Sandwich Generation Caregiving: A Complex and Dynamic Role

The overall purpose of this study was to explore the lived experiences of sandwich generation (SG) women and the influence multigenerational caregiving had on their health behaviors. The specific purpose of this paper was to examine the roles of SG women, whom are individuals providing care to both their aging parents/in-laws and children (Sinha, Spotlight on Canadians: Results from the General Social Survey: Portrait of caregivers, 2012. Statistics Canada catalogue no. 89-652-X – No. 001, Social and Aboriginal Statistics Division, Ottawa, Ontario, 2013). This study was qualitative in nature and utilized the theoretical orientation of phenomenology. Nine SG women completed a background questionnaire and a semi-structured one-on-one interview. After critically analyzing the data, four salient themes emerged, however, this paper only focused on the theme the role of the caregiver. Five subthemes were developed from this theme: (1) Physical care; (2) “Sounding board”: Emotional aspects of caregiving; (3) Never enough time in the day; (4) Am I a caregiver to my children?; and (5) Transitions and variations in caregiving. These findings provide an in-depth understanding of the role of SG women and the complexities that occur when faced with caregiving. This study hopes to provide more knowledge to support government legislation, sandwich generation caregivers, and healthcare providers.     

Gaze,dominance and humiliation in the Schreber case1

In this paper the author reviews Freud's study of Schreber's Memoirs and the Memoirs themselves from a perspective of nearly 100 years. He argues that Schreber's illness began as a melancholic depression but quickly developed paranoid features which subsequently escalated into a gross paranoia which nevertheless retained its depressive and hypochondriacal base. Finally the chaotic fragmentation became organized under the dominance of an omnipotent narcissistic organisation which led to a clinical improvement without any relinquishment of his delusional beliefs. As a subsidiary theme he examines the role of gaze in Schreber's object relations and argues that gaze was used to project into his objects, then to scrutinise the object to see if the projections had been received and tolerated, and finally as an expression of dominance. His urgent demand for relief provoked an omnipotence in his objects which he was then able triumphantly to frustrate and which ushered in a struggle over dominance in the course ofwhich Schreber was abused and humiliated. He was unable to find an object who could contain his distress and these factors contributed to the failure to tolerate guilt and to work through his depression.     

Effects of pharmacological manipulations of NMDA-receptors on deliberation in the Multiple-T task

Both humans and non-human animals have the ability to navigate and make decisions within complex environments. This ability is largely dependent upon learning and memory processes, many of which are known to depend on NMDA-sensitive receptors. When humans come to difficult decisions they often pause to deliberate over their choices. Similarly, rats pause at difficult choice points. This behavior, known as vicarious trial and error (VTE), is hippocampally dependent and entails neurophysiological representations of expectations of future outcomes in hippocampus and downstream structures. In order to determine the dependence of VTE behaviors on NMDA-sensitive receptors, we tested rats on a Multiple-T choice task with a reward-delivery reversal known to elicit VTE. Rats under the influence of NMDA-receptor antagonists (CPP) showed a significant reduction in VTE, particularly at the reward reversal, implying a role for NMDA-sensitive receptors in the generation of vicarious trial and error behaviors.     

Electronic records of undesirable driving events

The cause of the majority of road crashes can be attributed to drivers’ behavior. Recent in-vehicle monitoring technologies enable continuous and high resolution measurements of drivers’ behaviors. We analyzed the information received from a novel in-vehicle technology which identifies the occurrences of undesirable driving events such as extreme braking and accelerating, sharp cornering and sudden lane changing. We undertook an exploratory analysis to provide better understanding of events frequency (EF) statistical properties. Our findings show higher EF in trip edges (trip beginning and trip end) than in the middle of the trip, higher EF for males than for females and higher EF at nighttime than at daytime. Use of the in-vehicle technology’s continuous and high resolution measurements enabled interesting advanced statistical analyses. Future research can use our findings to build similar statistical models to predict the occurrence of undesirable driving events by other independent variables.     

An application of DSM-IV's outline for cultural formulation: Understanding conduct disorder in Latino adolescents

In the established guidelines for providers of services to ethnic, linguistic, and culturally diverse populations, the American Psychological Association addressed the need for practitioners to consider the role that culture and ethnicity plays in the psychosocial development of culturally diverse populations. Currently, there are over 24 million Latinos in the United States, and this population is expected to quadruple in size to over 81 million in the year 2050. This discussion of a case example highlights the appropriateness of utilizing the outline for cultural formulation in working with Latino adolescents diagnosed with Conduct Disorder. As indicated by the DSM-IV's outline for cultural formulation, this discussion addresses the importance of assessing the following: 1) Cultural identity of the individual; 2) Cultural explanations of the individual's illness; 3) Cultural factors related to psychosocial environment and levels of functioning; 4) Cultural elements of the relationship between the individual and the clinician; 5) Overall cultural assessment for diagnosis and care. In particular, the discussion focuses on specific reasons why the utilization of the outline for cultural formulation can greatly assist the clinician in understanding many psychosocial elements unique to treating Conduct Disorder in the Latino adolescent.     

Rumination-focused cognitive behaviour therapy for residual depression: a case series

The treatment of chronic and recurrent depression is a priority for the development of new interventions. The maintenance of residual symptoms following acute treatment for depression is a risk factor for both chronic depression and further relapse/recurrence. This open case series provides the first data on a cognitive-behavioural treatment for residual depression that explicitly targets depressive rumination. Rumination has been identified as a key factor in the onset and maintenance of depression, which is found to remain elevated following remission from depression. Fourteen consecutively recruited participants meeting criteria for medication--refractory residual depression [Paykel, E.S., Scott, J., Teasdale, J.D., Johnson, A.L., Garland, A., Moore, R. et al., 1999. Prevention of relapse in residual depression by cognitive therapy--a controlled trial. Archives of General Psychiatry 56, 829-835] were treated individually for up to 12 weekly 60-min sessions. Treatment specifically focused on switching patients from less helpful to more helpful styles of thinking through the use of functional analysis, experiential/imagery exercises and behavioural experiments. Treatment produced significant improvements in depressive symptoms, rumination and co-morbid disorders: 71% responded (50% reduction on Hamilton Depression Rating Scale) and 50% achieved full remission. Treating depressive rumination appears to yield generalised improvement in depression and co-morbidity. This study provides preliminary evidence that rumination-focused CBT may be an efficacious treatment for medication--refractory residual depression.     

Clarification of the dual task dilemma: Lateralized effects for perfunctory and purposeful tasks in left- and right-handed males

The hypothesis that behavioral asymmetries with the dual task paradigm represent manual dominance was investigated with right- and left-handed males performing verbal and spatial tasks ordered by complexity. Lateralization was assessed for nonideational (perfunctory) and ideational (purposeful) components of tasks with multivariate and ANCOVA procedures. The outcomes of prerequisite tests showed the assumptions for conducting ANCOVA procedures were not satisfied with different handedness groups in the same design. However, results of the multivariate analyses suggest lateralized effects are more likely to represent the cognitive task when interference is high and may represent manual dominance when interference is low.     

The impact of cognitive interference on performance during prolonged sleep loss

Summary A study was conducted on the effects of off-task cognitions on performance during sleep deprivation. Subjects answered the Thought Occurrence Questionnaire, assessing their proneness to engage in off-task cognitions, and were deprived of sleep for 72 hours, during which they performed a variety of tasks including visual discrimination and three versions of a logical reasoning task in which cognitive load was varied systematically. In addition, every day subjects answered the Cognitive Interference Questionnaire, which taps off-task cognitions during the experiment. Results indicated that subjects who habitually engage in off-task cognitions performed worse during 72 hours of sleep loss than subjects who do not engage in such distracting activities. In addition, it was found that the engagement in off-task cognitions increased during the 72 hours of sleep loss and such an engagement was related to deficits in performance accuracy. The mechanisms of off-task cognitions and sleep loss underlying these effects are discussed.