Child and parental executive functioning in type 1 diabetes: Their unique and interactive role toward treatment adherence and glycemic control.

OBJECTIVE: Managing type 1 diabetes (T1D) requires the ability to make complex and critical decisions regarding treatment, to execute complex tasks accurately, and to make adjustments when problems arise. This requires effective neuropsychological competences of patients and their families, especially in the domain of executive functioning (EF): the ability to self-monitor, plan, solve problems, and set priorities. Previous research focused mainly on child EF, neglecting the impact of parental EF. This study included both mothers and fathers and examined associations between child and parental EF and treatment adherence to T1D in a broad age range of patients. METHODS: Parents of 270 patients (6-18 years) with T1D (mean age 12.7 years; 52.6% female) were included. Mothers (N = 232) and fathers (N = 168) completed questionnaires on child and parental EF and on treatment adherence. Analyses examined the associations linking child and parental EF to treatment adherence and glycemic control (and potential moderation effects in these associations) using hierarchical linear regression. RESULTS: Child EF problems were negatively associated with treatment adherence. As an indication of moderation, this effect was stronger in older children. Better treatment adherence and glycemic control were reported when both child and parent showed less EF problems. Effects were more pronounced in mothers than in fathers. CONCLUSIONS: This study demonstrated a significant interplay between child and parental EF in the association with treatment adherence and glycemic control. Researchers and clinicians should remain attentive toward the role of neuropsychological concepts such as EF. Implementation in clinical practice seems meaningful.

Parenting and Treatment Adherence in Type 1 Diabetes Throughout Adolescence and Emerging Adulthood.

Objective: To examine the role of diabetes-specific parental regulation and general parenting dimensions (responsiveness and psychological control) in treatment adherence throughout adolescence and emerging adulthood. Methods: A total of 521 patients (aged 14-25 years) with Type 1 diabetes, 407 mothers, and 345 fathers were included. Analyses within and across informants examined the associations between the parenting variables and treatment adherence (and potential moderation effects in these associations). Results: Lower psychological control and higher parental responsiveness were associated with better treatment adherence. Diabetes-specific parental regulation was not linked to treatment adherence, except when combined with high levels of responsiveness. Some effects of psychological control and responsiveness were more pronounced in the older age-group. Conclusions: Researchers and clinicians should remain attentive to the potential role of parenting for treatment adherence, even in emerging adult patients.

Predicting quality of life in pediatric asthma: the role of emotional competence and personality.

PURPOSE: The present study examined the predictive value of emotional competence and the five-factor model of personality on the quality of life of children with asthma. METHODS: Participants were 90 children (M age = 11.73, SD = 2.60) having controlled and partly controlled asthma, undergoing everyday treatment. Children filled in questionnaires assessing emotional competence and quality of life. Parents completed questionnaires assessing the personality of their child. RESULTS: Results showed that two emotional competences, bodily awareness and verbal sharing of emotions, were related to the quality of life of children with asthma. Moreover, one personality trait, benevolence, was associated with children's quality of life. Regression analyses showed that the predictive value of these three dimensions remained significant over and above asthma control and socio-demographic variables frequently associated with the quality of life of children with asthma (age, gender, and educational level of parents). CONCLUSIONS: These findings emphasize the importance of alerting the clinician who works with children with asthma to observe and assess the child's expression of emotions, attention to bodily sensations, and benevolence.

Psychometric properties of the emotion awareness questionnaire for children in a French-speaking population.

In this study, we investigated the psychometric properties of the French version of the Emotion Awareness Questionnaire (EAQ30; Rieffe et al., 2008). The EAQ30 was administered to 707 French-speaking children aged 8 to 16 years old. The original 6-factor structure was replicated in our data. The internal consistency coefficients of the EAQ30 subscales were satisfactory. We found small significant differences for gender and age. Regarding convergent validity, we found positive correlations between EAQ30 scores and emotional intelligence and negative correlations between EAQ30 scores and alexithymia. There was preliminary evidence of discriminant validity, with EAQ30 scores being weakly related to school performance, and concurrent validity, with EAQ30 scores being negatively related to somatic complaints, depression, and anxiety. Finally, except for 1 dimension, EAQ30 scores were not susceptible to social desirability. Although some weaknesses of the scale remain to be addressed, these findings support the use of the EAQ30 for research and clinical purposes.

Reflecting on Psychotherapy Practice for Psychologists: Towards Guidelines for Competencies and Practices.

In 2017, the European Federation of Psychologists Associations made a statement on psychotherapy. It recognizes that psychotherapy is a "special competence" practiced by psychologists, and that psychologists practicing psychotherapy receive specific education, including supervision. The statement also stresses that they have demonstrated competencies in scientifically validated or established theories on human emotions, cognitions, and behavior, and on processes of development, as well as the application of these methods to achieve change. Moreover, the declaration recognizes that they are trained in the scientific application of the methods of change based upon these theories. Within the Standing Committee of Psychology and Health in collaboration with the S-EAC, the group on Psychotherapy is presently working on a conceptual framework and on guidelines for psychotherapy practiced by psychologists. This document is starting to define the necessary skills and competencies for European psychologists practicing psychotherapy. It also makes recommendations for basic training, for the development of practical skills and competencies, for continuing professional development, and for ethical decision making. It especially puts forward psychologists' scientific approach to psychotherapy.

Integrated Palliative Care for Nursing Home Residents: Exploring the Challenges in the Collaboration between Nursing Homes, Home Care and Hospitals.

INTRODUCTION: Nursing home residents are a vulnerable and frail segment of the population, characterised by their complex and palliative care needs. To ensure an integrated approach to palliative care for this target group, working on a collaborative basis with multiple providers across organisational boundaries is necessary. Considering that coordinators of palliative networks support and coordinate collaboration, the research question is: 'how do network coordinators perceive the process of collaboration between organisations in Flemish palliative networks?' METHODS: A dual-phase sequential mixed-methods design was applied. First, the coordinators of each of the fifteen palliative networks in Flanders completed a survey in which they evaluated ten aspects of collaboration for two types of cooperation: between nursing homes and home care, and between nursing homes and hospitals. Next, the survey results thus obtained were discussed to improve understanding in a focus group composed of the above coordinators, and which was analysed on the basis of content analysis. RESULTS: In both forms of cooperation, the 'formalisation' and 'governance' were the aspects that yielded the lowest mean scores. The coordinators in the focus group expressed a need for more formalised interaction among organisations with regard to palliative care, the establishment of formal channels of communication and the exchange of information, as well as the development of shared leadership. CONCLUSIONS: The perspectives of the coordinators on inter-organisational collaboration are a valuable starting point for interventions directed at the stronger integration of palliative care for residents of long term-care facilities.

Measuring child and adolescent emotional lability: How do questionnaire-based ratings relate to experienced and observed emotion in everyday life and experimental settings?

OBJECTIVES: Emotional lability (EL) is an important trans-diagnostic concept that is associated with significant functional impairment in childhood and adolescence. EL is typically measured with questionnaires, although little is known about the ecological validity of these ratings. In this paper, we undertook 2 studies addressing this issue by examining the relationship between rating-based measures of EL and directly measured emotional expressions and experiences. Furthermore, the associations between directly measured emotional expressions and experiences and attention-deficit/hyperactivity disorder (ADHD) symptomatology were also examined, given the clear association of EL with ADHD in former research. METHODS: In Study 1, we examined the relationship between parental report of children's EL and ADHD, and children's emotional expressions in an experimental context (N = 67). In Study 2, we examined the relationship between parental ratings and real-time measures of emotional experiences in daily life in adolescents (N = 65). RESULTS: EL ratings were associated with different elements of real-time emotional experiences and expressions. Elements of emotional expressions but not emotional experiences were also associated with ADHD symptom reports. CONCLUSIONS: These studies provide evidence for the ecological validity of EL ratings. Furthermore, they add evidence for the associations between EL and ADHD.

A rating measure of ADHD-related neuropsychological impairment in children and adolescents: Data from the Cognition and Motivation in Everyday Life (CAMEL) Scale from population and clinical samples.

A new parent-completed questionnaire, the Cognition and Motivation in Everyday Life (CAMEL) scale, was developed to provide a comprehensive assessment of neuropsychological impairment in children related to attention-deficit/hyperactivity disorder (ADHD) across diverse cognitive, motivational and energetic domains. Its psychometric properties were investigated. A total of 60 items were generated to cover a wide range of putative ADHD-related neuropsychological processes. A clinical (n = 142) and community (n = 810) sample of parents with children between 6 and 16 years of age completed the questionnaire. Data on ADHD symptoms were also collected with a commonly-used, validated parent rating scale to explore the associations between CAMEL scores and dimensional measures of child ADHD and conduct problems. Factor analysis identified six factors which we labeled (i) Cognition, (ii) Self-Direction and Organization, (iii) Effort Engagement, (iv) Arousal Regulation, (v) Motivational Responsiveness, and (vi) Cautiousness. Self-Direction and Organization and Arousal Regulation were the strongest predictors for ADHD symptomatology. Self-Direction and Organization was strongly associated with inattention and Arousal Regulation with hyperactivity-impulsivity symptoms. Parents distinguished between broad neuropsychological domains in reliable and plausible ways, making distinctions between key aspects of functioning. However, the boundaries between these domains did not map directly onto the distinctions drawn within traditional models of ADHD deficits. Further research is required to examine the predictive validity and cost-effectiveness of the CAMEL scale compared to direct objective testing using laboratory measures in predicting prognosis and treatment outcome.

Helpers' Self-Assessment Biases Before and after Helping Skills Training.

Several studies have shown that therapists are generally biased concerning their performed helping skills, as compared to judges' ratings. As clients' ratings of therapists' performance are better predictors of psychotherapy effectiveness than judges' ratings, this study examined the validity and effectiveness of a helping skills training program at reducing novice helpers' self-enhancement biases concerning their helping skills, in comparison to their clients' ratings. Helping skills were assessed by three objective measures (a knowledge multiple choice test, a video test and a role play), as well as by a self- and peer-reported questionnaire. In addition, some performed helping skills' correlates (relationship quality, session quality, and helpers' therapeutic attitudes) were assessed both by helpers and their simulated helpees. Seventy-two sophomores in psychology participated to this study, 37 being assigned to a 12-h helping skills training program, and 35 to a control group. Helpers were expected to assess the aforementioned performed helping skills and correlates as being better than their helpees' assessments at pretest, thus revealing a self-enhancement bias. At posttest, we expected that trained helpers would objectively exhibit better helping skills than untrained helpers while beginning to underestimate their performance, thus indexing a self-diminishment bias. In contrast, we hypothesized that untrained helpers would continue to overestimate their performance. Our hypotheses were only partly confirmed but results reflected a skilled-unaware pattern among trainees. Trained helpers went either from a pretest overestimation to a posttest equivalence (performed helping skills and performed therapeutic attitudes), or from a pretest equivalence to a posttest underestimation (performed session quality and performed therapeutic relationship), as compared to helpees' ratings. Results showed that trained helpers improved on all helping skills objective measures and that helpees' perceptions of their performance had increased at posttest. In conclusion, helping skills training leads helpers not only to improve their helping skills but also to have more doubts about their skills, two variables associated with psychotherapy outcome.

A Mindfulness-Based Intervention for Adolescents and Young Adults After Cancer Treatment: Effects on Quality of Life, Emotional Distress, and Cognitive Vulnerability.

PURPOSE: Adolescent and young adult cancer (AYAC) survivors show an elevated risk of distress. Targeted psychosocial interventions for this distinct population are needed. This study examined the potential efficacy of a mindfulness-based intervention (MBI) to alleviate emotional distress and improve quality of life (QoL) in AYAC survivors. METHODS: Participants were 16 AYAC survivors, aged 14-24, who had completed acute medical treatment. A two-baseline (8 and 1 week before the intervention), post- (1 week after the intervention) and 3 months follow-up within-subjects design was used. Each participant completed two baseline assessments, followed by an 8-week MBI. The primary outcome variables were emotional distress and QoL. Secondary outcomes were cognitive vulnerability factors and mindfulness skills. RESULTS: Multilevel modeling showed (1) a significant reduction in emotional distress and improvement in QoL at 3 months of follow-up, (2) a significant reduction in negative attitudes toward self (i.e., a cognitive vulnerability factor), and (3) a significant improvement in mindfulness skills. CONCLUSION: MBI is a promising approach that is used to treat emotional distress and to improve QoL in AYAC survivors. Further research using randomized controlled trials is needed to generalize these findings. Trial registration information: www.trialregister.nl ; NTR4358.

A nationally representative study of emotional competence and health.

Emotional competence (EC; also called "emotional intelligence"), which refers to individual differences in the identification, understanding, expression, regulation, and use of one's emotions and those of others, has been found to be an important predictor of individuals' adaptation to their environment. Higher EC is associated with greater happiness, better mental health, more satisfying social and marital relationships, and greater occupational success. Whereas a considerable amount of research has documented the significance of EC, 1 domain has been crucially under investigated: the relationship between EC and physical health. We examined the relationship between EC and objective health indicators in 2 studies (N1 = 1,310; N2 = 9,616) conducted in collaboration with the largest Mutual Benefit Society in Belgium. These studies allowed us (a) to compare the predictive power of EC with other well-known predictors of health such as age, sex, Body Mass Index, education level, health behaviors (diet, physical activity, smoking and drinking habits), positive and negative affect, and social support; (b) to clarify the relative weight of the various EC dimensions in predicting health; and (c) to determine to what extent EC moderates the effect of already known predictors on health. Results show that EC is a significant predictor of health that has incremental predictive power over and above other predictors. Findings also show that high EC significantly attenuates (and sometimes compensates for) the impact of other risk factors. Therefore, we argue that EC deserves greater interest and attention from health professionals and governments.

Emotional competence and quality of life of children with asthma: The mediating effect of coping strategies.

This study explored the mediating effect of coping strategies on the relationship between emotional competence (EC) and quality of life (QOL) among children with asthma. Participants were 87 children (M age = 11.72, SD = 2.58) with controlled and partially controlled asthma, undergoing everyday treatment. They filled in questionnaires assessing EC, coping strategies and QOL. Results showed that the association between some ECs and the QOL of children with asthma was fully mediated by two maladaptive cognitive coping strategies. Among children with asthma, a greater ability to differentiate their emotions, a reduced attention to bodily signals of emotions and a reduced analysis of their current emotional state were related to decreased engagement in two coping strategies ('Ignoring Asthma' and 'Worrying about Asthma'), which in turn increased their QOL. These findings show that EC has an indirect effect on QOL through very specific coping strategies. They also emphasise the importance of screening EC in children with asthma and the importance of developing and using multidisciplinary interventions for them.

The effects of mindfulness on executive processes and autobiographical memory specificity.

Previous studies have found that mindfulness training reduces overgeneral memories and increases autobiographical memory specificity (e.g., [Williams, J. M. G., Teasdale, J. D., Segal, Z. V., & Soulsby, J. (2000). Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients. Journal of Abnormal Psychology, 109, 150-155]). However, little work has investigated the mechanisms underlying this effect. The present study explored the role of executive processes as a mediator of MBCT effects in an unselected sample. An autobiographical memory task, a cognitive inhibition task, a motor inhibition task, a cognitive flexibility task and a motor flexibility task were administered before and after intervention. Compared to matched controls, MBCT participants showed increased autobiographical memory specificity, decreased overgenerality, and improved cognitive flexibility capacity and capacity to inhibit cognitive prepotent responses. Mediational analyses indicated that changes in cognitive flexibility partially mediate the impact of MBCT on overgeneral memories. Results are discussed in terms of Conway's [2005. Memory and the self. Journal of Memory and Language, 53, 594-628] autobiographical memory model.