Heart rate variability and drawing impairment in hypoxemic COPD

We studied 54 patients with hypoxemic chronic obstructive pulmonary disease (COPD). The Mini Mental State Examination and the Mental Deterioration Battery were used for neuropsychological assessment. Heart rate variability (HRV) was assessed based on 24-h Holter ECG recording. Mann–Whitney test was used to compare HRV parameters of patients performing normally or abnormally on individual neuropsychological tasks. Spearman’s rho was used to investigate the correlations between HRV parameters and neuropsychological scores, indexes of health status or COPD severity. Patients with defective performance at copying drawings with landmarks (CDL) test (N = 23) had lower very low frequency (VLF) power with respect to patients with normal performance (N = 31) (24 h: median 213; interquartile range 120–282 vs. 309; 188–431 ms², p = 0.043; daytime: 202; 111–292 vs. 342; 194–397 ms², p = 0.039). The CDL score correlated with the VLF power (24 h: ρ = 0.27, p = 0.049; daytime: ρ = 0.30, p = 0.028), and the normalized low frequency/high frequency (LF/HF) ratio (24 h: ρ = 0.27, p = 0.05; daytime: ρ = 0.33, p = 0.015). Sympathetic modulation decreased for increasing severity of COPD. In conclusion, drawing impairment correlates with depressed sympathetic modulation in patients with COPD, and both might be indexes of COPD severity.     

Components of Mindfulness in Patients with Chronic Pain

Methods of mindfulness are gaining increasing popularity within the behavioral and cognitive therapies and appear helpful for a range of clinical problems. The purpose of this study was to examine cognitive and behavioral processes underlying mindfulness. One hundred fifty patients seeking treatment for chronic pain completed a battery of questionnaires, including the 15-item Mindful Attention Awareness Scale (MAAS; Brown and Ryan, J Pers Soc Psychol 84:822–848, 2003). Preliminary analyses supported reliability and validity of the MAAS for patients with chronic pain. A confirmatory factor analysis provided incomplete support for a singe factor structure from the items of the MAAS. In turn, an exploratory factor analysis yielded a four-factor solution: Acting with Awareness, Present Focus, Responsiveness, and Social Awareness. Correlation and regression analyses indicated that the Acting with Awareness and Present Focus subscales were significantly related to measures of patient emotional, physical, and social functioning. Further research that explores and validates models of mindfulness-based processes is recommended.     

Motivational Interviewing in Primary Care

Healthcare systems are in the process of reforming themselves to better meet the needs of people with, or at risk of developing, chronic diseases and long term conditions. One goal of these efforts is the coproduction of activated, informed, engaged and motivated patients and citizens. The clinical, public health and financial benefits of achieving such a goal may be dramatic. Motivational Interviewing (MI) is a proven and practical front-line approach which can help deliver this goal whilst also helping to deliver such policy objectives and intermediate outcomes as increased levels of patient centered care, participatory or shared decision making, evidence-based healthcare and improved clinician-patient relationships. Until now, MI has been passively diffusing through the system as a result of the innovation and early uptake by insightful individuals and organizations. If healthcare systems want to breakthrough to higher levels of performance, investment in the conscious and deliberate implementation of MI into front-line settings may prove helpful.     

The Effectiveness of Cognitive and Behavioural Treatment of Chronic Pain in the Elderly: A Quantitative Review

This study provides a meta-analytic review of cognitive and behavioural interventions for chronic pain in the elderly, focusing on treatment effectiveness. Included in the analysis are studies in which a comparison was made either to a control condition or to pre-treatment. A total of 12 outcome studies published or reported between January 1975 and March 2008, were identified involving participants 60 years and above and providing 16 separate treatment interventions. The analysis indicated that cognitive and behavioural interventions were effective on self-reported pain experience, yielding an overall effect size of 0.47. However, there were no significant effects of cognitive and behavioural treatment on symptoms of depression, physical functioning and medication use. Methodological issues concerning design, outcome measures and treatment are discussed and recommendations for future studies are outlined.     

Psychologie sociale de la santé et compétences psychosociales en éducation thérapeutique : des enjeux pour la recherche et pour la pratique

The article presents the theoretical-methodological contributions of Social Health Psychology on the evaluation and reinforcement of psychosocial skills in the context of therapeutic patient education. This is illustrated by a synthesis of the results of several empirical researches in the field of pediatric diabetes. This synthesis shows that psychosocial skills are part of a system of actions and interpretations shaped by therapeutic and relational issues as well as social symbolism. Several practical implications emerge from these results for more effective work on the psychosocial skills of patients. The article concludes with the interest of a “psychosocial clinic” which draws on the viewpoint of Social Health Psychology to evaluate, analyze and intervene on the psychosocial determinants of health behaviours.     

The effects of smart phone video analysis on focus of attention and performance in practice and competition

ObjectivesResearch has consistently found that focus of attention (FOA) affects motor learning and performance. However, much of the previous work has used artificially manipulated FOA of novice participants performing laboratory tasks. There is a paucity of work that has tested transfer to more complex competition environments. We aimed to investigate the effects of smart phone video analysis, which commonly occurs in natural practice settings in golf, on skilled player’s FOA and performance in both practice and competition.DesignThis study employed a mixed experimental design. The between participants factor was the use of video analysis (practice with video vs practice only) and the repeated measures factor was time point (pre-intervention vs post-intervention).MethodAltogether, 19 skilled golfers (handicap: M = 5.79, SD = 5.80) took part in a four-week practice intervention with (n = 10) or without (n = 9) the use of smart phone video analysis. Driving range performance and competition performance were measured pre- and post-intervention. Practice diaries provided measures of FOA during the intervention period.ResultsThe practice with video group displayed a significantly more internal FOA throughout the intervention period than the practice only group. This resulted in a significant time by group interaction for driving range performance that showed an increase in performance for the practice only group and a decrease for the practice with video group. However, the performance effects did not transfer to competition scores.ConclusionsFindings enhance our understanding of the effects of video analysis on FOA and question whether FOA effects transfer from on range practice to on course performance.     

Parenting as relationship: a framework for assessment and practice

Parenting tends to be framed as a set of actions directed toward the child rather than as a relationship. This article helps therapists, parent-educators, and researchers conceptualize parenting as a socioculturally embedded relationship. The authors apply the relational orientations typology (Silverstein, Bass, Tuttle, Knudson-Martin, & Huenergardt, 2006) to parent-child relationships. The typology addresses two dimensions: whether the focus is on the child's meeting parental expectations or on expectations of mutuality and whether power between parent and child is expected to be symmetrical or asymmetrical. Four relational orientations are described: (1) rule directed, (2) position directed, (3) independence directed, and (4) relationship directed. These relational orientations describe the nature of the reciprocal relationship between parent and child and offer a framework from which to address parenting issues. A case illustration shows how the relational orientations framework helps therapists incorporate a larger systems/relational perspective into what was originally framed primarily as a child behavior problem.     

Anxiety Sensitivity and Disabling Chronic Health Conditions State of the Art and Future Directions

Anxiety sensitivity (AS) is a construct that denotes an individual difference in fear of anxiety. Most research into the AS construct has focused on its association with panic attacks, panic disorder and several other psychiatric disorders. There has been growing interest recently in AS as an important factor in the maintenance and exacerbation of morbidity associated with some disabling chronic health conditions (e.g. gastrointestinal dysfunction, asthma, vestibular dysfunction and chronic pain). The purposes of this paper are (a) to provide a brief overview of the theoretical framework within which the AS and chronic health condition literature can be synthesized, (b) to review the existing literature regarding AS and chronic health conditions and (c) to offer recommendations for assessment and treatment. Theoretically and practically relevant directions for future investigation are provided throughout the review.     

Group-based self-regulation: The effects of regulatory focus

We review a programme of research on responses to group-based feedback—specifically, on how the source, content, and context of feedback intersect to produce individual willingness to accept both criticism and praise and to change one’s actions accordingly. We first explore the conditions under which group-directed criticism is most effective in terms of stimulating willingness to amend group practices. This is followed by the investigation of the effectiveness of different types of group-based praise, and an analysis of the identity-verifying properties of positive feedback. Finally, we consider the effects of feedback delivered simultaneously at group and individual levels, and explore the reciprocal implications of feedback content for source categorisation. Throughout, we focus on the role of identity concerns and group image management in responses to feedback. We discuss how this approach fits with other areas of literature, including research on self-verification and strategic behaviour in intergroup contexts.