Differentiating Cognitive Impairment from Symptoms of Anxiety in Postcoronary Artery Bypass Grafting Encephalopathy: A Case Report

Post-coronary artery bypass grafting encephalopathy (CABGE) is associated with cognitive decline in a significant number of post-cardiac surgery cases. Patients may experience this condition as a result of being maintained on a heart-lung machine, which is referred to as the “pump”. The pump is used to circulate oxygenated blood during heart or valve surgery and may contribute to complication with oxygen flow to the brain. In some cases, the emotional traumatic effects of CABGE may produce symptoms of anxiety that can often mimic the cognitive decline associated with cardiac bypass and use of the pump. When this is the case, cognitive–behavioral assessment may be useful in helping patients to differentiate symptoms generated by anxiety from those produced by the effects of the pump. A discussion section addresses further implications of such overlapping symptoms and therapeutic strategies for treatment and remediation, along with the potential adverse effects that may occur through psychotherapy

Developing evidence-based practice: the role of case-based research

How can practitioners engage in evidence-based practice when the evidence for effectiveness of psychological treatments comes from randomized controlled trials using patient populations different from those encountered in everyday settings and treatment manuals that seem oversimplified and inflexible? The authors argue that important evidence about best practice comes from case-based research, which builds knowledge in a clinically useful manner and complements what is achieved by multivariate research methods. A multidimensional model of the research process is provided that includes clinical practice and case-based research as significant contributors. The authors summarize the principles of case-based research and provide examples of recent technical advances. Finally, the authors suggest ways in which practitioners can apply the case-based approach in researching and publishing their own cases, perhaps in collaboration with university-based researchers

Understanding quality of life in children with asthma and their parents: Family resources and challenges

The present research investigated the links between caregiver burden, family environment, and quality of life in 97 pairs of children with asthma and one of their parents (the primary family caregiver). Using structured equation modelling, within-participant analyses showed that family environment was positively linked to quality of life for both children and parents respectively. Across-participant analyses demonstrated that parents’ positive perceptions of family environment were associated with parents’ and children’s improved quality of life. In addition, parents’ perceptions of family environment mediated the link between caregiver burden and parents’ and children’s quality of life. Implications for intervention with families are discussed in light of this study’s important results

Lack of Mutual Respect in Relationship The Endangered Partner

Violence in a relationship and in a family setting has been an issue of concern to various interest groups and professional organizations. Of particular interest in this article is violence against women in a relationship. While there is an abundance of knowledge on violence against women in general, intimate or partner femicide seems to have received less attention. Unfortunately, the incidence of violence against women, and intimate femicide in particular, has been an issue of concern in the African setting. This article examines the trends of intimate femicide in an African setting in general, and in Botswana in particular. The increase in intimate femicide is an issue of concern, which calls for collective effort to address. This article also examines trends offemicide in Botswana, and the antecedents and the precipitating factors. Some studies have implicated societal and cultural dynamics as playing significant roles in intimate femicide in the African setting. It is believed that the patriarchal nature of most African settings and the ideology of male supremacy have relegated women to a subordinate role. Consequently, respect for women in any relationship with men is lopsided in favor of men and has led to abuse of women, including intimate femicide. Other militating factors in intimate femicide ,are examined and the implications for counseling to assist the endangered female partner are discussed

Infidelity in Dating Relationships: Gender-Specific Correlates of Face-to-Face and Online Extradyadic Involvement

This study examined the gender-specific correlates of face-to-face and online extradyadic involvement (EDI) in dating relationships. The sample consisted of 561 women (M age = 23.19 years) and 222 men (M age = 23.97 years), all of whom reported being in an exclusive dating relationship for an average of 35 months. Participants completed the following self-report measures: Extradyadic Behavior Inventory, Attitudes toward Infidelity Scale, and Investment Model Scale. During the current relationship, men were more likely than women to report engagement in face-to-face physical/sexual EDI (23.4 vs. 15.5 %) and online sexual EDI (15.3 vs. 4.6 %). Both men and women with a history of infidelity in a prior relationship were more likely to engage in EDI. More positive attitudes toward infidelity, lower relationship satisfaction, lower commitment, and higher quality of alternatives were significantly associated with EDI, regardless of gender. Women reporting infidelity of a partner in a prior relationship were more likely to engage in face-to-face and online emotional EDI; a longer relationship and a younger age at the first sexual encounter were significant correlates of the engagement in face-to-face emotional EDI. Women with higher education were approximately three times more likely to engage in online sexual EDI. Although men and women are converging in terms of overall EDI, men still report higher engagement in physical/sexual extradyadic behaviors, and the correlates of sexual and emotional EDI vary according to gender. This study contributes to a comprehensive approach of factors influencing the likelihood of EDI and encourages future research in this area

Examining the Scope and Concept of Schema: Should We Look Beyond Cognitive Structures?

Traditionally, cognitive therapy and the cognitive-behavior therapies have focused on three levels of cognitive phenomenon: automatic thoughts, cognitive distortion, and underlying assumptions. Underlying assumptions constitute the general notion of what is referred to as "schema." Schemas have traditionally served as sort of a template for the way in which an individual views him/herself, the world, and others. In addition, a proposed model has also appeared in the professional literature that includes memory structures and multimodal representations of stored information that serve to explain the concept of schema in general. Recently, some controversial research has raised the question as to whether separate memory cell networks in the body may play an additional role beyond cognitive structures. This article reviews some of the research on the role of neuropeptides in the process of memory and emotions and raises the question of whether or not an expansion of the concept of schema should be considered. The article also discusses what scientific support exists at this time and whether we can draw any clinical implications from such a theory. The article also discusses the impact of this theory on the view of schema resistance and the role of cognitive therapy, particularly as it relates to conditions involving trauma

Differentiating cognitive impairment from symptoms of anxiety in postcoronary artery bypass grafting encephalopathy: a case report

Post-coronary artery bypass grafting encephalopathy (CABGE) is associated with cognitive decline in a significant number of post-cardiac surgery cases. Patients may experience this condition as a result of being maintained on a heart-lung machine, which is referred to as the “pump”. The pump is used to circulate oxygenated blood during heart or valve surgery and may contribute to complication with oxygen flow to the brain. In some cases, the emotional traumatic effects of CABGE may produce symptoms of anxiety that can often mimic the cognitive decline associated with cardiac bypass and use of the pump. When this is the case, cognitive–behavioral assessment may be useful in helping patients to differentiate symptoms generated by anxiety from those produced by the effects of the pump. A discussion section addresses further implications of such overlapping symptoms and therapeutic strategies for treatment and remediation, along with the potential adverse effects that may occur through psychotherapy

True lies: delusions and lie-detection technology

Legally relevant lying is an intentional attempt to convince another of the truth of a proposition the liar believes to be false. Delusion is an unintentional product of impaired reality testing that occurs in a range of psychiatric conditions and psychological states, some of which could be clinically subtle, since deception, truth and delusion differ in the intent rather than reality testing criterion. Deception and delusion are influenced by the degree of congruence between subjective and objective reality and are probably mutually exclusive. Thus, a delusion could lead to an objectively false statement, that could nevertheless be subjectively true and indistinguishable from truth by its psychophysiological (i.e., the polygraph) signature. This article presents a relevant case as a starting point of an examination of the current and future role of neurophysiological (i.e., functional brain imaging) measurements in the detection of deception. The authors incorporate the recent data on functional brain imaging to the neuroanatomical mechanisms of true and false recall, behavioral regulation and deception into a testable model that could redefine deception and separate it from delusions on the basis of objective functional brain imaging measures

Interactions between Obsessional Symptoms and Interpersonal Ambivalences in Psychodynamic Therapy: An Empirical Case Study

The classical symptom specificity hypothesis (Blatt, 1974) particularly associates obsessional symptoms to interpersonal behavior directed at autonomy and separation from others. Cross-sectional group research, however, has yielded inconsistent findings on this predicted association, and a previous empirical case study (Cornelis et al., in press; see Chapter 2) documented obsessional pathology to be rooted in profound ambivalences between autonomous and dependent interpersonal dynamics. Therefore, in the present empirical case study, concrete operationalizations of the classical symptom specificity hypothesis are contrasted to alternative hypotheses based on the observed complexities in Chapter 2. Dynamic associations between obsessional symptoms and interpersonal functioning is further explored, aiming at further contribution to theory building (i.e., through suggestions for potential hypothesis-refinement; Stiles, 2009). Similar to the first empirical case study (Chapter 1), Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of supportive-expressive psychodynamic therapy. In line with findings from Chapter 1, findings reveal close associations between obsessions and interpersonal dynamics, and therapist interventions focusing on interpersonal conflicts are documented as related to interpersonal and symptomatic alterations. Observations predominantly accord to the ambivalence-hypothesis rather than to the classical symptom specificity hypothesis. Yet, meaningful differences are observed in concrete manifestations of interpersonal ambivalences within significant relationships. Findings are again discussed in light of conceptual and methodological considerations; and limitations and future research indications are addressed