Giving Voice to Patients: Developing a Discussion Method to Involve Patients in Translational Research

Biomedical research policy in recent years has often tried to make such research more ‘translational’, aiming to facilitate the transfer of insights from research and development (R&D) to health care for the benefit of future users. Involving patients in deliberations about and design of biomedical research may increase the quality of R&D and of resulting innovations and thus contribute to translation. However, patient involvement in biomedical research is not an easy feat. This paper discusses the development of a method for involving patients in (translational) biomedical research aiming to address its main challenges.After reviewing the potential challenges of patient involvement, we formulate three requirements for any method to meaningfully involve patients in (translational) biomedical research. It should enable patients (1) to put forward their experiential knowledge, (2) to develop a rich view of what an envisioned innovation might look like and do, and (3) to connect their experiential knowledge with the envisioned innovation. We then describe how we developed the card-based discussion method ‘Voice of patients’, and discuss to what extent the method, when used in four focus groups, satisfied these requirements. We conclude that the method is quite successful in mobilising patients’ experiential knowledge, in stimulating their imaginaries of the innovation under discussion and to some extent also in connecting these two. More work is needed to translate patients’ considerations into recommendations relevant to researchers’ activities. It also seems wise to broaden the audience for patients’ considerations to other actors working on a specific innovation.     

The Anxiety Depression Distress Inventory–27 (ADDI–27): New Evidence of Factor Structure,Item-Level Measurement Invariance,and Validity

Three studies examining the factor structure and psychometric properties of the Anxiety Depression Distress Inventory–27 (ADDI–27) extended the initial instrument development studies for this recently introduced inventory. The ADDI–27 is an empirically derived short form of the Mood and Anxiety Questionaire–90 (MASQ–90) comprising three scales: Positive Affect, Somatic Anxiety, and General Distress. The main objectives of Study 1 (N = 700) were to examine the factor structure of the ADDI–27 and its measurement invariance across gender at the item level. The objective of Study 2 (N = 538) was to examine evidence for the convergent and discriminant validity of scores on the ADDI–27. The objective of Study 3 (N = 240) was to assess further evidence for the nomological network and convergent and discriminant validity of the ADDI–27 scores. Results of exploratory structural equation modeling yielded strong support for a 3-factor model, with approximate fit indexes meeting or exceeding the conventional cutoffs. With p ≤ .001 as the criterion for detecting noninvariance, results of measurement invariance analysis suggested that all of the ADDI–27 items were invariant across gender. Results of multivariate validity analyses across 2 studies provided support for the convergent and discriminant validity of scores on the ADDI–27 scales.     

The Relationship Between Automatic Thoughts and Irrational Beliefs Predicting Anxiety and Depression

Cognitive behavioral approaches differ in their views on core cognitions and their hypothesized role in the etiology of depression and anxiety. The present study provides empirical evidence regarding the relationship between irrational beliefs and components of automatic thoughts and their role in the etiology of depression and anxiety. The present study utilized newer and improved questionnaires to assess components of irrational belief. Based on prior research by Safren et al. (Cogn Ther Res 24(3):327–344, 2000), a three-factor structure of the combined automatic thought questionnaires were utilized to measure components of automatic thoughts as they relate to depression and anxiety. Factor analytical methods were utilized to confirm the factor structure of the irrational beliefs and automatic thoughts components. Advanced path modeling was utilized to model the relationship between irrational beliefs and automatic thoughts in predicting anxiety and depression. The study used a sample of N = 542 undergraduate psychology students during stressful exam times. Results indicated that the irrational belief Demandingness represents a primary factor, followed by the secondary irrational beliefs as proposed by Rational Emotive Behavioral Theory. Selfdowning beliefs were fully mediated by depressive automatic thoughts in the case of depressive affect. Low frustration tolerance contributed unique variance to anxious and depressive affect that was not fully mediated by automatic thoughts. Results from the present study add empirical evidence that irrational beliefs indeed represent core and intermediary beliefs that lead to specific automatic thoughts, which is congruent with cognitive behavioral theory as proposed by Rational Emotive Behavioral Therapy.     

Cultural identity dynamics: Capturing changes in cultural identities over time and their intraindividual organization

Important life transitions – such as migration – have the potential to enrich one's sense of self, but they are also demanding and challenging. The current research investigates how cultural identities change and become configured over time among newly arrived international students and the social factors that predict these longitudinal changes. A four‐wave longitudinal study was conducted during international students' first year in their new country (N = 278). Multivariate hierarchical linear modeling analyses allowed us to unpack both baseline (between‐person) and intraindividual change (within‐person) effects. Whereas increased psychological need satisfaction via both the new and one's heritage cultural group predicted increased identity integration, greater discrimination (i.e., both at baseline and an increase over time) predicted increased compartmentalization and the predominance (categorization) of one identity over the others. Results are discussed in light of novel theoretical developments in the acculturation and identity change literatures.     

Like Father,like Child: Early Life Family Adversity and Children’s Bullying Behaviors in Elementary School

Family adversity has been associated with children’s bullying behaviors. The evidence is, however, dominated by mothers’ perceptions of the family environment and a focus on mothers’ behaviors. This prospective population-based study examined whether children’s bullying behaviors were associated with mother- and father-reported family adversity, assessed before and after child birth. Peer-nominations were used to assess bullying behaviors of 1298 children in elementary school (mean age 7.5 years). The following paternal risk factors were prospectively associated with children’s bullying behaviors: (1) father-reported prenatal family distress, (2) fathers’ hostility at preschool age, and (3) fathers’ harsh disciplinary practices at preschool age, but effect sizes were relatively small. The effect of maternal risk factors was less consistent, only mother-reported family distress in childhood was associated with children’s bullying behaviors. The associations were independent of background family risk factors (i.e., life stress, contextual factors, and other background factors such as parental education and risk taking record) and early childhood externalizing problems. Moreover, our results indicated that father-reported family adversity predicted children’s bullying behaviors over and above the background family risk factors, early childhood externalizing problems and mother-reported family adversity. We also demonstrated that the association of fathers’ prenatal hostility and family distress with subsequent bullying behavior of their child at school was partly mediated by fathers’ harsh disciplinary practices at preschool age. Our findings highlight the importance of fathers’ behaviors in the development of children’s bullying behaviors.     

Fear of missing out: prevalence,dynamics, and consequences of experiencing FOMO

Fear of missing out, known colloquially as FOMO, appears to be a common experience, and has recently become part of the vernacular, receiving frequent mentions in the popular media. The present paper provides a multi-method empirical examination of FOMO. In a first study, experience sampling was used to assess FOMO experiences among college freshmen. Nightly diaries and end-of-semester measures provided data on the short and long-term consequences of experiencing FOMO. Results showed that students experience FOMO frequently, particularly later in the day and later in the week, and while doing a required task like studying or working. More frequent experiences of FOMO were associated with negative outcomes both daily and over the course of the semester, including increasing negative affect, fatigue, stress, physical symptoms, and decreased sleep. A second experimental study investigated FOMO on a conceptual level, distinguishing FOMO from general self-regulation and exploring its links with social media.     

Philosophical Idling and Philosophical Relativity

Peter Unger has challenged philosophical objectivism, the thesis that traditional philosophical problems have definite objective answers. He argues from semantic relativity for philosophical relativity, the thesis that for certain philosophical problems, there is no objective answer. I clarify, formulate and challenge Unger's argument. According to Unger, philosophical relativism explains philosophical idling, the fact that philosophical debates appear endless, philosophical disagreements seem irresolvable, and very little substantial progress seems made towards satisfactory and definite answers to philosophical problems. I argue, however, that the reality of philosophical idling is doubtful and, ironically, undermined by philosophical relativism. I then raise problems for several steps in Unger's argument for philosophical relativity. I conclude by arguing that philosophical relativism can avoid self‐defeat only by an ad hoc limitation of its scope. 1     

Temporality in Psychosis: Loss of Lived Time in an Alien World

This article presents a model of the temporal structure of psychic life. Time is a rule-guided process. A person's psychic life, too, yields to an examination of necessary and regulated operations. To outline both the regular and the modified perception of time within psychic life, Sigmund Freud's model of the drive interaction is brought to bear on Jacques Marie Émile Lacan's understanding of psychosis. Both Freud's and Lacan's findings are explained with an eye on the temporal dimension of the psyche, temporal modifications manifested in states of psychotic delusion, and the role of time for one's meaningful engagement with the world. Psychic time is nonlinear. The future, the past, and the present must be engaged simultaneously, albeit not in the same way, to yield the sense of temporal fullness. For Freud, the cooperative functioning of the drives accounts for the sustainment of the lucid psychic life, whereas modifications in the drives’ interactions signal psychic disturbances. Lacan (1955/1993) stresses the atemporal character of the nonexistent, negated, or lost reality that pressures an individual to enter a psychotic delusion. This article makes the assumption that the psychological states in which the reckoning with time is lost are the consequences of an unsuccessful incorporation of traumatic stimuli that are caused both by outside phenomena and by the actions of an individual's inner drives. The findings of this article support the view that psychic traumas necessitate modifications to the sense of time. The findings also offer an understanding of the kinds of temporal modifications that occur in an individual's psychic life and the way in which these temporal changes lead to the experience of radical otherness that is present in some cases of psychological disturbances.