The impact of experiential avoidance on the relations between illness representations,pain catastrophising and pain interference in chronic pain

Objective: The aim of this study was to examine the effects of experiential avoidance (EA) on the indirect relationship of chronic pain patients’ illness representations to pain interference, through pain catastrophising

Design and main outcome measure: The sample consisted of 162 patients diagnosed with an arthritis-related or a musculoskeletal disorder. The effects of EA on the pathway between illness representations, pain catastrophising and pain interference were examined with PROCESS, a computational tool for SPSS

Results: After controlling for patient and illness-related variables and pain severity, the ‘illness representations–pain catastrophising–pain interference’ pathway was interrupted at the higher levels of EA. The reason was that, at the high levels of EA, either the relation of illness representations to pain catastrophising or the relation of pain catastrophising to pain interference was not statistically significant.

Conclusion: The findings indicate that EA is not a generalised negative response to highly aversive conditions, at least as far as the factors examined in this study are concerned. EA may rather reflect a coping reaction, the impact of which depends on its specific interactions with the other aspects of the self-regulation mechanism. At least in chronic pain, EA should become the focus of potential intervention only when its interaction with the illness-related self-regulation mechanism results in negative outcomes.     

Cultural context, obsessive-compulsive disorder symptoms, and cognitions: a preliminary study of three Turkish samples living in different countries

Previous research findings have suggested that recent cognitive accounts of obsessive-compulsive disorder (OCD) are valid across different cultural contexts for both clinical and nonclinical samples; however, there is evidence that cultural differences may have an impact on a number of cognitive variables. For this reason, immigration provides an exceptional opportunity for an examination of the role of cultural context in cognitions and possible changes in cultural characteristics. To this end, the present study examined the interrelationships between thought-action fusion, thought control strategies and OCD symptoms in three nonclinical samples, taking the immigration factor into consideration. Thus, the current study included three Turkish sample groups: those who remigrated to Turkey from Bulgaria, those still living in Bulgaria, and those that have always resided in Turkey. The findings of the study supported the role of thought and action fusion and control strategies in OCD symptoms in a cross-cultural context. To illustrate, worry, as a thought control strategy for OCD symptoms, was a common factor in all three sample groups. However, differences were also noted between the groups, despite having the same ethnic origin. Although they immigrated back to Turkey and have been living there for a considerable period of time, the Turkish remigrants retained similar characteristics to the respondents in Bulgaria on cognitions in general. Consequently, it may be suggested that cultural context might have a relative impact on certain correlates. A replication of these findings using different immigration groups and examining various cultural factors is strongly encouraged.     

Reconcilable Differences? Human Diversity,Cultural Relativity,and Sense of Community

Sense of community (SOC) is one of the most widely used and studied constructs in community psychology. As proposed by Sarason in (The Psychological sense of community: prospects for a community psychology, Jossey-Bass, San Francisco, 1974), SOC represents the strength of bonding among community members. It is a valuable component of community life, and it has been linked to positive mental health outcomes, citizen participation, and community connectedness. However, promotion of SOC can become problematic in community psychology praxis when it conflicts with other core values proposed to define the field, namely values of human diversity, cultural relativity, and heterogeneity of experience and perspective. Several commentators have noted that promotion of SOC can conflict with multicultural diversity because it tends to emphasize group member similarity and appears to be higher in homogeneous communities. In this paper, we introduce the idea of a community-diversity dialectic as part of praxis and research in community psychology. We argue that systematic consideration of cultural psychology perspectives can guide efforts to address a community-diversity dialectic and revise SOC formulations that ultimately will invigorate community research and action. We provide a working agenda for addressing this dialectic, proposing that systematic consideration of the creative tension between SOC and diversity can be beneficial to community psychology.     

Applying a Time‐Patterned Typology of Homelessness Among Individuals with Mental Illness

Identification of subgroups of the homeless populations, or typologies, has been an important research priority to guide homelessness services and policies. This study builds on previous typological research conducted in the general homeless population by focusing on individuals with mental illness to further delineate typologies within a more homogenous subset of the homeless population. A time‐patterned typology based on episodes of street and shelter homelessness over a four‐year period was applied to a sample of 246 individuals identified through mental health administrative records. Four groups were created based upon patterns of homelessness: 26.8% experienced homelessness for 4 years, 13.4% had one episode of homelessness but were no longer homeless at the end of the follow‐up, 48.4% had at least two episodes of homelessness, and 11.4% had a single episode of homelessness lasting 3 months or less. Findings from a multinomial logistic regression indicated that gender, presence of a psychotic disorder, substance abuse, and year of study enrollment significantly predicted group membership. Residential trajectories upon exit from homelessness and at the end of the four‐year follow‐up were examined. Implications for current policy and future research are discussed.     

神经症躯体症状的特点与诊断原则

作为临床医生,难免与一些难以解释的躯体症状打交道,这其中有些最终可以确定是精神障碍的躯体症状。从躯体症状识别精神障碍,没有捷径可走,除了良好的医学基础,更要了解精神障碍的特点。这样即便是躯体疾病同样存在的情况下,也能发现精神障碍。套用政治术语,叫做"两手抓,两手都要硬"。即便如此,还有一些医学难以解释的症状,其发生基础无论从生物学医学还是精神病学角度都还不清楚,而这正是需要我们着力研究的学科交叉点。     

Supporting adolescents who have a sibling with a life-threatening illness: An exploratory study

Aims: This research explores issues encountered by adolescents who have a sibling with a life-threatening illness, and those who work therapeutically with them. Method: Eight semi-structured, face-to-face interviews were conducted with participants who work therapeutically with this client group. Attention was given to the empathic quality of interviews. The interview sample included six females and two males, encompassing a wide demographic area within England and Wales. Five were counsellors and three had other professional trainings. Findings: Data was analysed using grounded theory. Results showed that the provision of family as well as individual therapeutic support for young people would ease stress for families and professionals alike, and that peer support was considered important. Implications for practice: The results of this research suggest that organisations working with families experiencing a life-threatening illness would benefit from attending to the quality of support offered to their staff, as well as the families they work with.     

上海市中学生心理健康自评量表的研究

本研究以中学生心理健康八条标准为理论构架,编制《上海市中学生心理健康自评量表(SISMSS)》。该量表共140个项目,由三个分量表组成,即适应性诊断量表、疾病性诊断量表和测谎量表,适应性诊断量表包含8个小测验,即主动学习、情绪乐观与稳定、自制力、自我认知、成就动机、与人沟通、责任感、性意识;疾病性诊断量表包含7个小测验,即精神分裂症倾向、抑郁症倾向、轻躁狂倾向、强迫症倾向、焦虑症倾向、恐怖症倾向、歇斯底里症倾向。适应性诊断量表与疾病性诊断量表之间并不是相互独立的,而是存在着一定程度的相关,有对应关系。SISMSS的内在一致性系数为0.9081(p<0.01),SISMSS与SCL-90之间的相关为0.589(p<0.01),SISMSS与MHT之间的相关为0.734(p<0.01)。     

常人疾病观及其对医患关系的影响

常人疾病观是普通人对于某一疾病的认知、解释和态度的集合。与专业医务人员相比, 普通人更关注心理、家庭和社会因素而非生物学因素的致病作用, 就医选择多元而并不遵循标准化的就医模式, 同时更愿意将疾病体验视为个人生活的特殊问题加以建构性理解。常人疾病观与科学医学观之间的不一致性可能降低患者的就医满意、对医信任和医嘱依从性, 从而影响治疗效果。立足中国社会的医学文化与医疗制度, 研究中国人的常人疾病观, 并探讨其对医患关系的影响作用与社会心理机制, 可为改善当下中国医患关系紧张现状提供有益建议。     

Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm

In this article, I argue that (1) transgender adolescents should have the legal right to access puberty-blocking treatment (PBT) without parental approval, and (2) the state has a role to play in publicizing information about gender dysphoria. Not only are transgender children harmed psychologically and physically via lack of access to PBT, but PBT is the established standard of care. Given that we generally think that parental authority should not go so far as to (1) severally and permanently harm a child and (2) prevent a child from access to standard physical care, then it follows that parental authority should not encompass denying gender-dysphoric children access to PBT. Moreover, transgender children without supportive parents cannot be helped without access to health care clinics and counseling to facilitate the transition. Hence there is an additional duty of the state to help facilitate sharing this information with vulnerable teens.     

Parental illness intrusiveness and youth glycaemic control in type 1 diabetes: intergenerational associations and processes

Objective: This study examined associations between the functioning of youth with type 1 diabetes and their parents, including parenting dimensions as intervening mechanisms. The study adds to the existing literature by focusing on (1) the concept of parental illness intrusiveness; (2) the (understudied) periods of adolescence and emerging adulthood; and (3) maternal and paternal functioning. Design: Questionnaires were completed by 317 patient-mother dyads and 277 patient-father dyads. All patients (aged 14–25) had type 1 diabetes. The hypothesised model was compared to an alternative model using structural equation modelling. Main Outcome Measures: Youth reported on depressive symptoms and treatment adherence; Physicians provided HbA_1c-values. Parents reported on illness intrusiveness, depressive symptoms, and their child’s treatment adherence. Patients and parents reported on psychological control and overprotection. Results: The hypothesised path model had a good fit to the data. Parental illness intrusiveness was positively associated with depressive symptoms and both were positively related to overprotection and psychological control. Psychological control was positively related to patients’ depressive symptoms and negatively to treatment adherence. Poorer treatment adherence was associated with worse HbA_1c-values. Conclusion: These findings underscore the relevance of parental illness intrusiveness and emphasise the importance of mothers’ and fathers’ roles throughout adolescence and emerging adulthood.