Fear of routine dental treatment in adults: Its nature and management

Abstract

The fear of dental treatment in adults can be characterised in several ways, loosely related, such as anticipating being afraid, avoiding dental check-ups and seeking treatment only under general anaesthesia. Defined thus, at least a quarter of adults are highly afraid of dentistry. The feared experiences are many, including most frequently, pain. Several studies have shown that anxious patients experience less pain during treatment than they expect. It remains to be confirmed that these are typical experiences because other studies show that local anaesthesia can fail to protect patients from sudden pain in 13% of treatments on average. Expectations of pain are highly resistant to change, the result probably of several influences including distortion in recall of pain-free treatment, intermittent experience of sudden severe pain, expecting pain in order to reduce its impact, and uncertainty about treatment. It has yet to be shown that experience free of discomfort can reduce these expectations. However, relaxation instructions and information about pain management and stop signals can reduce pre-treatment fear. To prevent the onset and the maintenance of anxiety: the prevention of pain is essential; controlled behavioural studies of the treatment of pain and other experiences such as panics are needed. Finally, the need for new instruments to assess all aspects of fear of dentistry is described.     

Socio-economic health inequalities: Their origins and implications

Abstract

Evidence attests to substantial variations in health contingent on socioeconomic position. It is argued that these effects cannot be dismissed as artefact nor can they be explained, in the main, by either social selection or an unequal distribution of accepted behavioural risk factors among different social groups. The most likely explanation would seem to be social causation. However, it is continuing social and material inequality that appears most implicated; accounts which locate the effects in childhood social and material causes are far less compelling. The persistence of socioeconomic health differentials into the materially better-off social strata and the possible determining role of relative as well as absolute living standards suggest that psychological, in addition to material, variables are likely to be involved. Isolating the key psychological variables and identifying the nature of their influences will not be easy tasks, although social relations, psychological stress, uplifts, and control have emerged as possible candidates. However, psychological mediators of this sort most probably constitute surface rather than basic causes. Socio-economic inequality, it is contended, remains the basic cause, and, as such, the proper target for intervention. Psychological interventions are unlikely to yield much in the way of dividends in this context and indeed could inadvertently contribute to victim blaming.     

Effect of pretesting on intentions and behaviour: A pedometer and walking intervention

This study addressed the influence of pedometers and a pretest on walking intentions and behaviour. Using a Solomon four-group design, 63 female university students were randomly assigned to one of four conditions: pedometer and pretest (n = 16), pedometer and no pretest (n = 16), no pedometer and pretest (n = 15), no pedometer and no pretest (n = 16). The pretest conditions included questions on walking, intentions to walk 12,500 steps per day, and self-efficacy for walking 12,500 steps per day. In the pedometer conditions a Yamax Digi-Walker SW-650 pedometer was worn for one week. All participants completed posttest questions. While significant pretest x pedometer interactions would have indicated the presence of pretest sensitisation, no such interactions were observed for either intention or self-reported walking. Wearing pedometers reduced intentions for future walking and coping self-efficacy. However, after controlling for pretest self-reported walking, pedometer use resulted in more self-reported walking. We conclude that wearing a pedometer increased self-reported walking behaviour but that a pretest did not differentially influence walking intentions, behaviour, or self-efficacy.     

Identity,coping style,and health behaviour among first generation Irish immigrants in England

Abstract

Berry's (1997) framework for acculturation research was used to explore the relationship between identity and health among Irish immigrants in England. One hundred and twelve first generation Irish immigrants completed questionnaire measures of ethnic identity, opportunities for identity expression, generalised coping style, and health behaviour. Significant, though small, positive correlations were observed between identity and health behaviour as predicted. Regression analyses and path analysis were used to present a model of the link between variables. Of particular note were the contrasting ways in which the two dimensions of identity were associated with health behaviour. Participants who positively evaluated their ethnic origins reported engaging in healthier behaviour and adopting more beneficial coping strategies when faced with day-to-day stresses and problems. Participants who reported their ethnic origin as more central to their overall identity were also more likely to adopt beneficial coping strategies. Concomitantly, however, they had fewer than desired opportunities for expressing their ethnic identity which was, in turn, associated with less beneficial coping and health behaviour. In looking for ways to tackle the well-documented health problems of both first and second generation Irish in England, the results suggest that encouragement to feel more positive about their ethnic identity might result in greater usage of behavioural approach coping and, relatedly, to improved health behaviour.     

Stemming the tide: Predicting women engineers' intentions to leave

This investigation adapts and extends the Social Cognitive Career Theory (SCCT) by integrating it with central constructs from turnover theory. The extended model proposes that domain specific self-efficacy and outcome expectations predict job satisfaction and organizational commitment — the two key job attitudes that have been established as influential predictors of turnover cognitions and behaviors. Further, we proposed that one form of organizational supports, specifically developmental opportunities at work, are sources of self efficacy and outcome expectations, and that the relationship between organizational supports and job attitudes is mediated by self-efficacy and outcome expectations. The proposed model was tested on a national sample of 2,042 women engineers. Overall, the results provided support for our newly developed model. Implications for theory, research, and practice are discussed.     

Assessing the role of aggression,empathy, and self‐serving cognitive distortions in trait emotional manipulation

This study extended the examination of the predictors of emotional manipulation. Participants (N = 243) completed measures of trait emotional manipulation, emotional intelligence, social skills, psychopathy, aggression, empathy, and self‐serving cognitive distortions in a cross‐sectional correlational design. For males, higher levels of emotional intelligence, social information processing, indirect aggression, and self‐serving cognitive distortions significantly predicted emotional manipulation. For females, being younger, higher levels of emotional intelligence, indirect aggression, primary psychopathic traits, and lower levels of social awareness significantly predicted emotional manipulation. However for females, emotional intelligence acted as a suppressor. These findings support previous indications that the mechanisms behind emotional manipulation differ as a function of gender. Future research could include ability, rather than trait measures of emotional manipulation, as well as the role of context (such as intimate relationships or workplace environments), thereby allowing additional examination of the nomological network of emotional manipulation.     

The current state of research by Polish linguists on the Brest Bible: an overview

Abstract

2013 marked the 450th anniversary of the publication of the Brest Bible (1563), the first Protestant (Reformed) translation of the entire Bible into Polish. This translation coincided with the mature phase of the Polish Renaissance, which was at the same time a key period in the history of Reformed thought. According to researchers, the Brest Bible is characterized by typographical and translational novelty and numerous linguistic qualities which have also gained recognition for it among Catholic theologians and contemporary Bible translators. This article presents the current state of research on various aspects of the language of the Brest Bible as carried out by Polish linguists. It demonstrates the high value of the language of the Brest Bible, its place among Polish biblical translations and the important role it played in the development of Polish language and culture.     

A comparison of two online cognitive‐behavioural interventions for symptoms of depression in a student population: The role of therapist responsiveness

Objectives: The study aimed to compare the efficacy of eight weekly sessions of a self‐administered online CBT treatment (cCBT; n=51) to a therapist‐assisted email CBT treatment (eCBT; n=50) in University students. Design: The design was a randomised parallel group trial. The study randomised participants with symptoms of depression to one of two available treatments. Method: Participants were offered eight weekly sessions of either cCBT or eCBT. Participants completed the Beck Depression Inventory‐II (BDI‐II) and the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE‐OM) at pre‐and post‐treatment, at weeks 16 and 32 follow‐up. The Working Alliance Inventory‐Short Form (WAI‐SR) was completed at weeks 2, 4, and 6. Results: For both groups, pre‐post within group effect sizes reported were large for the BDI‐II and the CORE‐OM and these were maintained at follow‐up. Perceptions of working alliance were similar in each group, but Bond was significantly stronger for the eCBT condition. WAI scores correlated more positively with the outcome on BDI‐II for those in the eCBT condition than the cCBT condition, but not significantly. Conclusion: There were no significant differences between the two online treatments, both reduced depressive symptoms and improved general functioning. Similarly, at post‐treatment and follow‐up, clinical improvement and recovery was demonstrated for both groups equally. The study demonstrates the possibility for cCBT in a university setting that may contribute to addressing the shortcomings in meeting increasing demands that mental health services presently face.     

An exploration of the therapeutic process while using computerised cognitive behaviour therapy

Background: Modern technologies that offer an alternative to face‐to‐face therapy have gained ground in the NHS. Critics have argued that some of the important elements of the therapeutic change process necessarily require a human therapist. Yet, the traditional understanding of the change process in psychotherapy is challenged by evidence that some computerised cognitive behaviour therapy (cCBT) programs may be as effective as face‐to‐face therapy, suggesting that in certain cases the interaction between user and a cCBT product satisfies sufficient criteria for personal change without the need for actual human contact. Aim: This study used the cCBT package Blues Begone as a means of investigating the process by which a computer‐mediated program helped adults with mild depression help themselves. Method: Seven qualitative interviews were conducted with mildly depressed users who had completed Blues Begone in their own homes without any additional human help or support. Findings: Interpretive phenomenological analysis (IPA) was performed with four main themes emerging. These were: the meaningful relationship; shape from confusion; stimulation and empowerment. This study illustrates some of the ways that some depressed users make use of cCBT self help.     

Do Cognitive Interview Instructions Contribute to False Beliefs and Memories?

To examine whether exposing people to false events using instructions taken from the cognitive interview creates false beliefs and false memories, we conducted an experiment where participants took part in two sessions. First, they rated how confident they were that they had experienced certain childhood events and their memories of those events; they also rated how plausible they thought the events were. Second, 2 weeks later, participants were exposed to two of three false target events: one high, one moderate, and one low plausibility. For the first event, participants were instructed to either report everything or mentally reinstate the event context. For the second event, participants received both instructions. The third event was the control event about which participants received no instructions. Finally, participants rated their confidence and memories the second time. The results showed that the cognitive interview instructions had little to no effect on the development of false beliefs and false memories. Copyright © 2012 John Wiley & Sons, Ltd.