Fear of routine dental treatment in adults: Its nature and management

Abstract

The fear of dental treatment in adults can be characterised in several ways, loosely related, such as anticipating being afraid, avoiding dental check-ups and seeking treatment only under general anaesthesia. Defined thus, at least a quarter of adults are highly afraid of dentistry. The feared experiences are many, including most frequently, pain. Several studies have shown that anxious patients experience less pain during treatment than they expect. It remains to be confirmed that these are typical experiences because other studies show that local anaesthesia can fail to protect patients from sudden pain in 13% of treatments on average. Expectations of pain are highly resistant to change, the result probably of several influences including distortion in recall of pain-free treatment, intermittent experience of sudden severe pain, expecting pain in order to reduce its impact, and uncertainty about treatment. It has yet to be shown that experience free of discomfort can reduce these expectations. However, relaxation instructions and information about pain management and stop signals can reduce pre-treatment fear. To prevent the onset and the maintenance of anxiety: the prevention of pain is essential; controlled behavioural studies of the treatment of pain and other experiences such as panics are needed. Finally, the need for new instruments to assess all aspects of fear of dentistry is described.     

Perfectionism and health: A mediational analysis of the roles of stress,social support and health-related behaviours

This study tested a model derived from personality theory in which perceived stress, perceived social support, health-risk and health-promotion behaviours mediate the relationship between perfectionism and perceived physical health. A sample of 538 undergraduate students completed a web-based survey assessing multi-dimensional perfectionism, perceived stress, perceived social support, health behaviours, physical health and a scale tapping elements of the five-factor model of personality. Analyses that account for the effects of traits from the five-factor model (e.g., neuroticism, conscientiousness and extraversion) indicated that socially prescribed perfectionism was associated with poorer physical health and this association was fully mediated by higher levels of perceived stress and lower levels of perceived social support. Self-oriented perfectionism was related complexly to health such that it was related to poorer health via higher levels of perceived stress, but was also related to better health via higher levels of perceived social support. Our findings illustrate the need for considering key mediators of the link between perfectionism and poor health outcomes.     

The sense of diachronic personal identity

In this paper, I first consider a famous objection that the standard interpretation of the Lockean account of diachronicity (i.e., one’s sense of personal identity over time) via psychological connectedness falls prey to breaks in one’s personal narrative. I argue that recent case studies show that while this critique may hold with regard to some long-term autobiographical self-knowledge (e.g., episodic memory), it carries less warrant with respect to accounts based on trait-relevant, semantic self-knowledge. The second issue I address concerns the question of diachronicity from the vantage point that there are (at least) two aspects of self—the self of psycho-physical instantiation (what I term the epistemological self) and the self of first person subjectivity (what I term the ontological self; for discussion, see Klein SB, The self and its brain, Social Cognition, 30, 474–518, 2012). Each is held to be a necessary component of selfhood, and, in interaction, they are appear jointly sufficient for a synchronic sense of self (Klein SB, The self and its brain, Social Cognition, 30, 474–518, 2012). As pertains to diachronicity, by contrast, I contend that while the epistemological self, by itself, is precariously situated to do the work required by a coherent theory of personal identity across time, the ontological self may be better positioned to take up the challenge.     

Goal disturbance,coping, and psychological distress in partners of myocardial infarction patients: Taking account of the dyad

Abstract

This study aims to explore the relationship between goal disturbance and levels of psychological distress in partners of myocardial infarction (MI) patients. Furthermore, the role of partner and patient coping behaviour in the context of goal disturbance is explored. Forty dyads were interviewed and completed questionnaires 1 month (T1) and 4 months (T2) post MI. All patients were men. Patients and partners do not differ on anxiety or depression scores, however, patients experience significantly more higher order goal disturbance at T1. Partners reporting more goal disturbance also show increased distress at T1. More use of approach coping by partners contributes to explained variance in their goal disturbance. Partner avoidant coping is moderated by patient avoidant coping. Approaches to reduce distress in partners should thus take account of goal disturbance and coping behaviours within the dyad.     

Abstract

Although Aristotle did not mention it, integrity can be understood in an Aristotelian framework. Seeing it in these terms will show that it is an executive virtue which concerns the existential well being of an agent. This analysis is not offered as an exegesis of Aristotle's text, but as an attempt to use an Aristotelian framework to understand a virtue deemed important today. This account will have the benefit of solving some problems relating to motivational internalism and, as such, will contribute to that recent current of thought which has been highlighting the importance of virtue thinking in moral theory. I will distinguish moral judgement from decision and show that moral judgement is dependent upon virtue more strongly than it is upon impartial rationality. I will suggest that integrity is the virtue to which moral judgement gives expression and is the virtue which links judgement to decision so as to overcome akrasia.     

A RECONSIDERATION OF KIERKEGAARD'S UNDERSTANDING OF THE HUMAN OTHER: The Hidden Ethics of Soteriology

In this article, I embark on an analysis of Søren Kierkegaard's view of human otherness in strict correlation to his Christian philosophy. More specifically, my aim is to show that Kierkegaard's thought is essentially informed by a decisive appropriation of the soteriological category of sin which has momentous implications for Kierkegaard's views of selfhood and intersubjectivity. The main argument is that both Kierkegaard's negative evaluation of human otherness and his acerbic indictments of any collectivist interference in salvific matters cohere with his appropriation of the doctrine of the Fall. At the same time, I show in what sense Kierkegaard deems human alterity to be indispensable to one's spiritual self‐becoming expressed through the Christian imperative of loving the other as neighbor. Seen thus, agape, while supplementing Kierkegaard's creationistic psychology, actually becomes the necessary restorative opposite of sinfulness in the self's encounters with the distinct uniqueness of the human other.     

Discrimination between hopes and expectancies for nonvolitional outcomes: psychological phenomenon or artifact?

Despite the large literature concerning the impact of hope and expectancy on various outcomes (e.g., nonvolitional), less is known about the constructs of hope and expectancy themselves. In a recent study, Montgomery et al. (2003) demonstrated that hopes and expectancies are separate but related constructs; however, because both hopes and expectancies were measured within the same context, it is possible that these findings were simply a methodological artifact. Furthermore, it is unknown whether these data would generalize to other populations. Taking into account the importance of this distinction for both the expectancy and hope literatures, the present study sought to: (1) Determine if the distinction between hope and expectancy is a general and reliable phenomenon by using a culturally different sample (i.e., Romanian sample); and (2) Examine the robustness of this distinction by controlling for the context effect. One hundred-twenty five volunteers completed items in regard to 10 nonvolitional outcome scenarios in one of five measurement contexts. The results revealed that hope and expectancy were distinct constructs (p<0.0001), and that this distinction is both general and robust across contexts. Implications for theory and research are discussed.