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The American Psychologist Jan 2021The COVID-19 pandemic has considerably impacted many people's lives. This study examined changes in subjective wellbeing between December 2019 and May 2020 and how...
The COVID-19 pandemic has considerably impacted many people's lives. This study examined changes in subjective wellbeing between December 2019 and May 2020 and how stress appraisals and coping strategies relate to individual differences and changes in subjective wellbeing during the early stages of the pandemic. Data were collected at 4 time points from 979 individuals in Germany. Results showed that, on average, life satisfaction, positive affect, and negative affect did not change significantly between December 2019 and March 2020 but decreased between March and May 2020. Across the latter timespan, individual differences in life satisfaction were positively related to controllability appraisals, active coping, and positive reframing, and negatively related to threat and centrality appraisals and planning. Positive affect was positively related to challenge and controllable-by-self appraisals, active coping, using emotional support, and religion, and negatively related to threat appraisal and humor. Negative affect was positively related to threat and centrality appraisals, denial, substance use, and self-blame, and negatively related to controllability appraisals and emotional support. Contrary to expectations, the effects of stress appraisals and coping strategies on changes in subjective wellbeing were small and mostly nonsignificant. These findings imply that the COVID-19 pandemic represents not only a major medical and economic crisis, but also has a psychological dimension, as it can be associated with declines in key facets of people's subjective wellbeing. Psychological practitioners should address potential declines in subjective wellbeing with their clients and attempt to enhance clients' general capability to use functional stress appraisals and effective coping strategies. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Adaptation, Psychological; Adolescent; Adult; Affect; Aged; Aged, 80 and over; COVID-19; Female; Follow-Up Studies; Germany; Humans; Individuality; Male; Middle Aged; Personal Satisfaction; Thinking; Young Adult
PubMed: 32700938
DOI: 10.1037/amp0000702 -
Gynecologie, Obstetrique, Fertilite &... Apr 2022Denial of pregnancy is a public health problem due to maternal, fetal, and neonatal morbidity, affecting both physical and mental health. It generally involves an...
Denial of pregnancy is a public health problem due to maternal, fetal, and neonatal morbidity, affecting both physical and mental health. It generally involves an absence of the physical signals associated with pregnancy such as abdominal swelling, amenorrhea, weight gain, or even perception of fetal movements. Despite the potential consequences for mother and child, there is still little data on its clinical features and the neurocognitive mechanisms involved. In this paper, we provide an update on the clinical, socio-demographic, and psychopathological characteristics of pregnancy denial based on contemporary scientific literature. We first define denial of pregnancy by referring to the history of the concept, previous definitions, and nosographic classifications. We then detail the clinic of denial by distinguishing the physical and psychological symptoms of this disorder, then the socio-demographic, gynecological, and psychiatric characteristics. We describe the consequences of denial on the mother, infant, and the dyad, referring to situations of cryptic neonaticide. Finally, we show the importance of perinatal neuroscience research on maternal interoception to understand the mechanisms involved in denial of pregnancy, and improve their medical management in clinical practice.
Topics: Child; Denial, Psychological; Female; Humans; Infant; Infant, Newborn; Infanticide; Mothers; Parturition; Pregnancy
PubMed: 35272081
DOI: 10.1016/j.gofs.2022.02.079 -
JAMA Network Open Oct 2023Prior authorization (PA) requires clinicians and patients to navigate a complex approval pathway. Resultant delays and denials can be particularly problematic for...
IMPORTANCE
Prior authorization (PA) requires clinicians and patients to navigate a complex approval pathway. Resultant delays and denials can be particularly problematic for patients with cancer, who often need urgent treatment or symptom management.
OBJECTIVE
To investigate the patient perspective of PA for cancer-related care, including perceptions about the process, outcomes (including delays and denials), and patient administrative burden.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional, anonymous survey used a convenience sample of patients with PA experience. Participants were recruited using social media and email lists of US-based cancer advocacy organizations from July 1 to October 6, 2022.
EXPOSURE
Prior authorization for any cancer-related service.
MAIN OUTCOMES AND MEASURES
Delays to care, outcome of PA, communication, and changes in anxiety (measured on a scale of 0-100, with 0 indicating no anxiety and higher scores indicating higher levels of anxiety) and trust.
RESULTS
Of 178 respondents (158 women [88%], 151 non-Hispanic White respondents [84%], 164 respondents [92%] <65 years), 112 (63%) reported that their cancer care was approved and given as recommended, and 39 (22%) did not receive recommended care due to delays or denials. Most respondents (123 [69%]) reported a PA-related delay in care; of those with delayed care, 90 (73%) reported a delay of 2 or more weeks. Most respondents (119 [67%]) had to personally become involved in the PA process; 35 (20%) spent 11 or more hours dealing with PA issues. Overall, the PA experience was rated as bad (70 [40%]) or horrible (55 of 174 [32%]); ratings were associated with the length of delay (ρ = 0.36; P < .001) and the time spent on PA (ρ = 0.42; P < .001). Self-reported PA-related anxiety was higher than usual anxiety (mean [SD] score, 74.7 [20.2] vs 37.5 [22.6]; P < .001) and was correlated with delay length (ρ = 0.16; P = .04), time spent on PA (ρ = 0.27; P < .001), and overall PA experience (ρ = 0.34; P < .001). After PA, 159 respondents (89%) trusted their insurance company less, and 148 respondents (83%) trusted the health care system less. Patient involvement in the PA process was associated with increased odds of distrusting their insurance company (β = 6.0; 95% CI, 1.9-19.2) and the health care system (β = 3.3; 95% CI, 1.4-8.1) and of having a negative experience (β = 6.6; 95% CI, 3.1-14.3).
CONCLUSIONS AND RELEVANCE
This survey-based cross-sectional study of the patient experience with PA highlights an adverse outcome of PA: 22% of patients did not receive the care recommended by their treatment team because of PA. Most respondents experienced a delay in recommended oncology care, and delays were associated with increased anxiety, a negative perception of the PA process, and patient administrative burden.
Topics: Humans; Female; Prior Authorization; Cross-Sectional Studies; Surveys and Questionnaires; Neoplasms; Patient Outcome Assessment
PubMed: 37851442
DOI: 10.1001/jamanetworkopen.2023.38182 -
BMC Psychiatry Apr 2022Major depressive disorder (MDD) is a global public health concern that is notably underdiagnosed and undertreated due to its complexity and subjective diagnostic...
BACKGROUND
Major depressive disorder (MDD) is a global public health concern that is notably underdiagnosed and undertreated due to its complexity and subjective diagnostic methods. A holistic diagnostic procedure, which sufficiently considers all possible contributors to MDD symptoms, would improve MDD diagnosis and treatment. This study aims to explore whether personality and coping styles can predict MDD status and differentiate between depressed patients and healthy individuals.
METHODS
Seventy healthy controls (N = 54 females) were matched to 70 MDD patients for age, sex, ethnicity, and years of education. MDD severity was measured using the Hamilton Depression Rating Scale, while personality traits and coping styles were measured by the Ten-Item Personality (TIPI) and Brief COPE questionnaires, respectively. Logistic regression analyses were conducted to investigate the diagnostic and predictive potential of personality and coping styles. Receiver operating characteristic (ROC) analyses were also conducted to examine their discriminative ability to distinguish between depressed and healthy individuals.
RESULTS
Introversion, lack of organisation skills, and neuroticism were statistically significant in predicting MDD status. Dysfunctional coping strategies, such as denial and self-blame, were also shown to significantly predict MDD status. ROC analyses found both the TIPI questionnaire (AUC = 0.90), and dysfunctional coping (as measured by Brief COPE) (AUC = 0.90) to be excellent predictors of MDD.
CONCLUSIONS
Our findings demonstrate the diagnostic and predictive potential of personality and coping styles for MDD in the clinical setting. They also demonstrate the remarkable ability of personality and coping styles to differentiate between depressed patients and healthy controls.
Topics: Adaptation, Psychological; Depressive Disorder, Major; Female; Humans; Male; Personality; Personality Disorders; Personality Inventory
PubMed: 35484526
DOI: 10.1186/s12888-022-03942-y -
BMC Psychiatry Jan 2022The prevalence of non-suicidal self-injury (NSSI) is high among adolescents. Parents have significant impact on the development of NSSI. Many quantitative studies have...
BACKGROUND AND OBJECTIVES
The prevalence of non-suicidal self-injury (NSSI) is high among adolescents. Parents have significant impact on the development of NSSI. Many quantitative studies have demonstrated the relationship between parental factors such as parenting behaviors and adolescents' NSSI. However, few studies have explored parents' responses and adolescent-parent reciprocal interaction during repeated NSSI. This study aimed to explore parents' cognition, behaviors and adolescent-parent reciprocal interaction during repeated NSSI.
METHODS
This is a phenomenological study. By purposive sampling, 24 parents of adolescents with repeated NSSI were recruited from a child and adolescent psychiatric ward in a mental health center in Chengdu, China. Semi-structured interviews were conducted and audio-recorded. Audio-recordings were transcribed verbatim and analyzed using thematic analysis.
FINDINGS
Three themes were identified: parents' attribution, perceptions and coping behaviors of NSSI. Chronic stress of adolescents and triggers of NSSI were associated with parental expectations. Parents initially perceived NSSI as a manifestation of puberty, a way of making needs met or a coping strategy of negative emotions, and gradually realized that it was a condition requiring psychological assistance. Parents' coping behaviors of NSSI were divided into 4 stages, namely denial, dissuasion, reflection and adaptation, and working as a team. To be more specific, parents' coping strategies at dissuasion stage included criticizing and conciliating, while those at reflection and adaptation stage included neglecting, avoiding conflicts and increasing control.
CONCLUSIONS
These findings suggest that adjusting parents' expectation and negative perceptions of NSSI is beneficial to reduce adolescent-parent conflict and adolescents' inner conflict and prevent NSSI. Furthermore, it's necessary to publicize NSSI related knowledge to promote the early detection and treatment of NSSI.
Topics: Adaptation, Psychological; Adolescent; Child; China; Humans; Parent-Child Relations; Parenting; Parents; Self-Injurious Behavior
PubMed: 35090423
DOI: 10.1186/s12888-022-03715-7 -
Journal of Cancer Research and... 2021Self-esteem refers to a person's positive and negative attitudes towards the self, and metacognition is an upper system providing awareness and direction of events and...
BACKGROUND
Self-esteem refers to a person's positive and negative attitudes towards the self, and metacognition is an upper system providing awareness and direction of events and mental functions. Coping refers to the specific and psychological efforts used to deal with stressful events or the negative effects of the agents of these. The aim of this study was to evaluate self-esteem, metacognition status and coping attitudes in patients with cancer, which is known to have severely destructive psychological effects.
MATERIALS AND METHODS
Fifty adult cancer patients who were followed up in the medical oncology clinic between July 2018 and June 2019 and 50 age- and gender-matched healthy controls as control group were included in this study. All the participants were applied with a sociodemographic data form, the Rosenberg self-esteem scale, the Metacognition Assessment Scale, and the Copying Orientation to Problems Experienced (COPE) inventory, and their results were compared between the groups.
RESULTS
The groups comprised 50% females with a median age of 58 (33-82) years. The values related to the degree of participation in discussions, problem-focused coping, active coping, planning, and state of emotional vulnerability were low in the cancer patient group compared to the control group (P < 0.005 for all). The sustaining of their self-image, feeling threatened in interpersonal relationships, and degree of daydreaming were higher, and in the metacognition tests, the positive beliefs related to anxiety, uncontrolled or dangerous negative thoughts, nonfunctional coping, religious coping, joking, reckless behavior, substance use, denial, and mental disengagement scores were higher (P < 0.05 for all).
CONCLUSION
Self-esteem was lower in cancer patients and upper level cognitive functions and problem-focused coping were determined to be worse compared to healthy controls. In the light of these results, psychosocial support given to cancer patients in this respect could contribute to quality of life and social conformity.
Topics: Adaptation, Psychological; Adult; Aged; Aged, 80 and over; Anxiety; Case-Control Studies; Female; Follow-Up Studies; Humans; Male; Metacognition; Middle Aged; Neoplasms; Prognosis; Quality of Life; Self Concept; Stress, Psychological; Surveys and Questionnaires
PubMed: 34528548
DOI: 10.4103/jcrt.JCRT_618_19 -
Psychodynamic Psychiatry 2021The author, an experienced psycho-oncologist, offers clinical insights that consider the importance of death anxiety in psychodynamic psychotherapy treatments during the... (Review)
Review
The author, an experienced psycho-oncologist, offers clinical insights that consider the importance of death anxiety in psychodynamic psychotherapy treatments during the COVID-19 pandemic. He reviews the contributions of Ernst Becker, Wilfred Bion and Sheldon Solomon, and formulates ideas of his own based on decades of experience treating patients with cancer. This short essay focuses on how to help patients during the COVID-19 pandemic work through fear and uncertainty while developing adaptive skills.
Topics: Adaptation, Psychological; Anxiety; Attitude to Death; COVID-19; Fear; Humans; Pandemics; Psychotherapy, Psychodynamic; SARS-CoV-2; Uncertainty
PubMed: 34478325
DOI: 10.1521/pdps.2021.49.3.384 -
BMC Women's Health May 2023Breast cancer impacts millions of people worldwide, and in Peru, breast cancer is the most common cause of cancer related death among women. Breast cancer treatment is...
BACKGROUND
Breast cancer impacts millions of people worldwide, and in Peru, breast cancer is the most common cause of cancer related death among women. Breast cancer treatment is physically and emotionally burdensome and challenging for patients.
METHODS
In-depth interviews were conducted with 14 female breast cancer patients and survivors in Lima, Peru. The interviews explored four main themes: the women's emotional experiences, coping mechanisms, resources available or needed, and advice for newly diagnosed breast cancer patients.
RESULTS
Respondents described a tremendous lack of informational support during and after diagnosis and treatment and requested more of this support from health professionals. Social support groups were helpful to participants; however, these forms of support were not available to all participants. Emotional and esteem support seemed amply received from family and friends, faith organizations, and fellow cancer patients. Participants experienced a range of emotions upon diagnosis and during treatment including fear, anxiety, difficulty accepting bodily changes, loneliness, and denial.
CONCLUSION
Breast cancer and its treatment can be a long, emotional journey; more extensive forms of informational support could help patients cope with this process.
Topics: Female; Humans; Breast Neoplasms; Peru; Social Support; Adaptation, Psychological; Emotions
PubMed: 37143060
DOI: 10.1186/s12905-023-02321-3 -
HealthcarePapers Jul 2023Despite notions of colour-blindness and denials of widespread systemic racism, anti-Black racism remains inherent in the political, economic, educational and healthcare...
Despite notions of colour-blindness and denials of widespread systemic racism, anti-Black racism remains inherent in the political, economic, educational and healthcare systems in Europe. We use the Netherlands as a case study to explore some of these mechanisms. Here, we discuss how a focus on cultural deficiency and the denial of racism allows the bearers of inequality and inequity to be blamed for their own disenfranchisement. Nonetheless, scholars in the Netherlands continue to show how everyday racism is negatively impacting marginalized people's lives and their access to the social determinants of health and well-being in society.
Topics: Humans; Racism; Antiracism; Delivery of Health Care
PubMed: 37887166
DOI: 10.12927/hcpap.2023.27195 -
Memory (Hove, England) Oct 2022False denials are sometimes used to cope with traumatic experiences. We examined whether false denials can affect true and false memory production for a traumatic event...
False denials are sometimes used to cope with traumatic experiences. We examined whether false denials can affect true and false memory production for a traumatic event and conversations surrounding the trauma. One hundred and twenty-six participants watched a trauma analogue video of a car crash before being randomly asked in a discussion with the experimenter to (1) respond honestly or (2) falsely deny that certain details happened in the video. After one week, all participants received misinformation about the discussion with the experimenter and the car crash. Finally, all participants were instructed to respond truthfully in a source memory task. Participants who falsely denied information during the first session were statistically significantly more prone than honest participants to omit details they denied and to report misinformation about what was discussed in the first session. Our work suggests that false denials of a traumatic experience might lead to both forgetting and increased false memory levels for earlier conversations about the event.
Topics: Adaptation, Psychological; Communication; Humans; Memory
PubMed: 35786402
DOI: 10.1080/09658211.2022.2094964