基于语义差异量表的心理疾病外显与内隐污名的结构及关系

采用语义差异法编制心理疾病污名语义差异量表,用于测量外显污名,并用语义差异量表的词对作为单类内隐联想测验的材料,测量内隐污名,用这两类材料研究外显污名与内隐污名的结构及关系。结果表明：外显污名的三维度模型具有良好的拟合度（χ²/df=2.99, RMSEA=0.075, CFI=0.918, TLI=0.902）;内隐污名的三维度模型也具有良好的拟合度（χ²/df=2.272, RMSEA=0.071, CFI=0.857, TLI=0.833）,且与外显污名的结构相同,都由认知评价、情感体验、行为反应三维度构成;心理疾病污名的外显认知评价与内隐认知评价存在显著相关（r=0.436）,外显污名与内隐污名的其它维度之间均不存在显著相关。     

Evidence for blatant dehumanization of mental illness and its relation to stigma

ABSTRACT

People with mental illness face stigma, and due to their low social status, they may also face blatant dehumanization that denies their status as fully evolved human beings. In the current research, three studies documented the existence of blatant dehumanization of mental illness. Study 1 (N = 112) showed that participants rated people with mental illness in general as being significantly less human than other dehumanized social groups such as Mexican immigrants and Muslims. Study 2 (N = 158) showed that dehumanization occurs for specific mental disorders but that the level of dehumanization varies widely among disorders. Study 3 (N = 223) documented significant correlations between dehumanization of mental illness and standard measures of stigma such as fear, pity, and social distance. Overall, the results establish the relevance of blatant dehumanization to mental illness stigma and suggest new directions for understanding stigma.     

Tortoise or hare? Supporting the chronotope preference of employees with fluctuating chronic illness symptoms

Objective: Our aim is to understand how to facilitate the job retention of employees with chronic illness. We focus on multiple sclerosis (MS) as a criterion chronic illness.

Design: An opportunity sample of 20 individuals of working age (13 female; 7 male) were recruited who had been in paid employment for over 28 months with a concurrent diagnosis of MS. Participants took part in one of three focus groups with a topic guide comprising keywords: work, coping, performance, support, future, expectations, sharing and symptoms. Data were analysed using dialogical analysis.

Main outcome measures: As a qualitative study, no outcome measure was used. However, the specific focus of interest was to search for differential patterns of ‘timespace’ – chronotope – that people with chronic illness utilise to manage their condition in the workplace.

Results: Participants oriented to two distinct chronotope types: unsustainable epic (characterised by condensed time) and temporary idyll (characterized by condensed space). Perceived managerial discretion was identified as possibly influencing participants’ chronotope preference.

Conclusion: Identifying chronotope preference has practical implications for health psychologists and related professionals who provide and advise on support to facilitate people with chronic illness to thrive in the workplace.     

Occupational Therapy Interventions in Mental Health: A Literature Review in Search of Evidence

A growing body of literature sheds light on occupational therapy (OT) interventions and outcomes in adult mental health. Although this research has not developed to the point where a systematic review is warranted, a synthesis of these findings is needed. This article provides an overview of OT interventions in adult mental health and their documented outcomes. Fifty peer-reviewed intervention studies targeting adults with mental illness were reviewed. Seven categories of interventions emerged: employment/education; psychoeducation; creative occupations/activity; time use/occupational balance; skills/habit development; group/family approaches; and animal-assisted therapy. Further research involving rigorous designs is needed to establish a solid evidence base for OT interventions in adult mental health.     

The virtual body of Christ and embrace of the seriously ill

ABSTRACT

Since the time of the Apostle Paul, the body of Christ has always been a virtual body, made up of members who were not always physically present to one another but were nevertheless part of the same catholic community. Virtual presence in today’s society comes most often via digital technology, a reality that prompts many Christian leaders and theologians to warn of the dangers of disembodied existence. This paper challenges the claim that virtual presence via digital technology is necessarily an inferior form of presence. Using autoethnographic research of living with advanced-stage cancer, the author explores how virtual connection via technology can sometimes be a superior form of presence for those undone by illness and other traumas. The article concludes with a call to churches to draw on biblical, theological, and liturgical resources to help imagine how digital devices can be used to practice healing forms of attentiveness to those who need it most.     

A series of n-of-1 studies examining the interrelationships between social cognitive theory constructs and physical activity behaviour within individuals

Objectives: Research supports the ability of social cognitive theory (SCT) to explain physical activity (PA) behaviour, but most studies have examined this theory between individuals in large group studies. The aim of the present study was to examine the interrelationships between SCT constructs and PA within individuals of varying activity levels.

Design: Correlational n-of-1 studies.

Methods: Six adults aged 29–65 with varying levels of PA provided daily measures of PA, and completed probe measures over a four-week period of SCT constructs (e.g. barrier self-efficacy, goal setting, planning, social support, outcome expectations, perceived barriers, enjoyment). Data were analysed using cross-correlational time series analysis.

Results: Cross-correlation analysis showed that at least one SCT construct was associated with PA in five participants, although no individual had the same pattern of associations across the study. On some occasions, SCT constructs predicted subsequent PA, but at other times, PA engagement caused a subsequent change in the SCT construct. There were also examples of PA and SCT constructs being concurrently associated.

Conclusions: SCT factors are associated with variations in PA behaviour, but the cause and effect of these relationships within individuals is complex.     

Psychological adjustment in patients post-curative treatment for oesophageal cancer: a longitudinal interview study

Objective: Oesophageal cancer is an increasingly prevalent disease with a demanding post-curative treatment recovery period and sustained longer-term effects. Although post-curative treatment is a key transitionary period, the process of psychological adjustment for the individual is under-researched which limits the evidence base to inform supportive care. The aim of this study was to understand the process of adjustment for oesophageal cancer patients post-curative treatment, in particular the beliefs participants hold regarding their condition and how these are appraised against their experience.

Design: Serial interviews were undertaken with six oesophageal cancer patients who have recently completed curative treatment, at baseline and at 6-month follow-up using interpretative phenomenological analysis.

Results: The findings demonstrate an effortful process of adjustment, including recognising and accepting a changed self, fostering control beliefs over the course of the illness and physical sequelae, searching for meaning, developing illness coherence and moving away from self-blame.

Conclusions: This study is the first to utilise a longitudinal qualitative design in oesophageal cancer, and provides an understanding of post-treatment adjustment over time for this clinical population through which to inform clinical practice and service development.     

Inpatient perspectives on physical activity in a secure mental health setting

This study offers the first insight into the perspectives of secure inpatients regarding exercise. Individuals living with severe mental illness (SMI) engage in less exercise and more sedentary behaviour than their counterparts in the general population. Secure psychiatric hospitals are often considered obesogenic environments that inadvertently promote inactivity. Access to exercise is often restricted due to issues of risk and patient safety. Existing literature exploring exercise perspectives is dominated by SMI populations living in the community. This study involved semi-structured interviews with 15 medium secure inpatients (aged 19–40, mean age 27.8). Primary diagnoses included; schizophrenia and affective disorders, mood disorders and personality disorders. Data were analysed using reflexive thematic analysis. Findings denoted three overarching themes; (i) Barriers to exercise; mental or environmental? (ii) Is exercise always holistically beneficial? (iii) Staff; a barrier and facilitator to exercise. Acute mental health symptoms and unwanted medication side effects, such as lethargy and weight gain limited exercise motivation. The restrictions of a secure environment limited opportunities to regularly exercise. Exercise provided a relief from both psychiatric symptoms and associated low mood, however in some cases engaging in exercise exaggerated manic symptoms and led to acts of aggression. Inpatients considered staff crucial to facilitate exercise, however access, education and inconsistent attitudes limit provision. Strategies to change the sedentary ‘culture’ within secure wards should involve both staff and patients.