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Biomedical subjects

D K Wellisch

Publications and source records attributed to D K Wellisch.

At least 19 recordsLinked to original sources
PubMed1999

Depression and anxiety symptoms in women at high risk for breast cancer: pilot study of a group intervention.

OBJECTIVE: The psycho-oncology literature to date contains only one outcome study based on a group model for high-risk relatives of breast cancer patients. The authors set out to study the effects of group intervention in high-risk relatives of breast cancer patients. METHOD: Thirty-three high-risk relatives of breast cancer patients participated in a six-session, 12-hour group intervention model that consisted of educational and psychosocial components. RESULTS: There was a significant reduction of depression symptoms as reported on the Center for Epidemiologic Studies Depression Scale. Similarly, there was a significant reduction of anxiety symptoms as reported on the State-Trait Anxiety Inventory state scale. CONCLUSIONS: In this pilot study, the investigators found the group intervention model effective at reducing symptoms of depression and reactive (not chronic) anxiety.

Adaptation, Psychological↗
PubMed1997

Impact of breast cancer on Asian American and Anglo American women.

This pilot study constitutes the first exploration of the impact of breast cancer on Asian American women. Three hypotheses guided this study: (1) Asian American women would choose breast conserving therapy and breast reconstruction at a lower rate than the Anglo American women due to cultural differences in body image, (2) Asian American women with breast cancer would express psychological distress somatically and Anglo American women would express distress emotionally, and acculturation levels of the Asian American women would modify the expressions of distress such that women with high acculturation will express distress more emotionally and less acculturated women would express distress more somatically, and (3) Asian American women would seek assistance for psychosocial problems at a significantly lower rate than Anglo women. Ethnicity, age, and levels of acculturation were found to be significant variables that had to be considered simultaneously. The three hypotheses were only partially supported: (1) Asian American women chose breast conserving therapy and adjuvant therapy at a significantly lower rate than the Anglo American women, (2) Contrary to the hypothesis, somatization did not appear to be a dominant form of symptom presentation for Asian American women regardless of level of acculturation, and (3) Asian American women sought professional assistance for psychosocial problems at a significantly lower rate than Anglo women. Asian American women reported using different modes of help-seeking behavior for emotional concerns and receiving different sources of social support than the Anglo American women. Cultural interpretations of the findings are offered to explain the differences in the physical, emotional, and social responses to the breast cancer experience of Asian American women compared with the Anglo Americans, and notably between the Chinese- and Japanese Americans as well. The findings of this study warrant more refined exploration in order to improve the medical, psychological and social outcomes for Asian American women with breast cancer.

Acculturation↗
PubMed1992

Psychological functioning of daughters of breast cancer patients. Part II: Characterizing the distressed daughter of the breast cancer patient.

Sixty daughters whose mothers had breast cancer were cross-sectionally studied. Daughters age 11-20 reported feeling significantly more uncomfortable about involvement in their mothers' illness than daughters age 20+. Daughters whose mothers died were more likely to report long-term life plan changes and role changes with their mothers during the mothers' illness. The Global Symptom Index was predicted by the daughter's perceived degree of involvement with her mother (during her mother's illness), current emotional resolution (about her mother's illness), and sexual satisfaction. Sexual satisfaction was predicted by role changes during the mother's illness, frequency of sexual relations, and a depression scale.

Adaptation, Psychological↗
PubMed1991

Psychological functioning of daughters of breast cancer patients. Part I: Daughters and comparison subjects.

Sixty daughters of mothers with breast cancer were matched for age, educational level, and race with 60 comparison subjects without a maternal history of breast cancer to assess the impact on psychological adjustment, coping, body image, sexual functioning, and health knowledge and practices of having had a mother with breast cancer. Daughters of breast cancer patients showed significantly less frequent sexual intercourse, lower sexual satisfaction, and greater feelings of vulnerability to breast cancer, and they could identify a greater number of symptoms of breast cancer. No differences between groups were found in psychological symptoms, coping styles, breast self-examination practices, mammography practices, health knowledge, or body-image ratings. Contrary to clinical studies, women at risk for breast cancer showed good overall coping with few signs of significant dysfunctions in relation to comparison subjects.

Adaptation, Psychological↗
PubMed1991

The Psychosocial Levels System. A new rating scale to identify and assess emotional difficulties during bone marrow transplantation.

The "Psychosocial Levels System" assesses patients on three gradations of intensity: Level 1 (mild/minimal); Level 2 (moderate); and Level 3 (severe), taking into account past psychiatric history, quality of family and social support, prior coping history, coping with disease and treatment, quality of affect, proneness to anticipatory problems, and mental status. Based on initial psychiatric interviews, 42 BMT patients were rated by the authors. Results showed strong and significant concordance amongst raters. Retrospective global "level" ratings assigned by each patient's liaison therapist were highly concordant with the record-review generated ratings by the authors, emphasizing the significant convergent validity of the system.

Adaptation, Psychological↗
PubMed1990

Long-term effects of testicular cancer on marital relationships.

Thirty-four long-term survivors of testicular cancer and their wives were interviewed individually almost four years past the end of treatment to measure psychological and relationship functioning. Factors identified as important for couple adjustment to cancer--good communication, spousal support, and marital satisfaction--all acted positively to facilitate functioning in this sample. Good psychological adjustment was reflected in scores on the POMS, CES-D, Sense of Coherence, and Relationship Dimension of the Family Environment Scales. Several couples demonstrated lasting impairment, but, overall, the great majority of relationships were strengthened and couples emerged more tightly bonded.

Adolescent↗
PubMed1990

Psychodynamic themes of bone marrow transplantation. When I becomes thou.

In-depth psychodynamic factors about bone marrow transplantation are described. These factors are related to the BMT recipient, donor, recipient's family, and hospital staff. The emphasis is on the meaning of the experience emotionally and symbolically for the participants in BMT.

Bone Marrow Transplantation↗
PubMed1989

Long-term effects of testicular cancer on sexual functioning in married couples.

Long-term sequelae of testicular cancer have not been reported from the perspective of patient and spouse. As part of a larger study, both members of 34 married couples were interviewed individually, almost 4 years after treatment ended. Spouse and patient responses were compared for concordance (agreement) regarding psychosexual functioning and fertility issues. Wives perceived fewer long-term problems than husbands and were extremely supportive throughout their husbands' illnesses. At interview, whereas 23.5% of patients still felt less attractive as a result of treatment, no spouses shared this perception. Patients were more likely to report decreased, and wives increased sexual satisfaction compared to before cancer. However, both patients and spouses were more likely to report decreased frequency of intercourse than increased. In other areas as well, concordance was generally high. Few couples reported that infertility would pose a problem, but 53% were parents; men who banked sperm were less likely to already have children.

Adolescent↗
PubMed1989

Psychosocial outcomes of breast cancer therapies: lumpectomy versus mastectomy.

The psychological status of 50 patients who had been treated for breast cancer was assessed an average of 21 months after treatment. The patients were grouped according to major treatment modalities: mastectomy with breast reconstruction, mastectomy without breast reconstruction, or lumpectomy. Lumpectomy patients had a significantly more intact body image (p less than .008) and a greater sense of sexual desirability (p less than .009) than patients in the other groups. The patients did not differ on frequency of sexual relations or on emotional symptomatology. The results of this study generally validate those found in comparable studies showing that lumpectomy promotes a more intact body image but that no surgical procedure either produces or inhibits psychological symptomatology.

Adult↗
PubMed1988

Psychosocial outcome in a randomized surgical trial for treatment of primary breast cancer.

A study of the differences in the psychosocial effects of mastectomy versus segmentectomy was done on a group of women who were in a prospective randomized protocol for treatment of primary breast cancer. Through questionnaires designed for this study and standardized psychologic tests, women with segmentectomies responded as significantly less anxious, less sad, and more in control of their life events than women with mastectomies. The women with segmentectomies had a statistically more positive sexual and body image than those with mastectomies. The trauma of viewing the surgery was much greater in patients with mastectomies. The concern about cancer recurrence was less in the segmentectomy group. The differences in psychosexual adaptation to mastectomy or segmentectomy and the fears of cancer recurrence were significantly better in the segmentectomy group. The adequacies of cancer therapy was the same for both groups in the national study. This study restresses the importance of the segmentectomy option for women with breast cancer in leading to a better quality of life.

Adult↗
PubMed1988

Relationship of dialysis modality and other factors to cognitive function in chronic dialysis patients.

To determine if dialysis modality may be an independent factor in the level of cognitive function in chronic dialysis patients, cognitive function was studied in 17 pairs of continuous ambulatory peritoneal dialysis (CAPD) and center hemodialysis (CHD) subjects matched for sex, age, diabetic status, and interval since dialysis onset. Data on current metabolic, medical, psychological, and vocational function status were obtained. Neuropsychological (NP) measures included the Number Cancellation Protocol (NCP), Trailmaking test forms A and B (TMT A, TMT B), Symbol Digit Modalities (SDM), and the Rey Auditory Verbal Learning Test (RAVLT). The CAPD subject group had consistently more efficient cognitive function than the CHD subject group. Regardless of modality, the groups of subjects under age 51 and those who were vocationally active had significantly better NP performance. No cognitive function differences were found in groups categorized by sex or duration of dialysis. Creatinine levels were more highly correlated with NP scores than were BUN levels, with higher creatinine levels associated with better cognitive function. Serum calcium, CO2, total protein, albumin, and SGOT levels also were correlated with NP scores. CAPD may be more effective than HD in reversing uremic encephalopathy by mechanisms mostly unrelated to serum creatinine and BUN levels. Longitudinal studies will be needed to determine if dialysis modality is an independent factor in the degree of reversal of uremic encephalopathy.

Adult↗
PubMed1987

The psychological contribution of nipple addition in breast reconstruction.

Two groups of consecutive patients from two different plastic surgical practice populations were evaluated to determine psychosocial differences between those who underwent nipple-areola reconstruction in addition to breast reconstruction (N = 33) versus those who did not undergo nipple-areola reconstruction in addition to breast reconstruction (N = 26). Psychological assessment consisted of a standardized symptom inventory (Brief Symptom Inventory) and a specially designed self-report questionnaire investigating reactions unique to surgeries for breast cancer and breast reconstruction. Both groups were equivalent sociodemographically, with the exception of age, where the nipple-added group was significantly younger (P = 0.035) than the nipple-not-added group. The nipple-added group reported significantly greater satisfaction with breast reconstruction with regard to overall satisfaction (P = 0.004), satisfaction with size (P = 0.02), satisfaction with softness (P = 0.0004), sexual sensitivity (P = 0.006), and satisfaction with nude appearance (P = 0.02). Of the nine scales of clinical symptomatology on the Brief Symptom Inventory, the nipple-added group showed more increased symptoms on seven of the nine. The nipple-added group was significantly higher on two of these scales, namely, paranoid ideation (P = 0.009) and anxiety (P = 0.03).

Adult↗
PubMed1986

Adaptation of adult bone marrow transplant recipient long-term survivors.

Although there is a small literature on psychosocial and psychiatric aspects of bone marrow transplants (BMT) in adult recipients during the BMT hospitalization phase, adaptation of long-term adult BMT recipient survivors has received little study. This study surveyed the adaptation of BMT recipient survivors over age 17 who were an average of 42 months posttransplant. Study variables included the recipients' current self-reported health status, mood state, social role function, self esteem, life satisfaction, and relationships with their BMT donors and other family members. A companion study of those who donated BMT to the recipients eligible for this study was also performed. The study participants were preponderantly young adults who currently were in an intimate relationship and vocationally active. About 1/4 of the subjects reported ongoing medical problems. Also, 15-25% reported significant emotional distress, low self-esteem, and less-than-optimal life satisfaction. The subjects' current quality of relationship with their donors was highly correlated with many measures of their psychosocial status. The findings indicate that about 75% of BMT recipient long-term survivors are doing well from a psychosocial as well as a medical standpoint, that the recipient-donor relationship may be sensitive to any changes in the recipient's status, and that 15-20% of BMT recipient survivors report a degree of psychological distress that might benefit from specific psychological/psychiatric intervention.

Adult↗
PubMed1986

Psychological adjustment of adult bone marrow transplant donors whose recipient survives.

The psychosocial and psychiatric impact of donating bone marrow (BM) has received little study. This mail questionnaire study of bone marrow donors whose recipient had survived more than one year post-BMT was undertaken to document the psychosocial consequences of donation on "successful" BM donors. Demographic, mood state, self-esteem, current life satisfaction, and donor-recipient relationship characteristics, donor-perceived approval from family members, and donor attitudes about BM donation were studied. A companion study of BM recipients was also performed to provide comparative data on the psychosocial status of donors and recipients. As a group BM donors manifested little emotional distress, high self-esteem, and a high degree of current life satisfaction. Donors reported little change in their relationships with their recipients since the BMT. However the current quality of their relationships with their recipients was highly correlated with several recipient health status and psychosocial variables, suggesting that recipient deterioration might significantly adversely impact donor psychosocial status. From 10% to 20% of donors indicated at least some negative consequences of donating.

Adult↗
PubMed1986

Psychiatric aspects of bone marrow transplantation: a review and current issues.

BMT represents a major medical advance and offers to most individuals who undergo this procedure the only hope for long term survival. The current psychiatric literature is anecdotal and mostly restricted to discussion of psychiatric issues related to the BMT hospitalization itself. There is substantial agreement about the important psychiatric issues concerning BMT recipients, their families, and the BMT team. However, many post-BMT hospitalization psychiatric and psychosocial issues need attention: the psychological impact of being a BM donor, the consequences of BMT for donor-recipient relationships, the long-term family consequences of BMT, and the long-term cognitive, neuroendocrine, sexual/reproductive, and psychosocial status of BMT survivors. Hopefully, these issues will be increasingly rigorously and effectively addressed in the near future, so that effective psychiatric and psychosocial interventions can be developed which maximize the psychosocial outcome of those affected by BMT.

Adaptation, Psychological↗