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Lemmer D, Moessner M, Arnaud N, Baumeister H, Mutter A, Klemm SL, König E, Plener P, Rummel-Kluge C, Thomasius R, Kaess M, Bauer S. The Impact of Video-Based Microinterventions on Attitudes Toward Mental Health and Help Seeking in Youth: Web-Based Randomized Controlled Trial. J Med Internet Res 2024; 26:e54478. [PMID: 38656779 PMCID: PMC11079770 DOI: 10.2196/54478] [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: 11/13/2023] [Revised: 12/22/2023] [Accepted: 03/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Mental health (MH) problems in youth are prevalent, burdening, and frequently persistent. Despite the existence of effective treatment, the uptake of professional help is low, particularly due to attitudinal barriers. OBJECTIVE This study evaluated the effectiveness and acceptability of 2 video-based microinterventions aimed at reducing barriers to MH treatment and increasing the likelihood of seeking professional help in young people. METHODS This study was entirely web based and open access. The interventions addressed 5 MH problems: generalized anxiety disorder, depression, bulimia, nonsuicidal self-injury, and problematic alcohol use. Intervention 1 aimed to destigmatize and improve MH literacy, whereas intervention 2 aimed to induce positive outcome expectancies regarding professional help seeking. Of the 2435 participants who commenced the study, a final sample of 1394 (57.25%) participants aged 14 to 29 years with complete data and sufficient durations of stay on the video pages were randomized in a fully automated manner to 1 of the 5 MH problems and 1 of 3 conditions (control, intervention 1, and intervention 2) in a permuted block design. After the presentation of a video vignette, no further videos were shown to the control group, whereas a second, short intervention video was presented to the intervention 1 and 2 groups. Intervention effects on self-reported potential professional help seeking (primary outcome), stigma, and attitudes toward help seeking were examined using analyses of covariance across and within the 5 MH problems. Furthermore, we assessed video acceptability. RESULTS No significant group effects on potential professional help seeking were found in the total sample (F2,1385=0.99; P=.37). However, the groups differed significantly with regard to stigma outcomes and the likelihood of seeking informal help (F2,1385=3.75; P=.02). Furthermore, separate analyses indicated substantial differences in intervention effects among the 5 MH problems. CONCLUSIONS Interventions to promote help seeking for MH problems may require disorder-specific approaches. The study results can inform future research and public health campaigns addressing adolescents and young adults. TRIAL REGISTRATION German Clinical Trials Register DRKS00023110; https://drks.de/search/de/trial/DRKS00023110.
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Affiliation(s)
- Diana Lemmer
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Nicolas Arnaud
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Agnes Mutter
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Sarah-Lena Klemm
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Elisa König
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Rainer Thomasius
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephanie Bauer
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
- German Center for Mental Health (DZPG), Partner site Mannheim/Heidelberg/Ulm, Heidelberg, Germany
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Agüera Z, Riesco N, Valenciano-Mendoza E, Granero R, Sánchez I, Andreu A, Jiménez-Murcia S, Fernández-Aranda F. Illness perception in patients with eating disorders: clinical, personality, and food addiction correlates. Eat Weight Disord 2021; 26:2287-2300. [PMID: 33387275 DOI: 10.1007/s40519-020-01083-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/24/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Although the role of illness perception in the clinical course of many physical diseases and certain mental disorders has been well described, little is known about illness perception in eating disorders (ED) so far. Therefore, the purpose of this study was to extend our understanding of illness perception in different ED diagnostic types and to explore its association between clinical, psychopathological, motivational, personality, and food addiction (FA) features. METHODS The sample consisted of 104 patients with ED [(23 anorexia nervosa (AN), 39 bulimia nervosa (BN), 19 binge eating disorder (BED), and 23 other specified feeding and eating disorders (OSFED)]. Illness perception was assessed by means of the revised version of the Illness Perception Questionnaire (IPQ-R). RESULTS The results supported the association between illness perception and clinical, psychopathological, and personality factors. Patients with BN and BED showed greater illness perception than the other types. Improved illness perception was positively associated with a longer duration of the disorder and FA. Furthermore, a relevant finding suggests that at least half of the patients with ED did not achieve a good level of illness perception until after having the disorder for 20 years on average. CONCLUSION Our findings suggest that higher levels of FA and longer duration of the ED are positively and directly associated with increased illness perception. This may explain the low levels of initial motivation in these patients and their high dropout rates in the early stages of treatment. LEVEL OF EVIDENCE III Case-control analytic study.
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Affiliation(s)
- Zaida Agüera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain. .,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain. .,Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain.
| | - Nadine Riesco
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | | | - Roser Granero
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Isabel Sánchez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Alba Andreu
- Department of Endocrinology and Nutrition, Obesity Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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Butt N, Ali Khan M, Rai L, Hussain Channa R, Khemani H, Abbasi A. Perception of Non-Alcoholic Fatty Liver Disease: Real-Life Experience From Pakistan. Cureus 2021; 13:e16029. [PMID: 34336516 PMCID: PMC8320969 DOI: 10.7759/cureus.16029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction Non-alcoholic fatty liver disease (NALFD) has become one of the most pervasive causes of hepatic pathology. Because of its marked association with metabolic syndrome, type II diabetes and cardiovascular disease, NAFLD has gained substantial focus recently. Its prevalence and incidence are on the rise in Pakistan. However, due to its indolent and mostly asymptomatic course, NAFLD is often overlooked. This reckless behavior towards a potentially deadly disease is influenced most notably by disinformation or flawed perception, although there are a number of other complex socioeconomic components to this as well. With respect to NAFLD, the gap between disease understanding and steps for management is growing in the Pakistani society. With this study, we hoped and aimed to evaluate just how far and wide these shortcomings were found and how was NAFLD perceived in the local populace via a self-administered survey. Methods This was a cross-sectional observational cohort study undertaken at the Department of Gastroenterology, Jinnah Postgraduate Medical Centre, and Medical Unit II, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan. All patients ≥18 years with a diagnosis of NAFLD were included in the study. NAFLD was diagnosed on the basis of sonographic evidence. All ultrasounds were done by a senior expert radiologist with at least 10 years of postgraduate experience. Ultrasounds were performed twice in all patients to rule out human error and bias. Perceptions regarding the knowledge of NAFLD were assessed using a self-administered survey questionnaire. Results The female-to-male ratio in our cohort was 3:1. The mean age and body mass index (BMI) recorded were 39.85 ± 9.79 years and 31.21 ± 3.6 kg/m2, respectively. Sixty participants (26.4%) knew about their disease (NAFLD) while only 36 (15.9%) knew what NAFLD was and only 33 (14.5%) participants knew about the cardiovascular risk associated with it. Nearly two-thirds of the patients considered themselves overweight, while 180 (79.3%) of them were willing to lose weight. However, just about half of the cohort admitted the need for improved eating habits and increased physical activity/exercise in their daily lives. Fifty-seven (25.1%) patients admitted to using alternative or quack medications and only 45 (19.8%) patients considered them harmful. Conclusions Patients harboring NAFLD have little to no knowledge about the disease and its nature or the fact that they are suffering from it despite being diagnosed clinically. Furthermore, while the general populace is willing to accept being overweight and having unhealthy eating habits, their willingness in initiating real-life practical steps to manage NAFLD is lacking.
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Affiliation(s)
- Nazish Butt
- Gastroenterology, National Medical Centre, Karachi, PAK.,Gastroenterology, Aga Khan University Hospital, Karachi, PAK.,Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | | | - Lajpat Rai
- Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | | | - Hanisha Khemani
- Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Amanullah Abbasi
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
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Averous P, Charbonnier E, Dany L. Assessment of illness representations in mental disorders: A mini review. Encephale 2021; 47:137-142. [PMID: 33589282 DOI: 10.1016/j.encep.2020.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/10/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022]
Abstract
Health beliefs, and especially illness representations, have been widely used to understand clinical outcomes and psychosocial adjustment in people with physical diseases. However, this area of research has been under-explored in the field of mental health, and the few studies that have been conducted have used very different methods. Therefore, the aim of our study was to identify the tools and methods that have been used to evaluate illness representations in psychiatry. To this end, a mini review has been conducted and 58 articles were retained. This mini review highlights that the quantitative method is the most used, and that the scales mobilised are often adapted for the study, but not validated. Indeed, multiple modifications and adaptations have been made by the authors (e.g. deletion of subscales, addition of items), which lead to questions about the reliability of what is measured. In the future, it is essential to have a validated generic tool for mental disorders, which could be based on the Illness perceptions questionnaire for schizophrenia.
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Affiliation(s)
- P Averous
- Aix Marseille Univ, Aix-en-Provence, France; UNIV. NIMES, APSY-V, Nîmes cedex 1, France.
| | | | - L Dany
- Aix Marseille Univ, Aix-en-Provence, France; APHM, Timone, Service d'Oncologie Médicale, Marseille, France
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Averous P, Charbonnier E, Dany L. Relationship Between Illness Representations, Psychosocial Adjustment, and Treatment Outcomes in Mental Disorders: A Mini Review. Front Psychol 2020; 11:1167. [PMID: 32612557 PMCID: PMC7309516 DOI: 10.3389/fpsyg.2020.01167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/06/2020] [Indexed: 01/04/2023] Open
Abstract
Understanding and improving the psychosocial adjustments (e.g., quality of life, depression) and treatment outcomes (e.g., adherence, beliefs about treatments) of people with mental disorders are major health issues. The self-regulation model (SRM) postulates that illness representations play a central role on adjustment and treatment of people with physical illnesses. Recently, the SRM has been used with people with mental disorders. However, the manifestations of somatic and psychiatric disorders can be very different. Therefore, the use of SRM in the field of mental health is very complex. This difficulty, as well as the growing interest for illness representations in the field of mental health, justifies the utility to conduct a review on this topic. The current review shows that illness representations are related to psychosocial adjustment and/or treatment outcomes for people with various mental disorders [e.g., psychotic disorders, mood disorder, posttraumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD)]. However, some limitations to the applicability of SRM to mental disorders have been highlighted. These limitations should be considered in future studies.
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Affiliation(s)
- Priscillia Averous
- Aix Marseille Univ, LPS, Aix-en-Provence, France.,UNIV. NIMES, EA 7352 CHROME, Nîmes, France
| | | | - Lionel Dany
- Aix Marseille Univ, LPS, Aix-en-Provence, France.,APHM, Timone, Service d'Oncologie Médicale, Marseille, France
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6
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Bullivant B, Rhydderch S, Griffiths S, Mitchison D, Mond JM. Eating disorders "mental health literacy": a scoping review. J Ment Health 2020; 29:336-349. [PMID: 32041463 DOI: 10.1080/09638237.2020.1713996] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: While it is apparent that much has been learned about "mental health literacy" (MHL) relating to certain mental health problems, such as depression, in recent years, what has been learned about MHL relating to eating disorders (ED-MHL) is unclear.Aims: A scoping review was conducted to inform the current state of knowledge in this field.Methods: A systematic search of relevant literature published between 1997 and 2017 was followed by a narrative synthesis of the findings.Results: The number of eligible studies increased from 32 in 1997-2001 to 98 in 2012-2017 (total = 264). Most studies originated from North America or Europe, recruited individuals with EDs receiving treatment or college students and included both female and male or only female participants. The majority of studies examined MHL relating to anorexia nervosa or bulimia nervosa and examined attitudes which facilitate recognition and appropriate help-seeking and knowledge and beliefs about professional help available.Conclusion: Interest in ED-MHL is increasing and there is now a considerable body of research addressing some aspects of ED-MHL in a range of study populations. Notable gaps in the literature exist, including a paucity of information about ED-MHL relating to EDs other than anorexia nervosa and bulimia nervosa, ED behaviour in males and the use of self-help interventions. We hope the findings will provide an incentive to further research in these and other aspects of ED-MHL.
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Affiliation(s)
- Bianca Bullivant
- Faculty of Medicine, Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia.,Department of Psychology, Macquarie University, Sydney, Australia
| | - Suzie Rhydderch
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Deborah Mitchison
- Department of Psychology, Macquarie University, Sydney, Australia.,School of Medicine, Western Sydney University, Sydney, Australia
| | - Jonathan M Mond
- Department of Psychology, Macquarie University, Sydney, Australia.,Centre for Rural Health, University of Tasmania, Launceston, Australia
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7
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Groeneveld IF, van der Pas SL, Meesters JJL, Schuurman JM, van Meijeren-Pont W, Jagersma E, Goossens PH, Kaptein AA, Vliet Vlieland TPM. Illness perceptions of stroke survivors: Predictors and changes over time - A 1 year follow-up study. J Psychosom Res 2019; 116:54-61. [PMID: 30654994 DOI: 10.1016/j.jpsychores.2018.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/11/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe the illness perceptions (IP) of stroke patients in the first year post stroke; to identify patient clusters with comparable IP trajectories and determine their associations with health. METHODS This prospective study included consecutive stroke patients after medical rehabilitation. Three and 12 months post stroke they completed the Brief Illness Perception Questionnaire (B-IPQ) and questionnaires on physical and mental health. All eight IP and their changes over time were described. Clusters of patients with comparable IP trajectories were constructed by k-means clustering, with subsequent comparison of patient characteristics. Multivariable logistic regression analyses were conducted to determine the association between IP clusters and 12-month mental health. RESULTS Hundred-and-eighty-four patients were included (men n = 107 [58.2%]; mean age 61.1 [SD 12.7] years). At 3 months, the scores of the IP coherence (mean 3.0, SD 2.3) and treatment control (mean 3.2, SD 2.5) were lowest (best), and consequences (mean 6.1, SD 2.8) and anticipated timeline (mean 6.0, SD 2.7) were highest (worst). At 12 months, the timeline and treatment control scores had significantly worsened. Three clusters of the trajectories of IP were identified, and designated as 'favourable', 'average', and 'unfavourable'. The unfavourable cluster was significantly associated with worse physical and mental health at 3 months (unadjusted) and depressive symptoms at 12 months. CONCLUSION Stroke patients' IP partly changed between 3 and 12 months post stroke. Patients with an unfavourable IP trajectory had a higher chance of depressive symptoms at 12 months. Illness perceptions could be considered as an additional target of treatment.
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Affiliation(s)
- I F Groeneveld
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands.
| | - S L van der Pas
- Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands; Mathematical Institute, Leiden University, the Netherlands
| | - J J L Meesters
- Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | | | - W van Meijeren-Pont
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | - E Jagersma
- Sophia Rehabilitation, The Hague, the Netherlands
| | - P H Goossens
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | - A A Kaptein
- Department of Medical Psychology, Leiden University Medical Center, Leiden, the Netherlands
| | - T P M Vliet Vlieland
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
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Matthews A, Lenz KR, Peugh J, Copps EC, Peterson CM. Caregiver burden and illness perceptions in caregivers of medically hospitalized youth with anorexia nervosa. Eat Behav 2018; 29:14-18. [PMID: 29413819 DOI: 10.1016/j.eatbeh.2018.01.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 01/14/2018] [Accepted: 01/22/2018] [Indexed: 12/31/2022]
Abstract
Caregiver burden is common in caregivers of youth with anorexia nervosa (AN) and could impede the successful implementation of family-based therapy (FBT). Thus, it is important to better understand mechanisms by which caregiver burden is developed and maintained. This study aimed to examine the relation between caregiver illness perceptions about AN, symptom severity indicators, and caregiver burden in a sample of medically hospitalized youth with AN. Fifty-one youth with AN (N = 34) or Atypical AN (AAN; N = 17; mean age = 14.85, SD = 1.41; 76% female) and their primary caregivers (N = 47 mothers and N = 4 fathers) completed self-report questionnaires at hospital admission. Collected data included caregiver and youth illness perceptions about AN, caregiver burden, and youth self-reports of psychological symptoms. Physiological data regarding symptom severity included admitting percent of expected body weight (%EBW) and minimum heart rate during admission. Findings indicated that caregiver beliefs about negative consequences of AN were associated with caregiver burden, independent of youth age, sex, illness duration, and diagnosis. Youth reports of symptom severity, %EBW, and low heart rate were not associated with increased caregiver burden. Findings suggest that the subjective experience of having a youth with AN are a greater determinant of caregiver burden than objective indicators of illness severity. Further, these findings provide support for the FBT clinician to strike a balance between providing information about the potential consequences of AN, while instilling hope for recovery and bolstering parent self-efficacy.
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Affiliation(s)
- Abigail Matthews
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, United States.
| | - Katrina R Lenz
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, United States
| | - James Peugh
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, United States
| | - Emily C Copps
- Xavier University, School of Psychology, United States
| | - Claire M Peterson
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, United States
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Differences Across Illness Perceptions in Inflammatory Bowel Disease and Their Relationships to Psychological Distress and Quality of Life. Gastroenterol Nurs 2017; 40:291-299. [PMID: 28746114 DOI: 10.1097/sga.0000000000000225] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Patients with greater inflammatory bowel disease activity readily identify poorer psychosocial outcomes; however, the role of gender, disease type, and individual illness perceptions facets are less well known. This study aimed to characterize the role of illness perceptions, gender, and disease type on anxiety, depression, and quality of life. Eighty-one patients diagnosed with inflammatory bowel disease (39 men, mean age 35 years) attending a tertiary hospital outpatient clinic were studied. Questionnaires used included the Manitoba Index, the Brief Illness Perceptions Questionnaire, Hospital Anxiety and Depression Scale, and the World Health Organization Brief Quality of Life Scale. Female patients with active disease tended to report increased anxiety, depression, and reduced quality of life. Regarding illness perceptions, patients with Crohn disease reported significantly more concerns about its chronicity, while female patients reported being significantly more concerned about the impact of their illness on identity, chronicity, overall concern, and having a greater emotional impact. Hierarchical regression indicated that 36% of depression, 42% of anxiety, and 57% of quality of life could be accounted for by disease activity and type, gender, and illness perceptions. The findings suggest that in addition to a patient's perceived disease status, gastroenterology nurses should also be aware that patient gender and their perceptions of illness play a significant impact not only on anxiety and depression but also on quality of life. Increased disease activity is associated with more severe anxiety and depression and reduced quality of life. Female patients are also at a greater risk of reporting negative illness perceptions and increased levels of anxiety, depression, and lower quality of life.
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Common sense model of mental illness: Understanding the impact of cognitive and emotional representations of mental illness on recovery through the mediation of self-stigma. Psychiatry Res 2016; 246:16-24. [PMID: 27644016 DOI: 10.1016/j.psychres.2016.09.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 09/11/2016] [Accepted: 09/11/2016] [Indexed: 11/20/2022]
Abstract
The present study applied the common sense model to understand the underlying mechanism of how cognitive and emotional representations of mental illness among people in recovery of mental illness would impact their endorsement of self-stigma, and how that would, in turn, affect clinical and personal recovery. A cross-sectional survey was administered to 376 people in recovery. Participants were recruited from seven public specialty outpatient clinics and substance abuse assessment clinics across various districts in Hong Kong. They were asked to report their perception towards their mental illness, self-stigma, symptom severity, and personal recovery. The results of structural equation modeling partially supported the hypothesized mediation model indicating that controllability, consequences, and emotional concern of mental illness, but not cause, timeline, and identity, were associated with self-stigma, which was subsequently negatively associated with clinical and personal recovery. The present study demonstrated the mediating role of self-stigma in the relationship between individuals' illness representations towards their mental illness and their recovery. Illness management programs aimed at addressing the maladaptive mental illness-related beliefs and emotions are recommended. Implications on developing self-directed and empowering mental health services are discussed.
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11
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Wisting L, Bang L, Skrivarhaug T, Dahl-Jørgensen K, Rø Ø. Adolescents with Type 1 Diabetes--The Impact of Gender, Age, and Health-Related Functioning on Eating Disorder Psychopathology. PLoS One 2015; 10:e0141386. [PMID: 26529593 PMCID: PMC4631487 DOI: 10.1371/journal.pone.0141386] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 10/06/2015] [Indexed: 12/15/2022] Open
Abstract
Objective To investigate correlates of eating disorder psychopathology in adolescent males and females with type 1 diabetes. Method A total of 105 adolescents with type 1 diabetes (42% males), aged 12–20 years, were recruited from the Norwegian Childhood Diabetes Registry in this population-based study. All participants were interviewed with the Child Eating Disorder Examination. Additionally, the Brief Illness Perception Questionnaire, the Adolescent Coping Orientation for Problem Experiences and the Beliefs about Medicines Questionnaire were administered to assess health-related functioning. Clinical data were obtained from the Norwegian Childhood Diabetes Registry. Results Significant gender differences were demonstrated in the pattern of correlates of eating disorder pathology. Among females, eating disorder psychopathology was significantly associated with body mass index adjusted for age and gender, age, insulin restriction, coping, illness perceptions, and perceptions of insulin concern. In a regression model, age, illness perceptions, and insulin restriction remained significantly associated with eating disorder psychopathology, explaining 48% of the variance. None of the variables were associated with eating disorder psychopathology among males. Discussion Greater clinical awareness of illness perceptions, attitudes toward insulin, and insulin restriction may potentially decrease the risk of developing eating disorders among female adolescents with type 1 diabetes, and the subsequent increased morbidity and mortality associated with comorbid type 1 diabetes and eating disorders.
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Affiliation(s)
- Line Wisting
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Oslo Diabetes Research Centre, Oslo, Oslo, Norway
- * E-mail:
| | - Lasse Bang
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Torild Skrivarhaug
- The Norwegian Childhood Diabetes Registry, Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Oslo Diabetes Research Centre, Oslo, Oslo, Norway
| | - Knut Dahl-Jørgensen
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Oslo Diabetes Research Centre, Oslo, Oslo, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Bonsaksen T, Lerdal A, Fagermoen MS. Trajectories of illness perceptions in persons with chronic illness: An explorative longitudinal study. J Health Psychol 2013; 20:942-53. [DOI: 10.1177/1359105313504235] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Accurate illness perceptions are essential to the self-management of chronic illness. This study explored trajectories of illness perceptions in persons with morbid obesity ( n = 53) and persons with chronic obstructive pulmonary disease ( n = 52) following a patient education course. Participants completed the Brief Illness Perception Questionnaire five times over a 1-year period. Repeated measures analysis of variance was employed. Over time, obese participants perceived shorter illness duration, fewer consequences, less emotional stress, and more personal control. Chronic obstructive pulmonary disease participants had initial increases in personal control and understanding, but these changes were not maintained throughout the follow-up period.
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Affiliation(s)
- Tore Bonsaksen
- Oslo and Akershus University College of Applied Sciences, Norway
| | - Anners Lerdal
- Lovisenberg Diakonale Hospital, Norway
- University of Oslo, Norway
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Hurt CS, Julien CL, Brown RG. Measuring Illness beliefs in neurodegenerative disease: Why we need to be specific. J Health Psychol 2013; 20:69-79. [DOI: 10.1177/1359105313498627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Positive perceptions of illness are typically associated with good health outcomes. However, this may not be true for all domains of illness perception in neurodegenerative diseases because of their progressive incurable nature. The appropriateness of current measures of illness belief in these conditions is not known. The validity and reliability of the Illness Perception Questionnaire–Revised was evaluated in 215 participants with Parkinson’s disease. A confirmatory factor analysis supported the structure of the Illness Perception Questionnaire–Revised with the exception of the treatment control domain. It is important to consider the nature of neurodegenerative diseases and limits of symptom control when planning interventions.
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Hvidberg L, Jensen LF, Pedersen AF, Aro AR, Vedsted P. Measurement properties of the Danish version of the Illness Perception Questionnaire-Revised for patients with colorectal cancer symptoms. J Health Psychol 2013; 19:1279-90. [PMID: 23818508 DOI: 10.1177/1359105313488978] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The aim of this study was to validate the measurement properties of the Danish version of the Illness Perception Questionnaire-Revised adapted to measure symptom representations among patients with colorectal cancer symptoms. A total of 488 colorectal cancer patients completed a questionnaire derived from the Illness Perception Questionnaire-Revised to retrospectively assess cognitive and emotional representations of experienced symptoms. A confirmatory factor analysis indicated no good comparative fit with the Illness Perception Questionnaire-Revised. Using exploratory factor analysis, a 7-factor structure was conducted, which fairly supported the Illness Perception Questionnaire-Revised. The modified Illness Perception Questionnaire-Revised is a promising tool for measuring symptom representations among Danish colorectal cancer patients.
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Affiliation(s)
- Line Hvidberg
- The Research Centre for Cancer Diagnosis in Primary Care (CaP), The Research Unit for General Practice, Aarhus University, Denmark
| | - Line F Jensen
- The Research Centre for Cancer Diagnosis in Primary Care (CaP), The Research Unit for General Practice, Aarhus University, Denmark
| | - Anette F Pedersen
- The Research Centre for Cancer Diagnosis in Primary Care (CaP), The Research Unit for General Practice, Aarhus University, Denmark
| | - Arja R Aro
- Unit for Health Promotion Research, University of Southern Denmark, Denmark
| | - Peter Vedsted
- The Research Centre for Cancer Diagnosis in Primary Care (CaP), The Research Unit for General Practice, Aarhus University, Denmark
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Rochelle TL, Fidler H. The importance of illness perceptions, quality of life and psychological status in patients with ulcerative colitis and Crohn’s disease. J Health Psychol 2012; 18:972-83. [DOI: 10.1177/1359105312459094] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The present study investigates illness perceptions of inflammatory bowel disease patients in an outpatient population, examining whether these illness perceptions are related to disease severity, quality of life and psychological adjustment. A cohort of 102 inflammatory bowel disease outpatients was prospectively enrolled on the study. The participants completed a questionnaire assessing illness perceptions, anxiety, depression and disease-specific symptoms. The study has identified specific illness perceptions of inflammatory bowel disease sufferers that are strongly associated with patients’ quality of life. By raising and addressing these issues, clinicians may be able to allay these significant and often unexpressed concerns, and improve quality of life for patients with inflammatory bowel disease.
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Affiliation(s)
- Tina L Rochelle
- The Lewisham Hospital NHS Trust, UK
- City University of Hong Kong, Hong Kong
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