Coping with adverse drug events in patients with heart failure: Exploring the role of medication beliefs and perceptions

This study describes coping strategies that patients with heart failure (HF) use to manage adverse drug events (ADEs). The included coping strategies were social support seeking, information seeking, non-adherence and taking alleviating medication. The role of beliefs about medication and ADE perceptions in explaining these coping strategies was assessed using the Self-Regulation Model. We performed a cross-sectional study including 250 HF patients who experienced an ADE. Patients completed validated questionnaires assessing their coping strategies, ADE perceptions and medication beliefs. Social support (60%) and information seeking (32%) were the most commonly used strategies to cope with ADEs. Non-adherence was reported by 7% of the patients. Multivariate linear regression analysis showed that demographics, clinical factors and medication beliefs explained only a small amount of the variance in coping strategies, whereas ADE perceptions explained a substantial amount of variance. Path analysis showed that patients’ perceptions about the timeline, consequences and controllability of ADEs by the health care provider were directly related to their coping behaviour. The effect of patients’ medication beliefs on their coping strategies was consistent with mediation through their ADE perceptions. Our results support the value of the Self-Regulation Model in understanding patients’ coping behaviour with regard to ADEs.     

Psychological impact of remote combat/graphic media exposure among US Air Force intelligence personnel

Since 2001 there has been a significant increase in the use of intelligence, surveillance, and reconnaissance (ISR) analysis for tactical, operational, and strategic decision makers engaged in global operations. To meet this demand, US Air Force intelligence personnel participate in remote combat and graphic media exploitation operations (e.g., review of still imagery, video, and audio), the long-term psychological effects of which are not well understood. Research to date has focused primarily on outcomes related to how intelligence personnel work, versus the specifics of what they do. Military psychologists embedded in ISR units conducted studies to address this gap. Intelligence analysts participated in focus groups and surveys assessing the frequency of exposure, previous exposures to other potentially traumatic events, symptoms of PTSD, moral injury, and other psychosocial experiences. Results showed that exposure levels, albeit virtual, rivaled or exceeded those reported by a sample of special operations forces. Results also showed that specific types of exposures (e.g., witnessing US military casualties, civilian casualties, atrocities committed by the enemy) are related to increased posttraumatic stress and other sequelae that may not adequately be captured by standard posttraumatic stress disorder screening measures. The results contribute to the existing literature on posttraumatic stress, shed new light on the emerging construct of moral injury, and highlight challenges presented by remote combat and graphic media exploitation operations to force health sustainment and performance optimization. The authors provide directions for future research and recommendations for ongoing assessment, monitoring, and selection and training of ISR personnel.     

Emotional Processing Therapy for post traumatic stress disorder

While prolonged exposure is considered one of the “gold standard” and recommended treatments for post traumatic stress disorder (PTSD), it has been poorly utilised in clinical practice. Individuals with PTSD often find it too distressing to confront memories, and therapists may be uncomfortable using the therapy. A new Emotional Processing Therapy is described in which an emotional approach to prolonged exposure provides individuals with a new insight into how trauma is processed. A conceptual analysis of exposure suggests that it is exposure to distressing emotional experiences which is a key element. Viewing it as an emotion-based therapy, allows the creative addition of new emotional elements. Through exploring the individual’s emotional processing style, previously learned and unhelpful patterns can be addressed, and the addition of an “emotional preparation” phase helps them understand why it is important to face emotionally distressing memories before exposure sessions begin. Emotional Processing Therapy is intuitive and makes sense to those affected by PTSD. It is framed in an emotional context and is presented as part of a lifestyle change that may reduce the likelihood of psychological problems developing in the future.     

Using Medical Family Therapy with Parents of an Adult Child with Traumatic Brain Injury

Abstract

Acquired traumatic brain injury (ATBI) is a public health concern causing approximately 2.5 million emergency room visits in the United States annually. Medical family therapy (MedFT) displays how biological issues impact each area of a client’s life. This paper highlights how MedFT can be utilized with parents of an adult child with ATBI; the case is presented as treatment occurred with benefits of the inclusion of MedFT. Researchers propose a call to the field of marriage and family therapy to increase access of MedFT to afford more opportunities to help families who experience medical conditions.     

Psychological wellbeing and the diathesis-stress hypothesis model: The role of psychological functioning and quality of relations in promoting subjective well-being in a life events study

Negative life events are associated with poor wellbeing and mental health outcomes. Following a diathesis-stress model, we tested whether psychological functioning and quality of interpersonal relationships moderated the effect of life events on subjective wellbeing. This study comprised data from a young and middle-aged adult sample (n = 364) drawn from an Australian university-student population. Results indicated that life events were associated with negative but not positive wellbeing outcomes. Perceived impact of life events was a stronger predictor of wellbeing than was the number of life events. Psychological functioning and quality of interpersonal relationships were associated with both wellbeing dimensions but only quality of interpersonal relationships moderated the effect of life events on wellbeing. In conclusion, perceived impact of life events was more strongly related to wellbeing than number of life events. Interpersonal relationships moderate the effect of life events with those reporting higher levels of quality of interpersonal relationships reporting less decrement in negative affect following stressful life events.     

Social anxiety and the accuracy of predicted affect

Social anxiety is theorised to arise from sustained over-activation of a mammalian evolved system for detecting and responding to social threat with corresponding diminished opportunities for attaining the pleasure of safe attachments. Emotional forecasting data from two holidays were used to test the hypothesis that greater social anxiety would be associated with decreased expectations of positive affect (PA) and greater anticipated negative affect (NA) on a holiday marked by group celebration (St. Patrick's Day) while being associated with greater predicted PA for daters on a romantic holiday (Valentine's Day). Participants completed symptom reports, made affective forecasts and provided multiple affect reports throughout each holiday. Higher levels of social anxiety were associated with greater anticipated PA for Valentine's Day daters, but lower experienced PA on the holiday; this was not found for trait anxiety and depression. Alternatively, trait anxiety, depression and social anxiety were associated with less predicted PA for St. Patrick's Day, greater anticipated NA and diminished experienced PA/greater NA during the holiday. Results are discussed in light of perceived hope for rewarding safe emotional contact for those daters in contrast to the greater possibility for social threat associated with group celebration typical of St. Patrick's Day.     

On questioning being: Foucault’s Heideggerian turn

Attempts to resolve the question of Foucault’s relationship to Heidegger usually look for points of substantive correlation between them: the coincidence of being and power, the meaning of truth, technology, ethics, and so on. Taking seriously Foucault’s claim in his final interview that he uses Heidegger as an ‘instrument of thought’, this paper looks for a correlation in practice. The argument focuses on a structural isomorphism between Heidegger’s concept of the fourfold event (Ereignis) of being and later Foucault’s critique of ‘problematization’ (problématique). This isomorphism, I argue, indicates a covert philosophical confrontation between Foucault and Heidegger, which was determinative for Foucault in the period of the turn to ethics (1976–84). This is a confrontation over the meaning of the ‘event of thought’. Such an interpretation not only permits a literal reading of Foucault’s comments regarding Heidegger in his final interview, but also casts the developments in Foucault’s later work in a fascinating new light. Foucault’s critique of problematization, on this view, is founded in an historicized version of Heideggerian ‘other’ thinking, and pivots on a ontologically tempered enactment of the Heideggerian turn (Kehre).     

Community-Based Interventions in New York City After 9/11

Abstract

The horrors of 9/11 have created tremendous psychosocial needs in the population of New York. For all major providers in this field, this has meant taking up the challenge of learning within the new situation, creating new frameworks for intervention, and implementing programs that previously had not been a part of the traditional social services environment. In this article, we will describe the process of transforming this challenge into an opportunity for organizational, professional and conceptual growth.     

Exploring the Nature of Traumatic Memory

Summary

For over 100 years clinicians have observed and described the unusual nature of traumatic memories. It has been repeatedly and consistently observed that these memories are characterized by fragmentary and intense sensations and affects, often with little or no verbal narrative content. Yet, possibly because traumatic memories cannot be precipitated under laboratory conditions, the organization of traumatic memories has received little systematic scientific investigation. In our laboratory we have developed an instrument, the Traumatic Memory Inventory (TMI), which systematically assesses the ways that memories of traumatic experience are organized and retrieved over time. In this article we report findings from our third study using the TMI, of 16 subjects who had the traumatic experience of awakening from general anesthesia during surgery. We assessed changes in traumatic memory characteristics over time and differences between memories of subjects with and without current Post-Traumatic Stress Disorder. Our findings suggest the need for more rigorous methods for the assessment of the evolution of traumatic memories. In order to develop a comprehensive and integrated understanding of the nature of traumatic memory, we need to combine careful clinical observations with repli-cable laboratory methods, including those of cognitive science and neuroscience.     

Attachment Mediates the Childhood Maltreatment–Daily Hassles Link in Low-Income,Suicidal African American Women

This study examined if attachment patterns mediated the link between childhood maltreatment and total daily and interpersonally oriented life hassles in 135 low-income, inner-city, suicidal African American women. Participants completed self-report measures of childhood maltreatment, attachment styles, and daily life hassles dimensions. Bootstrapping analyses revealed that (a) negative views of self mediated the relationship between childhood maltreatment and social and cultural difficulties and social acceptability; and (b) negative views of other mediated the relationship between childhood maltreatment and total daily life hassles, social victimization, and social and cultural difficulties. These findings can inform interventions for suicidal African American women with a history of childhood maltreatment and subsequent maladaptive attachment styles.