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Psychotherapie, Psychosomatik,... Jun 2024In the following casuistry, a denied advanced pregnancy was discovered during the diagnosis of an oncological disease. Faced with a life-threatening condition, the...
In the following casuistry, a denied advanced pregnancy was discovered during the diagnosis of an oncological disease. Faced with a life-threatening condition, the patient urged late termination of the pregnancy and was introduced to psychological counselling in order to find a viable and ethically justifiable solution. Strategies for crisis intervention and supportive approaches in the patient's care as well as interdisciplinary collaboration are presented and discussed.
PubMed: 38885657
DOI: 10.1055/a-2322-8408 -
Psycho-oncology Jul 2023This study was conducted to determine the relationship between religious attitudes and spirituality levels of geriatric oncology patients and their psychological...
AIM
This study was conducted to determine the relationship between religious attitudes and spirituality levels of geriatric oncology patients and their psychological reactions to cancer.
METHODS
The sample consisted of 261 geriatric oncology patients who were inpatients in oncology and hematology clinics of a university hospital. The research was conducted between 30 July 2020 and 26 January 2022. Data were collected using the Mental Adjustment to Cancer (MAC) scale, the Ok-Religious Attitude (ORA) scale, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) scale. The effect of the ORA scale and FACIT-SP scale scores on the MAC scale were analyzed using path analysis.
RESULTS
A positive relationship was found between Spiritual Well-Being and Fighting (β = 0.028, p < 0.001) and Anxious Anticipation (β = 0.024, p < 0.001); a negative relationship was found between Fatalism (β = -0.023, p < 0.001), Helplessness/Hopelessness (β = -0.04, p < 0.001) and Denial/Avoidance (β = -0.026; p < 0.001). A positive relationship was found between Religious Attitude and Fighting Spirit (β = 0.154, p = 0.009) and Anxious Anticipation (β = 0.231, p < 0.001), while a negative relationship was found between Religious Attitude and Despair/Hopelessness (β = -0.413, p < 0.001).
CONCLUSIONS
Patients' religious attitudes and spiritual well-being levels affected their psychological reactions to cancer, increased their "fighting spirit" and their "anxious preoccupation" about the disease, and decreased their helplessness/hopelessness, fatalism, denial and avoidance.
Topics: Humans; Aged; Spirituality; Adaptation, Psychological; Spiritual Therapies; Neoplasms; Attitude
PubMed: 37062928
DOI: 10.1002/pon.6144 -
Current Opinion in Psychology Dec 2022Strategies to mitigate dishonesty have met with limited success, leading behavioral ethics scholars to call for a deeper understanding of the psychological mechanisms... (Review)
Review
Strategies to mitigate dishonesty have met with limited success, leading behavioral ethics scholars to call for a deeper understanding of the psychological mechanisms underlying dishonesty. In this article, I introduce a conceptual framework, DENIAL, that identifies four fundamental mechanisms, or justifications, which provide people a rationale to consider themselves as ethical while acting unethically. I derive these justifications from a review of scholarship within cognate fields, drawing on Moral Disengagement Theory and Neutralization Theory. I identify the victim (they Deserve it), the situation (I blame my Environment), the harm (I cause No Injury), and the social relationship (I have other ALlegiances) as fundamental justifications for dishonesty. I discuss how future mitigation strategies might harness these justifications to improve their efficacy.
Topics: Humans; Deception; Morals
PubMed: 36103803
DOI: 10.1016/j.copsyc.2022.101456 -
Neurological Sciences : Official... Oct 2021This study aims to compare the styles of coping with stress between patients with epilepsy and healthy individuals and to examine the effects of clinical features on...
OBJECTIVE
This study aims to compare the styles of coping with stress between patients with epilepsy and healthy individuals and to examine the effects of clinical features on methods of coping with stress.
METHODS
The study enrolled 120 patients diagnosed with epilepsy. Forty healthy individuals were included as control group. Sociodemographic and clinical characteristics of the patients were recorded. The patients and controls completed the Coping Strategies with Stress Inventory (COPE), which comprises 60 items distributed into 15 scales. The COPE scores of the patients and controls were compared.
RESULTS
Comparing the COPE scores of the patients and controls, the substance use score was higher in the controls. In terms of gender, seeking instrumental social support, active coping, seeking emotional social support, acceptance, and emotion-focused total coping scores were higher in women among patients. In terms of marital status, the positive reinterpretation and growth score of single patients was significantly higher than that of married patients. In patients with a history of febrile convulsions, the active coping, seeking emotional social support, and denial scores were higher. In terms of treatment, for the patients receiving polytherapy, the suppression of competing activities, focus on and venting of emotions, and dysfunctional total coping scores were higher than in patients receiving monotherapy.
CONCLUSION
Epilepsy and stress are intertwined conditions. Epilepsy patients, confronted with stress, avoided using alcohol and substances compared to healthy individuals. There were differences among epilepsy patients according to gender, marital status, febrile convulsion history, number of medications, and approaches to coping with stress.
Topics: Adaptation, Psychological; Emotions; Epilepsy; Female; Humans; Social Support; Stress, Psychological; Surveys and Questionnaires
PubMed: 34142262
DOI: 10.1007/s10072-021-05372-2 -
International Journal of Clinical and... 2021The main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to...
UNLABELLED
The main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion).
METHOD
There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old ( = 33.48, = 11.13).
RESULTS
Groups showed differences in the use of some adaptive strategies (positive reinterpretation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depression levels were related to the use of less adaptive strategies.
CONCLUSIONS
These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels.
PubMed: 33519939
DOI: 10.1016/j.ijchp.2021.100223 -
Pulmonary Therapy Mar 2022Known for their pre-occupation with body image, self-identity creation, peer acceptance, and risk-taking behaviors, adolescents with asthma face unique challenges....
Known for their pre-occupation with body image, self-identity creation, peer acceptance, and risk-taking behaviors, adolescents with asthma face unique challenges. Asthma is a heterogeneous disease and accurate diagnosis requires assessment through detailed clinical history, examination, and objective tests. Diagnostic challenges exist as many adolescents can present with asthma-like symptoms but do not respond to asthma treatment and risk being mis-diagnosed. Under-recognition of asthma symptoms and denial of disease severity must also be addressed. The over-reliance on short-acting beta-agonists in the absence of anti-inflammatory therapy for asthma is now deemed unsafe. Adolescents with mild asthma benefit from symptom-driven treatment with combination inhaled corticosteroids (ICS) and long-acting beta-agonist (LABA) on an as-required basis. For those with moderate-to-persistent asthma requiring daily controller therapy, maintenance and reliever therapy using the same ICS-LABA controller simplifies treatment regimes, while serving to reduce exacerbation risk. A developmentally staged approach based on factors affecting asthma control in early, middle, and late adolescence enables better understanding of the individual's therapeutic needs. Biological, psychological, and social factors help formulate a risk assessment profile in adolescents with difficult-to-treat and severe asthma. Smoking increases risks of developing asthma symptoms, lung function deterioration, and asthma exacerbations. Morbidity associated with e-cigarettes or vaping calls for robust efforts towards smoking and vaping cessation and abstinence. As adolescents progress from child-centered to adult-oriented care, coordination and planning are required to improve their self-efficacy to ready them for transition. Frequent flare-ups of asthma can delay academic attainment and adversely affect social and physical development. In tandem with healthcare providers, community and schools can link up to help shoulder this burden, optimizing care for adolescents with asthma.
PubMed: 34743311
DOI: 10.1007/s41030-021-00177-2 -
Schizophrenia Research Jun 2022For people with a psychotic disorder lack of insight can be detrimental on their condition and recovery. For this reason, insight has been considered as a target for... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
For people with a psychotic disorder lack of insight can be detrimental on their condition and recovery. For this reason, insight has been considered as a target for therapy. We conducted a systematic review of the literature on pharmacological, psychological and other treatments to test the hypothesis that these interventions could improve insight.
METHODS
We performed a literature search (1970-2020) across the following databases: PubMed, EMBASE, PsychINFO, Medline and Web of Science. Within each database the following search terms and the associated Boolean operatives were used: "Insight AND (treatment OR therapy) AND (psychosis OR schizophrenia) AND (awareness or denial)". Further filters were applied to identify peer reviewed controlled trials on adults. Following assessment for bias and inclusion criteria, we calculated the effect size (Cohen's d) for each study and overall, using a random effects model with 95% confidence intervals.
RESULTS
Of 94 articles found in the initial literature search, 30 studies that examined the treatment of insight in psychosis met the initial selection criteria and were assessed for bias. A total of 21 studies were included in the final meta-analysis. The overall calculated mean effect size for all interventions was 0.441 (95% CI, 0.23-0.66), representing a medium effect size. The effect of psychoeducation studies alone was medium (0.613, 95% CI, -0.35-2.06), but not significant. The effect of CBT studies was small (0.235, 95% CI, 0.01-0.46), and significant. The effect of combined antipsychotic medication and psychosocial intervention was of medium size and significant (0.683, 95% CI = 0.54-0.83). Finally, tDCS over the left fronto-temporal cortex, produced a very large and significant improvement of insight 1.153 (95% CI = 0.61-1.70), which was present for at least a month after the intervention.
CONCLUSIONS
Despite the variation and small number and size of trials into possible interventions, the hypothesis that insight could be improved was confirmed. Whilst most research focuses on psychotherapies, there is scope and potential for pharmacological, as well as other interventions (e.g. physical exercise, self-video observation, Direct Current Stimulation) to improve insight over and above treatment as usual. Given the association of insight with illness severity and treatment adherence, it is important to direct efforts in therapies that target insight improvement in psychosis.
Topics: Adult; Antipsychotic Agents; Humans; Psychotherapy; Psychotic Disorders; Schizophrenia
PubMed: 35661550
DOI: 10.1016/j.schres.2022.05.023 -
Harefuah Sep 2022Obstetric violence has recently gained wide recognition and is defined as inappropriate or disrespectful treatment given by medical staff to women throughout the... (Review)
Review
Obstetric violence has recently gained wide recognition and is defined as inappropriate or disrespectful treatment given by medical staff to women throughout the antepartum period, delivery and postpartum. It includes verbal violence, denial of patient autonomy, the practice of unconsented or unnecessary medical procedures, discrimination based on race or ethnic background, and physical violence. The source of obstetric violence has been vastly studied by psycho-sociologists who have conceptualized it as stemming back to ancient gender role theories. In the medical literature, obstetric violence has been devoted increasing attention only in recent years. Clinical studies show it is a widespread phenomenon and reports indicate that up to 30% of women, both from low- and high-income regions, claim to have experienced a subtype of obstetric violence during childbirth. Obstetric violence may have a profound psychological impact: post-partum acute stress disorder (ASD), post-traumatic stress disorder (PTSD), and post-partum depression (PPD) are all well-documented mental health consequences of maternal mistreatment. Reactivation of past PTSD may also occur, as obstetric violence may be experienced as re-victimization by post-traumatic women. Currently, obstetric violence is defined with legislative backing only in a few countries in Latin America and medical research on the topic is still scarce. Both worldwide and at a local level, effective prevention and management of obstetric violence requires multidisciplinary cooperation and organizational changes. Those include greater social awareness, adjusted treatment protocols, improved training of healthcare professionals in the field of trauma-sensitive care, focused clinical research and targeted legislation.
Topics: Delivery, Obstetric; Female; Health Personnel; Humans; Parturition; Postpartum Period; Pregnancy; Stress Disorders, Post-Traumatic; Violence
PubMed: 36168158
DOI: No ID Found -
Applied Psychology. Health and... Nov 2023This follow-up study aimed to analyze the protective role of positivity and coping strategies on the well-being and psychological distress levels reported during... (Review)
Review
This follow-up study aimed to analyze the protective role of positivity and coping strategies on the well-being and psychological distress levels reported during Portugal's first and third waves of COVID-19. The total sample consisted of 135 participants (82.0% women) with ages ranging from 20 to 72 years (M = 39.29, SD = 11.46). Results suggested a significant decrease in well-being levels but no changes in psychological distress were observed. Positivity was a strong and significant predictor of well-being and psychological distress during the pandemic crisis. Among the set of strategies used by individuals at the first wave, denial, self-blame, and self-distraction predicted a poorer adaptation with more significant mental health impairment, with self-blame standing out as the most harmful. This study highlighted the key role of positivity in adjusting to the current pandemic crisis and the lasting detrimental impact of specific coping strategies.
Topics: Humans; Female; Male; Emotional Adjustment; COVID-19; Follow-Up Studies; Pandemics; Portugal; Adaptation, Psychological
PubMed: 37321921
DOI: 10.1111/aphw.12462 -
Adolescent Health, Medicine and... 2023Eating disorders (EDs) are serious psychiatric illnesses that typically develop during adolescence and emerging adulthood. Early intervention is important for improved... (Review)
Review
Eating disorders (EDs) are serious psychiatric illnesses that typically develop during adolescence and emerging adulthood. Early intervention is important for improved outcomes for young people with EDs, yet help-seeking is low and individuals often have a significantly protracted start to treatment, suggesting that early intervention is not well established in the ED field. Previous reviews on facilitators and barriers to early intervention for EDs largely cover perceived barriers related to patient variables and perspectives, whereas clinician-, service-, and healthcare system-related facilitators and barriers are less frequently reviewed. The aim of this review is to synthesize the literature on barriers to and facilitators of early intervention for EDs, regarding patient-, clinician-, service-, and healthcare system-related factors. A narrative review was conducted by searching for relevant peer-reviewed, English-language articles published up until July 2023 on PubMed and PsychINFO. The search was conducted in two steps. First, key search terms were used to identify existing reviews and meta-analyses on facilitators and barriers to early intervention for EDs. Then, additional search terms were added to search for primary and secondary research on patient/family, clinician, service, and healthcare system-related barriers and facilitators. The identified literature shows that, after overcoming intrinsic, motivational barriers (such as self-stigma, denial, and ambivalence), help-seeking individuals may be met with long service waiting lists and limited treatment options. Despite these barriers, there is ongoing research into early intervention in practice, which aims to reach underserved populations and facilitate early intervention despite high service demands and shortages of trained healthcare professionals. Funding for ED research and services has historically been low, and there is also a research-practice gap. This highlights the need for increased consideration of, and funding for early intervention for EDs, to remove barriers as well as facilitate discussions around how to make early intervention programs scalable and sustainable.
PubMed: 38074446
DOI: 10.2147/AHMT.S415698