The Effects of Spirituality and Religion on Outcomes in Patients with Chronic Heart Failure

Heart failure (HF) is a chronic progressive disease with marked morbidity and mortality. Patients enduring this condition suffer from fluctuations in symptom burden such as fatigue, shortness of breath, chest pain, sexual dysfunction, dramatic changes in body image and depression. As physicians, we often ask patients to trust in our ability to ameliorate their symptoms, but oftentimes we do not hold all of the answers, and our best efforts are only modestly effective. The suffering endured by these individuals and their families may even call into question one??s faith in a higher power and portends to significant spiritual struggle. In the face of incurable and chronic physical conditions, it seems logical that patients would seek alternative or ancillary methods, notably spiritual ones, to improve their ability to deal with their condition. Although difficult to study, spirituality has been evaluated and deemed to have a beneficial effect on multiple measures including global quality of life, depression and medical compliance in the treatment of patients with HF. The model of HF treatment incorporates a multidisciplinary approach. This should involve coordination between primary care, cardiology, palliative care, nursing, patients and, importantly, individuals providing psychosocial as well as spiritual support. This review intends to outline the current understanding and necessity of spirituality??s influence on those suffering from HF.     

A glass full of optimism: Enrichment effects on cognitive bias in a rat model of depression

Investigations of cognitive biases in animals are conceptually and translationally valuable because they contribute to animal welfare research and help to extend and refine our understanding of human emotional disorders, where biased information processing is a critical causal and maintenance factor. We employed the "learned helplessness" genetic rat model of depression in studying cognitive bias and its modification by environmental manipulations. Using a spatial judgment task, responses to ambiguous spatial cues were assessed before and after environmental enrichment to test whether this manipulation would cause an optimistic shift in emotional state. Twenty-four congenitally helpless and nonhelpless male rats were trained to discriminate two different locations, "rewarded" versus "aversive." After successful acquisition of this spatial discrimination, cognitive bias was probed by measuring responses to three ambiguous locations. Latencies to "reach" and to actively "choose" a goal pot were recorded alongside exploratory behaviors. An overall strain difference was observed, with helpless rats displaying longer "reach" latencies than nonhelpless rats. This implies a "pessimistic" response bias in helpless rats, underscoring their depressive-like phenotype. No strain differences were observed regarding other behavioral measures. Half of the animals were then transferred to enriched cages and retested. Environmental enrichment resulted in reduced "choose" latencies in both rat strains, associating enrichment with more optimistic interpretations of ambiguous cues. Our results emphasize the suitability of cognitive bias measurement for animal emotion assessment. They extend the methodological repertoire for characterizing complex phenotypes and bear implications for animal welfare research and for the use of animal models in preclinical research.     

Factor Structure and Psychometric Properties of the Modified Childhood Anxiety Sensitivity Index in a Sample of Croatian Children and Adolescents

Anxiety sensitivity (AS) refers to a person’s tendency to fear anxiety-related symptoms due to the belief that they have harmful consequences. The Childhood Anxiety Sensitivity Index (CASI) is a well accepted operationalization of the AS construct in children and adolescents. This study evaluated the factor structure, gender stability and psychometric properties of the CASI, modified to a 5-point scale, in a sample of Croatian children and adolescents (N = 1,679). Exploratory and confirmatory analysis and a Schmid-Leiman solution confirmed the multidimensional and hierarchical structure of the CASI, which consisted of three lower-order factors and a single higher-order factor. Further, the modification of the CASI to a 5-point scale resulted in higher reliability, while maintaining acceptable levels of factor stability and validity.     

Description of an Intensive Dialectical Behavior Therapy Program for Multidiagnostic Clients With Eating Disorders

The authors describe an intensive outpatient dialectical behavior therapy (DBT) program for multidiagnostic clients with eating disorders who had not responded adequately to standard, empirically supported treatments for eating disorders. The program integrates DBT with empirically supported cognitive behavior therapy approaches that are well established for the treatment of eating disorders. Attention is given to inclusion and exclusion criteria, how the program differs from standard treatments for eating disorders, and the application of specific DBT treatment components for multidiagnostic clients with eating disorders.     

Genetic Counseling and the Ethical Issues Around Direct to Consumer Genetic Testing

Over the last several years, direct to consumer(DTC) genetic testing has received increasing attention in the public, healthcare and academic realms. DTC genetic testing companies face considerable criticism and scepticism,particularly from the medical and genetic counseling community. This raises the question of what specific aspects of DTC genetic testing provoke concerns, and conversely,promises, for genetic counselors. This paper addresses this question by exploring DTC genetic testing through an ethic allens. By considering the fundamental ethical approaches influencing genetic counseling (the ethic of care and principle-based ethics) we highlight the specific ethical concerns raised by DTC genetic testing companies. Ultimately,when considering the ethics of DTC testing in a genetic counseling context, we should think of it as a balancing act. We need careful and detailed consideration of the risks and troubling aspects of such testing, as well as the potentially beneficial direct and indirect impacts of the increased availability of DTC genetic testing. As a result it is essential that genetic counselors stay informed and involved in the ongoing debate about DTC genetic testing and DTC companies. Doing so will ensure that the ethical theories and principles fundamental to the profession of genetic counseling are promoted not just in traditional counseling sessions,but also on a broader level. Ultimately this will help ensure that the public enjoys the benefits of an increasingly genetic based healthcare system.     

Factor structure and psychometric properties of the Anxiety Sensitivity Index in a sample of Croatian adults

Anxiety sensitivity (AS) refers to a person's tendency to fear anxiety-related symptoms due to the belief that these symptoms may have harmful consequences. The most widely used operationalization of AS in adults is the Anxiety Sensitivity Index (ASI). The factor structure, gender stability, and psychometric properties of the ASI in a sample of Croatian adults (N = 984) were evaluated. Results confirm the multidimensional and hierarchical structure of the ASI, which consisted of three lower-order factors (Physical Concerns, Psychological Concerns, and Social Concerns) and a single higher-order factor, AS. Furthermore, the achievement of normative scores for the ASI in a Croatian adult sample demonstrates the cross-national stability of the ASI. Reliability coefficients for the ASI, Physical Concerns, and Psychological Concerns are high and satisfactory in the total sample and for both genders. Overall, the results confirmed the cross-national stability, gender stability, reliability, and validity of the ASI in a sample of Croatian adults.     

Extending self‐leadership research to the East: Measurement equivalence of the Chinese and English versions of the MSLQ

In response to calls regarding the applicability of self‐leadership measurement in Eastern (collectivistic) and Western (individualistic) cultures, this study examined the psychometric properties and measurement invariance of the modified self‐leadership questionnaire (MSLQ). The sample consisted of 395 Chinese students and 241 Australian students. Results revealed that the modified self‐leadership questionnaire exhibited a satisfactory condition of psychometric properties across cultures. A series of multi‐sample confirmatory factor analyses demonstrated the cross‐cultural similarity of an 11‐factor model across the Chinese and Australian samples. The modified self‐leadership questionnaire was also found to possess measurement invariance, suggesting that it is appropriate for cross‐cultural research assessing differences of self‐leadership behaviour across Chinese and Western cultures. Implications for future research are also discussed.