Illness representations in patients with multimorbid long-term conditions: Qualitative study

Most research on illness representations explores how patients view single conditions, but many patients report more than one long-term condition (known as multimorbidity). It is not known how multimorbidity impacts on patient illness representations. This exploratory qualitative study examined patients’ representations of multimorbid long-term conditions and sought to assess how models of illness representation might need modification in the presence of multimorbidity. We explored two major issues: (1) the impact of multimorbidity on patient representations of their individual conditions and (2) the representation of multimorbidity itself. Twenty eight adults with at least two long-term conditions (mean of 4) were interviewed. The presence of multimorbidity impacted on patient illness representations in relation to the dimensions of identity, perceived cause, coherence and consequences. Representations of multimorbidity itself concerned representations of the burden of medication and perceived priorities among conditions and synergies and antagonisms between conditions and their management. The results have implications for the measurement of multimorbidity (through scales such as the Illness Perception Questionnaire) and the use of illness representations in the design and delivery of interventions to improve health behaviour and outcomes of patients with multiple long-term conditions.     

The opportunity to choose enhances long-term episodic memory

ABSTRACT

Episodic memory is typically studied under conditions that treat participants as passive agents. Here we sought to explore how actively engaging in ongoing naturalistic occurrences affects long-term episodic memory. Participants viewed 40 short movie clips that depicted a protagonist that conversed with the participants. In each clip, they were either offered the chance to (supposedly) determine the clip’s continuation (active condition), or let the computer decide for them (passive condition). Participants returned either two days or one week after the experience to undergo a true/false memory test for the clips’ details and a two-alternative recognition test for the choices made. Memory performance for both groups was superior for information and choices conveyed in the active vs. passive condition. These findings suggest that the sense of actively influencing the unfolding of events is beneficial to long-term memory of the experience at large, baring potential interventions in the fields of education and cognitive enhancement.     

Incidental image memorability

ABSTRACT

Recent studies using intentional memory tasks showed that images differ consistently in memorability. Here, we used a surprise recognition memory test. We asked how incidental encoding would affect the consistency and ranking of the memorability scores. If memorability is truly an intrinsic property of the image, one should not expect large differences between incidental and intentional conditions. On the other hand, participants might process images differently when not anticipating a memory test, yielding different results. The study list of our incidental memory task was identical to our previous, intentional study. Participants were to watch the images of this list carefully as they appeared on the screen one by one (free viewing); supposedly for a study about eye movements. Afterwards, a surprise recognition memory test was administered. Despite the free viewing instructions during the study phase, the resulting incidental image memorability scores still showed high levels of consistency across participants. In addition, the overlap between the incidental and intentional memorability ranking was large. These results provide further support for the idea of memorability as an intrinsic image property and add to its ecological validity, as people rarely memorise images intentionally.     

Cumulative Contribution of Child Maltreatment to Emotional Experience and Regulatory Intent in Intimate Adult Interactions

This study examined the link between experiencing multiple types of child maltreatment and intentions to control emotion during charged discussions with intimate partners in adulthood, and whether the link is mediated by intensity of negative emotions. Using video recall, 97 couples rated their levels of emotions and intentions to control emotion during charged discussions with partners. Number of types of child maltreatment reported was linked with effort to control emotion, and the relationship was partially mediated by intensity of participants’ feelings of hostility. For men, the link was also partially mediated by self-reported sadness and anxiety. Findings underscore the importance of attending to abuse survivors’ experiences of and attempts to manage intense emotions in treatment, particularly in couples therapy.     

Incidental encoding of numerosity in visual long-term memory

The visual system can readily extract numerosity information from brief experiences. This numerical perception is characterized by diminishing accuracy as numerosity increases, and impaired discrimination for similar quantities and large magnitudes. Here we assess whether these properties apply more broadly to numerosity in visual long-term memory. In surprise memory tests, we observed: Remarkable accuracy in estimating the number of repetitions of an exemplar image (Experiment 1a), that this accuracy decreased but remained high when estimating over categories (Experiments 1b and 1c), that numerical discrimination from memory exhibited psychophysical distance and size effects (Experiment 2), that these effects may derive from stored representations rather than post hoc approximation (Experiment 3a), and that they can reflect total elapsed experience in addition to discrete counts (Experiment 3b). Similar to how numerosity is readily extracted during visual perception, our results suggest that numerosity is encoded incidentally in visual long-term memory.     

Verbally Expressed Wishes of Children and College Women Students

This research examined the relationship between locus of control and two academic-related variables: study habits and attitudes, and college academic performance. Subjects were administered (a) the Brown-Holtzman Survey of Study Habits and Attitudes and (b) the Levenson Internal, Powerful Others, and Chance scales, the latter providing separate measures of two external control dimensions. Results indicated that internal control was related positively to effective study habits and attitudes and to college academic success, while the opposite was true for powerful others and chance control. Additional findings demonstrated significant differences between powerful others and chance control as related to study habits and attitudes and to college grade-point averages.     

Therapeutic Work with Trauma,Revictimization, and Perpetration: Bearing Witness,Offering Hope,Embracing Despair

ABSTRACT

This paper offers a case study of a survivor of childhood incest who in adulthood has become a victim of violence in her relationships with chosen partners and is concerned that she herself may be a perpetrator of sexual abuse. It examines selected literature on attachment, dissociation, transference/countertransference, role responsiveness and sadomasochistic therapeutic enactments, the two-system superego model, and the triadic self. The paper focuses on long-term treatment dynamics with survivors of cumulative trauma and explores such psychodynamic psychotherapy issues as the therapist as a perpetrator of violence, the development of sacred space, authenticity, and the importance of both offering hope and embracing despair in this work.     

Undercurrents

SUMMARY

In a story-telling mode, with a personal and intimate flavor, this article takes a look at one approach to the treatment of an extramarital affair. With roots in Bowen theory, and an attention to the underlying dynamics of the emotional system, the treatment is further enriched by an improvisational approach which acknowledges the self of therapist.     

Holocaust survivors in long-term care

ABSTRACT

Little research exists on the experience of older trauma survivors in long-term care settings. This study examined the experience of Holocaust survivors in community-based and facility-based long-term care. We wished to know if Holocaust survivors had a systematically different experience in such settings compared to persons without a trauma experience in their backgrounds. Through interviews with survivors, American-born Jews in the same settings, family members, and professional staff, we learned that there were differences in certain aspects of mental health and emotional well-being and that these differences are associated with the relative lack of a network of family members as compared to American-born Jews.     

Microstructural characterization of the M23C6 carbide in a long-term aged Ni-based superalloy

The microstructural features of M₂₃C₆ carbide in a long-term aged heat- and corrosion-resistant Ni-based superalloy have been investigated in detail using various kinds of transmission electron microscope (TEM) techniques. It is found that TEM contrast, which is related to structural and chemical inhomogeneities inside the grains, always exists in the interior of grains in the alloy. The structure of these inhomogeneous regions has been determined to be the same as that of the γ′ and t-M₂₃C₆ phases, where t-M₂₃C₆ indicates a transitional and metastable phase. Although possessing the same structure as the M₂₃C₆ phase, the chemical composition of the t-M₂₃C₆ is different from that of the M₂₃C₆ phase. Compared with M₂₃C₆, t-M₂₃C₆ is richer in Ni, Co, Al and Ti but poorer in W, Mo and Cr. This phenomenon of structural and chemical inhomogeneity demonstrates that pristine M₂₃C₆ carbide (p-M₂₃C₆) precipitated in standard heat-treated samples is unstable. Therefore, upon long-term ageing treatment, Ni, Co, Al and Ti may locally enrich inside the p-M₂₃C₆ phase, finally forming the γ′ phase, which can be described by the decomposition reaction p-M₂₃C₆ → M₂₃C₆ + γ′.