A Neuropsychological Normative Database for Lung Transplant Candidates

Psychologists are increasingly asked to make decisions regarding patient candidacy for transplantation. Despite the growing incidence of lung transplantation, normative research regarding cognitive functioning and end-stage obstructive lung disease is lacking. Hence, data are presented on 100 consecutively referred candidates for lung transplantation. The group data suggest essentially normal functioning on most cognitive tests for the majority of transplant candidates. Exceptions were seen on measures of attentional set shifting and short-term visual memory, which were impaired in nearly one fourth of this population. Additionally, one half of the patients displayed deficient performance on the Buschke Selective Reminding Test, with subjects at greater risk for severe rather than mild deficits. Unlike prior research, our group data suggest that there is potential risk of short-term noncontextual verbal memory difficulties because of end-stage pulmonary disease. Personality testing data, e.g., elevations on MMPI-2 scales measuring depression and anxiety, are also discussed.     

Psychological Distress in Caregivers of Liver and Lung Transplant Candidates

Although organ transplantation represents a stressful experience for the entire family, surprisingly little research has focused on the adjustment of caregivers. The purpose of this study was to examine what caregivers report to be the greatest benefits and stressors pretransplant, the prevalence of psychological distress and caregiver strain in pretransplant caregivers as compared to normative populations, and the physical, psychological, and demographic variables that predict distress. Fifty-two caregivers of transplant candidates (28 liver and 24 lung) completed a series of questionnaires, including the Psychosocial Adjustment to Illness Scale (PAIS-SR), SF-36 Health Survey, Caregiver Strain Index (CSI), and qualitative questions about benefits and stressors. The most commonly reported benefit of being a caregiver could be categorized as Helping the Patient, and the most common stressors were associated with Uncertainty/Waiting/Fears. Compared to normative samples of caregivers of patients with Alzheimer's disease, caregivers of liver transplant candidates reported more caregiver strain; there were no differences for lung transplant caregivers. Caregiver social functioning was found to be the only significant predictor of caregiver distress, with those caregivers who report greater distress also reporting extreme and frequent interference with normal social activities. Implications of these findings for psychological interventions are discussed.     

Pediatric Living Lung Donor Transplant Candidates: Psychiatric Status of Utilized and Non-Utilized Donors

Living donor lung (lobar) transplantation has greatly decreased in the past decade due to the success of the lung allocation score (LAS) system, instituted in 2005 by the Organ Procurement and Transplantation Network (OPTN). Between 1993 and 2006, 460 living lung donor transplants were performed in the United States with 369 donations occurring at the University of Southern California and Washington University in St. Louis. These two centers accounted for over 80% of all living donor lung transplants between 1994 and 2006. All potential donors received a psychological/psychiatric evaluation as part of the donor selection process, which is standard practice in the United States, Europe, and Asia. Utilized and non-utilized lung donors were compared in terms of their psychiatric history and present status. Results indicated that 31% (N?=?54) of the total sample had a lifetime prevalence of a psychiatric disorder, which is less than that the 46% lifetime rate for the general population (Kessler in Arch Gen Psychiatry 62:593–602, 2005). This study did find that psychiatric history or status was not exclusion factor for transplant surgery in either group. This observation about psychiatric issues in potential living lung donors should be useful to transplant centers who utilize adult live donors of any solid organ type for pediatric recipients and in Japan where live donor lung transplants still represent a significant proportion of lung transplants (Date in J Thorac Dis 8: S631–S636, 2016).

     

Quality of Life in Heart Transplant Candidates

Research on quality of life with heart transplant patients is complicated by the physical and psychological variables associated with heart failure. This study examined quality of life with several instruments in order to sample more general and more idiosyncratic aspects of quality of life in this particular patient population. We also examined the relationship between various aspects of quality of life and several psychosocial variables, including sensitivity to social desirability effects. The quality of life measures used in this study were found to be significantly correlated with each other and with measures of psychological distress. Implications of these findings are discussed.     

The Integrated Psychosocial Model of Criminal Social Identity (IPM-CSI)

The integrated psychosocial model of criminal social identity attempts to synthesize, distill, and extend our knowledge and understanding of why people develop criminal social identity, with a particular focus on the psychological and social factors involved. We suggest that the development of criminal social identity results from a complex interplay between four important groups of psychosocial factors: (1) an identity crisis that results in weak bonds with society, peer rejection, and is associated with poor parental attachment and supervision; (2) exposure to a criminal/antisocial environment in the form of associations with criminal friends before, during, and/or after incarceration; (3) a need for identification with a criminal group in order to protect one’s self-esteem; and (4) the moderating role of personality traits in the relationship between criminal/antisocial environment and the development of criminal social identity. The model produces testable hypotheses and points to potential opportunities for intervention and prevention. Directions for future research are discussed.     

Detection of a Psychiatric Diagnosis in Heart Transplant Candidates with the MBHI

The utility of the Millon Behavioral Health Inventory (MBHI) in screening for the formal diagnosis of a psychiatric disorder was investigated in a sample of 90 heart transplant candidates, a population at risk for psychiatric disturbance. Psychiatric disorders were identified in 71% of patients, the majority being adjustment disorder. Sensitivity and specificity rates of >70% were determined in discriminant function analyses, for presence or absence of a psychiatric condition. When Axis I conditions were differentiated as mild (adjustment reaction only) or severe (all other Axis I conditions, including comorbid Axis II disorders), the MBHI correctly identified every severe case as a probable psychiatric diagnosis. The rate of clinically significant elevations on certain MBHI scales and severity of Axis I psychiatric condition was also significantly associated. These findings suggest that the MBHI may have potential utility in identifying high-risk patients with diagnosable psychiatric conditions and help justify mental health consultation referrals at a time when managed care entities are vigorously rationing ancillary services with medically ill populations.     

Psychological Assessment of Homosexual Tendencies in Potential Candidates for the Roman Catholic Priesthood

While the recent Instruction by the Congregation for Catholic Education concerning the criteria for the discernment of vocations with regard to persons with homosexual tendencies has offered a clear direction to bishops and religious superiors in screening candidates, a discussion by psychologists on methods of assessing the presence of such tendencies within individuals is necessary. This paper will review relevant assessment techniques and suggest how psychologists can address this issue in evaluation reports, including making specific recommendations relevant to the issue of homosexual tendencies.     

Bringing the Social into Genetics: The Psychosocial Genetics Risk Assessment and Management Framework (PG-RAM)

As increasing numbers of people are identified at risk for multi-factorial diseases, questions of how to assess, communicate and manage genetic risk will be critical from health services and policy perspectives. However, there is currently no evidence-based genetic risk assessment and management framework to assist policy makers, clinicians and other stakeholders. A comprehensive psychosocial framework for risk assessment and management has been developed in the context of security hazards or threats. In an adaptation of that model, we present the Psychosocial Genetics Risk Assessment and Management framework (PG-RAM). It offers principles to enhance the integration of evidence-based best practices into genetics health services, as well as to identify issues, knowledge and gaps. The framework identifies the core elements of the situation, effects, population and interventions, all spanning several phases of genetic disorders. The framework provides an excellent starting point for knowledge syntheses in the context of genetic risk and could serve as the conceptual basis for practical tool development to guide healthcare professionals and decision makers in preparing for and responding to the psychosocial aspects of genetic risk.     

Depression,Quantified Medication Adherence,and Quality of Life in Renal Transplant Candidates and Recipients

Journal of Clinical Psychology in Medical Settings - Like patients with many chronic illnesses, ESRD patients experience psychological challenges with greater incidence of depression and reduced...     

Active Coping and Perceived Social Support Mediate the Relationship Between Physical Health and Resilience in Liver Transplant Candidates

Without a transplant, end-stage liver disease is associated with significant morbidity and mortality. Transplant candidates endure physical and psychological stress while awaiting surgery, yet little is known about the relationship between physical health and psychological resilience during the wait-list period. This study examined predictors of psychological resilience and mediators of the relationship between physical health and psychological resilience in liver transplant candidates. Wait-listed candidates (N?=?120) from a single Northeast transplant center completed assessments of physical functioning, coping, perceived social support, and resilience. Findings revealed that physical functioning, active coping, and perceived social support were positively associated with resilience; maladaptive coping was negatively associated with resilience. Perceived social support and active coping partially mediated the relationship between physical functioning and resilience. Transplant center care providers should promote active coping skills and reinforce the importance of effective social support networks. These interventions could increase psychological resilience among liver transplant candidates.     

Development of a Protocol for Simultaneous Assessment of Cognitive Functioning Under Psychosocial Stress

This study presents a protocol for induction of moderate psychosocial stress and investigates its impact on psychological and physiological responses. The proposed procedure was designed to enable researchers to assess cognitive performance under effect of various classes of stressors. The protocol's structure contains three main periods: baseline, assessment, and recovery. The assessment stage starts with task anticipation, during which audience (three-member commission) is introduced and apparatus (cameras, microphones, lights, and physiological measuring devices) stationed. Subsequently, cognitive performance was tested. The protocol was evaluated on 56 university students that were randomly assigned to control or stress (protocol) treatment and administered three cognitive tests (working memory operation span, remote associates test, and semantic fluency). Compared to control sessions, protocol induced state anxiety, interfering worry thoughts, and disturbance during recovery period. In addition, the stress group also showed elevated levels of skin conductance, higher average heart rates, and larger drops in peripheral temperature. Even though more research is needed, these results suggest that the protocol effectively induces both psychological and physiological stress responses and therefore encourages utilization in cognitive-affective and cognitive-biological fields of research.     

Assessment of Long-Term Psychosocial Sequelae Among POW Survivors of the Korean Conflict

Psychological and psychiatric assessments were performed among 20 prisoner-of-war (POW) Korean-Conflict survivors. Results revealed extraordinary biological and psychological abuse with weight losses exceeding 35% of preservice weights and long-term cognitive, emotional, and behavioral sequelae. The full range of posttraumatic stress disorder symptoms was seen in 90% to 100% of the cases with high prevalence of co-morbidity, specifically mood (75%), other anxiety disorders. Documented by clinical investigators at (45%), and alcohol abuse (20%) POW release and now more than 30 years later, symptoms of apprehensiveness, confusion, detachment, and depression reflect the persistence of psychiatric morbidity over time.     

Psychosocial and Behavioural Assessment of Chronic Pain: Recommendations for Clinicians and Researchers

Abstract

A variety of methods have been developed for the assessment of chronic benign pain. In research or in clinical practise, choosing an adequate measurement technique can be a laborious task. This article has two main purposes: to report on some basic features to consider when selecting assessment instruments, and to present a review of some psychosocial and behavioural measurement methods for the assessment of chronic benign pain. The selected methods have, with one exception, been evaluated on Swedish chronic pain populations and are used in international pain research. In conclusion, we recommend the use of psychometrically sound instruments, and that the purposes for use of a measure have to be thoroughly considered in advance. We also emphasize that in clinical practise, each separate measure must be interpreted in a wider context, where clinical findings and judgements are considered as a whole. In addition, none of the single reviewed assessment techniques can replace the communication between the patient and the clinician.     

Examination of the MMPI-2 Restructured Clinical (RC) Scales in a Sample of Bariatric Surgery Candidates

The current study examined the MMPI-2 Restructured Clinical (RC) scales (Tellegen et al., MMPI-2 Restructured Clinical (RC) scales: Development, validation, and interpretation. Minneapolis: University of Minnesota Press, 2003) in a sample of 1,091 bariatric surgery candidates. The RC scales were developed to address concerns about limited discriminant validity of the Clinical scales. Internal consistency and external validity analyses were conducted to evaluate the RC scales in this setting. Results indicated that the RC scales are generally more internally consistent than the Clinical scales and display significantly better convergent and discriminant validity in predicting a variety of behavioral, psychological, and developmental variables relevant to preoperative bariatric psychological evaluations. Implications of the results and recommendations for future research with the RC scales in medical settings are discussed.     

The Strengths Assessment Inventory: Reliability of a New Measure of Psychosocial Strengths for Youth

A new measure, the Strengths Assessment Inventory—Youth self-report (SAI-Y), was recently developed to assess the strengths of children and adolescents between the ages of 10 and 18 years. The SAI-Y differs from similar measures in that it provides a comprehensive assessment of strengths that are intrinsic to the individual as well as strengths associated with an individual’s interaction with his or her environment. Based on over 10 years of test development as well as previous research, the 120 items of the SAI-Y contribute to 11 content scales (e.g., Strengths at Home) and 12 empirical scales (e.g., Commitment to Family Values). The purpose of the current report is to describe the procedure that guided the development of the SAI-Y coupled with an initial study of the psychometric properties of the instrument. The SAI-Y was administered to 572 elementary and secondary school students of which 455 also completed the measure following a one- to two-week interval. Based on this data, the following psychometric properties were examined: internal consistency, standard error of measurement, and test–retest reliability. Overall, results indicated that the SAI-Y demonstrates acceptable to good levels of reliability and may be a valuable addition to current measures that assess aspects of positive functioning. Ongoing research projects and future directions are discussed.     

Psychosocial aspects of human immunodeficiency virus (HIV) infection in a pre-HAART sample

The psychosocial consequences of HLV-infection were studied using a semi-structured interview and the psychiatric questionnaire SCL-90-R, in 3 matched groups of homosexual men: 20 patients with Aids, 20 asymptomatic HIV-infected and 20 non-infected controls. The data was collected before the HAART (Highly Active Anti-retroviral Therapy) era. The results showed that the infected subjects more often concealed their homosexuality, engaged in more risky sexual behavior and were less inclined to regard AIDS as a serious problem. The infected subjects also revealed more psychopathology on 5 of the 9 indexes on the SCL-90. Across all 3 groups, contact ability was correlated to being open about homosexuality and to psychological well-being. These results indicate that HIV has considerable impact on psychological well-being among the infected and point to the need for health-care workers to be especially attentive to those HIV-infected who have difficulty in talking to others about their situation.