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Chen L, Huang Z, Jiang C, Wu C, He S, Zeng F, Huang S, Zhang F. Illness perception, coping and psychological distress among patients with metabolic dysfunction-associated fatty liver disease (MAFLD) in China. BMC Public Health 2025; 25:541. [PMID: 39930393 PMCID: PMC11812146 DOI: 10.1186/s12889-024-21260-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 12/31/2024] [Indexed: 02/13/2025] Open
Abstract
OBJECTIVES The study examined the effects of illness perception on mental health among patients with metabolic dysfunction-associated fatty liver disease (MAFLD) and the moderating role of coping style in this effect. METHODS The current study has collected the data of MAFLD patients at baseline and 8 months after. In both baseline and follow-up surveys, structural questionnaires were adopted to assess participants' illness perception (BIPQ), coping strategies (Brief COPE) and psychological distress (GHQ-12). A cross-lagged panel model was constructed to examine the associations between illness perception and psychological distress over 8 months. The moderating role of coping in the relationship between illness perception and psychological distress was addressed. RESULTS A total of 155 participants diagnosed with MAFLD were enrolled in the baseline survey, of which 71 patients engaged in the 8-month follow-up. The results showed that severe illness perceptions (perceiving MAFLD with more negative consequence, more negative emotions, lower coherence, and less treatment control) were associated with increased psychological distress 8 months later (β = 0.171, p < 0.05). Though approach coping showed an overall positive effect (β = 0.169, p < 0.05), people using it as a dominant strategy tend to be more subjected to the impacts of negative illness perceptions. CONCLUSION Threatening perceptions about MAFLD were associated with more psychological distress over time, and coping style has moderated the effects of illness perceptions. Healthcare providers should be aware of the impacts of negative illness perceptions, particularly when developing coping skill training programs to promote well-being and recovery.
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Affiliation(s)
- Liyuan Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Zhongxuan Huang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Chenqi Jiang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Chuanghong Wu
- Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Shihua He
- Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Fangfang Zeng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Shaofen Huang
- Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China.
| | - Fan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
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Fantini-Hauwel C, Geerts-Crabbé L, Antoine P. Relevance of the common-sense model for people living with a genetic predisposition for breast and ovarian cancer. Br J Health Psychol 2025; 30:e12752. [PMID: 39307844 DOI: 10.1111/bjhp.12752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/04/2024] [Indexed: 11/26/2024]
Abstract
OBJECTIVES BRCA1/2 pathogenic variants have been associated with an increased risk for breast, ovarian, pancreatic, prostate cancer as well as melanoma. The present research uses the Leventhal's common-sense model of self-regulation (CSM), a theoretical framework highlighting the role of mental representations on responses to a health-threat. We aim at understanding the personal meaning and representation of living with an hereditary breast and ovarian cancer predisposition. METHOD Semi-structured interviews of 15 BRCA carriers were analysed using the interpretative phenomenological analysis. RESULTS Mental representations develops in childhood and are influenced by childhood emotional responses to the familial experience of the BRCA predisposition. Pre-existing beliefs about BRCA, even erroneous, are deeply anchored and not called into question by medical informations given during the genetic counselling. This is particularly true when medical information is perceived as too complex, inconsistent or in contradiction with familial experience. These beliefs about the consequences of being carriers of the BRCA gene influence emotional and behavioural experiences leading to experience fear, anxiety, lack of hope for future or self-identity change. For participants with a traumatic familial experience of cancer, the lack of treatment for this genetic disease generates a perpetual overestimation of cancers' risk and the feeling of an unending danger associated with early death despite breast and ovarian prophylactic surgery. When strong negative representations of the BRCA predisposition are experienced, dysfunctional health behaviours, such as drugs consumption or overuse of medical consultations, could appear consecutively to emotional disorders.
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Affiliation(s)
- Carole Fantini-Hauwel
- Research Center of experiMEntAl, CogNItive & CliNical PsycholoGy (MEANING), Université Libre de Bruxelles, Brussels, Belgium
| | - Laura Geerts-Crabbé
- Research Center of experiMEntAl, CogNItive & CliNical PsycholoGy (MEANING), Université Libre de Bruxelles, Brussels, Belgium
- National Fund for Scientific Research (FRS-FNRS) - Télévie, Brussels, Belgium
| | - Pascal Antoine
- SCALab - Cognitives and Affectives Sciences, National Center of Scientific Research (CNRS UMR 9193), University of Lille, Lille, France
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Yang HM, Lau JTF, Fong LHN, Cheung SF, Wu AMS. How are illness representations of gambling disorder associated with gambling behaviors? A latent profile analysis. Addict Behav 2025; 160:108149. [PMID: 39260115 DOI: 10.1016/j.addbeh.2024.108149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 08/13/2024] [Accepted: 08/31/2024] [Indexed: 09/13/2024]
Abstract
Gambling disorder (GD) is a behavioral addiction that causes serious harm to individuals' mental health and social functioning. This study aimed to explore whether gamblers' illness representations (IR) for GD are related to disordered and/or controlled patterns of gambling under the framework of commonsense model of self-regulation (CSM). Based on CSM, different facets of IR do not exist in isolation but together form a total illness schema; we hence used a person-centered analysis method, latent profile analysis (LPA), to classify gamblers by their overall IR for GD (including consequences, personal and treatment control, timeline cyclical, emotional representations, and coherence) into groups and then tested whether these groups differed in GD symptoms, controlled gambling behaviors, and help-seeking intention. An anonymous online survey was conducted on a social media platform, and valid responses from 589 past-year adult gamblers were collected. LPA results supported a four-profile model, revealing four profiles of GD representations: the weak-perception profile, average profile, tensed-up profile, and rational profile. Significant differences were found in all outcome variables in these four profile groups. In particular, the rational group exhibited the lowest levels of GD symptoms and impaired behavioral control, the highest levels of responsible and controlled gambling, and the highest levels of help-seeking intention, whereas the weak-perception group reported the lowest levels of responsible and controlled gambling behaviors. The findings provide empirical support for the application of CSM to addictive behaviors, as well as preliminary evidence for the potential use of CSM-based interventions for GD prevention.
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Affiliation(s)
- Hong Mian Yang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China; Faculty of Health and Wellness, City University of Macau, Macao, China
| | - Joseph T F Lau
- Public Mental Health Center, School of Mental Health, Wenzhou Medical University, Wenzhou, China; Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lawrence Hoc Nang Fong
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, China; Department of Integrated Resort and Tourism Management, Faculty of Business Administration, University of Macau, Macao, China
| | - Shu Fai Cheung
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China
| | - Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao, China.
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Cannon ME, Martin JL, McAndrew LM, Brenner RE. Opioid Misuse by Adults with Chronic Pain: The Impact of Illness and Medication Beliefs. Int J Behav Med 2024:10.1007/s12529-024-10324-z. [PMID: 39363139 DOI: 10.1007/s12529-024-10324-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND Why do some adults with chronic pain misuse their prescription opioids when others do not? Based on the extended Common-Sense Model, the study evaluated whether adults' beliefs about their pain have an indirect effect on risk of opioid misuse through beliefs about opioids when controlling for depression. METHODS The sample included 297 adult participants in the U.S. recruited from Prolific, an online crowdsourcing website. Study measures included the Illness Perception Questionnaire-Revised (IPQ-R; protective and threat-related illness beliefs about chronic pain), the Beliefs about Medicines Questionnaire-Specific subscale (BMQ-Specific; concern and necessity medication beliefs about prescription opioids), and the Current Opioid Misuse Measure (COMM; risk of current opioid misuse). This cross-sectional parallel mediation analysis was conducted using MPlus. RESULTS After controlling for depression, the indirect effect of protective illness beliefs on opioid misuse risk through concern medication beliefs (b = -0.01, 95% CI (-0. 038, -0.001), and the indirect effect of threat-related illness beliefs on opioid misuse risk through necessity medication beliefs (b = 0.02, 95% CI (0.004, 0.036) were significant. The full model explained 35% of the variance of opioid misuse risk. CONCLUSIONS Adults with chronic pain with stronger protective beliefs about pain were less likely to have concerns about their opioids and were at lower risk for opioid misuse, while those with greater threat-related beliefs about pain were more likely to believe that their opioids were necessary and be at greater risk for opioid misuse. Results have implications for medical and mental health providers and future research.
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Affiliation(s)
- Margeaux E Cannon
- University at Albany, State University of New York, 1400 Washington Ave., Albany, NY, 12222, USA.
| | - Jessica L Martin
- University at Albany, State University of New York, 1400 Washington Ave., Albany, NY, 12222, USA
| | - Lisa M McAndrew
- University at Albany, State University of New York, 1400 Washington Ave., Albany, NY, 12222, USA
- Veterans Affairs, New Jersey Healthcare System, 385 Tremont Ave, East Orange, NJ, 07018, USA
| | - Rachel E Brenner
- University at Albany, State University of New York, 1400 Washington Ave., Albany, NY, 12222, USA
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Lu M, Li J, Wu Q, Zhang Y, Sun H. Latent Profile Analysis of Self-Stigma Among Individuals With Schizophrenia and Its Relationship With Illness Perception. J Psychosoc Nurs Ment Health Serv 2024:1-10. [PMID: 39172889 DOI: 10.3928/02793695-20240813-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
PURPOSE To investigate self-stigma among individuals with schizophrenia, identify potential categories of self-stigma, and analyze the association between self-stigma categories and dimensions of disease perception. METHOD Convenience sampling was used to select individuals with schizophrenia (N = 216) in psychiatric hospitals. A General Demographic Information Questionnaire, the Internalized Stigma of Mental Illness Inventory, and Brief Illness Perception Questionnaire were used for data collection. A latent profile analysis was performed on self-stigma characteristics of participants, and potential categories of influencing factors and their relationship with illness perception were examined. RESULTS Participants were classified into three potential categories: low self-stigma-low resistance (19.4%), medium self-stigma (55.6%), and high self-stigma-high discrimination (25%). Compared with the low self-stigma-low resistance group, those with higher illness representation and illness understanding scores were more likely to be classified as medium self-stigma, and emotional representation was the strongest predictor for high self-stigma-high discrimination. CONCLUSION Self-stigma among participants was mostly medium to high. Self-stigma of individuals with schizophrenia demonstrates group heterogeneity; therefore, nurses should formulate targeted interventions based on the characteristics of each category to achieve precise interventions and reduce self-stigma. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Gu X, Shen X, Zhou JR, Chu JH, Jiang L. The effects of common-sense model interventions on cancer patients: A systematic review. Medicine (Baltimore) 2024; 103:e37777. [PMID: 38669411 PMCID: PMC11049692 DOI: 10.1097/md.0000000000037777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/12/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND From the time of new diagnosis to treatment, cancer patients experience a variety of health problems that can affect the patient's health outcomes. Individuals with cancer are being given increasing responsibility for the self-management of their health and illness. The self-regulating common-sense model (CSM) is effective in patients' disease management. This article briefly introduces the common-sense model intervention, in which patients with cancer are affected by these interventions, what they are about, and what effects they have. METHODS The authors systematically review evidence for the common-sense model of self-regulation for cancer using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Based on a comprehensive literature search, we searched the Cochrane Library, PsycINFO, Embase, PubMed, Medline, CINAHL, CNKI, and WanFang databases. The included studies underwent a quality assessment using the Effective Public Health Practice Project (EPHPP). RESULTS Eleven empirical studies illustrated the aspects of common-sense model interventions for cancer patients. It is concluded that common-sense model intervention has an effect on symptoms in cancer treatment, behavior, and quality of life, but more studies are needed to verify the use of common-sense model intervention to explore in patients with different cancers. The systematic review summarized a four-point paradigm about intervention content, including assessing the current situation, setting goals, having a disease education and psychological adjustment, and getting feedback for further response. However, the application of intervention requires specific analysis of patient behavior and outcomes. CONCLUSION Common-sense model interventions are beneficial for the self-management of cancer patients; however, more intervention studies are needed to specify the cognitive, emotional, and coping styles of people with a particular cancer.
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Affiliation(s)
- Xue Gu
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xia Shen
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jun-Rui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jiang-Hui Chu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Lei Jiang
- Department of Radiology, Huadong Sanatorium, Wuxi, China
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Ahuvia IL, Schleider JL, Kneeland ET, Moser JS, Schroder HS. Depression self-labeling in U.S. college students: Associations with perceived control and coping strategies. J Affect Disord 2024; 351:202-210. [PMID: 38286232 DOI: 10.1016/j.jad.2024.01.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/20/2024] [Accepted: 01/26/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Research on mental illness labeling has demonstrated that self-labeling (identifying with a mental illness label, e.g., "I have depression") is associated with internalized stigma, maladaptive responses to that stigma, and lower quality of life. However, research has not yet examined the link between self-labeling and how individuals cope with emotional distress. It is important to understand this relationship because adaptive and maladaptive methods of coping can lead to positive and negative mental illness outcomes. METHODS This cross-sectional study examined the link between depression self-labeling, depression symptoms, and three constructs related to depression self-management (perceived control over depression, cognitive emotion regulation strategies, and help-seeking beliefs) in a large (N = 1423) sample of U.S. college students. RESULTS Approximately one-fifth of students (22.2 %) self-labeled as having depression, while 39.0 % were estimated to meet diagnostic criteria for MDD. After controlling for depression symptom severity, self-labeling was associated with lower levels of perceived control over depression (p = .002), more catastrophizing (p = .013), less perspective taking, refocusing, reappraisal, and planning (ps < 0.05), and more positive help-seeking attitudes towards medication (p < .001) but not therapy. LIMITATIONS Results are non-causal and may not generalize to non-college populations. CONCLUSIONS Self-labeling may inform how individuals cope with emotional distress, with the potential for positive and negative effects on clinical outcomes. This is consistent with well-established research on self-labeling with regards to stigma, but extends this research in important new directions.
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Affiliation(s)
| | - Jessica L Schleider
- Northwestern University Feinberg School of Medicine, United States of America
| | | | | | - Hans S Schroder
- University of Michigan Medical School, United States of America
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Ahuvia IL, Sotomayor I, Kwong K, Lam FW, Mirza A, Schleider JL. Causal beliefs about mental illness: A scoping review. Soc Sci Med 2024; 345:116670. [PMID: 38402842 DOI: 10.1016/j.socscimed.2024.116670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/02/2023] [Accepted: 02/07/2024] [Indexed: 02/27/2024]
Abstract
Research on causal beliefs about mental illness-the beliefs people hold about what causes a particular mental illness, or mental illnesses in general-is split across a number of theories and disciplines. Although research on this subject has provided a number of insights and practical applications, the diversity of theories, terminology, and keywords makes it challenging for a new reader to gain a comprehensive understanding. We sought to address this by conducting a systematic scoping review of research on causal beliefs. This review included English-language articles from any year that mentioned causal beliefs for mental illness in their title or abstract. We identified articles in two stages. In the first stage, we used a narrow set of search terms referring specifically to causal beliefs (1227 records identified, 417 included). In the second stage, we used a comprehensive set of terms relevant to research on causal beliefs (10,418 records identified, 3838 included). We analyzed articles qualitatively, organizing them into one of five theories or categories: the common-sense model of self-regulation, explanatory models, mental health literacy, biogenetic causal beliefs, and other research on causal beliefs. We provide a comprehensive summary of these literatures in terms of their history, typical research questions and study design, findings, and practical applications. These theories differ in their theoretical orientation towards causal beliefs, research methods, findings, and applications. However, they broadly share a view of causal beliefs as multifaceted, culturally determined, and relevant for additional psychosocial variables such as mental illness stigma and help-seeking. We conclude by making recommendations for researchers, clinicians, public health messaging, and for individuals with mental illness.
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Affiliation(s)
- Isaac L Ahuvia
- Stony Brook University, Department of Psychology Stony Brook University, Stony Brook, NY, 11794-2500, USA.
| | - Ian Sotomayor
- Stony Brook University, Department of Psychology Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Kelly Kwong
- Stony Brook University, Department of Psychology Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Fiona W Lam
- Stony Brook University, Department of Psychology Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Aqsa Mirza
- New York University Steinhardt School of Culture, Education, and Human Development 246 Greene St. New York, NY 10003, USA
| | - Jessica L Schleider
- Northwestern University Feinberg School of Medicine Department of Medical Social Sciences, 625 N. Michigan Ave., 21st Floor, Chicago, IL, 60611, USA
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Grégoire C, Baussard L, Ernst M, Diep A, Faymonville ME, Devos M, Jerusalem G, Vanhaudenhuyse A. Evaluation of a psychoneurological symptom cluster in patients with breast or digestive cancer: a longitudinal observational study. BMC Cancer 2024; 24:51. [PMID: 38195471 PMCID: PMC10777491 DOI: 10.1186/s12885-023-11799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND A psychoneurological symptom cluster composed of cancer-related fatigue, emotional distress, sleep difficulties, and pain is very common among patients with cancer. Cognitive difficulties are also frequently associated with this cluster. Network analyses allow for an in-depth understanding of the relationships between symptoms in a cluster. This paper details the study protocol of a longitudinal assessment of the psychoneurological symptom cluster in two distinct cohorts: breast cancer and digestive cancer survivors, using network analyses. METHODS Over two years, the symptoms involved in the psychoneurological symptom cluster, along with other common symptoms (e.g., digestive symptoms, financial difficulties) and variables (i.e., self-compassion, coping strategies) will be assessed in two cohorts: breast cancer survivors (N = 240) and digestive cancer survivors (N = 240). Online questionnaires will be completed at baseline, then 6, 12 and 24 months later. Network analyses will be used to assess the configuration of the symptom cluster at each measurement time and in each cohort. Comparison of networks between two measurement times or between the two cohorts will also be done with network comparison tests. DISCUSSION This study will enable a better understanding of the relationships between common symptoms endured by patients with cancer. The results will be employed to develop more cost-effective interventions which, ultimately, will significantly improve the quality of life of patients with breast or digestive cancer. TRIAL REGISTRATION ClinicalTrials.gov (NCT05867966). Registered on the 27th of April 2023. url: https://classic. CLINICALTRIALS gov/ct2/show/NCT05867966 .
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Affiliation(s)
- Charlotte Grégoire
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital, 1, 4000, Liège, Belgium.
| | | | - Marie Ernst
- Biostatistics and Research Method Center, University Hospital and University of Liège, Liège, Belgium
| | - Anh Diep
- Biostatistics and Research Method Center, University Hospital and University of Liège, Liège, Belgium
| | - Marie-Elisabeth Faymonville
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital, 1, 4000, Liège, Belgium
- Arsène Burny Cancerology Institute, University Hospital of Liège, Liège, Belgium
| | - Martine Devos
- Arsène Burny Cancerology Institute, University Hospital of Liège, Liège, Belgium
| | - Guy Jerusalem
- Medical Oncology Department, University Hospital and University of Liège, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital, 1, 4000, Liège, Belgium
- Algology Interdisciplinary Center, University Hospital of Liège, Liège, Belgium
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Ahuvia IL, Fox KR, Schleider JL. Adolescents' beliefs about what symptoms constitute depression: Are more expansive definitions helpful or harmful? SSM - MENTAL HEALTH 2023; 4:100259. [PMID: 38188868 PMCID: PMC10768966 DOI: 10.1016/j.ssmmh.2023.100259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Purpose What symptoms do people think constitute "depression"? In a mental health literacy framework, knowing more of depression's nine core symptoms (per formal psychiatric diagnostic criteria) is thought to help people identify and seek help for depression. However, the common-sense model of self-regulation suggests that more expansive beliefs about what symptoms constitute an illness may be maladaptive, whereby viewing more symptoms as characterizing a disorder predicts greater functional impairment. Methods We collected data from N = 281 U.S. adolescents experiencing elevated depression symptoms, recruited via social media. Symptom beliefs were assessed descriptively and with a latent profile analysis to test associations with other variables. Results Adolescents' beliefs about what symptoms constitute depression varied widely, and only 49% endorsed all DSM-5 depression symptoms as characterizing the disorder. Adolescents who identified more symptoms as belonging to depression had more severe depression symptoms (p = .004), reported more hopelessness (p = .021), and were more pessimistic about the permanence of depression (p = .007); they were also more likely to rate medication as potentially helpful (p = .001). Conclusion These findings simultaneously support and challenge elements of both the common-sense model and the mental health literacy framework. Future research on mental health literacy may examine why adolescents with more psychiatrically-accurate understandings of depression experience worse clinical outcomes. Likewise, future research on the common sense model should explore whether more expansive depression symptom beliefs may be adaptive as well as maladaptive.
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Okyere Asante PG, Tuck CZ, Atobrah D. Medical pluralism, healthcare utilization and patient wellbeing: The case of Akan cancer patients in Ghana. Int J Qual Stud Health Well-being 2023; 18:2238994. [PMID: 37490583 PMCID: PMC10392249 DOI: 10.1080/17482631.2023.2238994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 07/17/2023] [Indexed: 07/27/2023] Open
Abstract
PURPOSE As cancers increase in Ghana and in many low-and middle-income countries, healthcare utilization has become critical for disease management and patients' wellbeing. There is evidence that medical pluralism is common among cancer patients in Ghana and many other African countries, which results in lack of adherence to and absconding from hospital treatments. The objective of this study was to examine ways in which beliefs in disease causation influence medical pluralism among Akan cancer patients in Ghana. METHODS A qualitative research approach was employed in this study. In-depth interviews were conducted for thirty (30) cancer patients who were purposively recruited from Komfo Anokye Teaching Hospital in Ghana. Thematic content analysis was used in analysing data. RESULTS Our findings revealed that cancer patients ascribed both physical and spiritual causality to their illness. As such, they combined orthodox treatment with spiritual healing and herbal medicine. Regarding the order of therapeutic search, patients reported to herbal and spiritual centres before going to the hospital, a phenomenon which contributes to the late reporting and diagnosis as well as bad prognosis of cancers in Ghana. CONCLUSION The findings of this research elucidate the relationship between culture and health care choices of cancer patients in Ghana. Increased awareness creation is crucial in eradicating myths surrounding cancers in Ghana.
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Affiliation(s)
| | - Chloe Z Tuck
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Deborah Atobrah
- Institute of African Studies, University of Ghana, Legon, Accra, Ghana
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12
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McLaren T, Peter LJ, Tomczyk S, Muehlan H, Schomerus G, Schmidt S. The Seeking Mental Health Care model: prediction of help-seeking for depressive symptoms by stigma and mental illness representations. BMC Public Health 2023; 23:69. [PMID: 36627597 PMCID: PMC9831378 DOI: 10.1186/s12889-022-14937-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Only about half the people with depression seek professional health care services. To constitute the different predictors and associating variables of health care utilisation, we model the process and aim to test our hypothesised Seeking Mental Health Care Model. The model includes empirical influences on the help-seeking process to predict actual behaviour and incorporates superordinate (stigma, treatment experiences) as well as intermediate attitudinal variables (continuum and causal beliefs, depression literacy and self-efficacy). METHOD All variables are examined in an online study (baseline, three- and six-month follow-up). The sample consisted of adults with depressive symptoms (PHQ-9 sum score ≥ 8), currently not receiving mental health care treatment. To examine the prediction of variables explaining help-seeking behaviour, a path model analysis was carried out (lavaan package, software R). RESULTS Altogether, 1368 participants (Mage = 42.38, SDage = 15.22, 65.6% female) were included, 983 participating in at least one follow-up. Model fit was excellent (i.e., RMSEA = 0.059, CFI = 0.989), and the model confirmed most of the hypothesised predictions. Intermediary variables were significantly associated with stigma and experiences. Depression literacy (ß = .28), continuum beliefs (ß = .11) and openness to a balanced biopsychosocial causal model (ß = .21) significantly influenced self-identification (R2 = .35), which among the causal beliefs and self-efficacy influenced help-seeking intention (R2 = .10). Intention (ß = .40) prospectively predicted help-seeking behaviour (R2 = .16). CONCLUSION The Seeking Mental Health Care Model provides an empirically validated conceptualisation of the help-seeking process of people with untreated depressive symptoms as a comprehensive approach considering internal influences. Implications and open questions are discussed, e.g., regarding differentiated assessment of self-efficacy, usefulness of continuum beliefs and causal beliefs in anti-stigma work, and replication of the model for other mental illnesses. TRIAL REGISTRATION German Clinical Trials Register: DRKS00023557. Registered 11 December 2020. World Health Organization, Universal Trial Number: U1111-1264-9954. Registered 16 February 2021.
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Affiliation(s)
- Thomas McLaren
- Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489, Greifswald, Germany.
| | - Lina-Jolien Peter
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany.
| | - Samuel Tomczyk
- Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489, Greifswald, Germany
| | - Holger Muehlan
- Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489, Greifswald, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr. 10, 04103, Leipzig, Germany
| | - Silke Schmidt
- Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489, Greifswald, Germany
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Glattacker M, Rudolph M, Bengel J, von der Warth R. Illness Beliefs, Treatment Beliefs, and Fulfilled Treatment Expectations in Psychosomatic Rehabilitation: Associations with Patient Satisfaction. Patient Prefer Adherence 2022; 16:3303-3317. [PMID: 36545541 PMCID: PMC9762405 DOI: 10.2147/ppa.s390596] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose Patients' illness and treatment beliefs have been shown to predict health outcomes in many health care settings. However, information about their impact on patient satisfaction is scarce. The aim of this study was to investigate illness- and rehabilitation-related treatment beliefs and met rehabilitation-related treatment expectations and their relationship with patient satisfaction in psychosomatic rehabilitation. Methods In a repeated measures study design, patients filled out questionnaires 2 to 3 weeks before the start of rehabilitation and at the end of an inpatient rehabilitation 6 to 7 weeks later. The predictive value of illness beliefs, treatment beliefs, and fulfilled treatment expectations regarding patient satisfaction was analyzed with multiple hierarchical regression analyses controlling for sociodemographic and clinical variables. Results Two hundred sixty-four patients participated. The sample was composed of equal numbers of men and women (n = 129 each). The mean age was 50.4 years. Most patients had diagnoses from the ICD-10 diagnostic group F3 (affective disorders; n = 145) or F4 (neurotic, stress-related and somatoform disorders; n = 94). Sociodemographic and clinical variables were not associated with patient satisfaction. The explained variance of patient satisfaction increased to 10% by adding illness beliefs (namely personal control and coherence) (p = 0.006), to 5% by adding rehabilitation-related treatment beliefs (namely concerns) (p = 0.063), and to 49% by adding fulfilled expectations (namely a positive discrepancy between expectations and experiences related to outcome expectations and related to participation and treatment structure, and a negative discrepancy between expectations and experiences related to concerns) (p < 0.001) as predictor variables. Conclusion This study highlights the relationship of fulfilled (rehabilitation-related) treatment expectations with patient satisfaction in psychosomatic rehabilitation. Given the evidence underlining the importance of patients' illness and treatment beliefs and expectations, it is vital that these constructs are addressed in corresponding interventions.
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Affiliation(s)
- Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthias Rudolph
- Deutsche Rentenversicherung Rheinland-Pfalz (German Statutory Pension Insurance Rhineland Palatinate); Mittelrhein-Klinik (Clinic for Psychosomatic Rehabilitation), Boppard-Bad Salzig, Germany
| | - Jürgen Bengel
- Section of Rehabilitation Psychology and Psychotherapy; Department of Psychology; University of Freiburg, Freiburg, Germany
| | - Rieka von der Warth
- Section of Health Care Research and Rehabilitation Research, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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