Symptoms,blood-pressure information and mood effects on symptom recall

Abstract

After completion of an illness symptom checklist (PILL) covering the previous three months, 97 nor-motensives were allocated to either experimental (false pressor feedback, n=42), or information control (accurate pressor feedback, n = 55), groups. The median reported symptom score divided high from low symptom subjects. All were given standard cuff blood pressure (BP) assessment and were normotensive. However, experimental subjects were misinformed that their BP was raised while information control subjects were told their BP was normal. Subsequently, subjects completed the state anxiety form of the State-Trait Personality Inventory, the PILL, and were asked about their belief of the ascribed BP label (normo/hypertensive) and then any perceived causal relationship between their BP and symptoms. Experimental subjects had significantly higher anxiety scores but no change in symptom recall after pressor feedback, whereas control subjects showed lower anxiety scores and decreases in symptom recall.

A post hoc treatment control (no pressor information) group (n = 20) excluded effects of BP labeling on post-BP scores, and a post hoc symptom control group (n = 55) ensured that symptom levels were representative of the normal population. The majority of subjects in both groups rejected any association between BP labels and symptoms. Data are discussed in the light of Leventhal's models of illness representation.     

Perceived Change in Life Satisfaction and Daily Negative Affect: The Moderating Role of Purpose in Life

Perceiving changes in life satisfaction has been linked to diminished health and well-being. Purpose in life is theorized to promote well-being by providing a sense of personal consistency, which may buffer the negative consequences of perceived change. Using data from the Midlife in the United States study, a cluster analysis was performed to explore profiles of adults’ (N = 1,746) ratings of life satisfaction for their past, present, and future. The analysis yielded three distinct profiles: continuous high, incremental, and decremental. Relative to the other profiles, decremental adults reported greater levels and variability of negative affect in everyday life. However, purpose moderated these effects such that no between-profile differences in negative affect level or variability were detected for adults reporting greater levels of purpose. Purpose is discussed as an asset for promoting positive adjustment in adulthood.     

Improving sleep with mindfulness and acceptance: A metacognitive model of insomnia

While there is an accumulating evidence to suggest that therapies using mindfulness and acceptance-based approaches have benefits for improving the symptoms of insomnia, it is unclear how these treatments work. The goal of this paper is to present a conceptual framework for the cognitive mechanisms of insomnia based upon mindfulness and acceptance approaches. The existing cognitive and behavioral models of insomnia are first reviewed and a two-level model of cognitive (primary) and metacognitive (secondary) arousal is presented in the context of insomnia. We then focus on the role of metacognition in mindfulness and acceptance-based therapies, followed by a review of these therapies in the treatment of insomnia. A conceptual framework is presented detailing the mechanisms of metacognition in the context of insomnia treatments. This model proposes that increasing awareness of the mental and physical states that are present when experiencing insomnia symptoms and then learning how to shift mental processes can promote an adaptive stance to one's response to these symptoms. These metacognitive processes are characterized by balanced appraisals, cognitive flexibility, equanimity, and commitment to values and are posited to reduce sleep-related arousal, leading to remission from insomnia. We hope that this model will further the understanding and impact of mindfulness and acceptance-based approaches to insomnia.     

Knowledge and use of memory strategies in amnestic mild cognitive impairment

Despite the inclusion of memory strategy training in many interventions for amnestic mild cognitive impairment (aMCI), little research has directly examined knowledge and use of memory strategies in aMCI and their relationship to memory performance in order to guide the development of targeted interventions. The present study aimed to compare strategy knowledge and use between an aMCI and a healthy older adult (HOA) sample, and to determine the contribution of strategy knowledge and use to memory performance in each of these groups. The sample comprised 37 aMCI and 52 HOA participants aged over 60 years. All participants completed questionnaires to assess strategy knowledge and self-reported use of internal and external strategies in everyday life. In addition, strategy use was observed on the measures of retrospective and prospective memory performance (the CVLT-II and the CAMPROMPT). The aMCI group demonstrated decreased strategy knowledge and observed use of internal strategies, although equivalent observed use of external strategies compared with the HOA group. Furthermore, they reported equivalent use of both internal and external strategies. Observed use of strategies was significantly associated with retrospective memory performance for both groups and prospective memory performance for the aMCI group, supporting the inclusion of strategy training in interventions.     

Poverty and health: the mediating role of perceived discrimination

Social-class discrimination is evident in many societies around the world, but little is known about its impact on the poor or its role as an explanatory variable in the link between socioeconomic status and health. The current study tested the extent to which perceived discrimination explains socioeconomic gradients in physical health. Participants were 252 adolescents (51% male, 49% female; mean age = 17.51 years, SD = 1.03 years) who participated in Wave 3 of an ongoing longitudinal study focusing on the developmental consequences of rural poverty. Physical health was operationalized as allostatic load, a measure of cumulative wear and tear on the body caused by overactivation of physiological systems that respond to stress. Mediation analyses suggested that 13% of the effect of poverty on allostatic load is explained by perceived discrimination. The findings suggest that social-class discrimination is one important mechanism behind the influence of poverty on physical health.     

Learned irrelevance: A contemporary overview

This article reviews the recent literature on the topic of learned irrelevance. It asks whether the retardation of subsequent conditioning produced by uncorrelated preexposure is indeed the result of the animal learning that a conditioned stimulus (CS) and unconditioned stimulus (US) are unrelated, or whether it is better explained either as a result of the context specificity of latent inhibition, or as some other artefact of the uncorrelated schedule employed. The conclusion is that there is as yet no good evidence to support the existence of a “genuine” learned irrelevance effect.     

Analysis of the learned irrelevance effect in appetitive Pavlovian conditioning

In Experiments 1 and 2 rats received uncorrelated presentations of a light conditioned stimulus (CS) and a food unconditioned stimulus (US) on each day of a preexposure phase. Control subjects received the same number of USs during the first half of preexposure and the same number of CSs during the second. Uncorrelated preexposure retarded inhibitory conditioning. Experiment 3 showed, however, that the different patterns of US preexposure experienced by the two groups could in itself influence the course of subsequent inhibitory conditioning. When this factor was equated by restricting the uncorrelated treatment to the first half of the pre-exposure phase (Experiment 2) or by extending the control treatment throughout the phase (Experiment 4) it was found that uncorrelated preexposure retarded excitatory conditioning, but facilitated inhibitory conditioning. This outcome challenges an interpretation in terms of the concept of learned irrelevance, which predicts that uncorrelated preexposure should retard both forms of conditioning.