The psychometric properties of the Greek version of the State-Trait Anxiety Inventory in cancer patients receiving palliative care

Objectives: To validate the Greek version of the State-Trait Anxiety Inventory (STAI) in a sample of cancer patients. Design: The scale was administered twice, with a 3-day interval, to 99 eligible patients with cancer. Together with the Greek version of STAI scale, the patients also completed the anxiety subscale from the Hospital Anxiety and Depression scale (HAD). Observations: Factor analysis yielded a three-factor solution, explaining 47.143% of the variance. Cronbach α for three scales was between 0.729 and 0.852. Inter-scale correlations were moderate-to-high and ranged from 0.282 to 0.563 (p < 0.0005, p < 0.005). The assessment of the relationships among the Greek STAI scales and HAD-Anxiety showed statistically significant correlations between them (r ranged between 0.428 and 0.596, p < 0.0005). The test/retest reliability of scale (Pearson's ‘r’), showed that the coefficient agreement ranged between 0.85 and 0.90 (p < 0.0005). Univariate analysis revealed significant correlations between female gender, metastasis, performance status, chemotherapy, mild opioids and low education level with increased anxiety. Conclusions: These results support that the Greek version of STAI is an instrument with satisfactory psychometric properties, and is a valid research tool for Greek cancer patients.     

Lightness of an object under two illumination levels

Anchoring theory (Gilchrist et al, 1999 Psychological Review 106 795-834) predicts a wide range of lightness errors, including failures of constancy in multi-illumination scenes and a long list of well-known lightness illusions seen under homogeneous illumination. Lightness values are computed both locally and globally and then averaged together. Local values are computed within a given region of homogeneous illumination. Thus, for an object that extends through two different illumination levels, anchoring theory produces two values, one for the patch in brighter illumination and one for the patch in dimmer illumination. Observers can give matches for these patches separately, but they can also give a single match for the whole object. Anchoring theory in its current form is unable to predict these object matches. We report eight experiments in which we studied the relationship between patch matches and object matches. The results show that the object match represents a compromise between the match for the patch in the field of highest illumination and the patch in the largest field of illumination. These two principles are parallel to the rules found for anchoring lightness: highest luminance rule and area rule.     

Does quality of sleep mediate the effect of depression on hopelessness?

The objectives of the study were to evaluate the relationship between sleep quality, depression, and hopelessness in advanced cancer patients and whether sleep quality mediated the effect of depression on hopelessness. The final sample consisted of 102 advanced cancer patients under palliative treatment. Patients completed the Greek Pittsburgh Sleep Quality Index, a sleep quality instrument, the Greek Beck Depression Inventory for measuring depression, and finally the Beck Hopelessness Scale. Patients' performance status was assessed by their overall physical functioning, as defined by the Eastern Cooperative Oncology Group. Depression was highly associated with hopelessness (r = .52, p<.001). Statistically significant associations were found between sleep quality with hopelessness (r = .37, p<.001), as well as with depression (r = .36, p<.001). Mediation analyses indicated that depression influenced hopelessness directly as well as indirectly by its effect on sleep quality. About 14.58% of the variation in hopelessness was explained by depression; 4% of the variance in hopelessness explained by depression was accounted for by the mediation pathway indicating that sleep quality mediated the relationship between depression and hopelessness. Similarly, in the reverse mediation analysis, depression mediated the relationship between sleep quality and hopelessness; 43% of the variation in hopelessness was explained by sleep quality. In conclusion, some of the effect of depression on hopelessness was mediated by sleep quality, but depression had a direct effect on hopelessness as well. Additionally, some of the effect of sleep quality on hopelessness was mediated by depression. The current findings are important because improving sleep quality by treating depression may contribute to decreased hopelessness scores and vice versa: Treating depression by improving sleep quality may also contribute to lower hopelessness scores.     

The influence of cancer impact on patients’ preparatory grief

The aims of this study were to investigate the preparatory grief and traumatic distress in advanced cancer patients in a palliative care unit. A total of 94 advanced cancer patients completed the Preparatory Grief in Advanced Cancer Patients (PGAC) scale and the Greek version of the Impact of Events Scale- Revised (IES-R-Gr). The Eastern Cooperative Oncology Group was used to measure patients’ performance status. Statistically significant associations were found between PGAC, patients’ performance status, and all the IES-R-Gr scales (avoidance, intrusion, hyperarousal) and IES-R-Gr total score. The multiple regression analysis revealed that preparatory grief was predicted by patients’ young age, poor performance status, as well as by their high levels of intrusion and hyperarousal, in a model explaining 51.5% of the total variance. Concluding, in advanced cancer patients, preparatory grief is significantly correlated with the impact of cancer and patients’ physical condition, and seems to be influenced by components of the event impact, patients’ age, and physical performance.     

The moderating role of early traumatic experiences on the association of schizotypal traits with visual perception

The findings on the association of schizotypal traits with the perception of visual illusions are scarce and inconsistent and have not taken into consideration potential effects of childhood traumatic experiences, a risk factor for schizophrenia-spectrum conditions. Thus, the present study addressed the question of potential moderating effects of early traumatic experiences on the association between different aspects of schizotypal traits with the perception of the Müller-Lyer and Navon's Hierarchical Letters (NHL) illusions. The study revealed that (a) increased suspiciousness was associated with increased liability to the Müller-Lyer illusion, when the exposure to traumatic events was high, whereas the opposite pattern was true when the exposure to traumatic events was low; (b) negative schizotypy was associated with more accurate global perception, and high disorganized schizotypy was associated with superior accuracy when target letters were present during the NHL illusion, when early traumatic experiences were at lower levels; and (c) high negative, disorganized, and total schizotypy were associated with lower accuracy when target letters were present in the NHL paradigm, when early traumatic experiences were at higher levels. The findings of the study suggest that early traumatic events differentially moderate the relationship between various aspects of schizotypal traits and visual perceptual processing.     

An anchoring theory of lightness perception

A review of the field of lightness perception from Helmholtz to the present shows the most adequate theories of lightness perception to be the intrinsic image models. Nevertheless, these models fail on 2 important counts: They contain no anchoring rule, and they fail to account for the pattern of errors in surface lightness. Recent work on both the anchoring problem and the problem of errors has produced a new model of lightness perception, one that is qualitatively different from the intrinsic image models. The new model, which is based on a combination of local and global anchoring of lightness values, appears to provide an unprecedented account of a wide range of empirical results, both classical and recent, especially the pattern of errors. It provides a unified account of both illumination-dependent failures of constancy and background-dependent failures of constancy, resolving a number of long-standing puzzles.     

Parent training in nonviolent resistance for adult entitled dependence

"Adult entitled dependence" is a condition characterized by the extreme dependence of grown children on their family and by levels of dysfunction, seemingly excessive in light of their apparent capacity to function. The family and the dependent adult become involved in an interaction in which the very attempts to alleviate the problem may aggravate it. Parent-training in nonviolent resistance (NVR) is an intervention that has been shown to be helpful to parents of behaviorally disturbed youth. Parent training in NVR offers parents means to shift away from a stance of helplessness toward realistic goals that are accomplishable without the collaboration of their offspring. We report on the parents of 27 entitled dependent grown children who participated in parent training in NVR. Additionally, we present 2 detailed case studies that exemplify the problem and the therapeutic process. Before treatment, the dependent adults were not working or studying, drew heavily on parental services (financial or otherwise), and were resistant to parental attempts to change the situation. Most parents succeeded in overcoming their helplessness and reducing the provision of parental services. In a considerable proportion of cases, the grown children started working or studying or moved to independent lodgings.     

Grouping illumination frameworks

According to Koffka (1935), the lightness of a target surface is determined by the relationship between the target and the illumination frame of reference to which it belongs. However, each scene contains numerous illumination frames, and judging each one separately would lead to an enormous amount of computing. Grouping those frames that are in the same illumination would simplify the computation. We report a series of experiments demonstrating that nonadjacent regions of the visual field under the same illumination level are perceptually grouped together and function, to some extent, as a single framework. A small coplanar group of patches under its own illumination exhibits compression of perceived range of gray shades. We obtained the reduction in compression in the presence of an identically illuminated 25-patch Mondrian tableau mounted nearby the coplanar group. The influence of the Mondrian display was reduced when it was (a) moved laterally away from the test display, (b) moved farther back in depth from the test display, or (c) rotated to a different orientation.