Psychological adjustment to cleft lip and/or palate: A narrative review of the literature

Objective: Adjustment to cleft lip and/or palate (CL/P) is multifaceted, involving several domains of psychological and social functioning. A substantial increase in research in this area has been evident in recent years, along with a preliminary shift in how adjustment to CL/P is conceptualised and measured. An updated and comprehensive review of the literature is needed in light of the rapidly expanding and changing field.

Design: A narrative review of 148 quantitative and qualitative studies published between January 2004 and July 2015.

Main outcome measures: Findings are presented according to five key domains of adjustment: Developmental Trajectory, Behaviour, Emotional Well-being, Social Experiences and Satisfaction with Appearance and Treatment. Data pertaining to General Psychological Well-being were also examined.

Results: The overall impact of CL/P on psychological adjustment appears to be low. Nonetheless, the review demonstrates the complexity of findings both within and across domains, and highlights recurring methodological challenges.

Conclusions: Research findings from the last decade are considered to be largely inconclusive, although some areas of emerging consensus and improvements in the approaches used were identified. Efforts to collect data from large, representative and longitudinal samples, which are comparable across studies and encompassing of the patient perspective, should be doubled.     

Changes over time in head and neck cancer patients’ and caregivers’ illness perceptions and relationships with quality of life

Objective: This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months.

Design: Forty-two patient–caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor–Partner Interdependence Model.

Main Outcome Measure: Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N).

Results: Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up.

Conclusion: Patients’ and their caregivers’ perceptions of HNC are dynamic over time. Greater discrepancy between patients’ and caregivers’ illness perceptions at diagnosis predict poorer subsequent patient HRQL.     

The Development and Testing of a New Version of the Cognitive Reflection Test Applying Item Response Theory (IRT)

The cognitive reflection test (CRT) is a short measure of a person's ability to resist intuitive response tendencies and to produce a normatively correct response, which is based on effortful reasoning. Although the CRT is a very popular measure, its psychometric properties have not been extensively investigated. A major limitation of the CRT is the difficulty of the items, which can lead to floor effects in populations other than highly educated adults. The present study aimed at investigating the psychometric properties of the CRT applying item response theory analyses (a two‐parameter logistic model) and at developing a new version of the scale (the CRT‐long), which is appropriate for participants with both lower and higher levels of cognitive reflection. The results demonstrated the good psychometric properties of the original, as well as the new scale. The validity of the new scale was also assessed by measuring correlations with various indicators of intelligence, numeracy, reasoning and decision‐making skills, and thinking dispositions. Moreover, we present evidence for the suitability of the new scale to be used with developmental samples. Finally, by comparing the performance of adolescents and young adults on the CRT and CRT‐long, we report the first investigation into the development of cognitive reflection. Copyright © 2015 John Wiley & Sons, Ltd.     

Ways of desiring mutual sympathy in Adam Smith's moral philosophy

In this paper, I address the question of what we are really after when we seek Smithian mutual sympathy; I also show how the answer I propose can be used to illuminate a crucial feature of Smith's moral philosophy. The first section develops a Smithian response to egoistic interpretations of the desire for mutual sympathy. The second section identifies a number of different self- and other-relevant ways in which one could desire mutual sympathy. Some of these different ways of desiring mutual sympathy comprise a spectrum of degrees of self-centredness; others comprise a spectrum of degrees of other-centredness. The third section shows that the spectra of ways of desiring mutual sympathy can be used to explain the kind of sincere, motivating attachment to morality characteristic of fully developed Smithian moral agents.     

Thinking sadly: In favor of an adverbial theory of emotions

Introspective as well as empirical evidence indicates that emotions shape our thinking in numerous ways. Yet, this modificatory aspect of emotions has received relatively little interest in the philosophy of emotion. I give a detailed account of this aspect. Drawing both on the work of William James and adverbialist conceptions of perception, I sketch a theory of emotions that takes these aspects into consideration and suggest that we should understand emotions as manners of thinking.     

On some common objections to a behavioral approach to psychological categories

This paper addresses several objections that have been leveled against a behavioral approach to psychological categories. It reconstructs and critically assesses (a) the so-called causal objection; (b) alleged counterexamples whereby one can exhibit the typical behaviors associated with a psychological phenomenon without exhibiting the latter, including Lewis’ “perfect actor” case and Kirk’s “zombie”; (c) alleged counterexamples whereby organisms can exemplify psychological phenomena without exhibiting any behavior associated with them, including Armstrong’s imagined brain in a vat, Putnam’s “super-super-spartans” scenario, and related cases; and (d) the holistic objection. Mistaken assumptions in each of these objections are pinpointed. The paper starts with a brief characterization of behaviorism about psychological categories and a summary of the particular version thereof supported here, which draws upon Ryle and Skinner, among others.     

How can individual differences in autobiographical memory distributions of older adults be explained?

The reminiscence bump phenomenon has frequently been reported for the recall of autobiographical memories. The present study complements previous research by examining individual differences in the distribution of word-cued autobiographical memories. More importantly, we introduce predictor variables that might account for individual differences in the mean (location) and the standard deviation (scale) of individual memory distributions. All variables were derived from different theoretical accounts for the reminiscence bump phenomenon. We used a mixed location-scale logitnormal model, to analyse the 4602 autobiographical memories reported by 118 older participants. Results show reliable individual differences in the location and the scale. After controlling for age and gender, individual proportions of first-time experiences and individual proportions of positive memories, as well as the ratings on Openness to new Experiences and Self-Concept Clarity accounted for 29% of individual differences in location and 42% of individual differences in scale of autobiographical memory distributions. Results dovetail with a life-story account for the reminiscence bump which integrates central components of previous accounts.     

Three Conceptual Models of Patient and Public Involvement in Standard-setting: From Abstract Principles to Complex Practice

Clinical practice guidelines have been critiqued for prescribing standardized care that neglects patients’ personal circumstances and knowledge in health care decisions. To make care more patient centred, standard-setters are urged to involve patients and the public in guideline development and use. Despite widespread principled support for such Patient and Public Involvement (PPI), the underlying principles guiding PPI in standardization of care are mired on confusion and contradiction. Based on the PPI literature in general, and informed by empirical research on guideline development, it is possible to identify three rationales that justify PPI in clinical standard setting. Each rationale gives rise to a conceptual model which outlines a distinct purpose of participation, who is to be included, and what they are expected to contribute. The Consumer Choice model aims to involve autonomous consumers to personalize clinical care. The Democratic Voice model aims for health care recommendations to better reflect collective values of citizens. The Lay Expertise model aims to re-contextualize universal evidence by including experiential patient knowledge. However, these models can and should not function as ‘Gold Standards’ to be consistently followed in practice. First, the models rely on two distinct types of representation, resulting in contradictory notions of how to be a good representative. Second, imposing models on practice requires a top-down control that is practically and politically problematic. Not only is control difficult to achieve, it may compromise the participatory ideal of participants co-determine practice, and may result in excluding the values and views of ‘real’ patients and public entirely.     

Religious identification and interreligious contact in Indonesia and the Philippines: Testing the mediating roles of perceived group threat and social dominance orientation and the moderating role of context

This study integrates three theoretical perspectives provided by social identity theory, realistic group conflict theory, and social dominance theory to examine the relationship between religious identification and interreligious contact. It relies on a unique dataset collected among Christian and Muslim students in ethnically and religiously diverse regions of Indonesia and the Philippines, where social cleavages occur along religious lines. Religious identification directly predicts a higher quality of interreligious contact, whereas it indirectly predicts a lower quantity and quality of contact, mediated by higher perception of group threat, and a higher quality of contact, mediated by lower social dominance orientation. Furthermore, these direct and indirect relationships are moderated by religious group membership and relative group size. We conclude that religious identification functions as a ‘double‐edged sword’ predicting both higher quality and lower quantity and quality of interreligious contact through various pathways and with a varying strength depending on intergroup context.