Psychological adjustment to cleft lip and/or palate: A narrative review of the literature

Objective: Adjustment to cleft lip and/or palate (CL/P) is multifaceted, involving several domains of psychological and social functioning. A substantial increase in research in this area has been evident in recent years, along with a preliminary shift in how adjustment to CL/P is conceptualised and measured. An updated and comprehensive review of the literature is needed in light of the rapidly expanding and changing field.

Design: A narrative review of 148 quantitative and qualitative studies published between January 2004 and July 2015.

Main outcome measures: Findings are presented according to five key domains of adjustment: Developmental Trajectory, Behaviour, Emotional Well-being, Social Experiences and Satisfaction with Appearance and Treatment. Data pertaining to General Psychological Well-being were also examined.

Results: The overall impact of CL/P on psychological adjustment appears to be low. Nonetheless, the review demonstrates the complexity of findings both within and across domains, and highlights recurring methodological challenges.

Conclusions: Research findings from the last decade are considered to be largely inconclusive, although some areas of emerging consensus and improvements in the approaches used were identified. Efforts to collect data from large, representative and longitudinal samples, which are comparable across studies and encompassing of the patient perspective, should be doubled.     

Changes over time in head and neck cancer patients’ and caregivers’ illness perceptions and relationships with quality of life

Objective: This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months.

Design: Forty-two patient–caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor–Partner Interdependence Model.

Main Outcome Measure: Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N).

Results: Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up.

Conclusion: Patients’ and their caregivers’ perceptions of HNC are dynamic over time. Greater discrepancy between patients’ and caregivers’ illness perceptions at diagnosis predict poorer subsequent patient HRQL.     

Anselm's Quiet Radicalism

It is characteristic of Anselm to adopt the formulations of his authorities while giving them meanings of his own, hiding conceptual disagreement by means of verbal echoes. Anselm's considerable originality sometimes goes unnoticed because readers see the standard Augustinian language and miss the fact that Anselm uses it to state un-Augustinian views. One striking instance of Anselm's quiet radicalism is his understanding of free choice and the fall. He seems to uphold standard Augustinian privation theory when he affirms that injustice is merely an absence of justice where justice should be; he seems also to be committed to the standard Augustinian view that everything that has being is created by God. A closer examination, however, shows that Anselm clearly has qualms about whether privation theory can do all of the work to which Augustine had tried to put it; and Anselm actually affirms that every free choice has being and yet is not created by God. I begin by showing that Anselm regards unjust acts as being ontologically on a par with just acts. Injustice itself is nothing, a privation; but an unjust volition is something, and indeed no less something than a just volition. Moreover, creatures have their volitions solely from themselves, not from God. So Anselm must deny that God is the creator of everything that has being: free choices have being, and creatures are the sole causes of those choices. Anselm explicitly draws this radical conclusion, but he does so quietly, without fanfare, taking care to provide ways in which he can still say all the traditional things but mean something radical.     

Deleuze and Naturalism

Abstract

Against the tendency to regard Deleuze as a materialist and a naturalistic thinker, I argue that his core philosophical writings involve commitments that are incompatible with contemporary scientific naturalism. He defends different versions of a distinction between philosophy and natural science that is inconsistent with methodological naturalism and with the scientific image of the world as a single causally interconnected system. He defends the existence of a virtual realm of entities that is irreconcilable with ontological naturalism. The difficulty of reconciling Deleuze’s philosophy with ontological naturalism is especially apparent in his recurrent conception of pure events that are irreducible to their incarnation in bodies and states of affairs. In the last section of this essay, I canvass some of the ways in which Deleuze’s thought might be reconciled with a more liberal, pluralist and ethical naturalism that he identified in an early essay on Lucretius.     

The feasibility,acceptability and possible benefit of a positive psychology intervention group in an adolescent inpatient eating disorder service

Positive affect focused therapies could increase subjective happiness and life satisfaction for patients with eating disorders (EDs), illnesses known to significantly impact quality of life. This longitudinal pilot study aimed to develop and implement a five session ‘Positivity Group’ using positive psychology interventions (PPIs) in an adolescent ED inpatient service. Eight female inpatients aged 11–18 years attended the group and subjective happiness and life satisfaction were assessed before, after and at 6-month follow-up. Patients provided feedback on acceptability and feasibility was assessed via patient engagement, facilitator and team feedback and the data support the feasibility and acceptability of the group. A possible benefit was derived from the group, with 75% of patients reporting meaningful improvement in subjective happiness and 87.5% in life satisfaction. Involving the wider team and supporting homework were identified as considerations for future replication alongside the assessment of implementation, acceptability, feasibility and effectiveness in other clinical contexts.     

Happiness begets children? Evidence for a bi-directional link between well-being and number of children

The purpose of the current research was to examine the association between different facets of well-being and parenthood status. Specifically, using two longitudinal data sets, the present research explored whether individuals who possess high cognitive (Studies 1 & 2), emotional, and psychological well-being (Study 2) are more likely to subsequently become parents compared to their less happy counterparts. The results of both studies demonstrated that well-being at Time 1 positively predicted number of children at Time 2, controlling for a number of relevant variables (e.g. income, age). Additional analyses revealed that the relationship between cognitive well-being and subsequently having children was particularly strong for people who did not have any children previously. Potential mechanisms explaining how and why well-being may influence parenthood are discussed.     

Workplace and family support and work–life balance: Implications for individual psychological availability and energy at work

This study presents three studies that explore the ways in which multiple support sources (workplace and family social support) help individuals to experience work–life balance (WLB) and thereby develop a sense psychological availability and positive energy at work. We examine this serial mediation model across three population groups in Israel using time-lagged data from part-time students (sample 1), as well cross-sectional data from workers in the industrial sector (sample 2) and physicians in public hospitals (sample 3). The results indicate a complex process in which workplace and family support augment employee positive energy through WLB and psychological availability. The findings shed light on the importance of support from work and nonwork sources for the pursuit of employees to achieve balance in the spheres of work and life and suggest that the WLB helps in the development of psychological availability and augmenting employee positive energy.     

The three meanings of meaning in life: Distinguishing coherence,purpose, and significance

Despite growing interest in meaning in life, many have voiced their concern over the conceptual refinement of the construct itself. Researchers seem to have two main ways to understand what meaning in life means: coherence and purpose, with a third way, significance, gaining increasing attention. Coherence means a sense of comprehensibility and one’s life making sense. Purpose means a sense of core goals, aims, and direction in life. Significance is about a sense of life’s inherent value and having a life worth living. Although some researchers have already noted this trichotomy, the present article provides the first comprehensible theoretical overview that aims to define and pinpoint the differences and connections between these three facets of meaning. By arguing that the time is ripe to move from indiscriminate understanding of meaning into looking at these three facets separately, the article points toward a new future for research on meaning in life.     

Cognitive events in a problem-solving task: a qualitative method for investigating interactivity in the 17 Animals problem

Outside the cognitive psychologist's laboratory, problem-solving is an activity that takes place in a rich web of interactions involving people and artefacts. This interactivity is constituted by fine-grained action–perception cycles, and it allows a reasoner's comprehension of the problem to emerge from a coalition of internal and external resources. Taking an ecological approach to problem-solving, this paper introduces a qualitative method, Cognitive Event Analysis, for studying the fine-grained interactivity between a problem-solving agent and his/her environment. To demonstrate the potential of this method, it is used to study a single subject solving the so-called 17 Animals problem using a material model. The fine-grained procedure allows tracking the solution to a serendipity that was brought about because of the participant's aesthetic considerations and a change in her perceptual figure-ground configuration. While a qualitative single-case method cannot prove specific models of problem-solving, it questions prevalent mentalist models, and it generates new hypotheses on insight problem-solving, because it allows the researcher to attend to outliers and to variability on a fast and fine-grained between-measurement timescale.