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Volume 35 - Issue 4 - December 2018

Contents

Review Article

  • The Process of Patient Engagement in Cardiac Rehabilitation: A Model-Centric Systematic Review
  • Sepideh Jahandideh, Elizabeth Kendall, Samantha Low-Choy, Kenneth Donald, Rohan Jayasinghe
  • Published online by Cambridge University Press: 13 November 2018, pp. 185-202
  • View abstract

    This study aimed to compile existing evidence about the proposed relationships among variables at three stages of the model of therapeutic engagement (MTE): patient intention to engage in cardiac rehabilitation (CR), CR initiation, and sustained engagement. This model has not been tested in any rehabilitation setting. Therefore, this systematic literature review is key to future research and application of MTE to predict and enhance patient engagement in CR. Model-centric systematic literature reviews have been conducted for each stage of the MTE. A coherent approach to understanding and monitoring the process of patient engagement in CR is absent. Few relevant studies included in the model-centric reviews met the criteria: eight in stage 1, four in stage 2, and six in stage 3 of the MTE. In total, the tenets of the MTE were supported in patient intention to engage in CR. However, there was less evidence quantifying the proposed relationships among variables that impact on CR initiation and sustained engagement. There is a scarcity of research examining rehabilitation engagement in depth to better understand the complicated process contributing to behavioural outcomes. No decision-support models currently exist to alert patients and healthcare provider to the factors that influence non-engagement.

Standard Paper

  • Interpersonal Emotion Regulation: A Review of Social and Developmental Components
  • Abigail L. Barthel, Aleena Hay, Stacey N. Doan, Stefan G. Hofmann
  • Published online by Cambridge University Press: 18 October 2018, pp. 203-216
  • View abstract

    A staple theme in clinical psychology, emotion regulation, or the ability to manage one's emotions, is directly linked with personal wellbeing and the ability to effectively navigate the social world. Until recently, this concept has been limited to a focus on intrapersonal processes, such as suppression. Less emphasis has been placed on developmental, social, and cultural aspects of emotion regulation. We argue here that as social beings, our engagement in emotion regulation may often occur interpersonally, with trusted others helping us to regulate our emotions. This review will highlight recent research on interpersonal emotion regulation processes.

  • Parental Rejection as a Predictor of Emotional Eating After Inpatient Weight Loss Treatment for Youngsters
  • Julie Vandewalle, Ellen Moens, Taaike Debeuf, Caroline Braet
  • Published online by Cambridge University Press: 15 November 2018, pp. 217-227
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  • View abstract
    Objective

    The main objective of the study was to examine the relationships between parental rejection, maladaptive emotion regulation strategies, and the emotional eating style of youngsters who finished an inpatient multidisciplinary weight loss treatment program and were back in their home environment.

    Method

    Participants were 52 youngsters (age 11–17 years) with an average percent over ideal BMI of 186.11% (SD = 27.54) before treatment and 136.37% (SD = 19.65) at a mean follow-up of 4 months. Participants completed questionnaires assessing maternal and paternal rejection, maladaptive emotion regulation strategies, and emotional eating. Data were analysed using bootstrapping procedure.

    Results

    Mediation analyses showed that maladaptive emotion regulation partially mediated the association between maternal rejection and the youngsters’ emotional eating style. Paternal rejection was directly related to emotional eating.

    Conclusion

    The results suggest that the family climate may have an impact on the eating style of the youngsters after weight loss treatment.

  • Exploring Patterns of Change Processes Over Distinct In-Treatment Phases of Cognitive and Exposure Therapies for Electronic Gaming Machine Problem Gamblers
  • David Smith, A. Kate Fairweather-Schmidt, Rene Pols, Peter Harvey, Malcolm Battersby
  • Published online by Cambridge University Press: 06 August 2018, pp. 228-243
  • View abstract

    Little is known about the change processes in gambling disorder-specific cognitive therapy (CT) and exposure therapy (ET). These therapies are underpinned by the cognitive approach (i.e., restructuring gambling cognitions) and the psychobiological approach (i.e., elimination of gambling urges) to treating problem gambling. Here, piecewise-linear modelling is used in a secondary analysis of randomised trial data for a CT group (n = 44) versus an ET group (n = 43) with the aim to open a discourse on how individuals respond to CT and ET relative to theory. Measures were administered between therapy sessions (average = 6.2 per individual) across 18 weeks for gambling urge (GUS) and gambling cognitions (GRCS). Results indicated the ET group had a stronger reduction in GUS (p < .01) in the first 4 weeks of treatment. Between 4–12 weeks, improvement in GUS (p < .01) and GRCS (p = .02) was more rapid in the CT group. Both groups experienced comparable improvements from 12–18 weeks. These findings have implications for further treatment development, including a combined cognitive and exposure approach that is flexibly adapted to the patient. A larger trial is needed to formally establish change processes and identify differences in problem gambler subgroups. This would provide therapists capacity to offer each patient a clear direction and an expedited pathway to their preferred outcome.