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Biomedical subjects

A J Vingerhoets

Publications and source records attributed to A J Vingerhoets.

At least 19 recordsLinked to original sources

Self-reported crying during the menstrual cycle: sign of discomfort and emotional turmoil or erroneous beliefs?

Crying is generally associated with distress and discomfort, and is also part of the premenstrual syndrome in women. The present studies focussed on crying fluctuations during the menstrual cycle. First, a retrospective cross-cultural study of women from 33 different countries (n = 2447) was conducted. Crying proneness reportedly increased before menstruation, with remarkable cross-cultural differences. Women who were using oral contraceptives (OC) reported largely the same pattern of results as women who were not using OC. In a second study, 82 Dutch students kept a crying and mood diary for two consecutive menstrual cycles. During no phase of the menstrual cycle did actual crying episodes or crying proneness increase, although significant changes in mood were reported. Given the large cross-cultural differences on the one hand, and the remarkable correspondence between the self-reports of those using OC and those who did not use them on the other, it is concluded that the role of female sex hormone fluctuations in crying has to be questioned. Rather, it seems more likely that fluctuations in self-reported crying are based on implicit theories about the relationship between the menstrual cycle, mood and crying.

Adolescent↗

Hypertension and appraisal of physical and psychological stressors.

OBJECTIVE: In the operant conditioning of hypertension hypothesis, it is assumed that the frequently found diminished sensitivity to painful stimuli in hypertensives can be generalized to sensitivity to other stressors, including psychological stressors. The validity of this assumption is examined in the present study. METHODS: Unmedicated hypertensives (42) and normotensive controls (21) of both sexes were exposed to a physical stressor (electric current) and psychological active coping (mental arithmetic, free speech) and passive coping (unpleasant films) tasks, while indices of prestressor anxiety and task appraisal were measured. RESULTS: Hypertensive women, but not men, showed diminished pain sensitivity, together with lower prestressor anxiety and a tendency to lower negative appraisal of the tasks, compared to their normotensive counterparts. In addition, positive correlations were obtained between pain sensitivity and negative appraisal of psychological stressors involving interpersonal threat (speech) and passive coping (films). CONCLUSION: Preliminary support has been obtained for extrapolation of diminished pain appraisal to appraisal of some psychological stressors (although for a part only in women); an important assumption in the operant conditioning hypothesis of hypertension.

Adaptation, Psychological↗

Risk, severity and predictors of physical and psychological morbidity after axillary lymph node dissection for breast cancer.

The aim of this study was to investigate the nature and severity of the arm complaints among breast cancer patients after axillary lymph node dissection (ALND) and to study the effects of this treatment-related morbidity on daily life and well-being. 400 women, who underwent ALND as part of breast cancer surgery, filled out a treatment-specific quality of life questionnaire. The mean time since ALND was 4.7 years (range 0.3-28 years). More than 20% of patients reported pain, numbness, or loss of strength and 9% reported severe oedema. None of the complaints appeared to diminish over time. Irradiation of the axilla and supraclavicular irradiation were associated with a 3.57-fold higher risk of oedema (odds ratio (OR) 3.57; 95% confidence interval (CI) 1.66-7.69) causing many patients to give up leisure activities or sport. Women who underwent irradiation of the breast or chest wall more often reported to have a sensitive scar than women who did not receive radiotherapy. Women <45 years of age had an approximately 6 times higher risk of numbness of the arm (OR 6.49; 95% CI 2.58-16.38) compared with those > or = 65 years of age; they also encountered more problems doing their household chores. The results of the present study support the introduction of less invasive techniques for the staging of the axilla, sentinel node biopsy being the most promising.

Activities of Daily Living↗

Psychological aspects of in vitro fertilization: a review.

This paper reviews psychological research within the context of in vitro fertilization (IVF). The focus will be on psychological reactions before entering an IVF-procedure, during an IVF-treatment, and after both unsuccessful and successful IVF. The effects of psychosocial factors on the treatment outcome after IVF and interventions on conception rates will also be discussed. Undergoing an IVF-treatment is an emotional and physical burden, for both the woman and her partner. Research results suggest that couples entering an IVF-treatment program are, in general, psychologically well adjusted. Concerning reactions during the treatment, both women and men experience waiting for the outcome of the IVF-treatment and an unsuccessful IVF. as most stressful. Common reactions during IVF are anxiety and depression, while after an unsuccessful IVF, feelings of sadness, depression and anger prevail. After a successful IVF-treatment, IVF-parents experience more stress during pregnancy than 'normal fertile' parents. Mothers with children conceived by IVF express a higher quality of parent child relationship than mothers with a naturally conceived child. Research further suggests that psychosocial factors, like ineffective coping strategies, anxiety and/or depression are associated with a lower pregnancy rate following IVF-procedures. In addition, support has been found suggesting that stress reduction through relaxation training or behavioral treatment improves conception rates.

Adaptation, Psychological↗

Hypertension and pain sensitivity: effects of gender and cardiovascular reactivity.

Repeatedly, hypertensives have been found to appraise physical stressors as less aversive than normotensives. The main aim of the present study was to examine the effects of gender and cardiovascular reactivity in the relationship between hypertension and appraisal of pain. Forty-two unmedicated hypertensives and 21 normotensive controls of both genders were exposed to an electric current stimulus, while various cardiovascular parameters and prestressor anxiety were measured. In general, hypertensive women, but not men, showed diminished pain sensitivity compared to their normotensive counterparts. When the analyses were repeated with controlling for cardiovascular reactivity, the between-group effects were no longer significant. The results indicate that (i) profound gender differences exist in hypertension-related pain sensitivity and (ii) these effects seem to be mediated, at least partly, by cardiovascular reactivity.

Adult↗

Inhibition of emotional expression in breast cancer patients.

To obtain a better understanding of the inhibited emotional expression often reported in breast cancer patients, the authors compared 48 breast cancer patients and 49 healthy women with respect to disturbed emotional processes (alexithymia), emotional disclosure, emotional expression, assertiveness, repression, and distress. The patient group showed significantly more ambivalence over emotional expression, more restraint, and more anxiety than the healthy controls. No differences were found between the 2 groups in alexithymia, expressing emotions in general, or willingness to talk with others about emotions. The image of the breast cancer patient that emerged in the study was that of a person who has conflicting feelings with regard to expressing emotions, is reserved and anxious, is self-effacing, and represses aggression and impulsiveness. These findings suggest that cancer patients' inhibited behavior is a reaction to the disease rather than a reflection of a personality characteristic predisposing an individual to (breast) cancer.

Affective Symptoms↗

Psychosocial predictors of low birthweight: a prospective study.

OBJECTIVE: To examine the role of psychosocial risk factors for low birthweight. DESIGN: A prospective study. SETTING: Obstetric outpatient clinics of the University Hospital Vrije Universiteit, Amsterdam. PARTICIPANTS: Three hundred and ninety-six nulliparous women. METHODS: Questionnaires on background variables, daily stressors, psychological and mental wellbeing, social support and work factors were completed by the women in the first, second and third trimester of pregnancy. Low birthweight for gestational age was defined at different cut off points: 1. < or = 10th customised birthweight centile (n = 69); 2. < or = 5th customised birthweight centile (n = 54); 3. < 3rd customised birthweight centile (n = 35); and 4. < or = the 10th Dutch birthweight centile (n = 40). Multivariate logistic regression was applied and the results were expressed in odds ratios and their 95% confidence intervals. RESULTS: When the cut off level was defined < or = 5th and < 3rd customised centile, the number of daily stressors in the first trimester was a statistically significant risk factor (OR 1.04, 95% CI 1.01-1.07 and OR 1.04, 95% CI 1.01-1.08). No significant psychosocial risk factors could be identified when low birthweight for gestational age was defined < or = the 10th customised birthweight centile. When low birthweight for gestational age was defined < or = the 10th Dutch birthweight centile, number of hours housekeeping per week in the first trimester (OR 1.59, 95% CI 1.03-2.46), low subjective severity rating of daily stressors in the first trimester (OR 0.41, 95% CI 0.17-0.97) and depressive mood in the first trimester (OR 1.12, 95% CI 1.01-1.24) were statistically significant psychosocial risk factors after controlling for maternal weight and height, number of cigarettes smoked per day and educational level. CONCLUSIONS: In the first trimester of pregnancy maternal psychosocial factors are associated with an increased risk of low birthweight. The specific psychosocial risk factors found were different when the definition of low birthweight was changed. Therefore, in this field of research, we suggest use of the most valid outcome measure for low birthweight, being the customised birthweight centiles.

Anxiety↗

An exploratory investigation into types of adult homesickness.

BACKGROUND: It is not clear yet whether or not homesickness is a singular syndrome. Some authors have proposed different subtypes or forms of homesickness. Since there may be great differences between various subtypes of homesickness regarding etiology, causes, manifestations and consequences, a distinction of subtypes may have far-reaching implications for research and therapy. This exploratory study was conducted to find out whether homesickness can be considered a homogeneous syndrome, or whether there are distinct subtypes that differ in etiology, severity of the condition and manifestations. METHOD: Thirty-one individuals, who have had severe homesickness experiences, were interviewed, and verbal scripts were typed out. Twenty-four interviews were suited for analyses. All text related to the topics most relevant to the purpose of the study was extracted. The text was first analyzed searching for meaning and categories and afterwards coded and used in a HOMALS analysis. RESULTS: The HOMALS analysis yielded two dimensions. The first dimension can be described as a dimension of psychopathology differentiating 'recovered' and recurrent homesickness. The second dimension was strongly dominated by homesickness during holidays. CONCLUSIONS: It seems that there are reasons to presume the existence of at least two subtypes of homesickness: (1) recurrent homesickness related to signs of psychopathology and recurrent homesickness experiences and (2) recovered homesickness, which can be considered as a normal adjustment problem which most people overcome. Very tentatively, a third type of homesickness might be distinguished: holiday homesickness, which is associated with difficulties in breaking with old routines. Consequences for research and therapy are discussed. Furthermore, the need of validation studies is underlined.

Adaptation, Psychological↗

Elevated blood pressure and self-reported symptom complaints, daily hassles, and defensiveness.

The association between elevated blood pressure and low rates of self-reported problems has been hypothesized to be mediated by defensiveness. In a population screening study in which 1,120 women and 903 men between 20 and 55 years of age participated, multiple resting home blood pressure measurements were performed and questionnaires were administered measuring symptom complaints, daily hassles, and defensiveness. In women, after control for potential confounders, a low number of self-reported symptoms was associated with elevated blood pressure. However, this effect was not mediated by defensiveness, although repressive defensiveness predicted independently elevated blood pressure in women. In men, no significant associations were obtained. Furthermore, no relations emerged between daily hassles and elevated blood pressure. In conclusion, although defensiveness was more prevalent among women with elevated blood pressure, it does not provide a good explanation for the low rates of self-reported symptoms found in these women.

Journal Article↗

Prenatal diethylstilbestrol exposure and self-reported immune-related diseases.

OBJECTIVE: To compare self-reports of immune-related diseases in diethylstilbestrol (DES) daughters and controls. Prenatal exposure to DES has been associated with several malformations in the lower genital tract, a higher prevalence of adenosis, and increased risk of clear cell adenocarcinoma, and estrogen-dependent tumors. Lately, reports have been published indicating a link between DES exposure and alterations in the immune system. The present study focuses on the possible clinical consequences of an affected immune system. STUDY DESIGN: DES daughters (n=170) and control women (n=123) completed questionnaires containing lists of immune-related diseases, specified into three categories (i) allergies, (ii) auto-immune disorders, and (iii) infectious diseases. RESULTS: DES daughters reported significantly more disease conditions than the controls. Analyses for separate disease categories (allergies, auto-immune disorders, infectious disease), yielded a statistically significant difference only for infectious disease. Within this last category, two infectious diseases yielded highly significant differences: bladder infection and measles. CONCLUSION: The present findings suggest that DES daughters are at higher risk of developing immune-related disease states.

Adult↗

Defensive coping in relation to casual blood pressure and self-reported daily hassles and life events.

Our aim was to investigate the relationships between defensiveness and repression, on the one hand, and self-reported stressor exposure and resting blood pressure, on the other hand. In addition, different operationalizations of defensiveness and repression were compared. Participants were 310 male and 90 female employees representing a wide range of occupations. Before a medical examination, all subjects completed questionnaires measuring defensiveness, anxiety, repression, daily hassles, and life events. After controlling for potentially confounding variables, multiple regression analyses revealed an inverse association between defensiveness and self-reported number of daily hassles and a positive link between defensiveness and resting systolic blood pressure. In general, the interaction between defensiveness and anxiety (representing repression) did not add to the predictive power of defensiveness and anxiety alone. The results support the notion that defensive individuals tend to underreport problems, while exhibiting elevated resting blood pressures.

Adaptation, Psychological↗

Blood pressure, self-reported symptoms and job-related problems in schoolteachers.

The relationship between blood pressure and self-reports of physical symptoms and job-related problems was investigated in a sample of 262 male and female teachers. The subjects were divided into three groups: treated hypertensives (THT, N = 23); untreated hypertensives (UHT, N = 101); and normotensives (NT, N = 123). After controlling for eight potentially confounding variables, the groups differed significantly with respect to reported physical symptoms, with THT reporting the most and UHT the fewest symptoms. Moreover, after controlling for potential confounders, a multiple regression analysis revealed an inverse association between diastolic blood pressure and the number of reported physical symptoms in untreated subjects. A similar trend for systolic blood pressure did not reach significance. In addition, no significant results with respect to work-related problems were obtained, except for a group x gender interaction on job-related irritation: male THT showed lowest and female THT highest irritation scores. The potential role of altered appraisal, diagnosis, and gender are discussed.

Adult↗

Self-reported stressors, symptom complaints and psychobiological functioning I: Cardiovascular stress reactivity.

Taking into account neuroticism and lifestyle variables (smoking and alcohol consumption), cardiovascular and psychological reactions to stressful films were studied in four groups of subjects selected on self-reported levels of recent stressor load and symptom complaints (low-load/low-symptoms: low-load/high-symptoms; high-load/low-symptoms; high-load/high-symptoms). The films were known either to stimulate or to depress cardiovascular activity. The results showed that psychological reactions (distress; deactivation; openness/involvement) were associated with group membership and condition. In addition, high-symptom subjects were characterized by faster resting heart rates and smaller ECG T-wave amplitudes (TWAs), reflective of greater sympathetic tone on the myocard. Further, low-symptom subjects, in particular those labeled as stress-resistant (high-load/low-symptoms), exhibited larger myocardial responses to the cardiovascular-stimulating films than did high-symptom subjects. Low-symptom subjects showed predicted variations in physiological responses to the different films, whereas the responses by the high-symptom subjects showed lesser variation across films. It is concluded that the cardiovascular responses of low-symptom subjects more accurately followed the energetic demands of the body, whereas the high-symptom subjects were in a comparatively enduring state of arousal.

Adaptation, Psychological↗

Self-reported stressors, symptom complaints and psychobiological functioning-II: Psychoneuroendocrine variables.

The present study examined resting endocrinological functioning and endocrine responsivity to new challenges as a function of self-reported stress load and symptomatology. Following a baseline period, four groups of male subjects (low-load/low-symptoms; low-load/high-symptoms; high-load/low-symptoms; high-load/high-symptoms) were exposed to stressful films, followed by a rest period. Blood samples were drawn after each film and after the rest condition, and urinary samples were collected during two nights preceding the experimental session. Neuroendocrine variables measured in plasma included adrenaline, noradrenaline, ACTH, cortisol, growth hormone, prolactin, and testosterone. The urinary samples were assayed for noradrenaline and adrenaline (in relation to creatinin). High-symptom subjects had significantly higher plasma levels of noradrenaline and overnight urinary adrenaline levels, whereas their cortisol levels tended to be lower as compared to the low-symptom group. The plasma noradrenaline/cortisol ratio was higher among the high-symptom subjects. However, upon controlling for neuroticism and life style factors (smoking and alcohol consumption), all but the effects on cortisol failed to meet significance criteria. Higher stress load was associated with higher plasma adrenaline responses during the laboratory session, irrespective of neuroticism or life-style measures. These results therefore suggest that in addition to measuring exposure to real-life stressors, it is also necessary to measure outcomes, such as symptoms, and to be aware of the effects of neuroticism and life-style when attempting to understand which specific psychosocial factors effect psychoendocrinological functioning.

Adult↗

Homesickness: a review of the literature.

Homesickness has not received due attention from psychological researchers, in spite of the fact that it is of considerable interest to counsellors and care-givers of those who have migrated or moved temporarily or permanently (e.g. immigrants, refugees, students, soldiers). First, this review addresses the definition of homesickness, the possible different kinds of homesickness, its prevalence rate, and symptomatology, Secondly, an overview is given of the theories that account for psychological distress following leaving home. These theories link homesickness with separation-anxiety and loss, the interruption of lifestyle, reduced control, role change, and internal conflict. In addition, the review focuses on: (i) studies that show that subjects reporting homesickness differ from non-homesick persons in terms of personality; (ii) the analyses of environmental characteristics that may play a crucial role in the onset and course of homesickness. Thirdly, Fisher's (1989) composite model of homesickness, which summarizes key findings of the major studies on homesickness is discussed. Fourthly, methodological issues are addressed. Finally, suggestions for future research are presented and possibilities for interventions are proposed.

Adult↗

Gender-identity, body-experience, sexuality, and the wish for having children in DES-daughters.

The main focus of the present study is to examine the impact of being a DES-daughter upon gender-identity, body-experience, body-acceptance, sexual satisfaction, and the wish for having children. Subjects were DES-daughters (N = 206) and age-matched controls (N = 121) who were not prenatally exposed to DES. All subjects completed a battery of measures including Bem's Sex Role Inventory (1977), a written gynecological anamnesis, and questionnaires concerning body-experience, sexuality, and the wish for having children. First, it was expected that DES-daughters would be more masculinized in their self-concepts than non-exposed control subjects. Our second hypothesis was that DES-daughters would be lower in body-acceptance and sexual satisfaction, and would have stronger wishes and more emotionality concerning reproduction. Contrary to expectations, DES-daughters were not more 'masculinized' than controls. Instead, they tended to have higher scores on femininity. Furthermore, no differences between DES-daughters and controls appeared in body-acceptance and sexual satisfaction. However, the DES-daughters reported a stronger wish for having children and expressed more emotionality concerning the subject.

Adult↗

Psychosocial factors as predictors of maternal well-being and pregnancy-related complaints.

The aim of the current study was to investigate the effects of psychosocial variables on well-being and on pregnancy-related complaints throughout pregnancy. Three hundred and ninety-six nulliparous women completed questionnaires on number of daily stressors, social support, gestational factors and mental and physical work load in each trimester of pregnancy. In addition, the following dependent measures were assessed: depression, anxiety, somatic complaints, and the pregnancy-related complaints fatigue, nausea and back pain. The independent variables predicted depression best (r2 = 42-44%), followed by anxiety (R2 = 13-20) and somatic complaints (R2 = 16-21%). Number of daily stressors explained most of the variance. Satisfaction with social support and maternal age were negatively correlated with depression. In contrast, pregnancy-related complaints could be less accurately predicted by psychosocial factors. The amount of explained variance for fatigue ranged between 6 and 10%, for nausea between 2 and 6%, and for back pain between 5 and 7% for the three trimesters. It is concluded that depressive symptoms during pregnancy are associated with negative psychosocial factors, particularly the number of daily stressors and low satisfaction with received social support. To a lesser degree, this is also the case with anxiety and somatic complaints. Pregnancy-related complaints, on the other hand, appear to be relatively independent of psychosocial conditions.

Adolescent↗

Psychosocial factors and pregnancy outcome: a review with emphasis on methodological issues.

This review focuses on the research concerning the relation between psychosocial factors and pregnancy outcome. The following four outcome measures are dealt with: (1) birth weight, (2) preeclampsia, (3) preterm labour, and (4) intrapartum complications. The most consistent finding concerns the association between maternal exposure to taxing situations and preterm delivery. Three possible pathways are hypothesized: (1) an indirect influence via unhealthy coping and life style behaviour, (2) a direct influence via stress-dependent hormones, and (3) an additional direct influence via psycho-immunological factors. Intervention studies aimed at improving pregnancy outcome show fairly mixed results. It is recommended that studies on the relationship between psychosocial factors and pregnancy outcome should employ a prospective design with due attention to chronic stressors, should include appropriate biochemical assessments, and multivariate techniques are applied.

Bias↗