Susanna Kola

Determinants of pre‐procedural state anxiety and negative affect in first‐time colposcopy patients: implications for intervention

Women experience significant emotional distress in relation to further diagnostic evaluation of pre-cancerous cell changes of the cervix. However, less is known about the specific variables that contribute to elevated state anxiety and negative affect prior to colposcopy. The study aims to identify psychosocial factors that predict distress in this patient group, which can help in the development of more sophisticated interventions to reduce psychological distress. Socio-demographic variables, scores for state anxiety, negative affect, trait anxiety, fear of pain, coping style, pain-related expectancy and knowledge were assessed in 164 first-time colposcopy patients immediately before the colposcopy examination. Twenty-six per cent of variance in pre-colposcopy state anxiety was significantly explained by marital status, parity, trait anxiety, fear of minor pain and expectations of discomfort. Twenty-nine per cent of variance in pre-colposcopy negative affect was significantly explained by trait anxiety and expectations of pain. Women who are single, have children, are high trait anxious, and anticipate pain and discomfort appear to be at risk for pre-colposcopy distress. Interventions aimed at reducing pre-colposcopy psychological distress should include situation-specific variables that are amenable to change, and trait anxious women are likely to benefit from interventions to reduce distress.

The Role of Psychopathy and Exposure to Violence in Rape Myth Acceptance

The main aim of the present study was to specify and test a structural model to examine the relationships between four psychopathy dimensions (Interpersonal Manipulation, Callous Affect, Erratic Lifestyle, and Antisocial Behavior), childhood exposure to violence, and rape myth acceptance while controlling for gender, age, sample type (prisoner vs. non-prisoner), and relationship status. Participants were a sample of non-offending adults (n = 319) recruited from the University of Security in Poznan, and a sample of prisoners (n = 129) incarcerated in Stargard Szczecinski Prison. Results indicated that the model provided a good fit for the data, and that Callous Affect and childhood exposure to violence had a significant positive effect on attitudes toward rape and rape victims. Theoretical and practical implications of our findings are discussed.

Attention focus, trait anxiety and pain perception in patients undergoing colposcopy.

Few studies have compared the relative efficacy of attention‐focus strategies in reducing clinical pain. Colposcopy, a medical diagnostic examination performed to identify premalignant cervical cell changes, elicits both anxiety and pain in patients, while allowing little or no behavioural control over the event. Employing a multi‐group experimental design, the present study sought to investigate how different types of attention‐focus strategies impacted upon pain perception, state anxiety and affect, in a sample of 123 colposcopy patients. Patients were randomly assigned to one of three groups: sensory focusing, active distraction and undirected control. Psychometric measures of pre‐colposcopy pain expectancy and dispositional trait anxiety were also taken, in order to assess whether these factors further contributed to outcomes. Overall, when controlling for pain expectancy and trait anxiety, self‐reported pain intensity, sensory pain and affective pain did not differ across groups. Further, there were no significant between‐group differences in colposcopy‐related state anxiety or affect. However, pre‐colposcopy psychometric measures were found to be predictive of a range of outcomes. Pre‐colposcopy pain expectancy, but not trait anxiety, was found to be positively related to colposcopy‐related pain. It was further demonstrated that heightened state anxiety following colposcopy was due to experienced pain and pain unpleasantness, rather than to aspects of the pre‐colposcopy prediction of pain. The results have implications for management of acute clinical pain.

Firearms, Hanging, and Drowning Suicides in the Republic of Ireland

BACKGROUND The firearms climate in Ireland is rapidly changing, and there is currently no research on the risk profiles of those dying through firearms suicides. AIMS To compare the sociodemographic profile of firearms suicide deaths with hanging and drowning suicides. METHODS Analyses are based on data for 9,674 suicides that occurred between 1980 and 2005 and provided by the Central Statistics Office of Ireland (CSO). Risk factors included were gender, place of residence, employment status (agri-employed/not agri-employed), marital status, and age. RESULTS Those dying by shooting were twice as likely to be male than those dying by hanging (95% CI = 1.5 to 2.6) and 6.7 times more likely than those dying by drowning (95% CI = 4.9 to 9.1). They were also more likely to have resided in a rural location (hanging OR = 3.8, 95% CI = 2.8 to 5.0; drowning OR = 4.2, 95% CI = 3.1 to 5.6) and to have been agri-employed (hanging OR = 1.3, 95% CI = 1.1 to 1.6; drowning OR = 1.4, 95% CI = 1.1 to 1.7). Firearms suicides were significantly younger (H = 458.9, p < .0005). Model fit statistics from logistic regressions are presented. Factors included in the study were limited to those recorded by the CSO. CONCLUSIONS The findings have implications for awareness training for suicide prevention workers and for those concerned with Irelands increasingly liberal firearms climate.

Firearm-assisted suicide: Legislative, policing and clinical concerns

Until recent years the Republic of Ireland had one of the most restrictive regimes on firearms access with the Irish police (An Garda Siochana) consistently refusing to grant certificates for a wide range of guns including handguns, high calibre rifles and shotguns capable of holding more than three cartridges. In 2004 the High Court ruled that this policy was without legislative backing and since then the police began to issue certificates for firearms where the applicant is not disentitled under law from possessing a gun. Set against this backdrop, this paper explores the consequences of liberal gun regimes in the context of access to firearms by those suffering from mental illness and who pose a threat of parasuicide or suicide. Consideration is given to experiences in other jurisdictions and international research on firearm suicide prevention. Finally some recommendations for changes in legislation, policy and protocol in the Irish context are presented.

Challenging lives: an exploratory qualitative study of quality of life in young adults living with a chronic neurological condition

Abstract Objectives: The transition from adolescence to young adulthood is traditionally a time of self-discovery, career establishment, and the development of relationships. However, for young adults with a chronic illness this time in life can be very challenging, and the management of the transition is crucial for these young adults to reach their potential. The purpose of this study was to explore the lived experiences, perceptions, and challenges of young adults with a chronic neurological condition undergoing the transition from adolescence to adulthood. The Quality of Life model was used to inform the interview schedule and explored two specific areas: identity and condition. Methods: Six participants with chronic neurological conditions (age 18–25 years) took part in the study. Audio-recorded semi-structured interviews were transcribed verbatim and analyzed using Interpretive Phenomenological Analysis. Results: The findings revealed a number of interlinking superordinate themes across the participants: ‘condition’, ‘support’, ‘strive for independence’, and ‘transition’. Conclusions: The findings of this exploratory study provide a visible indication of the specific needs of the participant group, including informational and social support needs, and removal of barriers for successful participation. They also highlight holistic service requirements and the interlinking relationships of the direction of support which could be provided to meet these needs.