Stress and worry: examining intolerance of uncertainty's moderating effect

Intolerance of uncertainty (IU), or the way an individual perceives, interprets, and reacts to uncertainty in life, has been frequently investigated in relation to anxiety and worry. While a substantial body of research suggests that individual differences in IU foster stress and anxiety, IU's involvement as a potential moderator in the relation between stressful events and worry has only recently been investigated. Therefore, the present study examined the moderating effect of IU on the relation between daily hassles and worry as well as major life events and worry in a sample of 1092 young adults. Results revealed that IU showed a significant moderation effect in the relation between daily stress and worry. More specifically, when the two factors were examined individually only inhibitory IU served as a moderator between daily stress and worry. While major life events significantly predicted worry, no moderation effect was found for this relation. These findings highlight the need to better understand the mechanisms through which IU impacts worry and contributes to anxiety.     

Practical Aspects of Recruitment and Retention in Clinical Trials of Rare Genetic Diseases: The Phenylketonuria (PKU) Experience

Bringing treatments for rare genetic diseases to patients requires clinical research. Despite increasing activism from patient support and advocacy groups to increase access to clinical research studies, connecting rare disease patients with the clinical research opportunities that may help them has proven challenging. Chief among these challenges are the low incidence of these diseases resulting in a very small pool of known patients with a particular disease, difficulty of diagnosing rare genetic diseases, logistical issues such as long distances to the nearest treatment center, and substantial disease burden leading to loss of independence. Using clinical studies of phenylketonuria as an example, this paper discusses how, based on the authors’ collective experience, partnership among clinicians, patients, study coordinators, genetic counselors, dietitians, industry, patient support groups, and families can help overcome the challenges of recruiting and retaining patients in rare disease clinical trials. We discuss specific methods of collaboration, communication, and education as part of a long-term effort to build a community committed to advancing the medical care of patients with rare genetic diseases. By talking to patients and families regularly about research initiatives and taking steps to make study participation as easy as possible, rare disease clinic staff can help ensure adequate study enrollment and successful study completion.     

Teachers as therapeutic agents: perceptions of a school-based mental health initiative

Teacher–child relationship building (TCRB) is a play-based professional development programme adapted from kinder training and filial therapy. Intended for early education teachers and students, TCRB is designed to strengthen the teacher–child relationship, improve student behaviour, enhance academic involvement and develop teachers' classroom management skills. In the current study, we utilised a phenomenological approach to examine teachers' perceptions of the initial implementation of TCRB through identifying individual and collective perspectives in the summation of themes. Findings indicated that the teachers perceived the TCRB model to be informative, well organised, appropriately structured and effective in enhancing teacher–child relationships, improving classroom management skills and reducing behavioural problems among child participants. Limitations of the study, implications and suggestions for future research are discussed.     

Patient Perspectives on Medical Trauma Related to Inflammatory Bowel Disease

Journal of Clinical Psychology in Medical Settings - Post-traumatic stress symptoms (PTSS) in response to medical trauma are understudied in inflammatory bowel disease (IBD). Two studies identify...     

The patient experience of medically unexplained symptoms: an existentialist analysis

This article explores the patient experience of medically unexplained symptoms (MUS) from an existentialist standpoint. Drawing on the work of Jean-Paul Sartre and Simone de Beauvoir, I explore their concepts of existential situation, existential project, authenticity, and praxis. I then analyze the situation of MUS patients in the current cultural and institutional context, elucidating that a lack of explanation for their symptoms puts MUS patients in an existential bind. I illustrate the effects of the experience of MUS on patients’ existential projects. Last, I develop an ethical response in the existentialist tradition from the perspective of patients, providers, and society at large. I argue that there is a collective responsibility to foster conditions more conducive to authentic patient well-being and to improve the experience of patients with medically unexplained symptoms.

     

Self-ambivalence and resistance to subtle self-change attempts

Recent research has demonstrated the malleability of self-views to subtle situational influence but has not uncovered features of the self-concept representation that make it susceptible to such change. Using research on attitude ambivalence as a foundation, the current article predicted that the self would be most likely to respond to a subtle change induction when the targeted self-beliefs were objectively ambivalent (e.g., possessed both positive and negative features). Using self-esteem conditioning (Experiment 1) and outgroup stereotype priming (Experiment 2), it was found that people were more susceptible to subtle change inductions as objective self-ambivalence increased. Notably, the consistency between dominant self-views (positive or negative) and the change induction did not influence these results. These effects held for objective ambivalence, but not subjective ambivalence, and only when the objective ambivalence measure was relevant to the change induction. Mechanisms of the observed moderation and the implications of self-ambivalence for understanding self-change are discussed.     

Bidirectional Relationships Between Parenting Stress and Child Coping Competence: Findings From the Pace Study

The present study was designed to evaluate the bidirectional relationships between parenting stress and child coping competence. Data from a diverse sample of 610 parents enrolled in the parenting our children to excellence program was used to evaluate whether parenting stress negatively contributes to affective, achievement, and social coping competence in preschoolers, as well as whether child coping competence predicts parenting stress; after accounting for child disruptive behavior. Results from cross-lagged panel analyses demonstrated a bidirectional relationship, such that parenting stress predicted later child coping competence and child coping competence predicted later parenting stress. Assessment of ethnicity differences indicated that child coping continues to have a long-term impact on parenting stress, regardless of parent ethnicity. The same relationship did not hold for earlier parenting stress on later child coping competence, however, indicating a bidirectional relationship for African American families, but not for their European American counterparts. The relationship between parenting stress and child coping competence is discussed with respect to their conceptual and clinical implications. Suggestions for parent training intervention and prevention programs are given.     

The Development and Evaluation of a Parent Empowerment Program for Family Peer Advocates

Family-to-family services are emerging as an important adjunctive service to traditional mental health care and a vehicle for improving parent engagement and service use in children’s mental health services. In New York State, a growing workforce of Family Peer Advocates (FPA) is delivering family-to-family services. We describe the development and evaluation of a professional program to enhance Family Peer Advocate professional skills, called the Parent Engagement and Empowerment Program (PEP). We detail the history and content of PEP and provide data from a pre/post and 6-month follow up evaluation of 58 FPA who participated in the first Statewide regional training effort. Self-efficacy, empowerment, and skills development were assessed at 3 time points: baseline, post-training, and 6-month follow-up. The largest changes were in self-efficacy and empowerment. Regional differences suggest differences in Family Peer Advocate workforce across areas of the state. This evaluation also provides the first systematic documentation of Family Peer Advocate activities over a six-month period. Consistent with peer specialists within the adult health care field, FPA in the children’s mental health field primarily focused on providing emotional support and service access issues. Implications for expanding family-to-family services and integrating it more broadly into provider organizations are described.     

Structural and psychological empowerment climates, performance, and the moderating role of shared felt accountability: a managerial perspective

The authors proposed and tested a model in which data were collected from managers (n = 539) at 116 corporate-owned quick service restaurants to assess the structural and psychological empowerment process as moderated by shared-felt accountability on indices of performance from a managerial perspective. The authors found that empowering leadership climate positively relates to psychological empowerment climate. In turn, psychological empowerment climate relates to performance only under conditions of high-felt accountability; it does not relate to performance under conditions of low-felt accountability. Overall, the present results indicate that the quick-service restaurant managers, who feel more empowered, operate restaurants that perform better than managers who feel less empowered, but only when those empowered managers also feel a high sense of accountability.