The experience of attending a lay-led,chronic disease self-management programme from the perspective of participants with multiple sclerosis

A lay-led, community-based intervention, the Chronic Disease Self-Management Course (CDSMC) is effective for a range of long-term health conditions (e.g. arthritis, heart disease). However, the perceived value and experience of the CDSMC for people with Multiple Sclerosis (MS) has not been examined. The present qualitative study addressed this omission. Ten participants with MS (7 female; age range 35 to 60 years; disease duration 4 to 19 years) were interviewed before attending the CDSMC and at 4-month follow-up. Data were analysed using Framework Analysis. Some participants learned new self-management techniques and reported enhanced confidence (self-efficacy), whereas other participants were already confident in their self-management ability and found the CDSMC acted as a reminder of techniques previously used. Relaxation, pacing, and goal setting were particularly valuable for managing fatigue. Goal setting helped some participants to build confidence. Participants valued meeting similar others including those with different conditions. The CDSMC was an opportunity for social comparison and inspirational role modelling. Improvements to the CDSMC were suggested, including the addition of specific MS information. Overall, the CDSMC was viewed as a valuable source of new skills and a reminder of previously learned self-management skills, particularly in the context of managing fatigue. Gender differences emerged.     

Relations between acceptance of multiple sclerosis and positive and negative adjustments

This study examines relations between acceptance as defined in Acceptance and Commitment Therapy (ACT) and adjustment to multiple sclerosis (MS). A first step in this investigation was the development of a measure of acceptance of MS called the MS Acceptance Questionnaire (MSAQ). Consistent with prior findings and theoretical propositions, it was predicted that acceptance would be associated with better adjustment to MS (lower distress and higher positive affect, life satisfaction and marital adjustment and better health). A total of 128 persons with MS completed measures of demographics, illness and adjustment at Time 1 and measures of acceptance and adjustment 12 months later (Time 2). Factor analyses of the MSAQ revealed two factors, action and willingness. Associations between the MSAQ and other validated acceptance measures supported convergent validity. As predicted, after controlling for the effects of initial adjustment and relevant demographic and illness variables, greater acceptance was related to better adjustment, although the action factor emerged as the strongest predictor of better adjustment. This is the first study to examine the role of acceptance (as defined in ACT) in adjusting to MS over time and as such provides a first step for further investigation of acceptance in MS.     

Estimating One's Own and Others' Multiple Intelligence: A Cross-Cultural Study from Guinea Bissau and Portugal

This study examined the estimations of multiple intelligences for self, partner and parents. One hundred and fifty two students (males = 81, females = 68, and 3 have not indicated their sex; mean age = 24.02, SD = 3.08) from Guinea Bissau estimated their own, their partners', and their parents' IQ scores on each of Gardner's ten multiple intelligences: verbal (linguistic), logical (mathematical), spatial, musical, body-kinesthetic, interpersonal, intrapersonal, existential, spiritual and naturalistic. In contrast to previous results (A. Furnham, 2001) sex differences in self-estimates did not occur in this Guinean sample. Participants rated overall intelligence of their father higher than that of their mother. An existing data set on estimates of intelligence in a Portuguese sample was used for a cross-cultural comparison between Portuguese and Guinean participants. There were consistent and clear culture differences. Guinean gave higher self, partner and family ratings than Portuguese. Results are discussed in terms of the growing literature in the self-estimates of intelligence, as well as limitations of that approach.     

Andrew Robinson. God and the World of Signs: Trinity,Evolution and the Metaphysical Semiotics of C.S. Peirce

ABSTRACT

Christian theologians have considered the significance of life elsewhere in the cosmos since the fifteenth century, but the brevity of these discussions calls for greater theological precision: the notion of multiple incarnations, for example, is often explored without reference to the detail of Christological formulations. Attention to the logical mode in which such work is set out is also fruitful, where the scholastic category of suitability or fittingness holds particular promise. As suitable, God’s actions are free and yet congruent, being consistent with the divine nature, with creaturely natures, and with the ends of God’s dealings with creatures.     

Multiple Attachment Representations in Clinical Practice: Case Study of a Six-Year-Old Maltreated Child

Research on attachment predominantly traces the effect of a single or primary attachment and/or attachment style on working models and behavior. However, most children form multiple attachments. This article reviews research on multiple attachment representations in children and considers how such information can usefully be applied to clinical settings. Through the case study of a six-year-old adopted boy with a history of maltreatment, it explores how those internal working models can be assessed in treatment and the clinical value of recognizing different attachment representations and styles. Implications for treatment interventions are explored.     

Functional Somatic Syndromes and Childhood Physical Abuse in Women: Data From a Representative Community-Based Sample

This study investigated whether childhood physical abuse was associated with functional somatic syndromes (FSS) in women while controlling for age, race, and four clusters of potentially confounding factors: (a) Other childhood adversities, (b) adult health behaviors, (c) socioeconomic status and stressors, and (d) mental health. A regional subsample of the 2005 Canadian Community Health Survey of 7,342 women was used. Women reported whether they had been diagnosed with chronic fatigue syndrome (CFS), fibromyalgia (Fm), irritable bowel syndrome (IBS), or multiple chemical sensitivities (MCS). Fully 749 reported having been physically abused by someone close to them during their youth. When controlling for potentially confounding factors, childhood physical abuse was significantly associated with CFS (OR = 2.11; 95% CI = 1.22, 3.65), Fm (OR = 1.65; 95% CI = 1.08, 2.52), and MCS (OR = 2.82; 95% = CI 1.90, 4.17). Clinicians using reattribution and stepped care approaches in the management of FSS should assess for a history of abuse.     

Interventions on causal exclusion

Two strains of interventionist responses to the causal exclusion argument are reviewed and critically assessed. On the one hand, one can argue that manipulating supervenient mental states is an effective strategy for manipulating the subvenient physical states, and hence should count as genuine causes to the subvenient physical states. But unless the supervenient and subvenient states manifest some difference in their manipulability conditions, there is no reason to treat them as distinct, which in turn goes against the basic assumption of nonreductive physicalism. On the other hand, one can preserve the distinction between the two by introducing asymmetric manipulability conditions that the supervenience thesis entails. But this response can be used to argue that mental causes never have physical effects. However, this argumentation can also be used to show that mental causes can have mental effects.     

The personality of meaning in life: Associations between dimensions of life meaning and the Big Five

The goal of the current study was to identify aspects of personality that are associated with different ways in which people find meaning in life. This was achieved using constrained principal component analysis (CPCA) on data from 322 university students, who completed the Sources of Meaning and Meaning in Life questionnaire and the Big Five Aspects Scale. CPCA demonstrated that personality traits and life meaning are associated, but not redundant, with one another. Specifically, respondents with high scores on lower-level aspects of Openness to Experience tended to derive meaning from questioning, learning and challenging tradition, whereas those with high scores on aspects of Conscientiousness and Extraversion tended to derive meaning from success at work, health, and family. Results suggest that personality traits are associated with variations in the domains used to derive meaning in life, and demonstrate the utility of CPCA as an innovative statistical technique for the study of individual differences.     

Multiple schedules of conjugate reinforcement and extinction: A translational model for assessing automatically reinforced behavior

This study evaluated the extent to which a conjugate reinforcement schedule (CONJ) involving a contingency between pedaling a stationary bike and viewing a preferred movie could serve as a translational preparation for the analysis of automatically reinforced behavior. In part, researchers examined whether providing participants with either an accurate or an inaccurate rule about the extinction (EXT) component of a multiple schedule (MULT) contributed to the development of control by the MULT (CONJ EXT) schedule. Results show schedule control emerged for four of five participants who received the accurate rule and none of the five participants who received the inaccurate rule. In addition, participants who received accurate rules typically increased pedaling during CONJ components that followed two consecutive EXT components, suggesting that they experienced deprivation for audio and visual stimulation generated by pedaling. These preliminary findings suggest that researchers could use this translational preparation to identify matched interventions for some automatically reinforced behavior.     

Social evaluation research: the evaluation of two police patrolling strategies

In most social evaluation research it is difficult to achieve the degree of experimental rigor possible in an applied behavioral study. This study illustrates how the evaluation researcher can increase experimental rigor in the analysis of social interventions. In the first evaluation, a variation of the time-series design that offered maximum experimental control given the limitations of the situation, was employed to evaluate the effects of a specialized home-burglary police patrol. This design revealed that no effects could be attributed to the patrol. In the second evaluation, a multiple baseline-like design was possible in determining the effects of a police walking patrol. This design revealed that the patrol produced an increase in crime reporting but not in arrests. Social interventions often occur in a manner that allows varying degrees of experimental analysis. The evaluation researcher must attain optimal experimental analysis given the limitations of each social intervention.