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Copyright of Journal of Orofacial Pain is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In remote Aboriginal communities in Australia, researchers cast health beliefs and treatments as belonging to either an Aboriginal or biomedical system, which are considered to be irreconcilable and in conflict. Warlpiri people also speak of two distinct traditions that, they claim, are able to heal only specific classes of illness. Nevertheless, both Aboriginal and biomedical systems can be used simultaneously. An examination of two illness episodes will illustrate the complexity of how both Aboriginal and biomedical diagnoses and treatments are employed in a similar manner. I argue that while diagnosis is often stressed in statements regarding illness, it is only one of many factors that influence the treatment choices of individuals. [ABSTRACT FROM AUTHOR]

This study used Rasch analysis to examine the psychometric validity of the Diabetes Distress Scale and the Problem Areas in Diabetes scale to assess diabetes distress in 3338 adults with diabetes (1609 completed the Problem Areas in Diabetes scale ( n = 675 type 1 diabetes; n = 934 type 2 diabetes) and 1705 completed the Diabetes Distress Scale ( n = 693 type 1 diabetes; n = 1012 type 2 diabetes)). While criterion and convergent validity were good, Rasch analysis revealed suboptimal precision and targeting, and item misfit. Unresolvable multidimensionality within the Diabetes Distress Scale suggests a total score should be avoided, while suboptimal precision suggests that the Physician-related and Interpersonal distress subscales should be used cautiously.

People who develop depression experience a maelstrom of emotions as they struggle to understand what is happening to them. While the experience has been comparatively well documented in older adults, much less is known about the depression experience and responses of young people. In this study, we aimed to explore the experience of young people diagnosed with depression. Twenty-six young people were recruited from a youth mental health service. A qualitative interpretative design was used, incorporating semi-structured, audio-recorded interviews. Results provided four overlapping themes, reflecting the young people's difficulties in coming to terms with, and responding in self-protective, harmful and at times life-threatening ways to their depression: (1) struggling to make sense of their situation; (2) spiralling down; (3) withdrawing; and (4) contemplating self-harm or suicide. Study conclusions are that young people faced considerable difficulties coming to terms with, and responding to, depression. Improving young people's understanding of depression and its treatment, reducing community stigma and providing accessible and youth-focused services remain important targets for intervention. It is also important to improve mental health literacy in the community to increase awareness of depression and how mental health professionals, including nurses, respond effectively to the young person., (© 2011 Blackwell Publishing.)

The role of anxiety in pain is less well understood than the role of depression. Based on recent conceptual thinking about worry and pain, we explored the relationship between pain status and worry about health and anxiety in 1217 community-dwelling men aged 70 years or older who participated in the baseline phase of the Concord Health and Ageing in Men Project study, a large population-based epidemiological study of healthy ageing based in Sydney, Australia. We hypothesised that worry about health would be associated with having persistent pain, and that the association would be stronger in the presence of co-existing pain-related interference with activities (intrusive pain). Of men in the study, 12.5% had persistent and intrusive pain, 22.4% were worried about their health, and 6.3% had anxiety. We found a strong association between worry about health and pain that was both persistent and intrusive, and that remained after accounting for age, number of comorbidities, depression, self-rated health status, arthritis, and gait speed (adjusted odds ratio 2.9; 95% confidence interval 1.8-4.7), P<0.0001). The corresponding adjusted odds ratio for the association between anxiety and pain was 2.3 (95% confidence interval 1.0-4.8; P=0.0363). These findings suggest that at a population level, subthreshold anxiety and pain are strongly related, and worry about health occurs much more commonly than anxiety itself. To our knowledge, this is the first study to explore, specifically, the relationship between pain status and worry about health in older men. In older community-dwelling men, pain was robustly associated with worry about health, highlighting the potential importance of subthreshold anxiety-related psychological factors., (Copyright © 2010 International Association for the Study of Pain. All rights reserved.)

Objective: This study investigated the effect of the reference point of self-rated health (SRH) items on the trajectory of older adults' subjective health., Design: Seven waves of data from the Australian Longitudinal Study of Ageing (1992 to 2004) were used to determine change in SRH in a large sample (N = 2,081; 49% men) of older adults (65+ years)., Main Outcome Measures: Three SRH measures with different points of reference (global vs. age-comparative and self-comparative) were used., Results: Ordinal latent growth models revealed unique patterns of change. Global ratings became more negative in a linear fashion. Self-comparative ratings initially declined; however, the rate of change was found to decelerate over time. Age-comparative ratings showed a gender by age interaction, revealing that women's ratings remained relatively stable, whereas men's ratings were more likely to become more negative with age., Conclusion: Findings suggest that the reference point significantly influences how older adults evaluate their health over time. This has implications regarding the use of SRH items and indicates that the reference point is an important consideration in the subjective health assessment of older adults., (Copyright 2010 APA, all rights reserved.)

Objective: We investigated illness beliefs of recently hospitalized patients with coronary artery disease (CAD) and the prospective association between these beliefs and adherence to secondary prevention behaviors. Causal attributions of CAD and their concordance with actual patient risk profiles were also examined., Method: A prospective study of 193 patients was conducted. Data were collected by self-report and from medical records at 3, 6, and 9 months after discharge. Baseline depression was assessed by structured clinical interview. The association between illness beliefs and adherence was tested with hierarchical linear regression controlling for clinical and demographic confounders., Results: Most participants perceived high personal and treatment control and believed CAD to be chronic in duration with severe consequences. A relatively low number of symptoms were endorsed as being part of CAD. Heredity was considered the single most important and most commonly perceived cause of CAD. Smoking, alcohol, emotional state, and heredity were significantly more likely to be endorsed as causal factors by respondents with these risk profiles. In multivariate analysis, illness beliefs contributed an additional 6% of the total variance explained by the model (p = .02). Perceptions of more serious consequences predicted better adherence (p = .03). Social desirability was the best single predictor of adherence., Conclusion: Patient perceptions of risk factors were largely consistent with actual risk factors. Despite modest effect sizes, illness beliefs do contribute to our understanding of adherence to secondary prevention behavior. Interventions aimed at modifying these beliefs, particularly those related to the consequences of CAD, may improve patient outcomes.

Objective: To examine resolution of the diagnosis among parents of children with phenylketonuria (PKU) as a mechanism of adjustment for parents and children., Methods: Reaction to diagnosis interviews were conducted with 52 mothers and 47 fathers of 55 children with PKU aged 2-12 years. The parents also completed questionnaires assessing their personal adjustment (stress symptoms), their child's adjustment (behavior problems), and coping variables (personal hopefulness and coping strategies)., Results: Most mothers (69%) and fathers (77%) were resolved to their child's diagnosis. Lower levels of parent stress were explained by higher personal hopefulness (14% of the variance for mothers and 21% for fathers) and resolution of the diagnosis (15% of the variance for mothers and 6% for fathers) after taking account of demographic variables and severity of the child's PKU. Parent resolution, however, did not contribute independently to the variance explained in child behavior problems after taking account of coping variables and severity of PKU., Conclusions: Resolution of the diagnosis of PKU is a strong indicator of parent adjustment, and assessment of parent reactions should be considered an integral component of clinical care. Further research is warranted in relation to the implications of parent resolution for the child's response to PKU through different development stages and the effectiveness of interventions in aiding parent resolution.