Proactive Coping in Youth and Old Age as an Indicator of Identity Formation in an Anormative Context

Objective: This paper provides a comprehensive investigation of coping with distress, with a focus on the proactive approach, which is of particular significance for individuals who manage identity transitions periods. Researchers discuss findings from two independent projects analyzing individual variation in strategies for coping with difficult situations at the extremes of life: adolescence and old age. Both studies were conducted between 2014 and 2016. Proactivity preferences were analyzed in a sample of 332 adolescents. Similarly, results collected among 1552 seniors were analyzed. The tools used in the analysis were the Proactive Coping Inventory for Adolescents (PCI-A) and the Proactive Coping Inventory for Adults (PCI). Results: Our findings show that the strategies preferred by the adolescent group included: proactive coping, looking for emotional support and preventive coping. Whereas the results for the elderly group showed their preference for looking for emotional support, reflective and preventive coping. Nevertheless the proactive coping strategy was chosen by adolescents as well as the elderly. The analysis performed demonstrated no significant difference in the reflective coping strategy for the compared age groups. Conclusions: The findings can be explained by theoretical accounts that question the classical developmental models with normative life trajectories and develop more person-oriented idiographic approach with decollectivisation of the life course thesis (Loos, 2012) becoming increasingly evident. Key words: proactiveness, adolescence, ageing, transition, identity, medical practise, education

Anticipating manic and depressive shifts in patients with bipolar disorder using early warning signals

Background. In bipolar disorder treatment, accurate prediction of manic and depressive episodes is paramount but remains difficult. A novel idiographic approach to prediction is to monitor generic early warning signals (EWS), which may manifest in symptom dynamics. EWS could thus form personalized alerts in clinical care. The present study investigated whether EWS can anticipate mood shifts in individual patients with bipolar disorder. Methods. Twenty bipolar type I/II patients participated in ecological momentary assessment (EMA), completing five questionnaires a day for four months (Mean=491 observations per person). Weekly completed symptom questionnaires on depressive (Quick Inventory for Depressive Symptomatology Self-Report) and manic (Altman Self-Rating Mania Scale) symptoms were used to determine transitions. EWS (rises in autocorrelation at lag-1 and standard deviation) were calculated in moving windows over 17 affective and symptomatic EMA items. Positive and negative predictive values were calculated to determine clinical utility. Results. Eleven (of the twenty) patients reported 1-2 manic or depressive transitions. The presence of EWS increased the probability of impending transitions towards depression and mania from 32-36% to 46-48% (autocorrelation) and 29-41% (standard deviation). However, the absence of EWS could not be taken as a sign that no transition would occur in the near future. The momentary states that indicated nearby transitions most accurately (predictive values: 65-100%) were cheerfulness, focusing ability, full of ideas, worry, racing thoughts, agitation, energy, and tiredness. Large individual differences in the utility of EWS were found.Conclusions. EWS may improve anticipating manic and depressive transitions in bipolar disorder, but await further empirical testing.

Recommendations for the Development of Socioeconomically-Situated and Clinically-Relevant Neuroimaging Models of Pain

Pain is a complex, multidimensional experience that emerges from interactions among sensory, affective, and cognitive processes in the brain. Neuroimaging allows us to identify these component processes and model how they combine to instantiate the pain experience. However, the clinical impact of pain neuroimaging models has been limited by inadequate population sampling – young healthy college students are not representative of chronic pain patients. The biopsychosocial approach to pain management situates a person's pain within the diverse socioeconomic environments they live in. To increase the clinical relevance of pain neuroimaging models, a three-fold biopsychosocial approach to neuroimaging biomarker development is recommended. The first level calls for the development of diagnostic biomarkers via the standard population-based (nomothetic) approach with an emphasis on diverse sampling. The second level calls for the development of treatment-relevant models via a constrained person-based (idiographic) approach tailored to unique individuals. The third level calls for the development of prevention-relevant models via a novel society-based (social epidemiologic) approach that combines survey and neuroimaging data to predict chronic pain risk based on one's socioeconomic conditions. The recommendations in this article address how we can leverage pain's complexity in service of the patient and society by modeling not just individuals and populations, but also the socioeconomic structures that shape any individual's expectations of threat, safety, and resource availability.

Methodological approach in management and quality sciences

The article presents methodological approach in management and quality sciences. Quantitative research aims to test hypothesised relationships between variables. Three areas can be identified for assessing the methodological rigour of this type of research: (1) theories relating to phenomena; (2) measures of concepts explaining the phenomena; (3) the reality analysed. it was found that the idiographic approach predominates in the group of theoreticians and represents 59.6 % (239 indications). The nomothetic approach, on the other hand, is used less frequently, accounting for 40.4 % of the responses (162 indications).

Gaining Longitudinal Accounts of Carers' Experiences Using IPA and Photograph Elicitation

Fluctuations in positive and negative caregiving experiences remain only partially explained as the significant variability over time of potential predictive factors themselves is understudied. The current study aims to gain considerable insight into caregiving experiences and perceptions over time by using photovoice methodology to support semi-structured interviews. A case study, longitudinal design is taken with three female caregivers who provide detailed insight into their caregivers' experiences over a 12 month period. The interview transcripts were analyzed using IPA- Interpretative Phenomenological Analysis. This innovative combination of methods resulted in the emergence of three related themes which included consuming the role, feeling consumed by the role, and letting go of the role. The idiographic approach taken allowed both within case differences to be examined over time, and also between carer differences to be highlighted. Implications of illness type and its characteristics, and of attachment and relationship quality with the care recipient were seen in terms of how and when the caregivers moved between the themes identified. The use of others' support or respite care is examined vis-a vis caregiver's own beliefs, emotions, relationship attachment and motivations to care. Caregivers self-efficacy beliefs also shifted over time and were influential in caregiver experience as the care recipient condition or needs changed. No previous studies have found that negative caregiving consequences are, in part, under volitional control and yet our data on the underlying reasons for consuming caregiving or allowing themselves to consume, would suggest this may in part be true. This is important because it suggests that interventions to support caregivers should address relational and motivational factors more fully.

Supporting PhD Students to Become Faculty in Gerontological Social Work: AGESW’s Fellowship Program

In the United States, the field of social work faces a critical shortage of students and faculty with expertise in gerontology needed to meet the growing needs of an aging society. To help recruit, train, and retain aging-related social work practitioners, researchers, and educators, the Association for Gerontological Education in Social Work (AGESW) created the Pre-Dissertation Fellowship Program in 2010. AGESW provides leadership in the areas of gerontological social work education, research, and policy and its PDFP was designed to support doctoral students in their education and future careers. In this 10th anniversary year of the PDFP, this symposium presents multiple perspectives of PDFP program evaluation. The first paper uses qualitative data from eight years of PDFP evaluations to identify types of professional skills attained through the program and areas of professional development missing from PDFP fellows’ home doctoral programs. The second paper uses quantitative data from a retrospective survey administered to PDFP alumni to describe their perspectives on the effects of the program. The third paper uses data from a retrospective survey of three cohorts of PDFP alumni to demonstrate the use of social network analysis for program evaluation. The fourth and final paper uses an idiographic approach to explain benefits of the PDFP from the perspectives of early stage scholars who participated in the program. Overall, the symposium provides evidence that suggests the effectiveness of the PDFP in building professional networks, mentoring doctoral students, and teaching academic skills and discusses using the PDFP model in other gerontological fields.

Psychiatric, cognitive functioning and socio-cultural views of menstrual psychosis in Oman: an idiographic approach

Background Most documented cases of menstrual psychosis have been from Euro-American populations with reports from cross-cultural populations being only a few. A primary aim was to determine whether the cyclical/episodic nature of menstrual psychosis among case series observed at a tertiary care unit in Oman fulfills the diagnostic criteria of the International Classification of Diseases (ICD-10) and diverge into Brockington’s sub-types (World Psychiatry. 2005;4(1):9–17). Related aims were to solicit measures of psychometric functioning of those with menstrual psychosis and associated idioms of distress. Methods A series of consecutive patients seeking psychiatric consultation from January 2016 to December 2017 were screened via structured interview—Composite-International Diagnostic Interview (CIDI) and Brockington’s sub-types. The identified patients (n = 4) also underwent psychometric evaluation including examination of affective functioning, intellectual capacity and neuropsychological functioning (i.e.attention and concentration, learning and remembering, executive function, processing speed and speech and language). The analysis of outcome measures was via an idiographic approach. Results The spectrum of distress among people with menstrual psychosis does not fit existing psychiatric nosology. Evaluations revealed that a majority of the participants displayed something akin to morbid phenomena relating to manic and psychotic symptoms. In the parlance of traditional Omani society, this would be termed “spirit possession”. In terms of classification by timing within the menstrual cycle as expounded by Brockington, the present case series in Oman fulfilled the definition of catamenial psychosis and paramenstrual psychosis. With regard to psychometric function, all participants performed adequately on indices of intellectual functioning but appeared to have impairments in neuropsychological functioning, including the dimensions of processing speed, episodic memory, and executive functioning. Within the given society, the periodicity of mind alteration has been attributed to spirit possession. Conclusions This is one of the first case series of its kind in the country elucidating whether the manifestation of menstrual psychosis among individuals in Oman fulfills the subtypes postulated by Brockington. The present case series suggests that menstrual psychosis is marked with neuropsychological impairments that were previously observed in other phasic manic episodes or brief psychotic disorders.

Psychiatric, Cognitive Functioning and Socio-cultural Views of Menstrual Psychosis in Oman: An Idiographic Approach

Background: Most documented cases of menstrual psychosis have been from Euro-American populations with reports from cross-cultural populations being only a few in number. Objective: To determine whether the cyclical/episodic nature of menstrual psychosis among case series observed at a tertiary care unit in Oman fulfills the diagnostic criteria of the International Classification of Diseases (ICD-10) and diverge into Brockington’s sub-types (World Psychiatry. 2005;4(1):9-17). Related aims were to solicit measures of psychometric functioning of those with menstrual psychosis and narrated idioms of distress. Results: The spectrum of distress among people with menstrual psychosis does not fit existing psychiatric nosology. Evaluations revealed that a majority of the participants displayed something akin to morbid phenomena relating to manic and psychotic symptoms. In the parlance of traditional Omani society, this would be termed “spirit possession”. In terms of classification by timing within the menstrual cycle as expounded by Brockington, the present case series in Oman fulfilled the definition of catamenial psychosis and paramenstrual psychosis. With regard to psychometric function, all participants performed adequately on indices of intellectual functioning but appeared to have impairments in neuropsychological functioning, including the dimensions of processing speed, episodic memory, and executive functioning. Within the given society, the periodicity of mind alteration has been attributed to spirit possession. Conclusions: This is one of the first case series of its kind in the country elucidating whether the manifestation of menstrual psychosis among individuals in Oman fulfills the subtypes postulated by Brockington. The present case series suggests that menstrual psychosis is marked with neuropsychological impairments that were previously observed in other phasic manic episodes or brief psychotic disorders.

Development and Case Study Application of a Proxy-Generated Outcome Measure of Suffering for use with Clients with Illusory Mental Health

The concept of illusory mental health is described as the rationale for needing an approach for working with individuals who are unaware of their suffering and are therefore unable to describe their problems through self-report instruments. The use of a nomothetic approach using self-report or clinician-generated standardised instruments is compared with an idiographic approach for working with such individuals. A case study is used to illustrate the development and first application of a Proxy-Generated Outcome Measure (PGOM) that allows clinicians, observers and researchers to trace an individualised understanding of a client’s core sufferings and changes occurring during the process of psychotherapy. A comparison with a nomothetic outcome measure is also presented.