The work of worrying in children undergoing surgery

This study examined the relationship involving children's level of anxiety, defensiveness, and play patterns 1 week prior to, during, and 1 week after hospitalization for minor surgery. A 7-month follow up was also conducted in order to assess the children's recall for hospital events and coping style. The results suggested that two classes of children could be identified. The children in one group distinguished themselves in terms of their disposition to engage in the work of worrying (i.e., were low defensive prior to hospitalization, actively played with stress-related toys prior to hospitalization, and reported minimal distress and anxiety following surgery). Those in the second group were highly defensive, avoided playing with stress-related toys, and reported most anxiety following surgery. The parallel between children and adult patterns of dealing with surgery was considered in terms of Janis's (1958) model of coping with psychological stress.This research was supported by a grant from Canada Council, Grant No. S72-2314-52. The authors wish to thank the staff and children of Our Lady of Lourdes School of Waterloo, the Kitchener-Waterloo Hospital, and St. Mary's General Hospital for their cooperation. Appreciation is extended to Dr. Pat Bowers and Dr. Barney Gilmore for their help during the formative stages of this study and for their many constructive suggestions.     

Age,job complexity,satisfaction, and performance

Job complexity was measured for jobs in a Public Agency. Perceptions of job complexity were obtained from self-reports of 133 employees. Independent measures were obtained from interviews with the subjects. Career stages, based upon age groupings, were found to moderate the relationship between (1) job-satisfaction and perceived job complexity and (2) job-performance and independently rated job complexity. These results are discussed in light of the current literature.     

Decreasing Psychiatric Symptoms by Increasing Choice in Services for Adults with Histories of Homelessness

Despite the increase in consumer-driven interventions for homeless and mentally ill individuals, there is little evidence that these programs enhance psychological outcomes. This study followed 197 homeless and mentally ill adults who were randomized into one of two conditions: a consumer-driven “Housing First” program or “treatment as usual” requiring psychiatric treatment and sobriety before housing. Proportion of time homeless, perceived choice, mastery, and psychiatric symptoms were measured at six time points. Results indicate a direct relationship between Housing First and decreased homelessness and increased perceived choice; the effect of choice on psychiatric symptoms was partially mediated by mastery. The strong and inverse relationship between perceived choice and psychiatric symptoms supports expansion of programs that increase consumer choice, thereby enhancing mastery and decreasing psychiatric symptoms.     

Vanishing time in the pursuit of happiness

Happiness can be conceptualized as a positive affective state or as a goal whose pursuit ironically pulls the pursuer away from achieving it (Mauss, Tamir, Anderson, & Savino in Emotion, 11(4), 807–815, 2011). But how do people think about time during this latter, never-ending pursuit of happiness? The present investigation asks how seeking happiness influences perceptions of time availability. Four studies demonstrated that trait-level happiness seeking (Study 1) as well as direct manipulation of happiness seeking (Studies 2, 3, and 4) consistently reveal the same pattern: reduced feelings of time availability while pursuing happiness. This negative effect on time availability is mitigated when happiness seems like it has been achieved (Study 2) or seems quick to achieve (Study 3). In addition, pursuing happiness can ultimately decrease happiness, in part, by reducing perceptions of time availability (Study 4), extending theories on happiness, goal pursuit, and perceptions of time.     

Evidence of improved fluid management in patients receiving haemodialysis following a self-affirmation theory-based intervention: A randomised controlled trial

Objective: Haemodialysis patients are at risk of serious health complications; yet, treatment non-adherence remains high. Warnings about health risks associated with non-adherence may trigger defensive reactions. We studied whether an intervention based on self-affirmation theory reduced resistance to health-risk information and improved fluid treatment adherence.

Design: In a cluster randomised controlled trial, 91 patients either self-affirmed or completed a matched control task before reading about the health-risks associated with inadequate fluid control.

Outcome measures: Patients’ perceptions of the health-risk information, intention and self-efficacy to control fluid were assessed immediately after presentation of health-risk information. Interdialytic weight gain (IDWG), excess fluid removed during haemodialysis, is a clinical measure of fluid treatment adherence. IDWG data were collected up to 12 months post-intervention.

Results: Self-affirmed patients had significantly reduced IDWG levels over 12 months. However, contrary to predictions derived from self-affirmation theory, self-affirmed participants and controls did not differ in their evaluation of the health-risk information, intention to control fluid or self-efficacy.

Conclusion: A low-cost, high-reach health intervention based on self-affirmation theory was shown to reduce IDWG over a 12-month period, but the mechanism by which this apparent behaviour change occurred is uncertain. Further work is still required to identify mediators of the observed effects.     

Using FMRI to study the neural correlates of virtual reality analgesia

Excessive pain during medical procedures, such as burn wound dressing changes, is a widespread medical problem and is especially challenging for children. This article describes the rationale behind virtual reality (VR) pain distraction, a new non-pharmacologic adjunctive analgesia, and gives a brief summary of empirical studies exploring whether VR reduces clinical procedural pain. Results indicate that patients using VR during painful medical procedures report large reductions in subjective pain. A neuroimaging study measuring the neural correlates of VR analgesia is described in detail. This functional magnetic resonance imaging pain study in healthy volunteers shows that the large drops in subjective pain ratings during VR are accompanied by large drops in pain-related brain activity. Together the clinical and laboratory studies provide converging evidence that VR distraction is a promising new non-pharmacologic pain control technique.