Imagining the future in health anxiety: the impact of rumination on the specificity of illness-related memory and future thinking

Individuals with health anxiety experience catastrophic fears relating to future illness. However, little research has explored cognitive processes involved in how health anxious individuals picture the future. Ruminative thinking has been shown to impede the ability to recall specific autobiographical memories, which in turn is related to maladaptive, categoric future thinking processes. This study examined the impact of rumination on memory and future thinking among 60 undergraduate participants with varying health anxiety (35% clinical-level health anxiety). Participants were randomized to experiential/ruminative self-focus conditions, then completed an Autobiographical Memory Test and Future Imaginings Task. Responses were coded for specificity and the presence of illness concerns. Rumination led to more specific illness-concerned memories overall, yet at the same time led to more categoric illness-related future imaginings. Rumination and health anxiety together best predicted overgeneral illness-related future imaginings. Highly specific illness-related memories may be maintained due to their personal salience. However, more overgeneral illness-related future imaginings may reflect cognitive avoidance in response to the threat of future illness. This divergent pattern of results between memory and future imaginings may exacerbate health anxiety, and may also serve to maintain maladaptive responses among individuals with realistic medical concerns, such as individuals living with chronic illness.     

“Putting One Foot in Front of the Other”: A Qualitative Study of Emotional Experiences and Help-Seeking in Women with Multiple Sclerosis

Treatments for depression and anxiety in multiple sclerosis (MS) are effective but evidence suggests that individuals do not always seek help for emotional difficulties. This study explored how ten women with MS (aged 30–64), recruited via a hospital based MS clinic, coped with and understood their emotions. The semi-structured interviews were analysed using interpretative phenomenological analysis. Eight participants discussed the analytic process and themes. Four overarching themes emerged: Disclosure stress, Uncomfortable dependence, Facing deterioration and One step at a time. The women struggled emotionally with many aspects of living with MS yet coping alone provided a way of defying MS and maintaining independence and control. The women needed emotional support but reported thinking others either did not notice or understand; their emotions often felt invisible. More holistic care from services was desired. Non help-seeking for distress was partially influenced by a desire to keep things “normal” and a lack of knowledge regarding service provision.     

Failure of further learning: Activities,structure, and meaning

Previous research has shown that little benefit is achieved through spaced study and recall of text passages after the first recall attempt, an effect that we term the failure‐of‐further‐learning. We hypothesized that the effect occurs because a situation model of the text's gist is formed when the text is first comprehended and is consolidated when recalled; it dominates later recall after verbatim memories of more recent study episodes have been lost. Experiments 1 and 2 attempted to circumvent the effect by varying the activities of participants and requiring interactive exploration. In both experiments, recall after four, weekly sessions showed little benefit beyond performance on the first recall. Experiment 3 interfered with the formation of an immediate situation model by introducing passages that were hard to comprehend without a title. Performance improved substantially across four sessions when titles were not supplied, but the standard effect was replicated when titles were given. Experiment 4 made verbatim memories available by incorporating all re‐presentations and tests into one session; as predicted, recall improved over successive tests.     

Effects of treatment‐integrity failures on a response‐cost procedure

Effects of incorrect or partial implementation (poor treatment integrity) on response cost are largely unknown. We evaluated reduced treatment integrity during response cost on rates of 2 concurrently available responses. College students earned points by clicking on either a black circle or a red circle on a computer screen. Experiment 1 compared 2 types of treatment‐integrity failures (omission and commission errors) across 2 levels of integrity (20% and 50%). Compared to 100% integrity conditions, omission errors did not suppress responding to the same extent, and commission errors reduced target responding but also decreased rates of alternative behavior. Experiment 2 compared the effects of 20% and 50% omission errors within subjects. Implementation at 50% integrity adequately suppressed responding, but treatment effects were lost at 20% integrity. There may be a critical level at which response cost must be implemented to suppress responding, which has important implications for application.     

Procedural learning: A developmental study of motor sequence learning and probabilistic classification learning in school-aged children

In this study, we investigated motor and cognitive procedural learning in typically developing children aged 8–12 years with a serial reaction time (SRT) task and a probabilistic classification learning (PCL) task. The aims were to replicate and extend the results of previous SRT studies, to investigate PCL in school-aged children, to explore the contribution of declarative knowledge to SRT and PCL performance, to explore the strategies used by children in the PCL task via a mathematical model, and to see whether performances obtained in motor and cognitive tasks correlated. The results showed similar learning effects in the three age groups in the SRT and in the first half of the PCL tasks. Participants did not develop explicit knowledge in the SRT task whereas declarative knowledge of the cue–outcome associations correlated with the performances in the second half of the PCL task, suggesting a participation of explicit knowledge after some time of exposure in PCL. An increasing proportion of the optimal strategy use with increasing age was observed in the PCL task. Finally, no correlation appeared between cognitive and motor performance. In conclusion, we extended the hypothesis of age invariance from motor to cognitive procedural learning, which had not been done previously. The ability to adopt more efficient learning strategies with age may rely on the maturation of the fronto-striatal loops. The lack of correlation between performance in the SRT task and the first part of the PCL task suggests dissociable developmental trajectories within the procedural memory system.     

Developing a Model of Advanced Training to Promote Career Advancement for Certified Genetic Counselors: An Investigation of Expanded Skills,Advanced Training Paths,and Professional Opportunities

There are currently multiple paths through which genetic counselors can acquire advanced knowledge and skills. However, outside of continuing education opportunities, there are few formal training programs designed specifically for the advanced training of genetic counselors. In the genetic counseling profession, there is currently considerable debate about the paths that should be available to attain advanced skills, as well as the skills that might be needed for practice in the future. The Association of Genetic Counseling Program Directors (AGCPD) convened a national committee, the Committee on Advanced Training for Certified Genetic Counselors (CATCGC), to investigate varied paths to post-master’s training and career development. The committee began its work by developing three related grids that view career advancement from the viewpoints of the skills needed to advance (skills), ways to obtain these skills (paths), and existing genetic counselor positions that offer career change or advancement (positions). Here we describe previous work related to genetic counselor career advancement, the charge of the CATCGC, our preliminary work in developing a model through which to view genetic counselor advanced training and career advancement opportunities, and our next steps in further developing and disseminating the model.     

How does self stigma differ across people with psychiatric diagnoses and rheumatoid arthritis,and how does it impact on self-esteem and empowerment?

Self stigmatising attitudes have been found in people who have psychiatric diagnoses, however, research assessing self stigma in physical illnesses is rare. It is known that receiving a diagnosis of rheumatoid arthritis (RA) can affect a person’s identity and self esteem. This study aimed to compare levels of self stigma, self esteem and empowerment between people diagnosed with psychiatric illnesses and people diagnosed with RA to establish whether self stigma, and specifically endorsement of negative stereotypes, is associated with self esteem and empowerment across these two groups. A total of 202 participants (psychiatric group n = 102; RA group n = 100) were interviewed using the Internalised Stigma of Mental Illness scale (ISMI), or the Internalized Stigma of Mental Illness scale- Rheumatoid Arthritis (ISMI-RA), the Index of Self Esteem (ISE) and the Mental Health Confidence Scale (MHCS). Overall, the psychiatric group had higher self stigma scores (2.5 vs. 2.2, p < .01), lower self esteem (48.7 vs. 36.8, p < .001) and lower empowerment scores (3.8 vs. 4.3, p < .001) than the RA group. However, sizable proportions of both groups had high self stigma scores. ISMI/ISMI-RA was associated with the ISE and the MHCS. The stereotype endorsement subscale of the ISMI/ISMI-RA was not related to self esteem or empowerment in either group. Interventions that aim to decrease self stigma and increase self esteem could focus on alienation.     

Psychological ownership in relation to workplace trust and turnover intent

The study investigated the relationship between workplace trust, psychological ownership and turnover intent within a South African professional services organisation. A cross-sectional quantitative survey design was used to collect data from a purposive sample (n = 302) of skilled, highly skilled and professional employees in a professional services industry. The participants completed the Psychological Ownership Questionnaire, Workplace Trust Survey, and Turnover Intentions Scale. The results from structural equation modelling (SEM) suggest psychological ownership to be significantly related to workplace trust (positively) and turnover intent (negatively). In addition, the findings indicate psychological ownership to fully mediate the relationship between workplace trust and turnover intent. By implication, work environments that fostered workplace trust would increase the level of psychological ownership that employees’ experienced, which, in turn, would reduce employees’ intent to leave their workplace.     

Engagement in Group Psychotherapy Among Marginalized Individuals With Hepatitis C

This article examines an innovative psychoeducational group model at a community-based hepatitis C treatment program in Toronto, Canada. Group support is increasingly used as part of community-based, interdisciplinary approaches to addressing the complex psychosocial needs and barriers to care of individuals living with and/or undergoing treatment for hepatitis C. This article articulates the theoretical framework and details of one such group model. It also examines group engagement and outcomes using data collected over three group cycles. Psychotherapeutic engagement was higher than might be anticipated for a highly marginalized population. Specifically, group cohesion measures were equivalent or higher compared to norms for other support/psychotherapy groups. This study suggests that individuals with complex psychosocial issues have the ability to engage meaningfully in group therapy.