Living with Multiple Endocrine Neoplasia Type 1: Decent Care-Insufficient Medical and Genetic Information A Qualitative Study of MEN 1 Patients in a Swedish Hospital

This qualitative study explores how 29 Swedish patients with Multiple Endocrine Neoplasia type 1 (MEN1) experience living with the condition, appraisal of the clinical follow-up program, and surveys their future expectations. The aim of this study is to build knowledge about this patient group in order to provide optimal care. The participants describe physical, psychological, and social limitations in their daily activities and how these limitations influence quality of life. Our findings indicate that a majority of patients have adjusted to their situation, describing themselves as being healthy despite physical symptoms and treatment. The participants received decent care in the clinical follow-up program, - however, greater effort should be put into patient information. These patients might benefit from genetic counseling. Health professionals involved should recognize their potential impact and influence on a patient’s ability to adjust to these circumstances. Antonovsky`s Sense of Coherence theory is used to discuss these findings.     

The other way around: does health predict perceived support?

The aim in this study was to identify predictors of perceived social support before and after cataract surgery. We hypothesized that physical (comorbidity and visual acuity) and mental (depressive symptoms) health indicators would be directly and indirectly (through actually received support) associated with perceived support. One hundred and thirty-six cataract patients (69% women; mean age = 71.6 years) completed questionnaires before and after cataract surgery. Results showed that received support partially mediated the association between depressive symptoms and perceived support. However, mental and physical health variables were also directly associated with perceived support. We conclude that health status might feedback to perceptions of available support.     

Integrative neuropsychological characteristics of subcortical-frontal brain regions as a schizophrenia liability factor

In order to study neuropsychological characteristics of subcortical-frontal brain regions function and assessment of their relation with vulnerability to schizophrenia 59 patients and 23 controls were investigated using Luria's neuropsychological methods. The analysis established bilateral abnormalities of the function of prefrontal and profound frontal lobe zones in patients as compared with controls. These abnormalities were more predominate in the left hemisphere. Point biserial correlation coefficients of determined integrative neuropsychological indicators with liability to schizophrenia were 0.39 +/- 0.11 and 0.28 +/- 0.09, for the left and right brain zones respectively. The obtained data permits discussion of the integrative neuropsychological indicators of subcortical-frontal brain regions as potential markers of liability to schizophrenia and confirms the role of structural and functional brain asymmetry in the pathogenesis of schizophrenia.     

Cannabiskonsum und -missbrauch bei Jugendlichen und jungen Erwachsenen

After a long time of growth current studies on representative samples of adolescents indicate that the number of adolescent cannabis users in Germany is possibly decreasing. However, it may be presumptuous to expect a similar trend concerning the number of clients with cannabis-related disorders. Even if there is in fact a downward trend which is not yet proven, the rapidly growing number of clients presenting with these disorders in recent years cannot be explained by a similar growth in the number of regular cannabis users. Treatment centres should therefore expect a further inreasing number of especially male adolescents and young adults seeking help for problems related to cannabis use. The development, evaluation and implementation of specific treatment options concerning cannabis use disorders will be increasingly needed in the future. Cognitive-behavioral and motivational interventions have been shown to be evidence-based treatments. The paper describes some promising or already successful treatment approaches and related research projects in Germany.     

Psychotherapeutenausbildung aus Sicht der Absolventen

Background

A survey was performed to assess the current situation in education and to identify critical issues 10 years after the inception of the psychotherapy act in Germany.

Methods

In August 2008 all non-medical psychotherapists who had graduated since 2002 according the psychotherapy act were invited to take part in the survey and a total of 863 persons participated. The answers from 666 could be evaluated corresponding to a participation rate of 20%.

Results

A total of 57.6% of the graduates had completed a full-time training and approximately 50% of the graduates had completed the training within the allotted time. In the majority of cases evaluation occurred only for the theoretical courses. During the practical work (PT I) 36.8% of the graduates did not receive any salary or remuneration, 82% had their own field of activity and of these 38% treated patients without the presence of qualified tutor.

Conclusions

The training often lasts longer than intended, the financial situation in the PT I is exceptionally critical and in clear contrast to the field of activity in this section of training. Further detailed results will be presented and discussed.     

Effects of received and mobilized support on recipients' and providers' self-efficacy beliefs: a 1-year follow-up study with patients receiving radical prostatectomy and their spouses

From a proactive agentic perspective, social support is not just seen as a protective cushion against environmental demands. Rather, support may facilitate an individual's self-regulation by enhancing perceived self-efficacy (i.e., enabling hypothesis). In the present study, patient-reported indicators of mobilized and received spousal support as predictors of their own and their spouses' self-efficacy beliefs were investigated within 1 year following radical prostatectomy. During this time frame, postoperative sequelae such as urinary incontinence and erectile dysfunctions are still likely to interfere with couples' everyday activities. Seventy-two patients receiving radical prostatectomy and their spouses participated. Patients' and spouses' self-efficacy beliefs and patients' received and mobilized spousal support were assessed prior to and 12 months following surgery. Additional patient-reported covariates at 1 year post-surgery were degree of bother by urinary incontinence, overall sexual satisfaction, and relationship satisfaction. Results indicated that patients' received spousal support was associated with higher levels of patients' self-efficacy only cross-sectionally, but not longitudinally. Support mobilized by the patient prior to and 1 year after surgery, however, positively predicted spouses' levels and changes in self-efficacy. Results, thus, did not fully confirm predictions by the enabling hypothesis of social support; rather, associated aspects, such as the degree of being mobilized as a provider of support or being needed, seem to enhance agency beliefs in spouses.     

Using the MMPI-2 to Predict Symptom Reduction During Psychotherapy in a Sample of Community Outpatients

In the present study, potential MMPI-2 predictors of psychotherapy outcome were examined in a community clinical sample of 51 patients seeking treatment at a university training clinic. Results indicated that particular MMPI-2 scales (L, F, Pd, Pa, Sc, Trt) were the most predictive of initial levels of patient distress, whereas three other clinical scales (Hs, D, Hy) were significantly associated with actual symptom reduction over time. The clinical implications of these data include the use of the MMPI-2 in clinical practice as a means to frame the provision of direct feedback to patients regarding the likelihood of treatment response, which in turn, might actually have therapeutic benefits. The limitations of the study are reviewed and suggestions for future research are offered, including the potential use of widely known and utilized instruments in helping to predict response to psychotherapy.     

Marginally perceptible outcome feedback, motor learning and implicit processes

Participants struck 500 golf balls to a concealed target. Outcome feedback was presented at the subjective or objective threshold of awareness of each participant or at a supraliminal threshold. Participants who received fully perceptible (supraliminal) feedback learned to strike the ball onto the target, as did participants who received feedback that was only marginally perceptible (subjective threshold). Participants who received feedback that was not perceptible (objective threshold) showed no learning. Upon transfer to a condition in which the target was unconcealed, performance increased in both the subjective and the objective threshold condition, but decreased in the supraliminal condition. In all three conditions, participants reported minimal declarative knowledge of their movements, suggesting that deliberate hypothesis testing about how best to move in order to perform the motor task successfully was disrupted by the impoverished disposition of the visual outcome feedback. It was concluded that sub-optimally perceptible visual feedback evokes implicit processes.     

The impact of regulatory focus on affective responses to social discrimination

The impact of individuals' regulatory focus and the domain of outcomes (non‐gains vs. losses) on the target's affective responses to social discrimination were tested. Based on regulatory focus theory (Higgins, 1997 ), it was predicted that a prevention focus would lead to more anger and agitation after social discrimination, because experiencing social discrimination is similar to experiencing failure. This pattern was predicted to be more pronounced when social discrimination was based on losses than when social discrimination was based on non‐gains (i.e., when the in‐group was evaluated more negatively vs. less positively compared to the out‐group). The results of three studies using chronic and situationally induced regulatory focus confirmed these predictions. No effect was found for the promotion focus. Copyright © 2006 John Wiley & Sons, Ltd.