Pain and Depressive Symptoms: Exploring Cognitive Fusion and Self-Compassion in a Moderated Mediation Model

The association between chronic pain (CP) and depression is complex and influenced by several psychological processes. Cognitive fusion (i.e. being entangled with one´s internal experiences) and self-compassion (i.e. being touched by one´s suffering, with a motivation to alleviate it) have been hypothesized as relevant psychological processes in physical and mental health, but few studies have addressed them in CP, and none in a comprehensive model relating pain intensity and depressive symptoms. This study tests, in a moderated mediation model, the mediator role of cognitive fusion between pain intensity and depressive symptoms, and the moderator effect of self-compassion in this mediation. In a cross-sectional study, 231 female CP patients (Age: M?=?48.51, SD?=?10.89) responded online self-report measures. PROCESS, an SPSS macro for conducting path analysis modeling, was used to test the hypothesized model. The model explained 63% of depressive symptoms, and cognitive fusion mediates the association between pain intensity and depressive symptoms. Also, self-compassion moderates this mediation (regardless of self-compassion being low, moderate or high). Although pain intensity is a predictor of depressive symptoms, fusion with thinking in general mediates this association, this relationship is buffered when patients are able to respond to setbacks and perceived shortcomings with self-kindness and warmth. Clinical and theoretical implications are discussed.     

Driver perception hypothesis: Driving simulator study

According the driver perception hypothesis, horizontal curves appear sharper or flatter when overlapping with crest or sag vertical curves, respectively. Confirmations of this hypothesis are provided by studies carried out using non-interactive techniques that do not allow the analysis of the driver’s reactions to the visual perception of the road.This study was aimed to add to the body of knowledge concerning driver’s speed behavior on combined curves, as well as to test the perception hypothesis based on the speed data collected during tests in the interactive CRISS driving simulator.Speeds on the tangent-curve transition of crest and sag combinations were compared to those on the tangent-curve transition of horizontal curves with the same radii but on a flat grade (reference curves).For the crest combinations the results of the statistical analyses were fully consistent with the perception hypothesis. On the sag combinations, on the contrary, the driver’s speed behavior did not differ in any statistically significant way from that on the reference curves. Therefore this finding did not support the perception hypothesis on the sag combinations. The effects of the combined curves on the driver’s speed behavior did not change in function of the level of the radius. Some implications of these findings have been highlighted.     

The effects of age on the contributions of head and eye movements to scanning behavior at intersections

The current study was aimed at evaluating the effects of age on the contributions of head and eye movements to scanning behavior at intersections. When approaching intersections, a wide area has to be scanned requiring large lateral head rotations as well as eye movements. Prior research suggests older drivers scan less extensively. However, due to the wide-ranging differences in methodologies and measures used in prior research, the extent to which age-related changes in eye or head movements contribute to these deficits is unclear. Eleven older (mean 67 years) and 18 younger (mean 27 years) current drivers drove in a simulator while their head and eye movements were tracked. Scans, analyzed for 15 four-way intersections in city drives, were split into two categories: eye-only (consisting only of eye movements) and head + eye (containing both head and eye movements). Older drivers made smaller head + eye scans than younger drivers (46.6° vs. 53°), as well as smaller eye-only scans (9.2° vs. 10.1°), resulting in overall smaller all-gaze scans. For head + eye scans, older drivers had both a smaller head and a smaller eye movement component. Older drivers made more eye-only scans than younger drivers (7 vs. 6) but fewer head + eye scans (2.1 vs. 2.7). This resulted in no age effects when considering all-gaze scans. Our results clarify the contributions of eye and head movements to age-related deficits in scanning at intersections, highlight the importance of analyzing both eye and head movements, and suggest the need for older driver training programs that emphasize the importance of making large scans before entering intersections.     

Concurrent and prospective associations between facial affect recognition accuracy and childhood antisocial behavior

This study examined the concurrent and prospective associations between children's ability to accurately recognize facial affect at age 8.5 and antisocial behavior at age 8.5 and 10.5 years in a sub sample of the Avon Longitudinal Study of Parents and Children cohort (5,396 children; 2,644, 49% males). All observed effects were small. It was found that at age 8.5 years, in contrast to nonantisocial children; antisocial children were less accurate at decoding happy and sad expressions when presented at low intensity. In addition, concurrent antisocial behavior was associated with misidentifying expressions of fear as expressions of sadness. In longitudinal analyses, children who misidentified fear as anger exhibited a decreased risk of antisocial behavior 2 years later. The study suggests that concurrent rather than future antisocial behavior is associated with facial affect recognition accuracy. Aggr. Behav. 36:305–314, 2010. © 2010 Wiley‐Liss, Inc.     

重症医学科临床思维几点探讨

重症医学科危重病患者病情变化的错综复杂和诊治方法的特殊性对重症医学科医生的临床思维提出了新的要求,哲学的思维方法显得非常重要;本文对重症医学科医生临床思维中需经常面临的系统与局部、循证与经验、多学科协作、临床与人文之间的关系等重要问题进行初步的哲学思考。     

从比较治疗学角度看老年性黄斑变性的治疗决策

老年性黄斑变性(AMD)是发达国家中老年人群主要致盲眼病,患病率逐年上升。近年来其治疗方面取得很大进展,但治疗方法诸多,各种方案的疗效参差不齐。为了促进老年性黄斑变性治疗选择的最佳途径,本文通过利用检索国内外报道的文献,对其中老年性黄斑变性的治疗方法归纳总结,并运用比较治疗学的研究方法进行比较分析,旨在寻求最有效的治疗方案。     

An 8-year follow-up of treated obese children: Children’s, process and parental predictors of successful outcome

Objective

This study presents an 8-year outcome of overweight children who were treated in an outpatient program and aims to identify child and familial variables associated with long-term weight regulation.

Methods

A total of 90 children participated with a mean age of 10.1 years ± 2.6 at baseline and a mean adjusted BMI (actual BMI/50th percentile of BMI for age and gender × 100) of 153.1 ± 20.7% at baseline participated in the 8-year follow-up (retrieval rate 71%; response rate 89%). Children’s and parental factors, administered at baseline and at follow-up were related to the success of the treatment.

Results

The children obtained a mean reduction of 8% in adjusted BMI at the 8-year follow-up. A total of 59 children (66%) were successful in obtaining weight control (i.e. maintaining their original % adjusted BMI); 40% even decreased their adjusted BMI by 10% or more. Analyses revealed that the child’s age, the degree of overweight at baseline and the child’s global self-worth were positive predictors of long-term weight loss 8 years after treatment, whereas psychopathology in the mother was a negative predictor. The total explained variance was R² = 35%.

Discussion

Treatment of childhood obesity by means of a multidisciplinary cognitive-behavioural program enables the majority of children to control their weight in the long term. In order to predict the success of the treatment, it is recommended to take into account the child’s age, its degree of overweight, its global self-worth and the occurrence of maternal psychopathology.