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Interian A, Mann SL, Mavandadi S, St Hill LM, Kashan R, Rodriguez KM, Dobkin RD. Criticism in the Parkinson's Caregiving Relationship: A Key Target for Intervention. J Geriatr Psychiatry Neurol 2022; 35:671-679. [PMID: 34607483 PMCID: PMC11070948 DOI: 10.1177/08919887211049119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Caregiver distress is prevalent in Parkinson's disease (PD) and predictive of negative health outcomes for both people with PD and caregivers. To identify future intervention targets, it is important to better elucidate the specific processes, such as criticism, that perpetuate burden. OBJECTIVE Evaluate the frequency and impact of criticism and reactivity to criticism in PD caregiving dyads. METHODS Eighty-three people with PD and their caregivers independently completed measures of criticism and physical and emotional health. RESULTS Criticism in the caregiving relationship was reported by 71.1% (n = 59) of people with PD and 80.7% (n = 67) of caregivers. Both perceived criticism and emotional reactivity to criticism were significant predictors of caregiver distress, adjusting for PD motor and non-motor symptom severity. In contrast, criticism was not related to PD depression. CONCLUSION Criticism in the PD caregiving relationship is a clear target for psychotherapeutic intervention and may improve caregiver health and quality of life.
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Affiliation(s)
| | | | | | | | - Rachel Kashan
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA. Mann is now with Bellevue Hospital, New York, NY, USA
| | | | - Roseanne D Dobkin
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA. Mann is now with Bellevue Hospital, New York, NY, USA
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Coutinho J, Oliveira-Silva P, Fernandes E, Gonçalves OF, Correia D, Perrone Mc-Govern K, Tschacher W. Psychophysiological Synchrony During Verbal Interaction in Romantic Relationships. FAMILY PROCESS 2019; 58:716-733. [PMID: 29888517 DOI: 10.1111/famp.12371] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Previous studies about romantic relationships have shown that the reciprocal influence between partners occurs not only at the behavioral and socio-emotional levels, but also at the psychophysiological level. This reciprocal influence is expressed in a pattern of physiological synchrony between partners (i.e., coordinated dynamics of the physiological time series). The main aim of the present study was to explore the presence of a pattern of physiological synchrony in electrodermal activity (EDA) during a couple interaction task. A second objective was to compare the synchrony levels during a negative interaction condition versus a positive interaction condition. Finally, we analyzed the association between synchrony and self-perception of empathy, dyadic empathy, and relationship satisfaction. Thirty-two couples (64 individuals) participated in this study. Each couple performed a structured interaction task while the EDA of both partners was being registered. The quantification of synchrony was based on the cross-correlation of both members' EDA time-series. In order to control for coincidental synchrony, surrogate datasets were created by repeatedly shuffling the original data of spouses X and Y of a dyad and computing synchronies on the basis of the shuffled data (pseudosynchrony values). Our results confirmed the presence of significant EDA synchrony during the interaction. We also found that synchrony was higher during the negative interactions relative to the positive interactions. Additionally, physiological synchrony during positive interaction was higher for those couples in which males scored higher in dyadic empathy. The clinical implications of these findings are discussed.
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Affiliation(s)
- Joana Coutinho
- Psychological Neuroscience Laboratory, School of Psychology, University of Minho, Braga, Portugal
| | | | - Eugénia Fernandes
- Psychological Neuroscience Laboratory, School of Psychology, University of Minho, Braga, Portugal
| | - Oscar F Gonçalves
- Psychological Neuroscience Laboratory, School of Psychology, University of Minho, Braga, Portugal
| | - Diogo Correia
- Psychological Neuroscience Laboratory, School of Psychology, University of Minho, Braga, Portugal
| | | | - Wolfgang Tschacher
- Experimental Psychology Unit, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
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Perepezko K, Hinkle JT, Shepard MD, Fischer N, Broen MP, Leentjens AFG, Gallo J, Pontone GM. Social role functioning in Parkinson's disease: A mixed-methods systematic review. Int J Geriatr Psychiatry 2019; 34:1128-1138. [PMID: 31069845 PMCID: PMC6949188 DOI: 10.1002/gps.5137] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 04/19/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Parkinson's disease (PD) is a progressive neurodegenerative disease that often impedes activities of daily living (ADL) and social functioning. Impairment in these areas can alter social roles by interfering with employment status, household management, friendships, and other relationships. Understanding how PD affects social functioning can help clinicians choose management strategies that mitigate these changes. METHODS We conducted a mixed-methods systematic review of existing literature on social roles and social functioning in PD. A tailored search strategy in five databases identified 51 full-text reports that fulfilled the inclusion criteria and passed the quality appraisal. We aggregated and analyzed the results from these studies and then created a narrative summary. RESULTS Our review demonstrates how PD causes many people to withdraw from their accustomed social roles and experience deficits in corresponding activities. We describe how PD symptoms (eg, tremor, facial masking, and neuropsychiatric symptoms) interfere with relationships (eg, couple, friends, and family) and precipitate earlier departure from the workforce. Additionally, several studies demonstrated that conventional PD therapy has little positive effect on social role functioning. CONCLUSIONS Our report presents critical insight into how PD affects social functioning and gives direction to future studies and interventions (eg, couple counseling and recreational activities).
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Affiliation(s)
- Kate Perepezko
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jared T. Hinkle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Medical Scientist Training Program, Baltimore, MD, USA
| | - Melissa D. Shepard
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicole Fischer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Martinus P.G. Broen
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Albert F. G. Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Joe Gallo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gregory M. Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Esménio S, Soares JM, Oliveira-Silva P, Gonçalves ÓF, Decety J, Coutinho J. Brain circuits involved in understanding our own and other's internal states in the context of romantic relationships. Soc Neurosci 2019; 14:729-738. [PMID: 30806571 DOI: 10.1080/17470919.2019.1586758] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Social interactions require the capacity to understand both our and other's internal states. These semi-independent skills, the ability to understand oneself and others, seem to rely on the same type of representations and recruit similar brain areas. In this study, we looked at the neural basis of self and other processing in the context of an interaction with a significant other. Fourty-two participants in a monogamous relationship completed an fMRI task in which they watched a set of video-vignettes of his/her romantic partner expressing emotional contents. Participants were asked to elaborate on his/her spouse´s experience (other condition) and on his/her own experience when watching the video-vignettes (self-condition). The results showed a significant overlap in the brain activation for both conditions (e.g. anterior insula, posterior cingulate/precuneus, inferior frontal gyrus, inferior parietal lobule). In addition, the self-condition recruited brain areas associated with interoceptive processing and affect sharing (e.g., posterior insula), whereas the other-condition engaged brain areas involved in the cognitive representation of another's internal states and self-other distinction (e.g., fusiform, supramarginal gyrus, angular gyrus and temporoparietal junction).
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Affiliation(s)
- Sofia Esménio
- Psychological Neuroscience Laboratory, Psychology School, Minho University , Braga , Portugal
| | - José Miguel Soares
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho , Braga , Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal, Clinical Academic Center , Braga , Portugal
| | - P Oliveira-Silva
- Faculty of Education and Psychology, Catholic University of Portugal , Porto , Portugal
| | - Óscar F Gonçalves
- Psychological Neuroscience Laboratory, Psychology School, Minho University , Braga , Portugal.,Spaulding Center for Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School , Boston , MA , USA
| | - Jean Decety
- Department of Psychology, University of Chicago , Chicago , IL , USA
| | - Joana Coutinho
- Psychological Neuroscience Laboratory, Psychology School, Minho University , Braga , Portugal
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Daneault JF, Duval C, Barbat-Artigas S, Aubertin-Leheudre M, Jodoin N, Panisset M, Sadikot AF. Subthalamic stimulation improves motor function but not home and neighborhood mobility. Mov Disord 2014; 29:1816-9. [PMID: 24849309 DOI: 10.1002/mds.25911] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 04/03/2014] [Accepted: 04/08/2014] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Subthalamic (STN) deep brain stimulation (DBS) is a recognized therapy for alleviating motor symptoms of Parkinson's disease (PD). However, little is known about its impact on mobility, an important component of quality of life (QoL). To address this issue, we assessed the impact of STN DBS on life-space mobility and QoL. METHODS Twenty surgical patients with PD were assessed using mobility and QoL scales and the United Parkinson's disease rating scale, and results were compared before surgery and 6 to 9 months postoperatively. RESULTS STN DBS significantly improved motor dysfunction but had a limited impact on measures of life-space mobility and QoL. INTERPRETATION STN DBS improves motor function and some components of QoL. However, motor recovery does not translate into improved life-space in the intermediate term. In addition to a focus on motor function, multidisciplinary attention to increasing mobility may further improve QoL in the intermediate and long-term.
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Affiliation(s)
- Jean-François Daneault
- Cone Laboratory for Research in Neurosurgery, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
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Is elevated norepinephrine an etiological factor in some cases of Parkinson’s disease? Med Hypotheses 2014; 82:462-9. [DOI: 10.1016/j.mehy.2014.01.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 01/12/2014] [Accepted: 01/22/2014] [Indexed: 11/19/2022]
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Robles TF, Slatcher RB, Trombello JM, McGinn MM. Marital quality and health: a meta-analytic review. Psychol Bull 2014; 140:140-187. [PMID: 23527470 PMCID: PMC3872512 DOI: 10.1037/a0031859] [Citation(s) in RCA: 633] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This meta-analysis reviewed 126 published empirical articles over the past 50 years describing associations between marital relationship quality and physical health in more than 72,000 individuals. Health outcomes included clinical endpoints (objective assessments of function, disease severity, and mortality; subjective health assessments) and surrogate endpoints (biological markers that substitute for clinical endpoints, such as blood pressure). Biological mediators included cardiovascular reactivity and hypothalamic-pituitary-adrenal axis activity. Greater marital quality was related to better health, with mean effect sizes from r = .07 to .21, including lower risk of mortality (r = .11) and lower cardiovascular reactivity during marital conflict (r = -.13), but not daily cortisol slopes or cortisol reactivity during conflict. The small effect sizes were similar in magnitude to previously found associations between health behaviors (e.g., diet) and health outcomes. Effect sizes for a small subset of clinical outcomes were susceptible to publication bias. In some studies, effect sizes remained significant after accounting for confounds such as age and socioeconomic status. Studies with a higher proportion of women in the sample demonstrated larger effect sizes, but we found little evidence for gender differences in studies that explicitly tested gender moderation, with the exception of surrogate endpoint studies. Our conclusions are limited by small numbers of studies for specific health outcomes, unexplained heterogeneity, and designs that limit causal inferences. These findings highlight the need to explicitly test affective, health behavior, and biological mechanisms in future research, and focus on moderating factors that may alter the relationship between marital quality and health.
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Affiliation(s)
| | | | | | - Meghan M McGinn
- Mental Illness Research, Education, and Clinical Care, Veterans Affairs Puget Sound Healthcare System
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Daneault JF, Carignan B, Sadikot AF, Panisset M, Duval C. Drug-induced dyskinesia in Parkinson's disease. Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia? BMC Med 2013; 11:76. [PMID: 23514355 PMCID: PMC3751666 DOI: 10.1186/1741-7015-11-76] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 03/20/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dyskinesia, a major complication in the treatment of Parkinson's disease (PD), can require prolonged monitoring and complex medical management. DISCUSSION The current paper proposes a new way to view the management of dyskinesia in an integrated fashion. We suggest that dyskinesia be considered as a factor in a signal-to-noise ratio (SNR) equation where the signal is the voluntary movement and the noise is PD symptomatology, including dyskinesia. The goal of clinicians should be to ensure a high SNR in order to maintain or enhance the motor repertoire of patients. To understand why such an approach would be beneficial, we first review mechanisms of dyskinesia, as well as their impact on the quality of life of patients and on the health-care system. Theoretical and practical bases for the SNR approach are then discussed. SUMMARY Clinicians should not only consider the level of motor symptomatology when assessing the efficacy of their treatment strategy, but also breadth of the motor repertoire available to patients.
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Affiliation(s)
- Jean-François Daneault
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada
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How parkinsonism influences life: the patients’ point of view. Neurol Sci 2010; 32:125-31. [DOI: 10.1007/s10072-010-0435-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Accepted: 09/22/2010] [Indexed: 10/18/2022]
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Dobkin RD, Menza M, Bienfait KL. CBT for the treatment of depression in Parkinson's disease: a promising nonpharmacological approach. Expert Rev Neurother 2008; 8:27-35. [PMID: 18088199 DOI: 10.1586/14737175.8.1.27] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Depression is very common in Parkinson's disease (PD) and linked with a faster progression of physical symptoms, greater cognitive decline and poorer quality of life. Nonpharmacological approaches, such as cognitive-behavioral therapy (CBT), for the treatment of depression in PD (dPD) have received little experimental attention despite strong demonstrated efficacy in other geriatric and medical populations. Depressed PD patients often differ from the depressed non-PD elderly in that they present with increased rates of both executive dysfunction and comorbid psychiatric diagnoses, may differ in their depressive symptom presentation and typically have caregivers who are highly involved in their treatment. Therefore, it is not possible to conclude that empirically validated treatments in the depressed aged will generalize to those with PD. In order to be most effective for PD patients, CBT should be tailored to their unique needs. Additional controlled research is needed to further explore the efficacy of CBT for dPD.
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Affiliation(s)
- Roseanne DeFronzo Dobkin
- Department of Psychiatry, UMDNJ/Robert Wood Johnson Medical School, 675 Hoes Lane, Room D-317, Piscataway, NJ 08854, USA.
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Stiell K, Naaman SC, Lee A. Couples and Chronic Illness: An Attachment Perspective and Emotionally Focused Therapy Interventions. ACTA ACUST UNITED AC 2007. [DOI: 10.1521/jsyt.2007.26.4.59] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hodgson JH, Garcia K, Tyndall L. Parkinson's disease and the couple relationship: A qualitative analysis. ACTA ACUST UNITED AC 2004. [DOI: 10.1037/1091-7527.22.1.101] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kowal J, Johnson SM, Lee A. Chronic illness in couples: a case for emotionally focused therapy. JOURNAL OF MARITAL AND FAMILY THERAPY 2003; 29:299-310. [PMID: 12870405 DOI: 10.1111/j.1752-0606.2003.tb01208.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The onset of chronic illness is one of the most pervasive health problems facing North Americans today. Only recently have researchers and clinicians seriously examined chronic physical conditions in the context of close relationships. This article briefly reviews the literature on chronic illness in adult couples. Initially, the focus is on the reciprocal link between close relationships and chronic physical conditions. A number of clinical approaches for working with chronic illness in couples are outlined, a particular case is made for the utility of emotionally focused therapy, and a case study is presented.
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Affiliation(s)
- John Kowal
- School of Psychology, University of Ottawa, P.O. Box 450, Stn. A., K1N 6N5, Ottawa, Ontario, Canada.
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Abstract
This review focuses on the pathway leading from the marital relationship to physical health. Evidence from 64 articles published in the past decade, particularly marital interaction studies, suggests that marital functioning is consequential for health; negative dimensions of marital functioning have indirect influences on health outcomes through depression and health habits, and direct influences on cardiovascular, endocrine, immune, neurosensory, and other physiological mechanisms. Moreover, individual difference variables such as trait hostility augment the impact of marital processes on biological systems. Emerging themes in the past decade include the importance of differentiating positive and negative dimensions of marital functioning, the explanatory power of behavioral data, and gender differences in the pathways from the marital relationship to physiological functioning. Contemporary models of gender that emphasize self-processes, traits, and roles furnish alternative perspectives on the differential costs and benefits of marriage for men's and women's health.
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Affiliation(s)
- J K Kiecolt-Glaser
- Department of Psychiatry, Ohio State University College of Medicine, 1670 Upham Drive, Columbus, Ohio 43210, USA.
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Abstract
Forty patients with Parkinson's disease (PD) were studied to explore the relationship between aspects of psychological functioning (depression, problems in motoric, cognitive and psychological areas) and physical illness (stage and duration of illness, functional disability, global cognitive status). Depression, motoric, psychological and cognitive problems were found to be significantly greater in patients suffering from severe as compared to moderate disease. Functional disability correlated more strongly with variables assessing psychological functioning. It was concluded that problems of patients with PD were not restricted to the motoric domain but are multi-dimensional in nature, and other factors should be taken into account in the clinical management of the illness. These findings have implications for development of interventions for patients with PD.
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