Living with Multiple Endocrine Neoplasia Type 1: Decent Care-Insufficient Medical and Genetic Information A Qualitative Study of MEN 1 Patients in a Swedish Hospital

This qualitative study explores how 29 Swedish patients with Multiple Endocrine Neoplasia type 1 (MEN1) experience living with the condition, appraisal of the clinical follow-up program, and surveys their future expectations. The aim of this study is to build knowledge about this patient group in order to provide optimal care. The participants describe physical, psychological, and social limitations in their daily activities and how these limitations influence quality of life. Our findings indicate that a majority of patients have adjusted to their situation, describing themselves as being healthy despite physical symptoms and treatment. The participants received decent care in the clinical follow-up program, - however, greater effort should be put into patient information. These patients might benefit from genetic counseling. Health professionals involved should recognize their potential impact and influence on a patient’s ability to adjust to these circumstances. Antonovsky`s Sense of Coherence theory is used to discuss these findings.     

The Influence of Cancer-related Distress and Sense of Coherence on Anxiety and Depression in Patients with Hereditary Cancer

This study examines the association between Sense of Coherence and anxiety and depression amongst patients at risk of hereditary cancer receiving genetic counseling. When writing this article, 144 patients referred for genetic counseling due to a suspicion of hereditary cancer in the family were recruited for this multicentered longitudinal study on the psychosocial aspects of genetic counseling in Norway. A total of 96 (66%) patients responded to the follow-up survey distributed 6 months after genetic counseling. This survey included the Sense of Coherence-29 Scale, Impact of Event Scale, and Hospital Anxiety and Depression Scale. Multiple regression analyses were applied. Our results show association between cancer-related distress and symptoms of anxiety and depression. Sense of Coherence is significantly associated with both anxiety and depression. The hypothesis of Sense of Coherence buffering cancer-related distress and the possible impact of these findings for genetic counseling are discussed.     

Nonlinear principal components analysis: introduction and application

The authors provide a didactic treatment of nonlinear (categorical) principal components analysis (PCA). This method is the nonlinear equivalent of standard PCA and reduces the observed variables to a number of uncorrelated principal components. The most important advantages of nonlinear over linear PCA are that it incorporates nominal and ordinal variables and that it can handle and discover nonlinear relationships between variables. Also, nonlinear PCA can deal with variables at their appropriate measurement level; for example, it can treat Likert-type scales ordinally instead of numerically. Every observed value of a variable can be referred to as a category. While performing PCA, nonlinear PCA converts every category to a numeric value, in accordance with the variable's analysis level, using optimal quantification. The authors discuss how optimal quantification is carried out, what analysis levels are, which decisions have to be made when applying nonlinear PCA, and how the results can be interpreted. The strengths and limitations of the method are discussed. An example applying nonlinear PCA to empirical data using the program CATPCA (J. J. Meulman, W. J. Heiser, & SPSS, 2004) is provided.     

Executive disorders and perceived socio‐emotional changes after traumatic brain injury

Although socio‐emotional changes are very frequently encountered after traumatic brain injury (TBI), the psychological mechanisms underlying these disorders are still poorly understood. This study aimed to explore the relationships between dysexecutive syndrome (assessed with the Behavioural Assessment of the Dysexecutive Syndrome [BADS]) and socio‐emotional changes assessed by the Iowa scales of personality change (ISPC) in patients with TBI. The BADS was thus administered to 25 patients with TBI and to 25 healthy controls. Simultaneously, a close relative of each patient was given the ISPC in order to assess socio‐emotional changes. Results indicated that patients displayed significantly lower executive performances than controls and experimented significant socio‐emotional changes. The Modified Six Elements Test was the only subtask of the BADS to be significantly related to behavioural changes, and more specifically to externalizing disorders. It is concluded that executive functions, and especially multitasking, encompass processes whereby one can consciously control one's emotional reactions and behaviours.     

How Social Are Task Representations?

ABSTRACT— The classical Simon effect shows that actions are carried out faster if they spatially correspond to the stimulus signaling them. Recent studies revealed that this is the case even when the two actions are carried out by different people; this finding has been taken to imply that task representations are socially shared. In work described here, we found that the "interactive" Simon effect occurs only if actor and coactor are involved in a positive relationship (induced by a friendly-acting, cooperative confederate), but not if they are involved in a negative relationship (induced by an intimidating, competitive confederate). This result suggests that agents can represent self-generated and other-generated actions separately, but tend to relate or integrate these representations if the personal relationship between self and other has a positive valence.     

A behavioral route to dysfunctional representations: The effects of training approach or avoidance tendencies towards novel animals in children

We examined the effects of training to approach or avoid novel animals on fear-related responses in children. Ninety-five primary school children (9-13 years old) were instructed to repeatedly push away or pull closer pictures of novel animals. We tested whether this manipulation would lead to changes in self-reported attitudes, implicit attitudes, fear beliefs, and avoidance behaviors towards these animals.The training produced more positive self-reported attitudes towards the pulled animal and more negative attitudes towards the pushed animal. After the training, girls reported more fear and avoidance of the pushed animal than of the pulled animal, while such training effects were absent in boys. No significant training effects were observed on implicit attitudes. Interestingly, the level of anxiety disorder symptoms prior to training was related to some of the training effects: Stronger prior fear was related to stronger changes in self-reported attitudes, and in boys, also to fear beliefs.The finding that a simple approach-avoidance training influences children's fear-related responses lends support to general theories of fear acquisition in children as well as to models that try to explain the intergenerational transmission of anxiety. [184 words]     

Expectancy bias and the persistence of posttraumatic stress

Anxious individuals tend to overestimate the probability that encounters with anxiogenic stimuli (CS) will be followed by aversive consequences (UCS). This study examined whether such (biased) UCS expectancies predict the persistence of PTSD symptoms. A total of 265 soldiers were recruited before a four-month deployment to Iraq in 2004. About 2-5 months after deployment, 171 (65%) soldiers completed self-report scales about adverse events in Iraq and PTSD symptoms, and a UCS expectancy task. In this task, participants were exposed to a series of deployment-related and deployment-unrelated (control) picture stimuli. For each trial, the participants indicated the subjective probability that a particular slide would be followed by an imminent loud noise. Around 15 months after deployment, 130 (76%) soldiers completed surveys about PTSD symptoms again. Only a small group of participants had high levels of PTSD symptoms. Regression analyses showed that the level of PTSD symptoms at 15 months was predicted by earlier PTSD symptoms, but also and independently by an enhanced UCS expectancy to deployment-related stimuli. The findings support the notion that UCS expectancy bias contributes to the persistence of PTSD symptoms.     

Uncertainty about perception and dissociation after compulsive-like staring: Time course of effects

Repeated and compulsive-like checking reduces confidence in memory for the last check. Obsessive-compulsive (OC) patients are not only uncertain about memory, but may also be uncertain about perception, while this perceptual uncertainty may be associated with prolonged visual fixation on the object of uncertainty. It was reported earlier that, among healthy participants, prolonged staring at light bulbs or gas rings induces OC-like uncertainty about perception and feelings of dissociation [van den Hout, M. A., Engelhard, I. M., de Boer, C., du Bois, A., & Dek, E. (2008). Perseverative and compulsive-like staring causes uncertainty about perception. Behaviour Research and Therapy, 46, 1300–1304]. In that study, staring continued for 10 min. For patients, however, staring intervals seem to be considerably shorter. To test the clinical credibility of the paradigm as a model of the maintenance of OC perceptual uncertainty, we investigated whether the effects of staring materialize long before 10 min. Five groups of 16 undergraduates participated: one group did not stare at a gas stove while the others stared for 7.5, 15, 30 or 300 s. In the absence of staring, no pre-to-post increase in dissociation/uncertainty was reported, but after staring it was. The larger part of the observed dissociation/uncertainty after 5 min had occurred within 30 s, and around 50% of this maximal increase was reported between 7.5 and 15 s. Thus, even relatively short intervals of staring induce uncertainty about perception and dissociative experiences. Perseverative looking at objects may be a counter-productive OC strategy, which increases uncertainty about perception and may serve to maintain the disorder.