The relationship between purposiveness and information integration: The effect of metamotivational states on cognitive rules in sport

IntroductionInformation integration theory is based on an axiom of purposiveness (i.e. cognition is goal-motivated) and on an axiom of integration (i.e. an action or thought depends on the integration of several stimuli). The relationship between the two axioms has not previously been studied.ObjectiveTo explore the influence of metamotivational states on information integration. We looked at how 70 athletes combined four factors (autonomy, relatedness, competence, and the natural environment) when deciding whether or not to get involved in running under paratelic (activity-oriented) and telic (goal-oriented) conditions.MethodThe participants recorded their decision-making processes for two sets of 24 scenarios built from combinations of the four factors. Repeated-measures ANOVAs were applied to the data.ResultsAll four factors were taken into consideration by the participants when deciding whether or not to get involved in running. The participants used a conjunctive rule under the paratelic condition and an additive rule under the telic condition.ConclusionAn individual's metamotivational state may modify the cognitive algebra in information integration. Further research is required to confirm these initial findings.     

The acceptability of prophylactic mastectomy among lay people and health professionals: A pilot study

IntroductionWomen with certain genetic mutations have a risk of up to 85% of developing breast cancer. Bilateral prophylactic mastectomy is the most effective way to reduce risk of cancer.ObjectiveThis pilot study focuses on the acceptability of prophylactic breast surgery and examines, in a series of concrete cases, the cognitive processes by which health professionals and lay people make their judgments. This research also aims to identify the factors involved in these judgments. An additional objective is to determine whether there are groups with different patterns of responses.MethodWe recruited two samples in France, one comprising 90 lay people and the other 30 health professionals (n = 120) and asked them how acceptable it would be for a woman at a high risk of breast cancer to undergo a prophylactic surgery (mastectomy), in each of the 64 scenarios presented to them. The scenarios were all combinations of two levels of age, of marital status, of parenting status, of body appearance investment, of reconstructive surgery and also two levels of the person suggesting oncogenetic diagnosis.ResultsWe found that lay people and health professionals structured the factors in the scenarios in nearly the same way. They assigned importance to three factors: the most important one was reconstructive surgery, and then the age of the woman. The least important factor was the person who requested the genetic test. Furthermore, the age of the participants, and knowing a person who had cancer impacted the degree of acceptability assigned by participants. Being a lay person or a health professional did not have a direct impact on acceptability but influenced the integration of factors. In addition, cluster analysis showed that only a small group was opposed to mastectomy.ConclusionThis pilot study demonstrated that three factors have to be considered when judging the acceptability of prophylactic mastectomy and showed a common cognitive foundation for future discussion, at the levels of both clinical care and health policy, of the conditions under which prophylactic surgery might be acceptable.     

Interventions for Family Members and Carers of Patients with Borderline Personality Disorder: A Systematic Review

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full‐text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden.     

Dissociative Collusion: Reconnecting Clients with Histories of Trauma in Couple Therapy

This paper introduces the concept of “dissociative collusion” as a helpful theoretical and clinical tool for understanding and working with clients with histories of trauma in couple therapy. The paper describes ways to diagnose and treat dissociative collusion based on the integration of an object relations approach, a relational approach, and a narrative approach. Dissociative collusion, a unique version of the well‐documented “couple collusion,” describes relational unconscious dynamics where split‐off aspects of one or both partners are mutually dissociated in a complementary fashion that becomes a part of the shared unconscious and is reenacted in destructive ways. The dissociative collusion concept is especially relevant to couple therapists who work with clients with histories of trauma, who frequently use dissociation as a primary defense mechanism. We suggest that the challenge and goal for couple therapy with this population are to help them reconnect and better oscillate between dissociated self‐other configurations. A case of couple therapy of a wife who had been a victim of childhood sexual abuse and her husband who displayed frequent use of dissociative defenses is presented.     

The influence of training task stimuli on transfer effects of working memory training in aging

IntroductionWorking memory (WM) training is known to produce benefits in older adults’ WM. Transfer effects to untrained abilities, however, remain controversial and several aspects are thought to influence the generalization of benefits, including the kind of stimuli used in the training tasks, an aspect rarely addressed in older adults.ObjectiveThe present study had two aims: (1) to test the efficacy of a visuospatial WM training procedure in older adults, in terms of specific and transfer effects; (2) to examine in two experiments whether the type of stimuli used in the training task influences the training's effectiveness. Experiment 1 adopted images with a neutral valence while experiment 2 used emotionally positive images based on evidence that older adults tend to remember positive stimuli better. In both experiments, specific training-related gains in a visuospatial WM task (the criterion task) and transfer effects on measures of verbal WM, visuospatial short-term memory, processing speed and reasoning were examined. Maintenance of training benefits was also assessed at an 8-month follow-up.MethodSeventy older adult (63–75 years old) volunteers (35 for experiment 1, and 35 for experiment 2) were randomly assigned to a training or active control group. The same visuospatial WM training procedure was used in both experiments, manipulating only the type of stimuli used (neutral in experiment 1 and emotionally positive in experiment 2).ResultsIn both experiments, only trained participants showed specific benefits in the WM criterion task. These gains were also maintained at the follow-up, but no transfer effects were identified.ConclusionOverall, our findings using the present visuospatial WM training paradigm suggest that it is less effective, in terms of transfer effects, than the same paradigm administered verbally in a previous study, regardless of the type of stimuli used in WM training tasks (neutral or emotionally positive stimuli).     

Do patients suffering from chronic diseases retrospectively overestimate how healthy they were before they fell ill?

Background/Objective: To examine the impact of a disease on a person's subjective health state, patients are often asked to assess their current health state and to retrospectively assess how healthy they were before they fell ill. The objective of this study was to test whether patients generally overestimated the quality of their pre-disease health. Method: Six samples of patients with chronic diseases (cancer patients, cardiovascular patients, and patients diagnosed with sarcoidosis, N between 197 and 1,197) were analyzed. The patients assessed their current health states and their health states at the time before diagnosis. The retrospective scores were compared with matched data from general population studies. Results: In three of the six studies, the retrospective health ratings of the patients were significantly higher than the general population norms (effect sizes between 0.24 and 0.46), two studies yielded nonsignificant effects, and in one study there was an opposite trend. The general overestimation of pre-disease health was more pronounced in older patients as compared with younger ones, and it was more pronounced when global health/quality of life was to be assessed. Conclusions: Retrospective assessments of pre-disease health states are not appropriate for assessing disease-related changes in a person's health state.     

Loneliness predicts suicidal ideation and anxiety symptoms in long-term childhood cancer survivors

Background/ObjectiveLong-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method: A registry-based sample of N = 633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). Results: Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). Conclusions: Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. The extent to which young cancer patients’ re-integration into society is successful could thus have important implications for well-being in adulthood.