Quality of Life,Anxiety and Depression in Soft Tissue Sarcomas as Compared to More Common Tumours: An Observational Study

The aim of this study is to compare the quality of life and the levels of anxiety and depression in a relatively large group of subjects undergoing chemotherapy for soft tissue sarcoma and a control group of subjects undergoing chemotherapy for the most common types of cancer. 56 soft tissue sarcoma affected patients and 56 patients with common tumours, homogeneous in regards to stages of disease and sociodemographic characteristics, were enrolled in two oncological centres in Turin, Italy. Quality of life was assessed by Functional Assessment of Cancer Therapy-General and anxiety and depression by Hospital Anxiety and Depression Scale. All patients had ongoing chemotherapy. The comparison between the two groups shows no difference in either quality of life or in anxiety and depression. There are instead gender differences, since females in the group of common tumours show higher levels of anxiety in comparison to those affected by sarcomas, while males show, at a lower degree, the opposite trend. This study suggest that levels of Quality of Life, anxiety and depression are similar in rare and common tumours. The majority of patients are able to cope with the disease in an adaptive manner. However, for some patients the disease poses a threat to their physical and mental integrity; psychological support of these patients may reduce the development of significant morbidity and help patients to better manage the course of the disease and the effects of the treatment.     

A curious metaphor. Engaging with trauma: an analytical perspective

Abstract :  This paper explores the metaphor of in vitro fertilization in respect to those parts of the individual 'frozen' through early trauma. It describes the conditions necessary for the reintroduction of the frozen 'embryo' in the therapeutic relationship through use of an extended example. The role of the analytic relationship and the analyst's countertransference are highlighted within the context of implications for the process of therapy.     

The effect of reinforcement or stimulus control to reduce sedentary behavior in the treatment of pediatric obesity.

Obese children were randomly assigned to a family-based behavioral treatment that included either stimulus control or reinforcement to reduce sedentary behaviors. Significant and equivalent decreases in sedentary behavior and high energy density foods, increases in physical activity and fruits and vegetables, and decreases in standardized body mass index (z-BMI) were observed. Children who substituted active for sedentary behaviors had significantly greater z-BMI changes at 6 (-1.21 vs. -0.76) and 12 (-1.05 vs. -0.51) months, respectively. Substitution of physically active for sedentary behaviors and changes in activity level predicted 6- and 12-month z-BMI changes. Results suggest stimulus control and reinforcing reduced sedentary behaviors are equivalent ways to decrease sedentary behaviors, and behavioral economic relationships in eating and activity may mediate the effects of treatment.     

On Replacing the Ethical Principle of Autonomy With an Ethical Principle of Accordance

The author defines and critiques the ethical principle of autonomy. As a concept, autonomy is most aligned with paradigms of counseling that focus on the individual as a psychological entity with moral agency. It is less consistent with frameworks that focus on relationships philosophically and in practice. Autonomy is paradoxical, because it is a consensually defined principle imposed on counseling practice while denying counselors a choice in its application. The author suggests accordance as an alternative ethical principle. Accordance is consistent with relational paradigms of practice and the other relationship‐focused ethical principles in counseling. Accordance fully contextualizes individual responsibility and choice.     

Measurement,Classification, and Prediction of Paradigm Adherence of Marriage and Family Therapists

This study assessed the theoretical perspectives of marriage and family practitioners using the Paradigm Adherence Scale (PAS), which measures practitioner adherence to the psychological, systems, and social constructionist paradigms associated with marriage and family therapy. Results from a survey of clinical members of AAMFT ( N = 204) indicated that a majority of therapists were primarily adhering to the systems paradigm (43.6%) or practicing from a combination of paradigms (42.2%), while the social constructionism approach was used by a smaller but significant percentage of therapists (13.7%). Factors predicting membership in paradigm adherence groups included the current or most recent supervisor's preferred paradigm (most predictive), therapist gender, and years of clinical experience. While only 16.5% of the variance in paradigm adherence was accounted for by the set of predictor variables, this was viewed as having some practical significance in the difficult task of explaining choice and utilization of theoretical framework.     

Prevalence and Significant Determinants of Post-traumatic Stress Disorder in a Large Sample of Patients with Multiple Sclerosis

Chronic and life-threatening neurodegenerative diseases may be associated with post-traumatic stress disorder (PTSD). Therefore, the current study was an investigation of the prevalence of PTSD in multiple sclerosis (MS) patients, and identification of significant determinants of PTSD. Two hundred thirty-two MS patients were consecutively recruited and screened for the presence of PTSD with the Impact of Event Scale-Revised, corroborated by the Structured Clinical Interview for DSM-IV. Furthermore, participants were administered the Hospital Anxiety and Depression Scale and the Fatigue Severity Scale. Twelve patients (12/232, i.e. 5.17 %) were diagnosed as suffering from PTSD. Levels of education, anxiety and depression were significant determinants of the presence of PTSD. The role played by the levels of education, anxiety and depression in determining the presence of PTSD has been discussed. Further research on the psychological features of neurodegenerative diseases is urgently needed in order to plan appropriate treatments and improve patients’ quality of life.     

Delayed Matching to Sample With Outcome-Specific Contingencies in Mentally Retarded Humans

Four mentally retarded human subjects performed delayed identity matching-to-sample tasks under conditions of outcome-specific and nonspecific reinforcement contingencies. With outcome-specific contingencies, experimentally defined correct selections of different discriminative stimuli were perfectly correlated with one of two different consequences (e.g., different foods); with nonspecific contingencies, correct selections were equally likely to be followed by either consequence. Previous studies with pigeons have shown consistently higher accuracy on delayed-matching tasks with outcome-specific contingencies. Results of this study failed to replicate that finding. For three subjects, accuracy scores were similar in specific and nonspecific conditions at fixed delays ranging from 0 s to 5 s. For the other subject, delay duration varied within each session, and accuracy scores improved across sessions regardless of outcome condition.

     

Microcomputer-based programmed instruction in identity matching to sample for persons with severe disabilities

Three individuals with mental retardation, who had failed to learn identity matching to sample with standard fading and prompting procedures, were given microcomputer-based programmed instruction. The methods were based on an analysis of two features of typical identity matching procedures: (a) within each trial, the current sample stimulus must control comparison selection, and (b) across trials, specific comparison stimuli must function both as S+ and as S–, depending upon the sample presented (conditional discrimination). During the first phase of training, one-trial acquisition of discriminative stimulus control was established in a nonconditional discrimination context where the S+ or S– functions of specific stimuli did not change from trial to trial. After one-trial learning was established, conditional discrimination was programmed by gradually introducing reversals of S+/S– stimulus functions. All three participants learned to perform conditional identity matching. Avenues for further analysis of the prerequisites for conditional discrimination and continued development of programmed methods are discussed.