Longitudinal associations between mindfulness and well-being in people with multiple sclerosis

Background/Objective: Depression, anxiety, fatigue, and sleep problems are typical conditions reported in people with multiple sclerosis (MS), often resulting in a reduction of their quality of life (QOL) and well-being. Mindfulness is a multifaceted and complex construct that has been increasingly explored for its correlated to well-being. Despite preliminary evidence, longitudinal data about the impact of mindfulness on QOL in MS remain limited. In addition, Langerian mindfulness, one of the prominent approaches to mindfulness, is yet unexplored in this field. The study aims to examine the longitudinal relationships between two forms of mindfulness (Langerian and contemplative) and QOL, anxiety, depression, fatigue, and sleep. Method: Within a larger randomized controlled trial of an online mindfulness-based stress reduction intervention, a cohort of 156 people with MS was recruited and assessed for both mindfulness constructs, QOL, anxiety, depression, fatigue, and sleep problems. Assessments were repeated after 2 and after another 6 months. Results: Both mindfulness constructs were highly correlated with all investigated outcomes. Both Langerian and contemplative mindfulness predicted higher QOL, lower anxiety, depression, fatigue, and sleep, over time. Conclusions: In both approaches dispositional mindfulness is a protective factor against depression, anxiety, fatigue, and sleep in people with MS.     

个体特征因素对师徒之间选择倾向的影响

师徒的相互选择过程是师徒关系研究中的一个重要问题。本文采用三个实验探讨了影响师徒相互选择倾向的个体特征因素。实验一和实验二探讨了徒弟选师傅时,师傅的外向性、成就动机水平、管理职务和性别一致性对徒弟选择师傅倾向的影响。实验三探讨了师傅选择徒弟时,徒弟的外向性、成就动机水平和性别一致性对师傅选择徒弟倾向的影响。实验结果表明在徒弟选择师傅时,师傅的外向性、成就动机、管理职务,是影响因素;在师傅选择徒弟时,徒弟的外向性、成就动机水平是影响因素。     

Avoidance behavior associated with depressive symptoms in patients with implantable cardioverter defibrillators

Objective: Many patients with implantable cardioverter defibrillators experience depressive symptoms. In addition, avoidance behavior is a common problem among patients with implantable cardioverter defibrillators. We examined the association between avoidance behaviors and depressive symptoms in patients with implantable cardioverter defibrillators. Method: We conducted a single-center, cross-sectional study with self-completed questionnaires between May 2010 and March 2011. We measured avoidance behaviors (avoidance of places, avoidance of objects, and avoidance of situations) and depressive symptoms (using the Beck Depression Inventory, Version II) in 119 participants. An avoidance behaviors instrument was developed for this study and we confirmed its internal consistency reliability. Results: Ninety-two (77.3%) patients were aged older than 50 years, and 86 (72.3%) were men. Fifty-one (42.9%) patients reported “avoidance of places”, 34 (28.6%) reported “avoidance of objects”, and 63 (52.9%) reported “avoidance of activity”. Avoidance behavior was associated with increased odds for the presence of depressive symptoms (OR 1.31; 95% CI 1.06–1.62). Conclusions: This was the first study to identify the relationship between avoidance behavior and depressive symptoms among patients with implantable cardioverter defibrillators; however, there are a few methodological limitations.     

Spanish version of the Sexual Excitation/Sexual Inhibition Inventory for Women: Factorial structure,reliability and validity evidences

Background/Objective: The Dual Control Model suggests that sexual excitation and associated behaviors are the result of the balance between relatively independent excitatory and inhibitory mechanisms. Based on this theoretical model, the Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) was developed to evaluate excitation and inhibition dimensions in women. The aim was to adapt and validate the SESII-W in the Spanish population. Method: A sample of 1,380 heterosexual women (aged 18 to 52) completed the Spanish SESII-W, together with other related instruments. After the translation and adaptation of the SESII-W, a Confirmatory Factor Analysis (CFA) was performed. Results: CFA resulted in a version consisting of 33 items divided into eight sub-factors, which were grouped into two higher-order factors (Sexual Excitation and Sexual Inhibition). The sub-factors demonstrated adequate internal consistency values except for Sexual Power Dynamics and Concerns about Sexual Function. Test-retest reliabilities were good. Their scores correlated with erotophilia, sexual sensation seeking, age at first intercourse, and number of sexual partners in the expected direction. Conclusions: The Spanish version of SESII-W has adequate psychometric guarantees for use in clinical practice and research, although it would be necessary to further revise factors that showed a lower level of reliability.     

Analytical practice: do the new technologies have an impact?

Through commentary on four clinical vignettes, this article focuses on the anthropological transformations taking place in contemporary society, underlining their differences from the anthropologies of reference of the founding fathers of psychoanalysis. Hybridization between man and machine and the speeding up and alteration of communications which the new technologies promote are now crucial issues facing psychoanalysis. Social media and a 24/7 internet connection have produced deep changes in the way people live and perceive relationships. Analytical practice is not exempt from such issues, which can be particularly insidious, often subtle and difficult to recognize, or even underestimated or ignored by psychoanalysts outright, in order to preserve the illusion of a complete understanding of what unfolds in the analytical space. The authors suggest that such transformations, by (partially) rendering inadequate the theoretical and technical corpus on which the various depth psychologies are founded, require personal engagement on the part of psychoanalysts in the search for new strategies to treat their patients, with the consequent abandonment of the ‘certainties’ offered by sclerotic models of clinical procedure.     

Prevalence and correlates of ICD-11 adjustment disorder: Findings from the Zurich Adjustment Disorder Study

Background/Objective: The 11th revision of the International Classification of Diseases (ICD-11) will provide a new definition of adjustment disorder (AjD). The aim of the present study is to report on prevalence and correlates of ICD-11 AjD in a high-risk sample. Method: Three hundred thirty persons who had lost their job involuntarily were sampled by local job centres. The Munich Composite International Diagnostic Interview was administered with a new AjD module. Associations between AjD and correlates were investigated with logistic regression analyses. Results: 27.3% of the participants reported the AjD core symptom pattern. 13.8% men and 17.2% women met diagnostic guidelines of ICD-11 AjD. Prevalence increased with age and exposure to multiple stressors. The AjD core symptom pattern was associated with various sociodemographic correlates (e. g., lower financial household budget), whereas the full ICD-11 diagnosis including the exclusion algorithm was not. Regarding work-related factors, AjD occurred with a lower probability if the last job position had higher responsibilities and more general confidence for the future. Conclusions: ICD-11 AjD has a high prevalence among persons who lost their jobs involuntarily. Healthcare professionals should be aware of this problem. Research to investigate the ICD-11 AjD concept in the general populations and other subpopulations is needed.     

A case-controlled field study evaluating ICD-11 proposals for relational problems and intimate partner violence

Background/Objective: Intimate partner relationship problems and intimate partner abuse and neglect — referred to in this paper as “relational problems and maltreatment” — have substantial and well-documented impact on both physical and mental health. However, classification guidelines, such as those found in the International Classification of Diseases (ICD-10), are vague and unlikely to support consistent application. Revised guidelines proposed for ICD-11 are much more operationalized. We used standardized clinical vignette conditions with an international panel of clinicians to test if ICD-11 changes resulted in improved classification accuracy. Method: English-speaking mental health professionals (N = 738) from 65 nations applied ICD-10 or ICD-11 (proposed) guidelines with experimentally manipulated case presentations of presence or absence of (a) individual mental health diagnoses and (b) relational problems or maltreatment. Results: ICD-11, compared with ICD-10, guidelines resulted in significantly better classification accuracy, although only in the presence of co-morbid mental health problems. Clinician factors (e. g., gender, language, world region) largely did not impact classification performance. Conclusions: Despite being considerably more explicated, raters’ performance with ICD-11 guidelines reveals training issues that should be addressed prior to the release of ICD-11 in 2018 (e. g., overriding the guidelines with pre-existing archetypes for relationship problems and physical and psychological abuse).     

Perceived stigma of caregivers: Psychometric evaluation for Devaluation of Consumer Families Scale

Background/Objective: The Devaluation of Consumer Families Scale (DCFS) is commonly used to measure perceived stigma towards family members of people with mental illness. However, its factorial structure has never been confirmed using confirmatory factor analysis (CFA). This study aimed to test the psychometric properties of the DCFS Taiwan version (DCFS-TW). Method: Family caregivers (N=511) completed the DCFS-TW (97 completed the DCFS again after 2 to 4 weeks) and other instruments. CFA, test-retest reliability, internal consistency, concurrent validity, and known-group validity were analyzed. Results: The three-factor structure of the DCFS-TW performed better than the one-factor structure. Test-retest reliability (r = .66) and internal consistency were satisfactory (α = .85); concurrent validity (absolute r = .20 to .58) was acceptable; known-group validity was supported by the significantly different DCFS-TW scores in clinical characteristics (had been vs. had not been hospitalized; had been vs. had not been compulsorily admitted). Conclusions: The DCFS-TW has decent psychometric properties and is suitable for health professionals to measure perceived stigma towards family members of people with mental illness.     

Depressive symptoms in Friedreich ataxiaSíntomas depresivos en la ataxia de Friedreich

Background/Objective: Almost no attention has been paid to depression in Friedreich ataxia (FRDA), a highly disabling cerebellar degenerative disease. Our aim was to study the presence and the profile of depressive symptoms in FRDA and their relationship with demographic-disease variables and cognitive processing speed. Method: The study groups consisted of 57 patients with a diagnosis of FRDA. The Beck Depression Inventory-II was used to assess symptoms of depression. Speed of information processing was measured with a Choice Reaction time task. Results: The mean BDI score for patients was significantly higher than the mean score in the general population. Twenty one percent of participants scored in the moderate/severe range. A Cognitive-Affective score and a Somatic-Motivational score was calculated for each patient. Patients’ scores in both dimensions were significantly higher than the scores in the general population. Demographic and disease variables were not related with symptoms of depression, except for severity of ataxia. Depressive symptoms predict cognitive reaction times. The greater proportion of variance was explained by the Cognitive-Affective dimension. Conclusions: Our data show that both somatic-motivational and cognitive affective symptoms of depression are frequent in individuals with FRDA. In addition, depressive symptoms may influence cognition, especially, the cognitive and affective symptoms.