Abstract The current study aimed to investigate the relationship between (a) racial/ethnic matching between African American clients and their counselors (i.e., Black, White, and non-Black racial/ethnic minority counselors) and therapeutic outcomes (i.e., change in symptoms, treatment length, and premature termination), (b) while also controlling for the potential influences of client (i.e., initial distress level, family and social support, and socioeconomic status) and counselor (i.e., experience level) characteristics. Change in symptomology on specific domains of functioning (i.e., Depression, Generalized Anxiety, Academic Distress, and Distress Index) was assessed using the Counseling Center Assessment of Psychological Symptoms-34 (i.e., CCAPS-34; Locke et al., 2012). The change in symptomology was classified into one of three categories (i.e., improvement, no change, and deterioration). An archival data set that consisted of client data from the 2011-2012 academic year contributed by 120 university and college counseling centers in the U.S. that were participating members of the Center for Collegiate Mental Health was used. The sample sizes for the analyses were: 348 clients for change in functioning analyses, 1,418 clients for treatment length analyses, and 2,024 clients for premature termination analyses. The findings indicated that after controlling for the covariates, clients who were matched with White counselors were more likely to experience deterioration in overall distress symptoms, rather than no change in symptoms, compared to those who were matched to Black counselors. Also, those clients who were matched with White counselors were more likely to prematurely terminate their counseling sessions, compared to those who were matched to Black counselors or non-Black racial/ethnic minority counselors. The findings from this study may assist researchers and university counseling center staff in understanding the potential influence of ethnic matching on outcomes and service utilization for African American clients. Keywords: ethnic match, African American, outcome research, university counseling center, Counseling Center Assessment of Psychological Symptoms

yes / Background: The acute hospital is a challenging place for a person with dementia. Behavioural and psychological symptoms of dementia (BPSD) are common and may be exacerbated by the hospital environment. Concerns have been raised about how BPSD are managed in this setting and about over reliance on neuroleptic medication. This study aimed to investigate how BPSD are managed in UK acute hospitals. Method(s): A longitudinal cohort of 230 patients with dementia admitted to two acute NHS hospitals. BPSD were measured every four days (Behave-AD scale), as well as documentation of pharmacological prescriptions and non-pharmacological management. Results: The overall prevalence of BPSD was 75%, with aggression and activity disturbance being the most common. Antipsychotics were prescribed for 28 (12%) patients; 70% of these prescriptions were new on admission. Benzodiazepines were prescribed for 27 (12%) patients, antidepressants were prescribed for 37 (16%) patients, and sedatives were prescribed for 14 (3%) patients. Patients who were prescribed antipsychotics, after adjusting for end of life medication, age and dementia severity, were significantly more likely to die (adjusted hazard ratio 5.78, 95% CI 1.57, 21.26, p= 0.008). Nonpharmacological management was used in 55% of participants, most commonly psychosocial interventions (36%) with little evidence of monitoring their effectiveness. A form of restraint was used during 50 (22%) patients’ admissions. Conclusions: Antipsychotic medications and psychosocial interventions were the main methods used to manage BPSD; however, these were not implemented or monitored in a systematic fashion. / Alzheimer's Society; BUPA Foundation

no / Background Dementia is common in older people admitted to acute hospitals. There are concerns about the quality of care they receive. Behavioural and psychiatric symptoms of dementia (BPSD) seem to be particularly challenging for hospital staff. Aims To define the prevalence of BPSD and explore their clinical associations. Method Longitudinal cohort study of 230 people with dementia, aged over 70, admitted to hospital for acute medical illness, and assessed for BPSD at admission and every 4 (± 1) days until discharge. Other measures included length of stay, care quality indicators, adverse events and mortality. Results Participants were very impaired; 46% at Functional Assessment Staging Scale (FAST) stage 6d or above (doubly incontinent), 75% had BPSD, and 43% had some BPSD that were moderately/severely troubling to staff. Most common were aggression (57%), activity disturbance (44%), sleep disturbance (42%) and anxiety (35%). Conclusions We found that BPSD are very common in older people admitted to an acute hospital. Patients and staff would benefit from more specialist psychiatric support.

Câncer de mama e ginecológico tem alta incidência entre as mulheres brasileiras e seu diagnóstico produz diversas reações emocionais, como ansiedade, depressão e redução da qualidade de vida. Coping é definido como o conjunto de estratégias, cognitivas e comportamentais, utilizadas para lidar com situações estressoras. Quando são utilizadas estratégias relacionadas à religião para lidar com o estresse, ocorre o chamado coping religioso-espiritual. O objetivo deste trabalho foi avaliar o coping religioso-espiritual de mulheres com câncer e verificar a relação deste fator com a presença de sintomas psicológicos, com a percepção de suporte social e com a qualidade de vida. Após a aprovação pelo comitê de ética, 120 mulheres diagnosticadas com câncer de mama ou ginecológico, em atendimento em um hospital universitário, foram avaliadas quanto ao uso do coping religioso-espiritual (Escala CRE), à percepção de suporte social (Escala de Suporte Social - MOS), à presença de sintomas de ansiedade e depressão (HAD) e à qualidade de vida (WHOQol-Bref). Uma entrevista semi-estruturada foi aplicada para levantar informações sociodemográficas, aspectos clínicos e prática religiosa. Os resultados foram submetidos a testes estatísticos para verificar a existência de relações entre as variáveis. A média de idade da amostra foi de 52,1 anos; a maioria possuía companheiro, tinha menos de oito anos de estudo e renda per capita menor que um salário mínimo; 63% referiram história familiar de câncer e 55,8% estavam em tratamento para câncer em estádio III e IV; 90% declararam ter uma religião definida e destes 78% eram praticantes. Foram identificados sintomas depressivos e de ansiedade em 30% da amostra. Quanto ao coping religiosoespiritual, 81% utilizavam CRE total em frequência alta e há uma proporção maior de participantes que faziam uso do coping positivo em comparação ao uso do enfrentamento negativo. A amostra obteve índices elevados em todas as dimensões de suporte social e a qualidade de vida mostrou-se mais baixa que em outras populações. A análise comparativa entre as variáveis permitiu identificar que o uso de estratégias positivas de coping religiosoespiritual estava significativamente relacionado à ausência de sintomas ansiosos e depressivos, a maior percepção de suporte social e a melhor qualidade de vida, enquanto que o uso de estratégias negativas de coping está relacionado à piores índices em todos os instrumentos (p<0,05). O coping religioso-espiritual foi uma estratégia de enfrentamento bastante utilizada por esta amostra mulheres com câncer. Este resultado indica a importância das variáveis religiosidade e espiritualidade no processo de resiliência e de proteção à saúde. / Breast and gynecologic cancer has a high incidence among Brazilian women and their diagnosis produces emotional reactions such as anxiety, depression and reduced quality of life. Coping is defined as the behavioural and cognitive strategies used to face stressful situations. Strategies linked to religion, named religious/spiritual coping. This study aimed to evaluate religious coping in women with cancer and the relationship with the psychological symptoms, social support and quality of life. After approval of the Institutional Ethics Committee, 120 women diagnosed with breast or gynecologic cancer, attending in a university hospital were evaluated for the use of religious coping (RCOPE), social support (Social Support Scale - MOS), anxiety and depression (HAD) and quality of life (WHOQOLBREF). A semi structured interview collected data on socio demographic characteristics, clinical, and religious practice. The results were subjected to statistical tests to check for relationships between variables. The mean age of the sample was 52.1 years, the majority had a partner, had less than eight years of schooling and income lower than the minimum wage, 63% reported family history of cancer and 55.8% were under treatment cancer stage III and IV, 90% had a specific religion and 78% of these were practitioners. We identified depressive symptoms and anxiety in 30% of the sample. As for the religious coping, 81% used CRE total high frequency and there is a greater proportion of participants who made use of positive coping in comparison to the use of negative coping. The sample obtained high ratings in all dimensions of social support and quality of life proved to be lower than in other populations. The comparative analysis between the variables identified that the use of positive religious coping was significantly related to the absence of anxious and depressive symptoms, the greater social support and better quality of life, while the use of negative religious coping is related to worst rates on all instruments (p <0.05). Religious coping proved to be a strategy frequently used by patients with a breast or gynaecological cancer. It also seems to be a protection factor to the psychological stress caused by diagnosis and treatment of the disease.

Attachment theory which emphasizes the importance of the mother infant bond and its&rsquo / crucial role in determining multiple cognitive, emotional, and behavioral factors later in life, is gaining popularity in all domains of psychology. However, both in terms of conceptualization and methods of assessment, there is no consensus among the domains and this debate encourages researchers to develop new assessment methods to resolve the issue. The current study focused on the Turkish adaptation of the most recently developed unobtrusive measure of attachment: The Knowledge of Secure Base Script-Prompt Word Outline Method (KSBS) which aims to assess the degree of knowledge about the secure base script. For this purpose, four different studies were conducted each of which assesses the reliability and the validity of KSBS with varying samples and certain premises of the attachment theory were tested to validate KSBS. Accordingly, internal consistency, test-retest reliability and interrater reliability of KSBS was established. Addittionally, discriminant validity of KSBS was established presenting no relation with intelligence and certain socio-demographic variables as gender, age, education, and marital status. Also, consistent with the premises of the attachment theory, results revealed that among surgery patients the ones with lower KSBS score would display more state anxiety after the surgery than the ones with higher KSBS score. Similarly, psychiatric patients were shown to have considerably lower KSBS score than a control group with no psychiatric history. Lastly, the present study found that KSBS is correlated with perceived social support and coping strategies. Specifically, positive correlation was found between KSBS and perceived social support from friends, family, and significant others, and problem solving coping. Negative correlation was found between the helplessness and KSBS score. The expected and unexpected results of the study were discussed within the relevant literature, shortcomings of the current study, clinical implications and suggestions for future research were proposed.

Purpose of the study is to examine the relationship of ruminative tendency, internal working models of attachment (Self-Model and Other-Model) and help seeking attitudes (Positive Beliefs and Negative Beliefs) with psychological symptoms among the university students. In scope of the current research, the mediation role of rumination in the relationship between internal model of self and psychological symptoms was examined. By applying convenient sampling procedure, six hundred and ten university students were included into the current study from 9 different state universities in Ankara and Istanbul. Turkish version of Relationship Questionnaire (Bartholomew &amp / Horowitz, 1991), Relationship Scale Questionnaire (Griffin &amp / Bartholomew, 1994), Brief Symptom Inventory (Derogatis, 1992), Ruminative Response Scale (Nolen-Hoeksema &amp / Marrow, 1991) and Attitudes toward Seeking Psychological Help - Shortened (T&uuml / rk&uuml / m, 2001) were delivered to the university students at university campuses. Multiple regression analyses were implemented to evaluate the research hypotheses. The results revealed that rumination, internal model of others, and negative beliefs about psychological help significantly predicted the increase in psychological symptoms of Turkish university students. Positive beliefs about psychological help did not relate to psychological symptoms of university students for the current set of data. In addition to this, rumination mediated the relationship between internal model of self and psychological symptoms of university students. The research findings were discussed by relying on the previous research premises.

Hintergrund: Nach der deutschen Wiedervereinigung beschäftigte sich eine Reihe von Studien mit der psychischen Befindlichkeit der Menschen in Ost- und Westdeutschland. Die vorliegende Untersuchung stellt eine Replikation der Studie von Basten et al. [Psychische Beschwerden und körperliche Gesundheit im vereinten Deutschland: Eine Ost-West-Vergleichsuntersuchung an einer studentischen Stichprobe. Verhaltenstherapie 1994;4:90–95] 10 Jahre nach der Originaluntersuchung dar. Diese wurde 1991/1992 durchgeführt und untersuchte Unterschiede in der Depressivität, Angst, Somatisierung sowie im berichteten Essverhalten zwischen Studentinnen in Dresden und Marburg. Probanden und Methode: Von Oktober 2001 bis April 2002 wurden die psychischen Beschwerden und das Essverhalten bei Dresdner und Marburger Studenten untersucht. In die vorliegende Arbeit gingen Daten von 221 Studentinnen ein. Es wurden dieselben standardisierten Erhebungsinstrumente wie in der Originaluntersuchung eingesetzt. Ergebnisse: Im Unterschied zu der Originalstudie konnte keine höhere Depressivität bei der westdeutschen Stichprobe nachgewiesen werden. Stattdessen gaben ostdeutsche Studentinnen signifikant mehr Angstsymptome an als westdeutsche. Daneben gab es Hinweise auf einen stärker ausgeprägten Schlankheitswunsch der Ostdeutschen. Insgesamt wiesen die ostdeutschen Studentinnen in allen Verfahren höhere Mittelwerte auf als 10 Jahre vorher. Diskussion: Die Studie bestätigt vorliegende Ergebnisse, wonach nur geringe Unterschiede in der psychischen Befindlichkeit in Ost- und Westdeutschland bestehen. Allerdings sind in den letzten 10 Jahren Veränderungen geschehen, die aufgrund fehlender Längsschnittstudien nicht eruiert wurden. Die höhere Ausprägung der Angstsymptomatik der ostdeutschen Studentinnen wird als ein Sozialisationsergebnis interpretiert. / Background: After the German unification, several studies have focused on differences in the psychological health of people in East and West Germany. The current study is a replication of the Basten et al. study [Psychological wellbeing and health in a unified Germany: An East-West-comparison of two student samples. Verhaltenstherapie 1994;4:90–95] 10 years after the original research of 1991/1992. It investigated differences in depression, anxiety and bodily symptoms as well as problematic eating behaviour in female university students in Dresden (East Germany) and Marburg (West Germany). Subjects and Methods: From October 2001 to April 2002, we investigated psychological symptoms and eating behaviour in students of the universities of Dresden and Marburg. The current report includes data of 221 female students. We used the same standardized measures as had been used in the original research. Results: In contrast to the original study, students from West Germany did no longer exhibit higher depression scores. Instead, students from East Germany showed significantly increased anxiety symptoms. Furthermore, there was a trend towards a higher drive for thinness in East German students. In all, students from Dresden showed higher mean values in all measures than 10 years before. Discussion: This study corroborates results that there are only minor differences in psychological health between people in East and West Germany. However, our findings point out that during the past decade subtle changes might have occurred which have not been detected through lack of longitudinal investigations. The higher level of anxiety in East German students could be a result of socialisation. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Background: Persons with dementia diseases are today a large group that will increase significantly over the next few years. Behavioral and Psychological Symptoms of Dementia (BPSD) are very common and can cause major suffering. For dementia care professionals, persons with dementia suffering from BPSD may induce stress in the caregiving situation. With proper training and support, this stress may be reduced. In the BPSD register, the dementia care professionals may get information, advice and help suggesting non-pharmacological interventions that can help the person with dementia. Aim: The aim of the study was to investigate caregivers opportunities and experiences in implementing BPSD registration and follow up of non-pharmacological interventions in the caregiving situation within residential care for dementia. Furthermore, the aim was to compare if the dementia caregivers experience had significance for the experienced value of BPSD registration in Behavioral and Psychological Symptoms of Dementia. Method: A quantitative survey was conducted on residential care for dementia, N=5. The study- specific questionnaire covered possibility for BPSD- registration and interventions, considered value of BPSD estimation, and if non-pharmacological interventions are performed followed up, and considered to reduce BPSD. The results are presented using tables and diagrams. Kruskal Wallis test was used to compare variables between subgroups with varying working experience. Result: Most dementia caregivers considered that they had possibility to conduct BPSD registration 50% (n=28). They expressed 88% (n=49) that the non-pharmacological interventions that were initiated and performed decreased BPSD. Further they experienced BPSD follows up being important, 100% (n=56). There were no statistically significant differences between number of professional years and the compared variables (p-values ranged 0,266-0,981). Conclusion:The study found that dementia care professionals considered having possibilities to perform BPSD estimation, non-pharmacological interventions and follow- up. BPSD registration was experienced to be a helping tool for the dementia providers; and the length of the working experience had no significant relation to how they graded the value of the BPSD estimation.

Câncer de mama e ginecológico tem alta incidência entre as mulheres brasileiras e seu diagnóstico produz diversas reações emocionais, como ansiedade, depressão e redução da qualidade de vida. Coping é definido como o conjunto de estratégias, cognitivas e comportamentais, utilizadas para lidar com situações estressoras. Quando são utilizadas estratégias relacionadas à religião para lidar com o estresse, ocorre o chamado coping religioso-espiritual. O objetivo deste trabalho foi avaliar o coping religioso-espiritual de mulheres com câncer e verificar a relação deste fator com a presença de sintomas psicológicos, com a percepção de suporte social e com a qualidade de vida. Após a aprovação pelo comitê de ética, 120 mulheres diagnosticadas com câncer de mama ou ginecológico, em atendimento em um hospital universitário, foram avaliadas quanto ao uso do coping religioso-espiritual (Escala CRE), à percepção de suporte social (Escala de Suporte Social - MOS), à presença de sintomas de ansiedade e depressão (HAD) e à qualidade de vida (WHOQol-Bref). Uma entrevista semi-estruturada foi aplicada para levantar informações sociodemográficas, aspectos clínicos e prática religiosa. Os resultados foram submetidos a testes estatísticos para verificar a existência de relações entre as variáveis. A média de idade da amostra foi de 52,1 anos; a maioria possuía companheiro, tinha menos de oito anos de estudo e renda per capita menor que um salário mínimo; 63% referiram história familiar de câncer e 55,8% estavam em tratamento para câncer em estádio III e IV; 90% declararam ter uma religião definida e destes 78% eram praticantes. Foram identificados sintomas depressivos e de ansiedade em 30% da amostra. Quanto ao coping religiosoespiritual, 81% utilizavam CRE total em frequência alta e há uma proporção maior de participantes que faziam uso do coping positivo em comparação ao uso do enfrentamento negativo. A amostra obteve índices elevados em todas as dimensões de suporte social e a qualidade de vida mostrou-se mais baixa que em outras populações. A análise comparativa entre as variáveis permitiu identificar que o uso de estratégias positivas de coping religiosoespiritual estava significativamente relacionado à ausência de sintomas ansiosos e depressivos, a maior percepção de suporte social e a melhor qualidade de vida, enquanto que o uso de estratégias negativas de coping está relacionado à piores índices em todos os instrumentos (p<0,05). O coping religioso-espiritual foi uma estratégia de enfrentamento bastante utilizada por esta amostra mulheres com câncer. Este resultado indica a importância das variáveis religiosidade e espiritualidade no processo de resiliência e de proteção à saúde. / Breast and gynecologic cancer has a high incidence among Brazilian women and their diagnosis produces emotional reactions such as anxiety, depression and reduced quality of life. Coping is defined as the behavioural and cognitive strategies used to face stressful situations. Strategies linked to religion, named religious/spiritual coping. This study aimed to evaluate religious coping in women with cancer and the relationship with the psychological symptoms, social support and quality of life. After approval of the Institutional Ethics Committee, 120 women diagnosed with breast or gynecologic cancer, attending in a university hospital were evaluated for the use of religious coping (RCOPE), social support (Social Support Scale - MOS), anxiety and depression (HAD) and quality of life (WHOQOLBREF). A semi structured interview collected data on socio demographic characteristics, clinical, and religious practice. The results were subjected to statistical tests to check for relationships between variables. The mean age of the sample was 52.1 years, the majority had a partner, had less than eight years of schooling and income lower than the minimum wage, 63% reported family history of cancer and 55.8% were under treatment cancer stage III and IV, 90% had a specific religion and 78% of these were practitioners. We identified depressive symptoms and anxiety in 30% of the sample. As for the religious coping, 81% used CRE total high frequency and there is a greater proportion of participants who made use of positive coping in comparison to the use of negative coping. The sample obtained high ratings in all dimensions of social support and quality of life proved to be lower than in other populations. The comparative analysis between the variables identified that the use of positive religious coping was significantly related to the absence of anxious and depressive symptoms, the greater social support and better quality of life, while the use of negative religious coping is related to worst rates on all instruments (p <0.05). Religious coping proved to be a strategy frequently used by patients with a breast or gynaecological cancer. It also seems to be a protection factor to the psychological stress caused by diagnosis and treatment of the disease.

Bakgrund: Personer med demens är en snabbt växande patientgrupp både i Sverige och runt om i världen där siffran förväntas stiga till 152 miljoner personer världen över till år 2050. Sjukdomen är irreversibel och upp till 90% av alla med demens upplever någon gång under sjukdomsförloppet beteendemässiga och psykiska symtom (BPSD) i olika former som till exempel aggression eller depression. Terapeutisk djurkontakt har visat sig minska stress hos studenter och även minskat ensamheten hos äldre med hjälp av icke-verbala kommunikation. Syfte: Syftet med denna litteraturstudie var att undersöka vilken evidens som finns för att terapeutisk djurkontakt påverkar beteendemässiga och psykiska symtom hos personer med demenssjukdom. Metod: Studien genomfördes som en litteraturstudie med inriktning på terapeutisk djurkontakt inom behandling av demens. Databassökningen genomfördes med blocksökningar i CINAHL, PubMed samt PsycINFO. Litteraturstudien baseras på elva empiriska studier med kvantitativ ansats som fokuserar på terapeutisk djurkontakt och demens. Artiklarna har kvalitetsgranskats av författarna. Resultat: Det fanns bristande evidens för att terapeutisk djurkontakt påverkar BPSD på grund av stora skillnader i artiklarnas resultat. Fyra teman påträffades i studierna som fokuserade på Depression, Aggression och agiterat beteende, Sociala interaktioner och apati samt Påverkan på generellt beteende. Konklusion: Trots att terapeutisk djurkontakt har använts tidigare baserat på beprövad erfarenhet, kan denna litteraturstudie inte hitta ett samstämmigt svar på om terapeutisk djurkontakt verkligen påverkar BPSD. / Background: People with dementia is a fast growing group of patients in Sweden as well as the rest of the world, the number is expected to increase to 152 million people worldwide in 2050. The disease is irreversible and up to 90% of all people with dementia will experience behavioural and psychological symptoms (BPSD) in different forms like aggression or depression during the course of the disease. Animal-Assisted Therapy (AAT) has shown effect in relieving stress among students, it has also shown a decrease in loneliness among elderly trough animals unique non-verbal communication. Aim: The aim with this literature review was to explore if there is existing evidence that animal-assisted therapy has an impact on behavioural and psychological symptoms of dementia. Method: The study was conducted as a literature review with a quantitative approach with focus on animal-assisted therapy as a treatment for BPSD. The literature review was based on eleven empirical studies who share relevant content from the search that were made in CINAHL, PubMed and PsycINFO. The articles were quality reviewed by the authors. Results: There were lacking evidence that AAT had an effect on BPSD based on the differences in the articles findings. Four themes were developed from the studies and had focus on Depression, Aggression and agitated behaviors, Social interactions and apathy and General impact on behaviors which were not defined as aggression and depression. Conclusion: Despite the previous use of animal-assisted therapy based on previous experiences, this literature review did not find a unanimous answer to whether AAT affects BPSD among people with dementia.