Illness perceptions are the main predictors of depression and anxiety symptoms in patients with chronic pain

Depression and anxiety symptoms in chronic pain are associated with adverse clinical outcomes, and appear highly related to patient’s illness perceptions as well as with marital adjustment. This study aimed to investigate the predictive value of pain variables, marital adjustment and illness perceptions on depression and anxiety in patients with chronic pain. Two hundred patients were recruited from a pain unit in a public hospital in the north of Portugal. Patients completed a questionnaire that assessed illness perceptions (IPQ-Brief), marital adjustment (revised dyadic adjustment scale), depression and anxiety symptoms (hospital anxiety depression scale) and pain variables (pain intensity and pain disability index). Depression and anxiety symptoms were associated with pain intensity, pain-related disability, marital adjustment and illness perceptions. Results from hierarchical regression showed that illness perceptions contributed significantly to depression and anxiety symptoms over and above the effects of pain intensity, pain-related disability and marital adjustment, after controlling for gender. In multivariate analyses, pain intensity, pain-related disability and marital adjustment were uniquely related to depression and anxiety symptoms, whereas specific illness perceptions were uniquely related to depression symptoms (identity, treatment control, emotional response and coherence) and to anxiety symptoms (identity, emotional response and concern). Perceptions of greater symptomatology (identity) and of emotional impact, and lesser perceptions of treatment control and understanding of chronic pain (illness comprehensibility) were significantly associated with increased depression symptoms. Perceptions of greater symptomatology (identity), emotional impact and greater concern were associated with anxiety symptoms. These findings indicate that the contribution of illness perceptions was greater than that made by traditional covariates, and may therefore be a useful basis for future psychological interventions.     

Questions of Evidence in Evidence-Based Policy

Evidence-based approaches to policy-making are growing in popularity. A generally embraced view is that with the appropriate evidence at hand, decision and policy making will be optimal, legitimate and publicly accountable. In practice, however, evidence-based policy making is constrained by a variety of problems of evidence. Some of these problems will be explored in this article, in the context of the debates on evidence from which they originate. It is argued that the source of much disagreement might be a failure to addressing crucial philosophical assumptions that inform, often silently, these debates. Three controversial questions will be raised which appear central to some of the challenges faced by evidence-based policy making: firstly, how do certain types of facts candidate themselves as evidence; secondly, how do we decide what evidence we have, and how much of it; and thirdly, can we combine evidence. In addressing these questions it will be shown how a philosophically informed debate might prove instrumental in clarifying and settling practical difficulties.     

What Do White Counselors and Psychotherapists Need to Know About Race? White Racial Socialization in Counseling and Psychotherapy Training Programs

Multicultural training in academic counseling and psychotherapy programs is often designed to address the needs of minority populations, and it rarely places Whiteness in the spotlight. Its structure, in fact, risks mirroring the very dynamics embedded in White privilege. Using the framework of feminist theory, we build on key findings on White racial socialization—which has a profound impact on the quality of communication and interaction within and across racial groups—to outline the skills and awareness needed for White counselors and psychotherapists to promote racial justice in both their individual/counseling and community/advocacy work.     

Knowledge attribution revisited: a deflationary account

According to the usual way of understanding how true knowledge attribution works, it is not right to attribute knowledge of p to S unless p is true and S is justified in believing p. This assumption seems to hold even if we shun away from the idea that we can give an analysis of knowledge in terms of necessary and sufficient conditions. I want to raise some suspicions on the correctness of this traditional picture. I suggest that justification is not always perceived as a necessary condition for true knowledge attribution, according to our pre-theoretical usage of standard epistemic terms. This is not to say that justification is never seen as an important requirement; sometimes it certainly is. Still, the full-fledged, traditional position on epistemic justification needs to be seriously qualified. Ultimately, I will contend that this result lends support to a rival epistemological standpoint — what we might dub a Moderate Peircean stance on epistemic matters.     

Interference and conflict monitoring in individuals with amnestic mild cognitive impairment: A structural study of the anterior cingulate cortex

Amnestic mild cognitive impairment (aMCI) is a clinical condition characterized by memory impairment in the absence of any other cognitive impairment and is commonly associated with high conversion to Alzheimer's disease. Recent evidence shows that executive functions and selective attention mechanisms could also be impaired in aMCI. In this study, we investigated performance differences (i.e., reaction times [RTs] and accuracy) between a group of aMCI participants and a group of age‐matched healthy individuals on the attentional network task (ANT) focusing on situations with increased interference. In particular, we assessed the relationship between interference and conflict effects and grey matter volumes (GMVs) of the anterior cingulate cortex (ACC)/pre‐supplementary motor area in the entire sample because of its crucial role in conflict monitoring. When compared with controls, aMCI participants were less accurate on the ANT, showing increased interference and conflict effects, but no differences in RTs. In addition, aMCI participants exhibited lower GMV in the ACC than controls. While better accuracy for interference and conflict effects was associated with an increase of GMV in the ACC for both groups, RTs from the interference effect were negatively correlated with GMV of the ACC only in aMCI participants. In other words, lower GMV values of the ACC were paralleled with significantly impaired performance in terms of interference resolution. In conclusion, our study suggests the presence of a selective impairment in interference and conflict monitoring in aMCI, which in turn is associated with decreased GMVs in the ACC.     

Detrimental educational practices deemed as culturally acceptable: Adultcentrism and Black Pedagogy in Italian primary schools

Social Psychology of Education - In a complex and systemic view of human development, the educational relationship is conceived as the keystone of development (Pianta, 1999; Pianta, 2001). However,...     

Newborn preference for a new face vs. a previously seen communicative or motionless face

Newborn infants prefer to look at a new face compared to a known face (still-face). This effect does not happen with the mother-face. The newborns could be attracted by the mother-face because, unlike the still-face, it confirms an expectation of communication.Fifty newborns were video-recorded. Sixteen of them were recruited in the final sample: nine were exposed to a communicative face and seven to a still-face. All the 16 newborns were successively exposed to two preference-tasks where a new face was compared with the known face.Only newborns previously exposed to a still-face preferred to look at a new face instead of the known face. The results suggest that the newborns are able to build a dynamic representation of faces.     

A General Population Twin Study of Conduct Problems and the Auditory P300 Waveform

Reduced amplitude of the P300 event-related potential has been consistently associated with a variety of externalising problems, including conduct disorder. The few available genetically-informative studies of these relationships, however, were conducted among adolescents/adults (i.e., at an age when conduct disorder has typically already become manifest). Among 200 general population twins with a mean age of 9 years (range 6–14 years), we studied the relationship between the P300 waveform elicited by an auditory oddball task and the DSM-oriented conduct problems scale of the Child Behavior Checklist 6–18. Conduct problems scores were negatively and significantly correlated (r?=??0.19, p?=?0.01) with P300 amplitude; correlations between P300 amplitude and the other DSM-oriented Child Behavior Checklist scales were non-significant, except for oppositional defiant problems (p?=?0.01). We found moderate heritability estimates for both P300 amplitude (0.58, CI:0.37;0.73) and conduct problems (0.52, CI:0.25;0.70). Bivariate twin analyses indicated that the covariation between these two phenotypes can be explained by additive genetic factors only, with a genetic correlation of ?0.33. An association between reduced P300 amplitude and conduct problems can be substantiated already in childhood, at an age that precedes the most typical onset of conduct disorder. This relationship appears to be genetic in nature. Reduced P300 amplitude can represent a valuable marker for conduct problems, and can contribute to the early identification of children at high-risk for conduct disorder.     

Prevalence of anxiety and depression in Australian adolescents: comparisons with worldwide data

Data from two Australian studies were combined so that the prevalence of anxiety and depression in a large, normative sample of Australian adolescents could be investigated. The combined sample comprised 1,299 adolescents randomly selected from metropolitan and country schools in Melbourne, a large Australian city. The data were examined in order to ascertain the percentages of adolescents who scored above the clinical cut-off on two self-report instruments--the Revised Children's Manifest Anxiety Scale (C. R. Reynolds & B. O. Richmond, 1985) and the Reynolds Adolescent Depression Scale (W. M. Reynolds, 1986). The results of these analyses were then compared with previously reported prevalence rates from studies worldwide. This comparison revealed striking differences in the prevalence of anxiety and depression across different countries and cultures. Limitations attributable to different self-report measures and imposed-etic approaches are discussed. Issues pertaining to social and political climate are also raised.