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The perception of the effectiveness of instrumental actions is influenced by depressed mood. Depressive realism (DR) is the claim that depressed people are particularly accurate in evaluating instrumentality. In two experiments, the authors tested the DR hypothesis using an action-outcome contingency judgment task. DR effects were a function of intertrial interval length and outcome density, suggesting that depressed mood is accompanied by reduced contextual processing rather than increased judgment accuracy. The DR effect was observed only when participants were exposed to extended periods in which no actions or outcomes occurred. This implies that DR may result from an impairment in contextual processing rather than accurate but negative expectations. Therefore, DR is consistent with a cognitive distortion view of depression.

Disgust has been linked to several psychopathologies, although a role in depression has been questioned. However, it has recently been proposed that rather than general disgust sensitivity, disgust directed toward the self (self-disgust) may influence the development of depression, providing a causal link between dysfunctional cognitions and depressive symptomatology. This possibility was examined by developing a scale to measure self-disgust (the Self-Disgust Scale; SDS) and then using mediator analysis to determine if self-disgust was able to explain the relationship between dysfunctional cognitions (measured with the use of the Dysfunctional Attitudes Scale) and depressive symptomatology (measured with the use of the Beck Depression Inventory and the Depression, Anxiety and Stress Scale). The developed SDS was found to exhibit a high level of internal consistency, test-retest reliability, and concurrent validity. Principal-components analysis revealed two factors to underlie responses to SDS items: the 'Disgusting self,' concerned with enduring, context independent aspects of the self, and 'Disgusting ways,' concerned with behavior. Self-disgust was found to mediate the relationship between dysfunctional cognitions and depressive symptomatology, demonstrating for the first time that self-disgust plays a role in depression.

Much research has investigated the impact of dementia on spousal relationships. Most often this is from the point of view of the spouse, but occasionally people with dementia are interviewed independently or in parallel. The current study was novel in its aim to understand ‘couplehood’ as it is co-constructed by the couple when one partner has dementia and employed an innovative design that involved interviewing couples together about their relationship. Using grounded theory methodology, the study identified the changing identities within couplehood and the strategies couples employ to maintain their relationship, including normalizing, externalizing, sharing the experience and reframing the experience in light of the past. These findings are discussed in relation to other relevant research and suggest that co-constructed accounts of couplehood are valuable not only when researching the experiences of couples with dementia but also in their clinical assessment and treatment.

Findings have important implications for both research and practice, particularly the need for services to support couples' efforts to enhance couplehood in spite of dementia. Ultimately, this review adds further weight to arguments to refocus dementia care on relationships in addition to individuals.

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A growing body of literature suggests that the social context of experiencing dementia at a younger age may influence carers' and particularly partners' subjective experience and coping strategies. The current paper aims to explore the coping strategies adopted by six carers in order to adapt to changes in their relationship with their partner with young onset dementia. All were recruited from the north west of England and interpretative phenomenological analysis was used to analyse the data. Four major themes were evident: (1) 'this is not happening': the use of denial as a coping strategy; (2) 'let's not have anymore of this demeaning [treatment]': stigma in young onset dementia; (3) 'I've had to fight every inch': struggling to maintain control of events and emotions; (4) 'what will become of me?': carers' adaptation to loss. Comparisons with existing literature are made and implications for clinical practice are considered.

Objectives: The optimal care of people with dementia in general hospitals has become a policy and practice imperative over recent years. However, despite this emphasis, the everyday experiences of staff caring for this patient group is poorly understood. This review aimed to synthesise the findings from recent qualitative studies in this topic published prior to January 2014 to develop knowledge and provide a framework to help inform future training needs.Method: A systematic search of the literature was conducted across five academic databases and inclusion/exclusion criteria applied to the retrieved papers. A meta-ethnographic approach was utilised to synthesise the resulting 14 qualitative papers.Results: Five key themes were constructed from the findings: overcoming uncertainty in care; constraints of the environmental and wider organisational context; inequality of care; recognising the benefits of person-centred care; and identifying the need for training. These themes explore the opportunities and challenges associated with caring for this group of patients, as well as suggestions to improve staff experiences and patient care. Conclusion:The synthesis highlighted a lack of knowledge and understanding of dementia within general hospital staff, particularly with regard to communication with patients and managing behaviours that are considered challenging. This limited understanding, coupled with organisational constraints on a busy hospital ward, contributed to low staff confidence, negative attitudes towards patients with dementia and an inability to provide person-centred care. The benefits of dementia training for both ward staff and hospital management and peer discussion/support for ward staff are discussed.