Illness perceptions are the main predictors of depression and anxiety symptoms in patients with chronic pain

Depression and anxiety symptoms in chronic pain are associated with adverse clinical outcomes, and appear highly related to patient’s illness perceptions as well as with marital adjustment. This study aimed to investigate the predictive value of pain variables, marital adjustment and illness perceptions on depression and anxiety in patients with chronic pain. Two hundred patients were recruited from a pain unit in a public hospital in the north of Portugal. Patients completed a questionnaire that assessed illness perceptions (IPQ-Brief), marital adjustment (revised dyadic adjustment scale), depression and anxiety symptoms (hospital anxiety depression scale) and pain variables (pain intensity and pain disability index). Depression and anxiety symptoms were associated with pain intensity, pain-related disability, marital adjustment and illness perceptions. Results from hierarchical regression showed that illness perceptions contributed significantly to depression and anxiety symptoms over and above the effects of pain intensity, pain-related disability and marital adjustment, after controlling for gender. In multivariate analyses, pain intensity, pain-related disability and marital adjustment were uniquely related to depression and anxiety symptoms, whereas specific illness perceptions were uniquely related to depression symptoms (identity, treatment control, emotional response and coherence) and to anxiety symptoms (identity, emotional response and concern). Perceptions of greater symptomatology (identity) and of emotional impact, and lesser perceptions of treatment control and understanding of chronic pain (illness comprehensibility) were significantly associated with increased depression symptoms. Perceptions of greater symptomatology (identity), emotional impact and greater concern were associated with anxiety symptoms. These findings indicate that the contribution of illness perceptions was greater than that made by traditional covariates, and may therefore be a useful basis for future psychological interventions.     

Reclaiming alterity: strangeness and the queering of Islam in medieval and early modern Spain

ABSTRACT

This essay argues for the reclamation of radical alterity or the intentional embracing of difference/otherness/strangeness by Muslims as a location of solidarity with marginalized communities, who have been historically ostracized due to sexuality. As the initial social location of Islam vis-á-vis medieval and early modern Christendom, the rehabilitation of Muslim alterity/otherness today serves as a location for solidarity with other marginalized groups such as members of the LGBTQ community. The chosen historical timeframe of medieval and early modern Spain helps to situate this conversation both inside and on the fringes of European Christendom. This essay seeks to accomplish this by mining both Muslim and Christian sources in medieval and early modern Iberia with special attention being paid to discourses located at the intersections of Islamophobia and sexuality. The texts discussed allow for a more thorough investigation of Muslim alterity in the Iberian context, while serving as a launch point for deeper discussions of contemporary religious and sexual hierarchies.     

Depression and anxiety symptoms following cancer diagnosis: a cross-sectional study

Introduction: The aims of the present study were to assess demographic and clinical characteristics of patients after receiving a cancer diagnosis, and to determine possible risk factors for anxiety and depression. Methods: All consecutive patients aged 18 or above, were assessed before starting intravenous chemotherapy for the first time with the Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer, and a Visual Analog Scale for pain. Demographic and clinical data were also collected. Results: The patients assessed (n = 270) had a mean age of 59.4 (SD = 11.8) years, and 50.7% were women. Tumours were more frequently colorectal (27.2%), lung (18.8%) and breast (17.6%), and 68.9% were stages 3 or 4. A HADS Anxiety score ≥8 was present in 30% of the patients, a Depression score ≥8 in 24.1%, and a Distress score ≥4 in 44.4%. Independent risk factors for HADS Depression score ≥8 were being a woman (OR = 2.45; p = 0.004), being older (OR = 1.04; p = 0.005), and cancer stage 3–4 (OR = 2.24; p = 0.023) in the multivariable analysis; for Anxiety ≥8 they were being a woman (OR = 2.47; p = 0.002), having a past psychiatric consultation (OR = 2.83; p = 0.029), and cancer stage 3–4 (OR = 1.90; p = 0.047). Conclusion: These results suggest the need for greater awareness and a differentiated approach to patients at increased risk of anxiety and depression in the early stages of treatment and before starting chemotherapy.     

Perceived Benefits and Costs of Romantic Relationships for Young People: Differences by Adult Attachment Style

Bowlby's attachment theory suggested that the attachment experiences of early childhood influence adult approaches to close relationships. As a result of these experiences, the child develops typical mental schemas or internal working models. The aim of this study was to analyze how young people with different attachment styles perceive the benefits and costs involved in spending as much time as possible with their partner, and to determine whether their beliefs reflect the internal working models associated with their attachment style. A sample of 1,539 university students responded to the Relationship Questionnaire (Bartholomew & Horowith, 1991), and to a questionnaire about behavioral beliefs (perceived benefits and costs). Results show that young people with different attachment styles hold different beliefs about the consequences derived from engaging in a specific behavior in romantic relationships. Secure and preoccupied individuals perceived more benefits than costs associated with the behavior, whereas dismissing and fearful individuals perceived more costs than benefits. Furthermore, secure and preoccupied individuals rated those behavioral consequences leading to enhanced intimacy or closeness more positively than avoidant individuals, whereas dismissing individuals rated more negatively those consequences that involved a loss of independence. These results confirm that a congruity exists between the beliefs associated with the behavior studied and the internal working models related to each adult attachment style.     

Asymmetry arguments

In the First Meditation, the Cartesian meditator temporarily concludes that he cannot know anything, because he cannot discriminate dreaming from waking while he is dreaming. To resist the meditator’s conclusion, one could deploy an asymmetry argument. Following Bernard Williams (1978), one could argue that even if the meditator cannot discriminate dreaming from waking while dreaming, it does not follow that he cannot do it while awake. In general, asymmetry arguments seek to identify an asymmetry between a bad case that is entertained as a ground for doubt and a good case in which one takes oneself to know something. My aim in this paper is to consider how effective asymmetry arguments are as an anti-skeptical strategy. I conclude that although asymmetry arguments provide an effective response to dreaming skepticism, they fail as a response to brains-in-a-vat skepticism.     

Acculturation preferences and behavioural tendencies between majority and minority groups: The mediating role of emotions

The main goal of this research was twofold. First, we aimed at determining how acculturation preferences and emotions were related to specific intergroup behavioural tendencies towards majority and minority groups. Second, we aimed at developing an intergroup behavioural tendencies scale that differentiates between valence (facilitation and harm) and intensity (active and passive). The role of intergroup contact was also examined, as it is a known predictor of intergroup prejudice. In order to fulfil these goals, we carried out two studies. In Study 1 , Spanish participants (N = 279) answered a questionnaire about Moroccans (a devalued group) or Ecuadorians (a valued group) by reporting their acculturation preferences for immigrants, their positive and negative emotions, quantity of contact with them and behavioural tendencies towards them. In Study 2 , Moroccans (N = 92) and Ecuadorians (N = 87) assessed Spaniards on these measures. Results confirmed the structure of the new behavioural tendencies scale across four groups of participants. Overall, findings also showed that acculturation preferences and quantity of contact indirectly predicted behavioural tendencies through positive emotions. This research contributes to knowledge on how the majority and minority's acculturation preferences are related to their emotions and specific dimensions of intergroup behavioural tendencies, confirming the predominant mediating role of positive emotions in this process.     

The Social Anxiety Questionnaire for Children: Cross-Cultural Assessment with a New Self-Report Measure

This study describes a series of exploratory and confirmatory factor analyses that were conducted with the 44-item Social Anxiety Questionnaire for Children- 4th version (SAQ-CIV) to identify a reduced set of items that might be used to construct a new abbreviated instrument for measuring social anxiety in children and adolescents. The fourth version of the Social Anxiety Questionnaire for Children (SAQ-CIV) was administered to 12,801 non-clinical participants (ages 9 to 15 years) from 12 Latin American countries and Spain. Exploratory and confirmatory factor analysis supported a 6-factor structure of social anxiety in children, replicating a similar structure to that of adults (Caballo et al. in Behavioral Psychology/Psicología Conductual, 18(1), 5–34, 2010; Caballo et al. in Behavior Therapy, 43(2), 313–328, 2012): 1) Interactions with the opposite sex, 2) Criticism and embarrassment, 3) Speaking in public/Talking to teachers, 4) Assertive expression of annoyance and disgust, 5) Performing in public, and 6) Interactions with strangers. Each of the factors contains 4 items, yielding an abbreviated 24-item instrument, the Social Anxiety Questionnaire for Children (SAQ-C). The present results suggest this is a reliable, valid, and culturally sensitive instrument to assess social anxiety in youth.     

Neuropsychological predictors of conversion to probable Alzheimer disease in elderly with mild cognitive impairment

In the field of neuropsychology, it is essential to determine which neuropsychological tests predict Alzheimer's disease (AD) in people with mild cognitive impairment (MCI) and which cut‐off points should be used to identify people at greater risk for converting to dementia. The aim of the present study was to analyse the predictive value of the cognitive tests included in a neuropsychological battery for conversion to AD among MCI participants and to analyse the influence of some sociodemographic variables – sex, age, schooling – and others, such as follow‐up time and emotional state. A total of 105 participants were assessed with a neuropsychological battery at baseline and during a 3‐year follow‐up period. For the present study, the data were analysed at baseline. During the follow‐up period, 24 participants (22.85%) converted to dementia (2.79 ± 1.14 years) and 81 (77.14%) remained as MCI. The logistic regression analysis determined that the long delay cued recall and the performance time of the Rey figure test were the best predictive tests of conversion to dementia after an MCI diagnosis. Concerning the sociodemographic factors, sex had the highest predictive power. The results reveal the relevance of the neuropsychological data obtained in the first assessment. Specifically, the data obtained in the episodic verbal memory tests and tests that assess visuospatial and executive components may help to identify people with MCI who may develop AD in an interval not longer than 4 years, with the masculine gender being an added risk factor.