Multiple illness perceptions in older adults: Effects on physical functioning and medication adherence

Objective: Previous research on illness perceptions has focused on single illnesses, but most adults over 65 suffer from multiple illnesses (multimorbidity). This study tests three competing operationalisations of multiple illness perceptions in predicting physical functioning and adherence: (1) main effects and interactions model; (2) peak model with effects of the most prominent illness perception; and (3) combined model with averaged illness perceptions over multiple illnesses.

Design: Longitudinal study in N?=?215 individuals (65–86?years) with multimorbidity at two measurement points over six months. Participants filled in two Brief Illness Perception Questionnaires (B-IPQ) on their two most severe illnesses.

Main outcome measures: Physical functioning, medication adherence.

Results: Factor analyses suggest that the B-IPQ contains three dimensions; consequences, control and timeline. Multiple regression models fit the data best for (1) and (3). Timeline (β?=??.18) and control (β?=?.21) predict adherence in (1); consequences (β?=?.16) and control (β?=?.20) in (3). Physical functioning was significantly predicted by interacting control beliefs in (1; β?=?.13), by peak consequences in (2; β?=??.14) and by consequences (β?=??.15) in (3).

Conclusions: Individuals with multimorbidity hold both distinct and combined perceptions about their illnesses. To understand individual responses to multimorbidity, perceptions about all illnesses and multimorbidity as entity should be examined.     

Social-Cognitive Moderators of the Relationship between Peer Victimization and Suicidal Ideation among Psychiatrically Hospitalized Adolescents

Peer victimization among children and adolescents is a major public health concern, given its widespread individual and societal ramifications. Victims of peer aggression often face significant levels of psychological distress and social difficulties, such as depression, suicidal ideation, suicide attempts, and social rejection. The purpose of this study was to examine whether cognitive distortions and perceptions of social support moderate the association between peer victimization and suicidal thoughts among psychiatrically hospitalized adolescents. Participants included 183 psychiatrically hospitalized adolescents (ages 13 to 18). In multiple regression analyses that controlled for gender, social and cognitive factors served as significant resource factors. Cognitive factors also moderated the relationship between peer victimization and suicidal ideation.     

The de‐escalation of commitment: predecisional accountability and cognitive processes

Escalation of commitment describes the continuation of a course of action in spite of drawbacks and continuing insecurity of goal achievement. To prevent escalation and its associated costs, de‐escalation techniques are valuable. The present study investigates predecisional accountability to an unknown audience as a de‐escalation technique. In addition, the evolution of cognitive processes (reasons for persisting) during escalation is examined. As predicted, predecisional accountability has a de‐escalating effect. In addition, escalation is accompanied by an increase of nonrational reasons for continuing the respective course of action, and decision makers without accountability provide more nonrational reasons for not quitting than those who are held accountable.     

The influence of attachment and temperament on venipuncture distress in 14-month-old infants: the Generation R Study

Objective

This study examined the effects of attachment and temperament on infant distress during venipuncture.

Method

The study was embedded in the Generation R Study, a prospective population-based study. Two different research procedures (i.e., blood sampling and the Ainsworth Strange Situation Procedure) yielded measures of venipuncture distress and attachment security and disorganization in 246 infants aged 14 months. Four temperament traits (distress to limitations, fear, recovery from distress, and sadness) were assessed using the maternally reported Infant Behavior Questionnaire - Revised, at the age of 6 months.

Results

There were no differences between mean levels of distress during venipuncture in infants classified as having insecure attachment, but there was a trend for disorganized attachment. The temperament traits were not related to distress. However, children with a disorganized attachment and higher temperamental fear had more venipuncture distress.

Conclusion

When different risk factors are present simultaneously, infant distress is heightened.     

Affective and cognitive attitudes, uncertainty avoidance and intention to obtain genetic testing: an extension of the Theory of Planned Behaviour

To ensure successful implementation of genetic screening and counselling according to patients best interests, the attitudes and motives of the public are important to consider. The aim of this study was to apply a theoretical framework in order to investigate which individual and disease characteristics might facilitate the uptake of genetic testing. A questionnaire using an extended version of the Theory of Planned Behaviour was developed to assess the predictive value of affective and cognitive expected outcomes, subjective norms, perceived control and uncertainty avoidance on the intention to undergo genetic testing. In addition to these individual characteristics, the predictive power of two disease characteristics was investigated by systematically varying the diseases fatality and penetrance (i.e. the probability of getting ill in case one is a mutation carrier). This resulted in four versions of the questionnaire which was mailed to a random sample of 2400 Norwegians. Results showed genetic test interest to be quite high, and to vary depending on the characteristics of the disease, with participants preferring tests for highly penetrant diseases. The most important individual predictor was uncertainty avoidance.     

Thinking and feeling in the People's Republic of China: testing the generality of the "laws of emotion"

Cognitive theories of emotion assert that emotional reactions to events depend on the manner in which events are interpreted and appraised. From this perspective, the same outcome can produce different emotions. For example, a score of 85% on a test can evoke positive feelings if it is considered a success or negative feelings if it is considered a failure. Among the various appraisal dimensions that have been identified, causal attributions are thought to play a particularly influential role in shaping emotional reactions to various events. For example, success can evoke pride if it is attributed to high ability, gratitude if it is attributed to help from others, relief if it is attributed to a stroke of good fortune, or guilt if it is attained fraudulently or at the expense of others. These cognitive-affective linkages are thought to be universal. In this paper, we report two studies that tested the cross-cultural generality of some of these assumptions. In Study 1, participants from the People's Republic of China were led to succeed or fail on an (alleged) test of their intelligence and creativity. Consistent with previous findings with Western samples, attributions to ability predicted participants' emotional reactions to their test performance, with high ability attributions linked to greater pride following success. In Study 2, we extended these findings with American and Chinese participants, using a different experimental manipulation of success and failure, and a measure of attributions to effort. For both cultural groups, attributions to ability (but not attributions to effort) predicted greater emotional reactions to success. We conclude that attribution-emotion linkages have cross-cultural validity, and that pride is maximized when success is attributed to high ability.     

Recalled Childhood Teasing among Non-Clinical, Non-College Adults

This study examined the psychometric properties of the Teasing Questionnaire—Revised (TQ-R) in a non-clinical community sample of adults. The TQ-R, Brief Fear of Negative Evaluation Scale, Beck Depression Inventory-II, and UCLA Loneliness Scale were administered to 355 adults, aged 18–86 years. Confirmatory factor analysis showed the five-factor teasing model proposed by Storch et al. (Journal of Anxiety Disorders, 18, 665–679, 2004c) was not a good fit for these data. A three-factor model consisting of Academic, Social, and Appearance factors was found through exploratory analyses [termed the Teasing Questionnaire—Revised—Short Form (TQ-R-S)]. Internal consistency was good for the TQ-R-S Total Score and resultant TQ-R-S Academic, Social, and Appearance factors. TQ-R-S scores were directly correlated with current psychosocial functioning with correlations of a small to medium effect size. These results provide evidence that teasing during childhood is linked to later symptoms of depression, anxiety, and loneliness.     

Anterior but not intralaminar thalamic nuclei support allocentric spatial memory

Medial thalamic damage is a common cause of severe memory disruption in humans. Both the anterior thalamic nuclei (ATN) and the intralaminar thalamic nuclei (ILN) have been suggested as primary sites of diencephalic injury underlying learning and memory deficits, but their respective roles have yet to be resolved. The present study explicitly compared two spatial memory tasks in male PVGc hooded rats with selective neurotoxic lesions to either (1) the ATN or (2) the rostral ILN (and adjacent lateral mediodorsal thalamic nuclei; ILN/LT lesions). As predicted, the ATN group, but not the ILN/LT group, exhibited clear deficits in the Morris water maze task for the initial acquisition of a fixed hidden platform and its reversal to a new position. The second task examined acquisition of egocentric spatial reference memory for a left or right body turn, using any three arms in an 8-arm water maze on any given trial; contrary to predictions, both lesion groups performed as well as the Sham group. The lack of deficits in ILN/LT rats on this second task contrasted with previous findings reporting a detrimental effect of ILN/LT lesions on egocentric working memory. The clear dissociation between the influence of ATN and ILN/LT lesions with respect to allocentric spatial reference memory in the Morris maze emphasizes that caution is required when interpreting the effects of non-ATN thalamic lesions on spatial memory when the lesions encroach substantial areas of the adjacent ATN region.