Illness perceptions and self efficacy beliefs in adolescents and young adults with insulin dependent diabetes mellitus

Abstract

The study examined the role of illness perceptions and self-efficacy in diabetic regimen adherence and metabolic control among young patients with Insulin Dependent Diabetes Mellitus (IDDM). Sixty-four outpatients with Insulin Dependent Diabetes completed measures of illness perceptions, generalised and diabetes specific self-efficacy and a self-report measure of adherence. Metabolic control (HbAlc) was also assessed. Control, identity and consequences components of illness perceptions were significantly correlated with self-efficacy expectancies. Control beliefs were consistently associated with self-reported adherence across all treatment aspects and accounted for 39% of the predicted variance in total adherence. The associations of the other psychological predictors examined, varied depending on the regimen area. Multiple regression analysis showed that 30.8% of the variance in HbAlc assays was explained by patients' diabetes specific self-efficacy, consequences and identity. Our findings suggest that patients' beliefs are useful predictors of physiological and behavioural outcomes in diabetes self-management and should thus be the focus of routine clinical assessments and future interventions.     

心理疾病内隐污名述评

心理疾病内隐污名是个体无法内省或精确识别的与心理疾病有关的痕迹, 它潜在地调节着个体对心理疾病患者的观念和行为。心理疾病内隐污名的主要测量方法包括内隐联想测验、简式内隐联想测验、启动任务和生理心理测量。当前该研究领域集中在内隐污名的成分、公众内隐污名、自我内隐污名、去污名化评估等方面。未来研究可从心理疾病内隐污名的构成与结构、认知神经基础、测量整合和本土化等角度做进一步探讨。     

心理疾病自我污名:心理康复的一个高危因子

心理疾病自我污名是心理疾病患者内化公众的消极刻板印象、偏见和歧视,形成自我偏见和歧视的现象.心理疾病自我污名会给患者带来一系列的负面影响,是心理康复过程中的一个高危因子.自我污名可能是通过引发患者的消极认知、负面情感和自我歧视行为来危及心理康复过程的.对自我污名的干预应针对患者和社会公众分别加以实施.未来可以从理论构建、测量工具和干预措施的改进,以及去污名与心理康复的融合等方面展开自我污名本土化的研究.     

Citizenship and Community Mental Health Care

Citizenship is an approach to supporting the social inclusion and participation in society of people with mental illnesses. It is receiving greater attention in community mental health discourse and literature in parallel with increased awareness of social determinants of health and concern over the continued marginalization of persons with mental illness in the United States. In this article, we review the definition and principles of our citizenship framework with attention to social participation and access to resources as well as rights and responsibilities that society confers on its members. We then discuss our citizenship research at both individual and social‐environmental levels, including previous, current, and planned efforts. We also discuss the role of community psychology and psychologists in advancing citizenship and other themes relevant to a citizenship perspective on mental health care and persons with mental illness.     

19世纪西方医学对精神疾病诊治的影响

精神疾病是现代困扰人类的主要疾病之一。通过总结19世纪西方医学对精神疾病的认识及主要治疗方法,拟展现这个世纪中治疗方法随观念变化和实践深入而发展的轨迹,旨在说明19世纪是西医精神病学发展史上的重要时期,并揭示其与现代精神疾病治疗的历史传承性。     

Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson’s Disease

Parkinson’s disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD. This study was conducted at the Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. The first author was previously affiliated with the Houston Center for Quality of Care and Utilization Studies.     

Pigeons' preferences for stimulus information: effects of amount of information

A concurrent-chain procedure was used to study pigeons' preferences as a function of amount of information. Pigeons chose between two terminal links. Both terminal links ended in food reinforcement with probability (p) and in blackout with probability (1–p). One terminal link (noninformative link) was signalled by a stimulus uncorrelated with either food or blackout. The other terminal link (informative link) was signalled by stimuli correlated with these outcomes. Amount of information conveyed by these stimuli was varied across conditions by changing the probability of reinforcement (p) and blackout (1–p). The pigeons strongly preferred the informative link, and preferences were greater at p values above 0.50 than for their complements. The pigeons engaged in different behaviors during the stimulus periods, suggesting that the value of informative stimuli may be in their function as discriminative stimuli for interim activities and terminal responses.     

“Decoding MH”—A de-stigmatization campaign in the Hong Kong Police Force

Police officers are under high level of stress given the intense and emergent work nature. If left untreated, their mental wellbeing would be at risk and work performance compromised. However, mental health stigma is common among police officers and is perpetuated by factors like police cultures emphasizing toughness and self-reliance. In view of this, since 2016, the Hong Kong Police Force had launched a holistic campaign for Force members which was the first among law enforcement organizations in Hong Kong, aiming to reduce stigma, by enhancing mental health knowledge and decreasing negative attitudes and behaviors towards mental health issues. The programme incorporated standardised trainings of the Mental Health First Aid course with examples modified to the local police context, and psychoeducation via the use of digital medium and sharing by public figures. Positive feedback was received. It was foreseen that the campaign effects would increase Force members' awareness of their mental health, encourage help-seeking and facilitate officers' decision making when encountering crises in the community.     

A Reply to the Commentaries of Drs DiBenedetto and Pakenham

This commentary addresses some of the cogent responses offered by Drs. DiBenedetto and Pakenham and the idea of an alternative approach to addressing the self‐care needs of our profession.