Depression is common in people with coronary heart disease (CHD) and is associated with worse physical outcomes. The nature of the causal association between CHD and depression, and the mechanism underpinning the association of depression with worse physical outcomes, remains unclear. Perseverative negative thinking may contribute to the development of depression in people with CHD. The aim of this thesis was to investigate the prospective association of perseverative negative thinking with depression, anxiety and worse physical outcomes in people with CHD, and to explore factors that may mediate this association. First, a systematic review identified 30 studies, of which the majority found an association between measures of perseverative negative thinking and subsequent depression, anxiety or emotional distress in people with long term conditions. Studies that controlled for covariates showed more mixed results, though the majority (15 / 25) still supported a significant association, with effects being small in magnitude. Findings were limited mainly to the association of rumination and/or catastrophizing with subsequent depression, and study quality was limited. Next, in an observational prospective cohort study 169 inpatients and outpatients with recent acute coronary syndrome (ACS) completed self-report assessments of rumination (Ruminative Responses Scale brooding subscale), worry (Penn State Worry Questionnaire), depression (Patient Health Questionnaire-8), anxiety (Beck Anxiety Inventory), and health-related quality of life (EuroQol-5D health-related quality of life, Seattle Angina Questionnaire) after hospitalisation, and at 2 month and 6 month follow-up. Additionally, assessments of potential mechanistic factors (social support, problem solving, instrumental behaviours and negative cognitive biases) were made. Baseline brooding was a significant independent predictor of depression at 6 months after controlling for the effects of important confounding variables, accounting for 2% of the variance. Findings suggested that the association of brooding with depression may be explained by deficits in problem solving ability. Rumination and problem solving may provide useful targets for the development of evidence-based interventions to improve depression among people with CHD, although the findings presented here fall short of proving a causal relationship. Future trials could be used to investigate the causal nature of the association of rumination and problem solving with depression in people with ACS.

Die vorliegende Arbeit beschäftigt sich mit der Diagnostik unerwünschter Gedanken sowie der Spezifität von Gedankenunterdrückung bei phobischen Patienten. Zwei Fragebogenverfahren zum Thema Sorgen sowie ein Instrument zur Erfassung von Strategien im Umgang mit intrusiven Gedanken wurden bezüglich der Gütekriterien der deutschen Übersetzung in einer klinischen Stichprobe evaluiert. Dabei handelt es sich um den Worry Domains Questionnaire (WDQ), der Sorgeninhalte erhebt, den Penn State Worry Questionnaire (PSWQ), der die Intensität von Sorgen erfasst, und den Thought Control Questionnaire (TCQ) zur Erfassung der Gedankenkontrollstrategien. Die Verfahren wurden bei 440 Psychotherapie-Patienten zu drei Meßzeitpunkten eingesetzt. Hinsichtlich der inneren Konsistenz und der Retest-Reliabilität ergeben sich für alle Instrumente zufriedenstellende bis gute Kennwerte. Die Validität ist nur für den PSWQ als gut zu bezeichnen. Beim WDQ zeigen sich Probleme hinsichtlich der Trennung von Sorgen und sozialer Ängstlichkeit, während der TCQ wohl eher Aspekte allgemeiner Psychopathologie als spezifische Strategien erfasst. Eine zweite Studie befasste sich mit intentionaler Gedankenunterdrückung. Die paradoxen Effekte dieser Bemühungen wurden wiederholt mit psychischen Störungen, vor allem mit Angststörungen, in Verbindung gebracht. Dabei ist ein wichtiges Thema, ob die Gedankenkontrollfähigkeit nur für störungsspezifische Inhalte oder generell beeinträchtigt ist. Die vorliegende Studie verglich Patienten mit Agoraphobie und Patienten mit Sozialphobie mit einer gesunden Kontrollgruppe. Alle Personen mussten Gedanken an ein neutrales Kontrollthema sowie zwei störungsspezifische Themen unterdrücken. Es zeigte sich ein störungsspezifischer Effekt bei den Agoraphobikern. Sozialphobiker scheinen hingegen ein generelles Defizit ihrer mentalen Kontrolle aufzuweisen. Zusätzlich erwies sich soziale Ängstlickeit innerhalb einer Reihe psychopathologischer Variablen als stärkster Prädikator für Schwierigkeiten bei der Gedankenunterdrückung. Ingesamt weisen einige Ergebnisse dieser Arbeit darauf hin, dass Gedankenunterdrückung ein wichtiges Merkmal der Sozialphobie sein könnte. / The work conducted aimed at evaluating instruments investigating unwanted thoughts as well as determining the specifity of thought suppression in phobia. German translations of two questionnaires measuring worry as well as an instrument, measuring strategies used in dealing with unwanted thoughts, were evaluated in a clinical sample. We used the Worry Domains Questionnaire (WDQ), measuring contents of worry, the Penn State Worry Questionnaire (PSWQ), measuring the intensity of worry, and the Thought Control Questionnaire (TCQ), investigating strategies in thought control. The instruments were administered at three points in a sample of 440 patients receiving psychological treatment. Concerning internal consistency and retest-reliability all questionnaires showed acceptable to good results. Validity is only good concerning PSWQ. WDQ has problems in differentiating worry and social anxiety, where as TCQ seems to measure general psychopathology more than specific strategies. The second study investigated intended thought suppression. Its paradoxical effects have been linked to psychological disorders, namely anxiety disorders. One important issue is if thought suppression is impaired only for thoughts related to the disorder or if the ability for mental control is generally impaired in anxiety patients. This study compared groups of agoraphobics and social phobics with healthy controls. All subjects had to suppress a neutral topic and two topics related to the central fear of the two disorders. We found a rather specific deficit in thought suppression for the agoraphobics. Social phobics seem to be characterized by a general impairment of mental control. In addition, among several psychopathological variables, social anxiety proved to be the strongest predictor for problems with thought suppression. Taken together, there are several indicators that thought suppression may be an important feature of social phobia.

Tyrimo tikslas - ištirti vidurinės mokyklos abiturientų baimės ir pažangumo ypatumus bei sąryšį. Buvo ištirta 111 moksleivių. Darbe naudota metodika - „Diferencijuotas mokyklos baimės aprašas“ - (DBA) - (Diferentielle Leistungsangast Inventar (DAI), (Rost D. H., Schermer F. J. 1997), leidžiantis nustatyti abiturientų baimę provokuojančių veiksnių, baimės apraiškos formų bei baimės įveikos ir įtvirtinimo būdų lygius. Ji panaudota du kartus – vieną kartą likus mėnesiui iki egzaminų buvo naudojamas ilgasis variantas, o kitas trumpasis pakartotinis variantas – prasidėjus pirmiesiem įskaitų laikymam. Tyrimo rezultatai parodė, kad abiturientų įvairių baimės rodiklių išreikštumas pirmojo bei pakartotinio tyrimo metu skiriasi, o taip pat šie rodikliai skiriasi priklausomai nuo lyties, bet fiziologinės baimės apraiškos pakartojus tyrimą išlieka nepakitusios. Humanitarinį ir realinį mokymosi profilį pasirinkę abiturientai įvairių baimės rodiklių išreikštumu nesiskiria. Tik pakartotinio testavimo rezultatai rodo, kad į humanitarinius mokslus linkę abiturientai labiau nei linkę į realinius kontroliuoja baimę. Be to, pakartotinio testavimo rezultatai rodo, kad abiturientai, pasirinkę didesnį valstybinių egzaminų skaičių, mažiau linkę į išorinį ir vidinį baimės įtvirtinimą nei abiturientai, pasirinkę mažesnį egzaminų skaičių. / The aim of this research is to assess the connection between fears of school – leavers and academic achievement peculiarity. 111 school-leavers participated in this research. These method were used for investigation – Discriminating Fear of School Inventory (DBA) - (Diferentielle Leistungsangast Inventar (DAI), (Rost D. H., Schermer F. J. 1997), which lets to assess factors provoking fear of school- leavers, fear‘s expressions, coping ways with fear and levels of fear fix. School – leavers were assessed two times. The results indicated that fear index are different at testing first and second time. These indexes are different to men and women, but at first and second time of testing the physiological expresses of fear are the same. The index of fear are the same in school leavers with humanitarian and real profiler (first time testing), but humanitarians can control fear more effectively than real profiler schoolchildren (second time testing). One more thing – school- leavers who have chosen more exams were more prone to fix fear than school- leavers who have chosen less exams.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

No description available.

Negativa hemförhållanden har tidigare visats bidra till depressivasymptom. Syftet med denna studie var att undersöka: 1) omförhållanden som oro och katastroftänkande är mediatorer mellannegativa hemförhållanden och depressiva symptom, 2) om det finnsnågra könsskillnader i detta avseende. Studien baserades påinsamlade data från ett pågående projekt vid Örebro universitet. Enenkätundersökning utfördes på 18 högstadieskolor i tre mellansvenskastäder med totalt 2749 elever i årskurs 7 och 8. Resultaten visade enpositiv korrelation mellan negativa hemförhållanden och depressivasymptom, samt att båda faktorerna oro och katastroftänkande partielltmedierade mellan negativa hemförhållanden och depressiva symptom.Det fanns könsskillnader som visade att flickor som blev utsatta förpsykologisk kontroll speciellt hade ett katastroftänkande, somkorrelerade högt med depressiva symptom. Slutsatsen är attförhållanden hos människor, som uttalad oro och katastroftänkande,till väsentlig grad förklarar varför negativa hemförhållanden har såkraftig effekt på ungdomars depressiva symptom. / Negative home conditions have previously been shown to contributeto depressive symptoms. The purpose of this study was to examinewhether the conditions worry and catastrophic thinking are mediatorsbetween negative home conditions and depressive symptoms. Thedata was selected from an existing survey conducted among studentsin grades 7-8 at secondary schools in three Swedish cities. A total of2749 secondary school students participated in this cross-sectionalstudy. The results showed a positive correlation between negativehome conditions and depressive symptoms, and both factors worryand catastrophic thinking partially mediated between negative homeconditions and depressive symptoms. The conclusion is thatconditions in humans, such as pronounced worry and catastrophicthinking, to a substantial degreee explains why negative homeconditions have so powerful effects on young people’s depressivesymptoms.

Vid pågående och långvariga miljö- och hälsorisker är det viktigt att kommunicera med invånare kontinuerligt. Denna enkätstudie undersöker därför informationsbehovet hos invånare vid förorenade områden och hur det överensstämmer med myndigheternas syn på kommunikationen. Vidare undersöks oro och riskuppfattning hos invånarna samt hos kommunikatörerna på kommunerna och länsstyrelserna. Undersökningen görs med glasbruksområden som exempel då studier pekar på förorening vid och i närheten av dessa områden men risken för människors hälsa inte är helt fastställd. Resultatet visar att en stor andel av, både invånare och myndigheternas kommunikatörer, tror att det finns risk för och är oroliga för hälsa, miljö och kommande generationers hälsa i närheten av de förorenade områdena. Oron för att bo i närheten är inte lika stor som oron för hälsa och miljö. Både riskuppfattningen och oron är större för miljö än för hälsa. Av dem som bor närmre än 5 km från närmsta glasbruk vill 68 % ha mer information vilket är fler än bland dem som bor längre ifrån, 31%. Tidigare information har de flesta fått från lokala media. Helst vill invånarna kommunicera med kommunen, länsstyrelsen, Naturvårdsverket och till viss del även med lokala media. De som bor närmre än 5 km från ett glasbruk vill ha information via papperstidning, informationsmöten och brev. Detta överensstämmer inte helt med myndigheternas åsikt där kommunikation främst skett via hemsidan och där hemsida, informationsmöten och sociala media är de kommunikationsvägar myndigheterna vill använda. Kommunen, länsstyrelsen och Naturvårdsverket anses som ansvariga för kommunikationen och det är flest som litar på dessa aktörer. Sammantaget visar studien att kommunikationen hittills kan ses som bristfällig och att det behövs förbättrad kommunikation vid långvariga miljö- och hälsorisker. Det finns, i det specifika fallet, utrymme för att förbättra kommunikationen och förutsättningarna är goda om kommunicerande aktörer ser upp för fallgroparna. / At ongoing and long-term environmental- and health risks is it important to communicate with the inhabitants continuously. This study therefore uses a survey to investigate the need for information among inhabitants and how it aligns with the authorities view on the communication. Further, worry and risk perception is examined among inhabitants and the municipalities and the county administration. The study is done with glasswork areas as an example since earlier research indicate contamination on and near these areas but the risk for human health is not yet established. The result show that a substantial share, of both inhabitants and the authority’s employees, thinks there is risk for and is worried about health, environment, and future generations health at contaminated sites. The worry about living close by is not as big as the worry about health and environment. Both risk perception and worry are greater for the environment than for health. Of the inhabitants living closer than 5 km from nearest glasswork, 68% wants more information which is more than among the inhabitants living further away, 31%. Previous information has most people got from local media. The inhabitants prefer to communicate with the municipality, the county administration, and the Swedish EPA and to some extent even with local media. The ones living closer than 5 km from a glasswork want information through newspapers, briefings and letters. This is not fully consistent with what the authorities think, where communication mainly occurred through the website and the website, briefing and social media are the ways authorities want to use for communication. The municipality, county administration and the Swedish EPA considers as responsible for the communication and these authorities got most trust among the inhabitants. Altogether this study shows that the communication so far can be considered as inadequate and that there is a need for improved communication at long term environmental and health risks. There is, in the specific case, room to improve the communication and the conditions are good, if the communicating actors watch out for pitfalls.

In this study the researcher set out to determine the levels and the causes of workplace stress, as well as the consequences of stress in terms of witnessed and experienced aggression in the workplace, anxiety, depression, and worry for a sample of 205 subjects. To achieve this, the following tests were used: 1) Experience of Work and Life Circumstances Questionnaire, 2) the Aggression in the Workplace Questionnaire, 3) the IPAT Anxiety Scale,4) the Beck Depression Inventory, and 5) the Penn State Worry Questionnaire. The subjects’ ability to cope withexperienced stressors in relation to social problem solving was examined with the Social Problem-Solving Inventory-Revised. The raw data were analysed by means of the usual descriptivestatistics. In addition, inferential statistics including z-tests, t-tests, analysis of variance and posthoc analyses (Scheffé) were conducted for the following groups: total group, gender, marital status, age, organizational type, qualification and position level. Results indicate that most of the subjects in the sample experienced normal levels of stress, indicating that the participants generally experienced their circumstances within or outside the workplace as satisfactory. Generally, the results also indicated that their expectations regarding their work situation were met. With reference to the consequences of stress, the total sample reported low levels of witnessing and experiencing workplace aggression, normal levels of anxiety, low levels of depression and worry. Good overall social problem solving suggests the ability to cope with demands and stressors within and outside the workplace. Generally, Pearson correlations indicated significant relationships between a) levels of stress as experienced by subjects and b) witnessed and experienced workplace aggression, c) anxiety, d) depression, e) worry and f) social problem solving. That most of the subjects in this sample were able to deal effectively with the demands and stressors placed on them, from within and outside the workplace suggests the ability to use effective problem-focused coping involving social problem solving which for most participants, was due to a positive problem orientation and effective rational problem solving skills. These findings may be useful as part of a stress management programme to help employees deal with stress proactively by becoming more effective problem-solvers. In terms of a salutogenic paradigm, and consistent with recent developments in positive psychology, the findings indicate that more attention should be paid to possible reasons why some employees appear to cope with stress more effectively than others. / Thesis (PhD (Psychology))--University of Pretoria, 2008. / Psychology / PhD / unrestricted

The prevalence of anxiety amongst children with Autism Spectrum Conditions (ASC) is reportedly considerably higher than the general population (Ozsivadjian & Knott, 2011). Research considering intervention for children with ASC and anxiety has predominantly been from a clinical perspective, with limited evidence based literature being found that explored the needs of these students in relation to anxiety within the mainstream secondary school educational context. Anxiety can increase during adolescence for children with ASC (White, Ollendick, Scahill, Oswald, & Albano, 2009) and many of the anxiety related worries of children with ASC have been found to be related to school (Ozsivadjian & Knott, 2011). However, there is a dearth of research regarding practical support within an educational setting that can be implemented by schools on a needs basis to support students with ASC and signs of anxiety. Four students with a diagnosis of an ASC who had presented with signs of anxiety were identified from mainstream secondary schools across one English local authority. A parent and an educational practitioner who worked with each student also participated. A qualitative multiple embedded case study design was utilised. Suitably differentiated methods for gaining this cohort of students’ views and engaging them in the research were employed. Data from semi-structured interviews and educational documentation were analysed for main themes using thematic analysis based upon Braun and Clarke's (2006) six phase model. The perceived needs and difficulties of anxious students with ASC and what is considered to be effective practice in supporting them within a mainstream secondary school setting are outlined. The study provides some understanding of the needs of students with ASC and how schools support management of their anxiety. The research intends to extend knowledge of the needs of these students and what works in effectively supporting these students within a mainstream secondary school setting.

Bakgrund: Diabetessjukdomen är en kronisk sjukdom som drabbar ett stort antal människor världen över. I Sverige drabbas omkring cirka 50 000 människor av diabetessjukdomen rapporterar nationella diabetesregistret. Att leva med diabetes under en längre tid kan medfölja olika komplikationer. En av de är den allvarliga diabetesfotsår, som i sin tur uppkommer av kombinationen av nervskada och dålig blodcirkulation. Femton procent av diabetespatienter utvecklar minst ett fotsår under sjukdomens prevalens. Fotsår som har en lång läkningsprocess kan även leda till amputation. Behandlingen för dessa fotsår involverar olika instanser samt specialistfotteam. I behandlingen kan ingå egenvård, kirurgiska ingrepp, behandling med lokalt negativt tryck och hyperbar syrgasbehandling. Syfte: Syftet är att beskriva patienters upplevelser av att leva med diabetesfotsår. Metod: Metoden har genomförts som en litteraturöversikt vilket bygger på kvalitativ och kvantitativ vetenskaplig forskning. Databaserna som CINAHL Complete och Medline användes för att samla ihop materialet till den har arbetet. Bestämmande sökorden relaterad till ämne användes i både databaserna för att kunna få de lämpliga artiklarna till syftet. Noggrann analys utfördes av artiklarna och slutligen belystes fyra huvudkategorier i resultatet. Resultat: Arbetets resultat presenteras i fyra huvudkategorier som är: Fysiska smärtan, inre känslor, bristande kunskap och begränsningar av livssituationen. Inom den första kategorin framkom att patienterna upplevde smärta vid sömn, när de går, när de står men också smärta från själva såret med mera. Den andra beskriver att patienter med diabetesfotsår upplever en hel del negativa känslor i olika sammanhang. Tredje kategorin omfattar bristande kunskap kring fotsåren men också mötet med vårdpersonalen. Till sist framkom livsbegränsningar som handlar om utförande av vardagliga aktiviteter, begränsningar i sociala sammanhang och arbetsmiljön. Men också svårigheter när det gäller socioekonomiska området. Diskussion: Resultatet diskuteras utifrån Katie Erikssons caritativa teori kring lidande, hälsa och vårdande. / Background: Diabetic disease is a chronic disease affecting a large number of people worldwide. In Sweden, about 50,000 people suffer from diabetes, reports the National Diabetes Register. Living with diabetes for an extended period of time can come with various complications. One of them is the severe diabetic foot ulcer, which in turn arises from the combination of nerve damage and poor blood circulation. Fifteen percent of diabetic patients develop at least one foot ulcer during the prevalence of the disease. Foot ulcers that have a long healing process can also lead to amputation. The treatment for these foot ulcers involves various instances as well as specialist foot teams. The treatment can include self-care, surgical procedures, treatment with local negative pressure and hyperbaric oxygen therapy. Aim: The purpose is this study is to describe patient´s experiences of living with diabetes foot ulcers. Method: The method has been carried out as a literature review which is based on qualitative and quantitative scientific research. The databases such as CINAHL Complete and Medline were used to collect the material until it has worked. Determined keywords related to topic were used in both databases in order to get the appropriate articles for the purpose. A thorough analysis was carried out of the articles and finally four main categories were highlighted in the result. Results: The results of the work are presented in four main categories which are: Physical pain, inner feelings, lack of knowledge and limitations of the life situation. Within the first category, it emerged that patients experienced pain during sleep, when they walk, when they stand, but also pain from the wound itself and more. The second describes that patients with diabetes foot ulcers experience a lot of negative emotions in different contexts. The third category includes a lack of knowledge about the foot ulcers but also the meeting with the health care staff. Finally, life constraints emerged, which are about the execution of everyday activities, restrictions in social contexts, working environment and difficulties in the socio-economic field. Discussion: The result is discussed based on Katie Eriksson's charitable theory of suffering, health and caring.