Psychological impact of illness intrusiveness in epilepsy - comparison of treatments

Chronic illnesses are associated with multiple stressors that compromise quality of life (QOL). Implicit in many of these is the concept of illness intrusiveness, the disruption of lifestyles and activities attributable to constraints imposed by chronic disease and its treatment. This study tested the illness intrusiveness theoretical framework in epilepsy and compared the impact of pharmacological and surgical treatments on illness intrusiveness and QOL. Cross-sectional data compared three epilepsy groups (N = 145): (a) 40 patients admitted for presurgical evaluation to an Epilepsy Monitoring Unit; (b) 52 patients treated pharmacologically; and (c) 53 post-surgical patients. Illness intrusiveness differed significantly across epilepsy patients with the differences primarily related to seizure control. Illness intrusiveness varied inversely with seizure control (p < .05). Seizure freedom, whether achieved by surgical or pharmacological treatments, was associated with maximal reduction of illness intrusiveness. Increased illness intrusiveness correlated significantly with decreased QOL and increased depressive symptoms. Perceived control over diverse life domains correlated positively with QOL and psychosocial outcomes. Path analysis supported the validity of the illness intrusiveness theoretical framework in epilepsy. Illness intrusiveness is an important determinant of the psychosocial impact of epilepsy and its treatment. Effective pharmacological or surgical treatment may reduce illness intrusiveness in epilepsy. Findings also offer encouragement that QOL in epilepsy, as in other chronic conditions, may be enhanced by multidisciplinary bio-psychosocial efforts. Health care providers should consider multifaceted interventions to reduce illness intrusiveness and, thereby, improve QOL.     

I Surrender All: Subverting the Cruelty of Capitalist Optimism with Affective Expressions of Worship

This paper explores the experience of an affectively charged healing worship service comprised of mostly working-class parishioners. It suggests that they seek healing from a feeling of being worn out by the precarity of daily life and by their efforts to reach the “American dream.” The ensuing discussion is framed by Lauren Berlant’s (2011) cruel optimism: we are attached to ideals that both define our identities as productive members of a capitalist society and at the same time necessitate our failures at reaching those ideals. The work of relational psychoanalyst Stephen Mitchell is utilized to describe how affective worship builds a co-created relational space of vulnerability and care that subverts this dominant ideal. The paper concludes with Emmanuel Ghent’s suggestion that religious surrender leads to an expansion of the self.     

Hope as a Moderator of the Associations Between Common Risk Factors and Frequency of Substance Use Among Latino Adolescents

Ample research suggests that delinquency, depressive symptoms, and peer substance use are common risk factors associated with adolescent substance use. However, the factors that may help to buffer the deleterious effects of these risk factors on adolescent substance use, such as hope, have yet to be examined. The current study evaluated hope as a moderator of the associations between these common risk factors and frequency of substance use (alcohol, tobacco, and marijuana) in a sample of Latino high school students (M _age ?=?16.14 years, SD?=?1.30; 55 % female). Findings indicated that the influence of delinquency on frequency of tobacco and marijuana use depended on levels of hope, with delinquency only positively associated with frequency of use when levels of hope were low. Additionally, hope moderated the association between depressive symptoms and alcohol use, such that depressive symptoms were only positively associated with frequency of alcohol use when levels of hope were low. Results and their implications for intervention are reviewed.     

Satisfaction and frustration of autonomy and relatedness needs: Associations with parenting dimensions and psychological functioning

Framed from Basic Psychological Needs Theory (Ryan and Deci in American Psychologist 55:68–78; Ryan, Deci, American Psychologist 55:68–78, 2000) and Ka?itçiba?i’s Autonomous-Related Self Theory (Journal of Cross-Cultural Psychology 36:1–20; Ka?itçiba?i, Journal of Cross-Cultural Psychology 36:1–20, 2005), the study examined the relationships of adolescents’ satisfaction and frustration of autonomy and relatedness, with (a) adolescents’ perception of mother’s and father’s psychological control and autonomy support, and (b) adolescents’ self-acceptance and anxiety. Participants were 556 adolescents (M?=?17.25, SD?=?0.92). Path analysis showed more significant associations of autonomy support with satisfaction/frustration of autonomy and relatedness than psychological control, reporting also some differences between parents. Moreover, both satisfaction and frustration of autonomy and relatedness were associated with adolescents’ self-acceptance and anxiety although in different ways. Our study provides further data, useful to understand how needs for autonomy and relatedness are associated with parenting dimensions and contribute to the adjustment of adolescents living in psychologically interdependent cultures, taking into account the role of each parent as well as the separate contribution of need satisfaction and need frustration.     

The toll of ethnic discrimination on sleep architecture and fatigue.

Most work on ethnicity tends to focus on daytime health rather than how aspects of ethnicity affect nighttime functioning. The current study examined how discrimination and ethnic identity relate to sleep architecture and fatigue in 37 African Americans and 56 Caucasian Americans. The authors conducted sleep monitoring with standard polysomnography. African Americans had less slow-wave sleep and reported more physical fatigue than did Caucasian Americans (ps < .05). The authors conducted path analyses to examine relationships between ethnic identity, perceived discrimination, sleep, and fatigue. Perceived discrimination mediated ethnic differences in Stage 4 sleep and physical fatigue. Individuals who reported experiencing more discrimination had less Stage 4 sleep and reported experiencing greater physical fatigue (ps < .05). Although ethnic identity did not mediate ethnic differences in sleep latency, there was a significant relationship between ethnic identity and sleep latency, indicating that individuals who felt more connected to their ethnic group had more difficulty falling asleep while in the hospital (p < .05). These observations suggest that the effects of stress related to one's ethnic group membership carry over into sleep.