Altered Self-concept Research Articles

Giving Voice to Women with Substance Use Disorder: Findings from Expressive Writing About Trauma.

Trauma exposure is a risk factor for substance use disorders (SUD) among women. This study explores written content from an expressive writing (EW) intervention conducted within a residential SUD program to examine themes across trauma experiences and characterize their deep insight into such experiences. This qualitative study is a secondary data analysis of written content of the first writing session from women (n = 44) randomized to an EW condition while in residential SUD treatment. Nearly all participants (72.7% African American; mean age 37.3 years) reported a significant trauma event (93.2%) with an average of 3.7 types of trauma events (54.4% had a current posttraumatic stress disorder diagnosis). Four primary themes emerged: (1) trauma across the lifespan; (2) loss of safety; (3) altered self-concept; and (4) desire to move on. Most participants identified interpersonal trauma, especially at an early age, as well as parental neglect and physical and/or sexual violence. These themes indicate a pattern of interpersonal betrayal and paint a picture of trauma and the subsequent "rippling effect" such that the physical, mental, and emotional consequences were often as impactful as the event itself. However, there was also a desire to move on and gain a sense of normalcy. Findings highlight the importance of the written word and addressing underlying trauma in addiction treatment to facilitate healing and the woman's desire to move on.

Discrimination, stigmatisation et identité : une revue de littérature

ObjectiveThis study aimed to update the scientific knowledge concerning the relationship between discrimination, stigma and self-concept. MethodsA review was conducted and allowed to include 15 peer-reviewed articles for qualitative analysis, consisting of 13 unique samples (n=2830; Mage=37.6). The search was conducted on Pubmed and PsychInfo following this research protocol: “de stigmatization” ([Title/Abstract] or “destigmatization” [Title/Abstract] or “self-stigma” [Title/Abstract] or “Perceived stigma” [Title/Abstract] or “anticipated discrimination” [Title/Abstract] or “experienced discrimination” [Title/Abstract]) and (identi*[Title] or “self-concept” [Title]). The search resulted in 43 articles, plus three articles identified from other sources. Thirty-one articles were excluded because they did not align with the aim of the review. ResultsAmong the 15 articles included, there were 11 quantitative studies, two qualitative studies, one literature review and one theoretical article. The stigma was related to a mental disorder (n=8), a physiological or ethnic difference (n=5) or sexual orientation and gender identity (n=2). Among the 11 quantitative studies based on unique samples, all included both males and females (n=2616; Mage=36.7; 61.1% of women). Four studies established a significant impact of perceived stigma on social identity. This impact was negative when there was at least one other parallel social identity perceived favorably by the individual, and positive otherwise. In two studies, this impact was moderated by the importance of the stigmatized social identity in the self-concept. In one study, social identity was correlated to psychological distress. The sign, positive or negative, of this correlation depended on self-stigma. When self-stigma was high (i.e., self-concept is strongly perceived through the prism of negative stereotypes associated with the social identity), then social identity was positively associated with psychological distress. Otherwise, the sign of this association was negative. In one study, four distinct variables were predictors of suicidal ideation: experienced discrimination, perceived stigma, anticipated discrimination and self-stigma. Experienced discrimination predicted suicidal ideation through anticipatory discrimination and self-stigma; and perceived stigma predicted suicidal ideation through anticipated discrimination. Self-stigma and anticipatory discrimination predicted suicidal ideation at the same level. ConclusionsThe results suggest that a key variable to address in order to reduce the negative consequences of discrimination and stigmatization is self-stigma, i.e., the fact of conceiving the self-concept through the filter of the negative stereotypes associated with the characteristic perceived as discriminated. The altered self-concept should therefore be a main transnosographic diagnostic and therapeutic target. An easy-to-use proxy to detect the altered self-concept is the propensity to feel the emotion of shame, which is correlated to self-stigma.

Cleft Lip and Palate in Adolescence Identifying Variables Relating to Psychosocial Concerns

Background-It is postulated that individuals with cleft lip and palate may be at risk to experiencepsychosocial problem based upon their congenital malformation. Since cleft is one of the more common congenital malformations it is of importance to address this postulation. Purpose: To investigate if adolescents with cleft lip and palate have an altered self-concept, and to assess their degree of introversion. Materials and Methods: The cleft lip and/or palate group consisted of 55 adolescents (17 to 20 years) while the control group consisted of 31 adolescents (16 to 19 years). And Results: In this study, TSCS indicated the individuals with cleft did not experience low self- concept in comparison with the control group, in actuality the overall score indicated a significant higher self-esteem 356.60 +/- 30.22 (t (80) = 2.41; p<.05) as well in sub-scale; identity,behaviour and family self. When comparing the individuals with cleft lip and palate, cleft lip or cleft palate, they did not differ from one another (F (2,47) =1,79; p>.05). Conclusion: Adolescents with cleft seem to have a normal to high self-concept without an accentuated degree of introversion and also Academic achievement of adolescents with cleft is significantly reduced,particularly in the groupwith cleft palate.

Exercising With a Six Pack in Virtual Reality: Examining the Proteus Effect of Avatar Body Shape and Sex on Self-Efficacy for Core-Muscle Exercise, Self-Concept of Body Shape, and Actual Physical Activity.

This study investigates the Proteus effect from the first-person perspective and during avatar embodiment in actual exercise. In addition to the immediate measurements of the Proteus effect, prolonged effects such as next-day perception and exercise-related outcomes are also explored. We theorized the Proteus effect as altered perceived self-concept and explored the association between virtual reality (VR) avatar manipulation and self-concept in the exercise context. While existing studies have mainly investigated the Proteus effect in a non-VR environment or after VR embodiment, we aim to contribute to the literature by addressing this concern to explore how the Proteus effect works in actual VR exercise. Through a 2 (avatar body shape: with a six pack vs. normal) × 2 (sex: male vs. female) between-subject experiment, the results partially support the Proteus effect. Regarding actual physical activity, embodying an avatar with a six pack during exercise creates fewer body movements. No significant effect was found for perceived exertion. We also explored the role of sex as a potential moderator in the association of the Proteus effect on exercise outcomes. The Proteus effect was supported by immediate and next-day self-efficacy for core-muscle exercise only among female participants. The between-subject design allowed us to probe how avatar manipulation of muscular body shape with a six pack as opposed to normal body shape influences participants’ self-concept and exercise outcomes, as limited VR studies have employed within-subject comparisons. This also contributes to the literature by providing an upward comparison (e.g., muscular with a six pack vs. normal) as opposed to the previous downward comparison regarding body fitness (e.g., normal vs. obese). The overall results supported the Proteus effect in the context of core-muscle exercise when comparing normal and ideal body shape avatars. However, the Proteus effect as an altered self-concept and its effects on self-efficacy for exercise were supported among females but not males. Whereas the female participants who embodied avatars with a six pack associated themselves more with the muscular concept than other people, the male participants who embodied avatars with a six pack perceived themselves as more normal than others. Theoretical and practical implications are discussed.

Persons with Complex Regional Pain Syndrome Renegotiate Social Roles and Intimacy: A Qualitative Study.

Persons with complex regional pain syndrome often experience allodynia, where touch is painful. Allodynia is associated with poor prognosis, but the impacts on roles, activities, social relationships, and intimacy remain unclear. There is a need to examine intimacy in complex regional pain syndrome from a lived experience perspective. We conducted a secondary analysis of cognitive debriefing interview data from 44 persons with complex regional pain syndrome who completed a patient-reported questionnaire. Using interpretive description and thematic analysis, we analyzed items and responses addressing allodynia, relationships, and intimacy. Two themes were developed to understand intimacy related to the pain experience: a renegotiated social identity and participation and a reinvented intimate self. These themes included elements of a) loss of control, b) loss of shared experiences, c) feeling that their condition was misunderstood, d) a need for self-preservation, e) altered self-concept, and e) the concept of intimacy is broader than sexuality. Our findings suggest that complex regional pain syndrome has pervasive impacts on relationships and intimacy that merit discussion with their health care team. Persons with persistent pain need to be supported in roles and activities that allow them to express intimacy in their everyday lives.

Perspectives of patients and health professionals on the experience of living with psoriatic arthritis-related foot problems: a qualitative investigation.

The aim of the study was to explore how foot problems impact on the lives of people with psoriatic arthritis by interviewing patients and health professionals. Participants were recruited from outpatient rheumatology clinics in Sydney, Australia, and in Auckland, New Zealand, using a convenience sampling strategy. People with psoriatic arthritis were asked questions in semi-structured interviews about their foot problems and the impact they have on daily living until qualitative data saturation. Focus groups were undertaken with health professionals to explore their understanding of the patient experience of psoriatic arthritis-related foot problems. All interviews were audio-recorded and transcribed verbatim. Constant comparative analysis was used to identify emerging themes from the data. Twenty-one people with psoriatic arthritis-related foot problems and 17 health professionals participated. Three overarching key themes were derived from patients and health professionals: (1) structural and functional foot manifestations, (2) impact on daily life leading to social withdrawal and reduced work productivity and (3) mediating factors influencing the severity of impact from foot problems on their lives such as social support, self-management strategies and experiences of health care. Foot problems caused functional disability and altered self-concept, which lead to a cascade of social, economic and psychological consequences. People with foot problems contend with profound disruption to their functioning and life roles. Whilst health professionals recognised the functional and visual impact that foot problems have on daily life, the emotional burden may be under-appreciated. Future work to determine the scale and types of foot problems in psoriatic arthritis is required.

Screening for depression and anxiety in childhood neurogenic bladder dysfunction

Patients with chronic illnesses are known to have anxiety disorders and are likely to be depressed. Anxiety and depression (A/D) has been studied in adults with spina bifida (SB), however, no study has directly screened for A/D in pediatric patients with neurogenic bladder (NB) and their caregivers. The aims of our study were to determine the prevalence of A/D in caregivers of all children with SB and other NB dysfunction and in adolescents with validated screening measures. This was a preliminary cross-sectional screening investigation for A/D in pediatric patients with NB and their caregivers and adolescents with NB. Pediatric patients were defined as ages birth to 19 years and adolescents as ages 10 years-19 years. A caregiver was self-defined as a primary parent/guardian who took care of the pediatric patient for a majority of their time on a daily basis. We contacted 75 families by mail, of which 15 returned the consent and completed the questionnaires. Subsequently, 25 consecutive families whose children were seen for routine office appointments by the pediatric urology service at the Albany Medical Center in New York participated in person. 22 adolescents completed the Hospital Anxiety and Depression Scale (HADS). 47 caregivers completed both the HADS and the Center for Epidemiologic Studies Depression Scale (CES-D). Depression among adolescents: Of the 22 adolescents who completed the HADS, the median HADS score was 5.5 (Inter-quartile range (IQR): 1.75-8.75) for anxiety and 1.5 (IQR: 0-4.25) for depression; both scores were within the normal range (<8/21). Individual abnormal HADS scores (≥8/21) were seen in 6/22 (27%) for anxiety and 1/22 (5%) for depression. Anxiety and depression among caregivers: Of the 47 caregivers who completed the HADS and CES-D, the median HADS score was 7 (IQR: 4-11) for anxiety and 4 (IQR: 1-7) for depression; both scores were within the normal range. Individual abnormal HADS scores were seen in 23/47 (49%) for anxiety and 10/47 (21%) for depression. Abnormal CES-D scores (>15) were seen in 15/47 (32%). The median CES-D scores were 8 (IQR: 3-19). In this preliminary screening study, we found considerable anxiety in adolescents with NB and both A/D in caregivers. When screening by two validated surveys, adolescents with NB had median scores for A/D that were normal; yet 27% of these patients exhibited scores for anxiety that outwit the normal range. For the caregivers, the median scores were also normal; yet 49% and 32% had scores for A/D, respectively, that were abnormal. SB among pediatric patients has been shown to result in alterations in daily functioning and to increase the dependency on adult care, factors that are associated with altered self-concept, psychological distress, including A/D. Our findings underscore such results from previous studies. In caregivers, we observed a higher prevalence of anxiety than adolescents; similar findings have been reported for caregivers of other chronic conditions. Surprisingly, in caregivers, a lower percentage of scores for depression was observed. Although we have no data on the cause of this finding this may be related to a caregiver's ability to adapt to the demands of the situation in chronic illness or perhaps, lower expectations. The cross-sectional nature of our study limited us to draw any causal relationships for anxiety or depression between neurogenic patients and their caregivers. Despite our study limitations, the prevalence of anxiety in adolescents and in the caregivers is striking. Our data highlight that clinicians should screen for A/D more aggressively in pediatric patients with NB dysfunction and in their caregivers.

Subtle Psychosocial Sequelae of Genetic Test Results

Research using standard psychological measures has not revealed a dramatic psychological reaction to receipt of predictive genetic test results. Qualitative research, however, indicates that there are subtle psychosocial sequelae of receiving such results that should be considered by individuals and their clinicians prior to testing. Among these more subtle, but burdensome sequelae of testing are (i) changed social relationships (including relationships with clinicians), (ii) the impact of test results on important life decisions (e.g., career and reproductive choices), and (iii) altered self-concept among those tested. This review examines these more subtle sequelae, as well as the inadequacy of existing quantitative measures for assessing their impact, and discusses the relevance of such sequelae for decision-making about predictive genetic testing.

Think Twice before You Post: The Impact of Online Self-Presentation on the Self-Concept

The present work investigates the impact of online self-presentation on the self-concept. Online self-presentation is the goal-directed activity of publishing information on the Internet in order to influence the impressions formed by an online community about oneself. Web-based applications such as personal homepages, blogs, and social network sites facilitate online self- presentation. Prior studies found that the content of one’s online self-presentation is influenced by various internal and external demands. Moreover, research has shown that self-presentation in non-mediated, face-to-face environments, can change one’s self-concept. In this context, the present work addresses the following questions: How does the way one presents oneself online affect one’s self-concept? Under what circumstances is a person’s online self-presentation likely to lead to a self-concept change? What are the potential consequences of an altered self-concept? I develop a theoretical model based on self-identification theory, which suggests that self-presentation impacts the self-concept through a process of inference and spreading memory activation. I propose that the impact of online self-presentation on the self-concept is moderated by system factors (i.e. visibility, identifiability, and restrictiveness), online community factors (i.e. size and importance), and user factors (i.e. self-monitoring and self-concept clarity). In three sequential experiments (total N = 969), I test the proposed relationships by inducing participants to present themselves online as a risk-seeker while manipulating system and online community factors. Subsequently, I measure participants’ risk self-concept using self-report, behavioral, and social perception measures. Results suggest that online self-presentation can change one’s domain-specific self-concept -- an outcome referred to as carryover effect -- if people are led to recall and share specific memories relating to a particular content domain. Moreover, I found that system, online community, and user factors do not significantly influence the carryover effect. Lastly, my findings suggest that the self-concept has domain-specific consequences for one’s behavior as well as for one’s social perception. However, these consequences are greatly influenced by the characteristics of a given sample. Given the nascent stream of research on online self-presentation, the present work makes significant theoretical and practical contributions while opening multiple avenues for future research.

The BRCA Self‐Concept Scale: a new instrument to measure self‐concept in BRCA1/2 mutation carriers

Genetic testing for BRCA1/2 has psychosocial impacts including those related to views of personal health, sense of self and identity and body image. The centrality of a person's self-concept in maintaining physical and psychosocial well-being has been well recognized; however, to date research exploring altered self-concept related to carrier knowledge is limited. The objective of the study was to develop and validate a scale to measure the self-concept among individuals testing positive for BRCA1/2 mutations. The study was conducted in two phases: phase I: item generation and refinement and phase II: scale selection and initial validation. During phase I, scale items were generated through individual interviews and focus groups of women with BRCA1/2 mutations, including women with or without a prior diagnosis of cancer. In phase II items were selected based on several criteria resulting in a 25-item scale, which underwent a reliability analyses and preliminary validation with 115 women. A second sample of 126 women was used to conduct further validation and samples were pooled to conduct factor analysis and the final scale selection. A 17-item self-concept scale emerged having three factors: stigma, vulnerability and mastery demonstrating evidence for an instrument with promising psychometric properties (total scale alpha=0.90). The scale has direct relevance for research in facilitating our understanding of the specific aspects of the self, which are vulnerable to BRCA1/2 testing and which play a role in clinical outcomes, to facilitate the development and specific testing of interventions and may be used as an outcome measure. Specific measurement tools for genetic populations will ultimately assist in the clinical management of these populations.

Self-concept and introversion in adolescents with cleft lip and palate.

The purpose of this study was to investigate if adolescents with cleft lip, or palate, or both (CLP), have an altered self-concept, and to assess their degree of introversion, compared with a control group. The CLP group consisted of 55 adolescents (aged 17-20 years) and the control group consisted of 31 adolescents (16-19 years). The Tennessee Self Concept Scale (TSCS) was used to measure the subjects' self-concept, while the Eysenck Personality Questionnaire Inventory (EPQ-I) was used to measure introversion. The results indicate that those with CLP have a normal or even a high self-concept, and no signs of introversion.

Wound Healing in the Patient with Burns

The burn wound presents many unique challenges to the nurse who promotes optimal wound healing. Nursing care includes meticulous attention to the prevention of infection, wound cleansing and debridement, and application of topical antibacterial agents. Preparation of graft recipient sites, care of graft and donor sites, and use of various biologic and synthetic wound coverings are required. An interdisciplinary approach that provides for adequate nutrition, fosters physical function, and supports psychologic adjustment to altered self-concept is required for holistic healing of the burn wound.

Self-Concept as Altered by the Diagnosis of Cancer

From a review of the literature, it was cited that the severity of the treatment regimens for cancer results in altered self-concept with specific behaviors and emotions occurring after the diagnosis. The purpose of this study was to validate the behavioral and emotional defining characteristics of the psychological construct self-concept as it is altered by the diagnosis of cancer. Defining characteristics were derived from concept analysis and confirmed by a specified patient population.