Using continuous heart rate monitoring to investigate anxiety and its communication with the dentist–patient interaction

Abstract

The importance of communication within the dentist–patient relationship has long been recognised with regard to patient satisfaction and anxiety. However there has been little research into the anxiety experienced by both patient and dentist during the administration of dental treatment nor how such affects are perceived and communicated within the dentist–patient interaction.

The study reported here, examined affective communication between dental students (n=16) and their patients (n=64) by using continuous and simultaneous cardiovascular monitoring during an entire dental treatment session. The data was analysed using stepwise regression analysis together with the development of a measure of emotionality in order to understand the communication of anxiety during dental treatment procedures. The results suggested that anxiety was communicated between dental operator and patient but was dependent on the degree of clinical experience of the operator.     

The Role of the Therapist's Subjectivity: Using Countertransference in Psychotherapy

No abstract available for this article.     

The impact of uncertainty and communal coping on mental health following natural disasters

Abstract

Feelings of uncertainty are a central feature of the disaster experience. Surprisingly, though, there is very little systematic quantitative research about the impact of uncertainty on disaster survivors. Moreover, communal coping has increasingly received attention as a potential buffer of the negative effects of stressors but that literature is also limited in its application to disasters. This investigation applies research in the domain of uncertainty, together with the Theoretical Model of Communal Coping to better understand the experience of a community exposed to three wildfires in a one year period. A random-digit dialing procedure was used to gather data from 402 individuals. Participants completed measures of mental health, uncertainty, and communal coping in the context of their experience with the most personally stressful of the three wildfires. All analyses were examined separately for those who were evacuated and those who were not. Results support the negative impact of uncertainty across both evacuated and nonevacuated sub-samples and show a strong buffering role for communal coping among those who evacuated. The implications of these findings for the understanding of wildfire survivors' experiences are noted and future directions are proposed.     

Editorial

Abstract

This study examines the communication that occurs during routine genetic counselling sessions. It involves the qualitative analysis of nine consultations with one member of a clinical genetics team.

The consultations were characterised by a contrast between the sense of certainty apparent in how the clinician talked about the power and promise of the new genetics and the uncertainty communicated regarding the actual information produced by genetic tests and their limitations in solving people's problems. There was also a contrast between how the clinician seemed to control the format and agenda of the consultation and the apparently uncontrollable personal and social implications of the topics discussed. We speculate that this may be explained in terms of the clinician giving some order and certainty in an area of inherent uncertainty, and where great promises are as yet unrealised.     

Journal Reprints as Dissemination of Psychological Research: Courtesy,Obligation, or Obsolescence?

The proliferation of journals and the escalation of journal prices have made it difficult for psychologists, especially those in rural areas without access to comprehensive libraries, to obtain journal articles. A traditional source of otherwise unavailable papers is to request a reprint directly from the author. Although previous researchers found this method to be 60%-80% successful, there have been major changes in journal operations and alternative media since this research was conducted. In the present study, reprints were requested from 473 corresponding authors from 10 American Psychological Association journals. The compliance rate was 84% and reprints took, on average, 32 days to arrive. There was no difference in the rate or in the speed of response due to the requestor's status as an academic or applied psychologist. Although functional, the traditional reprint request method was slow, uncertain, and costly. It is suggested that a demand still exists for reprints, but that electronic reprints should replace the traditional paper format.     

Investigating medical decision‐making capacity in patients with cognitive impairment using a protocol based on linguistic features

A critical question is whether cognitively impaired patients have the competence for autonomous decisions regarding participation in clinical trials. The present study aimed to investigate medical decision‐making capacity by use of a Swedish linguistic instrument for medical decision‐making (LIMD) in hypothetical clinical trials in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Three comparable groups (age, education) participated in the study: AD (n = 20; MMSE: 24.1 ± 3.3) and MCI (n = 22; MMSE: 26.7 ± 2.4) patients and healthy controls (n = 37; MMSE: 29.1 ± 1.0). Medical decision‐making capacity was operationalized as answers to questions regarding participation in three hypothetical clinical trials. Answers were scored regarding comprehension, evaluation and intelligibility of decisions, and a total LIMD score was used as the measure of medical decision‐making ability. Groups differed significantly in LIMD with AD patients performing worst and MCI poorer than the control group. A strong association was found between all LIMD scores and diagnosis which supported the assertion that LIMD as it is designed is a one‐dimensional instrument of medical decision‐making capacity (MDMC). The results indicate that a fundamental communicative ability has an impact on the competence for autonomous decisions in cognitive impairment.     

A Case of Triple X Syndrome Manifesting with the Syndrome of Nonverbal Learning Disabilities

There has been a relative absence of studies that have examined comprehensively the neuropsychological profiles of females with Triple X Syndrome across a battery of tests and measures. A case is reported of a 9 1/2-year-old female with Triple X Syndrome whose neuropsychological test results were suggestive of greater right- versus left-cerebral hemisphere dysfunction. Overall, the patient's neuropsychological profile was indicative of the syndrome of Nonverbal Learning Disabilities (NLD) as proposed by Rourke (Rourke 1987, 1988, 1995; Rourke & Tsatsanis, 1996). The results are discussed in light of Rourke's NLD Syndrome and the related white matter model.     

Language: The art of therapeutic communication

Abstract

This article shares insights into the processes of suggestibility in the interaction between client and therapist. The article also draws on the work of Yapko and Langs and the insights of the author himself in order to make suggestions on how clinical practice and its supervision could be improved by greater scrutiny of the content of client-therapist interactions.     

The building blocks of social communication

In the present review, social communication will be discussed in the context of social cognition, and cold and hot cognition. The review presents research on prosody, processing of faces, multimodal processing of voice and face, and the impact of emotion on constructing semantic meaning. Since the focus of this mini review is on brain processes involved in these cognitive functions, the bulk of evidence presented will be from event related potential (ERP) studies as this methodology offers the best temporal resolution of cognitive events under study. The argument is made that social communication is accomplished via fast acting sensory processes and later, top down processes. Future directions both in terms of methodology and research questions are also discussed.     

Reducing Psychological Distress in a Genetic Counseling Consultation for Breast Cancer

High levels of cancer specific distress have been found before and after genetic counseling for breast cancer. This study investigated the process of reducing distress during 111 genetic counseling consultations for familial breast cancer. Consultations were audiotaped, transcribed, and a detailed coding system developed to measure cues of emotional distress from the patient, and consultant (clinical geneticist or genetic counselor) behaviors before and after the cues. At least 1 emotional cue was given in 64 consultations, with a median of 1 cue per consultation. More emotional cues of distress occurred when the consultant responded empathetically to the first cue of distress. Satisfaction outcomes were largely positive regardless of the consultant's attentiveness to distress. Postconsultation depression scores were significantly reduced if more empathic responses were given, but anxiety remained the same. These results are discussed and recommendations are made for improving patient care.