Do patients suffering from chronic diseases retrospectively overestimate how healthy they were before they fell ill?

Background/Objective: To examine the impact of a disease on a person's subjective health state, patients are often asked to assess their current health state and to retrospectively assess how healthy they were before they fell ill. The objective of this study was to test whether patients generally overestimated the quality of their pre-disease health. Method: Six samples of patients with chronic diseases (cancer patients, cardiovascular patients, and patients diagnosed with sarcoidosis, N between 197 and 1,197) were analyzed. The patients assessed their current health states and their health states at the time before diagnosis. The retrospective scores were compared with matched data from general population studies. Results: In three of the six studies, the retrospective health ratings of the patients were significantly higher than the general population norms (effect sizes between 0.24 and 0.46), two studies yielded nonsignificant effects, and in one study there was an opposite trend. The general overestimation of pre-disease health was more pronounced in older patients as compared with younger ones, and it was more pronounced when global health/quality of life was to be assessed. Conclusions: Retrospective assessments of pre-disease health states are not appropriate for assessing disease-related changes in a person's health state.     

Loneliness predicts suicidal ideation and anxiety symptoms in long-term childhood cancer survivors

Background/ObjectiveLong-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method: A registry-based sample of N = 633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). Results: Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). Conclusions: Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. The extent to which young cancer patients’ re-integration into society is successful could thus have important implications for well-being in adulthood.     

A LONGITUDINAL,PERSON‐CENTERED ANALYSIS OF EARLY HEAD START MOTHERS’ PARENTING

This study used a person‐centered approach to examine stability and change in parenting typologies across early childhood. Profiles were associated within and across time with contextual covariates, including demographic characteristics, risk factors, and Early Head Start participation. Participants were drawn from the Early Head Start Research and Evaluation Project (N = 2, 876). Parenting profiles were identified based on observed parenting dimensions at 14, 24, and 36 months, and pre‐Kindergarten (pre‐K). Results suggested a four‐profile solution at each time point: Supportive, Lukewarm (14 & 24 months)/Sufficient (36 months and pre‐K), Harsh, and Detached. Supportive was the largest, most stable, and most likely transitioned into profile while Harsh and Detached represented rare profiles with moderate to low membership stability across time. Depression and family conflict emerged as important correlates of unsupportive parenting profiles both within and across time. Findings are discussed in terms of their relevance for both policy and implementation practices for low‐income mothers with young children.     

OBSERVATION AND COMPARISON OF MEALTIME BEHAVIORS IN A SAMPLE OF CHILDREN WITH AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDERS AND A CONTROL SAMPLE OF CHILDREN WITH TYPICAL DEVELOPMENT

Despite widespread use of behavioral observations to evaluate child feeding behaviors in research and clinical practice, few studies have comprehensively characterized mealtimes or identified features that differentiate children with and without disordered feeding; these were the aims of the current study. Mealtime observations were conducted for 18 children with avoidant restrictive food intake disorder (ARFID) and 21 typically developing children. Observations were coded inductively, and associations between disorder and observed mealtime actions were examined. Most behaviors were observed across both clinical and nonclinical mealtimes, and many did not differ in frequency between children with and without ARFID. However, significant group differences were observed in the frequencies of behaviors relating to food intake, visual and physical engagement with feeding, and movement during mealtimes. The comparability of behaviors across clinical and nonclinical groups suggests that eating behaviors exist on a continuum from “normal” to “abnormal,” with group differences relating to frequency rather than type of behavior. The behavioral differences observed in this study suggest that identification of children with ARFID should focus on child engagement with food and restlessness during mealtimes. Reliance on emotional and escape‐maintained behaviors will lead to underrecognition of families in need of clinical support.     

The link between stress,well-being,and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention

Background/Objective: Prolonged stress can overwhelm coping resources, leading people to seek mental health care. Acceptance and commitment therapy (ACT) is an intervention that enhances well-being and reduces distress, assumedly by means of increasing psychological flexibility (PF). We examined the association between a total increase in PF during an intervention and decreases in stress and increases in well-being during and after the intervention. Method: The intervention was a randomized controlled trial of an ACT-based self-help intervention. Participants were 91 individuals reporting elevated levels of work-related stress. Measurements were completed at preintervention, postintervention, and 3-month follow-up. Results: Structural equation models revealed that the total increase in PF during the intervention was negatively associated with a decrease in stress (b = -0.63, SE = 0.14, p < .001) and positively associated with an increase in well-being during the intervention (b = 0.48, SE = 0.11, p < .001), but not with a decrease in stress (b = 0.03, SE = 0.27, p > .05) and well-being (b = -0.04, SE = 0.39, p > .05) following the intervention. Conclusions: Our study provides empirical support for decreasing stress and promoting well-being through ACT and emphasizes the potential of PF in promoting well-being.     

Psychometric properties of the Shared Decision-Making Questionnaire (SDM-Q-9) in oncology practicePropiedades psicométricas del Questionnaire Shared Decision-Making (SDM-Q-9) en oncología

Background/Objective: This study sought to assess the psychometric properties of the 9-item Shared Decision-Making Questionnaire (SDM-Q-9) in patients with resected, non-metastatic cancer and eligible for adjuvant chemotherapy. Method: A total of 568 patients were recruited from a multi-institutional, prospective, transversal study. Patients answered the SDM-Q-9 after visiting their medical oncologist who, in turn, completed the SDM-Q–Physician version. Reliability, factorial structures [exploratory factor analysis (EFA), confirmatory factor analysis (CFA)], and convergent validity of the SDM-Q-9 scores were explored. Results: SDM-Q-9 showed a clear factorial structure, compatible with a strong and replicable general factor and a secondary group factor, in patients with resected, non-metastatic cancer. Total sum scores derived from the general factor showed good reliability in terms of omega coefficient: .90. The association between patient and physician perception of SDM was weak and failed to reach statistical significance. Males and patients over 60 years of age displayed the greatest satisfaction with SDM. Conclusions: SDM-Q-9 can aid in evaluating SDM from the cancer patients’ perspective. SDM-Q-9 is helpful in studies examining patient perspectives of SDM and as an indicator of the degree of quality and satisfaction with health care and patient-physician relationship.     

Let's Talk About Race: Evaluating a College Interracial Discussion Group on Race

The authors evaluate Dialogues on Race, an interracial group intervention in which undergraduate student facilitators led conversations about race with their peers. The evaluation process is described, including developing collaborative relationships, identifying program goals, selecting measures, and analyzing and presenting results. The authors discuss lessons learned about evaluating an interracial dialogue intervention that did not originally include researchers in the hope that this examination will encourage others to evaluate similar campus interventions. Diálogos sobre Raza es una intervención de grupo interracial en la que estudiantes universitarios moderaron conversaciones sobre raza con sus compañeros. Se describe el proceso de evaluación, incluyendo el desarrollo de relaciones de colaboración, la identificación de objetivos del programa, la selección de medidas, y el análisis y presentación de los resultados. Los autores discuten las lecciones aprendidas sobre la evaluación de una intervención interracial dialogada que en principio no incluyó a investigadores con la esperanza de que este examen animará a otros a evaluar intervenciones similares en sus campus.     

Construction et validation de l’échelle de mesure des croyances relatives à la laïcité

Recently, social psychology has taken an interest in attitudes and beliefs about laïcité and their relations to other variables, such as expressions of prejudice. Laïcité can be defined as the separation of churches and State, the role of the State being to assure an equality and a freedom of religion. The aim of this study was to construct a measure of beliefs of laïcité, and then to compensate for the lack of reliable measures about the possible interpretations of laïcité. The exploratory (study 1) and confirmatory factor analyses (study 2) led to sixteen items being included in the scale and representing four laïcité dimensions: public expression of religious beliefs, religious neutrality of the State and its institutions, equality of different religious beliefs, and protection of religious groups. Correlations across different dimensions showed that the public expression of religious beliefs was positively correlated with equality of different religious beliefs and negatively to neutrality of the State and its institutions. Moreover, convergent and discriminant validity (studies 2 and 3) showed that dimensions of laïcité are differently correlated with prejudice, SDO, religiosity, or with the republican model's adhesion. t-tests showed that compared to Catholics, agnostics and atheistics want a stronger religious neutrality of the State, are more in favor of an equalitarian treatment of different religious beliefs, but are less in favor of a protection of religion by State. Concerning the attachment to laïcité, this variable is only very weakly correlated with the four dimensions. Statistical analysis conducted on attachment to laïcité and other psychosocial variables such as prejudice, social dominance orientation (SDO), religiosity, religious beliefs (atheistics and agnostics vs. catholics) and political orientation showed that only SDO is (negatively) related to attachment to laïcité. These results suggest different conceptions of laïcité depending on psychosocial variable such as religion, prejudice or SDO. Finally, a test-retest has been effected on the scale (study 4). The results shown that the adhesion to the laïcité’s dimensions is stable in the time.     

Evaluation of a French parent-training program in young children with autism spectrum disorder

Parent training programs (PTs) in young children with autism spectrum disorders (ASDs) are known to reduce parenting stress and improve child's behavior and parent-child interactions. Few PTs are available to French speaking families. In order to provide them with this type of intervention, we developed a French parent-training program of 12 bimonthly sessions and three individual home visits based on applied behavior analysis. The purpose of this study is to evaluate the social validity and efficacy of this new PT on eighteen parents who have a child with ASD and developmental delay. For 16 parents, the PT was considered effective, the objectives targeted important and the strategies learned acceptable for use with children. They have significantly improved their knowledge in ASD and behavioral intervention strategies and their children's socialization skills, and reduce their parental stress. This new French PT program seems to be a promising intervention.