ObjectiveFatigue after burns is often attributed to the hyperinflammatory and hypermetabolic response, while it may be best understood from a bio-psychological perspective, also involving the neuro-endocrine system. This longitudinal multi-center study examined the course of fatigue up to 18 months postburn. The contribution of bio-psychological factors, including burn severity, pain, and acute PTSD symptoms, to the course and persistence of fatigue was studied in a multifactorial model.MethodsParticipants were 247 adult burn survivors. Fatigue symptoms were assessed with the Multidimensional Fatigue Inventory (...) during the acute phase and subsequently at 3, 6, 12, and 18 months postburn, and were compared to population norms. Age, gender, burn severity, acute PTSD symptoms and pain were assessed as potential predictors of fatigue over time in a latent growth model.ResultsAt 18 months postburn, 46% of the burn survivors reported fatigue, including 18% with severe fatigue. In the acute phase, higher levels of fatigue were related to multiple surgeries, presence of pain, and higher levels of acute PTSD symptoms. Fatigue gradually decreased over time with minor individual differences in rate of decrease. At 18 months, pain and acute PTSD symptoms remained significant predictors of fatigue levels.ConclusionsProtracted fatigue after burns was found in almost one out of five burn survivors and was associated with both pain and acute PTSD symptoms. Early detection of PTSD symptoms and early psychological interventions aimed at reducing PTSD symptoms and pain may be warranted to reduce later fatigue symptoms. (shrink)

The present study examined the two-stage developmental theory of the understanding of embarrassment (Modigliani & Blumenfeld, 1979) through the administration of verbal and non-verbal measures. Moreover, the relationship between children's attributions of embarrassment and their ability to understand false beliefs and propensity to be shy was investigated. Ninety-five children (4 to 9 years old) were presented with brief stories in which the main character received negative, neutral, or positive social reactions. Verbal and non-verbal attributions of embarrassment were examined. In addition, (...) a false-belief task and a shyness-propensity questionnaire were administered. Using verbal measures, older children reported more embarrassment in the negative and neutral conditions compared to younger children. However, using non-verbal measures, these age differences disappeared. This suggests that young children may have a “mature” understanding of embarrassment, but may not be able to express this linguistically. Verbal and non-verbal embarrassment attributions were not related to the understanding of false beliefs, but they were related to shyness propensity. The results are discussed in terms of socio-cognitive and emotional factors in understanding emotions. (shrink)

There is an increased interest in how excessive avoidance can diminish. Avoidance reduction is typically tested by using Extinction with Response Prevention protocols, where feared stimuli a...

ABSTRACTAvoidance towards innocuous cues is a key diagnostic criterion across anxiety-related disorders. Importantly, the most effective intervention for anxiety-related disorders, exposure therapy with response prevention, sometimes does not prevent the relapse of anxiety's symptomatology. We tested whether extinction effects, the experimental proxy of exposure, are enhanced by increasing the discrepancy between the prediction of an unpleasant event happening, and the actual event. Forty-eight individuals first saw pictures of three stimuli. Two pictures were followed by a shock and one was not. (...) Next, participants learned to avoid the US by pressing a computer key. An extinction and response prevention procedure followed. In the first part of it, participants saw unreinforced presentations of all CSs. In the second part, the single group saw unreinforced presentations of the CSA and CS-. The compound group encountered compound unreinforced prese... (shrink)

Clinical and laboratory studies have demonstrated that executing a demanding dual-task while recollecting emotional memories weakens the emotional intensity and vividness of these memories. While t...