Cognitive-Behavioural Therapy Targeting Fear of Progression in an Interdisciplinary Care Program: A Case Study in Systemic Sclerosis

People living with chronic illness often report uncertainty about the future, fear of disease progression, fear of becoming physically disabled, and a reduced life expectancy as important sources of stress. However, little is known about psychological interventions targeting these concerns. The aim of this study is to illustrate an intervention to reduce emotional distress and concerns about the future in a patient with systemic sclerosis (SSc), a rare chronic rheumatic disease with serious consequences for most patients, and to present a preliminary report on its effectiveness using a single-case study design. Because of the complexity of symptoms and complaints due to SSc, the psychological intervention was embedded in an interdisciplinary care program also consisting of physical therapy, occupational therapy, and specialized nurse care.     

Relationships of career adaptabilities with explicit and implicit self-concepts

Career adaptability is a psychosocial construct that incorporates a set of essential resources to one's career development. The adaptability resources' relevance is even higher when it comes to former communist countries, such as Romania, where job security and stability were seen as central benefits for workers. The aim of this study was to provide a more comprehensive understanding of the stable underpinnings of career adaptabilities by exploring their relationships with aspects of the self that are driven by automatic processes and that are less affected by self-presentation biases. A sample of 359 participants completed the Career Adapt Abilities Scale (CAAS)-Romanian form, out of which a subsample of 212 participants also completed a set of scales comprising explicit and implicit measures of conscientiousness, extraversion, neuroticism, and self-esteem. Results revealed nonsignificant additive contributions of the implicit self-concept measures over what was already explained by the explicit self-concepts. The most noticeable effect resides in the significant interaction between explicit and implicit self-esteem in relation to control, confidence, and overall adaptability. These results reveal that individuals with high explicit and low implicit self-esteem perceive themselves as being the most adaptable. Notably, these results were obtained using a Romanian version of CAAS that possesses very good psychometric properties (i.e., excellent internal consistencies, the same four-factor multidimensional solution, replicated patterns of associations between CAAS and explicit self-concepts of personality).     

A self-regulation-based intervention to increase physical activity in cancer patients

The study examined whether a behavior-change intervention focusing on self-regulatory strategies and emphasizing role model support increases physical activity (PA) among insufficiently active (not meeting PA guidelines of 150 min/week) cancer patients. Ambulatory cancer patients [N = 72; 54% female; M = 56 years, SD = 12.34; most with breast or colon cancer (34, 15%)] were enrolled in the MOTIVACTION-study, a 4-week intervention (1-hr counseling, followed by weekly phone calls), with pretest (T1), posttest (T2) and a 10-week follow-up (T3). Participants were randomized to either an exercise or to a stress management intervention (active control). The exercise intervention emphasized self-regulatory strategies (e.g. action- and coping planning and self-monitoring); patients were also encouraged to contact a physically active same-sex role model as a potential exercise partner. The active control condition consisted of coping and relaxation techniques. Sixty-seven patients remained in the study and completed the SQUASH assessment of PA and a measure of perceived stress. PA was validated by Actigraph accelerometry. At T2, 46% of the patients in the exercise group and 19% of stress management patients increased their activity levels to meet PA guidelines (>150 min/week; χ²(1) = 5.51, p = .019). At T3, participants in the exercise intervention maintained their exercise level (46%), but also 31% of the stress management patients met the guidelines. All patients reported reductions in perceived stress. Additional analyses comparing patients in the exercise group by role model contact (63% realized contact) revealed that those who had contact with their role model were significantly more likely to adhere to the recommended guidelines (T2:50%; T3:64%) compared to those who did not have contact with a role model (T2:39%; T3:15%), suggesting the potential of mobilizing role model support to facilitate PA. In sum, cancer patients may not only benefit from an exercise intervention emphasizing self-regulation, but also from stress management, regarding both reducing stress and increasing PA.     

Dispositional Optimism and Judgments of Future Life Events: Affective States as Moderators

This research examined the relation between dispositional optimism and judgments of future life events and whether this relation is moderated by affective states. In this study the moderating role of experimentally induced affective states, using film clips (N = 259), was investigated. After filling in the questionnaire for dispositional optimism, the participants were randomly assigned in the experimental conditions in order to induce positive versus negative affective states. Finally, the participants filled in the affective states and judgments of future life events scales. The results indicated that the participants with a higher level of optimism had the tendency to judge positive events as more likely and negative events as less likely to happen in the future. We found evidence for affective states as moderators; the association between dispositional optimism and judgments of future positive events depended on experimentally induced affective states. Specifically, in positive affective state condition, the association between dispositional optimism and judgments of future positive events was weaker than in both negative affective state and control conditions. The implications of these findings for understanding the role of optimism and affective states, in determining the judgments about the likelihood of future events are discussed.     

Can we distinguish an “I” and “ME” during listening?—an event-related EEG study on the processing of first and second person personal and possessive pronouns

Theoretically, stimuli can be related to the self as subject (“I”) or object (“ME”) of experience. This event-related brain potential (ERP) study investigated whether listening to personal and possessive pronouns elicits different modes of self-processing regarding time-course and neural sources. Going beyond previous research, first (1PP) and second person (2PP) pronouns were included to determine the specificity of self-processing. Participants listened passively to German pronouns while the electroencephalogram was recorded. Modulation of ERPs revealed a processing advantage for the 2PP personal pronoun “du” (“you”) already in early time windows. Regarding possessive pronouns, N1 amplitudes indicated increased attention orientation to the 1PP pronoun “mein” (“my”), whereas during later time windows, processing of 1PP and 2PP possessive pronouns did not differ but differed from the third person pronoun “sein” (“his”). ERP source imaging suggests that primary sensory brain regions (auditory cortex), the insula and cortical midline structures are differentially involved into these two processing modes. The results support the idea of distinct self-processing modes (“I” and “ME”) and confirm their dynamic nature. Moreover, they demonstrate that on a neural level neither “I” or “ME” are invariantly tied to the first person, in line with the hypothesis that self-processing is relational and context-dependent.     

Differential response patterns to disgust-related pictures

ABSTRACT

In the present study, attentional bias was investigated as a potential predisposing mechanism for the contamination-related subtype of obsessive-compulsive disorder (C-OC disorder). Fifty healthy participants with varying degrees of subclinical C-OC symptoms performed a visual search task to measure differential attentional biases elicited by neutral, disgust-, and fear-specific pictorial material. Participants had to find a target picture within five neutral distractor pictures randomly presented on different locations in an array. The task was to decide whether the array contained an unpleasant target picture or not. In randomly-selected emotional trials, participants were further asked about the content of the picture and the confidence of their answer. The results show that the reaction times significantly differed between the emotional and neutral pictures. Participants were significantly more confident in answering questions referring to fear compared to disgust pictures. This effect was marginally amplified in participants with higher C-OC symptoms. We discuss the results within the framework of the cost and benefit hypothesis, which postulates that disgust evolutionarily elicits stronger uncertainty compared to fear, owing to the ambiguous nature of the stimuli. Increased uncertainty might be an important but underestimated factor for pathological disgust experience, such as in obsessive-compulsive disorder.     

Empathic accuracy: age differences from adolescence into middle adulthood

ABSTRACT

This study investigated age differences in empathic accuracy, the ability to correctly perceive others’ emotions, in a sample of 151 boys and men from three age groups: adolescents (M_age?=?16 years, SD?=?1.04), young adults (M_age?=?29 years, SD?=?2.78), and middle-aged adults (M_age?=?50 years, SD?=?3.07). All participants viewed nine newly developed film clips, each depicting a boy or a man reliving one of three emotions (anger, sadness, or happiness), while talking about an autobiographical memory. Adolescents and middle-aged men were less accurate than young men, and these age differences were associated with parallel age differences in fluid-mechanical abilities. In addition, age differences in vocabulary, one indicator of crystallized-pragmatic intelligence, were associated with age differences in empathic accuracy in adolescent and young, but not middle-aged, men. Within the limitations of cross-sectional data, this study provides evidence for the idea that empathic accuracy is an effortful task that requires cognitive resources and, thus, may show a normative increase until young adulthood followed by periods of stability and decline in subsequent decades.     

Embodied self-awareness among South African social services therapist-practitioners: An exploratory study

We explored South African social service therapist-practitioners’ experiences of their own lived body in the context of practice. The participants consisted of a convenience sample of 13 therapist-practitioners registered with the Health Professions Council of South Africa and the South African Council for Social Service Professions, in private practice (n?=?9) or government departments (n?=?4) in the Western Cape and Gauteng Provinces of South Africa. They provided data on their embodied self-awareness by means of naïve sketches and/or drawings, experiential body awareness activities, and in-depth one-on-one semi-structured interviews. Findings from the thematic analysis of the data indicated bodily self-awareness; including experiences of bodily felt sensations while doing therapy, intuitive knowing, a sense of warning/ danger, and a sense of the body-schema-in-relation. Most of the therapist-practitioners reported a tendency to deny, suppress, or control their sensory cues or to rationalise them. Embodied self-awareness appears to be a true phenomenon among South African therapist-practitioners.     

‘I feel better when…’: An analysis of the memory-experience gap for peoples’ estimates of the relationship between health behaviours and experiences

Objective: People often overestimate how strongly behaviours and experiences are related. This memory-experience gap might have important implications for health care settings, which often require people to estimate associations, such as “my mood is better when I exercise”. This study examines how subjective correlation estimates between health behaviours and experiences relate to calculated correlations from online reports and whether subjective estimates are associated with engagement in actual health behaviour.

Design: Seven-month online study on physical activity, sleep, affect and stress, with 61 online assessments.

Main Outcome Measures: University students (N = 168) retrospectively estimated correlations between physical activity, sleep, positive affect and stress over the seven-month study period.

Results: Correlations between experiences and behaviours (online data) were small (r = ?.12–.14), estimated correlations moderate (r = ?.35–.24). Correspondence between calculated and estimated correlations was low. Importantly, estimated correlations of physical activity with stress, positive affect and sleep were associated with actual engagement in physical activity.

Conclusion: Estimation accuracy of relations between health behaviours and experiences is low. However, association estimates could be an important predictor of actual health behaviours. This study identifies and quantifies estimation inaccuracies in health behaviours and points towards potential systematic biases in health settings, which might seriously impair intervention efficacy.     

Imitation in young children: when who gets copied is more important than what gets copied

Unlike other animals, human children will copy all of an adult's goal-directed actions, including ones that are clearly unnecessary for achieving the demonstrated goal. Here we highlight how social affiliation is key to this species-specific behavior. Preschoolers watched 2 adults retrieve a toy from a novel apparatus. One adult included irrelevant actions in her demonstration; the other only used actions causally related to opening the apparatus. After both adults took turns demonstrating, 1 left the test room, and the remaining adult gave the apparatus to the child. Children reproduced the irrelevant actions only when given the apparatus by the adult who had demonstrated them, even though the departed adult's actions emphasized how unnecessary these redundant actions were. Our results highlight the specialized skills for participating in cultural groups that have evolved in humans and provide insight into why finding such high fidelity copying in other animals has proven elusive.