Psychological Distress Reported by Patients Undergoing Limb Reconstruction Surgery: Implications for Psychological Interventions

Limb reconstruction is an orthopaedic surgical technique designed to restore or improve functioning and appearance. The aims of the present study were to investigate levels of psychological distress in adults undergoing limb reconstruction as a result of traumatic injury, to examine which variables could account for any variations in distress during and after treatment, and to ascertain the potential relevance of psychological interventions. A cross-sectional sample of patients completed measures of psychological distress, posttraumatic symptomatology, coping, social support, pain, and disability. Self-reported levels of psychological distress and posttraumatic symptoms were high but did not tend to vary across stage of treatment, suggesting that distress is not solely attributable to limb reconstruction treatment per se but to other factors. Both medical variables (pain and mobility) and psychological variables (symptoms of trauma and coping strategies) accounted for a significant percentage of the variance in HAD scores. These results suggest that both medical and psychological interventions have potential for reducing distress and increasing well-being in an orthopaedic population who are experiencing high levels of emotional distress.     

Efficacy of standard deviational ellipses in the application of criminal geographic profiling

The premise for this study is that the physical and cultural landscape has a deterministic effect on the location and distribution of serial crime. As a consequence, the distribution of linked crime scenes should exhibit a shape and orientation that is consistent with the underlying landscape. Geographic Profiling models that are able to account for these effects will provide more accurate results than those models that do not. Utilizing basic geographic principles of central tendency and spatial diffusion, this research first analyzed the output of circular and elliptical profile models generated for 30 serial burglaries (n = 164) and 67 serial robberies (n = 370) in Baltimore, Maryland between 1994 and 1997. A comparative analysis of the model output reveals that the Standard Deviational Ellipse is significantly (p = 0.000) better able to predict the home location of a serial offender than profiles generated from circles. Next, the relationship between the orientation of elliptical profiles and the mean linear orientation of the corresponding landscape was assessed to reveal a moderate but significant correlation (r = 0.511, p < 0.001). Together, these findings demonstrate that landscape does impact the locations of crime, and is a measurable parameter that can improve the efficacy of geographic profiling. Copyright © 2008 John Wiley & Sons, Ltd.     

Internet-based cognitive behavioral therapy for anxiety in an outpatient specialized care setting: A qualitative study of the patients’ experience of the therapy

Knowledge about user experiences of internet-based cognitive behavioral therapy (iCBT) has mostly been drawn from non-clinical groups or with iCBT offered via self-referral. The present study therefore focused on patients who had undergone iCBT with minimal support while actively awaiting outpatient psychological treatment in the form of face-to-face CBT. To seek out barriers to adherence the study also included patients who had withdrawn from the iCBT treatment before completion. The study was performed in an outpatient clinic for anxiety disorders where twelve participants with a primary diagnosis of either social anxiety disorder or panic disorder were recruited from an ongoing randomized control trial for semi-structured interviews. Statements from the interviews showed that the iCBT treatment was unfavorably compared to the usual face-to-face treatment at the clinic. Despite this, a majority of the interview participants still expressed to have experienced various benefits from the treatment. Some participants did however, experience difficulties putting the materials to practical use. Furthermore, a large majority of the participants expressed a need for additional support, with a strong tendency for non-completers specifically expressing a need for face-to-face contact with a clinician. Implications for future research and implementation of iCBT in clinical practice are discussed.     

A transdisciplinary model integrating genetic, physiological, and psychological correlates of voluntary exercise.

OBJECTIVE: Physical inactivity contributes to as many as 250,000 premature deaths per year (R. R. Pate et al., 1995). The authors' objective was to test a transdisciplinary model of the ways in which genetic variants, physiological factors, and psychological factors are thought to influence exercise with 64 healthy, regular exercisers. DESIGN: In a within-subjects design, psychological and physiological responses to exercise were compared with responses to a sedentary activity. MAIN OUTCOME MEASURES: The authors measured affective state, perceived exertion, heart rate, and temperature change in response to moderate exercise versus sedentary activity. They also quantified genotypes on a single nucleotide polymorphism in the brain-derived neurotrophic factor (BDNF) gene. RESULTS AND CONCLUSIONS: The data show a relation between increases in positive affective states and acute exercise behavior, as opposed to a sedentary control. The BDNF gene moderated the effect of exercise on mood, heart rate, and perceived exertion. Physiological factors were, in turn, related to mood response, and mood response was a significant correlate of motivation to exercise in the future and of current exercise behavior. The model has potential as a framework for the basic study of the genetic, physiological, and psychological processes involved with voluntary exercise and as a tool for the applied examination of tailored exercise interventions and their efficacy for different subsets of individuals.