Psychological impact of illness intrusiveness in epilepsy - comparison of treatments

Chronic illnesses are associated with multiple stressors that compromise quality of life (QOL). Implicit in many of these is the concept of illness intrusiveness, the disruption of lifestyles and activities attributable to constraints imposed by chronic disease and its treatment. This study tested the illness intrusiveness theoretical framework in epilepsy and compared the impact of pharmacological and surgical treatments on illness intrusiveness and QOL. Cross-sectional data compared three epilepsy groups (N = 145): (a) 40 patients admitted for presurgical evaluation to an Epilepsy Monitoring Unit; (b) 52 patients treated pharmacologically; and (c) 53 post-surgical patients. Illness intrusiveness differed significantly across epilepsy patients with the differences primarily related to seizure control. Illness intrusiveness varied inversely with seizure control (p < .05). Seizure freedom, whether achieved by surgical or pharmacological treatments, was associated with maximal reduction of illness intrusiveness. Increased illness intrusiveness correlated significantly with decreased QOL and increased depressive symptoms. Perceived control over diverse life domains correlated positively with QOL and psychosocial outcomes. Path analysis supported the validity of the illness intrusiveness theoretical framework in epilepsy. Illness intrusiveness is an important determinant of the psychosocial impact of epilepsy and its treatment. Effective pharmacological or surgical treatment may reduce illness intrusiveness in epilepsy. Findings also offer encouragement that QOL in epilepsy, as in other chronic conditions, may be enhanced by multidisciplinary bio-psychosocial efforts. Health care providers should consider multifaceted interventions to reduce illness intrusiveness and, thereby, improve QOL.     

Impact of semantic or phonemic cues in picture-naming tasks on the calculation of the objective age-of-acquisition norms: A cross-linguistic study

In picture-naming tasks, participants name a picture as quickly as possible. In several studies, when the participant did not provide the picture name in the first seconds after object presentation, the examiner provided phonemic or semantic cues. Under these conditions, word retrieval should be easier, thus lowering the age of acquisition (AoA). The goal of the present study was to collect objective norms of AoA in French without any kind of cue. The results were then compared with other European databases that relied on picture-naming tasks conducted with phonemic or semantic cues. Globally, the data of all the databases are significantly correlated. However, the AoA measures in these databases are always lower than in our study, except in Álvarez and Cuetos (2007), who did not provide any assistance to the participant. Therefore, giving phonemic and/or semantic cues lowers the AoA values, indicating that the values from different databases in this domain should be taken with caution. The objective AoA norms from this study may be downloaded from the Psychonomic Society’s Archive of Norms, Stimuli, and Data, www.psychonomic.org/archive.     

Personality change at the intersection of autonomic arousal and stress

We hypothesized that personality change in children can be predicted by the interaction of family risk with susceptibility to autonomic arousal and that children characterized by both high-risk families and highly reactive autonomic nervous systems tend to show maladaptive change. This hypothesis was tested in a 6-year longitudinal study in which personality-type prototypicality, problem behavior, and negative emotional intensity were measured at 2-year intervals. The results indicated that children who both had exaggerated skin conductance responses (a measure of autonomic reactivity) and were living in families with multiple risk factors were most likely to develop an undercontrolled personality type and to exhibit increases in problem behavior and negative emotional intensity. The implications of the results for understanding personality change are discussed.     

Rorschach Comprehensive System data for a sample of 409 adult nonpatients from Brazil

This is a normative study with 409 adult nonpatients living in the state of Sao Paulo, Brazil. The Rorschach was administered by a team of nine psychologists; eight had had further training in the Rorschach method by the Brazilian Rorschach Society and one intensively was prepared by the project coordinator. Of the study participants, 200 lived in the state capital (Sao Paulo) and the other 209 were in other large and small cities in the state, including a coastal city and one in the mountains. Previous psychological or psychiatric treatments were criteria for exclusion. Each protocol was coded independently by two examiners, and then agreement of the two codings was checked. Differences between the two codings were discussed in a meeting of the whole team, which was supervised by the project coordinator to guarantee codification quality control. Upon completion of the codings, an analysis of examiner differences was undertaken, the results of which are in the text. Interrater reliability statistics among examiners were calculated, including percentage of agreement and kappa. Reliability statistics among examiners at the response level are presented as are Comprehensive System (CS; 1999, 2003) findings.     

Biography: A Brief History.

Journal of Religion and Health -     

What I Was Doing Versus What I Did: Verb Aspect Influences Memory and Future Actions

ABSTRACT— This research examined whether describing past actions as ongoing using the imperfective aspect (rather than describing them as completed using the perfective aspect) promotes memory for action-relevant knowledge and reenactment of these actions in a future context. In Experiment 1 , participants who used the imperfective aspect to describe their strategy on a prior interpersonal task were more likely to use this strategy on a later task than were participants who used the perfective aspect to describe their prior strategy. Experiment 2 demonstrated that describing behaviors on a task using the imperfective rather than the perfective aspect increased willingness to resume that task by improving memory for task contents. The last two experiments showed that the effects of the imperfective aspect on memory decayed over time and that the imperfective aspect facilitated performance of a future behavior only when the described past behavior was relevant to the future behavior. Thus, the effects of aspect are moderated by memory decay and are behavior-specific.     

Contemplation: Beyond and Behind

This essay seeks to explore contemplation as it features in Christian theology and philosophy, both ancient and modern. Contemplation, in ancient philosophy, is transformed in Christian theology; nonetheless, it has the structure of what Jean Wahl calls ‘transascendance’, a rising to the heights. Although contemplation remains as a theme in modern Christian theology, it drops out in modern philosophy: that is, post-Renaissance philosophy. And yet it returns, both in analytic and continental philosophy, in the twentieth century. It returns, however, in the mode of ‘transdescendance’: by way of conditions of possibility, and fundamental orientations.     

Community vs. Clinic-Based Modular Treatment of Children with Early-Onset ODD or CD: A Clinical Trial with 3-Year Follow-Up

This study examines the treatment outcomes of 139, 6–11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC). To examine normative comparisons, a matched sample of 69 healthy control children was included. Multiple informants completed diagnostic interviews and self-reports at six assessment timepoints (pretreatment to 3-year follow-up) to evaluate changes in the child’s behavioral and emotional problems, psychopathic features, functional impairment, diagnostic status, and service involvement. Using HLM and logistic regression models, COMM and CLINIC showed significant and comparable improvements on all outcomes. By 3-year follow-up, 36% of COMM and 47% of CLINIC patients no longer met criteria for either ODD or CD, and 48% and 57% of the children in these two respective conditions had levels of parent-rated externalizing behavior problems in the normal range. We discuss the nature and implications of these novel findings regarding the role of treatment context or setting for the treatment and long-term outcome of behavior disorders. This study was supported by grants to the first author from the National Institute of Mental Health (MH 57727) and to the second author by the National Institute of Nursing Research (NR 07615). The fourth author was supported by grant K01 MH078039 from the National Institute of Mental Health. The authors acknowledge the research and clinical staff of the Resources to Enhance the Adjustment of Children (REACH) program, and Drs. David Brent, Tammy Chung, William Gardner, John Lochman, and Wayne Osgood. Reprints may be obtained from Dr. Kolko, WPIC, 3811 O’Hara St., Pittsburgh, PA 15213.     

When head is tempered by heart: Heart rate variability modulates perception of other-blame reducing anger

This study examined the relationship between heart rate variability (HRV), as an index of individual differences in emotion regulation, and perception of other-blame, as a mechanism of anger induction. The physiological responses were recorded while subjects read a story from a computer screen. The story narrated a negative event in self-referred way -dismissal from a job as the result of a colleague’s action- under conditions of intentionality versus non-intentionality. Cognitive and emotional variables were assessed by questionnaire immediately after the physiological test. The resulting structural model supports the conclusion that HRV exerts its regulatory influence directly on perception of other-blame rather than on emotion. In situations of intentionality, individuals with higher HRV make less extreme evaluation of the offender’s blame, versus those with lower HRV, thus leading to a reduction in anger reaction. These results suggest that HRV is a direct index of cognitive rather than emotional regulation.