Smoking, depression, & stress: predictors of fibromyalgia health status.

The purpose of the present study was to examine the effects of smoking, stress, and depression on fibromyalgia health status. Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain condition that negatively affects health status. Health status is not only affected by the constellation of physical symptoms, but also by mood symptoms, stress levels, and patient behaviors (e.g. smoking). Participants were 491 individuals with a physician's diagnosis of FMS. They completed self-report measures of their current levels of depression, stress, the number of cigarettes smoked per day, and health status. A linear regression analysis was conducted to determine whether these measures predicted FMS health status. All three measures predicted worse health status, predicting 51.5% of the variance in health status. However, it is important to evaluate and treat more than just the physical symptoms of FMS. Attention should also be paid to mental health status and to engagement in unhealthy behaviors in order to reduce their effects on FMS health status. Future researchers should design and evaluate interventions that target these modifiable risk factors to determine the extent to which they could improve health outcomes.

Evaluating Recall and Recognition Memory Using the Montreal Cognitive Assessment: Applicability for Alzheimer's and Huntington's Diseases.

We sought to investigate whether the Montreal Cognitive Assessment (MoCA) could provide a brief assessment of recall and recognition using Huntington disease (HD) and Alzheimer disease (AD) as disorders characterized by different memory deficits. This study included 80 participants with HD, 64 participants with AD, and 183 community-dwelling control participants. Random-effects hierarchical logistic regressions were performed to assess the relative performance of the normal control (NC), participants with HD, and participants with AD on verbal free recall, cued recall, and multiple-choice recognition on the MoCA. The NC participants performed significantly better than participants with AD at all the 3 levels of assessment. No difference existed between participants with HD and NC for cued recall, but NC participants performed significantly better than participants with HD on free recall and recognition. The participants with HD performed significantly better than participants with AD at all the 3 levels of assessment. The MoCA appears to be a valuable, brief cognitive assessment capable of identifying specific memory deficits consistent with known differences in memory profiles.

Assessing the Structure of the Ways of Coping Questionnaire in Fibromyalgia Patients Using Common Factor Analytic Approaches.

The Ways of Coping Questionnaire (WCQ) is a widely used measure of coping processes. Despite its use in a variety of populations, there has been concern about the stability and structure of the WCQ across different populations. This study examines the factor structure of the WCQ in a large sample of individuals diagnosed with fibromyalgia. The participants were 501 adults (478 women) who were part of a larger intervention study. Participants completed the WCQ at their 6-month assessment. Foundational factoring approaches were performed on the data (i.e., maximum likelihood factoring [MLF], iterative principal factoring [IPF], principal axis factoring (PAF), and principal components factoring [PCF]) with oblique oblimin rotation. Various criteria were evaluated to determine the number of factors to be extracted, including Kaiser's rule, Scree plot visual analysis, 5 and 10% unique variance explained, 70 and 80% communal variance explained, and Horn's parallel analysis (PA). It was concluded that the 4-factor PAF solution was the preferable solution, based on PA extraction and the fact that this solution minimizes nonvocality and multivocality. The present study highlights the need for more research focused on defining the limits of the WCQ and the degree to which population-specific and context-specific subscale adjustments are needed.

Honor Thy Parents: An Ethnic Multigroup Analysis of Filial Responsibility, Health Perceptions, and Caregiving Decisions.

The present study explores patterns of parity and disparity in the effect of filial responsibility on health-related evaluations and caregiving decisions. Participants who identified as White, Black, Hispanic, or Asian/Pacific Islander read a vignette about an older man needing medical care. They were asked to imagine that they were the man's son and answer questions regarding their likelihood of hiring a health care advocate (HCA) for services related to the father's care. A multigroup (ethnicity) path analysis was performed, and an intercept invariant multigroup model fits the data best. Direct and indirect effect estimation showed that filial responsibility mediated the relationship between both the perceived severity of the father's medical condition and the perceived need for medical assistance and the likelihood of hiring an HCA only for White and Hispanic participants, albeit differently. The findings demonstrate that culture and ethnicity affect health evaluations and caregiving decision making.

The Effects of Age, Mental Health, and Comorbidity on the Perceived Likelihood of Hiring a Healthcare Advocate.

BACKGROUND AND PURPOSE: The projected increase in chronically ill older adults may overburden the healthcare system and compromise the receipt of quality and coordinated health care services. Healthcare advocates (HCAs) may help to alleviate the burden associated with seeking and receiving appropriate health care. We examined whether having dementia or depression, along with hypertension and arthritis, or having no comorbid medical conditions, and being an older adult, affected the perceived likelihood of hiring an HCA to navigate the health care system. METHOD: Participants (N = 1,134), age 18 or older, read a vignette and imagined themselves as an older adult with either a mood or cognitive disorder, and comorbid medical conditions or as otherwise being physically healthy. They were then asked to complete a questionnaire assessing their perceived likelihood of hiring an HCA. RESULTS: Participants who imagined themselves as having dementia reported a greater likelihood of hiring an HCA than participants who imagined themselves as having depression (p < .001). CONCLUSION: It is imperative that health care professionals attend to the growing and ongoing needs of older adults living with chronic conditions, and HCAs could play an important role in meeting those needs.

Physical function and quality of well-being in fibromyalgia: the applicability of the goodness-of-fit hypothesis.

Objective: The goodness-of-fit hypothesis suggests that the effectiveness of a coping strategy depends on the match between type of strategy (problem-focused, emotion-focused) and the level of perceived control. This hypothesis was examined as a predictor of physical functioning and quality of well-being (QWB) in a large sample of women with fibromyalgia. Methods: Participants were 478 women with diagnosed fibromyalgia (Mage = 54.31, SD = 11.2), who were part of a larger intervention in which no intervention effects were found. Hierarchical, mixed selection regressions were performed to determine whether the relationship between coping and control-predicted physical functioning and QWB. Results: Participants who reported having lower levels of perceived control over their fibromyalgia syndrome and who engaged in more self-controlling coping (emotion-focused strategy) experienced greater QWB and physical functioning than those who used less self-controlling coping. Various main effects for coping and perceived control were also found. Level of physical functioning was also related to escape-avoidance, distancing, and perceived control. The level of QWB was related to social-support seeking, accepting responsibility, distancing, problem-solving, and perceived control. Conclusions: This study provides a greater understanding of the relationships among coping, perceived control, physical functioning, and well-being for women with fibromyalgia. Implications and directions for future research are discussed.

Personality and affective forecasting: trait introverts underpredict the hedonic benefits of acting extraverted.

People report enjoying momentary extraverted behavior, and this does not seem to depend on trait levels of introversion-extraversion. Assuming that introverts desire enjoyment, this finding raises the question, why do introverts not act extraverted more often? This research explored a novel explanation, that trait introverts make an affective forecasting error, underpredicting the hedonic benefits of extraverted behavior. Study 1 (n = 97) found that trait introverts forecast less activated positive and pleasant affect and more negative and self-conscious affect (compared to extraverts) when asked to imagine acting extraverted, but not introverted, across a variety of hypothetical situations. Studies 2-5 (combined n = 495) found similar results using a between-subjects approach and laboratory situations. We replicated findings that people enjoy acting extraverted and that this does not depend on disposition. Accordingly, the personality differences in affective forecasts represent errors. In these studies, introverts tended to be less accurate, particularly by overestimating the negative affect and self-consciousness associated with their extraverted behavior. This may explain why introverts do not act extraverted more often (i.e., they overestimate hedonic costs that do not actually materialize) and have implications for understanding, and potentially trying to change, introverts' characteristically lower levels of happiness.

The good life: assessing the relative importance of physical, psychological, and self-efficacy statuses on quality of well-being in osteoarthritis patients.

Background and Purpose. The purpose of the present study was to examine the interrelationships among physical dysfunction, self-efficacy, psychological distress, exercise, and quality of well-being for people with osteoarthritis. It was predicted that exercise would mediate the relationships between physical dysfunction, self-efficacy, psychological distress, and quality of well-being. Methods. Participants were 363 individuals with osteoarthritis who were 60 years of age or older. Data were collected from the baseline assessment period prior to participating in a social support and education intervention. A series of structural equation models was used to test the predicted relationships among the variables. Results. Exercise did not predict quality of well-being and was not related to self-efficacy or psychological distress; it was significantly related to physical dysfunction. When exercise was removed from the model, quality of life was significantly related to self-efficacy, physical dysfunction, and psychological distress. Conclusions. Engagement in exercise was directly related to physical functioning, but none of the other latent variables. Alternatively, treatment focused on self-efficacy and psychological distress might be the most effective way to improve quality of well-being.

Fibromyalgia and hysterectomy: the impact on health status and health care costs.

Women account for over 80 % of the fibromyalgia syndrome (FMS) population. Some researchers have noted that a large percentage of women with FMS have had hysterectomies. The purpose of this study was to examine the relationship between FMS and hysterectomies, and to examine the impact of having a hysterectomy on health status and health care costs. A sample of 573 American women, who were members of a health maintenance organization with a confirmed diagnosis of FMS, reported whether they had a hysterectomy. Participants completed the Quality of Well-Being Scale and their annual health care costs were calculated based on their medical records. Almost half of the sample (48.3 %) reported having had a hysterectomy, with 90.7 % reporting having had the surgery before their FMS diagnosis. Those who had a hysterectomy had significantly lower general health status and incurred higher health care costs than the women with FMS who did not have a hysterectomy. The percentage of women with FMS who had a hysterectomy was considerably higher than that found in the general population. In this study, having a hysterectomy and a diagnosis of FMS was related to poorer health status and higher health care costs.

Would introverts be better off if they acted more like extraverts? Exploring emotional and cognitive consequences of counterdispositional behavior.

People enjoy acting extraverted, and this seems to apply equally across the dispositional introversion-extraversion dimension (Fleeson, Malanos, & Achille, 2002). It follows that dispositional introverts might improve their happiness by acting more extraverted, yet little research has examined potential costs of this strategy. In two studies, we assessed dispositions, randomly assigned participants to act introverted or extraverted, and examined costs-both emotional (concurrent negative affect) and cognitive (Stroop performance). Results replicated and extended past findings suggesting that acting extraverted produces hedonic benefits regardless of disposition. Positive affect increased and negative affect did not, even for participants acting out of character. In contrast, we found evidence that acting counterdispositionally could produce poor Stroop performance, but this effect was limited to dispositional extraverts who were assigned to act introverted. We suggest that the positive affect produced by introverts' extraverted behavior may buffer the potentially depleting effects of counterdispositional behavior, and we consider alternative explanations. We conclude that dispositional introverts may indeed benefit from acting extraverted more often and caution that dispositional extraverts may want to adopt introverted behavior strategically, as it could induce cognitive costs or self-regulatory depletion more generally.