Pre-1970s was an exceptionally dark time for the chronically ill, where the mental wellbeing of terminally ill patients was treated as taboo. In this month’s roundup, there are some far reaching implications from the psychological-side of thanatology research (the scientific study of death).

Recently, we’ve celebrated the birth, on July 8, 1926, of the journalist and psychiatrist, Elizabeth Kubler-Ross, whose development of the five stages of grief model (denial, anger, bargaining, depression, acceptance) marked the turning point in improving care. As Kubler-Ross reminds us in her book, On Death and Dying (1969), on the importance of caring for the dying:

“The few who can do this will also discover that it can be a mutually gratifying experience; they will learn much about the functioning of the human mind, the unique human aspects of our existence, and will emerge from the experience enriched and perhaps with fewer anxieties about their own finality.”

THE BEST

Spirituality related to quality of life in terminal cancer patients

The quality of life, in the last few weeks of life, for 115 advanced cancer patients admitted to hospices in Italy were assessed using a series of different rating scales.

While anxiety, pain and being single were negatively associated with quality of life, a sense of spirituality on the other hand was related to improved quality of life. The researchers further note that when patients in the Italian sample were close to death, faith was a more important component of spirituality than meaning/peace, reiterating the importance of faith in end-of-life care.

Dementia patients, caregivers prefer better care, support over research for Alzheimer’s cure

A new study surveyed people with dementia and their care providers to assess how funding from the National Alzheimer’s Project Act (NAPA), a federal plan to overcome the disease, should be spent. In contrast to the current spending plan, the majority of respondents ranked caregiving support and resources for long-term care ahead of research for a cure, where person-centered approaches to care were a clear theme in many of the responses.

Quality of life after young ischemic stroke of mild severity is mainly influenced by psychological factors

Statistical analysis of questionnaires filled out by 170 young ischemic stroke patients of mild severity and 61 controls revealed that fatigue and to a lesser extent depression and anxiety affect quality of life. The study concluded that young stroke patients should be informed about, screened, and, if possible, treated for fatigue, depression and anxiety in order to improve their quality of life.

A new test of music therapy outcomes has been developed for people with dementia, care home staff and music therapists

As music therapy is making waves in care of people with neurodegenerative diseases, with promising research results, there has been an increasing need to develop rigorous and clinically relevant ways of testing its effectiveness.

Research coming from the Doctoral Programme in Music Therapy at Aalborg University demonstrated the robustness of their new measure, “Music in Dementia Assessment Scales (MiDAS)”, and revealed five key areas that influence the impact of music on people with dementia: Interest, Response, Initiation, Involvement and Enjoyment.

Stigma, shame and intentions to seek help should be targeted to promote suicide prevention

The American Association of Suicidology published an ecological study covering 20 regions within the Netherlands and Belgium. Significant associations were found between regional suicide rates and the intention to seek informal help, self-stigma and shame, where an individual’s intention to seek informal help mediated the relationship between self-stigma and suicide rate. These results suggest at the level of the regional population, stigma, shame, and intentions to seek help should be key targets for the prevention of suicide.

THE WORST

The trustworthiness of an inmate’s face may lead to the death penalty

According to new research, using photos and sentencing data for inmates in the state of Florida, inmates whose faces were rated as low in trustworthiness by independent observers were more likely to have received the death sentence than inmates whose faces were perceived as more trustworthy. What’s more, this association remained even after the researchers controlled for various other factors, including facial maturity, attractiveness and the width-to-height ratio of the face. Even more striking was the finding that the same link was found for inmates who had been sentenced but who were actually innocent and were later exonerated.

Societies attitudes towards old age makes euthanasia more attractive to the elderly

An analysis of interviews about euthanasia revealed that the anticipated dependency on poor care from (professional) others, made participants consider euthanasia and assisted suicide as ways of avoiding this stage of life and the associated loss of dignity. Researchers concluded that societal views and related behaviors, which devalue the dependent and old, might become internalized by older people, leading them to consider euthanasia and assisted suicide as preferable end-of-life options.

Terror mismanagement: evidence that mortality salience exacerbates attentional bias in social anxiety

In an eye-tracking experiment involving 36 socially anxious and 37 non-socially anxious individuals, half of the participants were reminded of their mortality and half were not. Socially anxious individuals reminded of death paid greater attention to social threats than those that did not or those without social anxiety. This indicates that reminders of death may exasperate social threats for those with social anxiety.

Early post-transplant depression increases risk for long-term transplant-related morbidity and mortality

As the long-term survival after lung transplantation remains poor it is important to identify modifiable risk factors, making psychological factors a promising target.

As such, 155 one-year survivors of lung transplants were recruited to assess the relationship between major depression or anxiety disorder and risk for subsequent bronchiolitis obliterans syndrome (BOS), mortality and graft loss for up to 15 years post-transplant. Recipients with post-transplant depression had an elevated risk of BOS, patient death and graft loss, indicating that screening to identify depression should be routine in post-transplant care.

Early psychosocial intervention does not delay institutionalization in persons with mild Alzheimer’s disease

Early psychosocial interventions are often recommended for Alzheimer’s disease (AD) therapy and care. The objective of the study in question was to assess the effect of early psychosocial intervention on delaying the institutionalization of persons with AD, AD progression, behavioral symptoms and health-related quality of life in both persons with AD and caregivers.

Unfortunately, no beneficial effects were found, with no major differences between patients who received early interventions and those that did not. The researchers suggest that instead of automatically providing psychosocial intervention courses, individualized support programs may be more effective.

References

Bovero A, Leombruni P, Miniotti M, Rocca G, & Torta R (2015). Spirituality, quality of life, psychological adjustment in terminal cancer patients in hospice. European journal of cancer care PMID: 26215314

de Bruijn MA, Synhaeve NE, van Rijsbergen MW, de Leeuw FE, Mark RE, Jansen BP, & de Kort PL (2015). Quality of Life after Young Ischemic Stroke of Mild Severity Is Mainly Influenced by Psychological Factors. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association PMID: 26215135

Finch EC, Iverach L, Menzies RG, & Jones M (2015). Terror mismanagement: evidence that mortality salience exacerbates attentional bias in social anxiety. Cognition & emotion, 1-10 PMID: 26211552

Koivisto AM, Hallikainen I, Välimäki T, Hongisto K, Hiltunen A, Karppi P, Sivenius J, Soininen H, & Martikainen J (2015). Early psychosocial intervention does not delay institutionalization in persons with mild Alzheimer disease and has impact on neither disease progression nor caregivers’ well-being: ALSOVA 3-year follow-up. International journal of geriatric psychiatry PMID: 26177825

Lamers CP, & Williams RR (2015). Older People’s Discourses About Euthanasia and Assisted Suicide: A Foucauldian Exploration. The Gerontologist PMID: 26220419

McDermott O, Orrell M, & Ridder HM (2015). The development of Music in Dementia Assessment Scales (MiDAS). Nordic journal of music therapy, 24 (3), 232-251 PMID: 26246670

Porock D, Bakk L, Sullivan SS, Love K, Pinkowitz J, & Barsness S (2015). National Priorities for Dementia Care: Perspectives of Individuals Living with Dementia and Their Care Partners. Journal of gerontological nursing, 41 (8), 9-16 PMID: 26248139

Reynders A, Kerkhof AJ, Molenberghs G, & Van Audenhove C (2015). Stigma, Attitudes, and Help-Seeking Intentions for Psychological Problems in Relation to Regional Suicide Rates. Suicide & life-threatening behavior PMID: 26207530

Rosenberger EM, DiMartini AF, DeVito Dabbs AJ, Bermudez CA, Pilewski JM, Toyoda Y, & Dew MA (2015). Psychiatric Predictors of Long-Term Transplant-Related Outcomes in Lung Transplant Recipients. Transplantation PMID: 26177087

Wilson JP, & Rule NO (2015). Facial Trustworthiness Predicts Extreme Criminal-Sentencing Outcomes. Psychological science, 26 (8), 1325-31 PMID: 26162847

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