Although sedatives can defuse anxiety and relieve pain, Esophagogastroduodenoscopy (EGD) still is uncomfortable and threatening for some patients. Identifying patients who tolerate digestive endoscopy less well remains difficult. Using a prospective design and a multimodal assessment of pain, the present study evaluated how anxiety-related variables predicted subsequent pain outcomes. Sixty-two consecutive patients referred for elective EGD were assessed for intolerance of uncertainty (IU), procedure-related worries, anxiety sensitivity and health distress before endoscopy. During endoscopy, a doctor rated patients’ pain behavior. After complete recovery from sedation, the patients retrospectively rated endoscopy pain and situation specific catastrophizing thoughts. Descriptive analyses showed that patients undergoing EGD for the first time were more distressed and anxious than patients accustomed to the procedure and needed a higher sedative dose. Notwithstanding sedation, the behavioral rating of pain was above the cut-off value for probable pain for more than half of the patients. IU assessed before endoscopy predicted situational pain catastrophizing (PC) and self-reported pain after endoscopy through procedure related worries. Situational PC not only mediated the effect of worry, but also female gender and younger age were associated with self-reported pain through increased catastrophizing thoughts. Health distress and anxiety sensitivity predicted PC only for women, younger patients, and those not accustomed to the procedure. Our study showed that psychological preparation before sedation is needed especially for first-timers, women, and younger patients, addressing maladaptive cognitive beliefs and acquainting patients with the somatic sensations that they might experience during the procedure.
We investigated the relationship between body mass index (BMI) and personality traits, socioeconomic status (SES), and body image (BI) at the beginning of preadolescence. Data were collected from 238 Italian children aged 10-11 years using self-report scales. Information about SES was derived from parental education and professional status. BI was the variable the most strongly associated with BMI. Controlling for BI, SES, and gender, Agreeableness was inversely associated with BMI, whilst Extroversion was related to BMI in girls only. Gender did not moderate the associations between BI and BMI at this age. The relationship of certain personality traits with BMI is likely to emerge during preadolescence. Early interventions to reduce overweight and obesity could consider the interplay of Agreeableness and Extroversion with gender, BI, and SES.
In this era of globalisation community psychologists have to examine how globalisation patterns interact with local cultural norms, to ®nd tools to promote a sense of community that ®ts a particular context. We cannot therefore acritically adopt for many European contexts, community psychology concepts and intervention strategies geared to USA values. The paper argues for the need to develop a European perspective in Community Psychology, built more on the European tradition of political concern for promoting social capital, besides an individual's freedom and autonomy. The paper attempts to identity some of the main differences that have emerged in the last decades between USA and European approaches to community psychology. It also describes two empowering tools, which integrate traditional and post modern views of science: community pro®ling and multidimensional organisational analysis, that have been used by European community psychologists to rebuild social capital in organisations and local communities.
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