caa a22 4500 606180672 CHVBK 20210128100807.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s11136-015-1017-4 doi (NATIONALLICENCE)springer-10.1007/s11136-015-1017-4 A new perspective on proxy report: Investigating implicit processes of understanding through patient-proxy congruence [Elektronische Daten] [Carolyn Schwartz, Armon Ayandeh, Jonathan Rodgers, Paul Duberstein, Bianca Weinstock-Guttman, Ralph Benedict] Background: Utilizing proxy report is a common solution to gathering quality-of-life information from people who are not capable of reliably answering questionnaires, such as people with dementia. Proxy report could, however, also provide information about patients' implicit processes of understanding, which we define as automatic, schema-driven cognitive processes that allow one to have a better understanding of oneself and of one's body, make oneself known and knowable to members of the social network, and allow one to react proactively in response to cues. We investigated whether implicit processes of understanding explain some of the association between reserve and healthy lifestyle behaviors. Methods: We operationalized three implicit processes of understanding: (a) psychosocial understanding; (b) insight into physical disability; and (c) somatic awareness. This secondary analysis involved a cohort of multiple sclerosis patients and their caregiver informants (n=118 pairs). Measures included a neurologist-administered Expanded Disability Status Scale, patient- and informant-completed survey measures, and a heartbeat perception test (interoception). Patient-other congruence assessed implicit processes of understanding: psychosocial understanding (neurocognitive and personality); physical-disability insight; and somatic awareness (interoception). Results: Effect sizes (ES) for the inter-correlations between the three implicit processes were small. Psychosocial understanding was associated with higher past reserve-building activities (small ES). Psychosocial understanding explained variance in healthy lifestyle behaviors over and above the variance explained by current reserve-building activities (∆R 2=0.04; model R Adjusted 2 =0.18). Conclusions: Proxy versus patient report can provide information about underlying interpretational processes related to insight. These processes are distinct from reserve, predict health outcomes, and can inform lifestyle-changing interventions. Springer International Publishing Switzerland, 2015 Proxy report nationallicence Implicit processes of understanding nationallicence Personality nationallicence Interoception nationallicence Neurocognition nationallicence Insight nationallicence Reserve nationallicence Resilience nationallicence Health behavior nationallicence Multiple sclerosis nationallicence Schwartz Carolyn DeltaQuest Foundation, Inc., 31 Mitchell Road, 01742, Concord, MA, USA aut Ayandeh Armon DeltaQuest Foundation, Inc., 31 Mitchell Road, 01742, Concord, MA, USA aut Rodgers Jonathan Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA aut Duberstein Paul Department of Psychiatry and Rochester Health Care Decision Making Group, University of Rochester Medical Center, Rochester, NY, USA aut Weinstock-Guttman Bianca Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA aut Benedict Ralph Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA aut Quality of Life Research Springer International Publishing 24/11(2015-11-01), 2637-2649 0962-9343 24:11<2637 2015 24 11136 https://doi.org/10.1007/s11136-015-1017-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s11136-015-1017-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schwartz Carolyn DeltaQuest Foundation, Inc., 31 Mitchell Road, 01742, Concord, MA, USA aut NATIONALLICENCE 700 1- Ayandeh Armon DeltaQuest Foundation, Inc., 31 Mitchell Road, 01742, Concord, MA, USA aut NATIONALLICENCE 700 1- Rodgers Jonathan Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA aut NATIONALLICENCE 700 1- Duberstein Paul Department of Psychiatry and Rochester Health Care Decision Making Group, University of Rochester Medical Center, Rochester, NY, USA aut NATIONALLICENCE 700 1- Weinstock-Guttman Bianca Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA aut NATIONALLICENCE 700 1- Benedict Ralph Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA aut NATIONALLICENCE 773 0- Quality of Life Research Springer International Publishing 24/11(2015-11-01), 2637-2649 0962-9343 24:11<2637 2015 24 11136