Christel Salewski

Quality of life among parents of children with phenylketonuria (PKU)

BackgroundParents of children with chronic conditions are known to be at risk of impairment in their quality of life (QoL). Studies considering other chronic conditions proposed diverse factors to have an impact on the parent’s QoL. So far, there has been little research on parents who have a child with phenylketonuria (PKU). This study was designed to evaluate the parental quality of life (PQoL) of parents of children and adolescents who have PKU and identify possible predictors of PQoL.MethodsIn this cross-sectional study 89 parents completed self-report measures of PQoL, family stress, social support, and parental coping. To determine the impact of these potential predictors on PQoL, regression and mediation analyses were performed.ResultsMost parents coped well with their children’s metabolic disorder. Family stress (β = −0.42; p < 0.001) and perceived social support (β = 0.33; p = 0.001) were proven to be the most powerful predictors, accounting together for 45% of the variance of PQoL. Social support mediated the association between family stress and PQoL.ConclusionsThe current study indicates that parents of younger children are an especially vulnerable group. Members of health-care teams should be able to identify and empower vulnerable parents to seek and maintain social support.

Illness Representations in Families with a Chronically Ill Adolescent: Differences between Family Members and Impact on Patients’ Outcome Variables

The impact of parents’ illness representations on well-being and illness-related strain of adolescents suffering from a chronic skin disease was examined. Because family characteristics have proved to be important for coping, adolescents’ perceived family cohesion was also assessed. Five categories of illness representations (causes, control, timeline, curability, and effective treatments) were assessed from 30 adolescents and their parents. Comparisons revealed differences between family members’ illness representations. Perceived family cohesion was a good predictor of adolescents’ wellbeing and strain, whereas parents’ illness representations had only little impact. In families with high similarity between the parents’ illness representations, the adolescents reported more well-being. Results are discussed with regard to developmental characteristics of adolescence, nature of outcome variables and methodological problems.

Illness representations as mediators of the relationship between dispositional optimism and depression in patients with chronic tinnitus: A cross-sectional study

Objective: Both dispositional optimism and illness representations are related to psychological health in chronic patients. In a group of chronic tinnitus sufferers, the interplay between these two variables was examined. Specifically, it was tested to what extent the relationship between dispositional optimism and depression is mediated by more positive illness representations. Method: The study had a cross-sectional design. One hundred and eighteen patients diagnosed with chronic tinnitus completed questionnaires assessing optimism (Life Orientation Test-Revised [LOT-R]), illness representations (Illness Perceptions Questionnaire-Revised [IPQ-R]) and depression (Hospital Anxiety and Depression Scale [HADS]). Results: Correlation analysis showed that optimism was associated with more positive illness representations and lower levels of depression. Simple mediation analyses revealed that the relationship between optimism and depression was partially mediated by the illness representation dimensions consequences, treatment control, coherence, emotional representations and internal causes. A multiple mediation analysis indicated that the total mediation effect of illness representations is particularly due to the dimension consequences. Conclusion: Optimism influences depression in tinnitus patients both directly and indirectly. The indirect effect indicates that optimism is associated with more positive tinnitus-specific illness representations which, in turn, are related to less depression. These findings contribute to a better understanding of the interplay between generalised expectancies, illness-specific perceptions and psychological adjustment to medical conditions.

Gender differences in eating behavior and eating pathology: The mediating role of rumination

OBJECTIVE Rumination is a maladaptive emotion regulation strategy which contributes to psychopathology and is more frequently used by women than men. It has been found to mediate the relationship between gender and the occurrence of anxiety disorders or depression. Since gender differences also appear in dysfunctional eating, the aim of the study is to test, whether rumination mediates the association between gender and several facets of eating pathology. METHOD A total of 295 participants (205 women) completed an online-questionnaire including the assessment of different facets of dysfunctional eating and rumination. Mediation analyses were conducted with PROCESS. RESULTS Women reported significantly higher levels in both, rumination and eating pathology. Moreover, rumination mediated the relationship between gender and all assessed aspects of dysfunctional eating. DISCUSSION The present study extends findings on the mediating role of rumination accounting for gender differences in psychopathology to eating pathology in a community sample. Results suggest that cognitive factors play a substantial role in explaining gender differences in eating pathology which tend to be reduced to biologicals factors and beauty ideals.

Subjektive Krankheitstheorien und Krankheitsverarbeitung bei neurodermitiskranken Jugendlichen

Zusammenfassung. Die subjektiven Krankheitstheorien von Jugendlichen mit Neurodermitis wurden hinsichtlich ihrer interindividuellere Ahnlichkeiten, ihrer Zusammenhange mit Strategien der Krankheitsbewaltigung und mit neurodermitis-spezifischen und globalen Masen der Anpassung sowie hinsichtlich der Altersabhangigkeit der Ausgestaltung der Krankheitstheorien untersucht. Insgesamt wurden 55 Jugendliche mit Neurodermitis zu acht Bereichen ihrer subjektiven Krankheitstheorien befragt: Annahmen uber Symptome, Verlauf, Ursachen, Konsequenzen, Behandlungsmoglichkeiten, Kontrollmoglichkeiten, Heilbarkeit sowie Sinn der Erkrankung. Durch clusteranalytische Verfahren liesen sich zwei Untergruppen identifizieren, die sich in funf dieser Bereiche unterschieden. Die beiden Gruppen zeigten daruber hinaus deutliche Unterschiede in der Krankheitsverarbeitung, der neurodermitisbezogenen Anpassung und dem Wohlbefinden. Beide Cluster unterschieden sich auserdem im Alter, aber nicht in anderen soziodemographischen Variablen ...

Improving attitudes toward e-mental health services in the general population via psychoeducational information material: A randomized controlled trial

Introduction In recent years, effective Internet-delivered electronic (e-) mental health services have been developed to overcome the limited resources in face-to-face health care. For the successful dissemination of e-mental health services, individual predictors for their uptake and utilization need to be explored. For instance, little is known about the role of different information sources in attitudes toward Internet therapies. On the basis of technology acceptance framework, this pilot study aimed to identify differences in both attitudes and intentions to use e-mental health treatment services after providing psychoeducational information. Methods 439 participants (mean age 33 years, SD = 10.6 years; 72% female) were randomly assigned to one of three text-based information groups (neutral text: n = 111; expert evaluation: n = 108; user evaluation: n = 112) or a control condition (no information: n = 108). We assessed attitudes toward e-mental health treatments using a 15-item German e-therapy attitudes measure. Results Descriptive analyses revealed overall neutral attitudes toward Internet therapies. Ambivalent perceptions were found in terms of Perceived Usefulness (positive attitude) and Relative Advantage (negative attitude). The awareness of Internet therapies was rather low. Most participants evaluated self-help books, health websites and face-to-face counselling as more useful than web-based counselling and therapies and reported higher intentions to use conventional services in case of emotional problems. As hypothesized, variance analyses demonstrated that text-based information, especially expert evaluations, were associated with significantly more positive attitudes toward e-mental health treatment services compared to the control condition. Conclusions Taken together, this pilot study suggested a positive connection between the provision of general facts about e-mental health treatment services and attitudes as well as behavioral intentions to future use such services. However, a limitation was the omission of baseline attitudes assessment. Thus, further research is needed to gain deeper insights into the impact of information on attitudes.

Chronische Krankheit als Stigma: Das Beispiel HIV/AIDS

An einer chronischen Krankheit zu leiden, kann fur die Betroffenen eine Vielzahl von negativen Konsequenzen mit sich bringen. Je nach Art der Erkrankung konnen die Symptome das korperliche Wohlbefinden und die individuelle Leistungsfahigkeit massiv beeintrachtigen (Helgeson & Reynolds, 2002). Haufig ist der Verlauf chronischer Erkrankungen nicht zu prognostizieren, was bei den Betroffenen Zukunftsangste und das Gefuhl von Hilflosigkeit und Kontrollverlust hervorrufen kann (Felton & Revenson, 1984; Taylor & Aspinwall, 1996). Schwerwiegende chronische Erkrankungen fordern zudem eine Auseinandersetzung mit der Perspektive, eigene Lebensziele nicht mehr erreichen zu konnen und moglicherweise fruher als erwartet zu sterben. Fur viele Betroffene stellt die therapeutische Behandlung ihrer Erkrankung auch eine erhebliche finanzielle Belastung dar, sei es weil kein ausreichender Krankenversicherungsschutz besteht, sei es weil die Versicherung alternative therapeutische Behandlungen oder Hilfsmittel nicht finanziert, von denen sich die Betroffenen Linderung oder Heilung versprechen.

Internet-Based Mindfulness-Based Cognitive Therapy for the Adjunctive Treatment of Major Depressive Disorder

Major depressive disorder (MDD) is among the most prevalent mental health problems and, due to its tendency to recurrence, a leading cause for chronic illness and disability worldwide. Mindfulness-based cognitive therapy (MBCT) has been developed as an 8-week face-to-face group program for the relapse prevention of MDD. Over the past three decades, MBCT was shown to be effective in the prevention and treatment of depression. However, participant engagement and commitment to regular mindfulness practice are obstacles for adherence to MBCT and its longer-term efficacy. Hence, there is a need to provide MBCT more conveniently, making it easier for patients implementing mindfulness practice into daily life. Internet-based delivery modes for MBCT provide benefits over traditional group formats. Due to the novelty of Internet-based MBCT, its efficacy and underlying mechanisms of change need to be clarified. To derive evidence-based recommendations for practice and research, this chapter aims to review the literature on the efficacy of different MBCT formats.

Coping mediates the influence of personality on life satisfaction in patients with rheumatic diseases

A rheumatic disease can severely impair a person’s quality of life. The degree of impairment, however, is not closely related to objective indicators of disease severity. This study investigated the influence and the interplay of core psychological factors, i.e., personality and coping, on life satisfaction in patients with rheumatic diseases. Particularly, it was tested whether coping mediates the effects of personality on life satisfaction. In a cross-sectional design, 158 patients diagnosed with a rheumatic disease completed questionnaires assessing the Big 5 personality traits (BFI-10), several disease-related coping strategies (EFK) and life satisfaction (HSWBS). Data were analyzed using a complex multiple mediation analysis with the Big 5 personality traits as predictors, coping strategies as mediators and life satisfaction as outcome. All personality traits and seven of the nine coping strategies were associated with life satisfaction (rs > |0.16|, ps ≤ 0.05). The mediation analysis revealed that personality traits had no direct, but rather indirect effects on life satisfaction through coping. Neuroticism had a negative indirect effect on life satisfaction through less active problem solving and more depressive coping (indirect effects > −0.03, ps < 0.05). Extraversion, agreeableness, and conscientiousness had positive indirect effects on life satisfaction through more active problem solving, less depressive coping and/or a more active search for social support (indirect effects > 0.06, ps < 0.05). Personality and coping play a role in adjustment to rheumatic diseases. The interplay of these variables should be considered in psychological interventions for patients with rheumatic diseases.

Psychology of rehabilitation as a part of health psychology at the Division of Psychology of Rehabilitation at the University of Applied Sciences of Magdeburg and Stendal

Abstract. This article summarizes the current research activities at the Division of Psychology of Rehabilitation at the University of Applied Sciences Magdeburg-Stendal. Our research activities predominately focuses on chronic illness and disability encompassing a broad range of target populations such as adolescents with atopic excema, patients suffering from non-life-threatening diseases such as eye diseases to patients suffering from severe diseases such as HIV/AIDS or renal disease. From a theoretical perspective, our group aims at a better understanding of illness representations of patients as well as from non-patients. From a methodological perspective, our group aims at developing psychometric measures to assess health- and illness-related cognitions.