Biomedical subjects

C P van der Staak

Publications and source records attributed to C P van der Staak.

10 recordsLinked to original sources

PubMed2003

[Personality diagnosis in elderly psychiatric patients using a Delphi technique].

A Delphi-technique was used as part of the development of a screening instrument to diagnose personality disorders in the elderly. Several statements regarding this subject were tested. Fifty-three Delphi-members, with expertise in the field of mental health services for the elderly and knowledge about the concept 'personality disorder', gave their opinion on the statements. In three successive rounds we aimed to get consensus as well as agreement on the contents of the statements. In the first round the Delphi-panel confirmed the importance of diagnosing personality disorders, with regard to individual therapy in older adults and psycho-educational activities. The DSM-IV Axis II criteria and related assessment-instruments do not take into account the emotional and social context of the elderly people. In the second round the Delphi-panel endorsed the importance of several information sources namely biographical information, informant information, behavioural observations and the reactions of the therapist himself. In the third round, 44 items considering diagnostics on personality were pro-pounded to the panel. There was agreement as well as consensus on 25 out of the 44 items. In conclusion, adjusting the DSM-IV Axis II criteria to the elderly will improve the quality of the diagnostics. Developments of a specific screening instrument for older adults probably will also increase the quality of the diagnostics.

Aged↗

PubMed2001

[Personality disorders in the elderly. Three case reports].

Little is known about diagnosing personality disorders in elderly persons. The current Axis II nosology is not age related and the majority of psychological tests are unreliable. Three cases dealing with personality disorders are presented. In these cases loss of health, relationships and autonomy are pointed out as the age specific stressors. We studied the relation between psychological symptoms, personality, coping style and age specific stressor. It appeared that elderly persons with personality disorders often have difficulties coping with these stressors. Inadequate coping styles may luxate or exaggerate axis I disorders. Therefore we recommend to pay more attention to the axis II classification during the diagnostical process.

Adaptation, Psychological↗

PubMed2000

Assessment of hostility in patients with coronary heart disease.

One of the problems in efforts to more clearly conceptualize hostility is the amount of method variance, which ranges from self-report techniques to interview-based methods and mirrors the multidimensional nature of hostility and related constructs. In addition, rather few studies concerned with the assessment of hostility have specifically used samples of coronary heart disease (CHD) patients. The purpose of this study was, therefore, to examine the multidimensionality of the construct of hostility in a sample of male coronary patients with some frequently used instruments. Factor analysis was used to detect the relevant underlying constructs, which were assessed using a variety of hostility measures in a sample of cardiac patients undergoing baseline assessment in an ongoing health-education intervention study. Measurement included both questionnaires and interviews. Participants (N = 235) were divided into 3 diagnostic groups: patients who had recently undergone (a) a myocardial infarction, (b) coronary artery bypass grafting, or (c) percutaneous transluminal coronary angioplasty. A 4-factor solution appeared to provide the best fit, and the following factors were isolated: Anger-Out, Negative Affect, Coping, and Anger-In. All intercorrelations were less than .50. Medical diagnosis did not differ with regard to the 4 factors found. The total hostility construct as measured by the structured interview (SI) did not fit into the 4-factor model. This study was the first to show that dimensions of anger and hostility constitute valid and relevant aspects of the general construct of hostility for a representative group of CHD patients. The 4 aspects of hostility isolated using some well-known hostility questionnaires and the SI explained most of the observed variance. Although the SI appeared to tap more general state anger, the 4 aspects of hostility may be differentially related to health in those who are coronary prone. Future studies on the role of hostile or negative emotions in CHD patients should, therefore, pay greater attention to the multidimensional nature of hostility and may clearly benefit from the use of the 4-factor model described in this article.

Adult↗

PubMed1997

Attachment representations of personality-disordered criminal offenders.

The relation between attachment representations and personality disorders was examined in a sample of 40 Dutch men held in a forensic psychiatric hospital for the commission of serious crimes. Secure attachment representations were virtually absent in the sample; separation from attachment figures in childhood was related to current insecure attachment as well as to personality disorders. Use of attachment theory in research and clinical work with criminals is discussed.

Adult↗

PubMed1995

Perception of heart rate and blood pressure: the role of alexithymia and anxiety.

While the ability to estimate heart rate in a laboratory setting appears to be related to anxiety and alexithymia, it is still unclear how the ability to estimate blood pressure is related to these psychological measures. The perception of heart rate and blood pressure in 24 normotensive subjects with varying degrees of alexithymia and anxiety was examined. Results indicate that the estimation of heart rate is related to psychological characteristics, while the estimation of blood pressure is not. More anxious subjects perceived heart rate more accurately than less anxious subjects. Furthermore, high alexithymic subjects perceived heart rate less accurately than low alexithymic subjects. The accuracy of estimation of blood pressure was, however, not related to alexithymia or anxiety. These findings provide further evidence that blood pressure estimates in a laboratory setting are mainly based upon situational cues.

Adult↗

PubMed1995

Submission and rebellion: excessive drinking of women in problematic heterosexual partner relationships.

Functionality of alcohol use for coping with partner relationship problems was explored in a group of 45 alcohol-dependent women with semistructured interviews. Six functions were categorized, three of them referring to adjustment and three to opposition to the partner. Respondents who had started excessive drinking mainly in response to problems with the partner reported more partner-related functions than respondents for whom a problematic partner relationship was not an important factor in the development of excessive drinking. Respondents of the first group also reported other characteristics of their relationship, notably they said more often that their partner was dominant. It was concluded that for a subgroup of women with alcohol problems, alcohol use may be a way of coping with a situation of powerlessness toward the partner.

Adaptation, Psychological↗

PubMed1991

Memories of parental rearing in alcohol and drug addicts: a comparative study.

Memories of parental rearing were investigated in 48 polydrug addicts and 91 alcohol addicts with the EMBU, an instrument for assessing parental rearing styles. Drug addicts remember their fathers and mothers as more rejecting and overprotecting and their mothers as more favoring than do alcoholics. When the age and the sex of addicts are taken into account, the kind of addiction and the sex of the addicts can explain a part of the variance of the overprotection dimension by fathers and mothers. The age of the addicts can explain a part of the variance of the rejection dimension by fathers and mothers. Finally, the variance in the favoring dimension by mothers can be explained by the kind of addiction.

Adult↗

PubMed1988

Smoking cessation studies: a methodological comparison.

A wide variety in outcome criteria hinders comparison of results between smoking cessation studies. Three important methodological issues are discussed: analysis of data of participants who drop out of therapy, treatment of missing data, and repeated use of significance tests. These issues determine to a great extent the results of evaluation studies. In general, they are of interest to all researchers of addiction who study the effects of interventions. Several ways to decide on these issues and the consequences of these decisions are considered. Little consensus exists about the criterion for dropout. It is concluded that a dropout criterion is a burden rather than a help. A better criterion would be the number of sessions present. Few satisfying techniques exist to handle the problem of missing data. Evaluation studies need to set a priori standards to counter the increased risk of a Type I error, caused by the repeated use of significance tests. Reviewers need to be aware of the variety in data treatment before comparing results.

Behavior Therapy↗

PubMedDate not supplied

Alcohol and social anxiety in women and men: pharmacological and expectancy effects.

A replication study was conducted to determine pharmacological and expectancy effects of alcohol on self-reported anxiety in a social interaction situation. Thirty-two male and thirty-two female social drinkers were randomly assigned to four conditions in a 2 x 2 factorial balanced placebo design, controlling for drink content and expectations. Results show that in women alcohol expectancy reduced self-reported anxiety, whereas in men there was no significant effect of expectancy. Alcohol consumption reduced anxiety in both men and women. Controlling for beliefs increased some of the effects we found. We conclude that although cognitive factors do mediate the effects of alcohol on self-reported anxiety, this influence seems to be different for men and women and the role of pharmacological factors might be more crucial.

Adult↗

PubMedDate not supplied

The effects of alcohol, expectancy, and alcohol beliefs on anxiety and self-disclosure in women: do beliefs moderate alcohol effects?

This study investigates the effects of alcohol, expectancy, and alcohol-related beliefs on self-reported anxiety and self-disclosure behavior in a social interaction situation. Seventy-two female social drinkers were assigned to eight conditions in a 2 x 2 x 2 factorial balanced-placebo design, controlling for drink content, expectancy, and beliefs. Results show that alcohol expectancy resulted in an anxiety reduction in subjects who believed that alcohol has a positive influence on social behavior, whereas expectancy had no effect in subjects with negative alcohol beliefs. Furthermore, subjects who expected alcohol were less anxious when they had positive alcohol beliefs than when they had negative beliefs, whereas beliefs made no difference in subjects who expected tonic. Our results suggest that the effect of alcohol expectancy on social anxiety in women is moderated by differences in the content of their alcohol-related beliefs. We conclude that the inconsistency in previous results about the effect of alcohol expectancy on social behavior might be explained by differences in subjects' alcohol beliefs. Finally, as neither of the three factors had any effect on self-disclosure behavior, we suggest that this behavioral measure is unrelated to self-reported anxiety.

Adult↗