Anxiety and Depression in Medically Ill Older Adults

Anxiety and depression are extremely common in the elderly with medical problems. They can manifest not only as symptoms of a primary psychiatric illness, but also as physiologic sequelae of medical illnesses and medical treatments. Recognition and treatment of depression and anxiety in the medically ill is especially difficult. If these states go untreated, they result in higher morbidity and mortality, higher health care costs and utilization, and poorer functional status and outcomes. Three of the most common medical illnesses that afflict geriatric patients, cardiovascular disease, pulmonary disease, and rheumatoid arthritis, will be presented to illustrate the difficulty in recognizing depression and anxiety and the impact of treating these symptoms in the medically ill elderly. Multidisciplinary approaches combining optimal medication regimens and psychosocial interventions can be effective for treatment of anxiety and depression in the medically ill elderly.     

Psychometric properties of reverse-scored items on the CES-D in a sample of ethnically diverse older adults

Reverse-scored items on assessment scales increase cognitive processing demands and may therefore lead to measurement problems for older adult respondents. In this study, the objective was to examine possible psychometric inadequacies of reverse-scored items on the Center for Epidemiologic Studies Depression Scale (CES-D) when used to assess ethnically diverse older adults. Using baseline data from a gerontologic clinical trial (n = 460), we tested the hypotheses that the reversed items on the CES-D (a) are less reliable than nonreversed items, (b) disproportionately lead to intraindividually atypical responses that are psychometrically problematic, and (c) evidence improved measurement properties when an imputation procedure based on the scale mean is used to replace atypical responses. In general, the results supported the hypotheses. Relative to nonreversed CES-D items, the 4 reversed items were less internally consistent, were associated with lower item-scale correlations, and were more often answered atypically at an intraindividual level. Further, the atypical responses were negatively correlated with responses to psychometrically sound nonreversed items that had similar content. The use of imputation to replace atypical responses enhanced the predictive validity of the set of reverse-scored items. Among older adult respondents, reverse-scored items are associated with measurement difficulties. It is recommended that appropriate correction procedures such as item readministration or statistical imputation be applied to reduce the difficulties.     

Quantitative and Qualitative Research: Beyond the Debate

Psychology has been a highly quantitative field since its conception as a science. However, a qualitative approach to psychological research has gained increasing importance in the last decades, and an enduring debate between quantitative and qualitative approaches has arisen. The recently developed Mixed Methods Research (MMR) addresses this debate by aiming to integrate quantitative and qualitative approaches. This article outlines and discusses quantitative, qualitative and mixed methods research approaches with specific reference to their (1) philosophical foundations (i.e. basic sets of beliefs that ground inquiry), (2) methodological assumptions (i.e. principles and formal conditions which guide scientific investigation), and (3) research methods (i.e. concrete procedures for data collection, analysis and interpretation). We conclude that MMR may reasonably overcome the limitation of purely quantitative and purely qualitative approaches at each of these levels, providing a fruitful context for a more comprehensive psychological research.

Evaluation of a psychosocial intervention on social support, perceived control, coping strategies, emotional distress, and quality of life of breast cancer patients

The purpose of this research was to demonstrate that a specific psychosocial intervention changes reactions to cancer and quality of life. This study was carried out on 66 patients with a first breast cancer. Patients were randomly divided into two groups: a specific intervention group (G1, 8 sessions) or a support group (G2, 8 sessions). A control group (G3) was composed of patients who refused to participate in psychological intervention. Social support, perceived control, repression of emotions, coping strategies, emotional distress, and quality of life were assessed one week before (T1) and at the end (T2) of the psychological intervention. Results showed that G1 did not have significantly modified quality of life or psychological scores. Patients of G2 had poorer emotional quality of life, use of internal causal attributions, and minimized their illness at T1 as compared to patients of G3. At Time 2 these differences were not observed.     

Jeri altneu sechzer (1926-2011)

Presents an obituary for Jeri Altneu Sechzer. Jeri studied at the University of Pennsylvania, where her mentor was the renowned physiological psychologist Elliot Stellar. She received her doctorate in 1962 with a specialty in physiological psychology. That same year she was elected to Sigma Xi, the scientific research society, and received the Creative Talent Award from the American Institute of Research for her doctoral dissertation. She completed a U.S. Public Health Service Postdoctoral Fellowship at the University of Pennsylvania School of Medicine, after which she accepted a position at Baylor University College, followed by a position at the New York Hospital-Cornell University Medical Center. She completed her career as a visiting professor in the Psychology Department at Pace University. Jeri's husband of 56 years, Philip, died in 2004. As a result of her experience looking after him during the long illness that preceded his death, she became interested in the psychological impact of the stresses that caregivers face. She was planning to organize a conference on this subject when she suffered her final illness, leading to her death on October 29, 2011, just before her 85th birthday. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Family law issues in family therapy practice

Abstract

The FAST represents a vast improvement over other figure placement techniques (FPTs). It offers an assessment procedure that measures both cohesion and power, assesses several family levels, allows for interpretation and comparison of individual and collective perceptions, and yields a more complex view of family dynamics by providing information regarding family organization across situations. Further, the FAST allows clinicians to hypothesize about treatment prognosis, plan systemic interventions, and monitor structural transformations that occur during therapy. As structural and developmental theories seem to be two of the more commonly recognized perspectives across disciplines (as evidenced by the types of relational additions in the soon-to-be-published DSM-IV), the FAST has the potential to become an interdisciplinary diagnostic and empirical link. Recommendations are noted here to maximize the potential of the FAST as a theoretically grounded and psychometrically sound family instrument.     

A Family Therapy Narrative

The evolution of the field of family therapy since its inception in the 1950s is traced in this article. Major contributory forces as well as key pioneers in the first generation and leaders in successive generations are highlighted. This is followed by an elucidation of the conceptual foundations and basic principles undergirding almost all of the main theoretical schools. Expansion in this now vast field is underscored through attention to the proliferation of the number of books and journals addressing family therapy/psychology topics as well as mention of the internationalization of the field. A typology of extant theoretical models is also presented. The article closes with a discussion of contemporary issues and trends.