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Neuroethics Oct 2023Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns...
INTRODUCTION
Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions.
OBJECTIVE
This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.
MATERIALS AND METHODS
Semi-structured interviews with clinicians ( = 29) and caregivers ( = 44) were conducted, transcribed, and coded.
RESULTS
Using thematic content analysis, four major themes from clinician interviews and five major themes from caregiver interviews related to hopes and expectations were identified. Clinicians expressed concerns about caregiver false hopes (86%, 25/29) and desperation (68.9%, 20/29) in light of DBS being a last resort. As a result, 68.9% of clinicians (20/29) expressed that they intentionally tried to lower caregiver expectations about DBS outcomes. Clinicians also expressed concern that, on the flip side, unrealistic pessimism drives away some patients who might otherwise benefit from DBS (34.5%, 10/29). Caregivers viewed DBS as the last option that they had to try (61.3%, 27/44), and 73% of caregivers (32/44) viewed themselves as having high hopes but reasonable expectations. Fewer than half (43%, 19/44) expressed that they struggled setting outcome expectations due to the uncertainty of DBS, and 50% of post-DBS caregivers (14/28) expressed some negative feelings post treatment due to unmet expectations. 43% of caregivers (19/44) had experiences with clinicians who tried to set low expectations about the potential benefits of DBS.
CONCLUSION
Thoughtful clinician-stakeholder discussion is needed to ensure realistic outcome expectations.
PubMed: 37905206
DOI: 10.1007/s12152-023-09524-3 -
Cambridge Quarterly of Healthcare... Jan 2024I present a qualified new defense of antinatalism. It is intended to empower potential parents who worry about their possible children's life quality in a world...
I present a qualified new defense of antinatalism. It is intended to empower potential parents who worry about their possible children's life quality in a world threatened by environmental degradation, climate change, and the like. The main elements of the defense are an understanding of antinatalism's historical nature and contemporary varieties, a positional theory of value based on Epicurean hedonism and Schopenhauerian pessimism, and a sensitive guide for reproductive decision-making in the light of different views on life's value and risk-taking. My conclusion, main message, to the concerned would-be parents is threefold. If they believe that life's ordinary frustrations can make it not worth living, they should not have children. If they believe that a noticeably low life quality makes it not worth living and that such life quality can be reasonably expected, they should not have children, either. If they believe that a noticeably low life quality is not reasonably to be expected or that the risk is worth taking, they can, in the light of their own values and beliefs, have children. The conclusion is supported by a combination of the extant arguments for reproductive abstinence, namely the arguments from consent, moral asymmetry, life quality, and risk.
Topics: Child; Humans; Parents; Morals; Philosophy; Dissent and Disputes; Emotions
PubMed: 36511114
DOI: 10.1017/S0963180122000317 -
Anxiety, Stress, and Coping Sep 2023Although dispositional optimism and pessimism have been prospectively associated with health outcomes, little is known about how these associations manifest in everyday...
BACKGROUND AND OBJECTIVES
Although dispositional optimism and pessimism have been prospectively associated with health outcomes, little is known about how these associations manifest in everyday life. This study examined how short-term optimistic and pessimistic expectations were associated with psychological and physiological stress processes.
METHODS
A diverse sample of adults (= 300) completed a 2-day/1-night ecological momentary assessment and ambulatory blood pressure (ABP) protocol at ∼45-minute intervals.
RESULTS
Moments that were more optimistic than typical for a person were followed by moments with lower likelihood of reporting a stressor, higher positive affect (PA), lower negative affect (NA), and less subjective stress (SS). Moments that were more pessimistic than typical were not associated with any affective stress outcome at the following moment. Neither optimism nor pessimism were associated with ABP, and did not moderate associations between reporting a stressor and outcomes.
DISCUSSION
These findings suggest that intraindividual fluctuations in optimistic and pessimistic expectations are associated with stressor appraisals.
Topics: Adult; Humans; Pessimism; Motivation; Blood Pressure Monitoring, Ambulatory; Blood Pressure; Personality; Affect
PubMed: 36371799
DOI: 10.1080/10615806.2022.2142574 -
Healthcare (Basel, Switzerland) Jan 2024The idea of artificially created social robots has a long tradition. Today, attitudes towards robots play a central role in the field of healthcare. Our research aimed...
The idea of artificially created social robots has a long tradition. Today, attitudes towards robots play a central role in the field of healthcare. Our research aimed to develop a scale to measure attitudes towards robots. The survey consisted of nine questions on attitudes towards robots, sociodemographic questions, the SWOP-K9, measuring self-efficacy, optimism, and pessimism, and the BFI-10, measuring personality dimensions. Structural relations between the items were detected using principal components analysis (PCA) with Varimax rotation. Correlations and Analysis of Variance were used for external validation. In total, 214 participants (56.1% female, mean age: 30.8 ± 14.4 years) completed the survey. The PCA found two main components, "Robot as a helper and assistant" (RoHeA) and "Robot as an equal partner" (RoEqP), with four items each explaining 53.2% and 17.5% of the variance with a Cronbach's α of 0.915 and 0.768. In the personality traits, "Conscientiousness" correlated weakly with both subscales and "Extraversion" correlated with RoHeA, while none the subscales of the SWOP-K9 significantly correlated with RoEqP or RoHeA. Male participants scored significantly higher than female participants. Our survey yielded a stable and convergent two-factor instrument that exhibited convincing validity and complements other findings in the field. The ASRS can easily be used to describe attitudes towards social robots in human society. Further research, however, should be carried out to investigate the discriminant and convergent validity of the ASRS.
PubMed: 38338172
DOI: 10.3390/healthcare12030286 -
Biological Psychiatry Oct 2023Repetitive negative thinking (RNT) is a frequent symptom of major depressive disorder (MDD) that is associated with poor outcomes and treatment resistance. While most...
BACKGROUND
Repetitive negative thinking (RNT) is a frequent symptom of major depressive disorder (MDD) that is associated with poor outcomes and treatment resistance. While most studies on RNT have focused on structural and functional characteristics of gray matter, this study aimed to examine the association between white matter (WM) tracts and interindividual variability in RNT.
METHODS
A probabilistic tractography approach was used to characterize differences in the size and anatomical trajectory of WM fibers traversing psychosurgery targets historically useful in the treatment of MDD (anterior capsulotomy, anterior cingulotomy, and subcaudate tractotomy) in patients with MDD and low (n = 53) or high (n = 52) RNT, and healthy control subjects (n = 54). MDD samples were propensity matched on depression and anxiety severity and demographics.
RESULTS
WM tracts traversing left hemisphere targets and reaching the ventral anterior body of the corpus callosum (thus extending to contralateral regions) were larger in the high-RNT MDD group compared with low-RNT (effect size D = 0.27, p = .042) and healthy control (D = 0.23, p = .02) groups. MDD was associated with greater size of tracts that converge onto the right medial orbitofrontal cortex regardless of RNT intensity. Other RNT-nonspecific findings in MDD involved tracts reaching the left primary motor and right primary somatosensory cortices.
CONCLUSIONS
This study provides the first evidence to our knowledge that WM connectivity patterns, which could become targets of intervention, differ between high- and low-RNT participants with MDD. These WM differences extend to circuits that are not specific to RNT, possibly subserving reward mechanisms and psychomotor activity.
Topics: Humans; White Matter; Depressive Disorder, Major; Depression; Pessimism; Anxiety
PubMed: 36965550
DOI: 10.1016/j.biopsych.2023.03.012 -
Psicologia, Reflexao E Critica :... Jun 2024Considering that beliefs may be assessed and changed, inventories measuring employability and career beliefs may be of utmost importance for career interventions.
BACKGROUND
Considering that beliefs may be assessed and changed, inventories measuring employability and career beliefs may be of utmost importance for career interventions.
OBJECTIVE
This study introduces the psychometric properties of a brief version of the Employability and Career Beliefs Inventory (ECBI) in a sample of unemployed persons.
METHODS AND RESULTS
Altogether, 2023 unemployed persons aged from 18 to 66 years old and living in Southern Portugal participated in an online survey. The ECBI's original internal structure was tested and did not fit the data. Exploratory and confirmatory factor analyses were implemented, and a three-factor solution was retained. The three factors discriminate three types of beliefs named growth, pessimism, and flexibility. Measurement invariance models identified scalar equivalence across gender and educational degree, and metric invariance across age. All items fit the graded response model's parameters. The growth and flexibility subscales were less effective in the assessment of low latent trait levels, whereas the opposite was observed with the pessimism subscale. Internal consistency is good yet discrimination between factors is questionable. Correlations to career decision-making self-efficacy evidence validity based on the relations to other constructs.
CONCLUSION
Despite the limitations, the brief version of the ECBI proposed in this study is ready for further use and development among unemployed persons.
PubMed: 38937371
DOI: 10.1186/s41155-024-00309-y -
Integrative Cancer Therapies 2024Promoting well-being is a key goal of cancer care, and it needs to be assessed using appropriate instruments. Flourishing is considered part of psychological well-being...
BACKGROUND/OBJECTIVE
Promoting well-being is a key goal of cancer care, and it needs to be assessed using appropriate instruments. Flourishing is considered part of psychological well-being and it is commonly assessed with the Flourishing Scale (FS). To our knowledge, no studies have analyzed the psychometric properties of the FS in breast cancer patients. Our aim here was to provide validity evidence for use of the FS in this context.
METHOD
Participants were 217 Spanish women with breast cancer who completed the FS and other scales assessing positive psychology constructs (life satisfaction, positive affect, resilience, self-esteem, optimism) and indicators of psychological maladjustment (negative affect, depression, anxiety, and stress). The internal structure of the FS was analyzed using confirmatory factor analysis (CFA). We calculated the average variance extracted (AVE) to evaluate convergent validity, and both McDonald's omega and Cronbach's alpha coefficients to estimate reliability. Item analysis was performed by computing corrected item-total correlations. Validity evidence based on relationships with other variables was obtained through Pearson correlation analysis, controlling for age and cancer stage.
RESULTS
The CFA supported a single-factor structure, with adequate goodness-of-fit indices (CFI = 0.997, NNFI = 0.996, RMSEA = 0.069, and SRMR = 0.047) and standardized factor loadings ranging from 0.70 to 0.87. The value of the AVE was 0.63, and the reliability coefficient obtained with both procedures was 0.91. Corrected item-total correlations ranged from .62 to .78. Correlation analysis showed direct and strong associations between the FS score and scores on positive psychology constructs (range from 0.43 to 0.74), the strongest correlations being with positive affect and life satisfaction. The FS score was inversely correlated with scores on depression, anxiety, stress, negative affect, and pessimism (range from -0.14 to -0.52), the strongest association being with stress.
DISCUSSION
The FS is a useful tool for exploring well-being in the breast cancer context, providing useful information for psychological assessment.
Topics: Humans; Female; Breast Neoplasms; Psychometrics; Middle Aged; Surveys and Questionnaires; Reproducibility of Results; Adult; Factor Analysis, Statistical; Aged; Anxiety; Depression; Quality of Life; Personal Satisfaction; Spain; Self Concept; Stress, Psychological
PubMed: 38755965
DOI: 10.1177/15347354241249935 -
Health Communication Oct 2023By fall 2020, students returning to U.S. university campuses were mandated to engage in COVID-19 mitigation behaviors, including masking, which was a relatively novel...
By fall 2020, students returning to U.S. university campuses were mandated to engage in COVID-19 mitigation behaviors, including masking, which was a relatively novel prevention behavior in the U.S. Masking became a target of university mandates and campaigns, and it became politicized. Critical questions are whether the influences of injunctive norms and response efficacy on one behavior (i.e. masking) spill over to other mitigation behaviors (e.g. hand-washing), and how patterns of mitigation behaviors are associated with clinical outcomes. We conducted a cross-sectional survey of college students who returned to campus ( = 837) to explore these questions, and conducted COVID-19 antibody testing on a subset of participants to identify correlations between behaviors and disease burden. The results showed that college students were more likely to intend to wear face masks as they experienced more positive injunctive norms, liberal political views, stronger response efficacy for masks, and less pessimism. Latent class analysis revealed four mitigation classes: who intended to wear face masks and engage in the other COVID-19 mitigation behaviors; and who intended to wear masks but only some other behaviors, and who intended to engage in no mitigation behaviors. Importantly, the and had the highest likelihood of positive antibodies; these two classes differed in their masking intentions, but shared very low likelihoods of physical distancing from others and avoiding crowds or mass gatherings. The implications for theories of normative influences on novel behaviors, spillover effects, and future messaging are discussed.
Topics: Humans; COVID-19; Cross-Sectional Studies; COVID-19 Testing; Intention; Students
PubMed: 35317696
DOI: 10.1080/10410236.2022.2049047 -
The Journal of Sexual Medicine Nov 2023Sexual distress, a determinant factor in diagnosing sexual dysfunction, plays a significant role in individuals' sexual well-being, yet it has been overlooked in...
BACKGROUND
Sexual distress, a determinant factor in diagnosing sexual dysfunction, plays a significant role in individuals' sexual well-being, yet it has been overlooked in research.
AIM
This exploratory study adopted a transdiagnostic approach to sexual distress and sought to examine the association between emotional regulation difficulties and sexual and psychological distress, with repetitive negative thinking as a potential mediator.
METHODS
We used a quantitative cross-sectional design with a sample of 509 partnered individuals.
OUTCOMES
The survey included a sociodemographic questionnaire, the Difficulties in Emotion Regulation Scale-Short Form, the Kessler Psychological Distress Scale, the Persistent and Intrusive Negative Thoughts Scale, and the Female Sexual Distress Scale-Revised.
RESULTS
Correlational analysis revealed significant associations among emotional regulation difficulties, repetitive negative thinking, psychological distress, and sexual distress. Furthermore, a mediation model demonstrated that repetitive negative thinking significantly mediated emotion dysregulation and psychological and sexual distress.
CLINICAL IMPLICATIONS
These findings underscore the importance of considering emotion regulation difficulties and repetitive negative thinking as a maladaptive coping strategy when evaluating sexual distress and suggest that therapeutic interventions targeting such difficulties and thoughts may yield beneficial outcomes.
STRENGTHS AND LIMITATIONS
These findings reinforce the importance of considering the role of emotional regulation difficulties and, consequently, repetitive negative thinking as a dysfunctional coping strategy, when studying and intervening in sexual distress. Future research with clinical samples should be developed to establish better the significance of considering these two dimensions in assessment and therapeutic intervention.
CONCLUSION
Future research should corroborate and expand upon these findings to advance our understanding of sexual distress and optimize interventions in this domain.
Topics: Humans; Female; Pessimism; Emotional Regulation; Cross-Sectional Studies; Sexual Behavior; Surveys and Questionnaires; Psychological Distress
PubMed: 37846102
DOI: 10.1093/jsxmed/qdad136 -
Medicine Aug 2023The aim of this study is to examine the relationship between fatalistic beliefs, self-care, and glycemic control among Mexican men with type 2 diabetes mellitus. This is...
The aim of this study is to examine the relationship between fatalistic beliefs, self-care, and glycemic control among Mexican men with type 2 diabetes mellitus. This is a cross-sectional study in men diagnosed with type 2 diabetes mellitus from 18 to 59 years of age from the Northeast of Mexico. Fatalistic beliefs, self-care, medication adherence, and HbA1C were evaluated. Patients were divided into glycemic control (<7% HbA1c) and without glycemic control (>7% HbA1c). Tests were performed to compare 2 independent groups, Student's t and U Mann Whitney. Correlation tests and multiple linear regression models were also performed. For statistical analysis, the SPSS v27 program was used. Forty-nine percent of the men had glycemic control (<7% HbA1c). Fatalistic beliefs were negatively correlated with self-care and medication adherence, but not with HbA1c. In multiple linear regression models, fatalistic beliefs were a negative predictor of self-care and medication adherence. In the model for HbA1c, the pessimism subdimension and self-care were the predictors. Fatalistic beliefs negatively affect self-care compliance and medication adherence, while the pessimism subdimension was related to the increase in HbA1c.
Topics: Male; Humans; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Hypoglycemic Agents; Cross-Sectional Studies; Self Care; Mexico; Blood Glucose
PubMed: 37543768
DOI: 10.1097/MD.0000000000034594