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.     

Perceived stress in prodromal Huntington disease

This study examines perceived stress and its relationship to depressive symptoms, life changes and functional capacity in a large sample of individuals who are positive for the Huntington disease (HD) gene expansion but not yet diagnosed. Participants were classified by estimated proximity to HD diagnosis (far, mid, near) and compared with a non-gene-expanded comparison group. Persons in the mid group had the highest stress scores. A significant interaction between age and time since HD genetic testing was also found. Secondary analyses using data from a different data collection point and including a diagnosed group showed the highest stress scores in the diagnosed group. Possible explanations and implications are discussed.     

The Role of Perfectionism in Relation to an Intervention to Reduce Anxious and Depressive Symptoms in Children

Research has demonstrated an association between perfectionism and depressive and anxious symptoms in children. We examined whether a school-based program targeting anxious and depressive symptoms would reduce perfectionism, and whether perfectionism would interfere with intervention outcomes. The participants were 78 school-age children identified as at-risk for anxiety and/or depression. At-risk children took part in a randomized controlled trial of a school-based intervention program. Levels of perfectionism, depression, and anxiety were assessed at pre-treatment (Time 1) and again at post-treatment (Time 2) after participating in either a cognitive behavioral group or a structured activity group. Participation in either group was associated with significant reductions in overall levels of self-oriented perfectionism, anxious symptoms, and depressive symptoms. Supplementary analyses indicated that pre-treatment self-oriented perfectionism influenced post-treatment depression scores, suggesting that perfectionism interferes with treatment outcome. Perfectionism in children appeared amenable to group-based intervention, and identifying perfectionism may be important for treating children with depressive symptoms.     

Risk and Prisoner's Dilemma: A Reinterpretation of Coombs' Re‐parameterization

We propose a model to measure risk in a prisoner's dilemma based on Coombs' (1973) re‐parameterization of the game as an individual risk decision‐making task that chooses between a gamble of cooperation and another gamble of defection. Specifically, we propose an index, r, to represent the risk associated with cooperation relative to defection. In conjunction with Rapoport's (1967) index of cooperation (K), our formulation of risk allows us to construct games that vary in risk (as indexed by r) while controlling for cooperativeness (as indexed by K). Following utility analysis that models risk seeking as a convex utility function and risk averse as a concave function, we predict that risk‐seeking people cooperate more in games that the cooperation choice is more risky, whereas risk‐averse people cooperate more in games that the cooperation choice is less risky. In the three studies that we varied game parameters, used different measures of risk orientation and prosocial orientation and used different experimental procedures, we found robust results supporting our predictions. Theoretical analysis of our formulation further suggests that risk and cooperativeness of a prisoner's dilemma game is not entirely independent. Games that have a higher cooperativeness index are necessarily more risky. Copyright © 2011 John Wiley & Sons, Ltd.     

Imagining novel futures: the roles of event plausibility and familiarity

The constructive episodic simulation hypothesis suggests that episodic memory supports the simulation of future events through extraction and recombination of stored information. The current study explicitly investigated the use of past episodic thought in the simulation of future scenarios. Participants simulated one of three possible scenarios, differing in plausibility and participants' prior experience of similar events. Participants recorded related memories and whether they were explicitly used during future event simulation. Memories were rated for source (self-experienced, other-experienced, or media). Findings suggest prior experience and event plausibility did not impact upon ease of future event simulation or the extent of memory usage during simulations. Differences emerged in the source of information used to assist future event simulation. These findings provide support for the hypothesis that episodic memories from a variety of sources are recombined when generating future simulations of novel events.     

Professional Counseling in Kenya: History,Current Status,and Future Trends

The authors examine the history and development of the counseling profession in Kenya. This profession is deeply rooted in responses to the HIV/AIDS epidemic, the emergence of mental health needs created by the impact of political and community‐based violence, increasing student unrest in public institutions, and government efforts to provide social–emotional support for students in public schools and universities. The authors also examine the challenges for the profession and make recommendations for the future.     

Beneficiary or benefactor: are people more prosocial when they reflect on receiving or giving?

Research shows that reflecting on benefits received can make people happier, but it is unclear whether or not such reflection makes them more helpful. Receiving benefits can promote prosocial behavior through reciprocity and positive affect, but these effects are often relationship-specific, short-lived, and complicated by ambivalent reactions. We propose that prosocial behavior is more likely when people reflect on being a benefactor to others, rather than a beneficiary. The experience of giving benefits may encourage prosocial behavior by increasing the salience and strength of one's identity as a capable, caring contributor. In field and laboratory experiments, we found that participants who reflected about giving benefits voluntarily contributed more time to their university, and were more likely to donate money to natural-disaster victims, than were participants who reflected about receiving benefits. When it comes to reflection, giving may be more powerful than receiving as a driver of prosocial behavior.     

Skilled deaf readers have an enhanced perceptual span in reading

Recent evidence suggests that, compared with hearing people, deaf people have enhanced visual attention to simple stimuli viewed in the parafovea and periphery. Although a large part of reading involves processing the fixated words in foveal vision, readers also utilize information in parafoveal vision to preprocess upcoming words and decide where to look next. In the study reported here, we investigated whether auditory deprivation affects low-level visual processing during reading by comparing the perceptual span of deaf signers who were skilled and less-skilled readers with the perceptual span of skilled hearing readers. Compared with hearing readers, the two groups of deaf readers had a larger perceptual span than would be expected given their reading ability. These results provide the first evidence that deaf readers' enhanced attentional allocation to the parafovea is used during complex cognitive tasks, such as reading.     

Quality of Life and Autonomy in Emerging Adults with Early-Onset Neuromuscular Disorders

Emerging adulthood is an important period in the development of one's identity and autonomy. The ways in which identity and autonomy are viewed by emerging adults and how they impact quality of life (QoL) in individuals with early-onset neuromuscular conditions is not yet known. This study focused on understanding and exploring relationships between self-perceptions of emerging adulthood, autonomy, and QoL. Five previously validated measures were incorporated into an online survey and distributed to young adults with early-onset neuromuscular conditions and unaffected controls. Topics explored included individuals' views regarding their overall QoL, disease-specific QoL, components of emerging adulthood, and autonomy. We found that a sense of higher disease impact was associated with a lower Overall General QoL. Additionally, perceptions of key autonomy factors "negativity" and "instability" were uniquely associated with Overall General QoL in the case group as compared to controls, whereas "attitudinal autonomy" (attaining the ability to plan and follow through with goals) was important to this age group regardless of health status. The specific factors of emerging adulthood and autonomy that were significantly correlated with Overall General QoL can be used for developing targeted counseling and interventions to improve QoL for individuals and their families.     

Utilizing Benchmarking to Study the Effectiveness of Parent–Child Interaction Therapy Implemented in a Community Setting

Benchmarking is a program evaluation approach that can be used to study whether the outcomes of parents/children who participate in an evidence-based program in the community approximate the outcomes found in randomized trials. This paper presents a case illustration using benchmarking methodology to examine a community implementation of Parent–Child Interaction Therapy (CI-PCIT) utilized as a child maltreatment prevention effort. Data were collected from 83 parent–child dyads. Change scores were compared to treatment and control effect sizes aggregated from the PCIT literature. Pre-post results indicated significant positive changes in child behavior for CI-PCIT completers. Benchmarking analyses revealed that parents who completed CI-PCIT reported significantly greater positive child outcomes than the aggregate control group benchmark, and significantly less than observed in the treatment benchmark. A summary of decision points and implications for utilizing this methodology in the child maltreatment field are postulated.