“What am I going to say here?” The experiences of doctors and nurses communicating with patients in a cancer unit.

in Frontiers in Psychology (2011), 2

This paper describes a study investigating the provider-patient communication perceptions, experiences, needs and strategies of doctors and nurses working together in a UK cancer setting. This was a ... [more ▼]

This paper describes a study investigating the provider-patient communication perceptions, experiences, needs and strategies of doctors and nurses working together in a UK cancer setting. This was a qualitative study using individual interviews and 32 focus group discussions. Interpretative Phenomenological analysis (IPA) was used to underpin data collection and analysis. Twenty-six staff participated in the project (18 nurses and 8 doctors). Both professional groups identified an inherent emotional strain in their daily interactions with patients. The strategies they adopted to reduce this strain fell into two main categories: 1) Handling or managing the patient to keep negative emotion at bay; and 2) Managing self to keep negative emotion at bay. These strategies allowed staff to maintain a sense of control in an emotionally-stressful environment. Most believed that their communication skills were sufficient. In conclusion, communicating with and caring for cancer patients causes considerable psycho-social burden for doctors and nurses. Managing this burden influences their communication with patients. Without recognition of the need for staff to protect their own emotional well-being, communication skills training programmes, emphasised in current UK cancer care guidelines, may have little impact on practice. [less ▲]

Enhanced behavioral inhibition in restrained eaters

in Eating Behaviors (2011), 12(2), 152-155

Impulsivity has been found to play a decisive role in both addiction and disordered eating. Behavioral and self-report measures show impulsive tendencies to even occur in non-clinical samples, e.g ... [more ▼]

Impulsivity has been found to play a decisive role in both addiction and disordered eating. Behavioral and self-report measures show impulsive tendencies to even occur in non-clinical samples, e.g. restrained eaters. Within this group, these traits interact with high reactivity to food-related cues leading to overeating. The aim of the present study was to investigate if restrained eaters show this behavioral disinhibition specifically in response to food-cues. Participants performed a Go/No-Go-task with stimuli encircled by pictures of high caloric foods or neutral objects. In contrast to our hypotheses, participants with medium-to-high restrained eating made less commission errors in response to both food and neutral pictures than unrestrained eaters. Additionally, participants' inhibitory performance in the high-restrained group were enhanced in the presence of food pictures. Results are in line with expanding evidence of counteractive-control mechanisms when restrained eaters are confronted with tempting food-related cues. [less ▲]

Selbstregulation und Inhibition von „Food Cravings“

in Vögele, Claus (Ed.) Von der Forschung zur Praxis 13. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation – DGVM (2011)

Overcoming selfishness: Reciprocity, inhibition, and cardiac autonomic control in the ultimatum game

in Frontiers in Psychology (2011), 2(173), 1-16

The processes underlying decision-making in response to unfair offers in the ultimatum game (UG) have recently been discussed in light of models of reciprocity and fairness-related behavior. It has been ... [more ▼]

The processes underlying decision-making in response to unfair offers in the ultimatum game (UG) have recently been discussed in light of models of reciprocity and fairness-related behavior. It has been suggested that behavior following norm-oriented, internalized expectations of reciprocity requires overcoming economic self-interest. In this study we investigated both, behavioral and peripheral-physiological indicators of inhibitory capacity related to neuronal networks that are likely to be involved in the behavioral response to unfair offers. Both heart-rate variability as an index of inhibitory capacity, and performance in a motor response inhibition task predicted rejection of unfair offers in an ultimatum game, suggesting an important role of inhibitory processes in overcoming economic temptations and regulating behavior conforming to social norms of reciprocity and fairness. The role of parasympathetic activity as a physiological trait-marker predicting inter-individual differences in the rejection of unfair offers is discussed. [less ▲]

Psychophysiological responses to idiosyncratic stress in Bulimia Nervosa and Binge Eating Disorder.

in Physiology and Behavior (2011), 104

This study examined psychophysiological stress responses to idiosyncratically relevant stress in bulimia nervosa (BN) and binge eating disorder (BED), in relation to autonomic cardiac control and ... [more ▼]

This study examined psychophysiological stress responses to idiosyncratically relevant stress in bulimia nervosa (BN) and binge eating disorder (BED), in relation to autonomic cardiac control and nutritional status. A total of 81 women with BN, BED and healthy controls (HC) took part in an in sensu exposure to idiosyncratic stress. Psychological and peripheral physiological parameters were measured, and tonic heart rate variability, nutritional status, and types of stress were determined. In response to stress exposure, both eating disordered groups showed a stronger reactivity of sadness, and the BED group showed a stronger reactivity of insecurity than the HC group. Desire to binge was increased in the context of interpersonal stress. Stress exposure led to increased cardiovascular activity and reduced electrodermal activity that did not differ by group. The BN-specific symptomatology moderated the association between autonomic cardiac control and psychophysiological stress responses. The results suggest common and specific psychophysiological processes in symptom maintenance through life stress in BN and BED. [less ▲]

Psychische Störungen bei HIV-Infektion und Aids: Klinisch-psychologische Diagnostik und Intervention

in Psychotherapeut (2010), 55(3), 194-202

Noch nie zuvor waren so viele Menschen mit dem „human immunodeficiency virus“ (HIV) infiziert wie heute. Mehr als 39 Mio. Menschen leben mit der HIV-Infektion. Durch die Fortschritte der medizinischen ... [more ▼]

Noch nie zuvor waren so viele Menschen mit dem „human immunodeficiency virus“ (HIV) infiziert wie heute. Mehr als 39 Mio. Menschen leben mit der HIV-Infektion. Durch die Fortschritte der medizinischen Behandlung leben die Betroffenen heute sehr viel länger als vor der Einführung der modernen Kombinationstherapie („highly active anti-retroviral therapy“, HAART; s. Abschn. „Medizinische Behandlung“). Dadurch ist die HIV-Infektion/Aids zu einer chronischen Erkrankung geworden, die vom betroffenen Patienten ein hohes Maß an Anpassungsleistungen verlangt. Sie ist nicht heilbar und in unserer Gesellschaft immer noch stigmatisiert. Psychische Störungen sind häufig, werden aber oft nicht erkannt oder behandelt. Dabei könnten psychologische Interventionen entscheidend zur Verbesserung der Lebensqualität und Behandlungsadhärenz, zur Behandlung psychischer Begleiterkrankungen und zur Stärkung des Immunsystems beitragen. [less ▲]

Neuropsychiatric Complications of Efavirenz Therapy: Suggestions for a New Research Paradigm

in Journal of Neuropsychiatry and Clinical Neurosciences (2010), 22

This review gives an up-to-date account of the current state of research on neuropsychiatric complications associated with efavirenz therapy and critiques the methods used in previous studies. The authors ... [more ▼]

This review gives an up-to-date account of the current state of research on neuropsychiatric complications associated with efavirenz therapy and critiques the methods used in previous studies. The authors suggest an extension of current research strategies using psychophysiological concepts and including behavioral regulation models. From a practical perspective, these may contribute to better screening methods for the identification of those at risk for neuropsychiatric complications and the improvement of neuropsychiatric monitoring during efavirenz treatment. From a theoretical viewpoint, the suggested research paradigms may help to move beyond the current state of descriptive approaches and thus improve our limited understanding of underlying mechanisms. [less ▲]

Cardiac autonomic regulation and anger coping in adolescents

in Biological Psychology (2010), (85), 465-471

The current study investigated spontaneous anger coping, cardiac autonomic regulation and phasic heart rate responses to anger provocation. Forty-five adolescents (27 female, mean age 14.7 years) attended ... [more ▼]

The current study investigated spontaneous anger coping, cardiac autonomic regulation and phasic heart rate responses to anger provocation. Forty-five adolescents (27 female, mean age 14.7 years) attended the single experimental session, which included monitoring of continuous heart rate and blood pressure responses to anger provocation (receiving an unfair offer) using a modified version of the Ultimatum Game (UG). Vagal activation was operationalized as high frequency component of heart rate variability during rest periods, and spontaneous baroreflex-sensitivity (SBR) during the UG. Adolescents employing cognitive reappraisal showed higher vagal activity under resting conditions and attenuated heart rate deceleration after receiving the unfair offer compared with participants who tended to ruminate about their anger and experienced injustice. Results from SBR suggested vagal withdrawal in anger ruminators during contemplation of the unfair offer. These results provide further support for the specificity and sensitivity of vagal responses to higher cortical functions such as emotion regulation. [less ▲]

Effects of peer influence on dietary intake and physical activity in school children

in Public Health Nutrition (2010), 13(3), 376-383

Objective: To investigate the dietary intake and physical activity of boys and girls aged 9–13 years, and the influence of peers on these behaviours. Design: Cross-sectional study. Setting: Nine primary ... [more ▼]

Objective: To investigate the dietary intake and physical activity of boys and girls aged 9–13 years, and the influence of peers on these behaviours. Design: Cross-sectional study. Setting: Nine primary and secondary schools in south-west London. Subjects: A total of 315 children wore sealed pedometers, provided self-report measures of dietary intake and answered a questionnaire relating to peer influence. Anthropometric measures of height and weight were also obtained. Results: Obese children had the lowest reported energy intakes and the lowest step counts per day. Boys took significantly more steps per day than girls, however girls were closer to achieving their recommended cut-offs for physical activity. Girls had lower energy intakes per day and lower BMI Z-scores than boys, however both genders, across all age groups, had higher than recommended intakes of saturated fat. There were significant associations between peer influence and physical activity levels but not between peer influence and dietary intake. Conclusions: Low energy intake and physical activity levels but high saturated fat intakes among boys and girls across all age groups highlight the importance of promoting both physical activity and healthy food choices. The finding that peers have a significant effect on physical activity levels but not on dietary intake offers an important approach for the design of health promotion interventions and obesity prevention programmes. Such designs may be particularly beneficial for obese youth, since the low physical activity levels found could be a major contributing factor to the maintenance of the condition. [less ▲]

Cognitive mediation of clinical improvement after intensive exposure-based therapy of agoraphobia and social phobia

in Depression and Anxiety (2010), (27), 294-301

Background: The present study investigated cognitive mediation of clinical improvement in patients with agoraphobia (N5427) or social phobia (N598) receiving high-density exposure therapy in a ... [more ▼]

Background: The present study investigated cognitive mediation of clinical improvement in patients with agoraphobia (N5427) or social phobia (N598) receiving high-density exposure therapy in a naturalistic clinical treatment setting. Methods: Patients were assessed before therapy, 6 weeks after the end of therapy, and 1 year thereafter, using a self-report assessment battery. Lower level mediation analyses provided support for the notion that cognitive changes partially mediate clinical improvement after exposure therapy. Results: Changes in cognitions relating to physical catastrophes mediated treatment outcome only for patients with agoraphobia, whereas changes in cognitions about loss of control mediated outcome for both agoraphobia and social phobia patients. Changes in relationship satisfaction did not mediate symptomatic improvement. Conclusions: The results extend previous findings by demonstrating mediation in an unselected clinical sample and by providing evidence for the specificity of mediation effects. They further support the importance of cognitive changes in cognitive–behavior therapy. Depression and Anxiety 27:294–301, 2010. [less ▲]