The experience of attending a lay-led,chronic disease self-management programme from the perspective of participants with multiple sclerosis

A lay-led, community-based intervention, the Chronic Disease Self-Management Course (CDSMC) is effective for a range of long-term health conditions (e.g. arthritis, heart disease). However, the perceived value and experience of the CDSMC for people with Multiple Sclerosis (MS) has not been examined. The present qualitative study addressed this omission. Ten participants with MS (7 female; age range 35 to 60 years; disease duration 4 to 19 years) were interviewed before attending the CDSMC and at 4-month follow-up. Data were analysed using Framework Analysis. Some participants learned new self-management techniques and reported enhanced confidence (self-efficacy), whereas other participants were already confident in their self-management ability and found the CDSMC acted as a reminder of techniques previously used. Relaxation, pacing, and goal setting were particularly valuable for managing fatigue. Goal setting helped some participants to build confidence. Participants valued meeting similar others including those with different conditions. The CDSMC was an opportunity for social comparison and inspirational role modelling. Improvements to the CDSMC were suggested, including the addition of specific MS information. Overall, the CDSMC was viewed as a valuable source of new skills and a reminder of previously learned self-management skills, particularly in the context of managing fatigue. Gender differences emerged.     

Anxiety Sensitivity and Interoceptive Exposure: A Transdiagnostic Construct and Change Strategy

Recent findings support the relevance of anxiety sensitivity (AS) and interoceptive exposure (IE) across emotional disorders. This study (a) evaluated levels of AS across different anxiety disorders, (b) examined change in AS over the course of transdiagnostic psychological intervention, and its relationship with outcome, and (c) described the implementation of IE to address AS with patients with different anxiety disorders. Participants (N = 54) were patients who received treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) in two consecutive treatment trials. Participants completed a measure of AS at pre- and posttreatment, and multiple occasions during treatment. Symptom severity was assessed at pre- and posttreatment, and clinical information related to physical symptoms and IE were collected as part of routine clinical practice. Elevated AS was observed at pretreatment across diagnoses and decreases in AS were observed from pre- to posttreatment. Similar changes occurred across the diagnostic categories, notably coinciding with the introduction of IE. Change in AS was correlated with reduced symptom levels at posttreatment and 6-month follow-up. Patients with different anxiety disorders endorsed similar physical symptoms and practiced similar IE exercises with similar effects. Results provide preliminary support for the usefulness of IE as a treatment strategy across the spectrum of anxiety disorders, and additional support for the transdiagnostic relevance of AS.     

A job-seeking self-efficacy scale for people with physical disabilities: preliminary development and psychometric testing

People with disabilities are at an increased risk of unemployment. The role of interventions aiming to enhance the employment prospects of people with disabilities is receiving increased attention. However, evaluation is hampered by the paucity of measures specific to the needs of the target population. The purpose of the present study was to develop and conduct preliminary testing of the psychometric properties of a job-seeking self-efficacy (JSS) scale that reflected the experiences of people with physical disabilities. Job-seeking self-efficacy was defined as perceived ability to perform the skills involved in seeking employment that are salient to people with disabilities. Scale development and testing involved four studies and resulted in the 12-item JSS scale and six-item managing disability at interview (MDI) component, both of which were unidimensional and had high internal consistency. In addition, there was evidence of construct and concurrent validity. Greater jobseeking self-efficacy and perceived ability to manage disability at interview were associated with more positive psychological well-being. Only the MDI component was associated with physical functioning: lower perceived ability to manage disability at interview was associated with greater impairment of physical functioning. The pattern of associations supported the rationale for a separate component reflecting the need to resolve practical issues linked to access and availability of facilities before participation in the interview procedure per se .     

Treatment approaches for sleep difficulties in college students

College students face many challenges and live experiences that may lead to sleep difficulties, including: varied and changing schedules, repeated deadlines, increased freedom and self-responsibility, and group living arrangements, to name but a few. A high frequency of sleep difficulties is commonly reported among college student and others who encounter similar life experiences. The prevalence of sleep difficulties is explored and a rationale provided for treatment. It is suggested that interventionists need to consider the impact of sleep difficulties on their clients' immediate and long-term functioning. To help psychologists, counsellors, and therapists better ameliorate sleep problems a number of proven techniques are reviewed which are applicable to individuals in both clinical and non-clinical settings.     

Investigating the relationship between trait and ability emotional intelligence and theory of mind

Theoretical links between emotional knowledge and theory of mind (ToM) have previously been proposed. This study investigates this relationship using measures of both ability and trait emotional intelligence (EI). Our sample comprised 194 children, divided into two age groups (5–7 years and 8–10 years). Children participated in measures of false belief understanding, advanced tests of ToM, ability EI and trait EI, and a standardized language assessment. For both age groups, we found that only ability EI was related to false belief understanding. Furthermore, regression analyses revealed that the understanding and managing branches of ability EI predicted unique variance in false belief understanding once controlling for age, language, and the other ability EI branches. Trait EI failed to display any association with false belief understanding. Ability and trait EI were associated with more advanced ToM tasks undertaken only by the older sample. These results offer support for previous research that has found a relationship between emotion perception and labelling and ToM. They also provide new knowledge: (1) higher order emotional knowledge, measured by ability EI, is associated with advanced ToM; and (2) emotional self efficacy, as measured by trait EI, is also important in advanced ToM. Furthermore, they provide the first account of associations between standardized EI measures and ToM.     

Fading to increase heterosexual responsiveness in homosexuals

Heterosexual responsiveness, measured by penile responses and reports of behavior, was strengthened in three homosexuals through a fading procedure. Using two slide projectors, colored slides of nude females were superimposed on colored slides of nude males. As the sexual response was emitted, the nude male was faded out and the nude female faded in. Heterosexual arousal decreased when the fading procedure was reversed or stopped and increased once again when fading was resumed. Homosexual arousal remained high during this experiment but had decreased in two subjects at follow-up. The results suggest that fading was responsible for altering stimulus control of sexual arousal and that aversive techniques may not be necessary in the treatment of sexual deviation.     

Comparison of bulimics, obese binge eaters, social phobics, and individuals with panic disorder on comorbidity across DSM-III-R anxiety disorders.

Eighty-two women, presenting as normal-weight bulimics, obese binge eaters, social phobics, and individuals with panic disorder, were compared on anxiety, depression, and substance abuse. All were administered the Anxiety Disorder Interview Schedule-Revised and completed the Michigan Alcohol Screening Test, Drug Abuse Screening Test, and Self-Consciousness Scale. A striking proportion of eating disorder subjects were comorbid for one or more anxiety disorders, the most frequent diagnoses being generalized anxiety disorder and social phobia. The results suggest that the place of anxiety in bulimia nervosa goes beyond that discussed within the context of the anxiety reduction model. Conflicting comorbidity findings among this and prior investigations are noted, however, and discussed in terms of the issue of differential diagnosis between eating and anxiety disorders.