Quality of Life in Pediatric Cancer Patients: The Relationships Among Parents’ Characteristics,Children’s Characteristics,and Informant Concordance

As advancements in the treatment of childhood cancer have resulted in increasing survival rates, the psychosocial functioning of child patients has become an increasingly important issue. In this pilot study, we investigate the relationships among parents’ characteristics, children’s characteristics, and the quality of life experienced by children who are diagnosed with cancer. Forty-seven mothers, sixteen fathers, and nineteen children completed measures about their own psychological functioning as well as measures about the children’s quality of life. Mothers’ ratings of their children’s quality of life were correlated positively with the ratings provided by both fathers and the children themselves. In addition, significant relationships were found between mothers’ depression and parenting stress and children’s quality of life as well as between mothers’ and fathers’ anxiety and children’s quality of life. Finally, using regression analyses, mothers’, fathers’, and children’s ratings of their own characteristics predicted significantly their ratings of the children’s quality of life. The importance of examining the psychological characteristics of family members when assessing the quality of life of children who are diagnosed with cancer is discussed.     

Self-consciousness impairments in schizophrenia with and without first rank symptoms using the moving rubber hand illusion

IntroductionThe moving rubber hand illusion allows the evaluation both the sense of body ownership and agency using visuo-motor stimulations.MethodsWe used the moving rubber hand illusion in anatomic congruence with explicit measures to compare active asynchronous and passive synchronous movements in patients diagnosed with schizophrenia with first rank symptoms (FRS) (n = 31) versus without FRS (n = 25).ResultsPatients with FRS are characterized by a lack of agency in active asynchronous condition. The two groups had no sense of ownership in synchronous passive condition. Using a multivariate regression model, we found an association between agency and body ownership measures in the active asynchronous condition in two groups (OR: 1.825, p < 0.001). In the passive condition, this association was only present in the group with first rank symptoms (OR: 2.04, p < 0.001).ConclusionTemporal proximity and sensorimotor information are essential in the understanding of self-consciousness disorders in schizophrenia.     

Community,Context, and Coping: How Social Connections Influence Coping and Well-Being for Military Members and Their Spouses

Military members and their spouses (n = 223 families) were selected from an Active Duty Army installation and assessed with regard to their connections with the military community, their levels of coping with military culture demands, and their reports of individual (depression and life satisfaction) and family well-being. Guided by the contextual model of family stress and the social organization theory of action and change, results from a structural equation model indicated that military community connections, for both military members and their civilian spouses, were related to coping with the military culture and its demands, which in turn was related to both individual and family well-being. Unique actor and partner effects also emerged where both active duty military members' and their civilian spouses' perceptions of military community connections influenced the civilian spouses' satisfaction with military life, but only the active duty military members' community connections influenced their military-specific coping. Additionally, the associations between military-specific coping and individual and family well-being only had actor effects. When examined within the context of important military culture elements, namely rank and extent of military transitions (deployment and relocation), these core findings linking communities to coping and well-being were unchanged. Implications for theory, future research, and practice are shared.     

Attachment theory: a framework for understanding symptoms and interpersonal relationships in psychosis

We investigated associations between adult attachment, symptoms and interpersonal functioning, including therapeutic relationships in 96 patients with psychosis. Using a prospective design, we also assessed changes in attachment in both psychiatrically unstable and stable groups. We measured attachment using the Psychosis Attachment Measure (PAM) and interpersonal problems and therapeutic relationships were assessed from both psychiatric staff and patient perspectives. Avoidant attachment was associated with positive symptoms, negative symptoms and paranoia. Attachment ratings were relatively stable over time, although changes in attachment anxiety were positively correlated with changes in symptoms. Predicted associations between high levels of attachment anxiety and avoidance and interpersonal problems were supported, and attachment avoidance was associated with difficulties in therapeutic relationships. Findings suggest that adult attachment style is a meaningful individual difference variable in people with psychosis and may be an important predictor of symptoms, interpersonal problems and difficulties in therapeutic relationships over and above severity of illness.     

Schizophrenia: Disease,Syndrome, or Dimensions?

Schizophrenia has the status of a clinical syndrome and may comprise a number of specific disease entities. This construct is similar to dementia, in which several diseases have been defined within the syndrome. Alternatively, schizophrenia may be a single disease entity with quite variable manifestations across cases. Kraepelin proposed dementia praecox as a disease entity, and Bleuler proposed dissociative pathology as fundamental to each case, thus substantiating the single disease entity concept. More recently, the nuclear schizophrenia construct defined the disease entity using specific criteria proposed by Schneider and Langfeldt. This view has been challenged by a series of studies during the past three decades. These investigations are summarized in this report. Implications for clinical work with families are considered.     

Individual Variation in Psychological and Psychomotor Symptoms Following Smoking Cessation: The Implications for Treatment

Some commonly experienced signs and symptoms occur during abstinence from tobacco, but specific signs and symptoms and their intensity vary greatly from individual to individual. The aim of this study was to re-examine psychological and psychomotor symptoms in smokers in the general population, and to explore the individual variation in these. Quitting smokers (n = 123) reported their experiences pre- and post-cessation, on a questionnaire developed for the study. Analysis of variance and frequency analysis showed significant decreases between pre- and post-cessation on positive experiences (F = 9.81, p<0.0001) but no significant change on negative experiences, suggesting a loss of pleasure rather than increased negative affect upon quitting. The variance of the pre- to post-cessation difference score suggested wide variation in the reporting of withdrawal symptoms. These results lead us to consider the implications for treatment, using cognitive therapies and moderating the significant emphasis that is at present put on withdrawal.     

The Influence of Mothers' and Fathers' Parenting Stress and Depressive Symptoms on Own and Partner's Parent‐Child Communication

This study examines how parenting stress and depressive symptoms experienced by mothers and fathers influence their own (actor effects) and the partner's (partner effects) parent–child communication. Based on the Actor‐Partner Interdependence Model, data from 196 families were analyzed, with both parents rating their parenting stress and depressive feelings, and parents as well as children rating the open parent–child communication. Actor effects were found between parenting stress and open parent–child communication, whereas partner effects were prominent between depressive symptoms and open parent–child communication. The results provide no evidence for gender differences in the strength of the pathways to open parent–child communication. Our findings demonstrate the need to include both parents in studies on parent–child communication to enhance our understanding of the mutual influence among family members.     

The effects of patient's frequency of attendance and etiology of symptoms,on the General Practitioners wellbeing

IntroductionThe presence of Medically Unexplained Symptoms and a high Frequency of Attendance negatively affects the General Practitioners’ (GP) wellbeing. Although, overlapping between both phenomena is partial, with a number of frequent attenders reporting medically unexplained symptoms during consultation, there is no evidence on how GP's well-being it is affected by the specific main effects of these factors and their interaction. Evidence is also scant on the psychological processes explaining the negative impact of attendance and the etiology of symptoms on GP's wellbeing.ObjectiveDrawing on the Job Demand-Control and the Conservation of Resource stress models, this paper tests the moderating effects of the GP’ perception of patient's attendance and etiology of symptoms on the relationship between patient's demands and feedback on the GP's wellbeing.MethodA total of 105 volunteer GPs self-reported on the study variables through an experience sampling methodology after 898 patients’ consultation. Patients attendance and etiology of symptoms were categorized according to the physician self-perception and an external criterion (organizational records).ResultsPerception of Patients Frequent Attendance and Medically Unexplained Symptoms were positively related to physician's Emotional Exhaustion. Contrary to expected the test of the moderation effects of patients characteristics on the relation between patient's demands and feedback and the GP's emotional exhaustion were stronger for normal attenders compared with frequent attenders. An ad hoc study shows this unexplained result is related to the GP's expectations on Frequent vs. normal attenders’ behaviors. No significant results were found when the external criterion of classification was used.ConclusionCombined analysis of Frequency of Attendance and Etiology of Symptoms lead to a better understanding of the GP's decreased wellbeing. Also, the perception of the strain level (demands/positive feedback levels) associated to the consultation with different types of patients contribute to explain the consequences for the GP's wellbeing, especially when GP's expectations on patient's behaviors are violated.