Self-statements of test-anxious children: thought-listing and questionnaire approaches.

Two methods of assessing cognition in high, moderate, and low test-anxious children, thought listing and self-statement questionnaire approaches, were investigated under naturalistic test-taking conditions. The amount of cognition, its content, and its relation to level of anxiety and task performance were examined. States of mind (SOM) analyses were performed. Furthermore, the comparability of findings from both methods was examined. Results showed that, relative to the questionnaire method, the thought-listing procedure underestimated positive and coping cognition. The benefits of the questionnaire approach were seen in the power of its scores to predict task performance. Implications for cognitive assessment and treatment of anxious children are discussed.

Coping self-talk and cognitive interference in anxious children.

The present study addressed the as-yet-unresolved issue of whether coping self-talk facilitates or interferes with effective task performance. Tests of the relationship between coping cognition and task performance are reported when potentially confounding relationships of negative cognition and task performance are controlled. The results indicate that coping self-talk of high-anxious children was positively correlated with negative thoughts but did not contribute significantly to performance. Implications for the functional value of coping self-talk are discussed.

Cognition in test-anxious children: the role of on-task and coping cognition reconsidered.

This study investigated cognition in children with high, moderate, and low test anxiety under naturalistic test-taking conditions. Children with high test anxiety not only reported more negative self-evaluations and more off-task thoughts but also more on-task and coping thoughts. Consistent with previous research, no "task-facilitating" role for these on-task and coping cognitions was found. This finding lends support to the notion of "the power of non-negative thinking". The only facilitating role was for positive self-evaluations. It was hypothesized that positive cognition could be task-facilitating under certain conditions. Limited support was found for this idea.

Multiple medically unexplained physical symptoms and health care utilization: outcome of psychological intervention and patient-related predictors of change.

OBJECTIVES: To test the effect of psychological intervention on multiple medically unexplained physical symptoms, psychological symptoms, and health care utilization in addition to medical care as usual. To identify patient-related predictors of change in symptoms and care utilization. METHODS: In a randomized controlled trial, subjects were assigned to one of two conditions: psychological intervention by a qualified therapist plus care as usual by a general practitioner (GP) or care as usual only. Participants (N=98) were administered a standardized interview and several outcome measures at intake and after 6 months and 12 months after intake. GPs rated medically unexplained and explained symptoms and consultations over a period of 1 1/2 years. RESULTS: ANOVAs for repeated measures showed that self-reported and GP-registered unexplained physical symptoms decreased from pretest to posttest to follow-up. Psychological symptoms and consultations decreased from pretest to posttest. GP-registered explained symptoms did not decrease. However, intervention and control groups did not differ in symptom reduction. Path analysis revealed two paths to a decrease in self-reported unexplained physical symptoms: from more negative affectivity via more psychological attribution and more pretreatment anxiety, and from more somatic attribution via more psychological attribution and more pretreatment anxiety. CONCLUSION: Intervention and control groups did not differ in symptom reduction. Reduction of self-reported medically unexplained symptoms was well predicted by patient-related symptom perception variables, whereas the prediction of change in registered symptoms and consultations requires a different model.

Predicting medically unexplained physical symptoms and health care utilization. A symptom-perception approach.

OBJECTIVES: The present study investigated the contribution of demographic characteristics (age, gender, socioeconomic status [SES]) and symptom-perception variables to unexplained physical symptoms and health care utilization. In addition, the consequences of the use of four frequently applied symptom-detection methods for relations among study variables were examined. METHOD: A group of 101 men and women were administered a standardized interview and several questionnaires. Their general practitioners (GPs) rated (un)explained symptoms and consultations over the previous year. RESULTS: Path analyses showed that direct and indirect effects on symptoms and GP consultations depend on method of symptom detection, the largest difference being between self-reported symptoms and registered symptoms. The model including self-reported common symptoms demonstrated the direct and indirect effects of the symptom-perception variables: chronic disease, negative affectivity, selective attention to bodily sensations, and somatic attribution. In the model including registered symptoms, only chronic disease and SES showed effects on symptoms and GP consultations. CONCLUSION: This study demonstrates the usefulness of a symptom-perception approach to the experience of unexplained symptoms, the importance of selection of a symptom-detection method, and the need for different models for the explanation of daily experienced symptoms and their presentation in health care.

[Prevalence and diagnosis of depression in frail nursing home patients; a pilot study]. / Depressie bij somatische verpleeghuispatiënten. Een pilotstudie naar prevalentie en herkenning.

The prevalence and recognition of depression among physically frail patients living in an urban Dutch nursing home were estimated. To patients with Mini-Mental-Status-Examination (MMSE) scores of 15 or above, the Geriatric Depression Scale (GDS) was administered (N = 80). With this screen clinically relevant depressive symptoms can be established. For diagnosing major depression according to the DSM-IV criteria, the Diagnostic Interview Schedule (DIS) (N = 57) was administered using a MMSE cut-off of 20. 49% of the respondents showed a score above the GDS cut-off (> 11), which means having clinically relevant depressive symptoms. 16% met the criteria for major depression according to DIS. Nursing home physicians recognized 39% of the patients with clinically relevant depressive symptoms and 67% of those with a major depression. Nurses recognized depressive patients slightly better but they were less specific in their judgement (more false-positive rates). We also found that in situations in which physicians and nurses had the same opinion the recognition of depression improved. Therefore it is recommended that physicians and nurses exchange their judgements on patients' mood on a regular basis.

[Alternative treatments in cancer; extent and background of utilization]. / Alternatieve geneeswijzen bij kanker; omvang en achtergronden van het gebruik.

OBJECTIVE: To determine the prevalence of use of alternative cancer therapies, as well as the characteristics of the patients who use these therapies, and their experiences with them. DESIGN: Descriptive study. SETTING: Outpatient departments of several hospitals in North-Holland. METHOD: In total, 1091 patients were asked to participate in the study; 949 patients agreed (87%): 535 women (56%) and 414 men, with an average age of 62 years. The sample was stratified by diagnosis: 233 breast, 183 lung, 278 stomach/colon cancer and 255 patients with various other cancer diagnoses. A structured face-to-face interview and several written questionnaires were used. RESULTS: 2XOf the 949 patients, 9.4% were currently using an alternative therapy in addition to conventional treatment, and 5.8% had used an alternative treatment in the past but had subsequently stopped. Patients using alternative therapies were relatively younger and more highly educated than patients who chose not to use these therapies. Use of alternative therapies was more frequent among patients undergoing palliative treatment and patients who were actively dealing with the problems surrounding their disease. Only a minority of the patients believed they could be cured by the alternative therapy; the majority hoped it would help to slow the progression of their disease or strengthen their resistance. CONCLUSION: The motivation for seeking alternative treatment more often appears to be fear and uncertainty rather than belief in the efficacy of the treatment. For many patients the use of alternative therapies represents a means of dealing with the anxiety and stress surrounding their disease.

The Impact-on-Family Scale: a test of invariance across culture.

OBJECTIVE: To test the cultural invariance of the Impact-on-Family Scale in order to make cross-cultural comparisons. METHODS: The Italian version of the scale was administered to mothers of children with chronic illnesses. Factorial invariance was examined to investigate whether the four factors found with the original United States (U.S.) scale could be replicated. RESULTS: The results clearly demonstrate the replicability of the first three factors, Financial Burden, Familial/Social Impact, and Personal Strain. In addition, internal consistency and the homogeneity of the items of the corresponding scales are satisfactory. However, the fourth factor, Mastery, could not be replicated, and the reliability of the corresponding scale is poor. Italian mothers scored significantly lower on the Financial Burden and on the Familial/Social Impact dimension, compared to the American sample. CONCLUSIONS: Three of the four factors of the Impact-on-Family Scale are useful for cross-cultural comparisons between U.S. and Italian samples.