设、神经噪声假设、经验缺失假设、时空加工异常假设、极端男性脑理论和社会脑假设。但到目前为止, 尚缺乏一个统一准确的、可验证的解释。未来研究应注重考察自闭症者视运动知觉异常的个体差异和神经生理机制, 进一步整合和验证解释理论, 并着眼开发有效的视运动知觉测评工具和干预策略     

Outgroup homogeneity effect in perception: An exploration with Ebbinghaus illusion

An outgroup homogeneity (OH) effect implies that outgroup members are perceived to be more similar than ingroup members. At present, however, it is not clear whether the OH effect is truly perceptual. Here, we used an Ebbinghaus illusion to demonstrate the OH effect in perception. Participants were presented with one central face that was surrounded by four surrounding faces. The central face was judged to be smaller as the size of the surrounding faces increased, thereby demonstrating an Ebbinghaus illusion. As predicted, however, this illusion was significantly greater when the faces allegedly belonged to an outgroup than when they allegedly belonged to an ingroup. This perceptual OH effect bore no significant relationship with cognitive OH measures. The perceptual versus cognitive OH effects might therefore be mediated by separate mechanisms.     

Risk perception in Poland: A comparison with three other countries

The present study is a cross-cultural comparison of risk perception. A psychometric approach has been followed in order to examine quantitative risk judgments of different hazards and the ratings of these same hazards on various risk-characteristic scales. A list of hazards was used that is comparable with other samples (American, Hungarian, Norwegian), but a certain number of hazards of an entirely different kind were added (e.g. social tensions, shortages of consumer goods) because these are important today for Polish society. In spite of the different list of hazards, the basic factor structure of risk perception turned out to be essentially the same as the structure found in other studies. There was considerable agreement in risk perceptions in the Polish and American samples. We also discovered a number of idiosyncratic qualities of risk perception in Poland, generally indicating the importance of the availability heuristic.