Investigating the dose-response relationship between motor imagery and motor recovery of upper-limb impairment and function in chronic stroke: A scoping review

The recovery of upper-limb impairment and dysfunction post-stroke is often incomplete owing to the limited time in therapy focused on upper-limb recovery and the severity of the impairment. In these cases, motor imagery (MI) may be used as a precursor to physical therapies to initiate rehabilitation early on when it would be otherwise impossible to engage in therapy, as well as to increase the dose of therapy when MI is used in adjunct to physical therapy. While previous reviews have shown MI to be effective as a therapeutic option, disparity in findings exists, with some studies suggesting MI is not an effective treatment for post-stroke impairment and dysfunction. One factor contributing to these findings is inconsistency in the dose of MI applied. To explore the relationship between MI dose and recovery, a scoping review of MI literature as a treatment for adult survivors of stroke with chronic upper-limb motor deficit was performed. Embase, Medline and CINHAL databases were searched for articles related to MI and stroke. Following a two-phase review process, 21 papers were included, and data related to treatment dose and measures of impairment and function were extracted. Effect sizes were calculated to investigate the effect of dosage on motor recovery. Findings showed a high degree of variability in dosage regimens across studies, with no clear pattern for the effect of dose on outcome. The present review highlights the gaps in MI literature, including variables that contribute to the dose-response relationship, that future studies should consider when implementing MI.     

Profession Differences in Family Focused Practice in the Adult Mental Health System

There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross‐sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices.     

Is depression the past tense of anxiety? An empirical study of the temporal distinction

It has long been recognised that depression and anxiety share a common core of negative affect, but research on similarities and differences between these two emotions is growing. The focus of the current study was on whether the timing of a triggering event can determine whether the dominant emotional reaction is depression or anxiety. It was hypothesised that aversive events in the past would elicit more depression than anxiety, whereas the same aversive events in the future would elicit more anxiety than depression. We created temporally varied versions of vignettes describing aversive events occurring at either time, and asked participants to rate the extent to which the events would elicit feelings of depression or anxiety. Results indicated that adverse past events elicited much higher ratings of anticipated depression and adverse future events elicited much higher ratings of anticipated anxiety. Implications for understanding these two emotions and depressive and anxiety disorders are discussed.     

Prospective memory training in older adults and its relevance for successful aging

In research on cognitive plasticity, two training approaches have been established: (1) training of strategies to improve performance in a given task (e.g., encoding strategies to improve episodic memory performance) and (2) training of basic cognitive processes (e.g., working memory, inhibition) that underlie a range of more complex cognitive tasks (e.g., planning) to improve both the training target and the complex transfer tasks. Strategy training aims to compensate or circumvent limitations in underlying processes, while process training attempts to augment or to restore these processes. Although research on both approaches has produced some promising findings, results are still heterogeneous and the impact of most training regimes for everyday life is unknown. We, therefore, discuss recent proposals of training regimes aiming to improve prospective memory (i.e., forming and realizing delayed intentions) as this type of complex cognition is highly relevant for independent living. Furthermore, prospective memory is associated with working memory and executive functions and age-related decline is widely reported. We review initial evidence suggesting that both training regimes (i.e., strategy and/or process training) can successfully be applied to improve prospective memory. Conceptual and methodological implications of the findings for research on age-related prospective memory and for training research in general are discussed.     

Timing of Stressful Life Events Affects Stability and Change of Neuroticism

Neuroticism is a predictor of many health problems. To study the determinants of within‐subject change in neuroticism, three hypotheses were tested: (i) subjects who experienced stressful life events (SLEs) show an increase in neuroticism; (ii) high baseline neuroticism moderated this effect; and (iii) recent SLEs had a greater impact on neuroticism than distant SLEs. Data came from the Finnish Twin Cohort. Neuroticism data were collected in 1975 and 1981 and SLEs data in 1981 (n = 21 085). By entering baseline neuroticism as a predictor for neuroticism at follow‐up, the outcome measure was change in neuroticism. Changes in neuroticism were predicted from SLE indices or their interaction with baseline neuroticism. Timing of SLEs was taken into account by distinguishing recent from distant SLEs. To control for confounding by shared genes and environments, both within‐twin pair and between‐twin pair effects were tested for monozygotic and dizygotic twin pairs separately. Neuroticism's six‐year stability was high (r = .58, p < .001). Exposure to SLEs modestly increased neuroticism (βs > .55, ps < .001), unconfounded by shared genes. This effect was not moderated by high baseline neuroticism. Recent SLEs (.09 < βs < .15) had more impact than distant SLEs (.03 < βs < .11; ps < .01). In conclusion, the findings strongly supported a model of environmentally driven SLEs causing dynamic fluctuations around a person's set point of neuroticism. Copyright © 2013 John Wiley & Sons, Ltd.     

Choice‐making,Expectations, and Treatment Positivity: How and When Choosing Shapes Aversive Experiences

Every day we use products and treatments with unknown but expected effects, such as using medication to manage pain. In many cases, we have a choice over which products or treatments to use; however, in other cases, people choose for us or choices are unavailable. Does choosing (versus not choosing) have implications for how a product or treatment is experienced? The current experiments examined the role of choice‐making in facilitating so‐called expectation assimilation effects—or situations in which a person's experiences (e.g., discomfort and pain) are evaluated in a manner consistent with their expectations. In Experiment 1, participants were initially exposed to a baseline set of aversive stimuli (i.e., sounds). Next, some participants were given expectations for two “treatments” (i.e., changes in screen display) that could ostensibly reduce discomfort. Critically, participants were either given a choice or not about which of the two treatments they preferred. Participants in a control condition were not provided with treatment expectations. Results revealed that discomfort experiences assimilated to expectations only when participants were provided with choice. Experiment 2 replicated this finding and provided evidence against the idea that demand characteristics and choice‐making unrelated to the core task (i.e., choices without associated expectations) could account for the results. Further, Experiment 2 showed that choosing reduced discomfort because of increased positivity about the treatment. Results are discussed in the context of extant research on choice‐making and expectation effects. Copyright © 2013 John Wiley & Sons, Ltd.     

A Multimodal Study of Childhood Trauma and Distress Tolerance in Young Adulthood

Individuals with a history of childhood trauma experience deficits in emotion regulation. However, few studies have investigated childhood trauma and both perceived (i.e., self-report) and behavioral measures of distress tolerance. The current study evaluated associations between childhood trauma (i.e., physical abuse, sexual abuse, and witnessing family violence) and measures of perceived (Distress Tolerance Scale) and behavioral distress tolerance (i.e., Paced Auditory Serial Addition Test, breath-holding). Participants were 320 undergraduate students with a history of interpersonal trauma (e.g., sexual/physical assault). Structural equation modeling was used to evaluate associations between frequency of childhood trauma type and distress tolerance. Greater childhood physical abuse was associated with higher perceived distress tolerance. Greater levels of witnessing family violence were associated with lower behavioral distress tolerance on the breath-holding task. No significant effects were found for Paced Auditory Serial Addition Test performance. Associations between childhood trauma and emotion regulation likely are complex and warrant further study.     

Impact of Well-being Interventions for Siblings of Children and Young People with a Chronic Physical or Mental Health Condition: A Systematic Review and Meta-Analysis

Siblings of children and young people with a chronic illness are at increased risk of poor psychological functioning. A number of studies have attempted to implement and evaluate interventions targeting the psychological well-being of this at-risk group. This systematic review summarises the evidence regarding psychological functioning of siblings following an intervention targeting their well-being. The meta-analysis considered behaviour and knowledge, two of the most frequently studied outcomes. The following databases were used: PsycINFO, EMBASE, CINAHL, PubMed, Scopus and Web of Science. Seventeen studies were eligible to be included in the systematic review and eight in the meta-analysis. Results from the systematic review reflected the inconsistency of intervention evaluations in this area with a high level of heterogeneity and a total of 23 outcomes considered across the 17 included studies. The meta-analysis estimated effect sizes using a standardised mean difference (SMD) approach. Pre-post analysis suggested significant improvement in behavioural outcomes and knowledge of their sibling’s health conditions with a SMD of ? 0.44 [95% CI (? 0.6, ? 0.29); p = 0.000] and 0.69 [(95% CI = 0.42, 0.96); p = 0.000], respectively. The SMD was not significant for behavioural outcomes when considering treatment–control studies. In conclusion, the findings suggest interventions for well-being have a positive effect on the psychological functioning of siblings of children and young people with a chronic illness, but their specificity needs to be established. There is a need for further, more methodologically robust research in this area.     

Factors related to life satisfaction among urban African American adults receiving care at a publicly-funded sexual health clinic

Life satisfaction is linked to premature morbidity and mortality and it may be compromised for individuals living in economically-disadvantaged, urban neighborhoods. The present study explores how behavioral and social-environmental health factors are associated with life satisfaction among a sample of African American young adults. Participants (N = 307, M_age = 26.6 years, 53% male) were recruited from a publicly-funded clinic for a randomized controlled trial (RCT). Data from the baseline assessment of the RCT, which included measures of sleep, depression, anxiety, social support, alcohol and drug use problems, city stress, and life satisfaction, were used for the current study. Correlation analyses assessed bivariate associations between life satisfaction and the demographic and health-related factors. Linear regression using backward elimination determined the best fitting model of factors associated with life satisfaction. Backward elimination resulted in the following variables remaining as significantly associated with life satisfaction: age (b = ?2.40, p = .017), anxiety (b = ?5.32, p < .001), and social support (b = 2.89, p = .004). Feeling rested upon waking also remained in the best fitting model, although this association did not achieve statistical significance (p = .099). The results suggest that African American adults who are younger, less anxious, and report adequate social support are more likely to report satisfaction with life. These findings add to the literature aimed at examining health and social factors impacting the well-being of African Americans living in low-income, urban communities.