The difficulties assessing spiritual distress in palliative care patients: a qualitative study

This paper reports on a focus group study aimed at exploring the difficulties that palliative care healthcare professionals encounter while assessing the spiritual distress of their patients. Three focus groups were conducted in a hospice (n = 15). Participants were all healthcare professionals working in the hospice in-patient unit. Interviews were taped and later transcribed. The data was analysed through content analysis. Emergent themes included: lack of vocabulary around spiritual issues, personal issues surrounding death and dying, training issues, fear of being unable to resolve spiritual problems, time constraints and difficulty separating spiritual and religious needs. Participants provided a number of recommendations for improving care. This pilot study has generated useful data in relation to how spiritual care of patients might be improved. Despite the abundance of academic publications and policies on spirituality, this area is not integrated well into palliative care.     

Neural Correlates of Age-related Reduction in Visual Motion Priming

ABSTRACT

Previously we reported that priming of visual motion perception is reduced in older adults compared to younger adults (Jiang, Greenwood, & Parasuraman, 1999 Jiang, Y., Greenwood, P. and Parasuraman, R. 1999. Age-related reduction in 3-D motion priming. Psychology and Aging, 14(4): 619–626.  [Google Scholar], Psychology and Aging, 14(4), 619; Jiang, Luo, & Parasuraman, 2002b Jiang, Y., Luo, Y. J. and Parasuraman, R. 2002b. Two-dimensional visual motion priming is reduced in older adults. Neuropsychology, 16(2): 140–145.  [Google Scholar], Neuropsychology, 16(2), 140). To examine the neural mechanisms underlying this age-related effect, event-related brain potentials (ERPs) were recorded during perceptual judgments of motion directions by younger and older adults in two experiments. When judging single-step motion, both younger and older adults evoked significantly larger ERP late positive component (LPC) responses to unambiguous motion compared to LPC responses elicited by ambiguous motion. In contrast, compared to the younger adults, the older adults evoked comparable but delayed ERP responses to single motion steps. In the second experiment the younger and older groups judged the directions of two successive motion-steps (either motion priming or motion reversals). Under short (200–400 ms) stimulus onset asynchrony (SOA), the difference between the ERP responses to priming and reversal conditions was significantly larger for the younger than for the older adults. This study provides the first electrophysiological evidence that brain aging leads to delayed processing of single motion direction and visual motion priming as early as 100 ms in the early visual cortex. Age-related changes in strength and temporal characteristics of neural responses in temporal-parietal regions were particularly pronounced in older adults when successive motion signals are placed closely in time, within 400 ms.     

Emotion as patheception

Emotions cannot be fully understood in purely cognitive terms. Nor can they be fully understood as mere feelings with no content. But it has not been easy to give an account of the relation of affect and cognition in a way that preserves the perceived unity of emotional experience. Consequently, emotion theories tend to lean either toward cognitivism, or, alternatively, the view that emotions are basically non-cognitive affairs. The aim of this paper is to argue for an account of emotion as a unity of affect and cognition. Emotions, it will be suggested, do not combine, blend, add, or causally relate cognition to affect, or affect to cognition, but are rather original unities which should be viewed as coordinate with, rather than subordinate to, either cognition, perception, feeling, or any other basic mental category.     

Self-efficacy,Work, and Psychological Outcomes in a Public Service Context

The study examined the prediction of psychological outcomes (conceptualized as psychological well-being and engagement) by general self-efficacy (GSE) and work context (conceptualized as job demands and job resources). The role of GSE as a moderator between work context and psychological outcomes was also examined in a cross-sectional survey of a sample of public sector employees (N = 459: males = 151, females = 273, and age ranging between 25 and 55). Multiple regression analyses showed that job demands and resources and GSE significantly predict both psychological well-being (positive affect, negative affect and satisfaction with life) and engagement (vigour and dedication). GSE moderated the relationship between work context and psychological outcomes. Work contexts characterised by a preponderance of job resources appear to facilitate both satisfaction with life and dedication.     

Evidence for utilitarian motives in emotion regulation

This investigation demonstrates that emotion regulation can be driven by considerations of utility per se. We show that as participants prepared for a negotiation, those who were motivated to confront (vs. collaborate with) another person believed that anger would be more useful to them. However, only participants who were motivated to confront another and expected to receive a monetary reward for their performance (i.e., high utility), were motivated to increase their anger in preparation for the negotiation. Participants who were motivated to confront another but did not expect their performance to be rewarded (i.e., low utility), did not try to increase their anger, even though they expected anger to be useful in the negotiation. Such patterns demonstrate that people are motivated to experience even unpleasant emotions to maximise utility.     

Persistence of preference for a flavor presented in simultaneous compound with sucrose

Rats exposed to a simultaneous compound of a flavor and sucrose subsequently exhibited a preference for the flavor over water. This preference persisted across repeated testing even though the flavor was presented in the absence of sucrose. The preference did, however, extinguish if the rats were hungry when trained or tested, or if they had been reexposed to sucrose between training and test. Though failing to extinguish the preference, presentation of the flavor outside the compound protected it from the effects of sucrose devaluation, indicating that these presentations extinguished the within-compound association between the flavor and sucrose. The authors conclude that the hedonic reaction elicited by sucrose imbues the flavor with the same hedonic properties, and these properties maintain the preference independently of the flavor-sucrose association.     

The role of memory representation in the vigilance decrement

Working memory load is critically important for the overall level of performance on vigilance tasks. However, its role in a key aspect of vigilance—sensitivity decrement over time—is unclear. We used a dual-task procedure in which either a spatial or a nonspatial working memory task was performed simultaneously with a spatial vigilance task for 20 min. Sensitivity in the vigilance task declined over time when the concurrent task involved spatial working memory. In contrast, there was no sensitivity decrement with a nonspatial working memory task. The results provide the first evidence of a specific role for working memory representation in vigilance decrement. The findings are also consistent with a multiple resource theory in which separate resources for memory representation and cognitive control operations are differentially susceptible to depletion over time, depending on the demands of the task at hand.     

Motor deficits in Parkinsonian reaching: dopa-sensitivity influenced by real-world task constraint

Parkinson's disease (PD) patients can perform many daily activities, but movement deficits are evident. Those deficits may be increased when the required movement is constrained in accuracy. Variable improvements in performance with PD medication have been demonstrated, and sensitivity to task constraint has been evident in some studies. The authors quantified both specific movement deficits and improvements for PD patients in a reaching task. PD patients (N=8) both on and off medication showed a need for greater ongoing control in movements with higher task-accuracy constraints. Increased task-accuracy constraints further compromised movement timing and structure among PD patients who were off medication, suggesting that unmedicated PD patients may typically compensate by using more conscious control of movement, resulting in increased slowing and segmentation of components when higher task accuracy is required.     

Effects of training intensity on observers' ratings of anxiety, social skills, and alcohol-specific coping skills

Few studies have addressed the amount of training needed to obtain reliable ratings in behavioral observation data. The current study examined the effects of differing intensities of frame-of-reference (FOR) rater training on observers' ratings of anxiety, social skills, and alcohol-specific coping skills in community volunteers with and without social anxiety and alcohol use disorders. Interrater reliability was assessed by comparing three training conditions (no-training, moderate FOR, and intensive FOR) on discrepancies between raters'scores and the strength of association between raters'scoring patterns. The discrepancies between raters' scores were significantly larger in the control condition than in the intensive and moderate training conditions. Generally, small and nonsignificant differences were found between intensive and moderate training's discrepancy scores. Strength of association results showed significantly lower correlations in the control group compared to the intensive group. However, these correlational results showed less consistent differences between the moderate and other training conditions; differences when found were in the expected directions. Study findings suggest that differing training intensities can affect rating scores and that interrater reliability may be meaningfully assessed through multiple methods.