Quality of Life and Neurological Illness: A Review of the Literature

This article highlights some of the conceptual and methodological problems associated with quality of life (QoL) measurement in individuals with neurological illness. It is suggested that these problems have contributed to the underdeveloped status of QoL research in neurological settings. Many of the existing QoL measures that have been used, or show potential for use with individuals with neurological illness, are reviewed in terms of their theoretical basis, content, and practicality. A large proportion of these measures fail to meet adequate psychometric standards and/or have rarely been psychometrically tested. The confusion that surrounds adequate psychometric standards is discussed, and the dynamic nature of QoL is highlighted as a factor that requires further attention. Research addressing the discrepancies between proxy and patient ratings of patient QoL is also warranted. More focused research in these areas may contribute to a clearer understanding of how to assess QoL in individuals with neurological illness.     

Therapeutic work with refugees living in exile: Observations on clinical practice

Asylum seekers and refugees fleeing to Britain or other host countries face a range of dilemmas, which are qualitatively different from those facing any other client group. Refugees find themselves in an entirely different country, having often fled at short notice without making preparations. They may have suffered multiple practical and psychological losses. Significant numbers of refugees will have been subject to organised violence in their country of origin. Responding clinically to the needs of some of those becoming refugees has many implications and challenges for existing models of therapeutic intervention. This paper draws upon the author's clinical work in Britain and abroad, it details some observations on therapeutic practice and highlights the challenges and rewards of working with this client group.     

Encouraging counsellor reflection

The evolution of an 'attributes checklist' tool for assisting counsellor development is described. The attributes relate to characteristics of case-notes that indicate evidence of counsellor reflection and consideration of the counselling process. The checklist was initially tested among a sample of 19 counsellors employed by an organisational EAP and was subsequently refined. The final checklist tool was found to be both usable and useful in differentiating 'process' from 'content' notes. The purpose of the checklist tool is not to enable quantitative assessment of counsellor notes, but rather to facilitate counsellor development within a professional supervisory relationship. The findings of the study are discussed, and suggestions for future research in this area are made.     

Alcohol Consumption and the Theory of Planned Behavior: An Examination of the Cognitive Mediation of Past Behaviorid

This study examined the predictive power of the theory of planned behavior (TPB) in explaining alcohol consumption in 3 prospective samples of students ( Ns = 178. 176. and 159). Generally, the TPB performed well. with attitudes, subjective norms and perceived behavioral control (PBC) explaining between 28% and 46% of the variability in intentions. Intentions and PBC explained between 12% and 50% of the variability in behavior. Measures of self-identity as a "drinker" and past behavior contributed to predictions of intentions over and above the contribution of attitudes. subjective norms. and PBC. Measures of past behavior but not self-identity consistently contributed to predictions of behavior over and above the contributions from intentions and PBC. The direct relationship between past behavior and intention and between past behavior and behavior (independent of the TPB variables or self-identity) could not be attributed to common method variance.     

The Iowa Personality Disorder Screen: development and preliminary validation of a brief screening interview

The length and expense of comprehensive personality disorder interviews makes them unwieldy for routine use. A brief but sensitive screen could eliminate administration of longer instruments in many instances. We describe the development of the Iowa Personality Disorder Screen (IPDS)--a mini-structured interview which can be completed in less than 5 minutes. Retrospective analyses using 1,203 SIDP-R interviews suggested that the IPDS items should provide good sensitivity and specificity. We present results from a prospective validation study, using a mixed group of 52 nonpsychotic inpatients and outpatients who were diagnosed using the SIDP-IV. Blind administration of the IPDS yielded excellent sensitivity (92%) and good specificity (79%), using a subset of five screening items. Addition of two more items leads to an estimated sensitivity of 79% and specificity of 86%. The IPDS shows promise as a quick personality disorder screen for use in research settings or standard clinical interviews.     

Development and Validation of the Female Muscularity Scale

Socially promoted physical appearance ideals for women place increasing importance on muscularity, resulting in growing muscularity concerns among traditional college-age women. To date, however, instruments for assessing the type of muscularity concerns reported by women are lacking. The aim of the present study was therefore to develop such a scale and examine its psychometric properties among a sample of young women. Findings from an exploratory factor analysis (n = 235) and a confirmatory factor analysis (n = 130) revealed a two-factor structure, including a five-item Attitudes subscale (α = .89) and a five-item Behaviors subscale (α = .90), which were moderately correlated, r = .50. In addition, the scale demonstrated good 2-week test-retest reliability (r = .76), and the subscales revealed moderate-to-large associations with body image concerns, drive for thinness, and exercise engagement, indicating concurrent validity. Thus the new Female Muscularity Scale is a useful and promising tool for assessing muscularity concerns among young women, and it may help toward understanding the role of pressures to achieve a toned body in the development of body image, eating, and exercise disorders.     

Peer Toy Play as a Gateway to Children’s Gender Flexibility: The Effect of (Counter)Stereotypic Portrayals of Peers in Children’s Magazines

Extensive evidence has documented the gender stereotypic content of children’s media, and media is recognized as an important socializing agent for young children. Yet, the precise impact of children’s media on the endorsement of gender-typed attitudes and behaviors has received less scholarly attention. We investigated the impact of stereotypic and counter-stereotypic peers pictured in children’s magazines on children’s gender flexibility around toy play and preferences, playmate choice, and social exclusion behavior (n?=?82, age 4–7 years-old). British children were randomly assigned to view a picture of a peer-age boy and girl in a magazine playing with either a gender stereotypic or counter-stereotypic toy. In the stereotypic condition, the pictured girl was shown with a toy pony and the pictured boy was shown with a toy car; these toys were reversed in the counter-stereotypic condition. Results revealed significantly greater gender flexibility around toy play and playmate choices among children in the counter-stereotypic condition compared to the stereotypic condition, and boys in the stereotypic condition were more accepting of gender-based exclusion than were girls. However, there was no difference in children’s own toy preferences between the stereotypic and counter-stereotypic condition, with children preferring more gender-typed toys overall. Implications of the findings for media, education, and parenting practices are discussed, and the potential for counter-stereotypic media portrayals of toy play to shape the gender socialization of young children is explored.     

Wisdom at the end of life: Hospice patients’ reflections on the meaning of life and death

The processes of aging and confronting mortality are often accompanied by unique psychological challenges. From the perspective of positive psychology, such challenges can yield opportunities for growth, including increased wisdom. This qualitative study explored 15 terminally ill hospice patients’ perspectives on wisdom, the dying process, and the meaning of life using consensual qualitative research methods. Most participants cited humility as a key component of wisdom, emphasizing that “Wisdom is when we realize ‘I don’t really know much’.” Other components of wisdom included self-knowledge, rationality, experiential learning, listening to and learning from others, and sharing knowledge with others. Participants also suggested that the process of facing illness and death presents opportunities for positive growth, including changing priorities and learning to appreciate life more fully in the present moment. In considering the sources of meaning in their lives, participants emphasized relational connections, personal growth, spirituality, vocational fulfilment, and living a full life. Participants also shared their reflections on important past experiences and regrets. Lastly, participants offered advice to others based on their experiences facing illness and mortality. Implications for psychological care of the dying and future research are discussed.