Postpartum depression is more prevalent in mothers and fathers of preterm infants compared to parents of full-term infants and may have long-term detrimental consequences for parental mental health and child development. The temperamental profile of an infant has been postulated as one of the important factors associated with parental depressiveness in the first months postpartum. This study aimed to examine the longitudinal relationship between depressive symptoms and perceived infant temperament at 3 months corrected age, and depressive symptoms at 6 months (...) corrected age among mothers and fathers of infants born preterm. We assessed 59 families with infants born before the 34th gestational week using the Edinburgh Postnatal Depression Scale and the Infant Behavior Questionnaire-Revised. We found that mothers’ scores on EPDS and infants’ Orienting/regulation at 3 months corrected age predicted mothers’ EPDS scores at 6 months corrected age. In particular, higher depressive scores were related to higher depressive symptoms at 6 months corrected age, whereas higher infant Orienting/regulation was related to lower depressive symptoms at 6 months corrected age. Due to the low internal consistency of EPDS at 6 months for fathers, we were unable to conduct similar analyses for fathers. Our results point to the importance of considering both early indices of maternal mood as well as mother-reported measures of preterm infant temperament in the attempts to predict levels of maternal depressiveness in later months of an infant’s life. Further studies are urgently needed in order to better understand the associations between depressiveness and infant temperament in fathers, and with more consideration for the severity of the effects of infant prematurity. (shrink)

The present longitudinal study used the traditional cross-lagged panel model and autoregressive latent trajectory model with structured residuals to examine the relationships between perceived interparental conflict, negative thinking, and depression symptoms in Chinese children. Changes in these three variables over time were also examined, as well as the trait and state aspects of the relationships between them. A sample of 516 third-grade primary students completed questionnaires about IPC, NT, and depression three times over a period of 1 year, at 6-month (...) intervals. The CLPM findings indicated that, assuming that stability of each variable across time was controlled, Chinese children’s perception of IPC significantly affected their level of depression through the mediating path of NT. After taking trait factors into account, among all the significant autoregressive and cross-lagged paths originally found in the CLPM, only one third remained significant in the ALT-SR model. More specifically, the ALT-SR model, revealed a driving effect of children’s NT on perceived IPC and depression symptoms. The CLPM model although elucidated the interplay among three variables, the ALT-SR model showed little evidence of their interrelated growth across time. Taken together, these results indicate that children’s perceived IPC in the long term are a stable trait, with few state-level fluctuations, and is not a significant within-person predictor of subsequent children’s internalization problems. These perceptions appear to contribute more to children’s general psychological tendency than do changes over time. The research is the first to test the reciprocal relationships between Chinese children’s perceived IPC, NT, and depression symptoms. The findings demonstrate that previously proposed theories about the bidirectional relation between IPC and children’s social adjustment, to some extent, may reflect a correlation at a trait level. Put another way, it is IPC’s central tendency to be sensitive in the long term as a stable trait that is associated with their children’s general tendency to show well adjustment. The study contributes to our understanding of that extend previous results and have implications for complementary theoretical and practical interventions. The complementary techniques of CLPM and ALT-SR models offer different insights into children’s internalization problems, and hold promise for supporting the building of more comprehensive children’s developmental theories that acknowledge the interconnectedness of different domains of mental health. (shrink)

Fear is a common and potentially distressful psychological response to the current COVID-19 pandemic. The factors associated with such fear remains relatively unstudied among older adults. We investigated if fear of COVID-19 could be associated with a combination of psychological factors such as anxiety and depressive symptoms, and risk perception of COVID-19, and demographic factors in a community sample of older adults. Older adults completed measures of fear of COVID-19, anxiety and depressive symptoms, and risk perception of COVID-19, (...) during a COVID-19 lockdown. These variables, together with demographics, were fitted to a structural equation model. Anxiety and depressive symptoms were highly correlated with each other and were combined into the higher order latent variable of affective symptoms for analyses. The final model revealed that fear of COVID-19 was positively associated with psychological factors of affective symptoms and risk perception. Older age was associated with greater fear of COVID-19. Our findings showed that fear of COVID-19 can be a projection of pre-existing affective symptoms and inflated risk perceptions and highlighted the need to address the incorrect risk perceptions of COVID-19 and socio-affective issues among older adults in the community. (shrink)

The aim of this article is to present a conceptual review and analysis of symptom understanding. Subjective bodily sensations occur abundantly in the normal population and dialogues about symptoms take place in a broad range of contexts, not only in the doctor’s office. Our review of symptom understanding proceeds from an initial subliminal awareness by way of attribution of meaning and subsequent management, with and without professional involvement. We introduce theoretical perspectives from phenomenology, semiotics, social interactionism, and discourse (...) analysis. Drew Leder’s phenomenological perspectives deal with how symptom perception occurs when any kind of altered balance brings forward a bodily attention. Corporeality is brought to explicit awareness and perceived as sensations. Jesper Hoffmeyer’s biosemiotic perspectives provide access to how signs are interpreted to attribute meaning to the bodily messages. Symptom management is then determined by the meaning of a symptom. Dorte E. Gannik’s concept “situational disease” explains how situations can be reviewed not just in terms of their potential to produce signs or symptoms, but also in terms of their capacity to contain symptoms. Disease is a social and relational phenomenon of containment, and regulating the situation where the symptoms originate implies adjusting containment. Discourse analysis, as presented by Jonathan Potter and Margaret Wetherell, provides a tool to notice the subtle ways in which language orders perceptions and how language constructs social interaction. Symptoms are situated in culture and context, and trends in modern everyday life modify symptom understanding continuously. Our analysis suggests that a symptom can only be understood by attention to the social context in which the symptom emerges and the dialogue through which it is negotiated. (shrink)

The clinical encounter begins with presentation of an illness experience; but throughout that encounter, something else is constructed from it – a symptom. The symptom is a particular interpretation of that experience, useful for certain purposes in particular contexts. The hermeneutics of medicine – the study of the interpretation of human experience in medical terms – has largely taken the process of symptom-construction to be transparent, focussing instead on how constellations of symptoms are interpreted as representative of (...) particular conditions. This paper examines the hermeneutical activity of symptom-construction more closely. I propose a fourfold account of the clinical function of symptoms: as theoretical entities; as tools for communication; as guides to palliative intervention; and as candidates for medical explanation or intervention. I also highlight roles they might play in illness experience. I use this framework to discuss four potential failures of symptom-interpretation: failure of symptom-type and symptom-token recognition; loss of the complete picture of illness experience through overwhelming emphasis on its symptomatic interpretation; and intersubjective feedback effects of symptom description altering the ill person’s own perceptions of their phenomenal experience. I conclude with some suggestions of potential remedies for failures in the process of symptom-construction. (shrink)

High levels of somatic symptom distress represent a core component of both mental and physical illness. The exact aetiology and pathogenesis of this transdiagnostic phenomenon remain largely unknown. The Affective Picture Paradigm (APP) represents an innovative experimental paradigm to study somatic symptom distress. Based on the HiTOP framework and a population-based sampling approach, associations between facets of somatic symptom distress and symptoms induced by the APP were explored in two studies (N1 = 201; N2 = 254) using (...) structural equation bi-factor models. Results showed that the APP effect was significantly positively correlated with general somatic symptom distress (PHQ-15, HiTOP), cardio-respiratory symptoms (PHQ-15), as well as difficulties identifying feelings. In conclusion, negative affective cues in the APP can elicit somatic symptoms, particularly in people with higher levels of somatic symptom distress. Difficulties identifying feelings might contribute to this phenomenon. Results are compatible with a predictive processing account of somatic symptom perception. (shrink)

Research conducted in Montreal with schizophrenic patients was aimed at exploring the mode of Being-in-the-world and the kind of lifeworld associated with a positive evolution. Data were collected through open-ended interviews with patients who were contrasted for their rate of rehospitalization. The analysis combined structural analysis, inspired by hermeneutics, and discourse analysis. The interpretation of the data was guided by the framework provided by European phenomenological psychiatry. The research indicates that nonrehospitalization is associated with a specific mode of Being-in-the-world, which (...) is described at several levels: At the structural level, it is marked by a stance of "positive withdrawal" dominated by personal detachment; self-perceptions evidence various semiological and rhetorical strategies that contribute to the rearticulation of a sense of personal identity; narratives reveal that patients resort to a limited number of specific life strategies for relocating themselves within their own biography and within the present world. Hypotheses are posed regarding the potential influence of the North American culture on the restorative strategies drawn from the patients' narratives. (shrink)

This essay examines constructions of deafness in medieval culture, exploring how deaf experience disrupts authoritative discourses in three textual genres: medical treatise, literary fiction, and autobiographical writing. Medical manuals often present deafness as a physical defect, yet they also suggest how social conditions for deaf people can be transformed in lieu of treatment protocols. Fictional narratives tend to associate deafness with sin or social stigma, but they can also imagine deaf experience with a remarkable degree of sympathy and nuance. Autobiographical (...) writing by deaf authors most vividly challenges diagnostic models of disability, exploring generative forms of perception that deafness can foster. In tracing the disruptive force that deaf experience exerts on perceived notions of textual authority, this essay reveals how medieval culture critiqued the diagnostic power of medical practitioners. Deafness does not simply function as a symptom of an individual problem or a metaphor for a spiritual or social condition; rather, deafness is a transformative capacity affording new modes of knowing self and other. (shrink)

Les mémorialistes témoignent du ressentiment persistant qui accompagne les édits de pacification des années 1563 à 1598. Non publiés à cette époque, ils reflètent le mécontentement de voir les édits favoriser leurs adversaires, croient-ils, et les divers moyens par lesquels une population peut traduire la permanence des agressivités détournées, quelles que soient la date et les clauses d’oubli. Le peu de crédit apporté à la décision royale de coexistence pacifique ne construit, au delà des apparences disciplinées, que la perception (...) d’une régression à ce qui était l’origine des conflits. (shrink)

Les mémorialistes témoignent du ressentiment persistant qui accompagne les édits de pacification des années 1563 à 1598. Non publiés à cette époque, ils reflètent le mécontentement de voir les édits favoriser leurs adversaires, croient-ils, et les divers moyens par lesquels une population peut traduire la permanence des agressivités détournées (insultes, émeutes, tracasseries juridiques, désignations diffamatoires), quelles que soient la date et les clauses d’oubli. Le peu de crédit apporté à la décision royale de coexistence pacifique ne construit, au delà des (...) apparences disciplinées, que la perception d’une régression à ce qui était l’origine des conflits. (shrink)

This landmark volume brings together the work of the world's leading researchers in sublimated perception. This compilation marks a fundamental shift in the current study of subliminal effects: No longer in question is the notion that perception without awareness occurs. Now, the emphasis is on elucidating the parameters of subliminal effects and understanding the conditions under which stimuli perceived without awareness significantly influence affect, cognition, and behavior. PERCEPTION WITHOUT AWARENESS firmly establishes subliminal perception within the mainstream (...) of psychological science. Well represented here are the two main research branches that have emerged: One directly investigates the nature of subliminal effects; the other uses subliminal techniques as tools for investigating psychological phenomena such as hypnosis, dreaming, repression, social judgment and inference, psychopathology, and symptom formation. Broadly grouped into three main sections, the contributed chapters explore * The cognitive perspective--including implicit memory and implicit perception, the measurement of unconscious perceptual processes, and methods for revealing unconscious processes * The clinical perspective--exploring the cognitive and dynamic aspects of subliminal perception, memory, and consciousness; direct recovery of subliminal stimuli; and validation of subliminal psychodynamic activation * The social perspective--discussing subliminal mere-exposure effects, affect and social perception, and the role of subliminality in social psychology Timely and thought-provoking, PERCEPTION WITHOUT AWARENESS is sure to be of enormous interest to all psychoanalytic clinicians and scholars, as well as cognitive, clinical, and social psychologists whose work touches upon issues relating to psychopathology, perception, cognition, and memory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Diacritics 30.4 (2000) 59-82 [Access article in PDF] Bombing and the Symptom Traumatic Earliness and the Nuclear Uncanny Paul K. Saint-Amour Many used the Japanese word bukimi, meaning weird, ghastly, or unearthly, to describe Hiroshima's uneasy combination of continued good fortune and expectation of catastrophe. People remembered saying to one another, "Will it be tomorrow or the day after tomorrow?" One man described how, each night he was (...) on air-raid watch, "I trembled with fear.... I would think, "Tonight it will be Hiroshima." These "premonitions" were partly attempts at psychic preparation, partly a form of "imagining the worst" as a magical way of warding off disaster. —Robert J. Lifton, Death in Life: Survivors of Hiroshima (1967) Robert J. Lifton's pathbreaking work on the survivors of the atomic bombing of Hiroshima focuses on the psychological aftermath of the bomb, but opens with a brief and surprising section called "Anticipation." Given the instantaneous and unprecedented devastation caused by the first atomic bomb, the anticipation of so singular an experience is just as difficult to imagine as its subsequent assimilation. In fact, the unassimilable nature of traumatic violence would seem to depend in some way upon the impossibility of its anticipation, as Lifton implies: "Neither past experience nor immediate perceptions—the two sources of prior imagination—could encompass what was about to occur." Yet Lifton also records an expectant, premonitory atmosphere in Hiroshima during the weeks before the bombing, a compound of past experience and immediate perceptions that, while inadequate to "encompass" the eventual experience of the bomb, cannot simply be dismissed as speculation that found an accidental correlate in the nuclear event. While no one in Hiroshima knew ahead of time what would occur on August 6, 1945, many had noted the city's eerie exemption from conventional bombardment and speculated as to the reasons for it. During the summer of 1945, a series of rumors circulated in Hiroshima, rumors attributing the sparing of the city, variously, to its modest military and industrial significance; to the presence of prominent foreigners there, possibly including President Truman's mother; to important American prisoners-of-war supposedly held in the city; to the number of its citizens who had emigrated to the US; to the presence of large numbers of American spies living among its citizens; to its physical appeal in the eyes of Americans who had saved the city as a site for their postwar occupation villas; and, most wishfully, to the wartime grace of a cartographic error: "We thought that perhaps the city of Hiroshima was not on the American maps" [Lifton 15-17]. 1 Other inhabitants [End Page 59] of the city feared that Hiroshima appeared all too prominently on US maps, but had been set aside for "something unusually big"—perhaps the inundation of the city by floodwaters that could be released by the bombing of a massive upstream dam. Still others spoke of a "special bomb" [PWRS 220-22; Lifton 17]. All these rumors responded to citizens' impression that their city had been in some way singled out, and the term bukimi—also meaning "ominous" or "uncanny"—spoke to the suspended question of whether Hiroshima and its inhabitants had been singled out for preservation or for annihilation.The survivors who recollected their anticipatory bukimi years after the bombing may have retrospectively amplified their memories of weird expectation, perhaps as a way of attempting to master an incommensurable and singular event by installing it within a narrative of causality, continuity, even prophecy. Nonetheless, the bukimi experienced by inhabitants of Hiroshima should not be understood as pure retrospection, nor as groundless hunch, since it arose from a series of empirical observations later revealed to have a single and coherent origin in US military strategy. By the summer of 1945, most Japanese cities whose size and military-industrial importance were similar to Hiroshima's had already been bombed with incendiaries: those who lived in Hiroshima had watched waves of American bombers fly past on their way to other targets, while the dozen or so bombs that had fallen accidentally on... (shrink)

Cyberbullying is associated with the expansion of digital devices and the Internet. In Italy and other European and non-European countries, the phenomenon is growing. Young people who suffer from cyberbullying develop psychopathological symptoms of anxiety, depression, and social phobia that can lead to extreme acts, such as suicide. The pressure, the sense of isolation, and helplessness experienced by cyber-victims also affect their family and the school context. Cyberbullying is acted through digital tools, it is often anonymous, and aims to destroy (...) and psychologically humiliate the victim. There are various forms of cyberbullying that involve different reactions and consequences. However, few studies have focused on adolescents’ perception of cyberbullying. Youths often engage in aggressive behaviors, ignoring the feelings and reactions of the victims. Based on these considerations, our article aims to provide a general overview of the spread of the phenomenon and to understand the various types of cyberbullying and its consequences on victims. We will also illustrate a brief evaluation conducted in Italian schools investigating the perception of cyberbullying in a sample of 600 Italian adolescents. Our work aims to investigate the cognition and the personal perception of youths about cyberbullying and its consequences and to promote educational interventions within and outside the context of school. (shrink)

In agreement with Behrendt & Young (B&Y), we considered the role of perception disturbances in schizophrenia in our first clinical approaches, using the Bender test with schizophrenic patients. Following this, we reproduced nuclear symptoms of schizophrenia in animal models, showing that perceptual disturbances, acquisition disturbances, and decrease in affective levels can be induced by glutamatergic blockade within the nucleus accumbens septi. Our results link the proposed corticostriatal dysfunction with the thalamocortical disturbances underlying perceptual problems reviewed by B&Y.

COVID-19 is an acute respiratory illness with higher mortality in older adults. This condition is spread person-to-person through close contact, and among policies employed to decrease transmission are the improvement of hygiene habits and physical distancing. Although social distancing has been recognized as the best way to prevent the transmission, there are concerns that it may promote increased depression symptoms risk and anxiety, mainly in older adults. This cross-sectional study aimed to verify self-concept of social distancing in adults compared to (...) older adults. All participants, over 18 years and residents of São Paulo state, were invited to join this research study by a message application and answered an interdisciplinary questionnaire during the period from May 23 to June 23, 2020. The questions were divided into the following aspects: sociodemographic data, financial conditions, routine-related perception, perception of health, physical and emotional state, and eating habits. The younger adult group was composed of 139 participants, with a mean age of 43.15 years, and the older adult group was composed of 437 participants with a mean age of 67.59 years of both sex. Changes in routine during the period of social distance were reported by 95% of adults and 96.8% of older adults, but adults indicated more significant alterations in routine. Although there was no difference between groups for several aspects, adults revealed greater alterations in sleep quality, evacuation frequency, and more difficulty to perform daily activities at home. Further studies are necessary to follow up the impacts of social distancing among adults and older adults in different socioeconomic contexts to better understand the long-term alterations and the necessity of interventions. (shrink)

The present paper aims to shed light on some post-oedipal moments of the Freudian-Lacanian psychoanalysis. Going beyond the stereotypical opposition between the oedipal psychoanalysis and the anti-oedipal schizoanalysis, it endeavors to reinvestigate the semiotic nature of theknotenpunktand thesinthomeby applying some Deleuzian and Bakhtinian concepts. Thus, theknotenpunktis described as a grotesque knot bringing together some heterogeneous elements. The involved disparate components establish a rhizomatic multiplicity irreducible to a common determiner. As far as thesinthomeis concerned, it is also illustrated as a grotesque (...) knot quilting the disseminated heterogeneous orders. In contrast to the dominant conception of the symptom with a complex mode of signifying (that is mainly bound to the oedipal topography), theknotenpunktand thesinthomehold a kind of hyper-formative mode of signifying. As a result, the latter may be regarded as pure formators irreducible to a meaning or a certain interpretation. Finally, the paper sets out to analyze and evaluate the relationship between thesinthomeand the foreclosure from a semiotic perspective. Accordingly, thesinthomeis explained as a reply to foreclosure which is specifically a perceptive-imperative (retroactive) contemplation (in the light of law according to the Peircean phaneroscopy) on the rhizomatic multiplicity of psychosis (the case of schizophrenia). (shrink)

BackgroundThe COVID-19 pandemic has led governments worldwide to implement unprecedented response strategies. While crucial to limiting the spread of the virus, “social distancing” may lead to severe psychological consequences, especially in lonely individuals.MethodsWe used cross-sectional and longitudinal designs to investigate the links between loneliness, anxiety, and depression symptoms and COVID-19 risk perception and affective response in young adults who implemented social distancing during the first 2 weeks of the state of epidemic threat in Poland.ResultsLoneliness was correlated with ADS and (...) with affective response to COVID-19’s threat to health. However, increased worry about the social isolation and heightened risk perception for financial problems was observed in lonelier individuals. The cross-lagged influence of the initial affective response to COVID-19 on subsequent levels of loneliness was also found.ConclusionThe reciprocal connections between loneliness and COVID-19 response may be of crucial importance for ADS during the COVID-19 crisis. (shrink)

Higher levels of reliance on cognitive reappraisal to manage daily emotional events are commonly associated with lower levels of depressive symptoms. However, reappraisal is a cognitively demanding regulation strategy, and its efficacy may depend on how successfully an individual is able to employ it. Individual differences in the association between reappraisal use and depressive symptoms may be particularly evident during adolescence, when the cognitive skills required to implement this complex strategy are still in development. The current study sought to determine (...) whether the association between reappraisal use and subsequent depressive symptom development is contingent on perceived regulatory success when using reappraisal. At Wave 1, adolescents (n = 178, mean age = 13.92, 49.7% female) used an experience-sampling smartphone app to report on their reappraisal use and perceptions of regulatory success over the course of two weeks. Six, 12, and 18 months later, adolescents completed a self-report measure of their depressive symptoms. Results showed that a) reappraisal use was associated with both subsequent depressive symptoms and trajectories of depressive symptoms over time, b) these associations were moderated by perceptions of regulatory success. Higher levels of reappraisal use were associated with lower levels of depressive symptoms only for those who reported higher than average between-subject regulatory success when reappraisal was enacted. (shrink)

Schizophrenia as a pathology of self-awareness has attracted much attention from philosophical theorists and empirical scientists alike. I view schizophrenia as a basic self-disturbance leading to a lifeworld of solipsism adopted by the sufferer and explain how this adoption takes place, which then manifests in ways such as first-rank psychotic symptoms. I then discuss the relationships between these symptoms, not as isolated mental events, but as end-products of a loss of agency and ownership, and argue that symptoms like thought insertion (...) and other ego-boundary disorders are by nature a multitude of paradoxes created by a fragmented awareness. I argue that such fragmentation does not always require or lead to a delusional elaboration as the definitive feature of its phenomenology, and present reasons for the role of the first-person pronoun as a mere metaphor used to represent the patient’s bizarre experiences where sensory perception and thinking processes converge. Further, I discuss the initi... (shrink)

The arts provide openings for symbolic expression by engaging the sensory experience in the body they become a source of insight through embodied cognition and emotion, enabling meaning-making, and acting as a catalyst for change. This synthesis of sensation and enactive, embodied expression through movement and the arts is capitalized on in The BodyMind Approach®. It is integral to this biopsychosocial, innovative, unique intervention for people suffering medically unexplained symptoms applied in primary healthcare. The relevance of embodiment and arts practices (...) in TBMA are discussed in relation to the views of participants in the pursuit of self-management. If widely employed TBMA could have an enormous impact, reach, and significance for patients and global health services. This original pre-clinical trial of qualitative research reports on the perceptions of participant patients with generic MUS, a world-wide issue usually treated by either psychological therapy or physiotherapy. TBMA is not a therapy but a health education program founded upon the concept of an integration of psychological elements with physiological, bodily, and sensory experiences. Thematic analysis of qualitative data sets from open-ended questions in semi-structured interviews and a written questionnaire post intervention is presented. Five aspects which appear to be key to learning self-management were derived from analyzing the data: body with mind connections; importance of facilitation; potential benefits; preparedness for change; self-acceptance/compassion. This article advances the discourse on the nature of self-management for MUS through changing the mind-set and the relationship participants have with their bodily symptom/s through employing embodied methods and arts practices, challenging current, and solely verbal, psychological conceptual frameworks. Rigor lies in the method of data analysis using cross verification of credibility between reported findings and scrutiny by stakeholders. We conclude that facilitated TBMA groups employing embodied methods and arts practices can act as a method for developing the self-management of MUS and improving wellbeing. (shrink)

Central African highland farmers' perceptions of common bean disease were investigated using both phytopathology and anthropological techniques. Farmers rarely mentioned diseases as production constraints in formal questionnaires. More participatory research showed farmers often related disease symptoms to the effects of rain and soil depletion for fungal diseases, or to varietal traits for bean common mosaic virus. Rain or moisture is divided into numerous forms through which it can damage plants, both physically and through putrefaction. Most conditions associated with putrefaction appear (...) to be linked to pathogens. Farmers have an understanding of plant health closely related to their concept of human health. In plants, this understanding is based on the prior state of plant health. Conceptually, local disease management strategies are based on prevention by managing the conditions that promote good plant health rather than by treating disease symptoms. Intervention strategies that build on local knowledge are encouraged. (shrink)

Attachment orientations reflect individuals’ expectations for interpersonal relationships and influence emotion regulation strategies and coping. Previous research has documented that anxious and avoidant attachment orientations have deleterious effects on the trauma recovery process leaving these survivors vulnerable to posttraumatic stress disorder symptoms. However, avoidant attachment may be more complicated. Prior work has also found those high in avoidant attachment but also low in anxious attachment may not experience such vulnerabilities. Further, avoidant attachment individuals often report higher self-efficacy than their anxiously (...) attached counterparts. The present study examined trauma coping self-efficacy as a previously unexamined mechanism of action between adult attachment and PTSD symptoms. Structural equation modeling results showed that anxious attachment was associated with lower CSE-T and greater PTSD symptoms six weeks later. Further, a significant indirect effect of anxious attachment on PTSD symptoms through CSE-T was found. Contrary to hypotheses, avoidant attachment also exhibited an indirect effect on PTSD symptoms through CSE-T, such that avoidant attachment was associated with lower CSE-T, which in turn, was associated with greater PTSD symptoms. Also contrary to hypotheses, the interaction between anxious and avoidant attachment was not significantly associated with either CSE-T or PTSD symptoms. Results suggest that both anxious and avoidant attachment orientations contribute to poor self-regulation following trauma, as they undermine perceptions of trauma coping self-efficacy. (shrink)

The coherence of autobiographical memories plays an important role in psychological well-being, as borne out by recent studies. This study aimed to advance this understanding by assessing whether coherence predicted depressive symptoms over time in adults. Further, it aimed to specify mediators through which this association might occur, namely psychological resources of self-esteem self-efficacy, meaning in life, and optimism. A sample of 160 participants completed surveys at three time-points spaced 1 week apart. The surveys contained measures of the perceived coherence (...) of life stories and autobiographical memories, psychological resources, and depressive symptoms. The results of a path analysis model, controlling for depressive symptoms at baseline, indicated that perceived causal coherence was the only unique predictor of later depressive symptoms, and that this occurred through positive self-concept, represented by self-esteem and self-efficacy. Limitations of the study include no examination of cultural background as a moderating factor and the short time-intervals. Overall, the findings provide further evidence that the perception of how events have unfolded and impacted on one's life and sense of self is particularly important in mitigating depressive symptoms. It extends on our understanding by showing this occurs through changes in self-concept. (shrink)

BackgroundThe diagnosis of Attention deficit hyperactivity disorder is primarily dependent on parents’ and teachers’ reports, while children’s own perspectives on their difficulties and strengths are often overlooked.GoalTo further increase our insight into children’s ability to reliably report about their ADHD-related symptoms, the current study examined the associations between children’s self-reports, parents’ and teachers’ reports, and standardized continuous performance test data. We also examined whether the addition of children’s perceptions of ADHD-symptoms to parents’ and teachers’ reports would be reflected by objective (...) and standardized data.MethodsThe study included 190 children with ADHD, aged 7–10 years, who were referred to a pediatric neurologic clinic. A retrospective analysis was conducted using records of a clinical database. Obtained data included children’s self-reports of their attention level and ADHD-related symptoms, parent, and teacher forms of the Conners ADHD rating scales, Child Behavior Checklist, Teacher’s Report Form, and CPT scores.ResultsChildren’s self-evaluations of their functioning were globally associated with their teachers’ and parents’ evaluations, but not uniquely. Children’s self-reports of ADHD symptoms were not uniquely linked to a specific CPT impairment index, but to a general likelihood of having an impaired CPT. The CPT performance successfully distinguished between the group of children who defined themselves as inattentive and those who did not.ConclusionPrimary school children with ADHD are able to identify their limitations and needs difficulties and that their perspectives should inform clinical practice and research. The clinical and ethical imperative of taking children’s perspectives into account during ADHD diagnosis and treatment is highlighted. (shrink)

The current study analyzed the relationship between Coronavirus Awareness, mental health, and willingness to seek professional psychological help. This was made through a quantitative approach, using online questionnaires to collect data from 855 subjects. The questionnaires included the Brief Symptom Inventory to measure mental health indicators, the Attitudes Toward Seeking Professional Psychological Help Scale–Short Form, and the Coronavirus Awareness Scale-10. An Exploratory Factor Analysis suggests that three factors underlie the CAS-10: Coronavirus Concern, Exaggerated Perception, and Immunity Perception. (...) Results indicate a significant positive correlation between Coronavirus Concern and both general anxiety and phobic anxiety symptoms. Immunity Perception is positively related to paranoid ideation and psychotic symptoms. A Mediation Analysis determined that Coronavirus Concern has a significant positive direct effect on Openness to Seeking Psychological Treatment, while Exaggerated Perception and Immunity Perception scores have significant direct negative effects on the Value and Need in Seeking Treatment scores. Indirectly, the relationship between Coronavirus Concern and OPST is significantly mediated by anxiety symptoms. Similar results were found for the VNST subscale. There is a negative significant effect of Immunity Perception over OSPT mediated by Paranoid Ideation. However, the overall model only achieved small r2 coefficients for the OSPT and VNST scores. Comparisons in Coronavirus Awareness between sex, age, and the presence of children and older adults at home were also made. These results are discussed regarding their practical implications for mental health providers and policymakers. (shrink)

ObjectiveTo examine the effect of family and perceived organizational support on the relationship between nurse adaptability and their experience with COVID-related PTSD (post-traumatic stress disorder) symptoms in frontline nurses working on COVID-19 units.BackgroundProximity to and survival of life-threatening events contribute to a diagnosis of PTSD, which is characterized by avoidance of reminders of trauma, intrusive thoughts, flashbacks of events, sleep disturbances, and hypervigilance. Using the job-demands and resource model, we examined the effect of adaptability, family support, and perceived organizational support (...) on PTSD symptoms for nurses during the COVID-19 pandemic. Specifically, we tested whether perceptions of environmental supports—i.e., family and organizational support—moderated the relationship between nurse adaptability and COVID-related PTSD symptoms.MethodsA sample of frontline nurses working on COVID-19 units during the COVID-19 pandemic in Texas (N= 277) participated in this cross-sectional, observational study. Frontline Nurses reported demographic information and completed surveys designed to measure adaptability, perceived organizational support, family support, and COVID-related PTSD symptoms.ResultsAdaptability was significantly positively correlated (medium effects) to perceived organizational and family support (r= 0.51 and 0.56, respectively,p< 0.01). Adaptability and perceived organizational support were also negatively correlated with COVID-related PTSD symptoms (medium effects). Adaptability was negatively correlated with COVID-related PTSD symptoms, supporting Hypothesis 1 (r= −0.43,p< 0.01). Perceived organizational support was also significantly negatively correlated with COVID-19-related PTSD symptoms (r= −0.30,p< 0.01). Family support was not significantly correlated with COVID-related PTSD but was positively related to experiencing COVID-related PTSD after other variables were accounted for.ConclusionFindings suggest that individual adaptability and organizational support may reduce PTSD severity in frontline nurses working during a crisis; however, family support may increase PTSD symptoms. We provide suggestions for strengthening individual adaptability and healthcare leadership including remaining highly engaged to show support by providing rapid communication, remaining calm during difficult circumstances, and maintaining a consistent, physical presence during difficult times. Moreover, our results suggest additional support for nurses with families to adapt to crisis. (shrink)

This study aims to explore the influence mechanism of COVID-19 risk perception on anxiety in emerging adulthood in the context of public health events of the second round of COVID-19 outbreaks and provide support for exploring the path of mental health after the normalization of the epidemic situation. An online questionnaire, combined with community social work, was used in this study, and data of 522 emerging adults were collected in February 2021. The Perceived Risk of COVID-19 pandemic scale, the (...) generalized anxiety disorder 7-item scale, the scale of affect balance, and the connor-davidson resilience scale were used to investigate. The results showed that: first, the risk perception of COVID-19 in early adulthood was positively predictive of anxiety symptoms [B = 0.110, p < 0.05, 95%CI = ]. Second, the affective quality of life plays a mediating role between the risk perception of COVID-19 and anxiety [B = 0.108, 95%CI = ]. Thirdly, resilience plays a moderating role between the risk perception of COVID-19 and anxiety, the higher the resilience of emerging adulthood, the weaker effects of the risk perception of COVID-19 negative prediction of anxiety [B = −0.110, p < 0.001, 95%CI = ]. Therefore, to control the anxiety of emerging adulthood in public health events, we should pay attention to the propaganda and management of epidemic information, improve the quality of life, and attention should be paid to the emerging adulthood with low resilience. (shrink)

BackgroundThe main purpose of this study was to describe the latent structure of pregnancy perception by investigating the role of risks and medical examinations in pregnancy perception across the sexes and pregnancy status.MethodsStudy 1 developed a questionnaire based on the responses of 29 young adults on their perception of pregnancy. Study 2 consisted of distributing the questionnaire among 290 participants.ResultsThe statistical clustering analysis revealed three major clusters of pregnancy perceptions: “evaluative,” “physio-medical,” and “future considerations,” each of them (...) encompassing several meaningful sub-clusters. This structure of pregnancy perceptions supports Beck and Beck-Gernsheim’s modernization approach. Negative emotions toward pregnancy were related to social cognitions, whereas thoughts about risks were included in the medical sub-cluster. After reliability analyses, comparisons of scale scores revealed that women experienced more positive emotions, thought more about physical symptoms and about future issues compared to men.ConclusionPregnant participants felt less ambivalence toward pregnancy, thought more about risks and medical examinations and less about parents’ duties than non-pregnant participants. (shrink)

Every year medical researchers make contact with a large number of cancer survivors with the aim of evaluating cancer treatment. For this reason we decided to investigate how Swedish cancer survivors perceived their participation in research studies focusing on the long-term consequences of being a survivor of gynaecological or urinary bladder cancer. Data were collected by means of two study-specific postal questionnaires, both consisting of questions covering physical symptoms, well-being and the experience of being a cancer survivor. Both questionnaires also (...) included questions evaluating the participants’ experience of being research subjects. The questionnaires were developed in close co-operation with cancer survivors. The study population consisted of 1068 cancer survivors. Of these, 95% (n=1003) reported that they thought the study was valuable and 54% (n=559) that they had been positively affected by participating. Four per cent (n=39) expressed that they had been negatively affected by their participation in the study. The vast majority of the cancer survivors thought that participating in their particular study was valuable. (shrink)

Aims and background: Little is known about how participants perceive prevention trials, particularly trials designed to prevent mental illness. This study examined participants’ motives for participating in a trial and their views of randomisation and the ability to withdraw from a randomised controlled trial for prevention of depression. Methods: Participants were older adults reporting elevated depression symptoms living in urban and regional locations in Australia who had consented to participate in an RCT of interventions to prevent depression. Participants rated their (...) agreement with various statements describing motivations for enrolment in the trial and opinions regarding randomisation and withdrawal. Results: The majority of participants expressed a triad of altruistic motivation for participation, relative lack of concern about randomisation and commitment to the trial. Certain subgroups of participants, such as women and those with higher depression scores, reported higher levels of concern about specific issues. Conclusions: The findings suggest that participants enrolled in prevention trials for mental illness are likely to hold positive attitudes towards research trials. The identification of relationships between key person factors and trial-related attitudes enabled profiling of participant groups, which can inform recruitment strategies and interactions of participants and research projects in future prevention trials. (shrink)

Schizophrenia is associated with a series of visual perception impairments, which might impact on the patients’ every day life and be related to clinical symptoms. However, the heterogeneity of the visual disorders make it a challenge to understand both the mechanisms and the consequences of these impairments, i.e., the way patients experience the outer world. Based on earlier psychiatry literature, we argue that issues regarding time might shed a new light on the disorders observed in patients with schizophrenia.We will (...) briefly review the mechanisms involved in the sense of time continuity and clinical evidence that they are impaired in patients with schizophrenia.We will then summarize a recent experimental approach regarding the coding of time-event structure in time, namely the ability to discriminate between simultaneous and asynchronous events. The use of an original method of analysis allowed us to distinguish between explicit and implicit judgments of synchrony.We showed that for SOAs below 20ms neither patients nor controls fuse events in time. On the contrary subjects distinguish events at an implicit level even when judging them as synchronous. In addition, the implicit responses of patients and controls differ qualitatively. It is as if controls always put more weight on the last occurred event, whereas patients have a difficulty to follow events in time at an implicit level. In patients, there is a clear dissociation between results at short and large asynchronies, that suggest selective mechanisms for the implicit coding of time-event structure. These results might explain the disruption of the sense of time continuity in patients.We argue that this line of research might also help us to better understand the mechanisms of the visual impairments in patients and how they see their environment. (shrink)

Little is known about how individuals with and without mood disorders perceive the inherent risks and helpfulness of participating in innovative psychiatric research, or about the factors that influence their willingness to participate. We conducted an online survey with 80 individuals (self-reported mood disorder [n = 25], self-reported good health [n = 55]) recruited via MTurk. We assessed respondents’ perceptions of risk and helpfulness in study vignettes associated with two innovative research projects (intravenous ketamine therapy and wearable devices), as well (...) as their willingness to participate in these projects. Respondents with and without mood disorders perceived risk similarly across projects. Respondents with no mood disorders viewed both projects as more helpful to society than to research volunteers, while respondents with mood disorders viewed the projects as equally helpful to volunteers and society. Individuals with mood disorders perceived ketamine research, and the two projects on average, as more helpful to research volunteers than did individuals without mood disorders. Our findings add to a limited empirical literature on the perspectives of volunteers in innovative psychiatric research. (shrink)

The research aimed to gain understanding of the self-perceptions of black professionals in relation to business leadership, and how these self-perceptions influenced their behaviors, aspirations and self-perceived abilities in leadership positions. The study was specifically focused on black South African professionals. Black professionals were found to exhibit signs of deep-rooted pain, anger and general emotional fatigue stemming from workplace-, socio-economic- and political triggers that evoked generational trauma and overall negative black lived experiences. The negative lived experiences could have led to (...) racial identity dissonance and, in extreme cases, complete racial identity disassociation. Moreover, black professionals were found to display symptoms of ‘survivor guilt,’ stemming from the shared history of oppression amongst black people in South Africa. The ‘survivor guilt’ contributed toward a profound sense of shared responsibility and purpose to change the circumstances, experiences and overall perceptions about the capabilities of black professionals. Results showed that upbringing, determination, resilience, black support networks, and black leadership representation within organizational structures were important ingredients that positively contributed to the leadership aspirations and success of black professionals. The research discovered that, in some cases, black professionals leveraged white relationships to propel their careers forward, however, this practice reportedly resulted in the black professionals experiencing feelings of self-doubt in their own abilities. Self-doubt, also found to be a result of historical oppression, could have and have been shown to eventually lead to self-deselection, negatively impacting the aspirations and career advancement prospects of black professionals in organizational leadership. Furthermore, the research found that black leaders believed that their blackness, specifically, its unique texture of experiences and history in South Africa, provided them with superior empathetic leadership abilities toward other black employees. Black leaders frequently highlighted the distinctive values of ubuntu as the cornerstone of their leadership approach. In addition, it was found that black professionals also considered their blackness, particularly the shade of their skin, to detract from their leadership opportunities, as it reduced the odds of being authorized as natural leaders, thus fortifying a skewed self-perception of their own leadership capabilities. (shrink)

BackgroundNonverbal social perception is the ability to interpret the intentions and dispositions of others by evaluating cues such as facial expressions, body movements, and emotional prosody. Nonverbal social perception plays a key role in social cognition and is fundamental for successful social interactions. Patients with schizophrenia have severe impairments in nonverbal social perception leading to social isolation and withdrawal. Collectively, these aforementioned deficits affect patients’ quality of life. Here, we compare nonverbal social perception in patients with (...) schizophrenia and controls and examine how nonverbal social perception relates to daily functioning.MethodsWe compared nonverbal social perception in 41 stable outpatients with schizophrenia and 30 healthy controls using the Mini Profile of Nonverbal Sensitivity. The participants evaluated 64 video clips showing a female actor demonstrating various nonverbal social cues. Participants were asked to choose one of two options that best described the observed scenario. We correlated clinical ratings, Self-report of Negative Symptoms, and functional assessments with Mini-PONS scores.ResultsPatients performed significantly poorer in the Mini-PONS compared to controls, suggesting deficits in nonverbal social perception. These deficits were not associated with either positive symptoms or negative symptoms. However, impaired nonverbal social perception correlated with distinctive domains of BNSS, as well as functional capacity and functional outcome in patients.ConclusionWe demonstrate that nonverbal social perception is impaired in stable outpatients with schizophrenia. Nonverbal social perception is directly related to specific negative symptom domains, functional capacity and functional outcome. These findings underline the importance of nonverbal social perception for patients’ everyday life and call for novel therapeutic approaches to alleviate nonverbal social perception deficits. (shrink)

Although there have been numerous studies on mental wellbeing impairment or other negative consequences of Workplace Violence against healthcare professionals, however, the effects of WPV are not limited to those who experience WPV in person, but those who exposed to WPV information indirectly. In the aftermath of “death of Dr. Yang Wen,” a cross-sectional study was conducted to explore the psychological status of healthcare professionals. A total of 965 healthcare professionals from 32 provinces in China participated in our research. The (...) prevalence rates of Post-Traumatic Stress Disorder symptoms, depression, anxiety among healthcare professional in the current study were 25.60, 46.01, and 27.88%, respectively. Moreover, our research suggested that the awareness of WPV-incident had a significant association with PTSD symptoms. In addition, risk perception was shown to mediate the effect of WPV awareness on PTSD symptoms. Furthermore, the present research also found a U-shaped relationship between issue salience and PTSD symptoms, and the relationship between issue salience and anxiety, indicating that higher awareness of WPV issue was negatively related to mental health status but only to the points at which there were no additional effects of more issue salience. This study highlighted that more protective measures for healthcare professionals need to be implemented in response to potential WPV events. More importantly, risk perception was found to mediate the effect of WPV issue salience on PTSD symptoms, it is critical to reduce the mental health burden through intervening in risk perception. (shrink)

Attention deficit/hyperactivity disorder (ADHD) has been linked to higher engagement in sexual risk-taking behavior (SRTB). The current study aims to establish the link between ADHD symptoms and SRTB in the general population and to examine whether an exaggerated perceived benefit of the positive outcomes of SRTB explains that link. A scale for measuring the frequency, likelihood, perceived benefit, and perceived risk of SRTB was developed. Young adult sexually active participants who did not have a stable partnership completed the above scale, (...) as well as a scale of ADHD symptoms. Level of ADHD symptoms positively correlated with the frequency and likelihood of SRTB, even when the overall level of sexual behavior was controlled for. ADHD symptoms also correlated with the perceived benefit of SRTB, but not with the perceived risk of SRTB. Mediation analysis confirmed an indirect pathway: ADHD symptoms predicted perceived benefit of SRTB, which in turn predicted increased likelihood to engage in SRTB. These findings suggest a positive link between ADHD symptoms and SRTB in the general population, which is accounted for by an exaggerated perceived benefit of SRTB. (shrink)

Attention deficit/hyperactivity disorder (ADHD) has been linked to higher engagement in sexual risk-taking behavior (SRTB). The current study aims to establish the link between ADHD symptoms and SRTB in the general population and to examine whether an exaggerated perceived benefit of the positive outcomes of SRTB explains that link. A scale for measuring the frequency, likelihood, perceived benefit, and perceived risk of SRTB was developed. Young adult sexually active participants who did not have a stable partnership completed the above scale, (...) as well as a scale of ADHD symptoms. Level of ADHD symptoms positively correlated with the frequency and likelihood of SRTB, even when the overall level of sexual behavior was controlled for. ADHD symptoms also correlated with the perceived benefit of SRTB, but not with the perceived risk of SRTB. Mediation analysis confirmed an indirect pathway: ADHD symptoms predicted perceived benefit of SRTB, which in turn predicted increased likelihood to engage in SRTB. These findings suggest a positive link between ADHD symptoms and SRTB in the general population, which is accounted for by an exaggerated perceived benefit of SRTB. (shrink)

Research has shown that addressing and integrating the existential dimension in treatment settings reduce symptoms like anxiety, depression and substance abuse. Healthcare chaplains are key personnel in this practice. A nationwide, cross-sectional survey influenced by a mixed-methods approach was used to examine the attitudes, practices, understanding and perceptions of mental health professionals, including healthcare chaplains, regarding the value of addressing the existential dimension in treatment programmes. The existential group practice was led by the healthcare chaplains as an integrated part of (...) specialist mental health services. A positive and open attitude towards addressing the existential dimension was identified among the informants. Despite this, a small gap between attitude and practice was reported. Existential, religious and spiritual concerns are reported as part of the existential dimension and as relevant topics to be discussed in specialist mental health services. The findings indicate that the existential group practice could have a positive influence on the co-leaders’ competence to address existential, religious and spiritual concerns; however, this should be further investigated. (shrink)

Background: Achieving a “good death” is a major goal of palliative care. Nurses play a key role in the end-of-life care of older patients. Understanding the perceptions of both older patients and nurses in this area could help improve care during this period. Objectives: To examine and compare the preferences and perceptions of older patients and nurses with regard to what they feel constitutes a “good death.” Research design: A cross-sectional study. Participants and research context: This study employed a self-report (...) questionnaire that asked about various options for end-of-life care. It was distributed to older patients who attended the outpatient clinic of internal medicine and nurses who worked at two medical schools in Thailand from September 2017 to February 2018. Patients were asked to respond to the questions as if they were terminally ill, and nurses were asked to imagine how older patients would answer the questions. Ethical consideration: Approval from Institutional Review Board was obtained. Findings: A total of 608 patients and 665 nurses responded to the survey. Nurses agreed with concepts of palliative care, but they rated themselves as having poor knowledge. The patient respondents felt that it was most important that they receive the full truth about their illnesses. The nurses thought the most important issue was relief of uncomfortable symptoms. On seven out of the 13 questions, nurses overestimated the importance of the relevant issue to patients and underestimated the importance on one question. Discussion: Both nurses and older patients signified concepts of palliative care, but nurses felt that they lacked adequate knowledge. Nurses estimated that patients would have positive attitudes toward autonomy and the closure of life affairs to a significantly greater degree than the patient respondents. Conclusions: We recommend that palliative care education be improved and that steps be taken to allow for more effective nurse–patient communication with regard to the patients’ end-of-life wishes. (shrink)

A neuropsychological perspective on auditory verbal hallucinations links key phenomenological features of the experience, such as voice location and identity, to functionally separable pathways in normal human audition. Although this auditory processing stream framework has proven valuable for integrating research on phenomenology with cognitive and neural accounts of hallucinatory experiences, it has not yet been applied to other symptoms presumed to be closely related to AVH – such as thought insertion. In this paper, I propose that an APS framework offers (...) a useful way of thinking about the experience of TI as well as AVH, providing a common conceptual framework for both. I argue that previous self-monitoring theories struggle to account for both the differences and similarities in the characteristic features of AVH and TI, which can be readily accommodated within an APS framework. Furthermore, the APS framework can be integrated with predictive processing accounts of psychotic symptoms; makes predictions about potential sites of prediction error signals; and may offer a template for understanding a range of other symptoms beyond AVH and TI. (shrink)

Aging is accompanied by stereotyped changes in functional brain activations, for example a cortical shift in activity patterns from posterior to anterior regions is one hallmark revealed by functional magnetic resonance imaging (fMRI) of aging cognition. Whether these neuronal effects of aging could potentially contribute to an amelioration of or resistance to the cognitive symptoms associated with psychopathology remains to be explored. We used a visual illusion paradigm to address whether aging affects the cortical control of perceptual beliefs and biases. (...) Our aim was to understand the effective connectivity associated with volitional control of ambiguous visual stimuli and to test whether greater top-down control of early visual networks emerged with advancing age. Using a bias training paradigm for ambiguous images we found that older participants (n = 16) resisted experimenter-induced visual bias compared to a younger cohort (n = 14) and that this resistance was associated with greater activity in prefrontal and temporal cortices. By applying Dynamic Causal Models for fMRI we uncovered a selective recruitment of top-down connections from the middle temporal to Lingual gyrus (LIN) by the older cohort during the perceptual switch decision following bias training. In contrast, our younger cohort did not exhibit any consistent connectivity effects but instead showed a loss of driving inputs to orbitofrontal sources following training. These findings suggest that perceptual beliefs are more readily controlled by top-down strategies in older adults and introduce age-dependent neural mechanisms that may be important for understanding aberrant belief states associated with psychopathology. (shrink)

Ethical dilemmas are common in the neonatal intensive care setting. The aim of the present study was to investigate the opinions of Swedish physicians and the general public on treatment decisions regarding a newborn with severe brain damage. We used a vignette-based questionnaire which was sent to a random sample of physicians (n = 628) and the general population (n = 585). Respondents were asked to provide answers as to whether it is acceptable to discontinue ventilator treatment, and when it (...) actually is discontinued whether or not it was acceptable to use drugs which hasten death unintentionally or intentionally. The response rate was 67 % of physicians and 46 % of the general population. A majority of both physicians [56 % (CI 50–62)] and the general population [53 % (CI 49–58)] supported arguments for withdrawing ventilator treatment. A large majority in both groups supported arguments for alleviating the patient’s symptoms even if the treatment hastened death, but the two groups display significantly different views on whether or not to provide drugs with the additional intention of hastening death, although the difference disappeared when we compared subgroups of those who were for or against euthanasia-like actions. The study indicated that physicians and the general population have similar opinions regarding discontinuing life-sustaining treatment and providing effective drugs which might unintentionally hasten death but seem to have different views on intentions. The results might be helpful to physicians wanting to examine their own intentions when providing adequate treatment at the end of life. (shrink)

Chronic obstructive pulmonary disease (COPD) is one of the most deadly and costly chronic diseases in the world characterized by many breathing problems. The management of COPD and the prevention of exacerbations are a priority goals to improve the quality of life in patients affected by this illness. In addition, it is also crucial to improve the patients’ adherence to care which, in turn, depends on their knowledge and understanding of some factors such as the prescribed medical treatment, changes in (...) dailylife, and the process of breathing. In turn, the adherence to care leads to greater autonomy for the patient who is thus able to better manage his illness. Here we presented the application of the Model IARA in patients affected by COPD in order to achieve their autonomy in illness management which, in turn, leads to a better quality of life. IARA is an intervention program which improve the awareness and knowledge of patients with respect to both the disease and symptoms through health education. Moreover, through IARA the patients are encouraged to become more actively involved in COPD care process, also regarding drug therapy adherence. Using St. George's Respiratory Questionnaire combined with qualitative analysis, we demonstrated that IARA could be considered a useful approach in COPD management. (shrink)