A 'good dyadic relationship' between older couples with one having mild cognitive impairment: a Q-methodology.

BACKGROUND: Cognitive impairment gradually brings changes to the relationship between older married couples. Therefore, this study aimed to understand the individual viewpoints of couple dyads on the important attributes of a 'good dyadic relationship' in the context of mild cognitive impairment (MCI), and to explore if the congruencies and discrepancies in their perceptions related to the quality and closeness of their relationship and well-being. METHODS: Q-methodology was used to reveal the perceptions of a 'good dyadic relationship' among couples with one having MCI. The participating couples were separated in two rooms and independently ranked 18 relationship attributes from least to most important on a 7-point Q-sort response grid. All participants also completed a post-sort interview and surveys to assess their psychological well-being and closeness. Q-sorts were analyzed using by-person factor analysis. RESULTS: Forty people with MCI and forty spousal partners completed the Q-sort. Three viewpoints, accounting for 48% of the total variance, were identified and were labeled 'Provider,' 'Problem-solver,' and 'Partner.' Different viewpoints of a 'good dyadic relationship' primarily varied by perceived importance of commitment, dedication, tolerance, and personal space. Despite these differences, there was wide consensus that respecting each other and cherishing the current moment are two universally salient attributes of a good relationship across all viewpoints. Couples with discrepant views scored significantly higher on perceptions of the quality of the relationship and closeness with the partner. CONCLUSIONS: This study advances the theoretical understanding of the dyadic relationship between couples with one having MCI, from both perspectives. MCI is a state in which couples can openly discuss their expectations. The findings provide practitioners with insights to work with couples experiencing MCI.

Effectiveness of Cognitive-Based Interventions on Psychological Distress in Adolescents With Physical Disabilities: A Systematic Review and Meta-Analysis.

Adolescents with physical disabilities experience common psychological distress that interacts with impaired physical function. While cognitive-based interventions have been implemented for adolescents with physical disabilities, their effects on enhancing psychological health remain uncertain. This systematic review aimed to synthesise the effects of cognitive-based interventions on the psychological distress of this population and identify optimal components for evidence-based interventions. Following the PRISMA guideline, nine databases were searched to identify eligible randomised controlled trials examining the effects of cognitive-based interventions for adolescents with physical disabilities from inception to October 2023. Data syntheses were performed using the R software, employing random-effects models. Twelve trials involving 1201 participants were identified. The pooled results revealed that cognitive-based interventions did not yield noticeable effects in reducing anxiety (g = -0.43 for postintervention; -0.14 for medium term; -0.37 for long term), depression (g = -0.05 for postintervention; -0.02 for medium term; -0.15 for long term) and stress levels (g = -0.15) over time. The secondary outcome (physical function) improved significantly in the long term compared to the control groups (g = 0.31). Furthermore, this review identified variations in the effectiveness of CBIs among different recipients, durations and modes of delivery. Given the limited number and overall low quality of identified studies for each outcome, conducting high-quality randomised controlled trials is recommended to validate the effectiveness of cognitive-based interventions in reducing psychological distress among adolescents with physical disabilities.

Adverse and benevolent childhood experiences in Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD): implications for trauma-focused therapies.

BACKGROUND: There is very little work on the role of positive or benevolent childhood experiences and how such events might offer protection from the insidious effects of adverse experiences in childhood or later in life. OBJECTIVES: We set out to test, using latent variable modelling, whether adverse and benevolent childhood experiences could be best described as a single continuum or two correlated constructs. We also modelled the relationship between adverse and benevolent childhood experiences and ICD-11 PTSD and Complex PTSD (CPTSD) symptoms and explored if these associations were indirect via psychological trauma. METHODS: Data were collected from a trauma-exposed sample (N = 275) attending a specialist trauma care centre in the UK. Participants completed measures of childhood adverse and benevolent experiences, traumatic exposure, and PTSD and CPTSD symptoms. RESULTS: Findings suggested that adverse childhood experiences operate only indirectly on PTSD and CPTSD symptoms through lifetime trauma exposure, and with a stronger effect for PTSD. Benevolent childhood experiences directly predicted only CPTSD symptoms. CONCLUSIONS: Benevolent and traumatic experiences seem to form unique associations with PTSD and CPTSD symptoms. Future research is needed to explore how benevolent experiences can be integrated within existing psychological interventions to maximise recovery from traumatic stress.

Objetivos: Nos propusimos evaluar, usando un modelo de variables latentes, si experiencias adversas y benignas en la infancia podrían ser mejor descritas como un continuo simple o bien como dos constructos correlacionados. También modelamos la relación entre experiencias adversas y benignas en la infancia y síntomas de TEPT y TEPT complejo (TEPTc) según la CIE-11 y exploramos si estas asociaciones eran indirectas a través del trauma psicológico.Métodos: Los datos fueron obtenidos de una muestra expuesta a trauma (N=275) que acudía a un centro especializado en trauma en el Reino Unido. Los participantes completaron mediciones sobre experiencias adversas y benignas en la infancia, exposición a trauma, y síntomas de TEPT y TEPTc.Resultados: Los hallazgos sugirieron que las experiencias adversas en la infancia operan sólo indirectamente en síntomas de TEPT y TEPTc a lo largo de exposición a trauma en la vida, con un importante efecto para TEPT. Las experiencias benignas en la infancia predijeron directamente sólo síntomas de TEPTc.Conclusiones: Las experiencias adversas y benignas parecen formar asociaciones particulares con síntomas de TEPT y TEPTc. Se requieren investigaciones futuras para explorar cómo las experiencias benignas pueden ser integradas en intervenciones psicológicas existentes para optimizar la recuperación de estrés traumático.