Caregiving in multiple sclerosis and quality of life: A meta-synthesis of qualitative research

Objective: The lack of adequate conceptualisation and operationalisation of quality of life (QoL) limits the ability to have a consistent body of evidence to improve QoL research and practice in informal caregiving for people with multiple sclerosis (MS). Thus, we conducted a meta-synthesis of qualitative research to improve the conceptual understanding of the experiences of MS carers and to identify factors that affect carers’ QoL.

Design: Systematic searches of five electronic databases yielded 17 qualitative studies which were synthesised using the principles of meta-ethnography.

Results: The synthesis resulted in nine inter-linking themes: Changes and losses; challenges revolving around MS; caregiving demands; burden of care; future concerns; external stressors; experiences of support; strategies used in managing the caregiving role; and motivating factors. Our findings suggest that MS carers can have both positive and negative experiences which may bring challenges and rewards to the carers.

Conclusion: We present a proposed QoL model for MS caregiving which can be used to inform the development of interventions for MS carers to improve their QoL. However, further empirical research is needed to examine the utility of this model and to explore the concept of QoL in MS carers in more detail.     

A Pilot Study of a Co-parenting Intervention for Parents of Children with Autism Spectrum Disorder

Journal of Child and Family Studies - The aims of this pilot study are to evaluate the feasibility, acceptability, and preliminary efficacy of a peer-delivered co-parenting program, Autism Parent...     

The interaction between duration, velocity and repetitive auditory stimulation

Repetitive auditory stimulation (with click trains) and visual velocity signals both have intriguing effects on the subjective passage of time. Previous studies have established that prior presentation of auditory clicks increases the subjective duration of subsequent sensory input, and that faster moving stimuli are also judged to have been presented for longer (the time dilation effect). However, the effect of clicks on velocity estimation is unknown, and the nature of the time dilation effect remains ambiguous. Here were present a series of five experiments to explore these phenomena in more detail. Participants viewed a rightward moving grating which traveled at velocities ranging from 5 to 15°/s and which lasted for durations of 500 to 1500 ms. Gratings were preceded by clicks, silence or white noise. It was found that both clicks and higher velocities increased subjective duration. It was also found that the time dilation effect was a constant proportion of stimulus duration. This implies that faster velocity increases the rate of the pacemaker component of the internal clock. Conversely, clicks increased subjective velocity, but the magnitude of this effect was not proportional to actual velocity. Through considerations of these results, we conclude that clicks independently affect velocity and duration representations.     

Empathic Experience and Attitudes Toward Stigmatized Groups: Evidence for Attitude Generalization

Two studies investigated the extent to which empathizing with a single member of a stigmatized group can yield positive attitudes toward other stigmatized groups. Participants read a scenario in which a member of a socially stigmatized group described the experiences of group membership. Participants then reported their attitudes toward the target group and a second group. Both studies revealed a generalization effect such that experiencing empathy for the target was associated with more positive attitudes, both toward the target group and the second group. Study 2 demonstrated that this generalization effect is confined to those groups located within the same superordinate category. Implications of these findings for attempts to structure people's orientation to stigmatized groups are discussed.     

Examining HPA-axis functioning as a mediator of the relationship between depression and cognition across the adult lifespan

Altered HPA-axis functioning is a hypothesized mechanism for worsened cognition in depression. The current study examines the indirect effects of depression on processing speed, executive functioning, and memory as a function of the HPA-axis. 38 individuals with a depression diagnosis and 50 healthy controls (HCs) aged 18–86 underwent neuropsychological testing and at-home diurnal salivary cortisol collection. Depression was assessed via structured clinical interviews and rating scales. Cognitive composite scores were derived from factor analysis. Daytime cortisol exposure was estimated using area under the curve (AUC). Depression was associated with higher cortisol levels and slower processing speed . A significant suppression effect of AUC was present on the relationship between depression and processing speed. Limitations include the cross-sectional design and limited sample heterogeneity. Though poorly modulated HPA-axis is one proposed mechanism of cognitive alterations in depression, our results did not support this conclusion for processing speed. Alternative mechanisms should be considered to inform interventions to target cognitive alterations in depression.     

Influence of Gender Roles on Perceptions of Teacher/Adolescent Student Sexual Relations

In this study we explored the effects of respondent gender and the specific gender combination (i.e., cross- and same-gender dyads) on perceptions of a sexual encounter between a teacher and an adolescent student. Respondents (120 male and 120 female undergraduates) read a brief scenario and answered questions about their perceptions of the encounter. Significant interactions emerged between teacher gender and student gender. For example, the male teacher/male student dyad was viewed as the least normative, and the female teacher/male student dyad was perceived as the most normative. Significant interactions also were found between teacher gender and respondent gender. Results generally were consistent with gender role stereotypes.     

Dissecting the brain's internal clock: how frontal-striatal circuitry keeps time and shifts attention.

The ability of organisms to time and coordinate temporal sequences of events and to select particular aspects of their internal and external environments to which they will attend is vital to the organism's ability to adapt to the world around them. Numerous psychological theories have been proposed that describe how organisms might accomplish such stimulus selection and represent discrete temporal events as well as rhythm production. In addition, a large number of studies have demonstrated that damage to the frontostriatal circuitry appears to compromise the ability of organisms to successfully shift attention and behavior to adapt to changing temporal contexts. This suggests that frontostriatal circuitry is involved in the ability to make such shifts and to process temporal intervals. A selective review is accomplished in this article which focuses upon the specific neural mechanisms that may be involved in interval timing and set shifting. It is concluded that prefrontal cortex, substantia nigra pars compacta, pedunculopontine nucleus, and the direct and indirect pathways from the caudate to the thalamus may provide the neuroanatomical and neurophysiological substrates that underlie the organism's ability to shift its attention from one temporal context to another.     

Women’s Attitudes Toward Testing for Fragile X Carrier Status: A Qualitative Analysis

Fragile X syndrome (FXS) is primarily due to a repeat expansion mutation found in the FMR1 X-linked gene. We have conducted a qualitative analysis of responses from women concerning their attitudes toward testing for carrier status of the fragile X mutation among reproductive-age women. We obtained responses from focus groups including women with and without FXS in their families. We found the following themes: (1) mothers of children with FXS have difficulty formulating their opinions on population screening because of their unique experiences surrounding their own carrier diagnosis and their relationship with their children with FXS, (2) the motivation for carrier testing and need for information differ by family history of FXS and parental status, and (3) the timing of carrier testing with respect to a woman’s life stage dictates whether carrier information will be viewed as beneficial or detrimental. There was evidence that non-carrier women from the general population would be wholly unprepared for positive carrier results. These findings have significant implications for genetic counseling as well as for population screening.