Irrational schematic beliefs and psychological distress in caregivers of people with traumatic brain injury.

Objective: To investigate the relation between irrational schematic beliefs and psychological distress in caregivers of persons with traumatic brain injury (TBI). Design: Cross-sectional mail survey. Participants: One hundred sixteen caregivers of persons with TBI living in the Australian states of Victoria and Queensland who were members of community support groups and brain injury associations. Measures: The Irrational Beliefs Inventory, Brief Symptom Inventory, income satisfaction, degree of personality and behavior change in the TBI individual, and injury severity. Results: Hierarchical regression analyses showed that after controlling for the effects of characteristics of the caregiving situation and the individual with TBI, greater adherence to irrational beliefs was related to higher levels of global psychological distress. Specifically, irrational beliefs related to Worrying were associated with all areas of psychological distress. Conclusion: Results support the cognitive theory proposal that irrational beliefs play an important role in the adaptation to TBI caregiving. Findings suggest the inclusion of cognitive therapy strategies in interventions for caregivers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of preoperative preparation on postoperative outcomes: The moderating role of control appraisals.

Objective: To test the proposal that external health locus of control and self-efficacy would moderate the effects of a psychological preparation for surgery on outcomes for surgical heart patients. Main Outcome Measures: Psychological distress, pain, serum cortisol, and tumor necrosis factor alpha. Design: A total of 80 coronary artery bypass graft patients were given standard care plus a psychological preparation or standard care alone using a single-blind methodology with random assignment. Data on psychological and biological functioning were collected at admission (baseline) and discharge. Results: As predicted, external health locus of control and self-efficacy moderated the effect of the preparation on all outcomes. Results indicated that for high external health locus of control, the preparation was related to lower distress for people with high self-efficacy compared with those with low self-efficacy. When external health locus of control was low, the preparation was related to lower distress for those with lower self-efficacy. Conclusion: These findings caution against the use of preparations and education for surgical patients without accounting for control appraisals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adaptive demands along the HIV disease continuum

Our knowledge of the problems or adaptive demands associated with HIV infection has largely been derived from clinical history taking and qualitative research of persons with AIDS. This study uses a behaviour-analytic approach to systematically describe and quantify the specific adaptive demands encountered by persons with HIV across the disease continuum. Ninety six HIV-infected gay men and 33 seronegative comparison group participants were interviewed in depth. Participants were divided into three groups representing the disease continuum: seronegative, HIV asymptomatic and HIV symptomatic groups. Responses to a Problem Checklist were statistically and content analysed. Distressing emotions, relationship difficulties and HIV-related symptoms were the three most frequently endorsed problems and were also the three most frequently reported problems of most concern. Overall there was a trend for instrumental difficulties to increase with disease progression, whereas emotional and existential problems did not vary as a function of HIV stage. The behaviour-analytic approach to the specification of problems related to HIV infection has implications for both clinical and research endeavours. The specification of problems provided a means for accurately identifying common problems to target and could, therefore, provide the basis for developing suitably matched interventions for use with HIV-infected persons.     

Evaluation of an intensive psychosocial intervention for children of parents with multiple sclerosis.

Objective: To evaluate an intervention for children of parents with multiple sclerosis (MS). It was hypothesized that the intervention would increase knowledge of MS, approach coping, and social support and decrease avoidant coping and stress appraisals. It was expected that these changes would reduce the adverse impacts of caregiving and produce better adjustment. Method: Twenty children (9-14 years) who had a parent with MS attended a 6-day camp intervention. These children completed questionnaires at pre- and postintervention and at 3-month follow-up; their parents with MS (N = 14) completed questionnaires at preintervention and at follow-up. Results: After the intervention, children reported significant decreases in distress, stress appraisals, caregiving compulsion, and activity restrictions and increases in social support and knowledge of MS. Parental data confirmed the increase in the children's knowledge of MS, and overall, qualitative data supported the quantitative findings. Qualitative data showed that the intervention had indirect effects on some parents and families. Conclusions: Findings offer preliminary support for the use of a stress- and coping-based intervention for supporting children and their families with parental MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benefit Finding in Multiple Sclerosis and Associations With Positive and Negative Outcomes.

This study examined the direct and stress-buffering effects of benefit finding on positive and negative outcomes. A total of 502 people with multiple sclerosis completed a questionnaire at Time 1 and, 3 months later, at Time 2 (n=404). Measures of illness were collected at Time 1, and number of problems, stress appraisal, benefit finding, subjective health, and negative (global distress, negative affect) and positive (life satisfaction, positive affect, dyadic adjustment) outcomes were measured at Time 2. Factor analyses showed the Benefit Finding scale to have 2 dimensions: Personal Growth and Family Relations Growth. Hierarchical regressions showed that after controlling for the effects of demographics, illness, problems, and appraisal, benefit finding showed strong direct effects on the positive outcomes. Benefit finding did not have a direct effect on distress or subjective health but had a weak association with negative affect. Family Relations Growth had a stress-buffering effect on distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Making sense of multiple sclerosis.

Objective: In this study, the aim was to examine the dimensional structure of a multi-item measure of sense making in people with multiple sclerosis (MS) and to investigate relations between sense making and both positive and negative adjustment outcomes. Method: Participants were 408 persons with MS and 232 caregivers. Questionnaires were completed at the initial assessment (Time 1) and 12 months later (Time 2). Results: Factor analysis of the Sense Making Scale (SMS) revealed 6 psychometrically sound factors: Redefined Life Purpose, Acceptance, Spiritual Perspective, Luck, Changed Values and Priorities, and Causal Attribution. Results of regression analyses indicated that the Time 2 SMS factors accounted for significant amounts of variance in each of the Time 2 adjustment outcomes (life satisfaction, positive states of mind, anxiety, depression, caregiver adjustment rating of the care receiver), after controlling for Time 1 adjustment and relevant demographic and illness variables. Conclusions: Findings delineate the dimensional structure of sense making in MS and the differential links between sense making dimensions and adjustment and have implications for the measurement of sense making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between adjustment to HIV and both social support and coping.

This study examined the relationships between HIV stage, social support, coping strategies, and adjustment to HIV. Ninety-six HIV-infected gay men and 33 seronegative comparison group participants participated in the study. In general, coping strategies and social support did not differ according to HIV stage. As predicted, adjustment was related to social support and coping strategies. Coping strategies were linked to psychosocial adjustment, whereas social support was more strongly associated with health-related variables. There was little evidence of buffering effects of either coping strategies or social support. Four coping strategies were related to low levels of psychological distress. Contrary to expectation, the relationships between coping strategies and adjustment did not vary as a function of HIV stage. However, the relationship between adjustment and some elements of social support varied as a function of HIV stage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychosocial impact of caregiving on young people who have a parent with an illness or disability: Comparisons between young caregivers and noncaregivers.

Objective: To investigate the psychosocial impact of young caregiving by empirically validating prominent qualitative themes. This was achieved through developing an inventory called the Young Caregiver of Parents Inventory (YCOPI) designed to assess these themes and by comparing young caregivers and noncaregivers. Method: Two hundred forty-five participants between 10 and 25 years completed questionnaires: 100 young caregivers and 145 noncaregivers. In addition to the YCOPI, the following variables were measured: demographics, caregiving context, social support, appraisal, coping strategies, and adjustment (health, life satisfaction, distress, positive affect). Results: Eight reliable factors emerged from the YCOPI that described the diverse impacts of caregiving and reflected the key themes reported in prior research. The factors were related to most caregiving context variables and theoretically relevant stress and coping variables. Compared with noncaregivers, young caregivers reported higher levels of young caregiving impact, less reliance on problem-solving coping, and higher somatization and lower life satisfaction. Conclusions: Findings delineate key impacts of young caregiving and highlight the importance of ensuring that measures used in research on young caregivers are sensitive to issues pertinent to this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment to multiple sclerosis: Application of a stress and coping model.

This study examined the use of a stress and coping model of adjustment to multiple sclerosis (MS). A total of 122 MS patients were interviewed and completed self-administered scales at Time 1 and 12 months later, Time 2 (n?=?96). Predictors included stressful life events, illness (duration, severity, and disability), social support, appraisal (threat and control/challenge), and coping (problem focused and emotion [wishful thinking, self-blame, and avoidance] focused). Adjustment outcomes were Time 2 depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that after controlling for the effects of Time-1 adjustment, better Time-2 adjustment was related to less disability, greater reliance on problem-focused coping, and less reliance on emotion-focused coping. There was limited support for the stress buffering effects of coping and social support. Findings offer some support for the use of a stress and coping model of adaptation to MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)