It has been widely documented that individuals who explain negative life events with a depressogenic attributional style (stable, global attributions) tend to have increased rates of depression and other poor outcomes (e.g., Sweeny, Anderson, & Bailey, 1986). The Content Analysis of Verbatim Explanations (CAVE) is a method of assessing attributional style in spontaneously-generated causal attributions appearing in accounts of real events (Peterson, Schulman, Castellon, & Seligman, 1992
This study assessed the reliability and stability of care preferences and life evaluations among older adults with and without dementia. The study also examined spouse proxy predictions of partner responses. Test-retest reliability over 1 week, stability over 1 year, and proxy knowledge were all moderate to good, but lower for people with dementia. In all 3 areas, however, there was broad interindividual variability. People with dementia may become less reliable and stable in their self-reports, and some spouse proxies may have flawed knowledge about their partner, but dementia status alone is not sufficient to presume poor reliability or knowledge.
This study explored physician opinion about how to disclose a dementia diagnosis. Qualitative analysis was used to examine group and individual variability regarding the philosophy about and pragmatics of disclosure in a sample of physicians experienced with dementia. While all clinicians believed they should disclose a dementia diagnosis, there was wide variability in what 'disclosure' meant to them. Even individual physicians said their disclosure strategy differs from patient to patient depending on the specifics of each case. Variability was seen in attitudes about when and to whom they disclose a dementia diagnosis, who should deliver the news, what language is used, and what topics are covered. Each physician seemed to apply an idiosyncratic and complex algorithm to make decisions about these process features of the conversation. They weigh shifting perceptions of the utility of disclosure in conjunction with a desire to facilitate care planning, an awareness of family dynamics, a responsibility to acknowledge preferences, and an obligation to communicate clear information, all within the time constraints of a medical consultation. Further empirical research is needed to establish best practices that promote psychological adjustment and successful disease management in patients and caregivers who receive a dementia diagnosis.
Several studies have identified increased age as a risk factor for the development of cognitive impairment in human immunodeficiency virus (HIV)-infected subjects, but few have examined the potential synergistic effect of age and HIV serostatus on cognitive decline. The authors examined the possible combined effect of age and HIV serostatus on cognitive decline in 254 subjects stratified by age group and HIV status. After controlling for the effect of education, there were significant effects for serostatus and age group on overall cognitive impairment and a number of neuropsychological measures but no interaction effects. These data suggest that older seropositive individuals are not at an increased risk for HIV-related cognitive impairment when normal age-related cognitive changes are considered.
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