OBJECTIVE:Autonomy is a fundamental issue for children and adolescents with chronic diseases, but specific challenges complicate its development, such as the management of medical care, emotional support, and relationships with those around them. To date, few studies have investigated the concept of autonomy in children. Furthermore, autonomy remains a construct with a broad, multi-theoretical, and non-consensual definition. This review aims to analyze the definitions, theoretical foundations, assessment tools, and different dimensions of autonomy in the context of pediatric chronic diseases. METHODS:Five electronic databases (EMBASE, PubMed, PsycINFO, CINAHL, and Scopus) were searched for studies containing a definition of autonomy or a description of its dimensions. Only studies involving children or adolescents (aged 0-18) with chronic physical diseases were included. RESULTS:The descriptive analysis provided a detailed inventory of the theoretical foundations underlying the definitions and the assessment tools for autonomy. Content analysis of the definitions of autonomy highlighted four themes relevant to understanding the conceptual overlay of autonomy in the context of pediatric chronic diseases: (1) dimensional conception of autonomy, (2) becoming a decision-maker, (3) becoming self-reliant and (4) becoming oneself. CONCLUSIONS:This review highlights the conceptual overlaps of autonomy, proposing a more unified vision. It also demonstrates the limitations of current conceptualizations and assessment tools, in which the specificities of chronic diseases in children are not considered. Integrating the role of healthcare providers and developmental issues would be essential to better support autonomy in the context of pediatrics.

The Stress Appraisal Measure (SAM) captures six different types of cognitive appraisals in anticipation of an upcoming stressful situation. The goal of this article was to examine the factorial structure and the validity of the scale in the French language while accounting for existing limitations in the literature. These include factorial structure instability and low internal consistency for specific subscales across multiple validation studies in other languages. In the first study (N = 425), the results from an exploratory factor analysis reliably suggested the removal of five items, the bridging of the threat and challenge subscales as one, and a new general five-factor structure. The new structure and its construct, convergent, and discriminant validity were confirmed in a second study (N = 308). We discuss the relevance of this five-factor scale for the studies focused on individual differences in stress and appraisals.

This qualitative study aims to gain a deeper understanding of the attentional mechanisms in anorgasmic and orgasmic women during dyadic sexual activities. Seven women aged 21 to 40 (M = 31.57, SD = 7.27) completed several questionnaires and participated in a semi-structured interview. The thematic analysis revealed that anorgasmic women exhibit attentional biases that may contribute to the onset and persistence of orgasmic dysfunction: 1) Attention directed towards non-erotic stimuli in the sexual relationship, 2) Attention focused on mental rumination, and 3) Attention directed towards dysfunctional cognitions. In contrast, orgasmic women employ attentional strategies that facilitate orgasm: 1) Attention directed towards bodily sensations, 2) Attention focused on erotic fantasies, and 3) Redirecting attention towards erotic stimuli. In conclusion, the attention of anorgasmic women appears to be captured by attentional biases, while orgasmic women concentrate on the present moment (erotic and pleasurable stimuli). Therefore, it is crucial to assess attentional resources to enhance future interventions.

Female sexual dysfunctions are difficulties encountered by many women but rarely evaluated and treated during routine examinations. These difficulties can generate personal suffering, including stress and anxiety, but also interpersonal suffering, such as relationship difficulties. This chapter strives to provide a better understanding of female sexual dysfunctions evaluation and treatment. A theoretical background of the female sexual response is first provided, followed by a step-by-step description of the first assessment sessions. The chapter then presents cognitive-behavioral and sexual therapy interventions for female sexual difficulties.

This large, international dataset contains survey responses from N = 12,570 students from 100 universities in 35 countries, collected in 21 languages. We measured anxieties (statistics, mathematics, test, trait, social interaction, performance, creativity, intolerance of uncertainty, and fear of negative evaluation), self-efficacy, persistence, and the cognitive reflection test, and collected demographics, previous mathematics grades, self-reported and official statistics grades, and statistics module details. Data reuse potential is broad, including testing links between anxieties and statistics/mathematics education factors, and examining instruments’ psychometric properties across different languages and contexts. Data and metadata are stored on the Open Science Framework website (https://osf.io/mhg94/).

A mixed-methods study was conducted to investigate sexual function among infertile patients undergoing medically assisted procreation for the first time. The study employed an interview and content analysis approach, involving 45 infertile patients prior to their medically assisted procreation procedures. The findings revealed that infertile patients are a group at risk for sexual distress. Furthermore, patients with sexual dysfunctions exhibited lower levels of sexual activity, potentially diminishing their chances of achieving pregnancy. Participants faced challenges in openly discussing their sexual problems and demonstrated limited knowledge of sexual functioning. Among infertile women with sexual dysfunctions, the most frequently reported issues were sexual interest/arousal disorders, with a majority also experiencing pain during sexual activity and associated genital-pelvic pain disorders. In contrast, delayed ejaculation and erectile disorder seem to be more common in infertile men, while sexual desire and excitement disorders and premature ejaculation disorders appeared to be as common as in the general population. While the relationship between infertility and sexuality is complex, our study suggests that sexual dysfunctions or the absence of sexual activity may explain infertility. Therefore, it is imperative for clinicians to evaluate the sexual functioning of both men and women undergoing medically assisted procreation treatment, to increase their chances of procreation and offer them sexological support if needed. Future studies should expand their scope to include a larger sample size and delve into the potential etiological factors associated with sexual dysfunctions.

Exposure to stress can have significant, negative consequences on long-term health. Among potentially modifiable targets for promoting more adaptive stress responses, executive functioning has emerged as a promising candidate. These functions may be involved in limiting excessive stress reactivity when exposed to an acute stressor, while also promoting faster recovery (i.e., return to baseline). Fewer studies have been conducted to date on the role of executive functioning in acute stress – especially with a focus on its distinct facets (e.g., inhibition, flexibility, working memory, and updating). Moreover, there is a need for research focused on potential cognitive and behavioral mediators explaining the relationship between executive functioning and stress responses. Thus, the current study sought to examine the extent to which executive functioning facets may play a beneficial role in acute stress reactivity and recovery. Furthermore, we will examine the mediational role of cognitive appraisals, repetitive negative thinking, and emotion regulation. The findings may shed light on existing cognition-stress pathways that promote more adaptive acute stress responses.

BACKGROUND:As cognitive functions and, more specifically, executive functions (EF) seem to influence autonomy among the elderly, we investigated the role of each of the five EF sub-components (inhibition, spontaneous flexibility, reactive flexibility, planning, and updating in working memory) for the risk of functional decline.METHOD:A total of 137 community-dwelling participants over 75 years of age were included in a prospective cohort study and assigned to three groups: individuals with neuro-degenerative cognitive disorders, those having cognitive disorders with non-degenerative aetiology, and a control group without any cognitive problems. We measured each EF sub-component and assessed functional decline by evaluating basic (b-ADL) and instrumental activities of daily living (i-ADL) at baseline and 6 months later. We conducted three separate multiple logistic regression models to examine the extent to which the five EF facets predicted overall functional decline at the end of the follow-up period.RESULTS:We found that people who exhibited a decline in b-ADLs or/and i-ADLs over 6 months had worse performance on inhibition and two flexibility tasks than those who did not experience a decline. The results suggest that decliners have more difficulties in managing unforeseen events. Inhibition and updating in working memory predicted a decline in b-ADL while spontaneous and reactive flexibilities predicted a decline in i-ADL.CONCLUSION:In our sample, specific executive dysfunctions were associated with a decline in functional status. With respect to the risk of decline in b-ADL, deficits in inhibition may represent a risk factor, as it regulates over-learned activities. Bothtypes of flexibility, which allow the shifting and generating of adaptive responses, predicted decline in i-ADL. In sum, paying more attention to particular EF profiles would help clinicians to anticipate some aspects of functional decline.

The goal of this systematic review and meta-analysis was to evaluate whether executive functioning predicts subsequent acute stress responses. A systematic search (conducted between May 22nd and 30th, 2019; updated on April 4th, 2020) on Cochrane, OpenGray, Proquest Dissertations and Thesis Global, PsycInfo, Pubmed, Scopus, and Web of Science revealed 27 correlational and five interventional studies. For quality appraisal, we used the BIOCROSS Tool, the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and the Revised Cochrane Risk-of-bias Tool for Randomized Trials. Attentional control was most consistently associated with acute stress. A robust variation estimation meta-analysis, conducted when sufficient data was available, revealed a small, significant, and negative correlation between higher working memory and subsequent lower cortisol reactivity (r = .09, p = .025, 95 % CI [0.15, 0.02]). These results highlight the role of executive functioning for acute stress responses, the scarcity of relevant data, and the need for both interventional designs and the consideration of mediators and moderators to understand underlying mechanisms.

Introduction: This study examines the effectiveness of integrating mindfulness-based techniques within therapy for women suffering to achieve orgasm. Although widely applied in psychotherapy, this approach has only recently been introduced in the treatment of female sexual dysfunction. Aim: To compare the effectiveness of a video-based self-administered treatment, rooted within the cognitive behavioral treatment (CBT) framework, with a video-based self-administered mindfulness treatment applying cognitive behavioral sexual therapy (mindfulness-based cognitive therapy), the latter of which was specifically created to increase women's ability to achieve orgasm. Methods: A convenience sample of 65 women suffering from difficulties to achieve orgasm, aged 18 to 58 years (mean = 32.66, standard deviation = 9.48), were randomly allocated using a randomization procedure to either a mindfulness-based cognitive therapy (N = 35) or CBT (N = 30) group. Each participant completed questionnaires before and after the start of treatment and 2 months after its completion. Main Outcome Measure: We applied repeated-measure general linear models to compare the 2 groups (ie, between participant factor) on each dependent variable across time (ie, the within-participant factor). Compare mean analyses for paired samples were only conducted when the interaction effect between condition and time was significant (ie, P < .05). Results: Statistical analyses show that women in both groups presented increased sexual functioning (P = .001) and decreased sexual distress (P < .001), as well as improved desire, arousal, orgasm, and sexual satisfaction (P < .05) after their respective treatments. Contrary to our hypothesis, significant reductions in sexual pain were only observed in CBT participants. Clinical Implications: To the best of our knowledge, this is the first study to apply a randomized allocation procedure to evaluate the effectiveness of a video-based mindfulness intervention for women struggling to achieve orgasm. These results should guide clinicians' decisions with respect to evaluating the relevance and the real added value of proposing mindfulness exercises to their patients with such difficulties. Conclusion: When women suffering from difficulties to achieve orgasm are randomly assigned to a mindfulness group or an active control, improvements in sexual functioning and reductions in sexual distress can be observed after both treatments. Copyright (C) 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Abstract Recent theoretical and empirical studies have considered higher cognitive performance as a protective factor with respect to reactivity, recovery and habituation to acute stressors. The goal of our study was to examine the individual role of inhibition, working memory, processing speed, reasoning, and category fluency in the regulation of the cortisol response to a laboratory challenge. Younger, middle-aged, and older participants (N =109, aged 22-84, M=55.90, SD=16.35) were invited to a laboratory session comprising a driving simulation and a set of cognitive tasks. At least one week in advance, baseline cognitive performance was measured using the Brief Test of Adult Cognition by Telephone (BTACT). Throughout the lab session, five saliva samples were taken, which allowed for the computation of a global measure of cortisol release (area under the curve (AUC)). Cortisol AUC was regressed on the individual BTACT cognitive tests, while controlling for age, sex, education, body mass index, physical activity, and time since awakening. The results revealed that inhibition and working memory significantly accounted for the cortisol response. These associations remained significant when other factors such as smoking, caffeine consumption, and medication use were included as covariates. The contributions of reasoning and speed of processing approached significance. Our findings contribute to the emerging evidence that cognitive functioning modulates stress responses to acute stressors. The findings are discussed in the context of cognitive interventions with transfers and implications for stress processes and healthy aging.