Do patients suffering from chronic diseases retrospectively overestimate how healthy they were before they fell ill?

Background/Objective: To examine the impact of a disease on a person's subjective health state, patients are often asked to assess their current health state and to retrospectively assess how healthy they were before they fell ill. The objective of this study was to test whether patients generally overestimated the quality of their pre-disease health. Method: Six samples of patients with chronic diseases (cancer patients, cardiovascular patients, and patients diagnosed with sarcoidosis, N between 197 and 1,197) were analyzed. The patients assessed their current health states and their health states at the time before diagnosis. The retrospective scores were compared with matched data from general population studies. Results: In three of the six studies, the retrospective health ratings of the patients were significantly higher than the general population norms (effect sizes between 0.24 and 0.46), two studies yielded nonsignificant effects, and in one study there was an opposite trend. The general overestimation of pre-disease health was more pronounced in older patients as compared with younger ones, and it was more pronounced when global health/quality of life was to be assessed. Conclusions: Retrospective assessments of pre-disease health states are not appropriate for assessing disease-related changes in a person's health state.     

Illness Beliefs,Treatment Beliefs and Information Needs as Starting Points for Patient Information: The Evaluation of an Intervention for Patients with Depression

Patients with depression are often dissatisfied with disease- and therapy-related information. The objective of this study was to evaluate an intervention that applied the Common Sense Model to the provision of information during inpatient rehabilitation for patients with depression. The intervention was evaluated in a sequential control group design. Analyses of covariance were used to assess differences between the control and intervention groups. Changes with respect to illness and treatment beliefs (personal control, treatment control, coherence and concerns about medicines), satisfaction with information about medicines, illness and rehabilitation, and depressive burden were selected as primary outcome measures. We observed significant between-group differences indicating the intervention group’s superiority in terms of satisfaction with information regarding medicines. However, the two groups’ changes during rehabilitation did not differ in terms of the other outcomes. The intervention resulted in patients judging that their medication information needs had been more thoroughly fulfilled than those patients who received care-as-usual information. However, the intervention did not prove to be effective when the other outcome variables are considered. Taken together and bearing in mind the limitations of our study—particularly the non-randomised design—our results should be replicated in a randomised controlled trial.     

Individual Learning Styles and Creativity

Business schools are in need of developing creative graduates. This article explores how creativity among business students can be stimulated. Because a considerable amount of knowledge is required for creative ideas to emerge, the learning process has a significant impact on creativity. This, in turn, indicates that learning style is important for creative performance. In addition to exploring the relationship between learning styles and creativity, the research reported here tested self-efficacy and enjoyment as mediators. One hundred and fifty students participated in this study. Hierarchical regression analysis indicated that independent and collaborative learning styles were associated with higher creativity. Although the independent learning style-creativity relationship was mediated by self-efficacy, the collaborative learning style-creativity relationship was partially mediated by enjoyment of the learning process. Implications for business education are discussed.     

Effects of mineralocorticoid receptor blockade on empathy in patients with major depressive disorder

Background

The mineralocorticoid receptor (MR) is highly expressed in the hippocampus and prefrontal cortex and is involved in social cognition. We recently found that pharmacological stimulation of the MR enhances emotional empathy but does not affect cognitive empathy. In the current study, we examined whether blockade of the MR impairs empathy in patients with major depressive disorder (MDD) and healthy individuals.

Methods

In a placebo-controlled study, we randomized 28 patients with MDD without psychotropic medication and 43 healthy individuals to either placebo or 300 mg spironolactone, a MR antagonist. Subsequently, all participants underwent two tests of social cognition, the Multifaceted Empathy Test (MET) and the Movie for the Assessment of Social Cognition (MASC), measuring cognitive and emotional facets of empathy.

Results

In the MET, we found no significant main effect of treatment or main effect of group for cognitive empathy but a highly significant treatment by group interaction (p < 0.01). Patients had higher cognitive empathy scores compared to controls in the placebo condition but not after spironolactone. Furthermore, in the spironolactone condition reduced cognitive empathy was seen in MDD patients but not in controls. Emotional empathy was not affected by MR blockade. In the MASC, no effect of spironolactone could be revealed.

Conclusion

Depressed patients appear to exhibit greater cognitive empathy compared to healthy individuals. Blockade of MR reduced cognitive empathy in MDD patients to the level of healthy individuals. Future studies should further clarify the impact of MR functioning on different domains of social cognition in psychiatric patients.

     

Shame: mechanisms of activation and consequences for social perception, self-image, and general negative emotion

In two experiments we explored Tomkins's (1963) concept of shame, comparing conscious versus unconscious shame activation. In line with Tomkins' theory, an impeded positive feedback sequence, consciously or unconsciously perceived, elicited more shame than continuously negative feedback. This was, however, true only for participants with an initially low degree of internalized shame. Participants with a high degree of internalized shame unexpectedly displayed shame following the positive feedback intended to elicit positive emotion. Whether this has implications for Tomkins's theory or rather for methodological issues is discussed. Exploring consequences of shame for social perception and self-image, we found reversed results depending on level of consciousness. Effects were consistently greater for women, although at marginal significance levels. Results partly support Tomkins's notion of shame, but imply that his theory might need modification in terms of the role played by consciousness and, possibly, by individual differences such as sex and shame proneness.     

Emotional Stroop task: effect of word arousal and subject anxiety on emotional interference

Inconsistent findings regarding the emotional Stroop effect in healthy subjects may be explained by confounding effects of stimulus valence and arousal, as well as individual differences in anxiety. We examined reaction time data in a healthy sample using the emotional Stroop task while carefully matching arousal level of positive and negative words. Independent of valence, emotional relative to neutral words elicited emotional interference, indicating that arousal determines emotional interference. Independent of valence, emotional words were better re-called and recognized than neutral words. Individual differences in state anxiety were associated with emotional interference, that is, emotional interference was enhanced in subjects with high state anxiety. There was no influence of trait anxiety. These findings indicate that word arousal produces emotional interference independent of valence. State anxiety exacerbates interference of emotional words by further biasing attention towards emotionally salient stimuli. Thomas Dresler and Katja Mériau have contributed equally.     

The Neurobiological Underpinnings of Coping With Pain

ABSTRACT— The biopsychosocial model treats pain as resulting from a complex interaction of biological, psychological, and social factors. Individual differences in approaches to coping with pain-related symptoms are important determinants of pain-related outcomes, and are often classified under the "psychological" category within the biopsychosocial model. However, engagement in various cognitive, affective, and behavioral pain-coping strategies appears to exert biological effects, which we review here. Pain-coping activities such as catastrophizing, distracting oneself from pain sensations, or reappraisal of pain may exert effects on activity in a variety of pain-processing and pain-modulatory circuits within the brain, as well affect the functioning of neuromuscular, immune, and neuroendocrine systems. The interface between pain-related neurobiology and the use of specific pain-coping techniques represents an important avenue for future pain research.     

A tool for thought! When comparative thinking reduces stereotyping effects

Stereotypes have pervasive, robust, and often unwanted effects on how people see and behave towards others. Undoing these effects has proven to be a daunting task. Two studies demonstrate that procedurally priming participants to engage in comparative thinking with a generalized focus on differences reduces behavioral and judgmental stereotyping effects. In Study 1, participants who were procedurally primed to focus on differences sat closer to a skinhead - a member of a negatively stereotyped group. In Study 2, participants primed on differences ascribed less gender stereotypic characteristics to a male and female target person. This suggests that comparative thinking with a focus on differences may be a simple cognitive tool to reduce the behavioral and judgmental effects of stereotyping.