Does training improve understanding of core concepts in cognitive behaviour therapy by people with intellectual disabilities? A randomized experiment

Background. People with intellectual disabilities (ID) experience similar or even higher rates of mental health problems than the general population and there is a need to develop appropriate treatments. Cognitive behaviour therapy (CBT) is effective for a wide range of disorders in the general population. However, there is some evidence that people with ID may lack the cognitive skills needed to take part in CBT. Aims. To test if people with ID can learn skills required for CBT, specifically the ability to distinguish between thoughts, feelings, and behaviours and to link thoughts and feelings (cognitive mediation). Method. A randomized independent groups design was used to examine the effect of training in CBT on two tasks measuring CBT skills. Thirty-four adults with ID were randomly allocated to the experimental condition ðN ¼ 18Þ or to the control condition ðN ¼ 16Þ. CBT skills were assessed blind at baseline and after the intervention. Results. The training led to significant improvements in participants’ ability to link thoughts and feelings, and this skill was generalized to new material. There was no effect of training on participants’ ability to distinguish amongst thoughts, feelings, and behaviours. People with ID can, therefore, learn some skills required for CBT. This implies that preparatory training for CBT might be useful for people with ID. The results might be applicable to other groups who find aspects of CBT difficult.

Continuity of care for carers of people with severe mental illness: results of a longitudinal study

Introduction: Continuity of care has been demonstrated to be important for service users and carer groups have voiced major concerns over disruptions of care. We aimed to assess the experienced continuity of care in carers of patients with both psychotic and non-psychotic disorders and explore its association with carer characteristics and psychological well-being. Methods: Friends and relatives caring for two groups of service users in the care of community mental health teams (CMHTs), 69 with psychotic and 38 with non-psychotic disorders, were assessed annually at three and two time points, respectively. CONTINUES, a measure specifically designed to assess continuity of care for carers themselves, was utilized along with assessments of psychological well-being and caregiving. Results: One hundred and seven carers participated. They reported moderately low continuity of care. Only 22 had had a carer’s assessment and just under a third recorded psychological distress on the GHQ. For those caring for people with psychotic disorders, reported continuity was higher if the carer was male, employed, lived with the user and had had a carer’s assessment; for those caring for people with non-psychotic disorders, it was higher if the carer was from the service user’s immediate family, lived with them and had had a carer’s assessment. Conclusion: The vast majority of the carers had not had a carer’s assessment provided by the CMHT despite this being a clear national priority and being an intervention with obvious potential to increase carers’ reported low levels of continuity of care. Improving continuity of contact with carers may have an important part to play in the overall improvement of care in this patient group and deserves greater attention.

I see happy people: attention bias towards happy but not angry facial expressions in Williams syndrome

Introduction: Observations of behaviour and research using eye-tracking technology have shown that individuals with Williams syndrome (WS) pay an unusual amount of attention to other people’s faces. The present research examines whether this attention to faces is moderated by the valence of emotional expression. Method: Sixteen participants with WS aged between 13 and 29 years (Mean=19 years 9 months) completed a dot-probe task in which pairs of faces displaying happy, angry and neutral expressions were presented. The performance of the WS group was compared to two groups of typically developing control participants, individually matched to the participants in the WS group on either chronological age or mental age. General mental age was assessed in the WS group using the Woodcock Johnson Test of Cognitive Ability Revised (WJ-COG-R; Woodcock & Johnson, 1989; 1990). Results: Compared to both control groups, the WS group exhibited a greater attention bias for happy faces. In contrast, no between-group differences in bias for angry faces were obtained. Conclusions: The results are discussed in relation to recent neuroimaging findings and the hypersocial behaviour that is characteristic of the WS population.

It is always on your mind: experiences and perceptions of falling of older people and their carers and the potential of a mobile falls detection device

Background. Falls and fear of falling present a major risk to older people as both can affect their quality of life and independence. Mobile assistive technologies (AT) fall detection devices may maximise the potential for older people to live independently for as long as possible within their own homes by facilitating early detection of falls. Aims. To explore the experiences and perceptions of older people and their carers as to the potential of a mobile falls detection AT device. Methods. Nine focus groups with 47 participants including both older people with a range of health conditions and their carers. Interviews were audio recorded, transcribed verbatim, and thematically analysed. Results. Four key themes were identified relating to participants’ experiences and perceptions of falling and the potential impact of a mobile falls detector: cause of falling, falling as everyday vulnerability, the environmental context of falling, and regaining confidence and independence by having a mobile falls detector. Conclusion. The perceived benefits of a mobile falls detector may differ between older people and their carers. The experience of falling has to be taken into account when designing mobile assistive technology devices as these may influence perceptions of such devices and how older people utilise them.

Reading together: an ethnographic study of a reading group for visually-impaired people

Because reading groups historically have been under-researched (Long, 2003), the literature in this field is limited, presenting this as an interesting area for researchers. A need for further research is also explained by the fact that the traditional model of a reading group has been expanded through recent library policies leading to the development of specific group types such as groups for visually-impaired people (VIPs). To date, there have been no long-term empirical studies of these groups. This thesis, therefore, makes a significant contribution to the literature in this field by providing an in-depth exploration of a VIP reading group. The thesis is an ethnographic study which follows a library-run reading group for visually-impaired people from its formation in September 2007 and concentrates on five of the group members. The methodology for the study is influenced by participatory approaches to research involving disabled people by inviting the participants to participate in the co-creation of knowledge about themselves (French & Swain, 2000, p. 1). It is also influenced by new ethnography’s preference for multi-layered texts by exploring both the individual and collective experiences of the participants. While the participants are defined throughout as readers, visual-impairment plays a role in their experiences. I show that visually-impaired readers and reading groups sit within a complex web of factors which impact on their experiences both as individual readers and as a group. The study also shows that VIP reading groups challenge traditional definitions of reading as a visual activity. The study explores issues of power and concludes that, because ownership of the group lies with the library, this challenges the idea of reading groups empowering their members. Furthermore, offering discrete groups for visually-impaired readers means that the role these groups play in contributing to agendas for social inclusion is problematic. The study concludes by making suggestions as to how these groups might develop to be more inclusive and empowering.

Cognitive appraisals in young people with obsessive-compulsive disorder

Background: A number of cognitive appraisals have been identified as important in the manifestation of obsessive-compulsive disorder (OCD) in adults. There have, however, been few attempts to explore these cognitive appraisals in clinical groups of young people. Method: This study compared young people aged between 11 and 18 years with OCD (N ¼ 28), young people with other types of anxiety disorders (N ¼ 28) and a non-clinical group (N ¼ 62) on three questionnaire measures of cognitive appraisals. These were inflated responsibility (Responsibility Attitude Scale; Salkovskis et al., 2000), thought–action fusion – likelihood other (Thought–Action Fusion Scale; Shafran, Thordarson & Rachman, 1996) and perfectionism (Multidimensional Perfectionism Scale; Frost, Marten, Luhart & Rosenblate, 1990). Results: The young people with OCD had significantly higher scores on inflated responsibility, thought–action fusion – (likelihood other), and one aspect of perfectionism, concern over mistakes, than the other groups. In addition, inflated responsibility independently predicted OCD symptom severity. Conclusions: The results generally support a downward extension of the cognitive appraisals held by adults with OCD to young people with the disorder. Some of the results, however, raise issues about potential developmental shifts in cognitive appraisals. The findings are discussed in relation to implications for the cognitive model of OCD and cognitive behavioural therapy for young people with OCD. Keywords: Cognitive models, inflated responsibility, obsessive-compulsive disorder, perfectionism, thought–action fusion. Abbreviations: ADIS-C: Anxiety Disorders Interview Schedule for Children; ADIS-P: Anxiety Disorders Interview Schedule for Parents; E/RP: Exposure/Response Prevention; LOI-CV: Leyton Obsessional Inventory – Child Version; MPS: Multidimensional Perfectionism Scale; OCD: Obsessive-Compulsive Disorder; RAS: Responsibility Attitude Scale; TAF-LO: Thought–Action Fusion – (Likelihood Other).

Use of the mini nutritional assessment tool in elderly people from long-term institutions of southeast of Brazil

Background: the Mini Nutritional Assessment (MNA) is a multidimensional method of nutritional evaluation that allows the diagnosis of malnutrition and risk of malnutrition in elderly people, it is important to mention that this method has not been well studied in Brazil. Objective: to verify the use of the MNA in elderly people that has been living in long term institutions for elderly people. Design: transversal study. Participants: 89 people (>= 60 years), being 64.0% men. The average of age for both genders was 73.7 +/- 9.1 years old, being 72.8 +/- 8.9 years old for men, and 75.3 +/- 9.3 years old for women. Setting: long-term institutions for elderly people located in the Southeast of Brazil. Methods: it was calculated the sensibility, specificity, and positive and negative predictive values. It was data to set up a ROC curve to verify the accuracy of the MNA. The variable used as a ""standard"" for the nutritional diagnosis of the elderly people was the corrected arm muscle area because it is able to provide information or an estimative of the muscle reserve of a person being considered a good indicator of malnutrition in elderly people. Results: the sensibility was 84.0%, the specificity was 36.0%, the positive predictive value was 77.0%, and the negative predictive value was 47.0%; the area of the ROC curve was 0.71 (71.0%). Conclusion: the MNA method has showed accuracy, and sensibility when dealing with the diagnosis of malnutrition and risk of malnutrition in institutionalized elderly groups of the Southeastern region of Brazil, however, it presented a low specificity.

The game of contacts: Estimating the social visibility of groups

Estimating the sizes of hard-to-count populations is a challenging and important problem that occurs frequently in social science, public health, and public policy. This problem is particularly pressing in HIV/AIDS research because estimates of the sizes of the most at-risk populations-illicit drug users, men who have sex with men, and sex workers-are needed for designing, evaluating, and funding programs to curb the spread of the disease. A promising new approach in this area is the network scale-up method, which uses information about the personal networks of respondents to make population size estimates. However, if the target population has low social visibility, as is likely to be the case in HIV/AIDS research, scale-up estimates will be too low. In this paper we develop a game-like activity that we call the game of contacts in order to estimate the social visibility of groups, and report results from a study of heavy drug users in Curitiba, Brazil (n = 294). The game produced estimates of social visibility that were consistent with qualitative expectations but of surprising magnitude. Further, a number of checks suggest that the data are high-quality. While motivated by the specific problem of population size estimation, our method could be used by researchers more broadly and adds to long-standing efforts to combine the richness of social network analysis with the power and scale of sample surveys. (C) 2010 Elsevier B.V. All rights reserved.

”Alltid saknad – aldrig glömd” : Om emotionella drivkrafter inom Missing People Sweden

”Forever missed – never forgotten”: Emotion and action in a swedish voluntary search and rescue organisation The article explores the phenomenon of voluntary policing, through a case study of the voluntary search and rescue group Missing People Sweden (MPS). The article focuses on how a collectively upheld emotionology guide members’ views on the problem MPS is engaging, how this problem should be engaged, and why people should join MPS in its activities. The material used was gathered in spring 2014; through eight semi-structured interviews, document studies and four participant observations of the organisation’s activites. The results indicate that MPS members relate their views to an emotionology consisting of two separate themes; one of equality and collectivism, and one of individualism and meritocracy. The article demonstrates that the Tönniesian terms Gemeinschaft and Gesellschaft can both be applied to describe the organisation’s social environment. It also demonstrates that the Tönniesian dichotomy is a theoretical concept that is suited to the analysis of voluntary policing groups.

Subjective quality of life, perceived control and dispositional optimism among older people

Objectives: To examine whether the subjective quality of life (QOL) of elderly people is held under homeostatic control, and to investigate the role of perceived control and dispositional optimism in the maintenance of subjective QOL.
Method: 100 older people (M=75.6 years) and a control group of 107 younger people (M=20.1 years) completed a self-report survey.
Results: Both groups had a level of subjective QOL within the normal range. The older group reported higher levels of secondary control and optimism, but similar levels of primary control, as the younger group. Primary control and optimism predicted subjective QOL for both groups. Secondary control was a significant predictor (or the younger group, however it was only marginally significant for the older group. Optimism accounted for the most subjective QOL variance for both groups.
Conclusions: The finding that the subjective QOL of the older group lay within the normative range supports the proposal that their subjective QOL is being successfully maintained under bomeostatic control. However, they appear to have an increased reliance on secondary control. The fact that dispositional optimism captures the predictive variance of perceived control, is an important finding adding to the understanding of subjective QOL maintenance.

Quality of life and multiple sclerosis: comparison between people with multiple sclerosis and people from the general population

This paper evaluated the quality of life (QOL) of people with multiple sclerosis (MS) and people from the general population. Gender differences between the 2 groups of respondents and the influence of coping style on adjustment were also evaluated. The participants were 381 (144 males, 237 females) people with MS, and 291 (101 males, 190 females) people from the general population. The results demonstrated that people with MS experienced lower levels of QOL than people from the general population for both the objective and subjective dimensions of all domains (physical health, psychological adjustment, social relationships, environmental adjustment). All coping strategies (problem-focused, focusing on the positive, detachment, wishful thinking, seeking social support) were important predictors of QOL for both males and females with MS, with wishful thinking being the strongest predictor of poor QOL. These results are discussed in terms of the various factors that impact on QOL among people with MS, and the types of coping strategies that are most adaptive in improving the QOL of people with this illness.

Regimes of risk: the need for a pedagogy for peer groups

Peer groups matter more than we think. In this paper we assert that peer group commitments and affiliations are often the primary social reference in determining the way young people think about and practice risk. It is, we argue, inappropriate to impose adult constructions of risk-taking and anti-social behaviour when trying to assert influence over the decisions and practices young people make in the context of their peers. Prominent in our discussion is a concern that mainstream educational theory and practice focuses disproportionately on the individual and their capacity to make rational and independent choices. We believe that within this individualizing framework, teachers have only a very limited capacity to influence the practices and decisions young people make in the presence of their peers, their friends. To ground this discussion we juxtapose the actions and interactions of two young male peer groups, to highlight their respective constructions of group identity.

Peer groups, power and pedagogy : the limits of an educational paradigm of separation

In contrast to the plethora of literature that suggests that the increasing gulf between teachers and young people is due to the shifting interests and expectations of young people, the focus of this paper is on the roles teachers play in this relationship. Provoking interest is a concern that some of the assumptions that underpin 'mainstream' pedagogic theory and practice might actually contribute, albeit unwittingly, to hardening rather than softening the communication divide. Drawing on an incident that took place between a group of 7–8 year old males in a primary school setting, the authors reveal the limits of a teaching paradigm that encourages teachers to adopt authoritative positions from which to separate and individualise student behaviour. In theoretical terms, they argue that the application of this paradigm asserts an exaggerated notion of agency to individuals in the construction of identity. In practical terms it promotes processes that individualise behaviour as a way of dealing with miscreance. Together these manifest themselves as a 'pedagogy of separation'. The process of building more productive pedagogic relationships, it is concluded, needs to begin with teachers better recognising and engaging with the collective investments of young people.

Exacerbation of symptoms among people with multiple sclerosis: impact on sexuality and relationships over time

This study was designed to evaluate the impact of an exacerbation in symptoms among men and women with multiple sclerosis (MS) on sexuality and relationship satisfaction. A total of 321 people with MS (120 men, M age = 48.10 years; 201 women, M age = 45.78 years), and 239 people from the general population (79 men, M age = 53.93 years; 160 women, M age = 45.89 years) completed measures of relationship satisfaction and sexuality, and then completed these measures again 18 months later. The results demonstrated that both men and women with MS reported significantly higher levels of sexual dysfunction than did the general population. The no exacerbation group also reported significantly lower levels of sexual activity and of relationship satisfaction than the general population group over the 18-month period. Women in all groups reported significantly higher levels of sexual dysfunction but also higher levels of sexual activity than did men at each time period. They also reported significantly higher levels of sexual satisfaction at the 18-month follow up. These results suggest that men and women respond in similar ways to MS, and that people with MS do not necessarily experience poorer levels of sexual interaction or relationship quality when they experience an increase in their physical symptoms.

Lay people's views of school food policy options: associations with confidence, personal values and demographics

A random population survey administered by mail to examine lay people's views of children's food policies and their associations with demographics, personal values and confidence in authorities was conducted among adults in Victoria, Australia. Three hundred and seventy-seven people responded (response rate 57.6%). The questionnaire contained 35 items about children's healthy eating policy options plus details like personal values, confidence and demographic items. There was widespread support for healthy school food policies. The strongest support was for life skills education and school-based nutrition and physical education programmes. Many age-related associations indicated that people >48 years were more in favour of healthy eating policies than younger people. There were fewer statistically significant associations with parent status and sex. In contrast, many associations showed that respondents with strong equity–harmony values and those with least confidence in the authorities were most in favour of healthy eating policies for schoolchildren. It is concluded that there is widespread support for school-based health and nutrition education and for active school food policies. However, differences between demographic and values groups suggest the need for caution in the promotion of public health nutrition initiatives among schoolchildren.