Caregivers’ beliefs about dementia: findings from the IDEAL study

Abstract

Objective: Informal caregivers of people with dementia develop their own beliefs about the condition, referred to as Dementia Representations (DRs), as they try to make sense of the changes they are observing. The first aim of this study was to provide a profile of the types of DRs held by caregivers. The second aim was to examine the impact of caregivers’ DRs on their well-being, satisfaction with life (SwL) and caregiving stress.

Methods: Participants were 1264 informal caregivers of people in the mild-to-moderate stages of dementia from time-point 1 of the IDEAL cohort study.

Measures: DRs were measured using questionnaire items covering: Identity, Cause, Control, and Timeline.

Results: Almost half (49.2%) of caregivers used a diagnostic term to describe the person’s condition, although 93.4% of caregivers stated they were aware of the diagnosis. Higher well-being, SwL, and lower caregiving stress were associated with the use of an identity term relating to specific symptoms of dementia, attributing the cause to ageing or not knowing the cause, and believing the condition would stay the same. Lower well-being, SwL, and higher caregiving stress were associated with believing there was little that could be done to control the effects of the condition.

Conclusion: Healthcare professionals should assess and gain an understanding of caregivers’ DRs in order to provide more tailored information and support.     

the inventory of recent life experiences for cancer patients (IRLE-C): A decontaminated measure of cancer-based hassles

Abstract

Cancer is recognized to have multifaceted stressful impact on all areas of a patient's life. Researchers commonly use self-report questionnaires, intended to measure stressors objectively. However, the item-content and response-format of such scales often tap physical and mental responses to stress, thereby contaminating prediction of adverse impact. This article reports the development and validation of English and French versions of the Inventory of Recent Life Experiences for Cancer Patients (IRLE-C) which is designed to minimize such “criterion-contamination”. This entailed (1) avoiding items reflecting physical or subjective distress; (2) rating stressors for degree of exposure only; and (3) use of an innocuous scale title. The initial item pool was administered serially to a sample of 100 Francophone breast-cancer and prostate-cancer patients. To guard against inflating reliability and validity estimates through capitalizing on chance, we administered the 30-item final scale to an independent sample of 96 Francophone breast-cancer and prostate-cancer patients undergoing radiation treatment. Following the item-selection step, factorial structure and validity analyses were performed using the combined French-speaking sample (n= 196). Second, we administered the English version of the scale to an English-speaking sample of 127 cancer patients (various cancer sites and stages). The measure showed good internal consistency (.94 and .89 for the Francophone and Anglophone samples respectively) and met criteria for a 2-week test-retest reliability (r= .70 for the item-selection subsample and .80 for the cross-replication sub-sample). Correlations between the IRLE-C and the POMS Total Mood Disturbance were around .60 for both the Francophone and Anglophone samples. Avoiding contamination (through content and format) without losing its relationship to subjective distress, the IRLE-C appears a useful instrument for applying the stress-process model in oncology to establish clear distinctions among stressors, mediators, reactions, and consequences.     

Intermingling and confusion

Abstract

An understanding of Descartes’ concept of ‘confusion’ is important both for making sense of his epistemological enterprise and for grasping his doctrine of the union of mind and body. An analysis of Descartes’ notion of confusion is offered which is grounded in the (more or less controversial) theses that confused thoughts are thoughts, that confusion is confusion by a thinker of one thought with another, and that confusion both can and should be avoided or ‘undone’. This analysis takes its rise from his contrast between ‘confused’ and ‘distinct’ : it exhibits confusion as a failure to distinguish between meanings of systematically ambiguous expressions. This failure is sometimes due to ‘bad intellectual habits’ which in his view ought to be broken, sometimes to ‘nature’ (where the confusion is in general beneficial to our welfare). Paradigmatically these are expressions which refer ambiguously to substances (i.e. mind and body) which are ‘really distinct’. Moreover, his ‘disambiguations’ indicate a central but neglected aspect of his aim in philosophizing: he can be seen as engaged in a moral project of ‘philosophical therapy’.     

Inverse discrimination time as a perceptual distance for alphabetic characters

Reaction times to discriminate lower‐case letters were collected in an experiment. The inverse discrimination times were used to build metrics on the space of letters. These metrics were found to be significantly correlated with various well‐known letter confusability measures, and a meaningful dimensional analysis of the alphabet was performed. This methodology is mathematically well founded, it requires fewer data than common methods, and it appears to be highly sensitive to visual similarity between letters, which allows visual letter features to be effectively analysed.     

Differential central resource demands of memory scanning and visual search: The role of consistent and varied mapping

In this paper we compare the effect of mapping on the central resource requirements of two search processes. With consistent mapping of items to the role of either target or distractor, search becomes very efficient; with varied mapping (each item serves as both a target and a distractor in the same experiment), search is less efficient. One interpretation of this effect of manipulating the consistency of mapping is that search under varied mapping requires limited capacity central resources but the requirement for these resources is reduced with consistent mapping. We tested this interpretation by varying the consistency of mapping in memory scanning (Experiments 1 and 2) and in visual search (Experiments 3 and 4) as the second of two tasks in the psychological refractory period (PRP) paradigm. Responses were location based, rather than present/absent judgements, and a target was present on every trial. The results indicated that there was less of a requirement for central resources with consistent mapping than with varied mapping in both memory scanning and in visual search; however, the effect of the mapping manipulation on central resource requirements was different for memory scanning than for visual search. Memory scanning was not done in parallel with a resource-demanding stage of a second task under varied mapping, but was done in parallel with this stage under consistent mapping. Part of visual search under both types of mapping was done in parallel with a resource-demanding stage of a second task and part was not; consistent mapping reduced the duration of the stage of processing that could not be carried out in parallel. We conclude that under consistent mapping, switching among items in memory becomes less controlled and therefore has less of a requirement for central resources than under varied mapping. In visual search, however, consistent mapping improves performance by facilitating the comparison of the target item to items in the search array.     

Development of Spatial Language and Cognition in Hindi- and Sanskrit-Medium Schools

This paper describes a study carried out at Varanasi on the development of geocentric spatial cognition with 4–14 year old children of Hindi and Sanskrit medium schools. A number of tasks and procedures were used to assess the spatial frames of reference children used in describing and interpreting spatial displays. Analysis revealed that Sanskrit medium school children used more geocentric language and encoding than Hindi medium school children. The effect of age was significant only for encoding, not for language. Geocentric spatial cognition was significantly linked to fundamental spatial cognitive ability, as measured by Story-Pictorial Embedded Figures Test and Block Designs Test. The stronger expression of geocentric language and geocentric encoding in Sanskrit than Hindi medium school children suggests that the use of the ability can be sharpened by its practice and actualization in day-to-day life. The relationship between language and encoding was found to be of a moderate level suggesting that geocentric cognition is not determined by language alone, but also by other factors present in children’s eco-cultural contexts.     

Sexual abuse as a theme in group-analytic therapy

The group-analytic approach, which emphasises the individual in a network of group relationships, is described with reference to the subject of sexual abuse in childhood. Three different National Health Service psychotherapy groups run by the author provide contrasting examples of how the theme, originating in an individual participant, was manifested in the dynamics of the group-as-a-whole. The therapeutic significance to the individual and the group is explored.     

Emotional expressivity in men and women: Stereotypes and self-perceptions

Three studies were conducted to assess prevalent stereotypes regarding men's and women's emotional expressivity as well as self-perceptions of their emotional behaviour. Emotion profiles were employed to assess both modal emotional reactions and secondary emotional reactions to hypothetical events and personal experiences. In Study 1 we asked how men and women in general would react to a series of hypothetical emotional events. In Study 2 we asked how participants themselves expected to react to these same situations and in Study 3 we asked participants to report a personal emotional event in narrative form. Two gender differences emerged across all three studies. Specifically, women were expected to be more likely to react with sadness to negative emotion-eliciting events in general. They also expected themselves to be more likely to react with sadness as well as to cry and to withdraw more when experiencing negative emotional events. Finally, women report more sadness when describing personal events. In contrast, men were expected to react with more happiness/serenity during negative emotional situations. Also, they expect themselves to react more frequently this way as well as to laugh and smile more and to be more relaxed in negative situations. Finally, men tend to report more happiness when describing negative personal events. In sum, the present study gives a more detailed portrayal of how men and women are expected and expect themselves to react to specific emotional situations and presents some evidence that these expectations may influence the way they reconstruct emotional events from their past.