Life events and psychological well-being in old age

Abstract

Although life event research has burgeoned in recent years, little attention has been paid to the prevalence of events among the elderly or their relationship to psychological well-being. This paper presents data from a three-wave longitudinal study of community elderly in Aberdeen. Negative life events were highly prevalent among both survivors [N=349) and non-survivors [N=108], but the relatively small differences between the groups indicate that attrition does not seriously affect longitudinal findings. Longitudinal analysis of survivors' data was performed using LISREL and yielded a model with a goodness of fit index of 0.918, demonstrating a close fit between the data and the model. The model parameters indicate that those in poor psychological state were more likely to report serious non-health events than health events, although the latter were more likely than the former to result in a decline in psychological well-being, even after prior psychological state was taken into account. While elderly people with low social integration experienced more severe reactions to life events in the short term than those with high social integration, there were no significant long term effects, even for those reporting highly stressful events. There was no evidence of a sub-group of elderly people lacked into a cycle of serious life events. However life events were not random occurrences; serious health events were more often reported by those with low education while women and those in lower social classes were more likely to report serious non-health events. Overall, long term disruption, directly attributable to life events, was minimal when viewed within the context of the community elderly's stable psychological state.     

Living with Hereditary Haemorrhagic Telangiectasia: stigma,coping with unpredictable symptoms,and self-advocacy

Abstract

Objective: Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic condition causing frequent nose bleeds, skin lesions (telangiectasia) and arteriovenous malformations. Approximately, 50% of people experience life-threatening HHT symptoms including haemorrhages in the brain, lungs and liver. This study aimed to gain a qualitative understanding of the psychosocial impact of HHT over time. Design: Using a phenomenological framework, a rigorous narrative analysis was performed on 20 semi-structured interviews with individuals with HHT aged 20s–60s. Main outcome measures: Qualitative themes explaining life experiences prior to and following a clinical diagnosis of HHT. Results: Narratives highlighted four psychosocial themes: (i) the psychological impact of visible symptoms was significant and related to experiences of social stigma, (ii) individuals struggled to identify triggers of symptoms in order to reduce unpredictability, (iii) an illness identity was rejected by minimising HHT when talking about the present self, and by positive reframing as ‘lucky’ and (iv) self-advocacy was necessitated due to lack of expert coordinated care. Conclusion: HHT has a demanding impact on social, physical and psychological well-being. These findings have significant implications for health care, as narratives about interactions with health professionals often used the terms ‘frustrating’ and ‘not being heard’.     

Social Problem-Solving Skills in Children with Traumatic Brain Injury: Long-Term Outcomes and Prediction of Social Competence

The effects of childhood traumatic brain injury (TBI) on social problem-solving were examined in 35 children with severe TBI, 40 children with moderate TBI, and 46 children with orthopedic injuries (OI). The children were recruited prospectively following injuries that occurred between 6 and 12 years of age. They were followed longitudinally, and ranged from 9 to 18 years of age at the time of the current study, which occurred on average 4 years post injury. They were administered a semi-structured interview used in previous research on social problem-solving to assess the developmental level of their responses to hypothetical dilemmas involving social conflict. Children in the severe TBI group defined the social dilemmas and generated alternative strategies to solve those dilemmas at the same developmental level as did children in the OI group. However, they articulated lower-level strategies as the best way to solve the dilemmas and used lower-level reasoning to evaluate the effectiveness of the strategies. After controlling for group membership, race, socioeconomic status, IQ, and age, children's social problem-solving, and particularly the developmental level of their preferred strategies for resolving conflicts, predicted parents ratings of children's social skills, peer relationships, aggressive behavior, and academic performance. The findings indicate that children with severe TBI demonstrate selective, long-term deficits in their social problem-solving skills that may help to account for their poor social and academic outcomes.     

The spatial thinking of origami: evidence from think-aloud protocols

Origami, the ancient Japanese art of paper folding, involves spatial thinking to both interpret and carry out its instructions. As such, it has the potential to provide spatial training (Taylor and Hutton under review). The present work uses cognitive discourse analysis to reveal the spatial thinking involved in origami and to suggest how it may be beneficial for spatial training. Analysis of think-aloud data while participants folded origami and its relation to gender, spatial ability measures, and thinking style suggest that one way that people profit from spatial training is through the possibility to verbalize concepts needed to solve-related spatial tasks.     

A Model for Peer Experiential and Reciprocal Supervision (PEERS) for Genetic Counselors: Development and Preliminary Evaluation Within Clinical Practice

A model for practising genetic counselors to obtain clinical supervision via reciprocal peer observation and feedback was developed and trialled. The model was developed in response to a perceived lack of opportunity for immediate observational feedback for practising genetic counselors. The aims reached by consensus were to facilitate learning new approaches and skills, to revitalise current ways of practising, and to enhance supervision skills in a two-way process, where the observer learnt from the counselor, and vice-versa. The genetic counselors agreed on a process of paired reciprocal observation whereby the observer was present in the room during the counseling session, and a reflective feedback discussion was arranged within 24 h of the session. Four main themes emerged from analysis of the recorded discussions were (i) “I wasn’t sure if I-”: voicing of doubts or internal questions that occurred during session for the counselor conducting the session, (ii) “I really liked that”: positive feedback and validation from the observer, (iii) “I wonder whether-”: offering of alternative views, insights and strategies by the observer, and (iv) “That’s a real thing for me to take away and think about”: evidence of learning by both observers and counselors.     

Pacific Islands Families (PIF) Study: Behavioural Problems During Childhood

Pacific peoples represent one of the fastest growing population subgroups in New Zealand and suffer disproportionately from diabetes, obesity, and other diseases. There is little research on the predictors of behavioral problems in Pacific children or the role that cultural variables play in shaping the unique environments in which child development occurs This study aims to examine the: (1) prevalence of behavior problems at 2, 4, and 6 years-of-age among Pacific children, and (2) relationships between maternal, cultural, and socio-demographic factors and behavioral problems. Data were gathered from the Pacific Islands Families Study. Maternal reports of child behavior were obtained using the Child Behavior Checklist for over 1000 Pacific children. The prevalence of clinical internalizing problems at ages 2, 4, and 6 years was 16.8, 22 and 8.5%, and clinical externalizing was 6.7, 10.7, and 14.6% respectively. Significant risk factors associated with clinical internalizing were maternal depression, maternal smoking, intimate partner violence, and having a single mother. Significant risk factors for clinical externalizing were harsh parenting, maternal depression, having a New Zealand born mother, and low household income. Across dimensions, a protective factor was found for children with mothers who described themselves as strongly aligned with Pacific traditions. These findings contribute to the limited longitudinal data specific to children from different ethnic groups and demonstrate the importance of cultural factors in developmental outcomes.     

Emerging Adults’ Perceptions of Acceptable Behaviors Prior to Forming a Committed, Dating Relationship

Recent available research demonstrates the pervasive use of communication technologies among emerging adults. The utilization of such digital media has redefined the process of contemporary coupling. The determination of appropriate behaviors in pre-romantic relationships differs on the basis of a variety of intrapersonal variables. This study examines the intrapersonal constructs of gender and religious involvement in the determination of acceptable pre-romantic relationship behaviors. Researchers collected data from 1,003 participants (aged 18–25) through an online survey about communication technology and “acceptable” dating behaviors. Data were analyzed using chi-square testing in and between independent variable groups to determine significance. Significant differences in gender and religious involvement were discovered. Application of findings is presented, and future directions for research are set forth.     

Inhibition of return promotes stop-signal inhibition by delaying responses

Inhibition of return (10R) refers to a mechanism that slows response times (RTs) to detect, localize, or discriminate a target that is presented at a location previously occupied by an irrelevant peripheral cue. Generally, the slowing of RTs is described as a negative effect on responding that is believed to promote searching to new locations. In this report, we consider whether IOR might benefit performance when the goal is to prevent a prepared response. Using the stop-signal paradigm, we show that IOR improved the ability to inhibit a prepared response by delaying responses to the target. Thus, in addition to aiding visual search, IOR may also provide an opportunity for the adjustment of decisions and behaviour in accordance with the demands of a dynamic environment.     

Associations of general religiousness and specific religious beliefs with coping appraisals in response to Hurricanes Katrina and Rita

An emerging scientific literature is investigating the construct of “compassionate love,” love that is “centered on the good of the other,” a construct empirically linked to physical and mental health. We evaluated effects of an 8-week, 16-hour programme for physicians, nurses, chaplains, and other health professionals, using nonsectarian, spiritually based, self-management tools. Participants were randomised to intervention (n = 30) or wait-list (n = 31). Pretest, post-test, 8- and 19-week follow-up data were gathered on six measures of prosocial qualities. Favorable treatment effects (p<0.05) were found for compassionate love (d = 0.49), altruistic actions (d = 0.33), perspective-taking (d = 0.42), and forgiveness (d = 0.61). Treatment adherence fully mediated effects on compassionate love. Furthermore, stress reduction mediated treatment effects on compassionate love, perspective-taking, and forgiveness; each also mediated gains in caregiving self-efficacy. This encouraging evidence suggests that nonlaboratory psychospiritual interventions can boost compassionate love to benefit the recipients and the larger society.     

Psychometric properties of a revised Spanish 20-item Toronto Alexithymia Scale adaptation in multiple sclerosis patients

There have been a small number of investigations of alexithymia in multiple sclerosis (MS) using the 20-item Toronto Alexithymia Scale (TAS-20). However, the TAS-20 factor structure has not yet been evaluated in a MS patient sample, and earlier Spanish translations of this instrument require some improvement. We aimed to evaluate the factorial validity and reliability of an improved Spanish translation of the TAS-20 (the TAS-20-S). The TAS-20-S was completed by 221 MS patients. Confirmatory factor analysis was used to compare the fit of six different factor models. Internal consistency and retest reliability coefficients were also computed. The correlated three-factor model and the higher-order factor model made up of Difficulty Identifying Feelings, Difficulty Describing Feelings, and Externally Oriented Thinking achieved the best fit. Alpha coefficients ranged between .87 and .67; mean inter-item correlations ranged between .48 and .20; and retest correlations after 6 months ranged between .61 and .52. A high degree of alexithymia was present in 18.1% of the sample. Reliability and the traditional three-factor structure were demonstrated for the TAS-20-S, which can now be recommended for assessing an aspect of emotional processing in MS patients.