Psychoeducational Interventions with Pediatric Cancer Patients: Part II. Effects of Information and Skills Training on Health-Related Outcomes

In Part I of this paper, we described a model that was used as a framework for reviewing studies of psychoeducational interventions intended to influence illness- and treatment-related behaviors and attitudes in pediatric cancer patients. In Part II, we distinguish between interventions that attempt to influence patients' behaviors just by providing information and interventions that specifically teach skills related to the behaviors they are trying to change. Many types of psychoeducational interventions appear to be effective and those that are training-based generally appear more effective than those that are information-based. Training-based interventions may face a barrier to wide adoption because they are resource-costly, but the development of digital-based training interventions may potentially overcome this barrier.     

Children's Adjustment to Parental Physical Illness

We review recent empirical literature examining the impact of parent physical illness on child functioning. We review studies of illness characteristics (n = 16), individual characteristics (n = 6), and family characteristics (n = 6). Although children's self-reports indicate heightened distress, parental reports do not suggest more problematic functioning. Child adjustment appears to be more closely related to perceptions of stressfulness rather than to objective illness severity indices. Adolescent girls seem to represent a group at heightened risk. Preliminary results suggest that family variables such as cohesion, conflict, and individual and family coping styles are important predictors of child adjustment.     

Theology of the Cross and the Experience of God's Presence: A Lutheran Response to Pentecostal Wonderings

As Lutherans and Pentecostals begin an official international dialogue, the author, a Lutheran member of the dialogue, responds to two related sets of questions raised by a Pentecostal member of the dialogue during a preceding six‐year consultation between these traditions: whether there is a place in the Lutheran tradition for a “theology of glory,” considering the centrality of “a theology of the cross” for Luther; and how Lutherans speak about experiencing the presence of God, and the means through which one encounters God.     

A Strange Fire: an exploration of psycho‐spiritual development aided by Jungian analysis and Vedanta

This paper explores the process of psychological and spiritual development through a series of active imaginations arising from the author's ‘psycho‐spiritual quest’, a process of transformation in which the individual progressively frees themselves from the ego's identifications and may be afforded a vision of the ‘self as consciousness’, as described by Vedanta. The author describes how this quest was facilitated by the disciplines of Transcendental Meditation, Jungian analysis and Vedanta, and how these three disciplines can work together to foster psycho‐spiritual development. The paper aims to de‐mystify the actual experiences that can accompany these practices. The records of these active imaginations, tracing some key stages in this process, are then presented, with a commentary by Marcus West, linking them to Jung's concepts of ego and Self and recent understandings of consciousness and ego development. There is a discussion of Jung's conceptualizations of the ego and the Self and his rejection of the Vedantic understanding of the Self as consciousness. These views are then explored and a reconciliation is suggested through the understanding of the process of disidentification where the difference between Jung's view of the Self and that of Vedanta is understood to be due to the extent of disidentification from the contents of consciousness.     

Health anxiety and hypochondriasis in the light of DSM-5

Background: In the DSM-5, the diagnosis of hypochondriasis was replaced by two new diagnositic entities: somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Both diagnoses share high health anxiety as a common criterion, but additonal somatic symptoms are only required for SSD but not IAD. Design: Our aim was to provide empirical evidence for the validity of these new diagnoses using data from a case–control study of highly health-anxious (n = 96), depressed (n = 52), and healthy (n = 52) individuals. Results: The individuals originally diagnosed as DSM-IV hypochondriasis predominantly met criteria for SSD (74%) and rarely for IAD (26%). Individuals with SSD were more impaired, had more often comorbid panic and generalized anxiety disorders, and had more medical consultations as those with IAD. Yet, no significant differences were found between SSD and IAD with regard to levels of health anxiety, other hypochondriacial characteristics, illness behavior, somatic symptom attributions, and physical concerns, whereas both groups differed significantly from clinical and healthy controls in all of these variables. Conclusion: These results do not support the proposed splitting of health anxiety/hypochondriasis into two diagnoses. Further validation studies with larger samples and additional control groups are warranted to prove the validity of the new diagnoses.     

Shoppers in the Spiritual Supermarket: A Quantitative Study of Visitors to Scandinavia’s Largest Alternative Fair

Presenting data from a quantitative survey (N=362) at ‘The Great Alternative Fair’ in Lillestrøm, Norway, this article explores the demographic and religious profiles of the ‘customers’ in the ‘spiritual marketplace’. Many adhere to ideas that are historically associated with different religious traditions. At the same time, there are strong positive statistical correlations between belief in alternative ideas, such as healing, reincarnation, channelling, and clairvoyance. This indicates that such ideas constitute a clustered and shared set of beliefs. Against this background, the article questions the widely held assumption that people who are oriented towards alternative spiritualities are independent of institutions and authorities and it argues that they are informed to a large extent by a set of collective resources. It is suggested that the marketplace, which constitutes a common framework of interaction, plays a key role in connecting various ideas and actors and in creating a common ideological profile.     

Message in a bottle: a comparative study of spiritual needs of children and young people in and out of hospital

Using the metaphor of a message in a bottle as a framework and sending an S.O.S. to adults, the question of what are the three biggest needs of children and young people was asked. Data consisting of 107 important needs of children and young people was collected from 36 children and young people both in and out of hospital: in hospital by chaplains and other health care professionals, and out of hospital by children and youth work undergraduate students. This was a convenience sample across the United Kingdom with the majority of respondents in the Midlands. The data were coded and then thematically analysed and separately compared to Maslow’s hierarchy of needs. Emotional needs was the largest theme for hospitalised children and young people and relationship needs for the non-hospitalised children and young people. For both groups Maslow’s level 3 need of belonging was the greatest averaging at just over half the needs shared. A discussion of the results of the analyses identifies some ways in which the needs of hospitalised children and young people may differ, identifying some implications for practice.     

THE NEUROSCIENCE OF WESLEYAN SOTERIOLOGY: THE DYNAMIC OF BOTH INSTANTANEOUS AND GRADUAL CHANGE

In his work Rewired: Exploring Religious Conversion, dealing with Wesleyan soteriology and neuroscience, Paul Markham claims that when one incorporates biology as an epistemic restriction in theologies of conversion, doctrines of instantaneous conversion are invalidated. He asserts that conversion must always be gradual, because the mechanism by which the brain changes in response to experience does not occur instantaneously; rather change is initiated and consolidated over an often lengthy span of time. I argue, however, that doctrines of instantaneous conversion are maintained when taking neuroscience into account. First, for doctrines of conversion that hold to the imputation of Christ's righteousness, neuroscience is irrelevant, because statements of instantaneous change are in terms of a relational status and not biological. Rapid conversion is maintained as a metaphysical position. Second, an embodied and neurologically realized change is expected in theologies of conversion that hold to impartation and, contrary to Markham, immediate change is neurologically possible in a variety of ways.     

Changes over time in head and neck cancer patients’ and caregivers’ illness perceptions and relationships with quality of life

Objective: This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months.

Design: Forty-two patient–caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor–Partner Interdependence Model.

Main Outcome Measure: Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N).

Results: Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up.

Conclusion: Patients’ and their caregivers’ perceptions of HNC are dynamic over time. Greater discrepancy between patients’ and caregivers’ illness perceptions at diagnosis predict poorer subsequent patient HRQL.     

Journeys With People Who Have Dementia: Connecting and Finding Meaning in the Journey

This article begins with a reflective journey with one person who was diagnosed with early onset dementia. It then turns to reflect on the subsequent journey of research with other people who have dementia and where they find meaning in life, through the process of spiritual reminiscence. The article views dementia through a theological lens that sees those who have dementia as people made in God’s image and the implications this has for the lives of those living with dementia and those who care for them. One of the important findings from research conducted in the small group process was that meaning was almost synonymous with relationship and connectedness for participants, just as it is for people who don’t have dementia.