The dimensional structure of benefit finding in multiple sclerosis and relations with positive and negative adjustment: A longitudinal study

Benefit finding is a meaning making construct that has been shown to be related to adjustment in people with MS and their carers. This study investigated the dimensions, stability and potency of benefit finding in predicting adjustment over a 12 month interval using a newly developed Benefit Finding in Multiple Sclerosis Scale (BFiMSS). Usable data from 388 persons with MS and 232 carers was obtained from questionnaires completed at Time 1 and 12 months later (Time 2). Factor analysis of the BFiMSS revealed seven psychometrically sound factors: Compassion/Empathy, Spiritual Growth, Mindfulness, Family Relations Growth, Lifestyle Gains, Personal Growth, New Opportunities. BFiMSS total and factors showed satisfactory internal and retest reliability coefficients, and convergent, criterion and external validity. Results of regression analyses indicated that the Time 1 BFiMSS factors accounted for significant amounts of variance in each of the Time 2 adjustment outcomes (positive states of mind, positive affect, anxiety, depression) after controlling for Time 1 adjustment, and relevant demographic and illness variables. Findings delineate the dimensional structure of benefit finding in MS, the differential links between benefit finding dimensions and adjustment and the temporal unfolding of benefit finding in chronic illness.     

Symptoms,impairment and illness intrusiveness–their relationship with depression in women with CFS/ME

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is an illness in which physiological and psychological factors are believed to interact to cause and maintain CFS/ME in an individual predisposed to it. The various symptoms and impairments associated with CFS/ME have a large impact on quality of life. The purpose of the present study was to identify the extent to which the core symptoms and impairments associated with CFS/ME relate to depression in women with CFS/ME, and to discover whether these relationships were mediated by illness intrusiveness. CFS/ME was found to be a highly intrusive illness, intruding into more life domains and to a greater degree than other illnesses. The effects of both symptoms and impairment on depression were, in part, mediated by illness intrusiveness. Although symptoms severity and impairment had both direct and indirect effects on depression, illness intrusiveness was the strongest predictor of depression.     

Comparison of the role of self-efficacy and illness representations in relation to dietary self-care and diabetes distress in adolescents with type 1 diabetes

This cross-sectional study examined the joint effects of self-efficacy and illness representations on dietary self-care and diabetes distress in adolescents with type 1 diabetes by comparing two theoretical models: the Self-regulation Model (Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common-sense representations of illness danger. In S. Rachman (Ed.), Medical Psychology (Vol. 2, pp. 7–30). New York: Pergamon.) and Social Cognitive Theory (Bandura, A. (1997). Self efficacy: The exercise of control. New York: W.H. Freeman.). One hundred and fifty-one adolescents with type 1 diabetes completed self-report measures of dietary self-efficacy, illness representations, dietary self-care and diabetes distress. Data were analysed using structural equation modelling. The model best supported by the data (Leventhal's Self-regulation Model) showed that dietary self-efficacy, perceived consequences and treatment effectiveness had direct and independent effects on both dietary self-care and diabetes distress. Together with dietary self-efficacy, perceived short-term treatment effectiveness was a significant predictor of dietary self-care. Age was found to be a negative predictor of short-term treatment effectiveness beliefs. Diabetes distress was best predicted by self-efficacy and perceived consequences. It can be concluded that to target effectively dietary self-care and distress, clinicians should focus on key illness representation variables (perceived short-term treatment effectiveness and perceived consequences) in conjunction with self-efficacy.     

Lay concepts of health and illness from a developmental perspective

Abstract

The concepts of children, adolescents and their mothers with regard to different aspects of health and illness in general and five specific diseases were explored in this study. An exploration with fully standardised questions and open answers was subjected to a content analysis. A reliable rating system was developed to score the sophistication of the answers. The study included 99 Ss of the age groups 5, 8, 12 and 16 years, as well as 48 mothers of the children. Many children and adolescents were able to define health positively (well-being) and not merely as the absence of illness. The definition of illness in general was frequently composed of somatic symptoms and disorders, feeling poorly and things one would like to accomplish but can't. The causality explanations of illness in general were dominated by contagion. The concepts of the older children and the mothers were richer, more elaborated, less concrete and less action-oriented than those of the younger children. However, abstract formulations and complex aspects of illness were very rarely expressed. In addition, concepts regarding the characteristics (definition, symptoms, causality, treatment and prevention) of five diseases (cold, measles, heart infarction, cancer and AIDS) were measured. The pattern of results was strongly influenced by age. By and large, the development of most disease concepts was linear with significant differences between age groups. Conversely, within a given age group, significant differences were found in the cognitive level of disease characteristics, either with respect to the same disease or between different diseases (“horizontal shifts”).     

Specificity of MMPI cluster types to chronic illness

Abstract

Cluster analysis derived MMPI profile types were compared for three distinct illness populations: chronic low back pain (CLBP), mixed headache (HA), and cardiac disease (CD). Results replicated previous findings in the chronic pain and cardiac literatures. Differences between diagnostic groups and genders were found for the prevalence of the derived MMPI profile types. Results indicated that, in males, the two chronic pain groups had similar profile types and similar relative frequencies of these types, but both differed from the CD sample. The chronic pain groups tended to have a greater number of patients with pathological and distressed MMPI profile types and a lesser representation in the subclinical profile type compared to the CD sample. Similar findings were obtained for females, though the CLBP group tended to have a higher frequency of highly distressed, pathological profiles than either the HA or CD groups. Results suggested that the MMPI may be a measure of response to illness rather than reflecting predisposing personality types for any given illness and that the higher frequency of highly distressed profiles in the chronic pain samples reflects the increased suffering of those populations compared to other illnesses.     

Impact of genetic testing on causal models of heart disease and arthritis: An analogue study

Abstract

An analogue study investigated the impact of genetic testing on perceptions of disease. Using a 2 × 2 design, participants (n = 212) imagined receiving the information that they were at increased risk for either heart disease or arthritis. The type of risk information was either genetic or unspecified. Presentation of genetic risk information resulted in the condition being perceived as less preventable. Causal models of disease where investigated using principal components analysis. When hem disease was the stimulus condition, attributions to genes and chance were positively associated following unspecified risk information, and negatively associated following genetic risk information. When arthritis was the stimulus condition, presentation of genetic risk information was associated with attributions to genes becoming separated from the other attributions. One explanation for this is that providing genetic risk information may decrease perceptions of a sense of randomness or uncertainty in disease causation. The extent to which these effects occur in clinical populations. and their behavioural consequences. needs to be established.     

Smoking-specific communication and children's smoking onset: An extension of the theory of planned behaviour

The aim of this study was to test whether maternal smoking-specific communication and parental smoking related to smoking cognitions (i.e. attitude, self-efficacy and social norm) derived from the Theory of Planned Behaviour in association with smoking onset during preadolescence. A total of 1478 pairs of mothers and children participated (mean age: 10.11; standard deviation?=?0.78). Structural equation models in Mplus were used to examine whether smoking-specific communication influences children's smoking cognitions, which in turn, affect smoking onset. A positive association was found between pro-smoking attitudes and smoking onset. Smoking-specific communication and parental smoking were related to smoking cognitions. Specifically, frequency of communication was negatively associated with pro-smoking attitudes, social norms of mother and best friend. Quality of communication related negatively to pro-smoking attitudes and positively to self-efficacy and norms of friends. Parental smoking was positively associated with pro-smoking attitudes and norms of mother and (best) friends. Additionally, more frequent communication and higher levels of parental smoking were associated with higher smoking onset. In conclusion, smoking-specific communication and parental smoking were associated with smoking cognitions and smoking onset. Already during preadolescence, parents contribute to shaping the smoking cognitions of their children, which may be predictive of smoking later in life.     

Understanding the impact of HIV diagnosis amongst gay men in Scotland: An interpretative phenomenological analysis

Objectives: Although a wide literature details the psychological impact of human immunodeficiency virus (HIV) diagnosis, it predates the introduction of effective treatment for HIV (i.e. anti-retroviral therapies, ARTs). This article explores the psychological impact of HIV diagnosis in post-ART accounts. This is important, given the recent policy developments which focus upon increasing HIV testing and thus diagnoses.

Design: This study presents a qualitative exploration of the experiential accounts of HIV-positive gay men living in Scotland. A total of 14 HIV-positive gay men took part in open-ended interviews.

Methods: Interpretative phenomenological analysis was employed to identify recurrent themes across the interviews.

Results: Our analysis focuses upon the participants’ struggles in adjusting to their HIV status. Diagnosis was a deeply shocking and unexpected experience. Stigma and fear of prejudice dominated their accounts. HIV was understood, variously, as a shameful, fatal and life-changing condition. Overall, within these accounts there was little sense of HIV normalisation.

Conclusions: In Scotland, where HIV prevalence is low, and where no accessible HIV-positive sub-culture exists, there is on-going psychological distress and morbidity amongst gay men testing HIV positive. As HIV-related policy increasingly focuses on increasing rates of antibody testing, there is a need to reduce the psychosocial costs associated with HIV-positive diagnoses.     

Depression as a Creative Illness: A South African Case Study

This case study presents a cultural perspective to supporting health and wellbeing in a young South African adult with depression and unresolved paternity issues. Issues around cultural identity appeared to influence the experience of depression and addressing the identifying aspects was helpful to recovery and wellbeing. Therapy facilitated the discovery of the client’s biological father and necessary ritual to reunite him with his African ancestry.     

The Illness/Injury Sensitivity Index: Validation of a German Version of the ISI-R

Three fundamental fears—anxiety sensitivity, fear of negative evaluation, and illness/injury sensitivity—are considered integral components of anxiety-related psychopathology and also bear connections with chronic pain. Scales measuring the first two fears, the Anxiety Sensitivity Index and the Fear of Negative Evaluation Scale, have been translated into German; however, the nine-item Illness/Injury Sensitivity Index-Revised (ISI-R) that measures fears of injury and illness has not been available in German language yet. The aim of this study therefore was a translation of the ISI-R into German language and an initial validation of the translated scale in two different samples. The German ISI-R was translated by both professionals and laypersons, and a final version was decided on by consensus. In Study 1, participants included 96 undergraduate students (85% women) who completed the German version of the ISI as part of a larger study. An exploratory factor analysis with oblique rotation was conducted and suggested a two-factor-solution with one factor representing fears of illness and the other fears of injury. This factor structure was confirmed via a confirmatory factor analysis (CFA) in Study 2. Participants included 117 community members (79% women). Convergent validity was supported using a visual analogue scale for fear of illness in both samples and the German translation of the Whiteley Index in Study. Overall, the results supported the German translation of the ISI-R. Comprehensive results, limitations, and directions for future research are discussed.