Evaluative Concerns and Personal Standards Perfectionism: Self-esteem as a Mediator and Moderator of Relations with Personal and Academic Needs and Estimated GPA

We examined the mediational role of self-esteem in the relation between evaluative concerns (EC) and personal standards (PS) perfectionism, and measures of personal concerns, academic concerns, and estimated grade point average (EGPA) in 386 university students. Self-esteem partially mediated the relation between EC perfectionism and students’ personal and academic concerns. EC perfectionism was a weak predictor of EGPA. PS perfectionism was not related to academic concerns. Although PS was associated with personal concerns both directly and indirectly through low levels of self-esteem in women only, these findings did not hold when controlling for EC perfectionism. PS perfectionism had a direct positive relation with EGPA. Neither PS nor EC perfectionism interacted with self-esteem to predict unique variance in personal or academic concerns or EGPA. The results are consistent with our view that a perfectionism dimension that is primarily maladaptive can be distinguished from a dimension that can be adaptive. The implications for research and treatment are considered.

Cancer Genetic Counseling: Communication and Counselees’ Post-Visit Satisfaction,Cognitions, Anxiety,and Needs Fulfillment

Little is known about the relation between communication during cancer genetic counseling and outcome. We assessed associations between counselor-counselee communication and counselee satisfaction, cognitions, anxiety, and fulfillment of major needs, corrected for pre-visit levels as appropriate. In total 171 consecutive new counselees, mainly referred for breast or colon cancer, received pre- and post-visit questionnaires assessing needs/fulfillment, knowledge, perceived control (PPC), anxiety (STAI), and satisfaction. Initial visits were videotaped and counselor eye gaze was recorded. Verbal communication was rated by Roter Interaction Analysis System (RIAS). Asking more medical questions was associated with lower satisfaction levels. Receiving more medical information was related to higher correct knowledge scores, higher reported fulfillment of some needs, and unrelated to perceptions of control. Receiving more psychosocial information and longer counselor eye gaze were related to higher anxiety scores. Longer visits were related to higher correct knowledge scores. Providing medical information appears the most powerful communication aspect to increase counselee satisfaction and address needs. More research is needed on how to address adequately (emotional) needs and increase feelings of control.     

Self-esteem,motivation and school attendance among sub-Saharan African girls: A self-determination theory perspective

Sub-Saharan samples are severely under-represented in the psychological literature. Taking an ecological approach, the current study examines key propositions derived from self-determination theory in a sample of adolescent girls in Mozambique. As a framework theory, self-determination theory consists of six sub-theories. We test the main premises of two of these theories: organismic integration theory and basic psychological need theory. In line with organismic integration theory, we assess the role of intrinsic, extrinsic, introjected and identified motivation for school attendance. We also test the possible moderating role of the ecological variable resource scarcity. The second part of the study focuses on the main premise of the basic psychological need sub-theory, which states that satisfaction of the needs for relatedness, competence and autonomy underlies intrinsic motivation, goal-directed behaviour (school attendance) and well-being (self-esteem). The study also assesses the moderation of resource scarcity in these relationships. Results provide support for both sub-theories of self-determination theory. Resource scarcity is not found to moderate the relationships between motivation and attendance or between need satisfaction and well-being, motivation and attendance. Implications for the universality claim of self-determination theory, as well as for the field of international development aid, are discussed.     

An exploration of the mechanisms of change following an integrated group intervention for stuttering,as perceived by school-aged children who stutter (CWS)

PurposeTo explore the process of change and role of resilience following an integrated group intervention for children who stutter (CWS).MethodUsing an exploratory multiple case study design, this research sought to identify the most significant changes perceived by seven participants following therapy, the mechanisms of change, and the role of resilience in the process of change. Quantitative measurements of resilience were combined with qualitative analysis of semi-structured interviews.ResultsThematic analysis of qualitative data showed that cognitive and emotional change was a key driver for therapeutic change, enabled by the shared experience of the group and a positive therapeutic environment. These changes were generalised into clients’ real-world experiences, facilitated by their support network. Quantitative data demonstrated a statistically reliable positive change in overall Resiliency scores for four participants and reduced impact of stuttering scores on OASES-S for all participants, maintained at 12 month follow-up.ConclusionsThis study demonstrates the importance of adopting an integrated approach in therapy for CWS, which incorporates Cognitive Behavioural Therapy (CBT) as a key component, to facilitate change and build resilience. These results are unique to this cohort of CWS and further investigation into the use of CBT and the process of change may be warranted.Educational ObjectivesThe reader will be able to (1) describe the integrated intervention used in this study (2) define the most significant change following therapy for the participants involved (3) summarise the key factors that facilitated change during the therapy process (as perceived by the participants).     

Developing comprehensive,individualized community-based services for children and youth with emotional and behavior disorders: Direct service providers' perspectives

Increased attention to the plight of children and youth with emotional or behavioral disorders (EBD) and their families has led to innovations in the manner in which these individuals are served. Two such innovations have been the development of public systems of comprehensive, community-based care and individualized wraparound services. This study was part of one community's attempt to merge these two innovations and provide individualized wraparound services to children and youth with EBD through the auspices of public agencies. Direct service providers were surveyed to gather their input into how such services could best be developed and implemented. The survey focused on existing barriers to providing services and specific service priorities for system development. Methods and results are presented. Implications for the local system and future research needs are discussed.     

Coming to terms: Client subjective experience of ending psychotherapy

How do clients consider their own contribution and that of their therapist in the last phase of therapy when they are moving toward the end? Thirty-seven clients who had received therapy from highly experienced clinicians were interviewed. Since the time for ending had not been decided at the onset, clients in both short- and long-term therapies were included. Thematic case-by-case analyses were carried out. Clients actively engaged in looking back and looking ahead, as means of reflecting on their capability to handle issues on their own. The majority of clients were satisfied with what they perceived as a reciprocal engagement that enabled them to come to terms with emotionally charged issues in life and in therapy. For some clients unresolved issues remained: wondering whether a therapist with another approach could have helped more; feeling pushed away by the therapist; having to take the lead in ending therapy; the fear of being an “unworthy” client; or wanting to end without the therapist’s approval. Coming to terms with the ending of therapy was highly personally meaningful and loaded with affective tensions, in ways that were not always shared with their therapist.     

La « préparation magistrale » en droit français : un lot exclusif par patient ?

Outpatient pharmaceutical needs are not always met by industrial products and do not necessarily justify hospitals activation. Preparing in advance and storing a batch of compounded drugs for one or more patients with identical/recurrent needs – as part of compound outsourcing in ambulatory sector – raises issues. While the french law does not expressly provide (and according to prevailing interpretations excludes) this hypothesis, it seems to us to be possible – in contrast to the prominent french judicial and administrative courts, as well as to the European Court of justice. We here propose to reset the debate within both the existing laws and a systemic perspective, and call for a normative clarification.     

Icy roads and urban environments. Passenger experiences in autonomous vehicles in Finland

This study focused on identifying customerś real-life experiences, perceptions and feelings about travelling in different autonomous vehicles and in various operating conditions in Finland in 2018. Quantitative convenience sample (n = 141) were collected from passengers travelling on an autonomous shuttle bus in Helsinki. Qualitative data (n = 70) were gathered by interviewing passengers of a driverless shuttle bus in Helsinki and passengers of an autonomous car in winter conditions in Lapland. This research was first one which included passengers’ real-life experiences after using autonomous vehicles in winter conditions. We applied the Theory of Planned Behaviour. The research questions were (a) What beliefs about outcomes and evaluation of outcomes do passengers have and carry out when they travel in an autonomous vehicle, irrespective of vehicle type or operating conditions? (b) What key factors influence people’s positive or negative attitudes towards autonomous vehicles? (c) What key factors could induce people to use autonomous vehicles? The quantitative data were analysed by nonparametric Kruskal-Wallis H test and qualitative data by inductive content analysis. According to the results, trust, safety and security were the main factors influencing people’s positive attitudes towards using autonomous vehicles. Results from passengers travelling in heavy winter conditions indicate that winter conditions do not significantly influence passengers’ attitudes towards using autonomous vehicles. There were no significant differences between gender regarding passengers’ perceptions of traffic safety, personal security and emergency management. However, younger passengers felt their personal security on board to be significantly better than older and students their possibilities to act in a case of emergency significantly better than employed people.