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PubMedDate not supplied

Emotional awareness deficits in inpatients of a psychosomatic ward: a comparison of two different measures of alexithymia.

OBJECTIVE: The TAS 20 has demonstrated strong psychometric properties in a broad variety of studies in healthy populations. Much less work has been done in clinical contexts exploring the validity of the TAS 20 as a measure of the cognitive processing of emotions. The TAS 20, a self-report scale, tends to correlate with self-reported negative affect, but in a clinical context it is important to be able to differentiate between negative affect and the cognitive processing of emotion. We therefore used the TAS 20 and a performance measure, the Levels of Emotional Awareness Scale (LEAS), which in previous studies demonstrated no overlap with measures of negative affect, to explore the ability of the two measures to detect deficits in emotional awareness in a clinical sample. METHODS: Data from inpatients of a psychosomatic ward were collected at onset (N = 394) and at the end of multimodal psychodynamic treatment (N = 249). The sample consisted of six diagnostic groups (depression; anxiety and compulsive-obsessive disorders, adjustment disorders, somatoform disorders, psychological factors related to somatic disorders, eating disorders). Changes in the TAS 20 and LEAS were compared at the two time points controlling for the effects of gender, age, educational level, and associations with self-reported negative affect. RESULTS: In contrast to the LEAS, the TAS 20 correlated with negative affect at the onset and the end of treatment. The scores of the TAS 20 decreased with treatment in all diagnostic groups but the change in the TAS 20 was not statistically significant when negative affect was controlled. In contrast, LEAS scores increased with treatment in the groups with somatoform disorders and psychological factors related to somatic disorders, and this change was independent of negative affect. CONCLUSION: The LEAS captured a change in emotional awareness due to treatment, whereas the TAS 20 captured a change in negative affect. The LEAS appears to be a more specific measure of change in emotional awareness in clinical contexts than the TAS 20.

Adult↗
PubMed2006

Reading skills and phonological awareness acquisition in Down syndrome.

BACKGROUND: Although reading abilities play a fundamental role in the acquisition of personal autonomy, up until now studies investigating these abilities in Down syndrome (DS) are aimed at defining educational or rehabilitation acquisition. However, studies describing the relationship between reading and phonological awareness in individuals with DS by comparing them to typically developing children often report contradictory results. The aim of this study is to explore reading and phonological awareness skills in a group of participants with DS. METHODS: We administered reading and phonological processing ability tests to 17 DS individuals and to 17 reading-age-matched typically developing children. RESULTS: Concerning reading abilities, participants with DS were impaired on non-word reading and on interpreting accuracy of non-homographic homophones. Their passage comprehension was also limited. Comparable ability was reported in the two groups on irregular word reading and passage reading tasks. Regarding phonological awareness ability, individuals with DS showed lower performances on several tasks, such as rhyming, deletion and syllable segmentation. CONCLUSIONS: People with DS show particular failure on non-word reading, a task where correct decoding is only partially influenced by lexical access or semantic context. Correct non-word reading mainly requires the use of the grapheme-phoneme conversion process. This process is based on the efficiency of phonological awareness abilities, which are partly impaired in people with DS. The rehabilitative implications of these findings are discussed.

Adolescent↗
PubMed1996

Awareness in anaesthesia: incidence, consequences and prevention.

Awareness during anaesthesia is a state of consciousness that is revealed by explicit or implicit memory of intraoperative events. Although large clinical surveys indicate an incidence of explicit awareness of < 0.3% during anaesthesia for general surgery, this adverse effect should be a great concern, because patients may be permanently disabled by the experience of being awake during surgery. Prevention of awareness during anaesthesia starts with an appropriate preoperative visit to the patient. The anaesthetic delivery machines must be properly checked before and during anaesthesia. The anaesthetic depth should be assessed by observation of movement responses, and consequently a minimum of muscle relaxants used. Because the anaesthetic depth can be controlled by determination of endtidal drug concentration, volatile inhaled anaesthesia may be associated with a lower frequency of awareness than other anaesthetic regimens.

Anesthesia, General↗
PubMed1997

The claims of compensation for awareness with recall during general anaesthesia in Finland.

BACKGROUND: Awareness during anaesthesia has been estimated to occur in 0.2%-0.4% of patients undergoing general surgery. In Finland, according to the Patient Injury Act, compensation is paid for an injury caused by medical treatment. We have analysed the claims for compensation involving awareness under anaesthesia filed between May, 1987 and December, 1993. METHODS: Original claims, hospital notes, and expert advisor's comments as well as the comments of the anaesthesiologist in charge of the anaesthesia, and decisions of the Patient Injury Association, were reviewed. RESULTS: A total of 23363 claims of patient injury were made during the study period. Of these, 391 considered anaesthetic treatments, and there were four cases of awareness with recall. CONCLUSION: Claims of compensation for awareness during anaesthesia were surprisingly few, possible reasons of which are discussed. Compensations paid were low in comparison with some other countries.

Adult↗
PubMed1993

Self-awareness, task failure, and disinhibition: how attentional focus affects eating.

Dieting and nondieting subjects were given either failure or neutral performance feedback on a problem-solving task. Failure subjects were then assigned to one of three self-awareness conditions: One group was forced to watch a video clip of themselves failing on the problem-solving task, one group was asked to watch a distracting video clip on bighorn sheep, and the final group was asked to sit quietly for 10 minutes. Subjects were then allowed to eat as much ice cream as they wanted. Only in those conditions which allowed--or promoted--low self-awareness (the failure/distraction and simple failure condition) did dieters show disinhibited eating. In the failure/videotape condition, which enforced high levels of self-awareness, eating in dieters remained inhibited. This supports the proposal that a reduction in self-awareness is necessary for lifting of inhibitions. Eating in nondieters was reduced in the failure/videotape and simple failure conditions, possibly because of the autonomic correlates of distress.

Achievement↗
PubMed1997

Marital conflict and adolescent distress: the role of adolescent awareness.

The present longitudinal study (1989-1991) of seventh-grade adolescents (173 boys, 197 girls; M age = 12.7 in 1989) living in the rural Midwest examined the influence of children's awareness of marital conflict and reported level of parental hostility on symptoms of adolescent distress. The theoretical model guiding the research indirectly linked marital conflict to adolescent perceptions of parents' hostility through the mediating effects of parents' and observers' report of hostility toward the adolescent and through adolescent awareness of the frequency of interparental conflict. Controlling for earlier levels of psychological distress, we hypothesized a direct path between adolescent report of parent hostility and adolescent maladjustment. Maximum likelihood estimation of the proposed model showed that marital conflict was significantly related to parents' and observers' reports of parent hostility toward the adolescent and to adolescent awareness of conflict frequency. Both parent hostility and adolescent awareness of the frequency of marital conflicts were significantly related to adolescent perceptions of parent hostility. When controlled for earlier distress, adolescent report of parent hostility significantly predicted the later internalizing and externalizing symptoms of these teenagers. The model predicted externalizing problems for boys but not girls. Otherwise, there were no gender differences in the postulated causal processes.

Acting Out↗
PubMedDate not supplied

Children's developing knowledge of the relationship between mental awareness and pretense.

This study investigated 3- and 4-year-old's understanding of the relationship between pretense and mental awareness. In Experiments 1 and 2, only a subset of 4-year-olds recognized that sleeping characters and characters ignorant of their appearance were not pretending. However, these experiments had certain linguistic demands, which potentially influenced performance. In Experiments 3, these demand characteristics were reduced; under these circumstances, 3- and 4-year-olds recognized that pretenders were aware of their actions or appearance. However, Experiment 4 showed that even using this modified procedure, 3- and 4-year-olds do not completely understand the relationship between pretense and awareness. These data support the hypotheses that by the age of 4, children have some, but not a complete, understanding of the relationship between pretense and mental awareness.

Awareness↗
PubMed2004

Awareness, use and opinions of methodological search filters used for the retrieval of evidence-based medical literature-a questionnaire survey.

The aim of this study was to determine the level of awareness of methodological search filters among health and academic librarians in the UK and Ireland, their use of filters and views on the perceived benefits, limitations and ways to increase usage of search filters. A random proportional sample of health and academic librarians were surveyed by telephone and fax. Overall, 88% (196/224) completed the telephone survey to establish awareness and use of filters. Eighty-four per cent (51/61) completed a fax survey focusing in more depth on usability issues surrounding filters. Results indicate a high level of awareness of methodological filters, but low level of usage. Furthermore, a high level of awareness did not necessarily correlate with a high level of knowledge or understanding. Examination of responses revealed limitations and recommendations beyond those reported in the literature and highlights the relationship between understanding and effective use of filters. Improved dissemination and publication of filters is required to better inform librarians on the concept of filters and how to use them effectively.

Awareness↗
PubMed1997

Fertility awareness in women attending a fertility clinic.

Eighty women attending for consultation at a tertiary referral fertility unit over a 3-month period were surveyed for their knowledge of fertility awareness and how they used this information to enhance their chances of conception. It was hypothesized that less than 50% of the subjects had an adequate understanding of when the fertile time occurred in their menstrual cycle. A questionnaire was completed anonymously by each subject and these were scored in 3 categories for fertility awareness by 2 independent Natural Family Planning teachers. Scores ranged from 0 for women who had no concept of fertility awareness, to 6 for women who were highly aware. The results showed that 26% (N = 21) of subjects had a score of 4 or greater which was considered as having an adequate understanding. The hypothesis was accepted, giving reason for concern about the effectiveness of consumer education at all levels of fertility investigation.

Adult↗
PubMed2006

Research awareness: An important factor for evidence-based practice?

BACKGROUND: Despite the growing body of literature, the reality of getting evidence into practice remains problematic. OBJECTIVE: The purpose of this study was to establish levels of research awareness amongst registered health care professionals (RHCPs) and the influence of research awareness on evidence-based practice activities. DESIGN AND METHODS: This was a descriptive quantitative study. A convenience sample of 2,126 registered RHCPs working in a large acute hospital in Northeast England, the United Kingdom was used. A self-completion Research Awareness Questionnaire (RAQ) was directed towards measuring RHCP: attitudes towards research, understanding of research and the research process, and associations with practising using an evidence base. Data were entered into a Statistical Package for Social Science (SPSS) database and descriptive and inferential statistics were used. FINDINGS: A total of 843 questionnaires were returned. Seven hundred and thirty-three (91%) RHCPs overwhelmingly agreed with the principle that evidence-based practice has a large part to play in improving patient care. This point was reinforced by 86% (n = 701) of respondents strongly agreeing or agreeing with the idea that evidence-based practice is the way forward to change clinical practice. Significant associations were noted between levels of confidence to undertake a piece of research and whether the individual had received adequate information about the research process, had basic knowledge and understanding of the research process, or had research awareness education or training. CONCLUSIONS: The study shows that RHCPs, regardless of position or grade, have a positive attitude towards research but face many obstacles. The key obstacles are lack of time, support, knowledge, and confidence. To address these obstacles, it is imperative that the organisation adopts a structured and coordinated approach to enable and empower individuals to practice using an evidence base.

Acute Disease↗
PubMed1985

Awareness of cognitive defences and stress management.

There is considerable disagreement regarding whether defences operate unconsciously, represent deliberate styles of coping with problems, or fall somewhere between. The present study considered the role of awareness in mediating the relation between defence and stress by establishing whether the conscious or unconscious nature of a given defence was associated with a distinct level of stress. The results for projection and rationalization confirmed the classical Freudian version of defence as an unconscious mechanism that reduces the stress of painful thoughts. Unconscious projectors and rationalizers reported singularly low levels of stress over the previous year. Repression without awareness was associated with a distinctly high level of stress, whereas denial with awareness was related to lower stress. While these results provide some support for the view that defences must be unconscious to work effectively, they also suggest the diversity among defences in the role played by awareness in coping with stress.

Adult↗
PubMed1992

Public awareness of home accident risks--some implications for health promotion.

Through daily contact with injured people there was a feeling that most people are sufficiently aware of the dangers in specific risk factor activities, but were not fully aware that they could do a lot to prevent harm coming upon themselves. This paper describes the results of a self-administered questionnaire about the accidents people suffered at home, their level of awareness of the risk they were undertaking, whether they had had a similar accident before, what they think the recovery period from their injury is likely to be and knowledge of, and accidents involving, 17 generally known risk activities. The results confirm that most people are indeed aware of dangers yet a large number still have accidents in spite of that. The results also indicate that campaigns advising people how to avoid these dangers could be successful.

Accident Prevention↗
PubMed2005

Self awareness and personality change in dementia.

BACKGROUND: Loss of insight is a core diagnostic criterion for frontotemporal dementia (FTD), whereas failure to recognise cognitive deficits and unawareness of disease (anosognosia) are well established findings in Alzheimer's disease (AD). However, self awareness of personality has not been quantified in these patient groups. METHODS: Twenty two patients (12 with frontal variant FTD; 10 with early AD) and 11 older adult normal controls completed self report questionnaires (the Interpersonal Adjectives Scales) describing their current personality. First degree relative informants completed two questionnaires, one describing the subject's current personality, the other retrospectively describing the subject's personality before disease onset. Differences between subject and informant reports of current personality were used to measure the accuracy of self awareness. RESULTS: Discriminant function analysis showed significant differences in self awareness among the three groups, with those in the FTD group showing the greatest magnitude of error in the largest number of personality dimensions (dominance, submissiveness, cold heartedness, introversion, and ingenuousness). Despite personality changes over time, patients with AD showed accurate self awareness in all personality dimensions except submissiveness and extraversion. Normal controls showed a pattern of underestimating positive qualities, whereas patients with FTD exaggerated positive qualities and minimised negative qualities. For the personality facets showing impaired insight, the self reports of patients with FTD and AD most closely matched their premorbid personalities, suggesting a failure to update their self image after disease onset. CONCLUSIONS: This study operationalises research criteria for loss of insight in FTD.

Aged↗
PubMed2006

The impact of acculturation on awareness of genetic testing for increased cancer risk among Hispanics in the year 2000 National Health Interview Survey.

Previous studies suggest disparities in use of preventive cancer services among U.S. Hispanics are partly explained by knowledge and access factors. One area of emerging interest is uptake of genetic counseling and testing services by underserved populations. This study aims to estimate the percentage of Hispanics in five ethnic subgroups who are aware of genetic testing for inherited cancer risk, and to assess the influence of acculturation factors primarily related to language on test awareness. Weighted data from 4,313 Hispanic respondents (age >25 years) in the year 2000 National Health Interview Survey were analyzed. Overall, 20.6% of Hispanics had heard of genetic testing for cancer risk, with percentages highest among Puerto Ricans (27.3%) and lowest among Mexicans (14.3%). Completing the interview in Spanish and English [odds ratio (OR), 0.52; 95% confidence interval (95% CI), 0.35-0.78], or only Spanish (OR, 0.60; 95% CI, 0.42-0.86), was inversely associated with test awareness (reference group, only English). Having an intermediate (OR, 0.66; 95% CI, 0.48-0.90) or low (OR, 0.63; 95% CI, 0.39-1.01) level of English language preference was also inversely associated (reference, high level) whereas being born outside the United States was weakly associated (OR, 0.80; 95% CI, 0.57-1.11). Estimates were adjusted for age, education, ethnicity, parents' cancer history, health care access, and selected health behaviors and beliefs. Results of this national survey indicate that acculturation factors related to language may affect cancer genetic test awareness in Hispanics. These factors must be taken into account when informing individuals about the role of genetics in cancer risk and providing cancer genetic health services.

Acculturation↗
PubMed2006

Awareness about glaucoma and related eye health attitudes in Switzerland: a survey of the general public.

OBJECTIVE: To assess the level of awareness about glaucoma and its consequences and to evaluate associated eye health attitudes in a randomly selected general urban and rural population in Switzerland. METHODS: A cluster random sample of the Swiss population was interviewed. Five-hundred and two telephone interviews with subjects who were representative of the 35- to 70-year-old population of the German- and French-speaking parts of Switzerland were conducted. Data were collected about their gender, age, educational status and professional situation. STUDY TYPE: Cross-sectional survey. RESULTS: In total, 76% (n = 383) of respondents did not have any (or any correct) association with the term 'glaucoma'. Only 24.7% (n = 123) of the interviewees could describe glaucoma as an eye condition. Awareness of glaucoma was independent of age, gender, educational status, and household income. Associated therapeutic measures were surgery (75%) and medical treatment (57%). Seventy-one percent of all respondents wear eyeglasses, 74% of all females and 67% of males. CONCLUSION: Awareness and knowledge about glaucoma are relatively low in the average Swiss population across all segments of society. The lack of awareness on this insidious disease has important implications for the uptake of ophthalmic care and may result in avoidable blindness. These data also show that the ophthalmologist is considered by the majority of people to be the primary contact for eye health-related information and sight corrections.

Adult↗
PubMed2006

Low levels of emotional awareness predict a better response to dermatological treatment in patients with psoriasis.

BACKGROUND: Personality and emotional factors are thought to influence the onset of psoriasis, the occurrence of relapses, and the sensitivity of this condition to dermatological treatments. OBJECTIVE: To explore the relationships between emotional disorders and emotional information processing in the one hand, and psoriasis severity and response to treatment on the other. METHODS: We recruited 93 patients through an article in the local press. These patients attended three consultations. We evaluated psoriasis severity by Psoriasis Area and Severity Index (PASI) score and response to treatment by change in PASI score from baseline to the 3-month visit. We screened for comorbid mental disorders, using the Mini International Neuropsychiatric Interview. We used the Hospital Anxiety and Depression Scale to assess anxiety and depressive symptoms. Alexithymia (difficulty in identifying and expressing emotions) was evaluated with the 26-item version of the Toronto Alexithymia Scale (TAS-26) and the ability to integrate and differentiate emotions (emotional awareness) was assessed with the Lane and Schwartz Levels of Emotional Awareness Scale (LEAS). RESULTS: Forty patients presented at least one psychiatric diagnosis and 33 were considered alexithymic (TAS > or =73). No psychological score was associated with baseline PASI score, which was higher in men and positively correlated with disease duration. Patients who considered their disease to be stress-reactive tended to have lower LEAS scores (p = 0.052). At the 3-month visit, PASI scores had significantly improved in the subset of patients (n = 67) presenting severe psoriasis at inclusion (PASI >2); emotional awareness and anxiety scores had also improved in these patients (p < 0.001), but dermatological and psychological changes were not statistically related. Dermatological improvement at 3 months with respect to baseline PASI was predicted by longer disease duration (>20 years) and lower baseline LEAS score (p = 0.044 and p = 0.021, respectively). CONCLUSION: This study demonstrates the value of assessing the ability of patients with psoriasis to process emotional information, as defined by emotional awareness. Patients with low LEAS scores appear to be more reactive to stress, but also to be more responsive to treatment, suggesting the activation of a particular stress physiology by negative affective states that are not experienced.

Adult↗
PubMed1991

Interpersonal awareness and smoking behavior in the workplace.

A questionnaire survey was conducted in small-scale production companies in Japan to examine "interpersonal awareness" and smoking behavior in the workplace. Interpersonal awareness (IA) of smokers is defined as awareness of other people's presence when smoking. Study participants were 1048 smokers and 744 nonsmokers, contrasted by worksite: office or production. Controlling for selected baseline variables, office work smokers, who smoked more in the workplace than production work smokers (77.4% vs 51.6%, p < .001), had a higher IA in the workplace (75.5% vs 58.9%, p < .001) but did not differ in IA at home (69.7% vs 66.0%). In male smokers of both worksites, degree of IA in the workplace correlated positively with that at home (rs = .36, p < .001, office; rs = .45, p < .001, production), and daily cigarette consumption correlated negatively with degree of IA at home (rs = -.44, p < .001, office; rs = -.17, p < .001, production). A predilection for smoking more at home than in the workplace correlated with higher IA in the workplace for male office smokers (rs = -.21, p < .01). In contrast, a predilection for smoking more at home than in the workplace correlated with lower degree of IA at home for production smokers of both sexes (rs = 20, p < .001, male; rs = .53, p < .05, female). Interpersonal awareness is deemed an important behavioral factor for smoking workers.

Adult↗
PubMed2002

Level of awareness about transplantation, brain death and cadaveric organ donation in hospital staff in India.

A questionnaire was distributed in a group of randomly selected hospital staff to ascertain the level and factors associated with awareness regarding organ transplantation, brain death, and cadaveric organ donation. Between October and December 2000, a total of 166 paramedical (nurses, technologists, medical physicists) and 100 nonmedical (administrative, clerical, engineering, social scientists, and miscellaneous) staff of a tertiary referral academic hospital in northern India received this questionnaire. Ninety-seven percent had good to excellent awareness about transplantation, 17.3% of the hospital staff thought that brain death was a reversible process, and 59.4% had misconceptions about the retrieval of cadaveric organs. A significant positive correlation (r = 0.147, P = .01) was observed between the awareness of transplantation, brain death, and organ donation. A significant association was also observed between the workplace (operating room and intensive care unit vs other areas) and awareness of transplantation (P = .048), and brain death and organ donation (P = .030).

Adult↗