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The chronic fatigue syndrome (CFS) remains a contentious and controversial presentation despite decades of systematic research from a variety of medical specialties and associated disciplines. Variously championed as a condition of immunological, neurological, neurophysiological, psychiatric or psychological origin, consensus on a cogent and evidenced-based pathway has yet to be achieved. Irrespective of the ambiguity regarding aetiology, what is incontrovertible is the experience of significant depression, which often accompanies this most distressing clinical presentation. The current paper examines the potential underlying mechanisms, which may determine and explain this relationship between CFS and depression. In doing so, it offers some insights, which may be of value in the development of evidence-based and scientifically-anchored interventions in individuals experiencing this diagnosis, to improve outcomes in relation to depression specifically and quality of life more generally.

The probiotics evidence-base: Improving quality through innovation in research methodologies

Phillipou et al. (2017) assert that anorexia nervosa (AN) should be thought of as a body image disorder (BID), and not as it is currently categorized as an eating disorder (ED, American Psychiatric Association, 2013). They propose that the change in description may serve as a more valuable and accurate portrayal of the illness, and suggest that conceptualizing AN as an ED is too simplistic and thus misleading. Phillipou et al. (2017) examine the view that AN is somehow different from other eating disorders such as pica, rumination disorder, avoidance/restricted food intake disorder, binge eating disorder and bulimia nervosa, because at its core AN is fundamentally an illness of ‘body image’. A parallel objective of Phillipou et al. (2017) is to alter the general public’s perception of AN, from one in which the public believe the AN patient is principally driven by disordered eating behaviour in order to reduce body fat, to one in which the patients’ overriding stimulus is actually body image.

In a traditional operations-centered model, decisions regarding patient care are determined by cost, efficiency, and operational flow. With increasing deductibles and health care expenses, US patients are now consumers of health care and, as such, have developed consumer demands of health care service levels. This is particularly true in the US assisted reproductive technology (ART) market, where the majority of fertility treatment is self-pay. The Continuous Quality Improvement (CQI) committee consists of an interdepartmental group of employees ranging from the senior management team to medical directors and laboratory management staff. It is an integrated, continuous effort to measure, monitor, and improve patient safety and the performance of infertility and ART services. Alignment of the organization around the patient is critical to the business of any ART center. The patient experience needs to align with patient expectations and these expectations need to be carefully and thoughtfully developed.

Previous work has established how achievement emotions are related to the trichotomous model of achievement goals, and how they predict academic performance. In our study we examine relations using an additional, mastery-avoidance goal, and whether outcome-focused emotions are predicted by mastery as well as performance goals. Results showed that outcome-focused emotions were predicted by mastery approach/avoidance, and performance-avoidance goals, whereas activity-focused emotions were predicted by mastery approach/avoidance goals only. Two achievement emotions, pride and hope, mediated relations between achievement goals and academic performance. These findings show that it is important to consider the hierarchical nature of achievement goals, that is, the distinction between goals and reasons. If students use grades as a basis on which to judge their task and intrapersonal competence, then mastery goals can predict outcome-focused emotions.

Body dysmorphic disorder (BDD) is a condition in which an individual perceives an area of their body to be fundamentally flawed. Individuals may notice small imperceptible blemishes that become the epicenter for obsessional repetitive ritualistic behaviors that can force them to spend many hours in front of mirrors examining and reexamining the same area. Any area of the body may become the perceived area of attention, but in general the most frequently reported areas are hair, face, breasts, stomach, and thighs. These problem areas may be explored for up to 8 hours/day. There is a strong association with obsessive–compulsive disorder, and BDD is found in 37% of those with the condition, with a lifetime prevalence of 83%. Even though the Diagnostic and Statistical Manual of Mental Disorders has no specific diagnostic category for BDD within an obese population, evidence has shown that many individuals seeking weight loss surgery report a number of psychological and physiological reasons. Body image dissatisfaction is a major contributing factor in the motivation to elect for surgical intervention. The events that occur after bariatric surgery with regards to BDD, body image, and quality-of-life (QoL) have remained largely unexplored. However, studies suggest that the antecedents to BDD, including anxiety and depression, are reported to be much improved following bariatric surgery. Individuals who have dramatic and relatively sudden weight loss following bariatric surgery often have postoperative skin folds. The skin folds can become a source of frustration and anxiety, and can even prevent further weight loss. It is suggested that the individual’s new body image may become a source of deep frustration, shame, and even humiliation.

Sexual function (SF) disorder is common among those seeking surgical intervention for excessive weight. Symptoms of sexual dysfunction (SD) can manifest in any one of the phases of the sexual response cycle, which include desire, excitement, orgasm, and finally, resolution. Females more than males have a greater impairment in sexual quality-of-life (QoL), and greater sexual difficulties prior to weight loss surgery. For example, they may report significant impairment in most domains of SF, including sexual desire, sexual arousal, lubrication, orgasm, and sexual satisfaction. Following bariatric surgery, however, women are more likely to report that their self-esteem had increased and anxiety around sex had diminished; they also report more intense feelings of desire and arousal. SD in males manifests primarily as erectile dysfunction (ED) or premature ejaculation. Following bariatric surgery, male ED and sexual QoL tend to normalize once weight is lost; a few studies have reported variations in sperm production and quality, but more research is required.

Copyright © 2016 Pennington et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This systematic literature review appraises critically the mediating variables of stereotype threat. A bibliographic search was conducted across electronic databases between 1995 and 2015. The search identified 45 experiments from 38 articles and 17 unique proposed mediators that were categorized into affective/subjective (n = 6), cognitive (n = 7) and motivational mechanisms (n = 4). Empirical support was accrued for mediators such as anxiety, negative thinking, and mind-wandering, which are suggested to co-opt working memory resources under stereotype threat. Other research points to the assertion that stereotype threatened individuals may be motivated to disconfirm negative stereotypes, which can have a paradoxical effect of hampering performance. However, stereotype threat appears to affect diverse social groups in different ways, with no one mediator providing unequivocal empirical support. Underpinned by the multi-threat framework, the discussion postulates that different forms of stereotype threat may be mediated by distinct mechanisms.