Resilience and coping

فَإِنَّ مَعَ ٱلۡعُسۡرِ يُسۡرًا

So truly where there is hardship there is also ease

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ خُذُواْ حِذۡرَكُمۡ فَٱنفِرُواْ ثُبَاتٍ أَوِ ٱنفِرُواْ جَمِيعࣰ ا

You who believe, be on your guard. March [to battle] in small groups or as one body

بِسْمِ اللَّهِ الرَّحْمَٰنِ الرَّحِيمِ In the Name of Allah, the Most Gracious, the Most Merciful. أَلَمْ نَشْرَحْ لَكَ صَدْرَكَ - وَوَضَعْنَا عَنكَ وِزْرَكَ - الَّذِي أَنقَضَ ظَهْرَكَ - وَرَفَعْنَا لَكَ ذِكْرَكَ - فَإِنَّ مَعَ الْعُسْرِ يُسْرًا - إِنَّ مَعَ الْعُسْرِ يُسْرًا - فَإِذَا فَرَغْتَ فَانصَبْ - وَإِلَىٰ رَبِّكَ فَارْغَب (1. Have We not opened your breast for you?)(2. And removed from you your burden.)(3. Which weighed down your back?)(4. And have We not raised high your fame?)(5. Verily, along with every hardship is relief,)(6. Verily, along with every hardship is relief.)(7. So when you have finished, devote yourself to Allah's worship.)(8. And to your Lord turn intentions and hopes.) The Meaning of opening the Breast Allah says, أَلَمْ نَشْرَحْ لَكَ صَدْرَكَ (Have We not opened your breast for you?) meaning, 'have We not opened your chest for you.' This means, 'We ill

Indeed, with difficulty and constraint, comes ease and options.

O you who believe take your precautions against your enemy that is be wary of him and be vigilant against him; then move forward prepare to fight him in companies in separate groups one raiding party followed by the next; or move forward all together in one assembly.

O you who believe! Take your precautions, and either go forth (on an expedition) in parties, or go forth all together (71)There is certainly among you he who would linger behind. If a misfortune befalls you, he says, "Indeed Allah has favored me in that I was not present among them. (72)But if a bounty comes to you from Allah, he would surely say ـ as if there had never been ties of affection between you and him, "Oh! I wish I had been with them; then I would have achieved a great success. (73)So fight those who trade the life of this world with the Hereafter, in the cause of Allah, and whoever fights in the cause of Allah, and is killed or gets victory, We shall bestow on him a great reward (74) The Necessity of Taking Necessary Precautions Against the Enemy Allah commands His faithful servants to take precautions against their enemies, by being prepared with the necessary weapons and

حَدَّثَنَا هَدَّابُ بْنُ خَالِدٍ، حَدَّثَنَا حَمَّادُ بْنُ سَلَمَةَ، ح وَحَدَّثَنِي زُهَيْرُ بْنُ حَرْبٍ، حَدَّثَنَا مُعَاذُ بْنُ مُعَاذٍ الْعَنْبَرِيُّ، ح وَحَدَّثَنِي مُحَمَّدُ بْنُ عَبْدِ الأَعْلَى، حَدَّثَنَا الْمُعْتَمِرُ، ح وَحَدَّثَنَا إِسْحَاقُ، بْنُ إِبْرَاهِيمَ أَخْبَرَنَا جَرِيرٌ، كُلُّهُمْ عَنْ سُلَيْمَانَ التَّيْمِيِّ، ح وَحَدَّثَنَا أَبُو كَامِلٍ، فُضَيْلُ بْنُ حُسَيْنٍ - وَاللَّفْظُ لَهُ - حَدَّثَنَا يَزِيدُ بْنُ زُرَيْعٍ، حَدَّثَنَا التَّيْمِيُّ، عَنْ أَبِي عُثْمَانَ، عَنْ أُسَامَةَ بْنِ زَيْدٍ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ قُمْتُ عَلَى بَابِ الْجَنَّةِ فَإِذَا عَامَّةُ مَنْ دَخَلَهَا الْمَسَاكِينُ وَإِذَا أَصْحَابُ الْجَدِّ مَحْبُوسُونَ إِلاَّ أَصْحَابَ النَّارِ فَقَدْ أُمِرَ بِهِمْ إِلَى النَّارِ وَقُمْتُ عَلَى بَابِ النَّارِ فَإِذَا عَامَّةُ مَنْ دَخَلَهَا النِّسَاءُ ‏"‏ ‏.‏

Usama b. Zaid reported that Allah's Messenger (way peace be upon him) said:I stood at the door of Paradise and I found that the overwhelming majority of those who entered therein was that of poor persons and the wealthy persons were detained to get into that. The denizens of Hell were commanded to get into Hell, and I stood upon the door of Fire and the majority amongst them who entered there was that of women

حَدَّثَنَا أَبُو كُرَيْبٍ، حَدَّثَنَا أَبُو أُسَامَةَ، عَنْ سَعِيدِ بْنِ أَبِي عَرُوبَةَ، سَمِعَ أَبَا رَجَاءٍ، عَنِ ابْنِ عَبَّاسٍ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم فَذَكَرَ مِثْلَهُ ‏.‏

This hadith is narrated likewise through another chain of transmitters

حَدَّثَنِي عَبْدُ اللَّهِ بْنُ مُحَمَّدٍ، حَدَّثَنَا عَبْدُ الْمَلِكِ بْنُ عَمْرٍو، حَدَّثَنَا زُهَيْرُ بْنُ مُحَمَّدٍ، عَنْ مُحَمَّدِ بْنِ عَمْرِو بْنِ حَلْحَلَةَ، عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي سَعِيدٍ الْخُدْرِيِّ، وَعَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ مَا يُصِيبُ الْمُسْلِمَ مِنْ نَصَبٍ وَلاَ وَصَبٍ وَلاَ هَمٍّ وَلاَ حُزْنٍ وَلاَ أَذًى وَلاَ غَمٍّ حَتَّى الشَّوْكَةِ يُشَاكُهَا، إِلاَّ كَفَّرَ اللَّهُ بِهَا مِنْ خَطَايَاهُ ‏"‏‏.‏

Narrated Abu Sa`id Al-Khudri and Abu Huraira:The Prophet (ﷺ) said, "No fatigue, nor disease, nor sorrow, nor sadness, nor hurt, nor distress befalls a Muslim, even if it were the prick he receives from a thorn, but that Allah expiates some of his sins for that

حَدَّثَنَا إِبْرَاهِيمُ بْنُ الْمُنْذِرِ، قَالَ حَدَّثَنِي مُحَمَّدُ بْنُ فُلَيْحٍ، قَالَ حَدَّثَنِي أَبِي، عَنْ هِلاَلِ بْنِ عَلِيٍّ، مِنْ بَنِي عَامِرِ بْنِ لُؤَىٍّ عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي هُرَيْرَةَ ـ رضى الله عنه ـ قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَثَلُ الْمُؤْمِنِ كَمَثَلِ الْخَامَةِ مِنَ الزَّرْعِ مِنْ حَيْثُ أَتَتْهَا الرِّيحُ كَفَأَتْهَا، فَإِذَا اعْتَدَلَتْ تَكَفَّأُ بِالْبَلاَءِ، وَالْفَاجِرُ كَالأَرْزَةِ صَمَّاءَ مُعْتَدِلَةً حَتَّى يَقْصِمَهَا اللَّهُ إِذَا شَاءَ ‏"‏‏.‏

Narrated Abu Huraira:Allah's Messenger (ﷺ) said, "The example of a believer is that of a fresh tender plant; from whatever direction the wind comes, it bends it, but when the wind becomes quiet, it becomes straight again. Similarly, a believer is afflicted with calamities (but he remains patient till Allah removes his difficulties.) And an impious wicked person is like a pine tree which keeps hard and straight till Allah cuts (breaks) it down when He wishes." (See Hadith No. 558, Vol)

حَدَّثَنَا عَبْدُ اللَّهِ بْنُ مَسْلَمَةَ بْنِ قَعْنَبٍ، حَدَّثَنَا سُلَيْمَانُ، - يَعْنِي ابْنَ بِلاَلٍ - عَنْ جَعْفَرٍ، عَنْ أَبِيهِ، عَنْ جَابِرِ بْنِ عَبْدِ اللَّهِ، أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم مَرَّ بِالسُّوقِ دَاخِلاً مِنْ بَعْضِ الْعَالِيَةِ وَالنَّاسُ كَنَفَتَهُ فَمَرَّ بِجَدْىٍ أَسَكَّ مَيِّتٍ فَتَنَاوَلَهُ فَأَخَذَ بِأُذُنِهِ ثُمَّ قَالَ ‏"‏ أَيُّكُمْ يُحِبُّ أَنَّ هَذَا لَهُ بِدِرْهَمٍ ‏"‏ ‏.‏ فَقَالُوا مَا نُحِبُّ أَنَّهُ لَنَا بِشَىْءٍ وَمَا نَصْنَعُ بِهِ قَالَ ‏"‏ أَتُحِبُّونَ أَنَّهُ لَكُمْ ‏"‏ ‏.‏ قَالُوا وَاللَّهِ لَوْ كَانَ حَيًّا كَانَ عَيْبًا فِيهِ لأَنَّهُ أَسَكُّ فَكَيْفَ وَهُوَ مَيِّتٌ فَقَالَ ‏"‏ فَوَاللَّهِ لَلدُّنْيَا أَهْوَنُ عَلَى اللَّهِ مِنْ هَذَا عَلَيْكُمْ ‏"‏ ‏.‏

Jabir b. Abdullah reported that Allah's Apostle (ﷺ) happened to walk through the bazar coming from the side of 'Aliya and the people were on both his sides. There he found a dead lamb with very short ears. He took hold of his ear and said:Who amongst you would like to have this for a dirham? They said: We do not like to have it even for less than that as it is of no use to us. He said: Do you wish to have it (free of any cost)? They said: By Allah, even if it were alive (we would not have liked to possess that), for there is defect in it as its ear is very short; now it is dead also. Thereupon Allah's Messenger (ﷺ) said: By Allah, this world is more insignificant in the eye of Allah than it (this dead lamb) is in your eye

حَدَّثَنِي مُحَمَّدُ بْنُ الْمُثَنَّى الْعَنَزِيُّ، وَإِبْرَاهِيمُ بْنُ مُحَمَّدِ بْنِ عَرْعَرَةَ السَّامِيُّ، قَالاَ حَدَّثَنَا عَبْدُ الْوَهَّابِ، - يَعْنِيَانِ الثَّقَفِيَّ - عَنْ جَعْفَرٍ، عَنْ أَبِيهِ، عَنْ جَابِرٍ، عَنِ النَّبِيِّ صلى الله عليه وسلم ‏.‏ بِمِثْلِهِ غَيْرَ أَنَّ فِي حَدِيثِ الثَّقَفِيِّ فَلَوْ كَانَ حَيًّا كَانَ هَذَا السَّكَكُ بِهِ عَيْبًا ‏.‏

Jabir reported Allah's Apostle (ﷺ) narrating a hadith like this with a slight variation of wording

ثم خاصية العقل واللب : التمييز بين مراتب المحبوبات والمكروهات بقوة العلم والتمييز وإيثار أعلى المحبوبين على أدناهما واحتمال أدنى المكروهين للتخلص من أعلاهما بقوة الصبر والثبات واليقين

وأمر المصاب بأنفع الأمور له وهو الصبر والاحتساب فإن ذلك يخفف مصيبته ويوفر أجره والجزع والتسخط والتشكى يزيد في المصيبة ويذهب الأجر

فالصبر مع نفسك و المصابرة بينك وبين عدوك و المرابطة الثبات وإعداد العدة وكما أن الرباط لزوم الثغر لئلا يهجم منه العدو فكذلك الرباط أيضا لزوم ثغر القلب لئلا يهجم عليه الشيطان فيملكه أو يخربه أو يشعثه

ويهيج أفراحهم قابلوه بالسكون والثبات والاستقرار حتى كأنه لم يهجم عليهم وقال كعب بن زهير في مدح المهاجرين :

الثالث اللزوم والثبات ومنه حب البعير وأحب إذا برك ولم يقم قال الشاعر

الركن الرابع: نفس الاحتساب، وله درجات وآداب.

Psychological resilience among palliative patients with advanced cancer: A systematic review of definitions and associated factors.: Objective: The palliative journey can be emotionally stressful for both patients with advanced cancer and their families. Psychological resilience is crucial in aiding with patients' adaptation and post-traumatic growth. The aim of this systematic review was to critically examine the definitions of psychological resilience and its associated factors in palliative patients with advanced cancer. Methods: Four databases were systematically searched from inception to August 2020. Both qualitative an

Resilience and related factors in colorectal cancer patients: A systematic review.: Purpose: To explore resilience and its related factors in adult colorectal cancer patients. Methods: Three databases (CINAHL, Scopus and PubMed) were searched for literature published from January 2009 to February 2021 using the terms colorectal and resilience or resilient or resiliency. The review was registered with PROSPERO and followed the PRISMA statement guidelines. Results: The studies (n = 11) showed that most colorectal cancer patients exhibit moderate levels of resilience. Resilience w

Post-traumatic growth in people living with a serious medical condition and its relations to physical and mental health: a systematic review.: Purpose: The diagnosis of a life-threatening illness can be an extremely stressful, traumatic experience. However, many survivors report also various positive changes, referred in empirical literature as post-traumatic growth (PTG). Empirical studies that documented stress disorders and PTG in patients and survivors of life-threatening diseases are reviewed in three areas: Predictors of PTG, relationships between PTG and indicators of mental health and the impact of PTG on the process of convale

A systematic review of resilience in the physically ill.: Background: Resilience is the capacity of individuals to maintain, or regain, their mental health in the face of significant adversity, including physical illness. Objective: We conducted a systematic review of resilience and related concepts in the physically ill to determine factors associated with predicting or promoting resilience. Methods: An electronic search of PsychInfo, Medline, and CINAHL databases between 1950 and May 2009 was performed using the terms resilience, and various types of

Resilience in Caregivers: A Systematic Review.: Background: Resilience is a multidimensional construct that explains why people facing the consequences of adversity and stress can have a positive outcome, emphasizing adjustment to experiences that are perceived as threatening. Objective: The aim of this study is to review the construct of resilience and associated variables in caregivers of patients with chronic, advanced illness and at the end of life. Methods: The review included studies published between January 2009 and January 2019, usin

Feasibility and acceptability of a resilience training program for intensive care unit nurses.: Background: The critical nursing shortage is particularly apparent in specialty areas such as intensive care units (ICUs). Some nurses develop resilient coping strategies and adapt to stressful work experiences, mitigating the development of common maladaptive psychological symptoms. Objectives: To determine if a multimodal resilience training program for ICU nurses was feasible to perform and acceptable to the study participants. Methods: In a randomized and controlled 12-week intervention stud

Comparison of depression, anxiety and stress in persons with traumatic and non-traumatic post-acute spinal cord injury.

Study design: Community cross-sectional self-report survey of adults with spinal cord injury (SCI). Objectives: The aim of this study was to examine the likelihood of depression, anxiety and stress in adults with non-traumatic SCI (NT-SCI) compared with adults with traumatic SCI (T-SCI). Setting: Victoria, Australia. Adults (N=443; NT-SCI n=62) living in the community and attending specialist SCI rehabilitation clinics. Methods: Participants completed a self-report survey by internet, telephone or hard copy. Items included demographic and injury-related characteristics and the short form Depression, Anxiety and Stress Scale (DASS-21). Results: Persons with NT-SCI were significantly more likely to be female (P<0.05), older (P<0.001) and have lower-level incomplete injuries (P<0.001). The probability of depression, anxiety or stress in respondents with NT-SCI did not differ from persons wi…

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Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer.

Context: Patients frequently rely on religious faith to cope with cancer, but little is known about the associations between religious coping and the use of intensive life-prolonging care at the end of life. Objective: To determine the way religious coping relates to the use of intensive life-prolonging end-of-life care among patients with advanced cancer. Design, setting, and participants: A US multisite, prospective, longitudinal cohort of 345 patients with advanced cancer, who were enrolled between January 1, 2003, and August 31, 2007. The Brief RCOPE assessed positive religious coping. Baseline interviews assessed psychosocial and religious/spiritual measures, advance care planning, and end-of-life treatment preferences. Patients were followed up until death, a median of 122 days after baseline assessment. Main outcome measures: Intensive life-prolonging care, defined as receipt of m…

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Discussing matters of sexual health with children: what issues relating to disclosure of parental HIV status reveal.

Little is published about the disclosure of parents' own HIV status to their children in Africa. Research shows that keeping family secrets from children, including those related to a parent's HIV status, can be detrimental to their psychological well-being and to the structure of the family. Further, children with HIV-positive parents have been shown to be more vulnerable to poorer reproductive health outcomes. This qualitative study in Botswana conducted in-depth interviews among 21 HIV-positive parents on antiretroviral therapy. The data revealed that parents found discussing the issue of HIV with children difficult, including disclosing their own HIV status to them. Reasons for disclosing included: children being HIV positive, the rest of the family knowing, or the parent becoming very sick. Reasons for not disclosing included: believing the child to be too young, not knowing how to …

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What we regret most are lost opportunities: a theory of regret intensity.

A recent theory (Roese & Summerville, 2005) has suggested that regret is intensified by perceptions of future opportunity. In this work, however, it is proposed that feelings of regret are more likely elicited by perceptions of lost opportunity: People regret outcomes that could have been changed in the past but can no longer be changed and for which people experience low psychological closure. Consistent with the lost opportunity principle, Study 1 revealed that regretted experiences in the most commonly regretted life domains are perceived as offering the least opportunity for improvement in the future, Study 2 indicated that people experience the most regret for outcomes that are not repeatable, and Study 3 revealed that perceptions of higher past than future opportunities and low psychological closure predict regret intensity. Discussion focuses on the hope-inducing yet ephemeral nat…

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Self-compassion versus global self-esteem: two different ways of relating to oneself.

This research examined self-compassion and self-esteem as they relate to various aspects of psychological functioning. Self-compassion entails treating oneself with kindness, recognizing one's shared humanity, and being mindful when considering negative aspects of oneself. Study 1 (N=2,187) compared self-compassion and global self-esteem as they relate to ego-focused reactivity. It was found that self-compassion predicted more stable feelings of self-worth than self-esteem and was less contingent on particular outcomes. Self-compassion also had a stronger negative association with social comparison, public self-consciousness, self-rumination, anger, and need for cognitive closure. Self-esteem (but not self-compassion) was positively associated with narcissism. Study 2 (N=165) compared global self-esteem and self-compassion with regard to positive mood states. It was found that the two co…

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Longitudinal association of adolescents' sense of coherence with tooth-brushing using an integrated behaviour change model.

Objective: To determine the association between adolescents' sense of coherence (SOC) and their tooth-brushing behaviour. Methods: This 18-month longitudinal study involved a representative sample of 8th-graders (n = 1025) from 11 randomly selected public high schools in the Limpopo Province, South Africa. Data collected by means of a self-administered questionnaire included respondents' socio-demographic profiles, vulnerability to depression, smoking status, dental treatment attendance pattern, frequency of and motivation for tooth-brushing. Based on the responses to the question on readiness to change brushing behaviour and in line with the integrated change model, respondents were also categorized as being in the pre-contemplation, contemplation or preparation/action stages. Respondents' SOC was measured using a six-item adapted Antonovsky SOC scale. Data analysis included chi-squared…

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Prefrontal-subcortical pathways mediating successful emotion regulation.

Although prefrontal cortex has been implicated in the cognitive regulation of emotion, the cortical-subcortical interactions that mediate this ability remain poorly understood. To address this issue, we identified a right ventrolateral prefrontal region (vlPFC) whose activity correlated with reduced negative emotional experience during cognitive reappraisal of aversive images. We then applied a pathway-mapping analysis on subcortical regions to locate mediators of the association between vlPFC activity and reappraisal success (i.e., reductions in reported emotion). Results identified two separable pathways that together explained approximately 50% of the reported variance in self-reported emotion: (1) a path through nucleus accumbens that predicted greater reappraisal success, and (2) a path through ventral amygdala that predicted reduced reappraisal success (i.e., more negative emotion)…

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Collaborative coping and daily mood in couples dealing with prostate cancer.

Collaborative coping (i.e., spouses pooling resources and problem solving jointly) may be associated with better daily mood because of heightened perceptions of efficacy in coping with stressful events. The study examined the daily processes of collaborative coping (individuals' perceptions that the spouse collaborated), perceived coping effectiveness (ratings of how well they dealt with the event), and mood (i.e., Positive and Negative Affect Scale) across 14 days in 57 older couples coping with stressors involving the husband's prostate cancer and daily life in general. In hierarchical multivariate linear models, collaborative coping was associated with more positive same-day mood for both husbands and wives and less negative mood for wives only. These associations were partially mediated by heightened perceptions of coping effectiveness. Exploratory analyses revealed that collaborativ…

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Sex differences in emotional and physiological responses to the Trier Social Stress Test.

Women are more likely than men to be diagnosed with depression and anxiety-related disorders, and it has been hypothesized that this difference is related to sex differences in stress reactivity. Women typically report higher levels of negative affect than men in response to psychosocial stressors, but the evidence for sex differences in physiological reactivity to stressful situations is not consistent. The present study sought to expand this work by evaluating sex differences in reactivity to a social stress challenge across neuroendocrine, autonomic and affective response domains. Participants (32 women, 30 men) completed a standardized psychosocial stress challenge (i.e., the Trier Social Stress Test (TSST)), during which several physiological (e.g., cortisol reactivity, heart rate) and psychological (e.g., depression, irritability, anger, fear) measures were assessed. The findings d…

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Are expressive suppression and cognitive reappraisal associated with stress-related symptoms?

Emotion dysregulation is thought to be critical to the development of negative psychological outcomes. Gross (1998b) conceptualized the timing of regulation strategies as key to this relationship, with response-focused strategies, such as expressive suppression, as less effective and more detrimental compared to antecedent-focused ones, such as cognitive reappraisal. In the current study, we examined the relationship between reappraisal and expressive suppression and measures of psychopathology, particularly for stress-related reactions, in both undergraduate and trauma-exposed community samples of women. Generally, expressive suppression was associated with higher, and reappraisal with lower, self-reported stress-related symptoms. In particular, expressive suppression was associated with PTSD, anxiety, and depression symptoms in the trauma-exposed community sample, with rumination parti…

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Behavioral and hormonal reactivity to threat: effects of selective amygdala, hippocampal or orbital frontal lesions in monkeys.

We compared the effects of bilateral amygdala, hippocampal or orbital frontal cortex lesions on emotional and hormonal reactivity in rhesus monkeys (Macaca mulatta). Experiment 1 measured behavioral reactivity to an unfamiliar human intruder before and after surgery. Animals with amygdala lesions demonstrated decreases in one passive defensive behavior (freezing), whereas animals with hippocampal lesions showed decreases in a more stimulus-directed defensive behavior (tooth grinding). Orbital frontal cortex lesions also reduced these two defensive behaviors, as well as decreased cage-shaking dominance displays. Animals with amygdala, hippocampal or sham lesions also demonstrated increased tension-related behaviors after surgery, but those with orbital frontal lesions did not. Finally, all three lesions diminished the operated animals' ability to modulate tension-related behaviors dependi…

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Patient perspectives on the impact of fibromyalgia.

Objective: The objective of this study was to elicit and assess important symptom domains and the impact of fibromyalgia on patients' quality of life and functioning from a patient's perspective. The intention was to collect this information as part of an overall effort to overcome shortcomings of existing outcome measures in fibromyalgia. Methods: This was a qualitative study in which six focus group sessions with 48 women diagnosed with fibromyalgia were conducted to elicit concepts and ideas to assess the impact of fibromyalgia on their lives. Results: The focus groups conducted with fibromyalgia patients identified symptom domains that had the greatest impact on their quality of life including pain, sleep disturbance, fatigue, depression, anxiety, and cognitive impairment. Fibromyalgia had a substantial negative impact on social and occupational function. Patients reported disrupted …

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Psychological inflexibility in childhood and adolescence: development and evaluation of the Avoidance and Fusion Questionnaire for Youth.

The authors describe the development and validation of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y), a child-report measure of psychological inflexibility engendered by high levels of cognitive fusion and experiential avoidance. Consistent with the theory underlying acceptance and commitment therapy (ACT), items converged into a 17-item scale (AFQ-Y) and an 8-item short form (AFQ-Y8). A multimethod psychometric approach provides preliminary support for the reliability and validity of the AFQ-Y and AFQ-Y8. In 5 substudies, 3 samples (total N = 1369) were used to establish (a) item comprehension (n = 181), (b) initial item selection (n = 513), (c) final item reduction and development of a short form for research (n = 346), (d) comprehensive psychometric evaluation of the AFQ-Y and AFQ-Y8 (n = 329), and (e) convergent and construct validity for both versions of the AFQ-Y. Overal…

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Longitudinal linkages between perceived social support and posttraumatic stress symptoms: sequential roles of social causation and social selection.

The authors examined social causation and social selection explanations for the association between perceptions of social support and psychological distress. Data came from a sample of 557 victims of natural disaster in Mexico. Structural equation modeling analyses indicated that social causation (more social support leading to less posttraumatic stress disorder [PTSD]) explained the support-to-distress relationship in the earlier postdisaster phase, 6 to 12 months after the impact. Both causal mechanisms emerged as significant paths in the midpoint of the study (12 and 18 months). Only social selection (more PTSD leading to less social support) accounted for the support-to-distress relationship at 18 to 24 months after the event. Interpersonal and social dynamics of disasters may explain why these two contrasting causal mechanisms emerged over time.

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PTSD in persons with burns: an explorative study examining relationships with attributed responsibility, negative and positive emotional states.

A sample of 90 persons who had been hospitalized for severe burns were interviewed 1-4 years after the incident. Current DSM-IV post-traumatic stress disorder (PTSD) was assessed with the Composite International Diagnostic Interview. Perceived attributed responsibility and related positive and negative emotional states were examined using a semi-structured interview. Findings showed that PTSD was established in 8% of the participants and partial PTSD in 13%. In a homogeneity analysis (HOMALS), PTSD was associated with the attribution of responsibility for the incident to impersonal relationships and with a negative emotional state. The absence of (partial) PTSD was associated with the attribution of responsibility to close relationships, internal and circumstance-related attribution of responsibility and neutral or forgiving feelings. In logit analyses, both emotional state as well as at…

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Cross-cultural adaptation, reliability, and validity of the German version of the Pain Catastrophizing Scale.

Objective: In patients with chronic pain, catastrophizing is a significant determinant of self-rated pain intensity and disability. The Pain Catastrophizing Scale (PCS) was developed to assist with both treatment planning and outcome assessment; to date, no German version has been validated. Methods: A cross-cultural adaptation of the PCS into German was carried out, strictly according to recommended methods. A questionnaire booklet containing the PCS, visual analogue scales (numeric rating scale) for pain intensity and general health, the ZUNG self-rating depression scale, the Modified Somatic Perception Questionnaire (MSPQ), the Fear Avoidance Beliefs Questionnaire (FABQ), and the Roland-Morris (RM) disability questionnaire was completed by 111 patients with chronic low back pain (mean age, 49 years), 100 of which also completed it again 7 days later. Results: Cronbach's alpha (interna…

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Peace, Equanimity, and Acceptance in the Cancer Experience (PEACE): validation of a scale to assess acceptance and struggle with terminal illness.

Background: The role of emotional acceptance of a terminal illness in end-of-life (EOL) care is not known. The authors developed a measure of peaceful acceptance at the EOL, and evaluated the role of peaceful acceptance in EOL decision-making and care. Methods: The authors developed the Peace, Equanimity, and Acceptance in the Cancer Experience (PEACE) questionnaire to measure the extent to which patients with advanced cancer have a sense of peaceful acceptance of their terminal illness. The scale was administered to 160 patients with advanced cancer along with measures of other attributes that hypothetically are related to acceptance, including cognitive acceptance of terminal illness. EOL outcomes in 56 patients who died during the study also were examined. Results: The 12-item PEACE questionnaire had 2 subscales: a 7-item Struggle With Illness subscale (Cronbach alpha = .81) and a 5-i…

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Attachment relationships as determinants of physical health.

Childhood adversity alters the relational world of the child and inhibits the development of secure attachment bonds. The purpose of this article is to survey recent evidence that attachment insecurity has the potential to impair physical health throughout the lifespan. It is proposed that attachment insecurity contributes to disease risk through a range of mechanisms which include (1) disturbances in arousal and recovery within physiological systems that respond to stress; (2) physiological links between the mediators of social relationships, stress, and immunity; (3) links between relationship style and various health behaviors; and (4) disease risk factors that serve as external regulators of dysphoric affect, such as nicotine and alcohol. The evidence for these mechanisms, particularly the evidence that has accumulated since the model was first proposed in 2000, is presented and disc…

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On positive psychological outcomes: what helps groups with a history of conflict to forgive and reconcile with each other?

Three studies examined the roles of traditional and novel social psychological variables involved in intergroup forgiveness. Study 1 (N = 480) revealed that among the pro-Pinochet and the anti-Pinochet groups in Chile, forgiveness was predicted by ingroup identity (negatively), common ingroup identity (positively), empathy and trust (positively), and competitive victimhood (the subjective sense of having suffered more than the outgroup, negatively). Political ideology (Right vs. Left) moderated the relationship between empathy and forgiveness, trust and forgiveness, and between the latter and competitive victimhood. Study 2 (N = 309), set in the Northern Irish conflict between Protestants and Catholics, provided a replication and extension of Study 1. Finally, Study 3 (N = 155/108) examined the longitudinal relationship between forgiveness and reconciliation in Northern Ireland, revealin…

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Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples.

Previous research on assessment of mindfulness by self-report suggests that it may include five component skills: observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience. These elements of mindfulness can be measured with the Five Facet Mindfulness Questionnaire (FFMQ). The authors investigated several aspects of the construct validity of the FFMQ in experienced meditators and nonmeditating comparison groups. Consistent with predictions, most mindfulness facets were significantly related to meditation experience and to psychological symptoms and well-being. As expected, relationships between the observing facet and psychological adjustment varied with meditation experience. Regression and mediation analyses showed that several of the facets contributed independently to the prediction of well-being and significantly mediated the …

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Three nursing home residents speak about meaning at the end of life.

This article provides a deeper understanding of how meaning can be created in everyday life at a nursing home. It is based on a primary study concerning dignity involving 12 older people living in two nursing homes in Sweden. A secondary analysis was carried out on data obtained from three of the primary participants interviewed over a period of time (18-24 months), with a total of 12 interviews carried out using an inductive hermeneutic approach. The study reveals that sources of meaning were created by having a sense of: physical capability, cognitive capability, being needed, and belonging. Meaning was created through inner dialogue, communication and relationships with others. A second finding is that the experience of meaning can sometimes be hard to realize.

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"That's like an act of suicide" patients' attitudes toward deactivation of implantable defibrillators.

Objective: To understand potential patient barriers to discussions about implantable cardioverter defibrillator (ICD) deactivation in patients with advanced illness. Design: Qualitative focus groups. Participants: Fifteen community-dwelling, ambulatory patients with ICDs assigned to focus groups based on duration of time since implantation and whether they had ever received a shock from their device. Approach: A physician and a social worker used a predetermined discussion guide to moderate the groups, and each session was audiotaped and subsequently transcribed. Transcripts were analyzed using the method of constant comparison. Results: No participant had ever discussed deactivation with their physician nor knew that deactivation was an option. Patients expressed a great deal of anxiety about receiving shocks from their device. Participants discussed why they needed the device and expre…

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Distress and its correlates in Korean cancer patients: pilot use of the distress thermometer and the problem list.

The distress thermometer (DT), a one-item measure for distress, provides a means for rapidly and effectively screening psychological distress in cancer patients. In this pilot study, a screening efficacy of the DT was investigated in a mixed cohort of 108 Korean cancer patients. Participants completed the DT, the problem list (PL), and the Hospital Anxiety and Depression Scale (HADS), and answered questions regarding supportive needs and their degree of satisfaction with several aspects of care. Receiver operating characteristic (ROC) curve analyses indicated that a DT cutoff score of 4 yielded an area under the ROC curve of 0.75 with a sensitivity of 0.83 and a specificity of 0.59 for HADS-total score defined cases (> or =15). HADS--Anxiety and Depression subscale scores explained 27% of the variability in the DT scores, implying that 'distress' is a broader concept that includes anxiet…

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Better or worse than expected? Aging, learning, and the ERN.

This study examined age differences in error processing and reinforcement learning. We were interested in whether the electrophysiological correlates of error processing, the error-related negativity (ERN) and the feedback-related negativity (FRN), reflect learning-related changes in younger and older adults. To do so, we applied a probabilistic learning task in which we manipulated the validity of feedback. The results of our study showed that learning-related changes were much more pronounced (a) in a response-locked positivity for correct trials compared to the ERN and (b) in a feedback-locked positivity for positive feedback compared to the FRN. These findings provide an important extension to recent theoretical accounts [Holroyd, C. B., & Coles, M. G. H. (2002). The neural basis of human error processing: Reinforcement learning, dopamine, and the error-related negativity. Psychologi…

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A pilot study of the feasibility and efficacy of the Strategies to Enhance Positive Parenting (STEPP) program for single mothers of children with ADHD.

Objective: The Strategies to Enhance Positive Parenting (STEPP) program was developed to address putative factors related to poor engagement in and outcomes following traditional behavioral parent training (BPT) for single mothers of children diagnosed with ADHD. Method: Twelve single mothers of children with ADHD were enrolled in an initial investigation of the feasibility and preliminary efficacy of the 9-week STEPP program. Results: Results indicated that the STEPP program was effective in reducing problematic child behavior and improving parental stress and psychopathology at posttreatment. The STEPP program resulted in high rates of treatment attendance and completion and consumer satisfaction with the program. However, results also indicated that the STEPP program did not improve childrens' overall psychosocial impairment and resulted in small effect size findings across measures. …

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