Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.     

Unexpected death,religious coping and conjugal bereavement outcomes in Africa (Togo)

This pioneering study in sub-Saharan African context examined the role played by religious strategies (religious coping, religious community support (RCS)) in the conjugal bereavement process and its outcomes depending on the expected or unexpected death. Based on cross-sectional approach, the study targeted Togolese bereaved spouses (N?=?162). The mean period of mourning was 112.52 months (SD?=?94.72). The results of a hierarchical regression revealed that RCS was positively associated with grief symptoms when the death was expected and, unsurprisingly, the negative religious coping predicted grief symptoms when the death was sudden and unexpected. Religious strategies would play a threefold role: providing refuge and comfort, regulating the bereavement distress and serving resources to give meaning to the loss of the beloved. Theoretical and clinical implications of these findings are discussed.     

Parenting style as a mediator between children's negative emotionality and problematic behavior in early childhood

Negative emotionality is considered to be the core of the difficult temperament concept (J. E. Bates, 1989; R. L. Shiner, 1998). In this correlational study, the authors examined whether the relations between children's negative emotionality and problematic behavior (internalizing and externalizing) were partially mediated by parenting style (authoritative and authoritarian) in a community sample of 196 3-year-old children and their mothers. The authors assessed maternal perception of child negative emotionality using the Children's Behavior Questionnaire (M. K. Rothbart, S. A. Ahadi, K. L. Hershey, & P. Fisher, 2001) and assessed problematic child behavior by means of maternal report using the Child Behavior Checklist (T. M. Achenbach, 1992). The results showed that the relations between child negative emotionality and internalizing and externalizing behaviors were partially mediated by mothers' authoritative parenting style. Moreover, when the authors used confirmatory factor analysis to decontaminate possible overlap in item content between measures assessing temperament and problematic behavior, the association between negative emotionality and internalizing behavior was fully mediated by authoritative parenting.     

Addressing confounding errors when using non-experimental, observational data to make causal claims

In their recent book, Is Inequality Bad for Our Health?, Daniels, Kennedy, and Kawachi claim that to “act justly in health policy, we must have knowledge about the causal pathways through which socioeconomic (and other) inequalities work to produce differential health outcomes.” One of the central problems with this approach is its dependency on “knowledge about the causal pathways.” A widely held belief is that the randomized clinical trial (RCT) is, and ought to be the “gold standard” of evaluating the causal efficacy of interventions. However, often the only data available are non-experimental, observational data. For such data, the necessary randomization is missing. Because the randomization is missing, it seems to follow that it is not possible to make epistemically warranted claims about the causal pathways. Although we are not sanguine about the difficulty in using observational data to make warranted causal claims, we are not as pessimistic as those who believe that the only warranted causal claims are claims based on data from (idealized) RCTs. We argue that careful, thoughtful study design, informed by expert knowledge, that incorporates propensity score matching methods in conjunction with instrumental variable analyses, provides the possibility of warranted causal claims using observational data.     

When Anxiety Symptoms Masquerade as Medical Symptoms: What Medical Specialists Know about Panic Disorder and Available Psychological Treatments

Under-recognition of somatic symptoms associated with panic in primary care settings results in unnecessary and costly diagnostic procedures and inappropriate referrals to cardiologists, gastroenterologists, and neurologists. In the current study specialists’ knowledge regarding the nature and treatment of panic were examined. One-hundred and fourteen specialists completed a questionnaire assessing their knowledge about panic attacks, including their perceptions of psychologists’ role in treating panic. Respondents answered 51% of knowledge items correctly. Although most knew the definition of a panic attack, they knew less about clinical features of panic and its treatment. Specifically, whereas 97.4% believed medication effectively relieves panic symptoms, only 32.5% knew that cognitive-behavioral therapy (CBT) is a first-line treatment. Only 6% reported knowing how to implement CBT, and only 56.1% recognized that psychologists could effectively treat panic. These findings demonstrate significant gaps in specialists’ knowledge about panic and the need to enhance physician knowledge about panic attacks and their treatment.     

Developing and Validating the Perceived Parental Media Mediation Scale: A Self‐Determination Perspective

The aim of this study was to develop the Perceived Parental Media Mediation Scale (PPMMS). The PPMMS measures adolescents' perceptions about how frequently their parents restrict or actively discuss their media use, and in what style (i.e., autonomy‐supportive, controlling, or inconsistent). In a first study among 761 preadolescents and early adolescents (10–14 years), we confirmed that the subscales of the PPMMS could be distinguished. In a second study, in which 499 adolescents were surveyed again, the test–retest reliability and validity of the PPMMS were established. The PPMMS met the standards of reliability, validity, and utility. Subscales correlated in the expected directions with general parenting styles, family conflict, prosocial behavior, and antisocial behavior.     

Cooperative responding in rats: II. Performance on fixed-ratio schedules of mutual reinforcement

Coordinated responses of 5 dyads of rats were investigated under fixed-ratio (FR) schedules of mutual water reinforcement. Coordinated responding was defined as 2 consecutive lever-presses, 1 from each of 2 rats, occurring <.5 s apart. In the FR schedules, each coordinated episode was defined as 1 response in the FR sequence. The size of FR schedules was parametrically manipulated assuming the values of FR 1, 6, 12, 18, 24, 30, 50, and 9, in this order. Each FR remained in effect until responding reached stability. Under all conditions, pairs of rats received access to water simultaneously (mutual reinforcement). Rates and proportions of coordinated responding showed a bitonic inverted U-shaped function of ratio size. Postreinforcement pauses increased systematically as the interreinforcement interval increased. Local rates and proportions increased as a function of response location within ratios. Results of a control condition with relaxed temporal constraints for mutual reinforcement showed decreases in rates and proportion of coordinated responses, suggesting that the coordinated responses were controlled by the mutual reinforcement contingencies. The present experiment showed that coordinated responding is quantitatively affected by 3 properties of FR schedules: response requirement, reinforcement rates, and proximity to reinforcement.