Cognitive predictors of posttraumatic stress symptoms six months following acute coronary syndrome

This study examined patients' illness representations assessed shortly after an acute coronary syndrome (ACS) as predictors of posttraumatic stress symptoms six months later. Illness representations were assessed in ACS patients using standard measures at a home visit three weeks after discharge from hospital. Posttraumatic stress symptoms were assessed at the same time, and again six months later. Patients were aged 61 years on average, the majority being men (89.8%) of white European decent (89%). Greater posttraumatic symptoms at six months were associated with beliefs that the illness would last a long time (timeline), that it had an unpredictable time course (timeline--cyclical), greater consequences, less personal and treatment control, poorer illness coherence and stronger negative emotional representations (emotional upset relating to the illness; p?相似文献   

Docosahexaenoic Acid and Visual Functioning in Preterm Infants: A Review

Preterm children are at risk for a number of visual impairments which can be important for a range of other more complex visuocognitive tasks reliant on visual information. Despite the relatively high incidence of visual impairments in this group there are no good predictors that would allow early identification of those at risk for adverse outcomes. Several lines of evidence suggest that docosahexaenoic acid (DHA) supplementation for preterm infants may improve outcomes in this area. For example, diets deficient in the long-chain polyunsaturated fatty acid DHA have been shown to reduce its concentration in the cerebral cortex and retina, which interferes with physiological processes important for cognition and visual functioning. Further, various studies with pregnant and lactating women, as well as formula-fed infants, have demonstrated a general trend that supplementation with dietary DHA is associated with better childhood outcomes on tests of visual and cognitive development over the first year of life. However, research to date has several methodological limitations, including concentrations of DHA supplementation that have been too low to emulate the in utero accretion of DHA, using single measures of visual acuity to make generalised assumptions about the entire visual system, and little attempt to match what we know about inadequate DHA and structural ramifications with how specific functions may be affected. The objective of this review is to consider the role of DHA in the context of visual processing with a specific emphasis on preterm infants and to illustrate how future research may benefit from marrying what we know about structural consequences to inadequate DHA with functional outcomes that likely have far-reaching ramifications. Factors worth considering for clinical neuropsychological evaluation are also discussed.     

Identity,past and present,in an historical child-care setting

This article puts into context the service offered today to adults (former pupils) who grew up in the care of the Foundling Hospital. Key issues referred to are attachment, loss, identity and the urge to reconnect with one's personal history. Reflections on these issues are based on the experience of Coram Family social workers, who have for the past thirty years provided a birth-record service to the former pupils of the Foundling Hospital and their descendants. It is a moving experience to hear from this group of individuals something of what it has meant to have grown up in such particular circumstances. Although there are many echoes with adoption and fostering today, other significant issues are raised which do not apply in the work of family placement as it is now practised. Some historical background is given below in order to set the scene for this unique piece of child-care history, also to allow examination of the challenges faced by some 20,000 children over 200 years, in recognition of which the service to those former pupils and their families is still offered.     

A brief assessment tool for investigating facets of moral judgment from realistic vignettes

Humans make moral judgments every day, and research demonstrates that these evaluations are based on a host of related event features (e.g., harm, legality). In order to acquire systematic data on how moral judgments are made, our assessments need to be expanded to include real-life, ecologically valid stimuli that take into account the numerous event features that are known to influence moral judgment. To facilitate this, Knutson et al. (in Social Cognitive and Affective Neuroscience, 5(4), 378–384, 2010) developed vignettes based on real-life episodic memories rated concurrently on key moral features; however, the method is time intensive (~1.4–3.4 h) and the stimuli and ratings require further validation and characterization. The present study addresses these limitations by: (i) validating three short subsets of these vignettes (39 per subset) that are time-efficient (10–25 min per subset) yet representative of the ratings and factor structure of the full set, (ii) norming ratings of moral features in a larger sample (total N?=?661, each subset N?=?~220 vs. Knutson et al. N?=?30), (iii) examining the generalizability of the original factor structure by replicating it in a larger sample across vignette subsets, sex, and political ideology, and (iv) using latent profile analysis to empirically characterize vignette groupings based on event feature ratings profiles and vignette content. This study therefore provides researchers with a core battery of well-characterized and realistic vignettes, concurrently rated on key moral features that can be administered in a brief, time-efficient manner to advance research on the nature of moral judgment.     

Concordance between patients' information preferences and general practitioners' perceptions

Brief planning interventions, usually delivered within paper and pencil questionnaires, have been found to be effective in changing health behaviours. Using a double-blind randomised controlled trial, this study examined the efficacy of two types of planning interventions (action plans and coping plans) in increasing physical activity levels when they are delivered via the internet. Following the completion of self-reported physical activity (primary outcome) and theory of planned behaviour (TPB) measures at baseline, students (N = 1273) were randomised into one of four conditions on the basis of a 2 (received instructions to form action plans or not) × 2 (received instructions to form coping plans or not) factorial design. Physical activity (primary outcome) and TPB measures were completed again at two-month follow-up. An objective measure (attendance at the university's sports facilities) was employed 6 weeks after a follow-up for a duration of 13 weeks (secondary outcome). The interventions did not change self-reported physical activity, attendance at campus sports facilities or TPB measures. This might be due to low adherence to the intervention protocol (ranging from 58.8 to 76.7%). The results of this study suggest that the planning interventions under investigation are ineffective in changing behaviour when delivered online to a sample of participants unaware of the allocation to different conditions. Possible moderators of the effectiveness of planning interventions in changing health behaviours are discussed.     

The psychosocial predictors of long-term distress in partners of patients with acute coronary syndrome

Objective: Partners of acute coronary syndrome (ACS) patients are at risk of experiencing long-term distress and the purpose of this study was to identify its predictors.

Design: Using an observational design, 80 partners of ACS patients completed validated questionnaires at three time points. The predictor variables, marital satisfaction and optimism were assessed three weeks after patient hospital discharge (T1). The outcomes, depressive symptoms and physical health status (from a quality of life scale) were measured 6 (T2) and 12 (T3) months post-discharge, and scores were combined to indicate the long-term response.

Main outcome measures: Depressive symptoms and physical health status.

Results: Partner depressive symptoms increased and physical health status deteriorated over the months following the patients’ ACS. After controlling for demographics, clinical severity of ACS and T1 levels of the outcome variable, partners’ long-term depressive symptoms were predicted by poor marital satisfaction and low optimism at T1, and poor physical health status was predicted by low T1 optimism.

Conclusion: Psychosocial factors are predictors of long-term distress for ACS partners. Partners in an unhappy marriage or with low optimism after ACS are at an increased risk of depression and low physical health status, and should be the target of additional support.     

Cognitive predictors of posttraumatic stress symptoms six months following acute coronary syndrome

This study examined patients’ illness representations assessed shortly after an acute coronary syndrome (ACS) as predictors of posttraumatic stress symptoms six months later. Illness representations were assessed in ACS patients using standard measures at a home visit three weeks after discharge from hospital. Posttraumatic stress symptoms were assessed at the same time, and again six months later. Patients were aged 61 years on average, the majority being men (89.8%) of white European decent (89%). Greater posttraumatic symptoms at six months were associated with beliefs that the illness would last a long time (timeline), that it had an unpredictable time course (timeline – cyclical), greater consequences, less personal and treatment control, poorer illness coherence and stronger negative emotional representations (emotional upset relating to the illness; p?<?0.05). In multiple regression analyses, controlling for demographic, clinical and psychological factors (age, gender, ethnicity, social deprivation, ACS severity, negative affectivity and cardiac symptom recurrence), more intense emotional representations (β?=?0.146, p?=?0.041) and reduced illness coherence (β?=??0.133, p?=?0.029), emerged as independent predictors of posttraumatic symptom severity at six months. There was a near significant effect for personal control (β?=??0.113, p?=?0.058). These results demonstrate the importance of illness representations of ACS in predicting longer-term posttraumatic stress symptoms.     

Construction Of Reality Or Dependent Origination? From Scientific Psychotherapy To Responsible Attention

The term ‘postmodernism’ has carved itself a niche in everyday, and specialised, vocabulary. We understand it as being the new mentality that emerges from the critique of modernity. This transformation, which has been underway since the second half of the twentieth century, undermines the foremost myth of the modern world, that we can discover an objective and stable truth, that is to say independent and lasting. This change is affecting all areas of human knowledge, from philosophy to physics, as well as human practices and experiences. Its origins are to be found in the theories that label themselves critical, starting with Marxism and existentialism, and in further developments such as hermeneutics, symbolic interactionism, post-structuralism, ethnomethodology, deconstructionism, and others. In this article we wish to recover one of the principal ideas of this change of mentality, the idea of ‘construction of reality’ and contrast it with ‘dependent origination’ (Paticcasamuppada) characteristic of the Dharma, a system of liberation from suffering synthesised by Buddha. We are interested in this relationship in the specific field of Psychotherapy, or in the broader field of Integral Psychology. To this end, firstly we inquire how constructivism has made a space for itself in the scientific world; we then address the constructivist features of the Dharma.