Phenotypes of sleeplessness: stressing the need for psychodiagnostics in the assessment of insomnia

Insomnia is a too general term for various subtypes that might have different etiologies and therefore require different types of treatment. In this explorative study we used cluster analysis to distinguish different phenotypes in 218 patients with insomnia, taking into account several factors including sleep variables and characteristics related to personality and psychiatric comorbidity. Three clusters emerged from the analysis. The ‘moderate insomnia with low psychopathology’-cluster was characterized by relatively normal personality traits, as well as normal levels of anxiety and depressive symptoms in the presence of moderate insomnia severity. The ‘severe insomnia with moderate psychopathology’-cluster showed relatively high scores on the Insomnia Severity Index and scores on the sleep log that were indicative for severe insomnia. Anxiety and depressive symptoms were slightly above the cut-off and they were characterized by below average self-sufficiency and less goal-directed behavior. The ‘early onset insomnia with high psychopathology’-cluster showed a much younger age and earlier insomnia onset than the other two groups. Anxiety and depressive symptoms were well above the cut-off score and the group consisted of a higher percentage of subjects with comorbid psychiatric disorders. This cluster showed a ‘typical psychiatric’ personality profile. Our findings stress the need for psychodiagnostic procedures next to a sleep-related diagnostic approach, especially in the younger insomnia patients. Specific treatment suggestions are given based on the three phenotypes.     

“I feel I can live every minute if I choose to”: participants’ experience of a positive mindfulness programme

Both separately and together, mindfulness and positive psychological interventions have been found to increase wellbeing against a number of measures. Research has been primarily based on the application of self-report scales, and little has been done to examine the lived experience of participants. The aim of this study was to apply an interpretative phenomenological approach to the experience of participants in a Mindfulness Based Flourishing (MBF) programme, which combines positive psychological interventions with mindfulness in order to more fully understand the impact of their experience on them. Three participants from a completed MBF programme each had a one-off semi-structured interview, the results of which were transcribed verbatim. The resulting texts were analysed, with five themes emerging, which demonstrated the impact of the programme on participants’ sense of self and on the nature of their connections with others. While all participants identified benefits accruing from the course, it also presented challenges emotionally as well as in terms of the embedding of knowledge and skills. Future research should look to examine the impact of such programmes in wider cultural and temporal frameworks and should explore the application of grounded theory to identify more theoretical level explanations of the phenomenon.     

How to Release Oneself from an Obligation: Good News for Duties to Oneself

In some cases, you may release someone from some obligation they have to you. For instance, you may release them from a promise they made to you, or an obligation to repay money they have borrowed from you. But most take it as clear that, if you have an obligation to someone else, you cannot in any way release yourself from that obligation. I shall argue the contrary. The issue is important because one standard problem for the idea of having duties to oneself relies on the impossibility of self-release. The argument (the ‘Release Argument’) is that a duty to oneself would be a duty from which one could release oneself, but that this is an absurdity, and so there can be no duties to oneself. This argument is to be rejected because a duty from which one can release oneself is perfectly possible, and such release occurs quite properly from time to time.     

Hard times and European youth. The effect of economic insecurity on human values,social attitudes and well‐being

While economic downturns have adverse effects on young people's life chances, empirical studies examining whether and to what extent human values, social attitudes and well‐being indicators respond to sudden economic shocks are scarce. To assess the claim that human values are less affected by economic shocks than social attitudes and well‐being, two distinct yet related studies based on the European Social Survey (ESS) are conducted. The first employs a fixed effects pseudo‐panel analysis of the 2008–2014 ESS‐waves to detect whether changes over time in the socio‐demographic group's unemployment risk and national youth unemployment affect individual dispositions to varying degrees. The second study captures micro‐ and cross‐national effects in the 2010 ESS cross‐section. Unique for this set‐up is that we can test whether the findings hold for over‐time changes in youth unemployment within countries (pseudo‐panel), as well as for cross‐country differences in youth unemployment (multilevel). Both studies indicate that political trust, satisfaction with the economy and subjective well‐being are lowered by economic risk and hardship, while social trust and self‐rated health are less affected by changes in youth unemployment. Secondly, human values are immune to economic risk, underscoring that values transcend specific situations and are therefore resistant against sudden economic shocks.     

Qualitative Assessment of Vaccination Hesitancy Among Members of the Apostolic Church of Zimbabwe: A Case Study

Vaccine hesitancy or lack of confidence in vaccines is considered a threat to the success of vaccination programs. The rise and spread of measles outbreaks in southern Africa in 2009–2010 were linked to objections among Apostolic Church members, estimated at about 3.5 million in Zimbabwe as of 2014. To inform planning of interventions for a measles–rubella vaccination campaign, we conducted an assessment of the factors contributing to vaccine hesitancy using data from various stakeholders. Among nine districts in three regions of Zimbabwe, we collected data on religious attitudes toward, and perceptions of, vaccines through focus group discussions with health workers serving Apostolic communities and members of the National Expanded Programme on Immunization; semi-structured interviews with religious leaders; and open-ended questions in structured interviews with Apostolic parents/caregivers. Poor knowledge of vaccines, lack of understanding and appreciation of the effectiveness of vaccinations, religious teachings that emphasize prayers over the use of medicine, lack of privacy in a religiously controlled community, and low levels of education were found to be the main factors contributing to vaccine hesitancy among key community members and leaders. Accepting vaccination in public is a risk of sanctions. Poor knowledge of vaccines is a major factor of hesitancy which is reinforced by religious teachings on the power of prayers as alternatives. Because parents/caregivers perceive vaccines as dangerous for their children and believe they can cause death or disease, members of the Apostolic Church have more confidence in alternative methods such as use of holy water and prayers to treat diseases. Under these circumstances, it is important to debunk the myths about the power of holy water on the one hand and disseminate positive information of the efficacy of vaccines on the other hand in order to reduce hesitancy. Education about vaccines and vaccination in conjunction with government intervention, for example, through the use of social distancing policies can provide a framework for reducing hesitancy and increasing demand for vaccination.     

Investigating the effectiveness of brief cognitive reappraisal training to reduce fear in adolescents

As adolescent anxiety is common and costly, identifying effective strategies to reduce symptoms is a priority. This study tested whether adolescents could learn to use cognitive reappraisal strategies to attenuate fear during extinction learning. Fifty-seven participants (12–15 years) viewed images of two neutral faces, one which was paired with a fearful expression and shrieking scream (conditioned threat stimulus) and the other that was never paired with the aversive outcome (conditioned safety stimulus) during fear acquisition. Before extinction, participants either received cognitive appraisal training, which explored alternative, benign meanings associated with the scream or a control activity. Self-reported fear ratings in the cognitive reappraisal group were significantly lower to both the conditioned threat and safety stimuli after extinction than the control group. These findings did not characterise fear-potentiated startle data. Potential reasons for the lack of consistency between measures are considered.     

Reflections 10 Years Post–Hurricane Katrina: Implications for Addiction Counseling

Ten years post–Hurricane Katrina, the authors reflected on the aftermath through the eyes of addiction treatment professionals to become better prepared for future tragedies. The lessons learned, the authors' personal reflections, and implications for clinical practice and counselor education are provided.     

The Impact of Mode of Administration on the Equivalence of a Test Battery: A Quasi‐Experimental Design

Two quasi‐experimental studies were conducted to examine the equivalence of an online unsupervised test battery (ICES ability, interests and personality tests) in relation to supervised paper administration and to test whether differences were because of the lack of supervision, the test being online as opposed to on a PC, or the computerization of the test. In the first study, data from a sample of 86 employed individuals suggested a lack of equivalence on ability scales between online unsupervised and paper supervised testing modes. Effect sizes ranged from .04 to .49 and corrected coefficients of equivalence and stability from .65 to .81. Study two used a more controlled design as well as obtaining data on personality and interest scales. Data from 118 college and university students were collected, with 64 students replicating the design in study 1 and 54 tested in supervised paper and supervised PC modes. For the ability scales, a similar pattern to study 1 was seen between supervised paper and unsupervised online testing as well as between supervised paper and supervised PC testing. Data for interest and personality scales were more positive showing lower effect sizes and higher coefficient values across testing modes. When ability test data from the online testing group were compared with data from the PC group, results showed that the scales were affected by the computerization process rather than the lack of supervision or because they were in online as opposed to PC mode.     

How probable is probably? It depends on whom you're talking about

Two studies tested whether people interpreted verbal chance terms in a self‐serving manner. Participants read statements describing the likelihood of events in their own future and in the future of a randomly chosen other. They interpreted the chance terms numerically. Chance terms were interpreted as denoting a higher probability when they were used to describe the likelihood of pleasant events in one's own future than when they were used to describe the likelihood of pleasant events in someone else's future (Study 1). Similarly, chance terms were interpreted as denoting a lower probability when they were used to describe the likelihood of unpleasant events in one's own future than when they were used to describe the likelihood of unpleasant events in someone else's future (Studies 1 and 2). These differences occurred primarily when the risk statements were threatening. Copyright © 2005 John Wiley & Sons, Ltd.