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Background: During the COVID-19 pandemic, psoriasis care underwent significant changes in consultation methods and treatment management. However, comprehensive data on these changes and patient perceptions are limited. Aims: To evaluate the pandemic's implications on psoriasis patients, focusing on access to information, consultation methods, patient satisfaction, disease control assessment, and treatment management changes. Methods: A multicenter cross-sectional survey was performed in psoriasis patients from 4 dutch hospitals during the second wave of the pandemic. Results: Among 551 respondents, approximately 55% received information their treatment in relation to COVID-19 from their treating physician, while 16.3% sought information online. Consultation methods were shifted to remote formats for 43.6% of patients, primarily via phone and the shift was often initiated by physicians. Overall patient satisfaction during the pandemic scored high (8.0), with remote consultations scoring between 8.0–9.0. Patients on biological treatment reported better disease control (8.0), compared to those on topical (6.0) or conventional systemic treatments (7.0). However, within the systemic treatment group and biologics group, a notable percentage interrupted (16.3% resp. 12.9%) or discontinued treatment (14.1 resp. 10.6%) during the pandemic. Disease control was moderate-to-good assessed by 75% of patients receiving face-to-face and 68% receiving remote consultations. Conclusion: Remote care appears to be a viable alternative to face-to-face consultations, with potential benefits in enhancing access to information provided by treating physicians. [ABSTRACT FROM AUTHOR]

A series of articles in the Journal of Personality challenge several central assumptions of the reformulated learned helplessness model: that perceptions of uncontrollability, awareness of noncontingency between responses and outcomes, and attributions made about the outcome are necessary to explain learned helplessness effects. The present article addresses the validity of this challenge through a consideration of the methodology employed in these and other traditional studies of human helplessness conducted in the laboratory. We maintain that although performance deficits can be demonstrated reliably following exposure to uncontrollable outcomes, a number of factors other than expectations of future uncontrollability (i.e., learned helplessness) may be responsible for these effects. In addition, demands of the experimental situation may prevent subjects from admitting their true underlying thoughts and feelings regarding the manipulations employed. Finally, the current use of artificial laboratory paradigms may unnecessarily restrict the study of a complex psychological phenomenon such as learned helplessness. We suggest that future researchers employ paradigms that more closely parallel real world situations to which they hope to generalize, or utilize naturally occurring uncontrollable life events to study the problem. In addition, we argue that future research should broaden its focus beyond attributions to explore other mediators of human helplessness. [ABSTRACT FROM AUTHOR]

Introduction: Neuro-QoL is a multidimensional patient-reported outcome measurement system assessing aspects of physical, mental, and social health identified by neurology patients and caregivers as important. One of the first neurology-specific patient-reported outcome measure systems created using modern test development methods, Neuro-Qol enables brief, yet precise, assessment and the ability to conduct both PD-specific and cross-disease comparisons. We present results of Neuro-QoL clinical validation using a sample of PD patients., Methods: A total of 120 PD patients recruited from academic medical centers were assessed at baseline, 1 week, and 6 months. Assessments included Neuro-QoL and general and PD-specific validity measures., Results: Participants were 62% male and 95% white (average age = 66); H & Y stages were 1 (16%), 2 (61%), 3 (18%), and 4 (5%). Internal consistency and test-retest reliability of Neuro-QoL ranged from Cronbach's alphas = 0.81 to 0.94 with intraclass correlation coefficients = 0.66 to 0.80. Pearson's correlations between Neuro-QoL and legacy measures were generally moderate and in expected directions. UPDRS Part 2 was moderately correlated with Neuro-QoL Upper Extremity and Mobility, respectively (r's = -0.44; -0.59). Parkinson's Disease Questionnaire-39 and Neuro-QoL measures of similar constructs showed strong-to-moderate correlations (r's = 0.70-0.44). Neuro-QoL measures of fatigue, mobility, positive emotion, and emotional/behavioral control showed responsiveness to self-reported change., Conclusions: Neuro-QoL is valid for use in PD clinical research. Reliability for all but two measures is sufficient for group comparisons, with some evidence supporting responsiveness to change. Neuro-QoL possesses characteristics, such as brevity, flexibility in administration, and suitability, for cross-disease comparisons that may be advantageous to users in a variety of settings. © 2016 Movement Disorder Society., (© 2016 International Parkinson and Movement Disorder Society.)

Background: Bereavement is a universal experience, and its association with excess morbidity and mortality is well established. Nevertheless, grief becomes a serious health concern for a relative few. For such individuals, intense grief persists, is distressing and disabling, and may meet criteria as a distinct mental disorder. At present, grief is not recognized as a mental disorder in the DSM-IV or ICD-10. The goal of this study was to determine the psychometric validity of criteria for prolonged grief disorder (PGD) to enhance the detection and potential treatment of bereaved individuals at heightened risk of persistent distress and dysfunction., Methods and Findings: A total of 291 bereaved respondents were interviewed three times, grouped as 0-6, 6-12, and 12-24 mo post-loss. Item response theory (IRT) analyses derived the most informative, unbiased PGD symptoms. Combinatoric analyses identified the most sensitive and specific PGD algorithm that was then tested to evaluate its psychometric validity. Criteria require reactions to a significant loss that involve the experience of yearning (e.g., physical or emotional suffering as a result of the desired, but unfulfilled, reunion with the deceased) and at least five of the following nine symptoms experienced at least daily or to a disabling degree: feeling emotionally numb, stunned, or that life is meaningless; experiencing mistrust; bitterness over the loss; difficulty accepting the loss; identity confusion; avoidance of the reality of the loss; or difficulty moving on with life. Symptoms must be present at sufficiently high levels at least six mo from the death and be associated with functional impairment., Conclusions: The criteria set for PGD appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction. The results support the psychometric validity of the criteria for PGD that we propose for inclusion in DSM-V and ICD-11. Please see later in the article for Editors' Summary.

Three assumptions guiding research and clinical intervention strategies for people coping with sudden, traumatic loss are that (a) people confronting such losses inevitably search for meaning, (b) over time most are able to find meaning and put the issue aside, and (c) finding meaning is critical for adjustment or healing. We review existing empirical research that addresses these assumptions and present evidence from a study of 124 parents coping with the death of their infant and a study of 93 adults coping with the loss of their spouse or child to a motor vehicle accident. Results of these studies indicate that (a) a significant subset of individuals do not search for meaning and yet appear relatively well-adjusted to their loss; (b) less than half of the respondents in each of these samples report finding any meaning in their loss, even more than a year after the event; and (c) those who find meaning, although better adjusted than those who search but are unable to find meaning, do not put the issue of meaning aside and move on. Rather, they continue to pursue the issue of meaning as fervently as those who search but do not find meaning. Implications for both research and clinical intervention are discussed.

Homosexual and bisexual men (N = 825) enrolled in the Multicenter AIDS Cohort Study in Chicago completed a 90-minute self-administered questionnaire that included the Rosenberg Self-Esteem Scale, a Well-Being Index, and the Hopkins Symptom Checklist. Participants indicated their experiences with gay stigma, their visibility as gay men, their involvement in the gay community, and their commitment to a positive gay identity. Data from this predominantly white, young, educated, and middle-class cohort are consistent with a structural model in which cultural stigma is negatively associated with positive self-perceptions. This within-group result contrasts sharply with between-group results that indicate our gay cohort was neither particularly low in global self-esteem nor high in psychological distress when compared to nonstigmatized samples.

Health benefits derived from personal trauma disclosure are well established. This study examined whether disclosing emotions generated by imaginative immersion in a novel traumatic event would similarly enhance health and adjustment. College women, preselected for trauma presence, were randomly assigned to write about real traumas, imaginary traumas, or trivial events. Yoked real-trauma and imaginary-trauma participants wrote about real-trauma participants' experiences. Imaginary-trauma participants were significantly less depressed than real-trauma participants at immediate posttest, but they were similarly angry, fearful, and happy. Compared with control group participants, both trauma groups made significantly fewer illness visits at 1-month follow-up; however, real-trauma participants reported more fatigue and avoidance than did the other groups. Imaginary-trauma group effects could reflect catharsis, emotional regulation, or construction of resilient possible selves.

The study examined how social constraints on discussion of a traumatic experience can interfere with cognitive processing of and recovery from loss. Bereaved mothers were interviewed at 3 weeks (T1), 3 months (T2), and 18 months (T3) after their infants' death. Intrusive thoughts at T1, conceptualized as a marker of cognitive processing, were negatively associated with talking about infant's death at T2 and T3 among socially constrained mothers. The reverse associations were found among unconstrained mothers. Controlling for initial level of distress, there was a positive relation between T1 intrusive thoughts and depressive symptoms over time among socially constrained mothers. However, higher levels of T1 intrusive thoughts were associated with a decrease in T3 depressive symptoms among mothers with unconstrained social relationships.

The NEO Five Factor Personality Inventory (NEO-FFI; Costa & McCrae, 1989) and representative personality scales drawn from health psychology were administered to 2 samples of male military recruits (Ns = 296 and 502). Factor analysis of health-related personality scales revealed 3 conceptually meaningful domains. Examination of these domains and their constituent scales, with reference to the 5-factor model of personality, permits 3 general conclusions. First, most health-relevant dimensions and scales appear to be complex mixtures of broad personality domains. Second, variation in many health-related personality instruments is explained to a significant degree by the 5-factor model. Third, 2 of the 5 personality domains (i.e., conscientiousness and openness) appear to be substantially neglected in health psychology research.

Parents (N = 124) who had lost an infant to sudden infant death syndrome were interviewed 3 weeks and 18 months postloss. Two components of religion (religious participation and religious importance) were assessed, and their relations with 3 coping-process variables (perceived social support, cognitive processing of the loss, and finding meaning in the death) were examined. Greater religious participation was related to increased perception of social support and greater meaning found in the loss. Importance of religion was positively related to cognitive processing and finding meaning in the death. Furthermore, through these coping-process variables, religious participation and importance were indirectly related to greater well-being and less distress among parents 18 months after their infants' deaths. Results suggest that further study of the social and cognitive aspects of religion would be profitable.

Survey data collected in 1984-85 from a community sample of 637 gay and bisexual men were used to determine the features of social relationships that were most conductive to changes in both psychological health and AIDS-related sexual risk behavior. Multiple regression analyses showed that both the perceived availability of social support and the absence of conflicts in the social network were related to improve psychological health. At the same time, the subjective experience of integration into social networks was associated with increased psychological distress, and validation (the experience of being accepted by others) was related to a higher level of risk activity. These findings are discussed in terms of the social relationships among community members that share a common stressor--in this case the shared problem of being at risk for AIDS.

Results from a 1986 national survey (N = 3,614) show that having ever been widowed is associated with current levels of depression and that this association is greater for men than women. Some of this apparent gender difference occurs because men have been widowed for a shorter average period of time than women and the effects of widowhood appear to lessen over time. Widowhood also is associated with different types and amounts of life strain for men and women. The results suggest that the primary mechanism linking widowhood to depression among women is financial strain. Among men, the more critical mechanisms seem to be strains associated with household management. When specific strains occur, they appear to have different effects on respondents who have ever been widowed and those who have not. Taken together, these results suggest that what appears on the surface to be a gender difference in vulnerability to the same life event turns out upon closer examination to occur because widowhood does not affect men and women in the same way.

A sample of 139 married couples with young children and with relatively equal status careers (wives were university professors or businesswomen) were interviewed about work and home life. Considerable, traditional inequity in the distribution of child-care tasks and chore responsibility was noted, but women were generally satisfied with their husbands' home involvement. In the academic sample, the longer hours each spouse worked, the more child care the other performed; in the business sample, child-care involvement was largely determined by the husband's work hours, income, and education. Overall, women were more self-critical than were men about their performance in home roles, and women's role performance was rated more highly by husbands than by themselves. Women professionals' continued use of traditional sex role standards and the importance of attending to both partners' perspectives in studies of married life are discussed.

Objective: The authors' goal is to provide basic epidemiologic data on the issue of reactivity to stress and HIV symptom onset by studying the relationship between a broad set of naturally occurring stressor events and HIV natural history in a large longitudinal community sample of HIV-seropositive homosexual men., Method: Subjects were recruited from a cohort of 1,011 homosexual men enrolled in the Chicago site of the Multicenter AIDS Cohort Study who also participated in the Coping and Change Study. The men were given self-administered questionnaires assessing behavioral, psychological, and psychosocial variables. Relationships between reports of stressful life events and longitudinal biomedical data measuring illness progression were examined. Life events were assessed by reports on the numbers of lovers, friends, and acquaintances who were diagnosed with AIDS or had died of AIDS and by scores on a checklist of 24 more general serious stressor events. The variables indicating progression of illness among initially asymptomatic men were a drop in T-helper lymphocyte percent (CD4%) between pairs of examinations of at least 25% and onset between examinations of thrush and/or fever lasting a minimum of 2 weeks., Results: The authors found no evidence that serious stressor events have any meaningful effect on symptom onset indicated by either a drop in CD4% or onset of fever or thrush., Conclusions: There is no need for asymptomatic people with HIV infection to restrict their lives in order to avoid exposure to stressful life experiences or to develop special skills for coping with stress to forestall the progression of HIV illness.

Field studies have not yet conclusively established how attributions affect adjustment to unanticipated traumatic events. This may be due, in part, to the adoption of several untested assumptions in most prior research. It has usually been assumed that attributional issues are important to people who experience a traumatic event, that such concern is adaptive, and that specific attributions (e.g., self-blame) influence subsequent adjustment. These assumptions were tested with longitudinal data collected over 18 months from 124 parents whose child died of Sudden Infant Death Syndrome. By 3 weeks postloss, 45% of parents were not concerned with attributional issues. These parents were less distressed and less likely to blame themselves or others for the death. Longitudinal analyses did not support the assumption that attributions influence subsequent adjustment. Rather, attributions to onself or others appear to be symptomatic of distress.

This paper provides a theoretical analysis of four models of helping and coping as they relate to cancer care. The four conceptual models focus on the issue of whether or not patients should be viewed as responsible for the cause or the treatment of their cancer. The moral model, characterized by the holistic health movement, holds patients responsible for both causing and resolving health problems. The compensatory model, exemplified by cancer education programs, attributes low responsibility to patients for causing health problems but high responsibility for resolving them. The medical model views patients as neither responsible for causing nor for resolving health problems. The enlightenment model, typified by the healing movement, holds people responsible for causing their health problems, but not for resolving them. An attempt is made to examine existing programs in cancer care in light of these models. The present analysis addresses the following questions. Why is each of these models appealing? Why are they sometimes embraced by patients or health care providers? What are the benefits and disadvantages of using each of these models with cancer patients? What happens when the health care provider and patient hold different models regarding the patient's responsibility or participation in the cause of the disease or its treatment? Further research is needed to determine the conditions under which a particular model results in better health outcomes for patients, and to assess how factors such as extent of disease or type of cancer influence the patient's choice of a model.

This experiment examined the effect of timing of an intimate disclosure and assignment of responsibility for the event disclosed on interpersonal attraction. Subjects were induced to interact with a confederate who in all cases revealed something quite personal about himself. The disclosure occurred either early or near the end of a 10-minute conversation. The confederate accepted responsibility for the event disclosed, did not mention responsibility, or assigned responsibility to external factors. Negative traits were assigned to the early disclosure, and he was liked significantly less than the late discloser. The results are explained in terms of differential attributions made to early and late disclosures. The results for the assignment of responsibility variable were surprising: The confederate who accepted responsibility for the event disclosed elicited more negative reactions than the confederate who blamed other factors or who did not mention responsibility. Some possible reasons for this unexpected finding are discussed.

The purpose of this study was to examine the relation between victims' attributions of causality for their accidents and their ability to cope with severe misfortune. A total of 29 individuals who had been paralyzed in serious accidents were intensively interviewed. Both quantitative and open-ended questions were used to elicit attributions of blame and causality by respondents; coping scores were obtained from a social worker and a nurse familiar with each respondent's case. Findings suggested that blaming another and feeling that one could have avoided the accident were successful predictors of poor coping; self-blame was a successful predictor of good coping. The question, "Why me?" was posed by all respondents, and 28 of the 29 related specific hypotheses that they entertained to explain why the accident had happened to them. Their responses seemed to illustrate the respondents' need for meaning in explaining the selective incidence of the accident.

In this article we examine the long-term effects of the sudden, unexpected loss of a spouse or child. In the spouse study, interviews were conducted with 39 individuals who had lost a spouse in a motor vehicle crash 4 to 7 years ago and with 39 matched controls. In the parent study, interviews were conducted with 41 parents who had lost a child in a crash and with 41 matched controls. Control respondents were matched to bereaved respondents case-by-case on the basis of sex, age, income, education, and number and ages of children. Significant differences between bereaved spouses and controls were revealed on several indicators of general functioning, including depression and other psychiatric symptoms, social functioning, psychological well-being, reactivity to good events, and future worries and concerns. For the most part, these differences persisted when variables such as present family income and present marital status were statistically controlled. Comparisons between bereaved and control parents also revealed significant differences on some measures of general functioning (especially depression), but these were not as pervasive as the differences obtained in the spouse study. Responses to questions about current thoughts and feelings suggest that the deceased continued to occupy the thoughts and conversations of bereaved spouses and parents. Moreover, a large percentage of respondents (from 30% to 85%, depending on the question), continued to ruminate about the accident or what might have been done to prevent it, and they appeared to be unable to accept, resolve, or find any meaning in the loss. Taken together, the data provide little support for traditional notions of recovery from the sudden, unexpected loss of a spouse or child.

The thermotropic behavior of large unilamellar dipalmitoylphosphatidylcholine vesicles containing the disialoganglioside Gd1a and the trisialoganglioside Gt1b on their outer surface has been studied as a function of the ganglioside molar fraction and Ca2+ concentration by using high-sensitivity differential scanning calorimetry and steady-state fluorescence spectroscopy. These studies indicate that both gangliosides have an ordering effect on the hydrocarbon region of the bilayer and that this effect is enhanced by the presence of Ca2+ ions. The calorimetric experiments also indicate that ganglioside Gt1b has an intrinsic tendency to phase separate into compositional-rich ganglioside domains even in the absence of Ca2+. Ganglioside Gd1a, on the other hand, only phase separates at Ca2+ concentrations equal to or higher than 10 mM. These studies have allowed us to identify and evaluate the factors affecting the rates of hydrolysis of gangliosides by the soluble neuraminidase from Clostridium perfringens. The data presented in this paper indicate that the rates of hydrolysis of membrane-bound gangliosides are correlated to the physical state of the membrane and the state of aggregation of the ganglioside molecules within the lipid bilayer. For membrane-bound gangliosides, maximal activation energies were found at temperatures slightly below the lipid phase transition temperature. The rates of hydrolysis of the soluble substrate sialyllactose or that of the micellar ganglioside is independent of Ca2+ concentration, whereas the rates of hydrolysis of membrane-bound ganglioside are inhibited by Ca2+ especially under conditions in which the clustering effect of Ca2+ is maximal. These studies suggest that the soluble neuraminidases from Clostridium perfringens prefer ganglioside substrates that are dispersed within the membrane and not forming part of largely aggregated clusters.

Drawing from theory and clinical lore, we consider how individuals are assumed to cope following irrevocable loss. Several assumptions are reviewed reflecting beliefs concerning the grieving process. Specifically, we examine the expectation that depression is inevitable following loss; that distress is necessary, and failure to experience it is indicative of pathology; that it is necessary to "work through" or process a loss; and that recovery and resolution are to be expected following loss. Although limited research has examined these assumptions systematically, available empirical work fails to support and in some cases contradicts them. Implications of our analysis for theoretical development and research are explored. Finally, we maintain that mistaken assumptions held about the process of coping with loss fail to acknowledge the variability that exists in response to loss, and may lead others to respond to those who have endured loss in ways that are unhelpful.

Data from a general population sample of 621 healthy homosexual men are used to evaluate the social and emotional effects of HIV antibody status, clinical signs detected by medical examination, and subjectively perceived symptoms. Participants are unaware of their serologic status at the time of data collection, thus allowing the effects of the virus to be separated from reactions to the knowledge of serologic status. The data show that seropositivity for HIV is not associated with elevated levels of social or emotional impairment. Clinical signs lead to impairment in baseline data, but these effects do not persist at a second wave. This weakening suggests that the effects are mediated by psychological pathways rather than biologic ones. This suspicion is confirmed in further analyses, which show that the effects of clinical signs are mediated by subjectively perceived symptoms. These results show that neither social nor emotional impairment is likely to be a prodromal sign of HIV infection in otherwise healthy homosexual men. The substantial levels of distress found among these men is more directly influenced by psychological determinants than biologic ones. This suggests that physicians should be aware of the psychological toll imposed on gay men who develop health problems in the current atmosphere of uncertainty regarding risk of AIDS.

In this paper, an attempt has been made to provide an overview of the major issues facing cancer researchers who are interested in the conceptualization and measurement of social support. Taken as a whole, the literature reflects a growing appreciation for the complexity of the social-support construct, and a need for greater conceptual and research specificity. The following issues were discussed: (1) the importance of measuring support in a way that will permit assessment of distinct types of support (e.g., emotional support, advice) by distinct providers (e.g., spouse, physician) since available evidence suggests that the impact of support is strongly affected by these factors; (2) the importance of using a multimethod approach to support measurement which includes both structural aspects and subjective assessments of the adequacy of the support network; and the problems inherent in assuming that structural variables alone are an indication of the adequacy of support; (3) the importance of considering negative as well as positive support, since there is evidence suggesting that such behaviors may be very prevalent in the interactions between cancer patients and those in their support network that they may have strong influence on subsequent health outcomes; (4) the need to consider the perspective of the provider as well as the recipient in obtaining judgments of the effectiveness of particular kinds of support, given the evidence that providers sometimes make attempts to be supportive that are regarded as unhelpful; (5) the importance of focusing on actual utilization as well as availability of the support network, since an understanding of how people mobilize their support networks has important theoretical and practical implications; and, finally, (6) the importance of studying more explicit, specific behaviors that occur between cancer patients and those in their support network, as well as more general judgments regarding whether support is adequate. Investigators in the social support area agree that it is time to move beyond demonstrations of a relationship between support and health outcomes to a more careful explication of the processes underlying support. This review highlights the importance of designing research that will shed light on the precise mechanisms through which support influences health outcomes. Hopefully, such research will clarify how social support interacts with other important psychosocial variables such as coping strategies and self-esteem.(ABSTRACT TRUNCATED AT 400 WORDS)