Leisure activities, caregiving demands and catecholamine levels in dementia caregivers

This study examined whether satisfaction from leisure activities moderates the relationship between caregiving demands (i.e., hours per day spent caring for a spouse with dementia) and resting levels of the catecholamines norepinephrine (NE) and epinephrine (EPI). Spousal caregivers (n?=?107; mean age?=?73.95?±?8.12 years) were assessed in home for plasma levels of NE and EPI, amount of care provided, and leisure satisfaction. Regression was used to determine whether leisure satisfaction moderated the relationship between hours providing care per day and catecholamine levels. A significant interaction was found between hours caregiving and leisure satisfaction for NE, but not for EPI. Post?hoc regressions were conducted for both NE and EPI. At low leisure satisfaction, time spent caring for a spouse was positively associated with plasma NE (β?=?0.41; p?=?0.005) and EPI (β?=?0.44; p?=?0.003). In contrast, at high levels of satisfaction, time caregiving was not significantly associated with plasma NE (β?=?-0.08; p?=?0.57) or EPI (β?=?0.23; p?=?0.12). These findings suggest that leisure satisfaction may protect caregivers from increases in catecholamines, which have been implicated in cardiovascular risk. Further support for these findings may impact psychological treatments for distressed caregivers.     

Towards a psychosocial mediator model of hostility and CHD

Abstract

How might hostility contribute to the development of CHD? One possible explanation, labelled “psychosocial vulnerability”, is that hostile individuals inhabit a more taxing interpersonal world, and that increased stress, in turn, causes CHD. However, previous research testing this proposition has suffered from a measurement confound by employing self-reports of stress, social support, and hostility. One hundred and twelve subjects participated in the current study and completed the Cook-Medley Hostility scale. Then, each subject's closest friend was asked to estimate for the past year: (1) how many stressors had been encountered by the subject; (2) how easily the subject was upset by a stressor; (3) how many emotional reactions the subject disclosed after a stressor; and (4) how much social support was available to the subject. Results suggested that hostile men and women may both be phychosocially vulnerable, but they are so at different stages of the stressor-distress process. There was no relation between hostility and observed stressor frequency for either men or women, however, hostility in men was found to be related to increased distress in reaction to stressors and in women was related to decreased disclosure about these stressful events. Importantly, hostility in both men and women was related to decreased levels of observed social support, as compared to their non-hostile peers.     

Humor styles impact the relationship between symptoms of social anxiety and depression

Recent research suggests that examining humor styles may contribute to our understanding of clinical problems, such as risk and resiliency. The goal of the current study was to examine whether humor styles moderate the association between social anxiety and depressive symptoms in an unselected sample. Three-hundred and six participants (66% female) at a large Southern US university completed self-report measures of humor styles and symptoms of social anxiety and depression. Regression analyses suggested that affiliative and self-defeating humor styles individually moderated the relationship between social anxiety and depressive symptoms. Clinical implications regarding the monitoring of humor use as a means of understanding the maintenance of depressive symptoms among socially anxious individuals are discussed.     

Global or Domain Specific Self-Esteem: Can it Predict Aggression Among Children and Adolescents?

The study examined whether self-esteem predicted aggression among children and adolescents. Through a multistage method of sampling, the study utilized 170 (N = 170) participants from primary (elementary) and secondary (high) schools across Trinidad. Participants completed a demographic questionnaire, The Culture Free Self Esteem Inventory (CFSEI), and the Direct and Indirect Aggression Scale (DIAS). Using hierarchical regression analyses, both global and domain specific measures of self-esteem were used as predictors of the three types of aggression: direct physical, direct verbal and indirect aggression. The results revealed that global self-esteem was a stronger predictor of aggression for children than domain specific self-esteem. However, domain specific self-esteem was a stronger predictor of aggression among adolescents. As it relates to aggression, the pathways to global self-esteem differed from domain specific self-esteem. Implications for the comparative use of multidimensional and global self-esteem were discussed, and recommendations for future research have been proposed.     

Lotteries,Quasi-Lotteries,and Scepticism

I seem to know that I won't experience spaceflight but also that if I win the lottery, then I will take a flight into space. Suppose I competently deduce from these propositions that I won't win the lottery. Competent deduction from known premises seems to yield knowledge of the deduced conclusion. So it seems that I know that I won't win the lottery; but it also seems clear that I don't know this, despite the minuscule probability of my winning (if I have a lottery ticket). So we have a puzzle. It seems to generalize, for analogues of the lottery-proposition threaten almost all ordinary knowledge attributions. For example, my apparent knowledge that my bike is parked outside seems threatened by the possibility that it's been stolen since I parked it, a proposition with a low but non-zero probability; and it seems that I don't know this proposition to be false. Familiar solutions to this family of puzzles incur unacceptable costs—either by rejecting deductive closure for knowledge, or by yielding untenable consequences for ordinary attributions of knowledge or of ignorance. After canvassing and criticizing these solutions, I offer a new solution free of these costs.

Knowledge that p requires an explanatory link between the fact that p and the belief that p. This necessary but insufficient condition on knowledge distinguishes actual lottery cases from typical, apparently analogous ‘quasi-lottery’ cases. It does yield scepticism about my not winning the lottery and not experiencing spaceflight, but the scepticism doesn't generalize to quasi-lottery cases such as that involving my bike.     

Preschoolers Use Questions as a Tool to Acquire Knowledge From Different Sources

How do children use questions as tools to acquire new knowledge? The current experiment examined preschool children's ability to direct questions to appropriate sources to acquire knowledge. Fifty preschoolers engaged in a task that entailed asking questions to discover which special key would open a box that contained a prize. Children solved simple and complex problems by questioning two puppet experts who knew about separate features of each key. Results indicate dramatic developmental differences in the efficiency and efficacy of children's questions. Although even 3-year-olds asked questions, their questions were largely ineffective and directed toward inappropriate sources. Four-year-olds directed questions toward the appropriate sources but asked approximately equal numbers of effective and ineffective questions. Only 5-year-olds both asked the appropriate sources and formulated effective questions. Implications for the development of problem-solving abilities are discussed.     

Language and understanding of cardiopulmonary resuscitation amongst an aged inpatient population

Greater patient involvement in health decision-making requires exchange of information between the patient and the healthcare professionals. Decisions regarding healthcare at the end of life include consideration of cardiopulmonary resuscitation (CPR). The stated objectives of this study were to determine how often language around concepts of resuscitation is used in the community by examination of the English language corpora (ELC); to explore the understanding of the same language by a group of older hospital patients; and to determine the patients’ knowledge of the process and success of CPR, as well as the sources of their information. Medical inpatients aged 75 years and older were surveyed to this end in the setting of a tertiary university teaching hospital. Interrogation of the Australian, British and American English Corpora was accomplished by a linguist, and a questionnaire and semi-structured interview were administered to ascertain patient knowledge. We demonstrated that although medical inpatients have some familiarity with terms relating to resuscitation, there is a lack of understanding of the context, process and outcomes of CPR. The predominant sources of information were television and print media. Examination of the ELC revealed a paucity of the use of terms related to resuscitation. This finding indicates that physicians have a duty of care to determine patients’ understanding around resuscitation language, and terms used, in discussions of their preferences before assuming their engagement in shared decision-making. More open public discussion around death and resuscitation would increase the general knowledge of the population and would provide a better foundation for the discussions in times of need.     

Expanding the evidence: Developments and innovations in clinical practice,training and competency within voice and communication therapy for trans and gender diverse people

Background: Speech and language therapists (SLTs) deliver voice and communication therapy for trans and gender diverse people to facilitate authentic vocal and communicative expression. Davies, Papp, and Antoni (2015) have provided a comprehensive review of the literature, with recommendations for good clinical care. Several areas highlighted as gaps in the research were identified by the current authors as ones in which evidence is expanding.

Aims: To demonstrate 1) an expansion of the evidence base in particular innovations in voice group therapy for trans women and trans men; 2) the importance of delivering voice and communication therapy as part of a complete approach to trans and gender diverse health care; and (3) developments in training and competency in the UK.

Method: Data were drawn from three small-scale projects, two surveys, and one audit.

Measurements: Data from survey and audits and pre- and post-group acoustic measures of and client self-perceptual measures, including the Transsexual Voice Questionnaire (TVQ^MtF); a client-generated set of questions for trans men; and the migration of vocal identity map, adapted from Narrative Therapy practices.

Results: Positive outcomes for both pitch measures and client perception were recorded. Audit and survey data provided evidence of developments in training and competency in the UK.

Conclusion: Evidence supports group therapy as a successful approach for trans individuals across a number of parameters of voice and self-perception. Voice group protocols for both trans men and trans women should take account of the social context within which to explore relational presence and authentic voice. SLTs within gender identity clinics provide voice and communication as part of a broader pathway of care, alongside sharing professional knowledge and skills. Current UK developments are documented as indicators of positive responses to the growth in the number of SLTs seeking to develop specialist skills within this field.