Effects of antipsychotic medication on discrimination learning for institutionalized adults who have mental retardation

Reduction in medication levels of drugs used to suppress inappropriate behavior (chlorpromazine, thioridazine and haloperidol) resulted in increases in performance on a discrimination learning task for seven residents of a state institution who are mentally retarded. After training to criterion on a matching-to-sample task, these participants experienced reductions in medication in an N of 1 AB replication paradigm. Two controls were medication free, and one remained on a stable dosage throughout. Improvement of performance on the first dependent variable (number of trials needed to meet criterion) ranged from 13.8% to 53.3% for the seven participants, while the three controls improved less than 1%. Improvement of performance on the second dependent variable (percentage of correct responses) ranged from 2.7% to 19.7% for experimental subjects; five of the seven subjects exhibited a minimum improvement of 8%. The change in percentage of correct responses for the three controls ranged from ?4.9 to 1.3. Treatment implications are discussed.     

Patient personality and time-limited group psychotherapy for complicated grief

We used a randomized clinical trial to investigate the interaction of two patient personality characteristics (quality of object relations [QOR] and psychological mindedness [PM]) with two forms of time-limited, short-term group therapy (interpretive and supportive) for 139 psychiatric outpatients with complicated grief. Findings differed depending on the outcome variable (e.g., grief symptoms, general symptoms) and the statistical criterion (e.g., statistical significance, clinical significance, magnitude of effect). Patients in both therapies improved. For grief symptoms, a significant interaction effect was found for QOR. High-QOR patients improved more in interpretive therapy and low-QOR patients improved more in supportive therapy. A main effect was found for PM. High-PM patients improved more in both therapies. For general symptoms, clinical significance favored interpretive therapy over supportive therapy. Clinical implications concerning patient-treatment matching are discussed.     

Health practices and hardiness as mediators in the stress-illness relationship

Two stress and illness models that include the joint mediating effects of health practices and hardiness were tested prospectively over a 2-month period. At the beginning of one academic quarter, 60 female and 26 male undergraduate students completed five subscales indexing hardiness. Stress, health practices, and illness for the prior month were assessed at this time as well as 1 and 2 months later. Stress was measured by the number of negatively rated stressors reported on the Life Experiences Survey. Health practices were measured by the Self Care Inventory. In the first model, illness was measured by the severity of physical symptoms reported on the Seriousness of Illness Rating Scale; in the second model, it was measured by the number of symptoms reported. Correlations between all measures of stress and illness were typical for life events research (r = .22 to .29). In both models, path analyses revealed that stress acted directly to affect illness as well as indirectly by changing health practices. Hardiness also had a direct effect on illness as well as in indirect effect through health practices. Hardiness did not appear to have a stress-buffering effect on illness; rather, its effects on illness appeared to be independent of its effects on stress. Implications for life events research are discussed.     

Dietary restraint, body dissatisfaction, and psychological distress: a prospective analysis

This study uses prospective data from a survey of 1,177 adolescent girls to examine whether emotional eating, binge eating, abnormal attitudes to eating and weight, low self-esteem, stress, and depression are associated with dietary restraint or body dissatisfaction. In analyses that included both restraint and body dissatisfaction as independent predictors, restraint was associated only with more negative attitudes to eating, whereas body dissatisfaction was significantly associated with all the adverse outcomes. These results cast doubt on the proposition that restrained eating is a primary cause of bulimic symptoms, emotional eating, and psychological distress seen in individuals who are trying to control their weight, and rather suggest that body dissatisfaction is the key factor.     

Nursing students’ reflections on an interprofessional placement in ambulatory care

Reflection has been identified as key to interprofessional education as it facilitates a focus on interprofessional communication, collaborative practice and professional roles, while contributing to debunking ingrained understandings of roles and behaviours. The aim of this study is to explore the written reflections of nursing students following an interprofessional placement in ambulatory care. A deductive analysis of nursing student reflective journal entries mapped against the university interprofessional framework was conducted. A purposeful sample of 19 graduate entry Master of Nursing Science students participating in a two-week interprofessional educational placement completed a reflective journal relating to an interprofessional placement in ambulatory care. The analysis of the journals found that all students were able to reflect on their interprofessional clinical experience, but the ability to reflect varied between students. Despite the challenges that some nursing students experienced in achieving deep levels of reflection, the study demonstrated the usefulness of incorporating reflective journals into nursing curriculums and as part of interprofessional practicums.