Caregiving in multiple sclerosis and quality of life: A meta-synthesis of qualitative research

Objective: The lack of adequate conceptualisation and operationalisation of quality of life (QoL) limits the ability to have a consistent body of evidence to improve QoL research and practice in informal caregiving for people with multiple sclerosis (MS). Thus, we conducted a meta-synthesis of qualitative research to improve the conceptual understanding of the experiences of MS carers and to identify factors that affect carers’ QoL.

Design: Systematic searches of five electronic databases yielded 17 qualitative studies which were synthesised using the principles of meta-ethnography.

Results: The synthesis resulted in nine inter-linking themes: Changes and losses; challenges revolving around MS; caregiving demands; burden of care; future concerns; external stressors; experiences of support; strategies used in managing the caregiving role; and motivating factors. Our findings suggest that MS carers can have both positive and negative experiences which may bring challenges and rewards to the carers.

Conclusion: We present a proposed QoL model for MS caregiving which can be used to inform the development of interventions for MS carers to improve their QoL. However, further empirical research is needed to examine the utility of this model and to explore the concept of QoL in MS carers in more detail.     

Age Differences in the Variance of Personality Characteristics

In contrast to mean‐level comparisons, age group differences in personality trait variance have received only passing research interest. This may seem surprising because individual differences in personality characteristics are exactly what most of personality psychology is about. Because different proposed mechanisms of personality development may entail either increases or decreases in variance over time, the current study is exploratory in nature. Age differences in variance were tested by comparing the standard deviations of the five‐factor model domain and facet scales across two age groups (20 to 30 years old versus 50 to 60 years old). Samples from three cultures (Estonia, the Czech Republic and Russia) were employed, and two methods (self‐reports and informant‐reports) were used. The results showed modest convergence across samples and methods. Age group differences were significant for 11 of 150 facet‐level comparisons but never consistently for the same facets. No significant age group differences were observed for the five‐factor model domain variance. Therefore, there is little evidence for individual differences in personality characteristics being systematically smaller or larger in older as opposed to younger people. We discuss the implications of these findings for understanding personality development. Copyright © 2015 European Association of Personality Psychology     

Are Longshots Only for Losers? A New Look at the Last Race Effect

There is evidence that betting on longshots increases in the last race of a day of horse racing. Previous accounts have assumed that the phenomenon is driven by bettors who have lost money and are trying to recoup their losses. To test this assumption of “reference dependence,” three laboratory experiments simulated a day at the races: In each of several rounds, participants chose either (i) a gamble with a small probability of a large gain and a large probability of a small loss (the “longshot”) or (ii) a gamble with a moderate chance of a small gain or a small loss (the “favorite”). The first two experiments employed a game played for points, while a third experiment included monetary incentives and stimuli drawn from a real day of racing. These experiments provide a clear demonstration of the last race effect in a laboratory setting. However, the results indicate that the effect is largely reference independent: Participants were more likely to choose the longshot in the last round regardless of whether, and how much, they had won or lost in previous rounds. Winning or losing, bettors prefer to “go out with a bang” at the end of a series of gambles. Copyright © 2015 John Wiley & Sons, Ltd.     

Collective Narcissism Predicts Hypersensitivity to In‐group Insult and Direct and Indirect Retaliatory Intergroup Hostility

Results of five studies (N = 1596) linked collective narcissism—a belief in in‐group exaggerated greatness contingent on external validation—to direct and indirect, retaliatory hostility in response to situations that collective narcissists perceived as insulting to the in‐group but which fell well beyond the definition of an insult. In Turkey, collective narcissists responded with schadenfreude to the European economic crisis after feeling humiliated by the Turkish wait to be admitted to the European Union (Study 1). In Portugal, they supported hostile actions towards Germans and rejoiced in the German economic crisis after perceiving Germany's position in the European Union as more important than the position of Portugal (Study 2). In Poland, they supported hostile actions towards the makers of a movie they found offensive to Poland (Studies 3 and 5) and responded with direct and indirect hostility towards a celebrity whose jokes about the Polish government they found offensive (Study 4). Comparisons with self‐positivity and in‐group positivity indices and predictors of intergroup hostility indicated that collective narcissism is the only systematic predictor of hypersensitivity to in‐group insult followed by direct and indirect, retaliatory intergroup hostility. Copyright © 2016 European Association of Personality Psychology     

Impulse control disorders in Parkinson’s disease: Predominant role of psychological determinants

Objectives: Impulse Control Disorders (ICDs) in Parkinson’s disease (PD) have previously almost exclusively been considered to result from anti-parkinsonian medication. However, this biomedical perspective has failed to achieve a full understanding of the phenomenon and it is argued that a failure to consider psychological factors is a critical omission.

Design: The present study examined the predictive relationship between ICDs in PD and a range of psychological measures, whilst controlling for a number of biomedical determinants.

Main outcome measures: One hundred participants with idiopathic PD completed questionnaires that assessed demographic and clinical characteristics, psychological measures and the presence of ICDs (QUIP-RS).

Results: Increased use of a ‘negative’ coping strategy, stronger illness identity, more emotional illness representations and stress were found to be significant predictors of ICDs, and different psychological predictors were associated with different ICDs. Medication was not found to predict ICDs in the presence of psychological factors, either when total treatment levels were considered or when agonist dose was considered alone.

Conclusions: This study provides the first quantitative evidence of a predominant predictive relationship between psychological factors and ICDs in PD. The results suggest that psychological interventions may have useful therapeutic role to play for ICDs in PD.     

Remembering and telling self-consistent and self-discrepant memories

It has been argued that memories that are inconsistent with one's self would differ from those that are consistent with the self. The present study addresses retrieval, phenomenology, rehearsal and narrative characteristics of autobiographical memories that are consistent versus discrepant with one's self. One hundred participants were asked to recall one self-consistent and one self-discrepant memory as well as an episode of telling these memories to others. They also filled out the Autobiographical Memory Questionnaire and the Centrality of Event Scale for each memory. Results showed no difference between self-consistent and self-discrepant memories in retrieval time, specificity or phenomenology. However, self-discrepant memory narratives contained more meaning-making statements and less autonomy than self-consistent memories. Compared to self-consistent memories, self-discrepant memories were told to fewer people, and listener responses were more negative when they were told. Results are discussed in relation to the functions these memories serve.     

M. Parkinson: L-Dopa nach wie vor wirksamste Therapie

More than 50 years after its introduction into clinical practice, L?dopa still is the most effective therapy for Parkinson’s disease and the gold standard for all other medications. In this article, two case reports are used to illustrate the good clinical efficacy and also the long-term complications of L?dopa therapy. The cause for these problems are the pharmacokinetics of L?dopa in combination with the progressive loss of nigrostriatal dopaminergic neurons in the course of the disease. New formulations of L?dopa offer hope for the improvement of these complications. One of these will soon be available for clinical use, while others are being tested in ongoing clinical trials.