Physicians' understanding of patients' personal representations of their diabetes: accuracy and association with self-care

The degree of accuracy with which physicians understand their patients' views may be of central importance for promoting self-care in the majority of chronic illnesses and in type 2 diabetes in particular. The objectives of this study were to measure the accuracy of the general practitioners' understanding of the patients' views and relate it to health behavioural outcomes in patients with non-complicated type 2 diabetes. The participants in this cross-sectional study consisted of 14 clinicians and 78 of their patients from Paris, France. The predictors were levels of accuracy in understanding the patients' views derived from the illness perception questionnaire-revised (IPQ-R). The outcomes were patient-reported self-care measures. In regression models controlling for clinical and personal variables, higher accuracy on chronicity beliefs was associated with an improved diet and increased blood glucose self-testing and higher accuracy in identifying treatment control beliefs was associated with better dietary self-care. Accuracy was higher with regard to beliefs about causes, treatment control and consequences. These results suggest that accuracy may impact self-care in specific domains of illness perception but not others. The results may help identify useful avenues of communication training designed for professionals.     

Presentation modality effect on false memories in younger and older adults: the use of an inference paradigm

Classically, false memories are studied using the DRM paradigm (Deese, 1959; Roediger & McDermott, 1995), involving use of words lists. The words of each list are linked to a critical word not presented. Participants create a false memory in recognising and/or recalling this critical word. In most cases older adults have more false memories than younger adults in this paradigm. To use less strategy-dependent material, we compared predictive inferences activated during text reading in young and healthy older participants. For example, in the sentence "The fragile porcelain vase was thrown against the wall" the predictive inference was that the vase is broken. After reading or hearing the texts, the participants had false memories in recalling and/or recognising the predictive inferences. Older adults had more false recognitions than younger adults when they read or heard the text. However, the difference did not reach significance with the cued recalled task. It is concluded that, in more ecological situations such as text reading, abilities in older adults can be preserved.     

Habitual computer game playing at night is related to depressive symptoms

This study investigated whether the amount and circadian time of habitual computer game playing were related to depressive symptoms in adolescents and young adults. We expected that habitual late playing relates to more depressive symptoms beyond the effect of the total time of computer game playing as playing at night may involve short, irregular, and disturbed sleep as well as misalignment of the circadian rhythm. 646 adolescents and young adults (ages 13–30; 90.9% males) who play the internet role-playing game World of Warcraft completed an online questionnaire. Habitual computer game playing between 10 pm and 6 am was related to an increased risk of high depression scores independent of the total amount of playing. Adolescents (ages 13–17 years) were most vulnerable when habitually playing during early night (i.e., 10–12 pm), while emergent adults (ages 18–22 years) showed more vulnerability when habitually playing late at night (i.e., after 2 am). The effect was partly mediated by daytime sleepiness but not by sleep loss or insomnia problems.     

Rorschach variables related to blood glucose control in insulin-dependent diabetes patients

In this article, we explored relations between selected Rorschach variables and blood glucose control in Insulin-Dependent Diabetes Mellitus (IDDM) patients. Three domains of psychological functioning are taken into consideration: emotional distress, coping and problem solving, and cognitive efficiency. Seventy-one IDDM patients (38 men, 33 women; mean age 42.2 +/- 14.9 years) from an outpatient unit took the Rorschach Comprehensive System (Exner, 1986). Nine variables were selected as independent variables. Blood glucose, a dependent variable, was measured by the proportion of glycated hemoglobin. Results of 2 regression analyses show that Y and C' correlate to higher blood glucose. WSum C and the absence of texture related to lower levels of blood glucose. A confounding effect of complications was observed. The findings suggest that emotional factors should be accorded greater attention in behavioral self-regulations in diabetes.     

Organisation and evocation of the semantic knowledge: a non-abstractive approach

The majority of the models which attempt to explain category-specific deficits are based on the assumption that the conceptual knowledge is represented in a permanent way in memory (abstractive view). showed that a non-abstractive view would be more suitable to account for some of these cases. The present study aims to assess the hypotheses on the meaning evocation process as formulated by these authors, using a property verification task conducted on healthy subjects. The data were in agreement with these hypotheses and would be more hardly accounted in the frame of the abstractive view.     

Item learning in cognitive skill training: Effects of item difficulty

Item difficulty effects in skill learning were examined by giving participants extensive training with repeated alphabet arithmetic problems that varied in addend size (e.g., C ? D = ? is easy; C ? J = ? is harder). Recognition memory for the items, as measured by interpolated recognition tests, was acquired early in training and was unaffected by item difficulty. Memory for the solutions to items, as measured by the participants’ strategy reports that they had retrieved, rather than computed, the solution, was acquired later and was affected by item difficulty. Solutions to easier items were learned earlier in training for both young adults (18–24 years) and older adults (60–75 years), superimposed on an overall lower level of solution learning in older participants. The results suggest that the formation of associations between problems and their solutions is effortful and shares limited processing resources with the computational demands of the problem.     

Negotiating Identity: Three Events that Weaken the Maternal Identity of Addicted Law-Breaking Women

This qualitative study aimed to comprehend how mothers experienced and built their maternal identity throughout their lives. Thirty-eight semi-structured interviews were conducted with drug-using and law-breaking mothers. Results showed that three events were significant for participants: pregnancies, loss of custody, and incarceration. As each event challenged their maternal identity, they questioned their substance use and their criminal involvement. Our results suggest that these events represent key moments to encourage their growing awareness and to foster changes in their deviant lifestyle. We conclude this article by discussing interventions possible for each of these important moments in these mothers’ lives.     

Evaluation into the relationship: Reflections on new trends in evaluation,assessment, and classification

From a clinical and psychoanalytically informed point of view, the process of evaluation is mainly concerned with the formation of a working alliance with the infant. Assessment is, therefore, considered as a process that cannot be applied in a systematic way, regardless of the situation. On the contrary, it is based upon transference and countertransference, which guides the clinician, along with the infant's behavior and reactions, during the consultation. From this perspective, evaluation should always have some therapeutic impact. Paradoxically, this therapeutic action is linked with the suspension of diagnostic process for a period of time. The prognosis and treatment planning is mostly based upon the evaluation of change during the expended assessment period. The more serious the situation, the longer the assessment to determine why the infant is at risk, what are the positive aspects of the situation, and what are the ways to reach the infant through the relationship with the parents. © 1997 Michigan Association for Infant Mental Health     

A study of minorities as victims

This article presents the idea that during the 1990s an important change took place in relation between minorities and majorities: the emergence of minorities as victims alongside the formerly predominant active, militant minorities. A hypothesis is raised that these two types of minorities differ in their agenda as well as in the nature of the influence they exert. Active minorities trigger an external conflict with majority and induce conversion (latent rather than overt influence); minorities as victims create an internal conflict, a sense of guilt, within the majority, while they exert an exclusively overt influence. We report two experiments confirming our hypothesis. We discuss the novelty of this phenomenon and its relevance. Copyright © 2006 John Wiley & Sons, Ltd.     

Supportive interventions and nonsymbolic mental functioning

The author aims to show how supportive interventions are the analyst's most relevant therapeutic means to helping patients with a feeble symbolic system transform nonsymbolic episodes and reestablish symbolic mental functioning. Symbolic and nonsymbolic modes of mental functioning are first outlined. Supportive interventions are redefined as an analyst's effort at improving a patient's nonsymbolic mental functioning, by using principally pragmatic or interactive aspects of communication to deal with her or his patient's nonsymbolic in-session experiences. These interventions are psychoanalytic when transference focused, in so far as they foster the symbolization and transformation of more primitive (nonsymbolic) layers of the transference. Some probable mechanisms underlying the effect of supportive interventions on nonsymbolic functioning include the modification of mental procedures. Supportive interventions also help restore symbolic mental elaboration through the gratification of a basic ego or self-need, bringing about a temporary relief from psychic pain, with increased affect tolerance and a renewed capacity to use symbols. This soothing effect accounts for a missing link in Bion's model of the elaborative effect of the analyst's reverie.