The experience of psychological therapies for people with multiple sclerosis: A mixed-methods study towards a patient-centred approach to exploring processes of change

Psychological therapies are effective for managing multiple sclerosis (MS) symptoms such as depression, pain and fatigue. Cognitive behavioural therapy (CBT), mindfulness and other theory-led approaches have been applied and were found to have moderate effects. The present study adopts a patient-led approach to investigate people with MS' (PwMS) experiences of psychological therapies and the change processes they identify. In this naturalistic, mixed-methods design, semistructured interviews were conducted and three questionnaires were administered to 20 PwMS at two different times. Qualitative data collection and analysis followed the interpretative phenomenological analysis (IPA) guidelines, and quantitative data were analysed using paired t tests. Four superordinate themes described the participants' experiences of change as related to their psychological therapy: from despair to relief; from feeling their body as alien to becoming acquainted with an unpredictable new body; from helplessness to empowerment; and from punishment to forgiveness. Quantitative results showed that physical function and general health perception improved, and anxiety was significantly reduced. Despite seeking help from diverse psychological therapy modalities, the analysis revealed common themes that the participants found significant in their therapy stories. Following a patient-centred approach, the development of psychological therapies for PwMS should focus on their relationships, everyday lives, body perception, losses, shame and guilt. PwMS also need to be understood and acknowledged beyond their condition.     

Motivational interviewing for employment: An exploration of practitioner skill and client change talk

Motivational interviewing (MI) is an evidenced-based approach for building and strengthening motivation for change. The effect of MI training on practitioner conversations with unemployed clients within a government work and income service was evaluated using a mixed-method approach, comprising a multiple-baseline across practitioner (n = 5) design and a pre/post quasi-experimental design. After workshop MI training, practitioners demonstrated greater MI skills in conversations with clients, and MI skills were maintained during the period of post-workshop feedback and coaching. There was also more change talk spoken by clients in conversations that occurred post-MI workshop training compared to pre-training, suggesting increased motivation for change.     

Parenting stress and competence among mothers of young children with substance use disorders: The roles of trauma and reflective functioning

Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale-Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mothers with SUDs who had young children. Two multivariate regression analyses found that (1) lower parental reflective functioning and higher posttraumatic stress symptoms were associated with higher parenting stress, and (2) only higher posttraumatic stress symptoms were associated with lower levels of parenting sense of competence. Findings underscore the importance of addressing trauma symptoms and PRF when aiming to improve parenting experiences for women with an SUD.     

Chronic illness and COVID-19-related risk and protective behaviors

People with chronic illnesses are at increased risk of contracting COVID-19. Still, little is known about whether such an increased risk relates to COVID-19-related protective behaviors among those with chronic illness. This study compares the self-reported COVID-19 risky and protective behaviors—specifically physically distancing, handwashing, and having houseguests—of people (N = 936) (1) living with chronic illnesses or (2) cohabiting with someone with chronic illness to those who fall in neither category at the beginning of the COVID-19 pandemic (April 2020). Study results were mixed: people with a chronic illness were more likely to have had houseguests in the past 5 days and less likely to have increased their handwashing in response to the pandemic, but were also more likely to physical distance when outside the home. Those cohabiting with someone with a chronic illness were more likely to have had houseguests, but did not differ in other outcomes.     

The Nuts and Bolts of Behavioral Observation of Marital and Family Interaction

Despite considerable discussion in the literature about the advantages of observational research and the relative benefits of different coding systems and strategies, little is written about the actual implementation of this assessment strategy. This paper presents an overall framework as well as the essential components involved in collecting (selection of task, setting, unit of analysis, and coding system) and coding (transcribing, selecting and training coders, transforming data, and analyzing reliability) of observational data. To achieve success with observational methods, we emphasize several issues, including (a) the research question as the motivator for all decisions, (b) the interrelatedness of tasks, and (c) the implications of decisions early in the process for later stages of analysis and interpretation. Investigators are encouraged to communicate the details of their observational and coding procedures so that these methods are readily accessible for purposes of replication and comparison.     

The trajectory of a dot crossing a pattern of tilted lines is misperceived

The straight trajectory of a dot crossing a pattern of tilted lines is perceived as being sinusoidal. Manipulation of the size of the angle between the trajectory and the tilted lines, the velocity of the dot, and the distance between the tilted lines shows that the magnitude of the illusion is inversely proportional to the size of the incidence angle, to velocity, and to the distance between the lines. The illusion is interpreted as being the result of an integration process of local distortions occurring at the intersections with the tilted lines.     

A short note on the estimation of the asymptotic covariance matrix for polychoric correlations

By using a Taylor expansion of the equations that define the two step estimator for polychoric correlations, the asymptotic covariance matrix for the estimated correlations can be derived in a simple and straightforward way.     

The ethics of the pharmaceutical industry and the need for a dual market system

In an era of increasing medical costs and cries for health care reform in the United States, the pharmaceutical industry has come under intense scrutiny. Ethical issues are inherent in the pharmaceutical marketplace, and there is a need to address the moral rights and responsibilities of drug manufacturers consumers, health care professionals, and governmental agents in the production, distribution, regulation, and use of these products. A dual market system protecting individual rights to access and autonomy without placing an undue strain on societal resources would provide an adequate and equitable framework for an ethical pharmaceutical industry.     

Individual differences in type A behavior and cardiovascular responses to stress

The purpose of this study was to predict heart rate and blood pressure responses to a stressor task in 166 male and female university students using the multidimensional approach of the Survey of Work Styles. The Survey of Work Styles is comprised of scales for Impatience, Anger, Time Urgency, Work Involvement, Job Dissatisfaction, and Competitiveness. Systolic blood pressure, diastolic blood pressure, and heart rate were measured before and during a 5 min serial subtraction task. Three bipolar Survey of Work Styles profiles were identified for each sex. In males, similarity to each profile was uniquely related to one task cardiovascular measure. In females, two of the three profiles were uniquely related to one physiological measure assessed during the task. The data thus support separate treatment of male and female data. Consideration was given to the possible influence of TABP components, such as Anger, in the differences in the patterns of physiological responses for different Type A profile types. Implications of the physiological results for future studies on psychophysiological differences between Type A and B individuals, and the pathological links between Type A behavior and coronary heart diseases are discussed with emphasis on the recognition of the heterogeneity of personality profiles associated with Type A behavior.