Contributions of age and clinical depression to metacognitive performance.

One aspect of metacognition is the ability to judge the accuracy of our own performance, even in the absence of external feedback, which is often measured using confidence ratings. Past research suggests that confidence is lower in Major Depressive Disorder (MDD). Less is known about the ability of MDD patients to discriminate correct from incorrect performance (metacognitive efficiency). The metacognitive performance of aged MDD patients (62-89y) was compared to an age-matched control group. A younger control group (21-28y) was included to also explore the relationshipbetweenageandmetacognitive performance. We found no difference in confidence bias nor metacognitive efficiency between MDD patients and age-matched controls.We found age-related differences in metacognition:normal aging was associated with higher confidencebut lower metacognitive efficiency. The overconfidence was specifically driven by overconfidence in incorrect trials. Our results point to the importance ofage while investigating the relation between MDD and metacognitive performance.

Difficultés et besoins non satisfaits des aidants de personnes âgées démentes : une analyse phénoménologique interprétative avant et après un groupe de psycho-éducation.

Résumé Une analyse phénoménologique interprétative longitudinale des difficultés et des besoins non satisfaits rencontrés par les aidants de patients atteints de maladies neuro-dégénératives a été effectuée sur un groupe de 14 conjoints avant (T1) et après (T2) avoir participé à un groupe de psychoéducation de 6 mois. Lors du premier temps (T1), les aidants décrivent principalement une perte des échanges avec le patient, la solitude et la détresse qu'elle entraîne. Ils verbalisent également les difficultés de gérer la relation d'aide, en particulier leurs besoins non satisfaits de temps libre. Lors du second temps (T2) et sous les effets de la progression de la pathologie, ce sont nouvelles difficultés qui apparaissent, avec l'augmentation de la difficulté à gérer les pertes fonctionnelles et les troubles psychocomportementaux. Nos résultats suggèrent que la psychoéducation a aidé les soignants à faire face aux difficultés liées au fardeau objectif (besoin de temps personnel). Les interventions psychoéducatives devraient à l'avenir aborder davantage la relation dyadique et le besoin de soutien affectif de l'aidant, car il s'agit d'un besoin fort, non satisfait, des aidants. Des interventions de psychoéducation systématiques et répétées peuvent ainsi permettre de mieux identifier les difficultés et les besoins des aidants et de leur fournir une aide adaptée, tout particulièrement en ce qui concerne la relation de couple et l'état émotionnel des aidants. Abstract Psycho-education provides information, tools and support to caregivers, and a strong consensus favors the importance of tailoring psycho-education interventions to caregiver needs. Most studies assess needs cross-sectionally, neglecting the evolving nature of needs and challenges inherent to dementia and caregiving, failing to report on how psycho-educative interventions address or incorporate caregiver needs. The purpose of this study was to provide a qualitative and longitudinal assessment of the difficulties and unmet needs of spousal caregivers before and after participating in a psycho-education group. To investigate the difficulties and needs related to caregiving, before and after psycho-education participation, we used a longitudinal Interpretative Phenomenological Analysis (LIPA). LIPA is a prospective person-centered method that explores the lived experience of phenomena without formulating a priori hypotheses. The psycho-educational program was available to any informal caregiver of a person living with dementia (PLWD) in the Brussels region. The multimodal program contains: educational and practical information on dementia sessions with a neuropsychologist specialized in dementia, group sharing and support; home visits by a nurse for personalized assistance to caregivers, art therapy group: available for PLWD that could not be left unsupervised in conjunction with psycho-education sessions. Our study yielded three key findings: (1) caregivers described a loss of relational reciprocity with the person living with dementia at T1 and T2, and reported feeling distressed; (2) at T1, caregivers verbalised difficulties related to their role, the majority of them only identified the lack of personal time as an unmet need; (3) at T2, most caregivers had actively addressed their unmet need for personal time and used respite services to obtain personal time. Our findings would suggest that psycho-education helped caregivers to address difficulties related to objective burden (need for personal time). Psycho-education interventions should systematically and repeatedly assess caregiver difficulties and assist them in identifying their needs in order to provide adequate and tailored strategies and support.

The relation between task-relatedness of anxiety and metacognitive performance.

It is well established that anxiety influences a range of cognitive processes such as cognitive control or decision-making. What is less known is how anxiety influences the metacognitive evaluations individuals make about their own performance. The present study explored the importance of task-relatedness in the relation between anxiety and metacognitive awareness. More specifically, we hypothesized that induced anxiety would affect metacognitive performance in opposite directions depending solely on whether the threat is perceived as related or unrelated to the performance. We conducted two experiments to test this hypothesis. In both studies, electric shocks were administered randomly, regardless of participant's performance. In experiment 1, participants were informed that the shocks would be administered randomly, unrelated to performance. In experiment 2, participants were told that their metacognitive performance would influence the administration of the electric shocks (i.e. fewer electric shocks with better metacognitive performance). Our predictions were confirmed. Threat perceived as unrelated to metacognitive performance (Experiment 1) decreased metacognitive performance. Threat believed to be related to metacognitive performance resulted in improved performance (Experiment 2). These findings confirm that induced anxiety exerts a strong influence on metacognitive awareness while sparing first-order task performance. We furthermore demonstrate that the perceived relatedness of the anxiety determines whether metacognitive performance decreases or improves performance under threat.

The influence of sad mood induction on task performance and metacognition.

In many situations, the ability to make appropriate metacognitive judgements on our performance is essential to make decisions and adapt our behaviour. Past research suggests a strong relationship between metacognition and emotional disorders such as depression. Depressive disorders have been associated with an underestimation bias: depressive patients report lower confidence in their performance than healthy individuals. It is currently not clear whether the induction of a negative mood in healthy participants has similar consequences. Yet, such knowledge would permit to isolate the causal influence of the negative affect on metacognition, free of all the comorbidities associated with depression. In this study, we used a combination of films, pictures, and recalls to induce negative and neutral moods during a perceptual metacognitive task. Negative mood induction had no impact on the perceptual task. Participants did report lower confidence levels in the negative condition compared with a neutral condition. This study thus confirms a causal relationship between negative affect and metacognitive abilities.

Growing up with a rare genetic disease: an interpretative phenomenological analysis of living with Holt-Oram syndrome.

BACKGROUND: Holt-Oram syndrome (HOS) is a rare genetic disease characterized by variable radial upper limb and cardiac defects. The aim of this research was to shed light on people's subjective perceptions of their diseases, how these perceptions provide meaning, and the consequences the syndrome can have in daily life and across all life stages. METHODS: Semistructured interviews with ten participants diagnosed with HOS were conducted in France and analyzed using interpretative phenomenological analysis. RESULTS: Participants' experiences fall under two main themes, namely, "stages of self-construction as different" and "when I am no longer the only one involved", each of which has three subthemes. From childhood onwards, symptoms monopolize the physical and psychological spheres. The feeling of being different is unavoidable until the patient can appropriate his or her condition, and by the end of adolescence, the patient generally feels that he or she has adapted to the syndrome. In adulthood, other concerns arise, such as the fear of rejection, the need to better understand the genetic issues of the condition and the desire for offspring to not experience the same life difficulties. CONCLUSION: The findings underscore the specific psychological issues associated with the syndrome at different life stages and the need for holistic genetic treatment with dedicated reference centers to improve care and further address these issues.IMPLICATIONS FOR REHABILITATIONHolt-Oram syndrome is a genetic disease characterized by abnormalities of the upper limbs and shoulder girdle and associated with a congenital heart defect.Specific issues arise at different stages of life: the physical consequences of the syndrome arise during childhood, the self-construction of pervasive difference during adolescence, the fear of being rejected as a young adult, and concerns about future parenthood and the transmission of the syndrome and the desire that one's child not be confronted with the same difficulties in adulthood.The complexity and entanglement of medical and existential issues related to HOS requires the development of multidisciplinary consultations that promote holistic care.The rarity of the syndrome and the lack of knowledge about HOS among health professionals and the general public make it necessary both to establish reference centers and to create patient associations to support patients.

Evolution of lived experience of dementia caregivers after a psycho-educational group: an interpretative phenomenological analysis.

The 'Help and Support for Caregivers and Patients' psycho-education group aims to educate and support dementia caregivers. Fourteen spousal caregivers were interviewed before (T1) and after (T2) psycho-education participation. Intrapersonal processes and the potential evolution of lived experience were explored using longitudinal interpretative phenomenological analysis. Three trajectory groups were identified at T1: proactive help-seekers, passive but hopeful caregivers and ambivalent caregivers. T2 interviews revealed that caregivers experienced growth in their role, benefitted from peer interactions, feelings of guilt were addressed and they were using out-of-home dementia-specific services. Identifying beliefs or attitudes that might prevent caregivers from getting help or support is important. Caregiver well-being remains a public health priority and furthering our knowledge about their complex and changing needs is paramount to provide well-designed and tailored resources.

Emotion Regulation Difficulties Are Not Always Associated With Negative Outcomes on Women: The Buffer Effect of HRV.

The Heart Rate Variability (HRV) is regularly associated with depression and trait emotion regulation. However, the interaction between HRV and emotional disturbances is still debated. Only a few studies indicate that HRV moderates the effect of personality traits involved in psychopathological disorders. Since the regulation of emotions is a transdiagnostic factor for most psychological disorders, this study aimed to explore whether HRV moderates the relationship between trait emotion dysregulation and depressive symptoms. We collected data from 148 participants via online questionnaires and HRV measurements at rest. Results show for the 114 female remaining in the study that whereas high emotion regulation difficulties led to higher depressive symptoms severity when resting HRV is low, depressive symptoms remain stable in the same condition but when resting HRV is high. Overall, high resting HRV appears to dampen the consequences of trait emotion regulation difficulties. Further studies are needed to confirm this result, but this suggests that usual response tendencies could be overcome by deactivating or inhibitory processes such as those implied in cognitive flexibility reflected through HRV, according to the neurovisceral integration model.

Habitual Routines and Automatic Tendencies Differential Roles in Alcohol Misuse Among Undergraduates.

There is a debate over whether actions that resist devaluation (i.e., compulsive alcohol consumption) are primarily habit- or goal-directed. The incentive habit account of compulsive actions has received support from behavioral paradigms and brain imaging. In addition, the self-reported Creature of Habit Scale (COHS) has been proposed to capture inter-individual differences in habitual tendencies. It is subdivided into two dimensions: routine and automaticity. We first considered a French version of this questionnaire for validation, based on a sample of 386 undergraduates. The relationship between two dimensions of habit and the risk of substance use disorder and impulsive personality traits was also investigated. COHS has good psychometric properties with both features of habits positively associated with an Obsessive-Compulsive Inventory score. Besides, the propensity to rely more on routines was associated with lower levels of alcohol abuse and nicotine use, suggesting that some degree of routine might act as a protective factor against substance use. In contrast, a high automaticity score was associated with an increased risk of harmful alcohol use. These results demonstrate that the COHS is a valid measure of habitual tendencies and represents a useful tool for capturing inter-individual variations in drug use problems in undergraduates.

[Dementia caregiver journey and motivation to participate in a psycho-educational group: an interpretative phenomenological analysis]. / Cheminement de l'aidant proche et motivation à la participation à un groupe de psychoéducation : une analyse phénoménologique interprétative.

The "Help and support for caregivers and patients program, (ASAPP) is a multidisciplinary project to better the interactions between unformal caregivers and patients living with a neurodegenerative disorder, by improving the disease understanding. OBJECTIVE: The aim of our study was to understand the trajectory, expectations and motivation of the caregivers to participate in the program. METHODS: 7 spousal caregivers participated in a semi-structural interview, whose results were analysed by means of a qualitative technique of phenomenological analysis. RESULTS: Three main themes emerged 1) loneliness, social isolation and emotional impact of the illness, 2) lack of time for themselves, and feelings of solitude, 3) expectations of improvement by the psychoeducational program. CONCLUSION: These results highlight the importance to understand the expectations of the caregivers to tailor the intervention program according to their main needs.

Difficulties adapting to Nail-Patella syndrome: A qualitative study of patients' perspectives.

Nail-Patella syndrome (NPS) is a genetic disorder generating physical malformations and, in approximately one in three cases, ocular and renal damage. The present research aimed to deeply understand patients' subjective experience with NPS, particularly the aspects of the syndrome that affect patients' adaptation and to propose interventions that can improve genetic and psychological counseling and help patients cope with their condition. Semi-structured interviews of nine people diagnosed with NPS were analyzed using interpretative phenomenological analysis. Results highlighted attempts to look like a person without disabilities by hiding malformations and not telling the truth about symptoms' genetic origin because of patients' poor self-esteem, negative self-cognition, and social isolation experienced from childhood to adulthood. Difficulties of adaptation to physical limits and pain were also identified. The majority of participants who were not diagnosed at birth tended to consider physical symptoms as "birth malformations" without imagining other potential implications until receiving a diagnosis. Despite the diagnosis, the majority continued to minimize the potential complications by considering NPS as a "physical difference" and not adhering to medical surveillance.

On the Processes Underlying the Relationship Between Alexithymia and Gambling Severity.

A great number of individuals with persistent problematic gambling behavior exhibit alexithymic tendencies, greater impulsivity, impaired working memory and poor mood. However, the relationship between these cognitive, affective and personality factors in problem gambling remains poorly understood. Our aim was to investigate multiple pathways of the alexithymia and problem gambling relationship. One hundred and six male subjects with different levels of gambling problem severity were recruited. Alexithymia, impulsivity and verbal working memory were evaluated, and their relationships to disordered gambling was examined by means of a path analysis. Results indicate that alexithymia is related to an increase in the severity of gambling indirectly, i.e., through distress severity. In addition, a rise of alexithymic tendencies was also associated with problem gambling severity through enhanced impulsivity that directly increased distress. Working memory capacity failed to significantly impact our path model. Overall, our findings contribute a new finding to the literature by highlighting the importance of alexithymia, in addition to impulsivity, in the understanding of gambling problem severity and its clinical course.

Type D personality: Application of DS14 French version in general and clinical populations.

The aim of this study was to validate the French-language version of the Type D personality scale-14 among general and clinical populations (acute coronary syndrome and breast cancer patients). The two-factor structure of the Type D personality scale-14 was confirmed by factorial and confirmatory analyses. Internal consistency for both subdimensions of Type D personality scale-14 (negative affectivity and social inhibition) was very good with α = .87 for each. Contrary to our expectations, the Type D prevalence was much higher in the breast cancer group than in the acute coronary syndrome patients. In conclusion, the French-language Type D personality scale-14 showed good psychometric properties among general and clinical populations.

The Subjective Experience of Patients Diagnosed with Hereditary Hemorrhagic Telangiectasia: a Qualitative Study.

The aim of the present study was to understand the context and psychological impact for patients diagnosed with hereditary hemorrhagic telangiectasia (HHT). Semi-structured interviews were conducted with 9 patients affected by HHT, and the transcripts were analyzed using interpretative phenomenological analysis. The results of this study allowed us to propose a new hypothesis to explain the delay in diagnosis: the trivialization of symptoms associated with HHT. Moreover, the results showed that a genetic diagnosis of HHT results in emotional shock, uncertainty about the future, and worry about one's children in parents who are confronted with the dilemma of facing the reality of the diagnosis or delaying dealing with the diagnosis until disease onset. Family and personal perceptions of the disease influenced not only the delay in diagnosis but also the emotional and behavioral reactions of patients following a genetic diagnosis.

Live happily live in hiding (from our affect): Alexithymia Influences affect intensity and affect frequency ratings in men.

Alexithymia has been frequently studied in the context of negative affect frequency but rarely in the context of positive affect frequency or in the context of affect intensity. However, affect intensity and frequency, even if they are independent, are generally confounded due to an overlap in items wording (tapping both dimensions). The aim of the study was to examine the incremental validity of alexithymia for predicting both affect intensity and frequency, regarding positive and negative valence. Two hundred and fifty five students fulfilled measurements for alexithymia, affect intensity and affect frequency. Results showed that the factor "Difficulty identifying feelings" is related to higher positive and negative affect intensity, as well as to negative affect frequency. Men were also more sensitive to positive affect intensity and frequency if they scored higher on alexithymia. They experienced less often positive affect, but the intensity of their affect was more intense. Conversely, alexithymia did not influence women's affect intensity or affect frequency. Thus, alexithymia factors are associated with specific patterns of affect intensity and frequency, highlighting an overall deficit in the processing of emotions with contrasting patterns regarding gender.

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.

Validation of the short-cognitive inventory of subjective distress (S-CISD).

ABSTRACT Background: This investigation aimed to develop a screening tool based on the Cognitive Inventory of Subjective Distress (CISD). Two studies were designed in order to test the second-order factorial structure of the CISD, to shorten its length and to assess its replicability on a second large independent sample. Methods: We recruited a first sample (n = 290) living at home or in retirement centers and a second community-based sample (n = 1,429). The first sample completed the original CISD as well as cognitive, autonomy, anxiety, and depression assessments. The second sample completed the Short-CISD (S-CISD). Results: Factor analyses supported a second-order factorial structure allowing to engage in a refinement of the scale. We retained seven items corresponding to a dimension of cognitive schemas. Confirmatory Factor Analysis (CFA) demonstrated that the S-CISD exhibited satisfying psychometric properties as well as factorial replicability and structural invariance in two different samples. Further, the internal consistency of the S-CISD is acceptable. Conclusion: The S-CISD is a relevant screening tool for rapidly assessing psychological distress. It is directed towards old and very old individuals either living at home or in a retirement center, while also taking into account the fatigability and potential cognitive impairment of this population. This screening tool can be confidently used for psychopathological assessment and can serve as a baseline for following patients over time or in the course of therapy.

Factor structure, evolution, and predictive power of emotional competencies on physical and emotional health in the elderly.

OBJECTIVE: Emotional competence (EC) has been found to be an important predictor of individuals' health. While it is well known that EC predicts important outcomes in young adults, its importance is less clear in the elderly. We aimed to address this gap: Is the structure of EC the same in older as in younger adults? How do EC evolve between 50 and 80 years old? Does the predictive power of EC, regarding physical and emotional adjustment, increase or decrease with age? METHOD: A total of 6,688 participants filled subjective health and EC questionnaires. We gathered their medication consumption over the last 11 years, from the database of health insurance. RESULTS: While the structure of ECs remains stable in older adults, it generally declines as people get older, except for emotion regulation, which improves with age. Results also show that EC predicts both physical and emotional health. DISCUSSION: These results suggest that the development of specific interventions to improve EC may be useful for the elderly.

What is the emotional core of the multidimensional Machiavellian personality trait?

Machiavellianism is a personality trait characterized by interpersonal manipulation and associated with specific patterns of emotional and social cognition skills. The aim of this study was to investigate its socio-cognitive characteristics by determining its association and predictors on the basis of a multidimensional approach to Machiavellianism. We used Mach IV scale to assess "Machiavellian Intelligence" skill of participants (Christie and Geis, 1970). It includes three subscales that are (1) the use of deceit in interpersonal relationships, (2) a cynical view of human nature and (3) the lack of morality. Associations were found between Machiavellianism and low levels of empathy and affective ToM, and high levels of alexithymia, anhedonia, depression, and anxiety. These associations were observed in varying proportions depending on the three subscales of Machiavellianism. The addition of anhedonia and trait-anxiety to the concepts of empathy and alexithymia made it possible to gain a better understanding of the emotional core of Machiavellianism. These findings are discussed in the light of developmental and adaptive perspectives.

Inmates-to-staff assaults, PTSD and burnout: profiles of risk and vulnerability.

Prison employees are often confronted with critical incidents and chronic stressors that may lead to trauma or burnout symptoms. However, most of the research on clinical aspects of interpersonal violence in prisons (inmates-to-staff violence, specifically) focuses either on trauma or on burnout. The purpose of the present study is (a) to examine both burnout and posttraumatic stress among prison staff and (b) to examine the influences of inmates-to-staff violent relations on posttraumatic stress in terms of risk profile to develop PTSD. A random sample of French correctional employees has completed various self-reported questionnaires assessing burnout, posttraumatic stress, and stress as well as victimization and demographic characteristics. Correctional employees demonstrated high levels of PTSD symptoms, burnout, and stress. Violent interactions with inmates lead to experienced trauma of all types (PTSD, secondary, or vicarious trauma). Results have highlighted a prison worker's profile prone to PTSD: he or she expresses high levels of emotional exhaustion, intense levels of stress, high levels of depersonalization, and high levels of intrusion, avoidance, and hyperreactivity. This study contributes to an understanding of the literature by explaining the complex association between burnout and posttraumatic stress after interpersonal violence. These findings suggest a need to support prison workers and to address inmates-to-staff relational dynamics.

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.