Optimizing preoperative expectations in cardiac surgery patients is moderated by level of disability: the successful development of a brief psychological intervention

Patients’ expectations have shown to be a major psychological predictor of health outcome in cardiac surgery patients. However, it is unclear whether patients’ expectations can be optimized prior to surgery. This study evaluates the development of a brief psychological intervention focusing on the optimization of expectations and its effect on change in patients’ expectations prior to cardiac surgery. Ninety patients scheduled for coronary artery bypass graft were randomly assigned to (1) standard medical care, (2) additional expectation manipulation intervention (EMI), and (3) additional attention control group. Therapists’ fidelity to intervention manuals and patients satisfaction with the intervention were assessed for both active intervention conditions. Patients’ expectations about post-surgical disability, treatment control, personal control, and disease duration were assessed before and after the psychological intervention. Demographical, medical, and psychosocial characteristics and disability were assessed at baseline. Treatment fidelity and patient satisfaction was very high in both intervention conditions. Only patients receiving EMI developed higher personal control expectations and longer (more realistic) expectations of disease duration. The effect of intervention group on patients’ disability expectations and patients’ personal control expectations was moderated by patient’s level of disability. EMI patients with low to moderate disability developed positive expectations whereas patients with high disability did not. This study shows the successful development of a short psychological intervention that was able to modify patients’ expectations, especially in those with low to moderate disability. Given the robust association of expectations and surgery outcome, such an intervention might offer the opportunity to enhance patients’ health following cardiac surgery.     

Reason explanation and the second-person perspective

On a widely held view, the canonical way to make sense of intentional actions is to invoke the agent's ‘motivating reasons’, where the claim that X did A for some ‘motivating reason’ is taken to be neutral on whether X had a normative reason to do A. In this paper, I explore a challenge to this view, drawing on Anscombe's ‘second-personal’ approach to the nature of action explanation.     

Assessing DSM–5 Level of Personality Functioning From Videotaped Clinical Interviews: A Pilot Study With Untrained and Clinically Inexperienced Students

Several authors have raised the concern that the DSM–5 Level of Personality Functioning Scale (LPFS) is relatively complex and theory laden, and thus might put high requirements on raters. We addressed this concern by having 22 untrained and clinically inexperienced students assess the personality functioning of 10 female psychotherapy inpatients from videotaped clinical interviews, using a multi-item version of the LPFS. Individual raters’ LPFS total scores showed acceptable interrater reliability, and were significantly associated with 2 distinct expert-rated measures of the severity of personality pathology. These findings suggest that, contrary to the previously mentioned concerns, successfully applying the LPFS to clinical cases might require neither extensive clinical experience nor training.     

Integration sozialarbeiterischer Kompetenz in die psychotherapeutische Versorgung

Social and socioeconomic issues are a risk factor for the development of mental health problems and have the potential to negatively impact the psychotherapeutic treatment process. In addition, mental disorders can also result in socioeconomic stress. Neither professional training nor parameters of everyday practice of medical or psychological psychotherapists are geared towards acquiring sufficient competence to adequately handle complex social problems of highly impaired patients. Especially in times of social crises, three interrelated strategies may be helpful: to enhance psychotherapists’ sensibility and competence to recognize and deal with severe social crises, to promote cooperation with clinical social workers and to incorporate sociotherapeutic elements in the overall treatment planning. Using an approach of integrated care at a university medical department as an example, this article presents examples of how to implement these strategies into everyday therapeutic practice.     

The Regression Trap and Other Pitfalls of Replication Science—Illustrated by the Report of the Open Science Collaboration

The Open Science Collaboration’s 2015 Open Science Collaboration. (2015). Estimating the reproducibility of psychological science. Science, 349, aac4716. doi:10.1126/science.aac4716[Crossref], [PubMed], [Web of Science ®] , [Google Scholar] report suggests that replication effect sizes in psychology are modest. However, closer inspection reveals serious problems. When plotting replication effects are against original effects, the regression trap is lurking: Expecting replication effects to be equally strong as original effects is logically unwarranted; they are inevitably subject to regressive shrinkage. To control for regression, the reliability of original and replication studies must be taken into account. Further problems arise from missing manipulation checks and sampling biases. Our critical comment highlights the need for replication science to live up to the same methodological scrutiny as other research.     

Researching mind wandering from a first‐person perspective

Mind wandering is an inherently inner (or first‐person) phenomenon that leaves few direct traces for third‐person enquiry. Nonetheless, psychologists often study mind wandering using third‐person (e.g., behavioral or neuronal) research methods. And although research–participants may well be asked to introspect on their mind wandering experiences (e.g., via experience‐sampling or think‐aloud techniques), such introspective self‐observations typically lack methodological rigor and are hence of only preliminary value. Here, we argue that it is a missed opportunity to not train researchers to introspect on their own mind‐wandering experiences to better understand the associated mental processes. We propose a novel approach to cultivating an educated form of introspection in the study of attentional focusing and mind wandering. Our research adds to the current theoretical understanding by explicating conditions that facilitate mind wandering (e.g., the shifting and broadening of concepts) and help find the way back to the primary task (e.g., commitment; deliberate shifts between focusing and defocusing).     

Better to be optimistic,mindful, or both? The interaction between optimism,mindfulness, and task engagement

This paper investigates the relationships between optimism, mindfulness, and task engagement. Specifically, we hypothesized that optimism, mindfulness, and their interaction would facilitate individuals’ task engagement. We tested our research model in four studies: two surveys among gig workers and two experiments. The results of the two surveys among gig workers indicated that optimism predicted higher task engagement, but trait mindfulness did not, and that a multiplicative interaction existed between high optimism and high mindfulness in stimulating task engagement. Our two experiments confirmed a significant interaction between optimism and induced state mindfulness and showed that the most engaging situation is being high in both mindfulness and optimism. Although optimism predicted task engagement, the experiments indicated that the effect of the state mindfulness manipulation was above and beyond that of optimism. Finally, we discuss the nuances of the interaction between optimism and mindfulness in predicting task engagement.