Caregivers' experiences and coping strategies relating to patient's subjective treatment-related cognitive impairment following Haematopoietic Stem Cell Transplant (HSCT)

The treatments involved in cancers of the blood and bone marrow can be physically and psychologically challenging and be associated with adverse secondary effects, including cognitive impairment. The incidence and severity of treatment-related cognitive impairment varies widely, however it can significantly impact quality of life by interfering with patients’ activities of daily living, relationships and future plans. It can also pose challenges for the patients’ caregivers, an area which has received comparatively less research attention. The aim of this study was to investigate caregivers’ experiences of treatment-related cognitive impairment in patients who have undergone Haematopoietic Stem Cell Transplant (HSCT); how they coped, both practically and emotionally, and what supports they believe could help them. Participants were caregivers to individuals who had undergone HSCT within the past 20 years and who had reported cognitive changes at the HSCT Late Effects Clinic, Beatson West of Scotland Cancer Centre. Five participants completed a single semi-structured interview. The data was then analysed using Interpretative Phenomenological Analysis (IPA). Results of this analysis illustrated four super-ordinate themes: noticing change; managing expectations, managing personal feelings and commitment. Findings from the current study highlighted the importance of caregiver education regarding post HSCT cognitive and behavioural changes and providing caregiver emotional support. Future research should explore the mutual needs of both care recipient and caregiver.

Heaven's Sense: a novel / At hand-grips with ruin: the psychology of writer's block

There is a significant attitude of scepticism when it comes to belief in the existence of writer's block as a valid psychological phenomenon, alongside what might be described as the "Tortured Artist Personality". It is contended here that both writer's block and the "Tortured Artist Personality" do exist in a minority of professional and aspiring fiction writers, and furthermore that these phenomena are forms of personality behaviour that have already been well-catalogued by the academic fields of psychiatry, psychology and psychotherapy: specifically, writer's block is a form of unconscious maladaptive procrastination - expressed through avoidance coping or escape coping behaviour - which in turn arises from the fully-accepted personality trait of perfectionism. Aspects of perfectionism, together with various sub-scale traits and mediators, are also the key components in at least one form of "Tortured Artist Personality". This paper lays out the extensive evidence for these assertions, using existing research in the fields of psychology, psychiatry, psychotherapy and neuroscience.