Waiting for a kidney from a deceased donor: an interpretative phenomenological analysis

Demand for kidneys from deceased donors far outstrips supply. Despite this, there appears to be little research that focuses solely on the experience of waiting for a kidney from a deceased donor. This study uses the qualitative methodology interpretative phenomenological analysis to explore the lives of 10 people on the transplant list, with the aims of illuminating the potential psychological challenges those on the list may face during this time, and providing information to help clinicians more fully support such people in the future. Two themes connected to the experience of waiting – adjustment to the uncertainty of waiting and thinking about receiving a kidney from a living donor – are presented here. Participants describe a sense of confusion and uncertainty around life on the list, and discuss their strategies for dealing with this. Novel complexities around the ambiguous challenge of receiving an organ from a deceased donor are revealed. It is recommended that health care teams provide a forum for this patient group to work through these feelings of confusion and ambiguity.     

Making Sense of Dynamic Systems: How Our Understanding of Stocks and Flows Depends on a Global Perspective

Stocks and flows (SF) are building blocks of dynamic systems: Stocks change through inflows and outflows, such as our bank balance changing with withdrawals and deposits, or atmospheric CO₂ with absorptions and emissions. However, people make systematic errors when trying to infer the behavior of dynamic systems, termed SF failure, whose cognitive explanations are yet unknown. We argue that SF failure appears when people focus on specific system elements (local processing), rather than on the system structure and gestalt (global processing). Using a standard SF task (n = 148), SF failure decreased by (a) a global as opposed to local task format; (b) individual global as opposed to local processing styles; and (c) global as opposed to local perceptual priming. These results converge toward local processing as an explanation for SF failure. We discuss theoretical and practical implications on the connections between the scope of attention and understanding of dynamic systems.     

Trait interpersonal vulnerability attenuates beneficial effects of constructive criticism on failure responses

The extant literature on interpersonal criticism suggests that relative to destructive criticism, constructive criticism significantly minimizes the injurious psychological aftermath people experience after failure. However, we propose the possibility that for some people, these psychological benefits of constructive criticism are less apparent. Specifically, we hypothesized that for people high in trait interpersonal vulnerability, a construct marked by maladaptive cognitive‐emotional responses in interpersonal contexts and/or by dysfunctional relational concerns, effects of constructive (vs. destructive) criticism on reduced maladaptive appraisals will diminish, and this diminution of reduced maladaptive appraisals will predict downstream effects on worsened post‐failure mood. An experiment had a college sample (N = 349) complete four instruments represented under an interpersonal vulnerability construct (IVC). Next, participants imagined failing in various domains and receiving subsequent feedback from emotionally important others. Feedback type was manipulated to typify either destructive criticism or constructive criticism. Finally, participants provided ratings of maladaptive appraisals and post‐failure mood. Latent variable path modelling supported hypotheses. Effects of constructive (vs. destructive) criticism on reduced maladaptive appraisals (namely, shame proneness) diminished as IVC increased, which predicted worsened post‐failure mood. Findings have implications for multidisciplinary theoretical perspectives relevant to interpersonal vulnerability and offer practical considerations for clinicians working with vulnerable clients.     

运动员情绪调节心率变异性的影响因素

以183名运动员为被试,以心率变异性为指标,考察不同情绪状态、不同情绪调节策略下运动员自主神经反应的性别、运动年限、运动等级特点。结果发现：（1）快乐情绪状态下的心率变异性显著高于悲伤情绪状态下;表达抑制的心率变异性显著高于认知重评;短运动年限运动员的心率变异性显著高于长运动年限运动员;男性运动员的心率变异性显著高于女性运动员。（2）在快乐情绪状态下采用表达抑制策略时,低运动等级运动员的心率变异性显著高于高运动等级运动员;在悲伤情绪状态下,高运动等级运动员采用表达抑制策略比认知重评策略产生更高的心率变异性     

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.     

Enhancing treatment effectiveness through social modelling: A pilot study

Objective: Medical treatments take place in social contexts; however, little research has investigated how social modelling might influence treatment outcomes. This experimental pilot study investigated social modelling of treatment effectiveness and placebo treatment outcomes.

Design: Fifty-nine participants took part in the study, ostensibly examining the use of beta-blockers (actually placebos) for examination anxiety. Participants were randomly assigned to observe a female confederate report positive treatment effects (reduced heart rate, relaxed, calm) or feeling no different.

Main outcome measures: Heart rate, anxiety and blood pressure were assessed, as were symptoms and attributed side effects.

Results: Heart rate decreased significantly more in the social modelling compared to control condition, p = .027 (d = .63), and there were trends towards effects in the same direction for both anxiety, p = .097 (d = .46), and systolic blood pressure, p = .077 (d = .51). Significant pre-post placebo differences in heart rate, anxiety and diastolic blood pressure were found in the social modelling group, ps < .007 (ds = .77–1.37), but not the control condition, ps > .28 (ds = .09–.59).

Conclusions: Social observation of medication effectiveness enhanced placebo effectiveness in heart rate, and showed a trend towards enhancing treatment effectiveness in both anxiety and systolic blood pressure. Social modelling may have utility in enhancing the effectiveness of many active medical treatments.     

Cognitive and attentional functioning in adolescents and young adults with Tetralogy of Fallot and d-transposition of the great arteries

The objective of this study is to investigate cognitive and attentional function in adolescents and young adults with operated congenital heart disease. Previous research has indicated that children with congenital heart disease have deficits in broad areas of cognitive function. However, less attention has been given to survivors as they grow into adolescence and early adulthood. The participants were 18 non-syndromic adolescents and young adults with tetralogy of Fallot and d-transposition of the great arteries that required cardiac surgery before the age of 5 years, and 18 healthy, unaffected siblings (11–22 years of age for both groups). Cases with congenital heart disease and their siblings were administered Wechsler Intelligence scales and reported attention problems using the Achenbach System of Empirically Based Assessments. Cases were compared to both healthy siblings and established norms. Cases performed significantly lower than siblings on full scale IQ and processing speed, and significantly lower than norms on perceptual reasoning. Cases also reported more attention problems compared to both siblings and norms. Effect sizes varied with medium-to-large effects for processing speed, perceptual reasoning, working memory, and attention problems. Findings suggest that neurocognitive function may continue to be affected for congenital heart disease survivors in adolescence and young adulthood, and that comparisons to established norms may underestimate neurocognitive vulnerabilities.     

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。     

构建科学的冠心病介入治疗临床决策

临床决策已成为临床医学的重要内容,但目前还为许多冠心病介入医生所忽视。阐述了临床决策的概念,分析了冠心病介入治疗决策中存在的问题及原因,探讨了如何构建科学的冠心病介入治疗决策,为冠心病介入治疗合理应用提供科学的决策方法。