Prediction of end-of-life fears in COPD – hoping for the best but preparing for the worst

Objective: The diagnosis of a life-threatening illness can trigger end-of-life fears. Early studies show that end-of-life fears play an important role in chronic obstructive pulmonary disease (COPD). However, predictors of these fears have not yet been identified. This study investigated the relevance of socio-demographic variables, illness severity, psychological distress and disease-specific anxieties as predictors of end-of-life fears in COPD.

Design: A total of 131 COPD patients participated at two time points. Regression and mediation analyses, as well as cross-lagged panel analyses were conducted.

Main outcome measures: The participants completed questionnaires assessing end-of-life fears (Multidimensional Orientation toward Dying and Death Inventory), psychological distress (Hospital Anxiety and Depression Scale), and disease-specific anxieties (COPD Anxiety Questionnaire). Pulmonary function and a 6-min walk test served as measures of illness severity.

Results: Illness severity was not predictive of end-of-life fears. However, gender and psychological distress explained incremental variance. When disease-specific anxieties were included as additional predictors, psychological distress was no longer significant. Cross-lagged panel analyses mostly supported these results. Moreover, disease-specific anxieties mediated the association between psychological distress and end-of-life fears.

Conclusion: Administration and intensity of end-of-life care (especially concerning end-of-life fears) in COPD patients should be based not only on illness severity, but rather on psychological distress and disease-specific anxieties.     

Computer-assisted dieting: Effects of a randomised controlled intervention

In this pilot study, the effects of two computer-assisted dieting (CAD) interventions on weight loss and blood chemistry were examined among overweight and obese adults. Participants (91 community members, average age 42.6 years) were randomly assigned to CAD-only (a single-session introduction and provision of a dieting software, n = 30), CAD plus an additional four-session self-management group training (CAD+G, n = 31) and a waitlist control group whose members were randomised into the two interventions at the 3-month follow-up (n = 30). A three (group)-by-two (time) repeated measures ANOVA revealed no significant group by time interaction during the initial 3-month period. However, the two intervention groups combined showed a significant, though moderate weight loss relative to the control group. Further, although a general improvement was found with regard to the lipid panel results during the first 3 months of the trial, the treatment by time interaction was not significant. A comparison of the developments in the two intervention groups during the 3- to 6-month follow-up time period revealed a tendency towards greater weight regain in the CAD-only condition. The evidence suggests that CAD supports initial weight loss; however, additional self-management training might be necessary to support maintenance.     

Coping strategies and quality of life in women with advanced breast cancer and their family caregivers

Abstract

This study examines the effects of personal resources of both heart patients and their close social partners on patients' coping and quality of life. Generalized personal resources (self-efficacy beliefs, dispositional optimism, self-regulation competence) and outcomes were assessed by questionnaire 1–3 days before surgery (n = 122) and again six months later (n= 50). Outcome variables were coping styles, social resources (social support and social integration), emotional states, and further measures of quality of life. Patients' personal resources were dominant in the prediction of most of the outcomes. Partners' resources were uniquely related to social support, social integration, and quality of life as perceived by the patients. Further, partners' personality resources predicted changes in patients' loneliness and energy levels during the six-month interval.     

Habitual Self‐Control: A Brief Measure of Persistent Goal Pursuit

Habitual self‐control is defined as a trait‐like personal resource factor that facilitates the enactment of difficult intentions. A 14‐item Habitual Self‐Control Questionnaire (HSCQ) was developed to assess this trait. Reliability, factorial validity, and criterion validity were assessed in five undergraduate student subsamples with an overall N of 2224. Internal consistency was .81 across the entire sample, and test–retest reliability was .83 over a one‐month interval. The HSCQ showed a theoretically meaningful pattern in terms of convergent and discriminant validity and criterion validity in predicting a variety of health behaviours that relate to self‐control, including exercise, dieting behaviour, binge eating and weight loss success. Further, the HSCQ contributed uniquely to the prediction of health behaviours beyond alternative self‐control scales. In a longitudinal part of the study, the HSCQ added to the prediction of action plan completion and satisfaction beyond motivation and moderated the relationship between motivation and enactment of action plans as theoretically expected. In sum, the results provided strong evidence for the reliability and validity of the HSCQ and highlighted some theoretically meaningful differences to already existing measures of self‐control. Theoretical implications are discussed. Copyright © 2012 John Wiley & Sons, Ltd.     

Attentional Performance in Children and Adolescents with Tic Disorder and Co-Occurring Attention-Deficit/Hyperactivity Disorder: New Insights from a 2 × 2 Factorial Design Study

The aim of the present study was to investigate the effect of both tic disorder (TD) and attention-deficit/hyperactivity disorder (ADHD) on attentional functions. N = 96 children and adolescents participated in the study, including n = 21 subjects with TD, n = 23 subjects with ADHD, n = 25 subjects with TD+ADHD, and n = 27 controls. Attentional performance was tested based on four computerized attention tasks (sustained attention, divided attention, go/nogo and set shifting). The effect of TD as well as ADHD on attentional performance was tested using a 2 × 2 factorial approach. A diagnosis of TD had no negative impact on attentional functions but was associated with improved performance in the set shifting task. By contrast, regardless of a diagnosis of TD, subjects with ADHD were found to perform worse in the sustained attention, divided attention and go/nogo task. No interaction effect between the factors TD and ADHD was revealed for any of the attention measures. Our results add to findings from other areas of research, showing that in subjects with TD and ADHD, ADHD psychopathology is often the main source of impairment, whereas a diagnosis of TD has little or no impact on neuropsychological performance in most cases and even seems to be associated with adaptive mechanisms.     

NOTE ON THE CONSTRUCTION OF TESTS OF Q FACTOR ISOLATES IN THE PREDICTION OF CLINICAL CLASSES

The present paper describes two related methods of evaluating items for purposes of test construction intended to yield measures of Q -factor isolates. The principle procedure is based on the use of correlations between the items and the Q -factor loadings. Empirical studies are cited demonstrating the internal consistency and factorial stability of the constructed tests. Evidence of 'qualitative similarity' between the tests and their Q -factor equivalents is also provided.     

The Assessment of Optimistic Self-beliefs: Comparison of the German, Spanish, and Chinese Versions of the General Self-efficacy Scale

L'auto-efficacité générale est mesurée grâce à une courte échelle composée de dix items. Son usage est très répandu et elle a été adaptée à plusieurs cultures. Cet article compare des versions qui ont été proposées à des étudiants: 430 Allemands, 952 Costariciens et 293 Chinois. lies validités internes sont respectivement de.84,.81 et.91. L'unidimensionnalité de l'échelle est réapparue dans tous les échantillons. L'équivalence items-modèle interlinguistique ne fut que modérément approuvé par des analyses factorielles de confirmation. On a trouvé des différences au niveau des moyennes des scores totaux entre les langues. De plus, une intéraction entre sexe et langue s'est manifestée. Des corrélations avec la dépression, l'anxiété' et l'optimisme ont fourni des éléments complémentaires en faveur de la validité de construction.
General self-efficacy is measured by a widely used parsimonious ten-item scale that was developed for use in several cultures. The present paper compares the verions that were examined in samples of 430 German, 959 Costa Rican, and 293 Chinese university students. The internal consistencies were.84,.81, and.91, respectively. The unidimensional nature of the scale was replicated in all samples. Multilingual item-pattern equivalence was only moderately supported by confirmatory factor analyses. Mean differences of sum scores between languages were found. Moreover, an interaction between gender and language emerged. Correlations with depression, anxiety, and optimism provided some further evidence for construct validity.     

Die Bedeutung der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung für die Entstehung und Prognose von Störungen des Sozialverhaltens im Kindes- und Jugendalter

Attention Deficit/Hyperactivity Disorder (ADHD) and Conduct Disorder (CD) are two of the most common neurobehavioral disorders of childhood. Despite of their high comorbidity rate both disorders can be reliably differentiated. Especially the comorbid condition is associated with a poor outcome and some of the affected children develop an Antisocial Personality Disorder. This article summarizes diagnostic criteria and epidemiological data of both disorders and emphasises the role of ADHD in the aetiology and pathogenesis of antisocial behavior. ADHD seems to have a negative impact particular in children of the early-starter subtype of CD. Findings from genetic, psychophysiological and neuroimaging studies emphasise the relevance of biological risk factors in the etiological models and developmental pathways of antisocial behavior. We present so far unpublished data of children with ADHD and ADHD/disruptive behavior disorders which indicate group-specific neurocognitive impairments in the comorbid condition. ADHD and CD seem to constitute a synergistic and interactive relationship in that each disorder aggravates the other. Recent findings point to a “true hybrid” of ADHD/CD. Considering the negative outcome of the comorbid condition, several findings suggest that high-quality treatments may have considerable impact on restoring ADHD children to better functioning.     

Vom Glück zu dritt

The transition to parenthood is a normative, age-based transitional phase in life. Contrary to the romantic idea of “happiness for three”, empirical research indicates sometimes massive impairments of the quality of the partnership from the time of pregnancy up to 1 year or longer after the birth of the first child. Different influencing factors interact together and can lead to an increase in the strain of each individual and change the previous relationship of a couple. Very few couples expect the birth of their first child to have negative consequences on their relationship. Some typical challenges that a loving couple face when becoming parents are illustrated in this article by a case vignette.