‘It was all intertwined’: Illness representations and self-management in patients with cancer and anxiety/depression

Objective: Cancer and anxiety/depression frequently co-occur, leading to poorer outcomes for these illnesses. However, the majority of existing research investigates how participants view single illnesses alone. This study aimed to explore the content of individuals’ multimorbid representations and how these relate to their coping behaviours and self-management strategies for cancer and anxiety/depression.

Design: A semi-structured qualitative research design with theoretical thematic analysis.

Main Outcome Measures: Multimorbid illness representations, coping behaviours, and self-management strategies.

Results: In interviews with 21 participants multimorbid representations varied, three participants viewed cancer and anxiety/depression as unrelated, five participants were uncertain about the relationship between cancer and anxiety/depression, and the majority of participants perceived cancer and anxiety/depression as related. This third group of participants often described relationships as causal, with representations having both positive and negative influences on coping behaviours and self-management strategies. Representations were shown to change over the course of the cancer experience, with fear of cancer recurrence and the influence of participants’ most challenging illness also discussed.

Conclusions: People hold multimorbid illness representations that can influence self-management. An awareness of these representations by researchers, health professionals, and patients is important for the creation of future interventions that aim to improve and maintain patient wellbeing.     

‘I think a little bit of a kick is sometimes what you need’: Women’s accounts of whole-body scanning and likely impact on health-related behaviours

Objective: This study was designed to investigate whether whole-body scanning might promote healthy eating and physical activity in women, and to explore the effects of scanning on body image.

Design: Fourteen women aged 22–45 years without histories of eating disorders or whole-body scanning took part in semi-structured interviews before and after scanning. Data were analysed using inductive thematic analysis.

Results: Scans did not look as expected, and participants expressed ‘surprise’ and ‘shock’. Participants focused on perceived negative aspects of their bodies as revealed in scan images, and agreed that women with body concerns would find scans too ‘real’ and ‘raw’. Eleven women who met UK Government physical activity and healthy eating guidelines reported that the scan provided additional motivation to maintain, and in nine cases to increase, those behaviours. Two women who neither exercised nor ate healthily would not increase physical activity or change their diets significantly following scanning.

Conclusion: Whole-body scanning may enable maintenance or even acceleration of physical activity and healthy eating, but is unlikely to be useful in promoting initiation of these behaviours. Participants engaged in unhelpful body critique when viewing scans; scanning needs to be confined to contexts where support is provided, to avoid increasing body-related concerns.     

Strategies for learning proper names: expanding retrieval practice,meaning and imagery

Name learning strategies including retrieval practice, semantic associations and imagery were compared in laboratory‐based and real‐life experiments. Experiments 1 and 2 studied expanding retrieval practice and a semantic association strategy as memory improvement techniques for learning proper names. Participants either retrieved or restudied names on the same, expanding schedule. After a short, filled interval, cued recall of names was about 250% better following retrieval than restudy and 200% better with than without semantic associations. Together, the techniques improved recall by 300–400%. In Experiment 3, retrieval practice was compared with an imagery mnemonic for name learning under real‐life social conditions: Participants sought to learn the names of people they met at a party. Retrieval practice produced 50% higher recall after 24–72 hours but the imagery mnemonic was no more effective than non‐directed instructions to learn names. Copyright © 2005 John Wiley & Sons, Ltd.     

The extent of working memory deficits associated with Williams syndrome: exploration of verbal and spatial domains and executively controlled processes

The present study investigated verbal and spatial working memory (WM) functioning in individuals with the neuro-developmental disorder Williams syndrome (WS) using WM component tasks. While there is strong evidence of WM impairments in WS, previous research has focused on short-term memory and has neglected assessment of executive components of WM. There is a particular lack of consensus concerning the profile of verbal WM functioning in WS. Here, WS participants were compared to typically developing participants matched for (1) verbal ability and (2) spatial ability (N = 14 in each of the 3 groups). Individuals with WS were impaired on verbal WM tasks, both those involving short-term maintenance of information and executive manipulation, in comparison to verbal-matched controls. Surprisingly, individuals with WS were not impaired on a spatial task assessing short-term maintenance of information in memory (remembering spatial locations) compared to spatial-matched controls. They were, however, impaired on a spatial executive WM task requiring the manipulation of spatial information in memory. The present study suggests that individuals with WS show WM impairments that extend to both verbal and spatial domains, although spatial deficits are selective to executive aspects of WM function.     

The closed mind: ‘Experience’ and ‘cognition’ aspects of openness to experience and need for closure as psychological bases for right‐wing attitudes

Openness to Experience and Need for Closure (NFC) are dispositional variables related to social‐cultural right‐wing attitudes. The present study investigated their joint effects. Factor analysis revealed an ‘experiential’ dimension with high loading openness items, and a ‘cognition’ dimension with high loadings for most NFC items and about a quarter of the openness item set. The experiential openness items were weakly related to right‐wing attitudes, demonstrating little predictive value. Conversely, the cognitive openness and NFC items were powerful predictors of right‐wing attitudes, and also played an important role in integrative models, both as a predictor of authoritarianism‐based racism and as a mediator of age related increments in right‐wing attitudes. It is concluded that right‐wing attitudes should be primarily understood in terms of (motivated) cognition, and to a smaller extent in terms of experiential openness. The distinction between ‘experiential’ and ‘cognitive’ openness is critically assessed, and it is asserted that because cognition is a multifaceted construct openness contains more than one cognitive dimension. Copyright © 2010 John Wiley & Sons, Ltd.     

Probabilistic reasoning in prediction and diagnosis: Effects of problem type,response mode,and individual differences

In prediction, subset relations require that the probability of conjoined events is never higher than that of constituent events. However, people's judgments regularly violate this principle, producing conjunction errors. In diagnosis, the probability of a hypothesis normatively is often higher for conjoined cues. An online survey used a within‐subjects design to explore the degree to which participants (n = 347) differentiated diagnosis and prediction using matched scenarios and both choice and estimation responses. Conjunctions were judged more probable than a constituent in diagnosis (76%) more often than prediction (64%) and in choice (84%) more often than direct estimation (57%), with no interaction of type of task and response mode. Correlation, regression, and path analyses were used to determine the relationships among individual difference variables and the diagnosis and prediction tasks. Among the correlation findings was that time spent on the task predicted higher conjunction probabilities in diagnosis but not prediction and that class inclusion errors predicted increased conjunction errors in choice but not estimation. Need for cognition and numeracy were only minimally related to reasoning about conjunctions. Results are consistent with the idea that people may misapply diagnostic reasoning to the prediction task and consequently commit the conjunction error. Copyright © 2010 John Wiley & Sons, Ltd.     

Measuring strategic control in artificial grammar learning

In response to concerns with existing procedures for measuring strategic control over implicit knowledge in artificial grammar learning (AGL), we introduce a more stringent measurement procedure. After two separate training blocks which each consisted of letter strings derived from a different grammar, participants either judged the grammaticality of novel letter strings with respect to only one of these two grammars (pure-block condition), or had the target grammar varying randomly from trial to trial (novel mixed-block condition) which required a higher degree of conscious flexible control. Random variation in the colour and font of letters was introduced to disguise the nature of the rule and reduce explicit learning. Strategic control was observed both in the pure-block and mixed-block conditions, and even among participants who did not realise the rule was based on letter identity. This indicated detailed strategic control in the absence of explicit learning.     

Motor inhibition associated with the affordance of briefly displayed objects

Research has demonstrated that left- and right-hand responses are facilitated when they are performed with the hand compatible with the orientation of a viewed object. This suggests that graspable objects automatically activate the motor representations that correspond to their orientation. It has recently been proposed that similar positive stimulus-response compatibility effects (PCE) may turn into negative compatibility effects (NCE) when a prime object is displayed very briefly. These NCEs are suggested to reflect motor inhibition mechanisms--motor activation triggered by briefly viewed objects may be treated by the motor system as unwanted, and thus it is rapidly inhibited. We examined whether the motor activation triggered by the orientation of a task-irrelevant object is similarly inhibited when the object is displayed briefly. In Experiment 1, a NCE was observed between the orientation of an object and the responding hand when the object was displayed for 30 or 70 ms. The effect turned into a PCE when the object was displayed for 370 ms. Experiment 2 confirmed that this motor inhibition effect was produced by the handle affordance of the object rather than some abstract visual properties of the object.     

Skulking around the dinosaur: Eliciting cues to children's deception via strategic disclosure of evidence

Research has shown that cues to deception are more salient as an effect of strategic use of evidence (SUE) during interviews. This study examined the feasibility of the SUE‐technique for eliciting cues to children's deception. Experiment 1 investigated verbal cues to deception as a function of early vs. late disclosure of evidence. Eighty‐four children (12–14 years) either guilty or innocent of a mock crime were interviewed. As predicted, deceptive statements were significantly more inconsistent with the evidence than truthful statements, and this was more pronounced as a function of late compared to early disclosure of evidence. In Experiment 2, adult observers (N = 168) made veracity assessments of the videotaped statements. Observers in the late disclosure condition achieved an accuracy rate higher than chance (63.1%), whereas accuracy rates in the early disclosure condition were at chance level (56%). Accuracy rates were significantly higher for truthful (70.2%), than deceptive statements (48.8%). Copyright © 2009 John Wiley & Sons, Ltd.