Illness perceptions are the main predictors of depression and anxiety symptoms in patients with chronic pain

Depression and anxiety symptoms in chronic pain are associated with adverse clinical outcomes, and appear highly related to patient’s illness perceptions as well as with marital adjustment. This study aimed to investigate the predictive value of pain variables, marital adjustment and illness perceptions on depression and anxiety in patients with chronic pain. Two hundred patients were recruited from a pain unit in a public hospital in the north of Portugal. Patients completed a questionnaire that assessed illness perceptions (IPQ-Brief), marital adjustment (revised dyadic adjustment scale), depression and anxiety symptoms (hospital anxiety depression scale) and pain variables (pain intensity and pain disability index). Depression and anxiety symptoms were associated with pain intensity, pain-related disability, marital adjustment and illness perceptions. Results from hierarchical regression showed that illness perceptions contributed significantly to depression and anxiety symptoms over and above the effects of pain intensity, pain-related disability and marital adjustment, after controlling for gender. In multivariate analyses, pain intensity, pain-related disability and marital adjustment were uniquely related to depression and anxiety symptoms, whereas specific illness perceptions were uniquely related to depression symptoms (identity, treatment control, emotional response and coherence) and to anxiety symptoms (identity, emotional response and concern). Perceptions of greater symptomatology (identity) and of emotional impact, and lesser perceptions of treatment control and understanding of chronic pain (illness comprehensibility) were significantly associated with increased depression symptoms. Perceptions of greater symptomatology (identity), emotional impact and greater concern were associated with anxiety symptoms. These findings indicate that the contribution of illness perceptions was greater than that made by traditional covariates, and may therefore be a useful basis for future psychological interventions.     

Understanding Forgiveness as Discovery: Implications for Marital and Family Therapy

This article explores the concept of forgiveness in relationship systems and examines various conceptualizations and definitions found in the literature. Forgiveness is described as a complex psychological and relational process that is more a discovery than an act of will. A rationale for viewing forgiveness in a contextual, historical, and relational attachment paradigm is presented, and the association of forgiveness with empathy and emotional intelligence is discussed. Marital and family therapists are encouraged to attend to contextual family of origin issues and to facilitate an empathic relational environment where ambivalence is expected and tolerated for enhancing the process of forgiveness. Relevant clinical cases are shared to illustrate the process of forgiveness as discovery.     

Marital Therapy and Marital Power: Constructing Narratives of Sharing Relational and Positional Power

Scholars continue to emphasize in their conceptualizations of marital power the capacity to exert influence in the marital relationship based on the control of valued resources and status (positional power). Much less attention has been given to the capacity to exert authority in the marital relationship through the context of an intimate relationship and the opportunities for influence it provides (relational power). Strategies are suggested for co-authoring narratives with couples in the process of therapy that create opportunities for them to share these bases of power within their families in ways that free them from the negative constraints associated with cultural discourses about gender and power.     

Toleration and Neutrality: Incompatible Ideals?

Toleration and neutrality are not always distinguished. When they are, they are often offered as two complementary solutions for the problem of achieving political unity and a degree of mutual acceptance within a pluralist liberal polity. The essay shows the concepts to be fundamentally distinct, and then argues that instead of being mutually supporting, they are mutually exclusive. Neutralist liberals, it is argued, must give up toleration in favour of the virtue of neutrality on the part of citizens. This revised version was published online in August 2006 with corrections to the Cover Date.     

Belief in common fate and psychological well‐being among Chinese immigrant women

Three studies were conducted to develop and test a construct of Chinese marital commitment in the context of immigration. ‘Belief in common fate’ refers to an unfailing devotion to a Confucian ideal of the marital union as hierarchical without regard for external contingencies or individual needs. Women who did not believe in common fate reported a more positive affect. When women reported the occurrence of a severe life stressor, a strong belief in common fate was associated with psychological distress and negative affect. We discuss the importance of considering contextual factors, such as migration and life adversity, in interpreting the significance of cultural belief systems.     

个体自尊与婚姻满意度关系的模型构建

本研究探讨了个体的自尊、自我保护倾向、对伴侣的回应方式、承诺与删因满意度的关系。结果表明：自尊通过对伴侣的回应方式和自我保护影响着个体的承诺和蜊因满意度;自尊、对伴侣的回应方式和自我保护通过承诺影响着个体的婚姻满意度。本研究还构建了自尊与婚姻满意度关系的理论模型。     

The structure of tradeoffs in model building

Despite their best efforts, scientists may be unable to construct models that simultaneously exemplify every theoretical virtue. One explanation for this is the existence of tradeoffs: relationships of attenuation that constrain the extent to which models can have such desirable qualities. In this paper, we characterize three types of tradeoffs theorists may confront. These characterizations are then used to examine the relationships between parameter precision and two types of generality. We show that several of these relationships exhibit tradeoffs and discuss what consequences those tradeoffs have for theoretical practice. John Matthewson and Michael Weisberg have contributed equally to this paper.     

Exerting Self‐Control ≠ Sacrificing Pleasure

Self‐control is a prominent topic in consumer research, where it is often conceptualized as the abstinence from hedonic consumption. We examine whether this conceptualization accurately captures consumers’ experiences of self‐control conflicts/failures in light of seminal self‐control theories in economics and psychology. Rejecting that notion, we argue that self‐control failures are choices in violation of superordinate long‐term goals accompanied by anticipated regret, rather than choices of hedonic over utilitarian consumption. This conceptualization has important methodological, theoretical, and practical implications. Methodologically, it highlights the need for experimental paradigms with higher construct validity. Theoretically, it helps elucidate how self‐control is distinct from impatience and self‐regulation. Practically, it provides a rich set of implications for deducing interventions on the individual and public policy level to help consumers exert self‐control.     

The role of stress mindset in support provision

To better understand the antecedents of support provision within relationships, this study examined the potential role of a novel individual difference; spouses' stress mindset (i.e., beliefs about whether stress‐is‐enhancing or stress‐is‐debilitating). As individuals with a stress‐is‐enhancing mindset often underestimate other's stress, we hypothesized that those with a stress‐is‐enhancing mindset will generally provide less and worse support compared to individuals with a stress‐is‐debilitating mindset. The results revealed few significant associations and the associations that were significant were contrary to predictions. For example, wives with a stress‐is‐enhancing mindset provided more support, and husbands who perceived their partner as having a more stress‐is‐enhancing mindset provided better support. Further research is needed to replicate these results and determine whether stress mindset has interpersonal consequences.     

Get healthy to marry or marry to get healthy?

This study tested selection and causal effects on the marriage‐health link by analyzing predictors of mortality through body mass index (BMI) and chronic illnesses (CI) on emerging adults (EA; N = 302) who were followed biannually for 8 years from the Panel Study of Income Dynamics. Results showed EA with unhealthy BMI's are more likely to marry and improve their BMI after marrying, substantiating selection and causal effects. Only the selection effect was substantiated for CI, whereby White EAs with CI were less likely to marry. Marriage appears to benefit overall health for EA, as findings suggest improved health behaviors after marriage. Future research should assess what health behaviors change during marriage for EA and if they help CI management.