Research provides evidence about the high levels of anxiety and depression in myocardial infarction (MI). This is because patients with MI face both an acute life-threatening illness and the potential for living with a major illness (Roebuck et al. 2001, Thornton 2001, Kim et al. 2000). Consequently, the patients' whole sense of meaning and purpose in life is at stake (Walton 1999, Burnard 1987, Simsen 1985). Research on spiritual coping and spiritual well being (SWB) in MI is still in its infancy. Therefore the aim of the study was to identify possible relationships between spiritual coping strategies (SCS) and anxiety, depression, SWB and personal characteristics of Maltese patients with MI, during hospitalisation and the first three months after discharge.The longitudinal descriptive correlational study recruited a homogenous systematic sample of seventy male (n=46) and female (n=24) patients with first MI, mean age of 61.9 years. The variables under investigation were assessed by the translated versions of the Hospital Anxiety and Depression (HAD) scale (Zigmond and Snaith 1983), JAREL------ SWB scale (Hungelmann et al.1985) and Helpfulness of Spiritual Coping Strategies (HSCS) scale designed for the study. The rationale for the perceived helpfulness of SCS was explored by the semi-structured face to face interview.The theoretical framework which guided the study incorporated the Cognitive Theory of Stress and Coping (Lazarus and Folkman 1984) and the Idea of the Holy (Otto 1950). Analysis of the qualitative data was guided by Burnard (1991) analysis model. Additionally, analysis of the quantitative data utilized both parametric and nonparametric statistical tests in order to identify differences between means of subgroups of the personal characteristics and correlations between SCS and anxiety, depression and SWB across time.The findings revealed a constant decline of anxiety and depression across time which is inconsistent with published research. However, the return of anxiety and depression to normal limits by the third month is congruent with research. In contrast, scores of SWB and SCS increased on discharge and remained stable across time.The qualitative data revealed that SCS, SWB and the Maltese culture, which promotes family support in illness, may have contributed towards the relief of anxiety and depression. The quantitative data exhibited a negative, significant relationship between SCS and anxiety and depression on the sixth week after discharge. Additionally, positive significant relationships were identified between SCS and SWB across time.The findings suggest that SWB may be a precursor to the relief of anxiety and depression. The minimal significant differences in SCS between the subgroups of personal characteristics propose the possible impact of the event of MI on spiritual coping and negative mood states. However these speculations may only be confirmed by further research as recommended in the study. Hopefully, the new knowledge produced by the study will be applied to the clinical practice and nursing education to promote patient care.

Thesis (M.A.)--Kent State University, 2008. / Title from PDF t.p. (viewed Oct. 29, 2009). Advisor: David Fresco. Includes bibliographical references (p. 34-43).

Eating Disorder research has highlighted the role of neuropsychological functioning, informing the treatment of Anorexia Nervosa. There is ambiguity in the data relating to cognitive impairment in Bulimia Nervosa, with the latest review providing inconclusive results. Executive function impairments in the area of set shifting and inhibition reported in BN are proposed to relate to traits of compulsivity and impulsivity. Other psychological disorders have also demonstrated executive function impairments. Among anxiety disorders, only PTSD and OCD have strong evidence of executive function deficits while a number of studies point towards executive function deficits in depression. This thesis aims to investigate the specificity of cognitive impairments seen in a group of female outpatients with bulimia nervosa, using a clinical comparison group of anxious and/or depressed female outpatients. Methods A systematic review was conducted to address a gap in the anxiety disorder literature and assess the neuropsychological profile of panic disorder. In order to address the main study aims, a comparison between a group of patients with BN and an anxious depressed group was conducted on neuropsychological measures of the Trail Making Test, Wisconsin Card Sorting Test, Hayling and Brixton tasks, Stroop and Verbal Fluency. In addition, psychological symptoms were assessed using SCL-90-R, Yale- Brown Obsessive Compulsive Scale and the Self-liking Self Competence scale. Social problems solving skills were assessed as a potential real world effect of executive function difficulties associated with eating disorders. The relationships between psychological and neuropsychological variables were investigated. Results The systematic review concluded that there was limited evidence of specific impairment in short term memory in panic disorder. The empirical study indicated no group differences on the above neuropsychological measures. Groups also did not differ on NART estimated IQ or self reported psychological symptoms. No relationships were found between psychological symptoms and neuropsychological measures. Few individual participants were found to be impaired on neuropsychological measures in either group. However, those impaired in the BN group were exclusively impaired on the non-perseverative errors and categories completed variables of the WCST, which is thought to be related to impulsivity. Conclusion These findings suggest that the neuropsychological profile of bulimia is broadly similar to that of an anxious and/or depressed clinical group on measures of set shifting and inhibition. Although there was evidence of a deficit in inhibition among patients with bulimia further investigation is required.

Objective To investigate symptoms of anxiety and depression in lesbian couples undergoing assisted reproductive treatment (ART), and to study the relationship of demographic data, pregnancy outcome and future reproductive plans with symptoms of anxiety and depression. Design Descriptive, a part of the prospective longitudinal ‘Swedish study on gamete donation’. Setting All university clinics in Sweden performing gamete donation. Population A consecutive sample of 214 lesbian couples requesting assisted reproduction, 165 of whom participated. Methods Participants individually completed three study-specific questionnaires and the Hospital Anxiety and Depression Scale (HADS): time point 1 (T1), at commencement of ART; time point 2 (T2), approximately 2 months after treatment; and time point 3 (T3), 2–5 years after first treatment. Main outcome measures Anxiety and depression (HADS), pregnancy outcome and future reproductive plans. Results The vast majority of lesbian women undergoing assisted reproduction reported no symptoms of anxiety and depression at the three assessment points. A higher percentage of the treated women, compared with the partners, reported symptoms of anxiety at T2 (14% versus 5%, P = 0.011) and T3 (10% versus 4%, P = 0.018), as well as symptoms of depression at T2 (4% versus 0%, P = 0.03) and T3 (3% versus 0%, P = 0.035). The overall pregnancy outcome was high; almost three-quarters of lesbian couples gave birth 2–5 years after sperm donation treatments. Open-ended comments illustrated joy and satisfaction about family building. Conclusion Lesbian women in Sweden reported good psychological health before and after treatment with donated sperm. / <p>Funding Agencies|Merck Serono||Uppsala/Orebro Regional Research Council||Medical Research Council of Southeast Sweden||Marianne and Marcus Wallenberg Foundation||</p>

Background: There has been growing interest and research into the construct of self-compassion. Self-compassion has been positively associated with psychological well-being, and negatively associated with a range of psychological difficulties. The origins of self-compassion have been linked to early attachment experiences, with poor attachment relationships proposed to result in an inability to self-soothe and take a compassionate stance towards the self. Whilst research in nonclinical populations provides some initial support for these hypotheses, there is a lack of research conducted in clinical populations. Given a large effect size has been found for the association between self-compassion and psychological difficulties, this suggests it may be an important target for therapeutic change. There is a growing evidence-base for the use of compassion-focused therapies, with research suggesting they are effective in reducing mood symptomology. However, less is known about the impact of these therapies on levels of self-compassion, or whether reductions in mood symptomology occur as a causal effect of increased self-compassion. In addition, other ‘third wave’ therapies may also indirectly increase self-compassion. Aims: The research aims were two-fold. The first aim was to conduct a systematic literature review to evaluate the effectiveness of compassion-focused and mindfulness-based interventions in increasing levels of self-compassion. The second aim was to examine the role of self-compassion and its relationships with attachment and interpersonal problems in adults attending a primary care psychological therapies service. Specifically, self-compassion and interpersonal problems were hypothesised as potential mediators between insecure attachment and anxiety and depression. Method: To address the first research aim, a systematic search was conducted to identify studies that utilised a compassion and/or mindfulness-based intervention with a clinical population, and included self-compassion as an outcome measure. To address the second research aim, a cross-sectional, quantitative study was conducted. Participants (N=74; 60% female, mean age = 40 years) attending a primary care psychological therapies service completed four self-report questionnaires assessing self-compassion, attachment, interpersonal problems and anxiety and depression. Results: The findings of the systematic review suggested that self-compassion can be increased through both compassion-focused and mindfulness-based interventions. However, methodological weaknesses across studies highlighted that further research is needed and definitive conclusions cannot be drawn. The results of the empirical study indicated that low self-compassion, attachment avoidance and high levels of interpersonal problems were all associated with increased emotional distress. Furthermore, self-compassion mediated the relationship between attachment avoidance and emotional distress and anxiety. Interpersonal problems was not a significant mediator. Conclusions: Taken collectively, the findings here suggest that self-compassion may be an important target in psychological therapy. In addition, results of the mediation analysis indicated that low self-compassion can be a pathway to overall emotional distress and anxiety for individuals with attachment avoidance. This provides support for the theory that self-compassion is linked to early attachment experiences.

Clinical and preclinical research both indicate that early life adversities alter sensitivity to stress well into adulthood. Although clinical research identifies infancy, childhood, and adolescence as periods of heightened vulnerability, the majority of preclinical research experiments have examined the enduring impact of stressors delivered either prenatally or prior to weaning. It was recently shown that exposing rats to intermittent stressors across the childhood/ adolescent period (PD 21-51) increased their behavioural and endocrine sensitivity to stress in adulthood. The purpose of the current project was to determine whether specific developmental periods are differentially sensitive to the lasting effects of intermittent stress. Male and female Long-Evans rats were exposed to three stressors (foot shock, elevated platform exposure, and cold water emersion) two times each, randomly over a twelve day period (childhood: PD 22-33 vs. adolescence: PD 35-46). Age-matched controls were briefly handled on each of the stressor application days. After completion of the stress exposure period, rats were left undisturbed for 27 days and behavioural testing commenced in adulthood. Intermittent physical stress exposure during the childhood period increased anxiety-like behaviours in adulthood, as indexed by the Elevated-Plus Maze (EPM) and Shock Probe Burying Test (SPBT). This also increased depression-like behaviour in adult male rats and decreased depression-like behaviour in adult female rats, as indexed by the Forced Swim Test (FST). Intermittent physical stress exposure in the adolescent period increased open-arm activity, increased burying behaviour and increased immobility in the forced swim test, in both male and female rats. Stress during either developmental period, failed to alter corticosterone (CORT) reactivity to restraint stress in adulthood. Thus, it appears that the long lasting behavioural impact of early-life adversity can vary, according to the developmental period the stressors are experienced in, but this is further modified by sex and the type of test used to evaluate adult behaviour. / Thesis (Master, Psychology) -- Queen's University, 2010-08-25 18:53:24.136

Thesis (Psy.D.)--Adler School of Professional Psychology, 2002. / Includes bibliographical references (leaves 88-94).

The purpose of this study was to examine whether child temperament, parent personality, and the interaction between the two would predict anxiety/depressive problems, and also whether the presence of positive factors would be related to child anxiety/depressive problems. It was also hypothesized that child mood would be predictive of symptoms of anxiety and depression, even after accounting for heritability. Participants were 106 5-year-old twin pairs and their parents, who completed questionnaires and a parent-child interaction. As hypothesized, child negative mood and parent personality were significant predictors of anxiety/depressive problems. However, their interaction was not significant. For children in the negative mood group, as their level of family conflict decreased, their score on anxiety/depression also decreased, providing evidence that low family conflict is protective. Results also revealed that anxiety/depression is heritable and that child mood was significant in predicting symptoms of anxiety and depression even after first accounting for heritability.

Anxiety and depression are common mood disorders in cancer patients, regardless of mental state prior to diagnosis. A gap in the education of oncology nurses in an eastern Caribbean island was discovered regarding their ability to identify anxiety and depression symptoms and to help patients who suffered from these disorders. The purpose of this project was to improve oncology nurses' assessment skills by reviewing appropriate use of the Hospital Anxiety and Depression Scale (HADS) tool and familiarizing nurses with resources to help patients who score high on the HADS. The Levine conservation model was the theoretical framework for this project. The research question addressed whether a staff education module regarding the use of the HADS tool would improve staff knowledge about screening cancer patients for mood disorders in a clinic setting. This project involved a staff education module with a pretest/posttest assessment and evaluation of the responses and levels of improvement. A total of 10 oncology nurses with varying academic degrees and years of experience participated in the project. The pretest showed that many had inadequate knowledge of the HADS tool. Based on posteducation assessment scores, all participants understood how to use the tool to screen for mood disorders. The implication of this study for positive social change is that oncology nurses will be able to use a screening tool to identify undiagnosed anxiety and depression symptoms in cancer patients and provide patients with appropriate resources.

No / The factor structure of the Hospital Anxiety and Depression Scale (HADS) were investigated in 376 individuals with facial disfigurement. Exploratory factor analysis and confirmatory factor analysis were used to determine the underlying factor structure of the instrument. Competing one-factor, two-factor and three-factor models were evaluated to identify best model fit. The best model fit to the data was found to be consistently provided by three-factor models. However, further research into the factor structure of the HADS is suggested, particularly in terms of developing and scoring the instrument as a three-dimensional affective state screening tool.