Quality of life in patients before and after kidney transplantation

Abstract

The aim of the present study was to differentially determine quality of life (QOL) in patients with end-stage renal disease (ESRD) after successful kidney transplantation (RT, Group A) compared with ESRD patients on a waiting list for RT (Group B). and with healthy controls (Group C) because opinions vary as to which treatment modality can best assure ESRD patients a high QOL.

Groups A, B and C each consisted of 149 persons, matched for age and gender. The Munich Quality of Life Dimensions List (MLDL) was used to measure global aspects of QOL. Distinct aspects of QOL were investigated by the Brief Symptom Inventory (BSI) and the Questionnaire for Social Support (K-22).

Groups A and C reported similar QOL. Which was significantly higher than in group B (p < .0001). This was particularly true for the physical and psychological status and daily activities, but not for the social situation. Groups A and B reported similar social support, which was significantly, lower than in group C (p < 006). Both ESRD groups reported higher satisfaction with social support than healthy controls (p < .0001).

Successful RT nor only improved distinct aspects of QOL in patients with ESRD, but even put them on par with healthy controls regarding physical and psychological QOL.

Lower social support and higher satisfaction with social support in both groups of ESRD patients should be evaluated further. From a clinical viewpoint. the improvement of physical and psychological aspects of QOL in RT patients is impressive; but more attention should be paid to constantly low social support in this group of patients. International multi center longitudinal studies to investigate QOL in ESRD patients under different treatments am necessary.     

Mentalisierungsbasierte Psychotherapie bei schizophrenen Psychosen

Recently, there has been growing interest in new methods of psychotherapeutic interventions for schizophrenic patients. Social cognition, social functioning and quality of life are central objectives. Mentalization-based therapy (MBT) is a specific psychodynamic method developed from the fundament of attachment theory and empirical psychotherapy research for the treatment of borderline personality disorder, particularly focusing on attachment relationships, mentalizing capacity and affect regulation. Studies have shown that MBT is able to ameliorate interpersonal experience and social life. The latest neuroscientific findings support this view and encourage the application of a modified form of MBT in the treatment of schizophrenic patients. The authors present a concept for disorder-specific interventions in schizophrenia, including psychoeducational aspects and mentalizing exercises which step-by-step lead to a more reflective work in mentalization-based group psychotherapy.     

To Live Is to Know,to Know Is to Change: Change in Personal Construct Psychology and Psychological Constructivism

This article deals with the subject of personal change. As such, one could be tempted to say that it deals with psychology as a whole: What else should psychology be concerned with? But this is not exactly how things are, as I will argue by answering a first question: Is psychology, as a discipline, mainly concerned with the study of human change? To a second question—whether personal construct theory (PCT) in particular is mainly concerned with the study of human change—I give an affirmative answer, after some necessary qualifications. I would like to dwell particularly on answering a third question: Can the way personal construct theory deals with change be regarded as centering around a peculiarity? I am convinced that the revolutionary and cutting-edge nature of PCT can be fully appreciated only by pinpointing and highlighting such a peculiarity. In discussing this, I find it convenient to answer a last question: Is the way PCT deals with change akin to the way other theories handle it? After having discussed personal change as it is treated in PCT, I give a bird's eye view of the contribution of personal construct psychology to the fields of psychology more concerned with change—namely, developmental and educational psychology. The last part of the article will focus on the role of change in clinical psychology, and on what Kelly pointed out as the focus of convenience of his theoretical construction: personal construct psychotherapy as a relational process aimed at favoring a personal change.     

Dementia and suicidal behavior

Behavioral and psychological symptoms of dementia, including depression, might complicate the course of the disorder additionally. Dementia is more frequent in older people and suicide rates are higher in later life than in any other age group. To explore the phenomenology of suicidal behavior in patients with dementia, we searched electronic databases and key journals for original research and review articles on suicide in demented patients using the search terms “suicide, suicidal behavior, dementia, Alzheimer disease, and old age”. Although cognitive impairment could result in a diminishing ability to think flexibly and to solve problems or to cope with conflict, in the early stage of dementia such impairments are absent or mild, and suicidal behavior might be expected, especially following diagnosis. In addition, personality changes based on declining cognitive capacity and the neurochemical imbalances described in late-life depression and in dementia may predispose patients to aggressive or impulsive acts, such as suicide attempt. The literature on suicidal behavior and dementia highlights the need for further research in this area.     

The four faces of omission

In this paper, the ontological, terminological, epistemological, and ethical aspects of omission are considered in a coherent and balanced framework, based on the idea that there are omissions which are actions and omissions which are non-actions. In particular, we suggest that the approach to causation which best deals with omission is Mackie's INUS conditional proposal. We argue that omissions are determined partly by the ontological conditional structure of reality, and partly by the interests, beliefs, and values of observers. The final upshot is that moral judgments involved in cases of omissions cannot be grounded on, but are the ground for judgments about what INUS conditions count as omissions.     

Positive fantasies dampen charitable giving when many resources are demanded

Previous research found that positive fantasies about an idealized future yield low energy to pursue the fantasized future. We examined how positive fantasies about the resolution of a crisis (i.e., a lack of pain medication in Sierra Leone, the risk of flooding after Hurricane Irene) influence people's agreement to donate to charitable efforts directed at crisis resolution. In three studies, positive fantasies dampened the likelihood of agreeing to donate a relatively large amount of money, effort, or time, but did not affect the likelihood of agreeing to donate a relatively small amount of these resources. The effect of positive fantasies was mediated by perceiving the donation of larger (but not smaller) amounts of resources as overly demanding. These findings suggest that charitable solicitations requesting small donations might benefit from stimulating positive fantasies in potential donors, but those requesting large donations could be hurt.     

Dispositions and interferences

In this paper I argue that olfactory experience, like visual experience, is exteroceptive: it seems to one that odours, when one smells them, are external to the body, as it seems to one that objects are external to the body when one sees them. Where the sense of smell has been discussed by philosophers, it has often been supposed to be non-exteroceptive. The strangeness of this philosophical orthodoxy makes it natural to ask what would lead to its widespread acceptance. I argue that philosophers have been misled by a visuocentric model of what exteroceptivity involves. Since olfaction lacks the spatial features that make vision exteroceptive the conclusion that olfaction is nonexteroceptive can appear quite compelling, particularly in the absence of an alternative model of exteroceptivity appropriate to olfaction. I offer a model according to which odours seem to be external to the body because they seem to be brought into the nose from without by sniffing and breathing through the nostrils. I argue that some natural-seeming objections to this model rely on substantive assumptions about how the senses are distinguished from one another, and how perceptual experience is put together out of its modality-specific parts, that require defence.     

Alcohol intake leads people to focus on desirability rather than feasibility

According to alcohol myopia theory (Steele and Josephs in Am Psychol 45:921–933, 1990) intoxicated people disproportionally focus on the most salient aspects of a situation and ignore peripheral information. We investigated whether consuming alcohol leads people to disproportionally focus on the desirability rather than feasibility of important personal goals. Students named an important personal goal and then either consumed alcohol or a placebo. Thereafter, we asked them to freely think about their goal and to write down their thoughts and images. We content-analyzed students’ elaborations with regard to what extent they focused on the goal’s desirability and on its feasibility. Intoxicated students wrote more about aspects of desirability and less about aspects of feasibility than those who consumed a placebo. The results suggest that this effect is one mechanism by which alcohol intake leads people to feel committed to personal goals despite low feasibility of attaining these goals (Sevincer and Oettingen in J Abnorm Psychol 118:623–633, 2009).     

Ambiguous emotion recognition in temporal lobe epilepsy: The role of expression intensity

The lateralization of emotion processing is currently debated and may be further explored by examining facial expression recognition (FER) impairments in temporal lobe epilepsy (TLE). Furthermore, there is also debate in the literature whether FER deficits in individuals with TLE are more pronounced in the right than in the left hemisphere. Individuals with TLE were tested with an FER task designed to be more sensitive than those classically used to shed light on this issue. A total of 25 right- and 32 left-TLE patients, candidates for surgery, along with controls, underwent an FER task composed of stimuli shown not only at full-blown intensities (100 %), but also morphed to lower-intensity display levels (35 %, 50 %, and 75 %). The results showed that, as compared to controls, right-TLE patients showed deficits in the recognition of all emotional categories. Furthermore, when considering valence, right-TLE patients were impaired only in negative emotion recognition, but no deficits for positive emotions were highlighted in left-TLE patients. Finally, only the right-TLE patients’ impairment was found to be related to the age of epilepsy onset. Our work demonstrates that the FER deficits in TLE span multiple emotional categories and show manifestations dependent on the laterality of the epileptic focus. Taken together, our findings provide the strongest evidence for the right-hemisphere model, but they also partially support the valence model. We suggest that current models are not exhaustive at explaining emotional-processing cerebral control, and further that multistep models should be developed.