Illness perceptions in dialysis patients and their association with quality of life

The present study explored illness perceptions of end stage renal disease (ESRD) patients on both haemodialysis (HD) and peritoneal dialysis (PD) treatment, and their associations with quality of life. Leventhal's self-regulation model (SRM) was used as a theoretical framework. Illness perceptions and quality of life were assessed with the IPQ-R and the SF-36 in 91 HD and 42 PD patients participating in the NECOSAD-study. Compared to HD patients, PD patients experienced more personal control and had a better understanding of the illness. Illness perceptions explained from 17 to 51% of the variance in quality of life scores. Perception of more symptoms, more consequences and lower personal control were associated with lower well-being. The concept of illness perceptions is useful in understanding the impact of ESRD and of dialysis treatment on quality of life. Interventions aimed at providing more knowledge about ESRD and dialysis, and provision of skills to coping with the illness and its consequences may improve quality of life in dialysis patients.     

Constructing a Theory and Evidence-Based Approach to Promote and Evaluate Autonomy in Addiction

ABSTRACT

In this article we use theory and empirical evidence to synthesize a model for the analysis of autonomy in people with addictions. We review research on motivation and denial as accepted addiction constructs that need to be replaced with non-stigmatizing and autonomy-supportive language when seeking to ‘treat’ addicts. We present three main factors involved in relational autonomy in addiction (mentalizing, positive self-concept, and stigma), and illustrate our model by examining variations on these parameters in two case studies of heroin addicts. We conclude that a growth perspective is needed to assess functioning in populations believed to be ‘addicted’ and make suggestions for assessment.     

Predictors of Diabetes Self‐care,Metabolic Control,and Mental Health in Youth with Type 1 Diabetes

The purpose of this study was to explore the psychosocial predictors of diabetes self‐care (adherence to care regimes), metabolic control (glycated haemoglobin), and mental health among rural‐ and urban‐dwelling youth with type 1 diabetes. One hundred and twenty three adolescents/young adults (aged 13?25 years, mean = 16 years, standard deviation = 3.8 years) with type 1 diabetes, 50 males and 73 females, completed questionnaires reporting on diabetes self‐care, metabolic control, mental health (negative affect, quality of life), risk‐taking behaviours and attitudes, diabetes self‐efficacy, community engagement, and perceived social support. No rural/urban differences were detected on key predictors or outcome variables. Structural equation modelling revealed that high diabetes self‐efficacy, lower risk behaviour, and more conservative attitudes to risk taking predicted better diabetes self‐care, which in turn predicted better metabolic control and mental health. Social support and engagement in community activities did not influence diabetes self‐care. The study has significance because both diabetes self‐efficacy and propensity towards risk behaviour are potential targets for educational and counselling interventions designed to improve diabetes self‐care regimes and resultant metabolic and mental health outcomes.     

Knowledge junkies or careerbuilders? A mixed-methods approach to exploring the determinants of students' intention to earn a PhD

What are the determinants of students' interest in earning a PhD? In this study, we use a mixed-methods approach to pursue this question. Based on qualitative interview data, we develop a model in which academic motivation and academic achievement interact with contextual factors such as working conditions to influence career intentions. We then test this model using a sample of 229 students currently enrolled in master-level courses of study at a German university. Our results speak to the role of intrinsic versus extrinsic motivations in the context of PhD intentions. In contrast to our expectations, results suggest that while intrinsic life aspirations and the intellectual challenge of gaining a PhD play a significant role for students' intention to pursue a PhD, extrinsic life aspirations and contextual determinants seem to be less influential. Furthermore, results highlight the importance of gaining familiarity and experience with academic work for students' career decisions.     

Subtle cognitive deficits in severe alcohol addicts – Do they show a specific profile?

Although alcohol dependency is a burden to society, data on cognitive performance in therapy‐resistant patients after multiple withdrawals are poor. In this study, 22 patients without reported cognitive deficits and 20 control subjects performed extensive cognitive testing and a motor task assessing short‐term memory. Patients displayed subtle deficits (mainly in executive function), while memory functions were relatively unimpaired. Our results suggest that subtle frontal‐executive deficits may contribute to a poor prognosis, but could be missed by routine clinical tests.     

Conventions’ Revenge: Davidson,Derangement, and Dormativity

Davidson advocates a radical and powerful form of anti-conventionalism, on which the scope of a semantic theory is restricted to the most local of contexts: a particular utterance by a particular speaker. I argue that this hyper-localism undercuts the explanatory grounds for his assumption that semantic meaning is systematic, which is central, among other things, to his holism. More importantly, it threatens to undercut the distinction between word meaning and speaker’s meaning, which he takes to be essential to semantics. I argue that a moderate form of conventionalism can restore systematicity and the word/speaker distinction while accommodating Davidson’s insights about the complexities and contextual variability of language use.     

Coping Strategies in Late Adolescence: Relationships to Parental Attachment and Time Perspective

The authors investigated adolescents' use of coping strategies in relation to attachment to parents and time perspective. Adolescents in Grade 3 upper secondary school (M age = 18.3 years, SD = 0.6 years; n = 160) completed the Inventory of Parent and Peer Attachment, the Zimbardo Time Perspective Inventory, and the Brief COPE. Correlational analyses showed that attachment to parents was associated with a more favorable view of the past (higher past positive and lower past negative), a less fatalistic view of the present, and a more favorable view of the future (higher future positive and lower future negative). Parental attachment accounted for significant variance in composite coping scores (adaptive and maladaptive) when entered before, but not after, time perspective subscales in hierarchical regression analyses. However, time perspective (mainly present hedonistic and positive or negative future) predicted adaptive or maladaptive coping over and beyond attachment. The results are consistent with the hypothesis that most of the relationship between adolescents' attachment to parents and coping is mediated by individual differences in time perspective. By contrast, factors other than attachment to parents (e.g., temperament) must be considered to fully account for the relationship between time perspective and coping.     

Parental socioeconomic status and child intellectual functioning in a Norwegian sample

Socioeconomic status (SES) in childhood has been linked to cognitive function and future academic and occupational success in studies from several countries. However, previous Nordic studies have shown inconsistent results regarding the strength of this link. We therefore investigated the association between SES and cognitive functioning in a sample of 255 Norwegian children, including 151 typically developing children and 104 children with a psychiatric diagnosis. The third edition of the Wechsler Intelligence Scale for Children (WISC‐III) to assess cognitive function was used. SES was defined from maternal and paternal education and family income of typically developing children and of a subsample of children with a psychiatric diagnosis. Multiple adjusted regression analyses were used to investigate the relation between SES and cognitive functioning. The analyses showed that SES explained a significant part of the variance of the full‐scale WISC‐III score and two WISC‐III indices (Verbal Comprehension and Freedom from Distractibility). Overall, the strength of the relations was weaker than expected from reports from other non‐Nordic countries. Parental education was the only significant individual predictor, suggesting that income was of minor importance as a predictor of cognitive functioning. Further studies should investigate how diverse political and socioeconomic contexts influence the relation between SES and cognitive functioning.     

Secret Agent Society: A Randomized Controlled Trial of a Transdiagnostic Youth Social Skills Group Treatment

Group programs are key for targeting social skills (SS) for children with developmental disorders and/or mental illness. Despite promising evidence regarding efficacy of group treatments, there are several limitations to current research regarding generalizability and effectiveness across diagnoses. This randomized control trial assessed whether the Secret Agent Society (SAS) group program was superior to treatment as usual (TAU) in improving social-emotional functioning for children with Attention Deficit-Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and/or anxiety. Eighty-nine youth (8–12) with ADHD, ASD, and/or an anxiety disorder receiving treatment at hospital-based outpatient clinics were randomized to receive SAS (n?=?47) or TAU (n?=?42) over a three-month period, at which point TAU participants were offered the SAS intervention. Parent report showed significant improvement in Emotion Regulation (ER) and Social Skills (SS) for youth in SAS vs. TAU (Fs?≥?6.79, ps?≤?01). Gains for the SAS condition were maintained at 6-months. Intent-to-treat analysis of teacher report indicated youth in SAS had positive gains in SS (F?=?0.41, p?=?0.475) and ER (F?=?0.99, p?=?0.322), though not significantly better than youth in TAU. Clinically reliable improvement rates were significantly higher for SAS participants than TAU for parent and teacher reported SS and ER. Improvements were significant for youth with single and comorbid diagnoses. Results suggest that SAS was superior to TAU in improving SS and ER for youth aged 8–12 with ADHD, ASD, and/or anxiety. Gains maintained in the medium-term. Trial registration number NCT02574273, registered 10/12/2015.

     

Aprendiendo de La Vida (Learning from Life): Development of a Radionovela to Promote Preventive Health Care Utilization among Indigenous Farmworkers from Mexico Living in California

Journal of Medical Humanities - Mixtecs and Zapotecs, originating from the Oaxaca area in Mexico, are among the largest indigenous groups of workers in California. Many adults in this community...