‘A necessary evil’: associations with taking medication and their relationship with medication adherence

Cognitive factors, like beliefs, have been studied extensively as determinants of medication adherence, while affect associated with taking medicines has been studied much less. In the present study (N = 525), we investigated affect by assessing patients’ first associations with taking their medicines. Results showed that these associations were related to self-reported medication adherence: Patients who associated taking medicines with negative affect were the least adherent, while those associating taking medicines with the need to take medicines were the most adherent. Our results support the idea that affect should be considered an important determinant of adherence.     

Everyday worry in adolescents with and without chronic pain: a diary study

Young people report frequent worry, but we know little about the extent, character, or consequence of worry in adolescence, or individual differences associated with worry. Adolescents with chronic pain are one population that are known to have high levels of anxiety, which is associated with higher levels of disability and depression, impairing function. In this study we report a diary study: adolescents (N = 60; aged 16–18) recorded their worry over seven days. Our first aim was to describe the characteristics of adolescent worry and its consequences in a community sample. Our second aim was to compare the experience of girls to boys, and to compare the experience of those with and without chronic pain. Adolescents reported characteristics of each worry they had throughout the week, including content, frequency, strength, interference, emotion, and the strength of emotion associated with worry content. Adolescents reported the consequence for each content and the strength of the consequence. Worry content and consequences were categorised into four categories; health, relationship, personal competence, and other. Adolescents reported 675 unique episodes of worry over the seven-day period that were predominantly about personal competence. The strength of worry content was (M = 6.61, SD = 1.27) and the strength associated with the worry consequence was (M = 5.59, SD = 1.41). Worries were not reported as highly interfering (M = 4.14, SD = 1.61). Contrary to predictions, there were no differences in worry characteristics between adolescents with and without chronic pain. To conclude, worry is a frequent occurrence in older adolescents and the characteristics of worry are discussed. Adolescents worry mostly about personal competence. Adolescents with and without chronic pain reported similar worry characteristics.     

Meaning in life and violations of beliefs and goals: reciprocal relations among individuals with congestive heart failure

Background and objectives: In the context of highly stressful experiences, violations of beliefs and goals and meaning in life may have a reciprocal relationship over time. More violations may lead to lowered meaning, whereas higher meaning may lead to lowered violations. The present study examines this relationship among congestive heart failure (CHF) patients.

Design: A cross-lagged panel design was used.

Methods: CHF patients (N?=?142) reported twice, six months apart, on their meaning in life and the extent to which CHF violates their beliefs and goals.

Results: Overall, results were consistent with a reciprocal relationship, showing that greater goal violations led to negative subsequent changes in meaning, whereas greater meaning led to favorable subsequent changes in violations of beliefs and goals.

Conclusions: Meaning in life and violations may contribute to one another, and therefore, in understanding the adjustment process, it is important to consider their interrelationship. The results are also broadly informative regarding the experience of meaning, showing that disruption of beliefs and goals may undermine meaning.     

Influences on help-seeking pathways among people with chronic illness and disease in a rural South African community

The study sought to explore influences on help-seeking pathways followed by patients with chronic illness and disease (CID) in a rural community of the Limpopo Province, South Africa. The sample consisted of ten people with CID (female = 6; age range 42 to 96 years; sugar diabetes = 50%, and high blood pressure = 30%). The participants responded to semi-structured interviews pertaining to the influences on their choices for help-seeking pathways. The data were analysed applying Interpretative Phenomenological Analysis (IPA). Prevailing influences on help-seeking pathways with CID included presumed cause of the illness, diagnosis agent and family process, nature of preferred treatment modality, and openness to alternative and complementary medicine.     

Stupidity in the analytic field: Vicissitudes of the detachment process in adolescence

This paper has the objective of broadening the understanding of technical aspects in working with adolescents who defend themselves against detachment from infantile aspects through defensive organizations. These organizations numb the adolescent toward both triangular reality and narcissistic defenses. The families of such young people may be part of the organization and the analyst can also be recruited to participate in it. But the analyst's perception can become blurry and this fact makes him appear stupid. Aspects of the myths of Narcissus and Oedipus are used here as models for studying stupidity. The analysis of a psychotic teenage girl who is symbiotic in relation to her family shows how the analytical field can be invaded by defensive configurations. Collusions of idealization and domination/submission involve the young person, her family and the analyst but the defensive organizations are only identified after their traumatic breakdown. The expansion of the symbolic network allows symbiotic transgenerational organizations to be identified, while models related to enactments prove helpful for understanding technical ups and downs. The paper ends with imaginative conjectures where Oedipus, as ‘patient’, is compared to the patient discussed here. These conjectures lead to reinterpretations of aspects of the Oedipus myth. The reinterpretations, together with the theoretical and clinical study, may serve as models for understanding the technical ups and downs in working with troubled teens.     

Subjective age and sleep in middle-aged and older adults

Objective: Chronological age is commonly used to explain change in sleep. The present study examines whether subjective age is associated with change in sleep difficulties across middle adulthood and old age.

Design: Participants were drawn from the second (2004–2005) and third (2013–2014) waves of the Midlife in the United States Survey (MIDUS, N = 2350; Mean Age: 55.54 years), the 2008 and 2014 waves of the Health and Retirement Study (HRS, N = 4066; Mean Age: 67.59 years) and the first (2011) and fourth (2014) waves of the National Health and Aging Trends Survey (NHATS, N = 3541; Mean Age: 76.46). In each sample, subjective age, sleep difficulties, depressive symptoms, anxiety and chronic conditions were assessed at baseline. Sleep difficulties was assessed again at follow-up.

Main outcome measures: Sleep difficulties.

Results: An older subjective age at baseline was related to an increase in sleep difficulties over time in the three samples, and was mediated, in part, through more depressive symptoms, anxiety and chronic conditions. Feeling older was associated with an increased likelihood of major sleeping difficulties at follow-up in the three samples.

Conclusion: Subjective age is a salient marker of individuals’ at risk for poor sleep quality, beyond chronological age.     

欺骗判断与欺骗行为中自我控制的影响

欺骗判断与欺骗行为有着不同的心理机制, 正确认识二者之间的关系有助于增强人际间的信任和团队的长远利益。采用行为学实验从两种视角下考察自我控制对欺骗的影响。实验1采用材料评定的方法考察了识别他人自我控制能力状况对欺骗判断的影响, 结果发现对比高自我控制能力的人, 被试更倾向于认为低自我控制能力的人更有可能为了自己的利益产生欺骗行为和欺骗倾向。实验2采用颜色Stroop任务考察了识别他人自我控制资源衰竭状况对欺骗判断的影响, 结果发现当识别他人自我控制资源衰竭时, 在评价他人为自己利益去欺骗、为他人利益去欺骗以及在特定情境中欺骗倾向上, 没有发现任何显著的主效应或交互作用。实验3采用视觉−感知任务来考察不同水平的自我控制能力对欺骗行为的影响, 结果发现, 对比高自我控制组, 低自我控制组有更多的欺骗行为和欺骗倾向。实验4采用颜色Stroop任务和视觉−感知任务来考察自我控制资源对欺骗行为的影响, 结果发现, 对比控制组, 自我控制资源衰竭组有更多的欺骗行为和欺骗倾向。这些研究结果表明, 在进行欺骗判断时, 相比自我控制资源状况, 个体会优先识别他人的自我控制能力水平来判断其是否具有欺骗动机或欺骗倾向。在欺骗行为中, 高自我控制能力的个体, 能够更好地抑制自私动机, 更多的考虑长远利益, 出于自身利益去欺骗的可能性会更小; 自我控制资源充足的个体, 更有可能会经得住诱惑, 自私自利的欺骗行为发生的可能性也会更小。     

疼痛恐惧相关的注意偏向及其矫正

疼痛恐惧是影响和维持慢性痛的重要因素。不同材料和被试类型情况下, 疼痛恐惧均主要作用于个体对疼痛相关信息的早期注意加工阶段, 表现为注意警觉模式。该注意模式使个体将注意维持在疼痛上, 从而干扰了对非疼信息的注意能力。矫正疼痛恐惧相关注意偏向可以改善疼痛体验。未来研究应采用更具生态效度的任务测量疼痛恐惧相关的注意偏向及其神经基础, 进一步考察矫正疼痛恐惧相关注意偏向能否改善慢痛患者的忧郁和功能丧失等问题。     

近三十年小儿肾小球疾病治疗的回顾

总结了28年共2453篇有关小儿肾小球疾病治疗的文献,发现其发展规律符合科学的发展观药物的选择趋向于疗效肯定而且毒副作用小的药物,新方法新技术不断涌现,药物疗效的评价日趋合理,药物作用机制从系统、器官水平深入到细胞、分子及基因水平,各学科间的合作与联系增加。     

慢性心力衰竭与恶性肿瘤发病机制的理论比较

阐明慢性心力衰竭的病理生理机制对制定防治策略具有重要的作用.根据"内因"与"外因"的辩证关系,借鉴时肿瘤发病机制的一些认识,从另外一个角度对慢性心力衰竭的发病机制进行细致的剖析,以期为临床防治提供一个全新的方向.