Personal Difficulties Research Articles

Anchor-Based and Distributional Responsiveness of the Spanish Version of the Edinburgh Feeding Evaluation in Dementia Scale in Older People with Dementia: A Longitudinal Study

Background/Objectives: Patients with dementia present with feeding difficulties (FDs) since diagnosis, conditioning their progression. Early identification is vital for preventing deterioration due to nutritional problems. The Edinburgh Feeding Evaluation in Dementia Scale (EdFED) identifies the FDs of patients with dementia by studying their behaviours while eating or being fed. The aim of this study was to assess the responsiveness of the EdFED over time in older people with cognitive impairment and to compare its effectiveness in identifying malnutrition and risk with that of the gold standard Mini Nutritional Assessment (MNA) method. Methods: This was a multicentre, prospective, observational, longitudinal, analytic study with a follow-up period of 18 months (with patients participating in nursing homes and in the community). Sociodemographic and nutritional data (body mass index (BMI), MNA, forearm circumference (FC), calf circumference (CC), and a nutritional blood test) were collected; EdFED score was reported by nurses, nursing assistants, and family caregivers. Results: The total sample consisted of 359 individuals—60.7% residential participants and 39.3% community participants. In the last follow-up there were 149 remaining (41.5%). Malnutrition was more than 30%, and the risk was 40% at the three follow-ups. The results suggest that the EdFED scale is a useful tool for assessing feeding difficulties (FDs) in older persons with dementia. It demonstrated good sensitivity and specificity in detecting malnutrition, similar to the MNA, and, more importantly, detecting risk and also identifying changes in nutritional status over time. Conclusions: The EdFED scale provides a means of evaluating nutritional problems, making it possible to work on prevention.

Overview of Coping Strategies for Caregivers of Elderly Individuals with Dementia at Senior Care Darmawan Park Sentul

Dementia is a clinical condition that is mostly experienced by the elderly and can be identified by progressive cognitive decline that disrupts one’s ability to be independent. Elderly people with dementia require special services from others as caregivers who can provide good care in everyday life. However, caregivers often experience personal difficulties in caring for elderly people with dementia. Hence, they need strategies to deal with potential problems. This paper is a qualitative research with a case study approach. The aim of this study is to describe the coping strategies of caregivers of elderly dementia at Darmawan Park Sentul Senior Care. The respondents of this study were two caregivers who worked for elderly people with dementia in Senior Care. Results shows that both subjects developed two coping strategies: problem-focused and emotion-focused coping. The dominant coping strategy used by both respondents in this study was emotion-focused coping. The aspects of emotion-focused coping that are still used by both respondents are seeking social emotional support and self-control. The form of effort most often used by both respondents in dealing with their problems was telling the closest people around them, such as their family, friends, co-workers, and superiors, to get advice, attention, and suggestions.

Depression in the schistosomiasis japonica population based on the PHQ-9 scale: a cross-sectional survey from Jiangxi Province, China

Depression is the second leading-cause of disability in China. Although studies have shown that more than 80% of patients with advanced schistosomiasis (AS) suffer from anxiety and depression, these study groups are all hospitalized patients with AS and do not represent the extent of the disease in the whole group. To our knowledge, there are no studies assessing the severity of depression in patients with other forms of schistosomiasis japonicum. Therefore, it is necessary to evaluate the occurrence and potential risk factors of depression in the schistosomiasis endemic population. This cross-sectional study was conducted in Jiangxi Province, where schistosomiasis is relatively common in China, as the investigation site. The Patient Health Questionnaire-9 (PHQ-9) scale was selected to assess the depressive symptoms in the study population. At the same time, basic personal information of the research subjects and relevant socio-economics and schistosomiasis endemic area indicators were collected. The survey results show that AS has the highest incidence of depression (34.35%), while non-advanced schistosomiasis (N-AS) and control group (CG) have 22.35% and 22.24% respectively; the incidence of depression in AS is significantly higher than in N-AS and CG, while there is no statistical significance in the comparison between N-AS and CG; the incidence of mild depressive symptoms accounts for 61.08%-75.54% of the total incidence of depression in different groups; multivariate analysis shows that the occurrence of moderate/severe depressive symptoms in the AS group was significantly related to above 60 years old, male, the combination of other serious diseases, personal financial difficulties, and marshland and lake endemic areas. In the N-AS group, the occurrence of moderate/severe depressive symptoms was significantly related to the combination of other serious diseases, personal financial difficulties, significant correlation between marshland and lake endemic areas and the level of control of schistosomiasis epidemics. In conclusion, depression is still relatively common among patients with schistosomiasis patients, especially those with AS. It is recommended that the government and relevant departments consider mental health care when developing prevention and control work in schistosomiasis-endemic areas, in order to effectively protect the physical and mental health of schistosomiasis patients and residents in endemic areas.

Playing Through Tough Times: Exploring the Relationship between Game Aspects and Coping Strategies during Difficult Life Challenges

The potential benefits of playing video games during times of difficulty have been increasingly recognised by researchers yet little is known about how particular aspects of games may relate to different forms of coping. An exploratory survey of 130 participants and content analysis identified 31 game aspects, across 6 categories, that were beneficial or detrimental to players. Our findings illustrate that games can support a range of coping strategies, including emotion-focused, avoidance, and meaning-focused coping. We also identify how specific aspects of games relate to different coping strategies during times of personal difficulty. For instance, emotion-focused coping was most commonly linked to challenge game aspects, where overcoming difficulties allowed players to experience positive emotions such as competence. The findings of this study provide valuable insights into how games may be able to facilitate a range of coping strategies during tough times.

Personality difficulty: A useful addition to the literature on personality disturbance.

The term personality difficulty has become part of the personality disorders and related traits section of the 11th Revision of the International Classification of Diseases. People with this condition make great use of health services as it can be associated with distress and poor social functioning. In the WHO guidebook, Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders (CDDR) (2024) personality difficulty is included to aid clinicians in diagnosing mental, behavioural and neurodevelopmental disorders. It is not a diagnosis but has a formal code (QE 50.7) as a 'problem associated with interpersonal interactions'. The use of this subsyndromal condition is currently uncertain and, in some quarters, may be challenged, but it is an essential part of the dimensional classification of personality dysfunction and is likely to help in overcoming the stigma around personality issues.

Personal relationships during and after an initial psychotic episode. First-person experiences

Background Psychosis is often associated with loneliness, the absence of a confidant and a perceived lack of social support. In addition, the social isolation and solitude experienced can aggravate internalised stigma, depressive symptoms and/or suicidal tendencies, and worsen the course of the disorder. Aim This study explores the experiences and perceptions of persons with psychosis concerning how their interpersonal relationships have evolved from the earliest symptoms of the disorder to its subsequent clinical stabilisation. Method A qualitative content analysis was performed of the findings from five focus groups and six in-depth interviews (36 participants). Results In the prodrome and initial symptoms stage, five themes were coded: social withdrawal, loss of friends, loss of personal skills, communication difficulties and breakdown of life project. During the recovery phase, four themes were coded: family support, partner support, loneliness and the desire for more close relationships. Finally, during the clinical stabilisation phase, three themes were coded: the recovery of interpersonal relationships, including with peers; reconstruction of the life project and increased interpersonal sensitivity. Conclusions These findings highlight the impact that psychosis can have on social life and show that recovery is also related to the development of maeningful interpersonal relationships.

Examining Dropout Among Graduate and Undergraduate Public Affairs and Political Science Students

Within the domain of public affairs and political science (PAPS), student dropout emerges as a critical concern. This study delves into the factors influencing the decisions of undergraduate and graduate PAPS students to discontinue their programs. Employing a comprehensive mixed-methods approach, we surveyed 384 at-risk undergraduates and conducted in-depth interviews with 18 former graduate students. Thematic analysis of these interviews revealed six pivotal factors influencing graduate student dropout: the financial burden of study (including tuition and limited financial aid), program curricular challenges (such as demanding thesis requirements and inadequate practical components), the delicate balance of multiple responsibilities (work, study, and family), health-related issues (including anxiety and stress), poor academic performance, and personal difficulties (such as lack of family support). At the undergraduate level, descriptive analyses indicated that 38% of PAPS students contemplated dropping out, with 30% considering changing their major. Exploratory Factor Analysis and Multiple Regression highlighted the significance of factors such as family and societal influences, economic considerations, program and curriculum structure, institutional dynamics, academic performance, personal attitudes, and student health in shaping these contemplations. This research not only expands the application of integration and engagement theory and the pull, push, and failing out theory but also validates their effectiveness in predicting dropout within PAPS programs. The study offers valuable insights for both researchers and policymakers, underscoring the imperative for more supportive, flexible, and financially viable educational structures to enhance student retention in the realm of public affairs and political science.

‘I want to go to the brink’: Cycling, the fold and men's sporting stories

This article tells the stories of three cyclists: Rob, Lucas and Cayden. For each, racing offers catharsis and emotional expression between riders deeply familiar with one another, riding together every day across years in Sydney, Australia. At Glenwood Cycle Club, the stories athletes tell of how to be a ‘hard’ racing man allows for the simultaneous denial of what is a core functioning of such sporting relationships, namely unspoken intimations of love and care. Cycling affords these riders an understanding where each can avoid speaking to the emotional difficulties that necessitate their being on road, where they share stories that gesture to personal difficulty, but rarely in detail. To explain such sporting practice, I rely on the ‘fold' as a methodological and theoretical framework to re-conceptualise dominant myths in both sport but also ‘masculinities’ studies. Rather, than ask ‘what kind of masculinity’ a person is, I ask what does a person do? What are the life-narratives men tell, interwoven with sporting movement, to fantastically augment their lives in advanced capitalist conditions specific to Sydney, Australia?

B - 96 Relationships between Self-Reported Cognitive Dysfunction, Functional Activities, and Intraindividual Cognitive Variability in Persons with Multiple Sclerosis (Pwms)

Abstract Objective To examine the relationships between intraindividual cognitive variability (IIV) and self-reported cognitive and functional difficulties in persons with multiple sclerosis (pwMS). We hypothesized higher perceived cognitive and functional difficulties would be associated with higher IIV. Method Participants (n = 35) were pwMS from a prospective memory intervention study. During the baseline evaluation, participants completed an objective neuropsychological test battery and a self-report measure of cognitive functioning (Perceived Deficits Questionnaire; PDQ Total). Participants were asked if they had problems in eight different functional areas due to their memory, with the number of endorsed problems summed. Two measures of IIV, an intraindividual standard deviation (ISD) score and maximum discrepancy score (MDS), were created from 11 indices. The relationship between the IIV and PDQ were assessed with individual linear regressions, controlling for demographics and disease-related characteristics, while Spearman correlations examined the associations with the number of reported functional memory problems. Results The PDQ was not significantly associated with either the ISD (b = −0.03, 95% CI: −0.15, 0.10, p = 0.672) or MDS (b = −0.01, 95% CI: −0.51, 0.32, p = 0.645). The overall number of functional memory problems was correlated with both the PDQ (ρ = 0.40, p = 0.018) and ISD (ρ = −0.35, p = 0.039), but not MSD (ρ = −0.22, p = 0.201). Conclusion(s) Perceived cognitive dysfunction was not associated with IIV. However, self-reported functional problems with memory were associated with perceived cognition, as well as one metric of IIV. ISD may better reflect moment to moment fluctuations that lead to difficulties with daily functioning, as opposed to MDS which may reflect underlying variation (e.g., base rates of impairment) in cognitive performance.

B - 4 The Neuropsychological Impact of Myocardial Infarction Induced Cerebral Hypoxia and Acute Encephalitis Following Electrocution: a Case Study

Abstract Objective Cerebral hypoxia and acute encephalitis subsequent to myocardial infarction (MI) are often associated with a decline in cognitive functioning (Wang et al., 2022; Caplan, 2004). While this relationship is well documented in existing literature, less research has investigated the potential nuanced cognitive and behavioral impacts of hypoxia and encephalitis due to electrocution-induced atrial fibrillation (AFib). The present case study uses neuropsychological assessment to clarify further the impact of significant electrocution and subsequent morbidities on cognition. Method We present a case study of a 30-year-old right-handed transgender female with 12 years of education who was referred for neuropsychological assessment pursuant to mental status changes manifested by disorientation and amnesia (the patient believed it was ten years prior) following the MI due to electrocution complicated by an estimated period of 10–15 minutes of non-responsiveness and anoxic encephalopathy. Results Neuropsychological assessment revealed difficulties with cognitive efficiency, language functioning, sequencing, problem-solving, complex attention, and semantic fluency. Overall, performance was inconsistent with education-weighted norms and estimated premorbid functioning. An objective measure of psychological functioning reflected a negative self-evaluation, depression, thoughts of self-harm, anxiety, and personality difficulties marked by fluctuating emotions. Findings supported a diagnosis of cognitive impairment and altered mental status associated with anoxic brain injury from the above-noted MI. Conclusion This case highlights the consequences of anoxic encephalopathy from MI subsequent to electrocution on cognitive, emotional, and behavioral functioning. Neuropsychological assessment provided clear evidence of cognitive impairment beyond the initial diagnoses, and further defined cognitive and behavioral correlates not explained by other dispositional variables.

Fear, Guilt, and Survival: A Socio-Psychological Analysis of Danny’s Dilemma in Aravind Adiga’s Amnesty

Aravind Adiga’s Amnesty is a gripping socio-psychological investigation of the immigrant experience told via the story of Danny, an undocumented Sri Lankan residing in Sydney, Australia. The present research paper deals with the aspect of how the novel delves into the psychological difficulties of persons who live in legal and social limbo, always negotiating dread, guilt, and moral uncertainty, and it will also study how Danny’s identity and actions are shaped by dread of deportation, the burden of ethical quandaries, and the desire for survival, all of which are intertwined with his complicated psychological quandary. The paper also highlights how his fear is exacerbated by his awareness that his silence could have negative effects, demonstrating how cognitive dissonance and moral obligation interact to cause psychological strain in people facing such problems. The novel emphasizes the universal human need for security and belonging, as well as how these needs shape, and are affected by the hostile circumstances in which they exist. This paper will also analyze how the novel depicts the human cost of living in the shadows, emphasizing the severe emotional and psychological toll of continually balancing survival and morality.

Age- and gender-based social inequalities in palliative care for cancer patients: a systematic literature review.

Cancer is a major public health problem worldwide, given its magnitude and growing burden, in addition to the repercussions on health and quality of life. Palliative care can play an important role improving quality of life and it is cost-effective, but some population groups may not benefit from it or benefit less based on age and gender inequalities. The aim of this systematic review was to analyze the available evidence on age- and gender-based social inequalities in access to and use of palliative care in cancer patients. A systematic review was conducted following the PRISMA guidelines. An exhaustive literature research was performed in Pubmed, CINHAL and Embase until November 2022 and were not restricted by language or date of publication. Eligible studies were observational studies analyzing the access and use of palliative care in cancer patients. Fifty-three studies were included in the review. Forty-five analyzed age and 44 analyzed gender inequalities in relation to use of and access to palliative care. Our results show that older people receive poorer quality of care, worst symptom control and less preferences for palliative care. In relation to gender, women have a greater preference for the use of palliative care and generally have more access to basic and specialized palliative care services and palliative care facilities. This review reveals difficulties for older persons and men for access to key elements of palliative care and highlights the need to tackle access barriers for the most vulnerable population groups. Innovative collaborative services based around patient, family and wider community are needed to ensure optimal care.

Lived Experiences of Migrant Fathers in the Perinatal Period: A Systematic Review and Analysis.

The worldwide population of migrant families is on the rise, and there is growing acknowledgement of the significance of supporting parental mental health within these families. However, understanding of the experiences of migrant fathers during the perinatal period remains incomplete. The objective of this review is to provide an overview of existing research on perinatal migrant fathers' experiences in different cultures. Multiple searches were conducted in April 2023 for quantitative, qualitative, and mixed-methods studies across six electronic databases: Medline, CINAHL, Embase, PsycINFO, Web of Science, and Scopus. Fourteen eligible articles were identified, including nine qualitative studies, five quantitative studies, and no mixed-methods studies. The Mixed-methods Appraisal Tool was used to assess the quality of these studies. The quantitative findings were transformed into narrative summaries to be analysed thematically along with the qualitative data. Three themes were identified: (1) Cultural competence (dealing with cultural differences, needs related to original country); (2) Parenthood in a new country (challenges and adaptation to fatherhood, challenging traditional gender norms, lack of extended family and building new support networks, being the main supporter for the family); (3) Needs of the fathers and their personal difficulties. The findings of this review suggest a direction for future research in perinatal psychology. The review also provides insights into the need for social and community support for migrant fathers and how healthcare services can support this group during the perinatal period.

Investigating Graduate Youth Unemployment in Puntland: Causes, Consequences, and Solutions

Globally, youth unemployment is a serious problem that affects political stability and socioeconomic growth. In Puntland, a semi-autonomous area in northeastern Somalia, this study investigates the problem of graduate youth unemployment, concentrating on its causes, effects, and possible solutions. Many Puntland graduates have significant obstacles in finding work, despite greater access to education and increasing participation in postsecondary institutions. This underscores a serious mismatch between the demands of the labor market and educational attainment. Beyond just personal difficulties, unemployment has a negative impact on the economy, productivity, social inequity, and political instability. This study uses a mixed-methods approach to collect data from 582 respondents, including stakeholders, policymakers, and graduates. The main causes of unemployment, according to the findings, are a lack of job prospects, a mismatch in skills, unstable economic conditions, and a lack of work experience. The study emphasizes the detrimental effects that unemployment has on graduates' social, mental, and financial well-being; many of them think about leaving their home country in search of better prospects. Addressing graduate youth unemployment in Puntland requires complete policy reforms, educational enhancements, and strategic investments in job-creating sectors. Among the suggestions are matching educational programs to industry demands, encouraging career services, encouraging entrepreneurship, and supporting vocational training. To foster an environment that is conducive to long-term economic growth and the generation of jobs, cooperation between government agencies, academic institutions, and the private sector is essential. The objective of this research is to enhance policy discussions and stimulate practical approaches to mitigate graduate joblessness, hence promoting Puntland's sustainable growth

Exploring the Associations of Personality and Sexual Health Using the DSM-5 Alternative Model for Personality Disorders

This study explored the relationships between sexual health indicators (i.e., sexual satisfaction, distress, and function) and the DSM-5 Alternative Model for Personality Disorders, a promising dimensional framework for assessing personality pathology. A sample of 489 participants seeking help in private practice clinics completed self-report measures of sexual satisfaction, distress, and function, as well as dyadic adjustment, psychological distress, romantic attachment, personality impairment, and pathological personality facets. Results first showed that participants reaching the cutoffs for a personality disorder had significantly higher sexual distress and lower sexual function compared to participants without a personality disorder. Second, path analyses controlling for psychological distress, dyadic adjustment, and romantic attachment revealed that, for women, the Criterion B Intimacy Avoidance facet was consistently linked with higher sexual distress and lower sexual satisfaction and function. For men, result patterns were more complex, linking Criterion B Separation Insecurity with high sexual distress, and Separation Insecurity and Intimacy Avoidance facets with low sexual function. In addition, Criterion B Irresponsibility, Rigid Perfectionism, as well as Criterion A Intimacy impairment were linked with higher sexual satisfaction. These findings improve our understanding of the links between personality and sexual health and provide support for considering personality difficulties in sexual health interventions.

The Avoidance of Strong Ties

Theorists have proposed that a value of close friends and family—strong ties—is the ability to confide in them when facing difficult issues. But close relationships are complicated, and recent studies report that people sometimes avoid strong ties when facing personal issues. How common is such avoidance? The question speaks to theoretical debates over the nature of “closeness” and practical concerns over social isolation. We develop an approach and test it on new, nationally representative data. We find that, when facing personal difficulties, adult Americans are as likely to avoid as to talk to close friends and family. Most avoidance is not actively reflected on but passively enacted, and, contrary to common belief, is not limited to either specific network members or particular topics, depending instead on the conjunction of member and topic. Building on Simmel, we propose that a theory of the fundamental need to conceal and reveal helps account for the findings. We suggest that there is no more empirical justification for labeling strong ties as those who are trusted than for labeling them as those who are avoided. In turn, isolation might be less a matter of having no intimates than of having repeatedly to avoid them.

An In-Depth Qualitative Exploration of Normale Lecture Classes (NLec) in Mathematics: Understanding Student Experiences and Pedagogical Implications

Normale Lectures is a delivery model of academic coursework designed as an innovative response to address the challenges of human and infrastructural limitations. To respond to these challenges, the Philippine Normal University has developed an academic course delivery model called PNU Normale Lectures, or NLec. Along this line, I was interested in exploring general education students' experiences in NLec mathematics class. With this, an open-ended questionnaire was administered to the eighty-three students of the Philippine Normal University, Visayas. Responses generated five essential themes about their challenges: a) classroom environment and distractions; b) teacher’s impact and teaching style; c) personal engagement and learning difficulties; d) classroom structure and size; and e) online learning and technology. Coping strategies, on the other hand, are (a) study materials and notes; (b) peer and teacher support; (c) online resources and technology; (d) positive attitude and motivation; (e) practice and review; and (f) active listening and notetaking. These findings underscore the complex nature of these challenges and emphasize the importance of educators and institutions addressing them for improved student outcomes. The study also identified coping strategies, highlighting the need for innovative approaches to enhance the mathematics education experience for these students.

Personal and social factors as a determinate of adolescent smoking

ABSTRACT Background Personal and social difficulties are key contributors to smoking during adolescence. This study examined personal and social factors that influence adolescent smoking. In all the study examined gender, perception of academic success, relationship between students’ teaching-students relationship, and adolescent smoking. Method Data used for this study are a portion of a large cross-sectional archival survey data titled “A questionnaire for high-school students on cigarette-alcohol-substance use” that was collected in 2018 among three high-school types (Anadolu High School, Imam Hatip High School, and Vocation high school) in Bagcilar, Istanbul. We examined the association between personal factors, social factors, and adolescent smoking by using the Spearman correlation and chi-square test of independence. Findings Of all the variables irrespective of the influence of school types, the results found a link between negative perception of academic success, teacher–student relationships, peer relationships, and gender on adolescent smoking. More specifically, a negative perception of academic success was found to influence adolescent smoking in vocational high schools, while teacher–student relationships, and gender were found to influence adolescent smoking in Imam Hatip high schools. The only variable that was found to influence adolescent smoking in Anadolu high schools was peer relationship pressures.

A Study to Assess Personality, Psychological Distress, and Adjustment Difficulties Among Undergraduate Nursing Students in the National Capital

A Study to Assess Personality, Psychological Distress, and Adjustment Difficulties Among Undergraduate Nursing Students in the National Capital

Effectiveness of psychological interventions for reducing depressive symptomatology and overload and improving quality of life in informal caregivers of non-institutionalized dependent elderly: a systematic review.

The phenomenon of aging is distinguished by profound life transformations, with the most dependent group being constituted by elderly individuals. The responsibility for their care primarily falls on the figure of the informal caregiver. The scarcity of time, the stress associated with caregiving, the financial, work-related, and personal difficulties it entails, make it a collective with high probabilities of experiencing various psychological disorders. Interventions that have shown the best results are those of multiple components, composed of various techniques that seek to adapt to the reality of the informal caregiver. The purpose of this study is a systematic review of effective interventions on depressive symptoms, emotional wellbeing, burden, or quality of life in informal caregivers of non-institutionalized dependents from 2018 to the present. A search was conducted in November 2023, on Pubmed, Pubmed Central, Proquest, and Scielo. The final review was conducted on 11 articles. The results indicate that multiple component interventions including cognitive behavioral techniques and psychoeducation in combination with stress coping techniques and social support are more effective on depressive symptoms, burden, quality of life, and increasing the social support network. Results on web-based programs demonstrate their efficacy and effectiveness, but require a greater number of trials to adjust their methodological quality and content to the idiosyncrasies of the informal caregiver.