Motivational Interviewing Promotes Adherence and Improves Wellbeing in Pre-Dialysis Patients with Advanced Chronic Kidney Disease

Low rates of adherence to medical treatments and adverse emotional states are a widespread problem in advanced chronic kidney disease (ACKD). Motivational interviewing using the stages of change model is an effective combination in promoting behavior modifications. The objective of the present study was to determine the effectiveness of an individual, pre-dialysis intervention program (monthly sessions of 90 min over a 6-month period) in terms of adherence, emotional state and health-related quality of life (HRQL). Forty-two patients were evaluated for adherence, depression, anxiety and HRQL with standardized self-report questionnaires. Biochemical markers were also registered. The results show that after the intervention, patients reported significantly higher levels of adherence, lower depression and anxiety levels, and better HRQL (i.e., general health and emotional role domains). Biochemical parameters were controlled significantly better after the intervention, except for iPTH. These findings highlight the potential benefit of applying individual psycho-educational intervention programs based on motivational interviewing and using the stages of change model to promote adherence and wellbeing in ACKD patients.     

A Cross-Sectional and Longitudinal Investigation of the External Correlates of Sluggish Cognitive Tempo and ADHD-Inattention Symptoms Dimensions

The objective was to determine if the external correlates of sluggish cognitive tempo (SCT) and ADHD-inattention (IN) dimensions were the same in cross-sectional and longitudinal analyses. Teachers and aides rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), and depression along with academic impairment in 758 Spanish children (55 % boys) on three occasions (twice at the end of the first grade year [6-week separation] and then again 12-months later at the end of the second grade year). Three of eight SCT symptoms showed substantial loadings on the SCT factor and substantially higher loadings on the SCT factor than the ADHD-IN factor for teachers and aides at each assessment (seems drowsy, thinking is slow, and slow moving). Cross-sectional and longitudinal analyses yielded similar results with SCT and ADHD-IN factors having different and unique external correlates (higher scores on SCT predicted lower scores on ADHD-HI and ODD while higher scores on ADHD-IN predicted higher scores on ADHD-HI and ODD with SCT and ADHD-IN both uniquely predicting academic impairment and depression). Developmental and methodological reasons are discussed for the failure to find an inconsistent alertness SCT factor (daydreams, alertness fluctuates, absent-minded, loses train of though, and confused).     

The black community's reactions to the 1992 los angeles riot

This article is based on field (street) interviews with a sample of 227 black community members living and/or working in South Central Los Angeles at the time of the 1992 riot. The interview instrument comprises 20 questions designed to (1) ascertain the reactions and feelings of black community members to the riot; and (2) compare a sample of black participants in the riot with nonparticipants. The participant group was found to be more frequently younger males with less education and lower income, and they were more likely to have arrest records prior to the riot than nonparticipants. Though reactions and feelings were mixed and contradictory, both groups reported an overall acceptance of the disorders. Differentials in reactions were in degree rather than in kind. Most objected to the riot in principle but concluded that collective violence “pays off.” The preriot structural facilitators (poverty, relative deprivation, unemployment, police brutality, racial discrimination, and negative police‐community relations) were similar to those found in the riot literature. Whatever the participants’ reasons and justifications for rioting might be, they present themselves as worthy protesters and freedom fighters. Unless their message is heeded and acted upon by ameliorating their adverse social, economic, and political conditions, similar riots are likely to occur.     

Creativity and future time perspective: Exploring fantasy and realistic measures

The purposes of this study were to investigate the relationship between the cognitive dimensions of creativity and Future Time Perspective (FTP) and to explore the usefulness of a real‐world measure of divergent thinking. The sample consisted of 135 female undergraduate students with a mean age of 19 years. Creativity was measured using Guilford's Consequences and FTP was measured using the Future Problem‐Solving Task (FPST). Consequences is a fantasy oriented assessment and the FPST is a realistically oriented assessment. Results showed that Consequences and the FPST were moderately correlated. These findings suggest that both creativity and practicability play important roles in an adolescent's ability to solve real‐world future problems. Implications center on the appropriateness and utility of employing real‐life problems in creativity problem‐solving tasks for adolescents.     

Cognitive Factors in Fibromyalgia: The Role of Self-Concept and Identity Related Conflicts

Fibromyalgia is a syndrome characterized by the presence of diffuse and chronic musculoskeletal pain of unknown etiology. Clinical diagnosis and the merely palliative treatments considerably affect the patient's experience and the chronic course of the disease. Therefore, several authors have emphasized the need to explore issues related to self in these patients. The repertory grid technique (RGT), derived from personal construct theory, is a method designed to assess the patient's construction of self and others. A group of women with fibromyalgia (n = 30) and a control group (n = 30) were assessed using RGT. Women with fibromyalgia also completed the Fibromyalgia Impact Questionnaire and a visual-analogue scale for pain, and painful tender points were explored. Results suggest that these women had a higher present self–ideal self discrepancy and a lower perceived adequacy of others, and it was more likely to find implicative dilemmas among them compared to controls. These dilemmas are a type of cognitive conflict in which the symptom is construed as “enmeshed” with positive characteristics of the self. Finally, implications of these results for the psychological treatment of fibromyalgia are suggested to give a more central role to self-identity issues and to the related cognitive conflicts.     

Diagnosis of cognitive impairment onset in older adults based on limitations in language skills / Diagnóstico del inicio del deterioro cognitivo en mayores a partir de limitaciones en las capacidades lingüísticas

Abstract

Progressive decline in language has been described in neuropsychological studies on Alzheimer’s disease and Mild Cognitive Impairment (MCI). We investigate this decline in its early stages, as well as its manifestations and the linguistic differences between participants at risk of developing MCI and without impairment. Participants were 36 older adults, all aged over 65. They were assessed using 31 subtests grouped into eight areas: fluency, comprehension, oral expression, reading, writing, memory, perceptual organization and processing speed. Our results showed significant differences between participants at risk of developing MCI and without impairment in verbal tests but not in manipulative tests. All participants at risk of developing MCI scored lowest in these eight areas. Our findings illustrate the relevance of investigating language skills in people at risk of developing MCI. Investigating these neuropsychological changes will help design appropriate intervention programmes that affect areas with higher levels of impairment.     

An evaluation of a perceived overqualification scale across work settings

The authors extended and evaluated the dimensionality of the L. J. Khan and P. C. Morrow (1991) subjective underemployment scale. They used data from 3 independent samples to assess the measurement properties of the scale. The results of confirmatory factor analyses supported 2 dimensions and indicated that the measurement model parameters partially generalized across samples. Correlational and additional confirmatory factor analytic results rendered empirical support for most of the postulated relationships of the 2 overqualification dimensions with the somatization, job satisfaction, and organizational commitment variables. The findings indicate that the scale of perceived overqualification needs to be further developed and validated in different samples. The implications of the findings for person-job fit are discussed.     

“Weapons effect” revisited: Motor effects of the reception of aversive stimulation and exposure to pictures of firearms

The effect of presenting images of firearms on the speed of clenching of the fist of human subjects simultaneously receiving an aversive stimulation was studied. It was thought that, whereas the classic interpersonal experimental situation confounds the effects of the stimulus presented and several interpersonal processes, speed of fist clenching in a noninterpersonal setting could constitute a valid measure of the subject's readiness to fight. Twenty-four male and 24 female students (ages > 20 and <36 years) were instructed to press with their right hand a device commanding the projection of slides upon reception of an acoustic signal. Speed of clenching of the hand was recorded in the four conditions generated by the combination of two levels of acoustic signal (aversive and nonaversive) and two modalities of slides (firearms or tools). The results show that the reception of aversive sound accelerates fist clenching. Simultaneous presentation of slides of firearms and reception of aversive noise increases the speed of clenching of the fist. The slides' main effect was not significant. More irritable subjects tend to execute this movement faster than their less irritable counterparts, and more emotionally susceptible subjects tend to be slower than less susceptible ones. Male subjects were faster than females. This pattern of results is discussed in relation to the hypothesis formulated by the authors.