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Biomedical subjects

F Verhage

Publications and source records attributed to F Verhage.

At least 37 records · Page 2Linked to original sources

[Presymptomatic DNA diagnosis in Huntington's chorea: reactions to the certainty of not being a genetic carrier].

Presymptomatic DNA diagnostics in Huntington's chorea make it possible to establish with approx. 98% certainty whether an at-risk person is a gene carrier. Sympathy and care are usually shown to those demonstrated to have the gene and so will become affected in the future. Persons shown not to be carriers sometimes do not experience the expected relief. The authors successively discuss the effects of a favourable finding on the family system, such as survivor's guilt and emotional numbing as aspects of a coping process. It is concluded that even a favourable finding needs to be worked through, a process that takes years rather than months.

Adult↗

[Relationship between perioperative anxiety and postoperative recovery].

One day before surgery and three days postoperatively, 118 cholecystectomy patients were investigated by means of several self-report anxiety-question(naire)s. On the basis of these, the patients were assigned to either the category more anxious postoperatively (A+) or the category less anxious postoperatively (A-). A+ patients rated preoperatively lower and postoperatively higher on the anxiety-question(naire)s than A- patients, and they stayed longer in hospital postoperatively.

Adult↗

Factors influencing the reproductive decision after genetic counseling.

Here we report a follow-up study involving interviews with 164 couples 2-3 years after genetic counseling to assess the influence of various factors on their reproductive planning. The results show that the desire to have children and the absence of personal experience with the disorder (no close relative being affected) are important single factors for the decision to opt for having children after genetic counseling. The magnitude of the genetic risk is of relative importance in reproductive planning. Seventy percent of the couples with a high genetic risk (greater than 15%) opted for having children. When the disorder was perceived as severe and the risk was interpreted as high, 72% opted for having children. The availability of prenatal diagnosis became important only in combination with a high genetic risk (greater than 15%). Forty-seven percent of the couples with a high genetic risk refrained from having children when prenatal diagnosis was not available. In the absence of prenatal diagnosis, couples who had an affected child were more cautious about trying again than those who did not--50% versus 14% decided to abstain. This study has provided some insight into the complexity of reproductive decision-making after genetic counseling. The findings may help genetic counselors and clinical geneticists understand and support counselees in their decision-making process, which is "multi-factorial."

Chromosome Aberrations↗

Model identifying the reproductive decision after genetic counseling.

To assess the identifiability of reproductive planning after genetic counseling, a model was designed to study 8 relevant factors influencing reproductive decisions after genetic counseling. Altogether, 164 couples were interviewed at home 2 to 3 years after genetic counseling. The factors were arranged in a flow chart distinguishing 3 groups: reproductive outcome prior to genetic counseling, desire to have children, and interpretation of information gained from genetic counseling. The model based upon these retrospective data showed that reproductive decisions were identified correctly in 91% of the cases. The model consisted of 8 factors and documented the urgency of the desire to have children and the interpretation of the genetic risk. In addition, linear discriminant analysis of the 8 relevant factors enabled identification of the reproductive decision in 96% of the cases. This model may prove helpful to counselors and counselees by showing what other couples have decided in comparable circumstances and for which reasons.

Discriminant Analysis↗

Psychic effects of physical training and relaxation therapy after myocardial infarction.

The psychological impact of exercise training and relaxation therapy was investigated in 156 myocardial infarction patients. They were randomly assigned to either exercise plus relaxation and breathing therapy (Treatment A: n = 76) or exercise training only (Treatment B: n = 80). Patients in Treatment A improved on three out of eight psychological measurements (anxiety, well-being, feelings of invalidity). No change was demonstrable in Treatment B. The difference between the treatments was significant for wellbeing (p less than 0.005). Physical outcome, measured by exercise testing was positive in about half of the patients (Treatment A: 55%, Treatment B: 46%). A negative outcome occurred less in Treatment A (p less than 0.05). Training success was not associated with psychic benefit. The association differed for the two treatments. It was concluded that exercise training was effective for some but not for all cardiac patients, and that a psychic effect of exercise could not be demonstrated. Relaxation therapy enhanced physical and psychic outcome of rehabilitation.

Adaptation, Psychological↗

Relaxation training in school classes does not reduce headache complaints.

The effect of teacher-presented Progressive Relaxation Training (PRT) on headaches, fear of failure and school problems was studied in school students. During ten physical education lessons, students received either PRT (n = 110) or placebo training (n = 92). The effect of the training was investigated in students who indicated the presence of headaches in a pre-training diary. No significant differences were found between both training groups regarding headache frequency, duration and intensity and the psychological variables. On the basis of these and previous findings, it is recommended to present PRT to fairly small groups of self-selected subjects instead of complete classes.

Adolescent↗

Value of the teeth.

A random sample of 542 respondents answered questions concerning the value assigned to the teeth, dental attendance pattern, oral health status, and dental anxiety. Non-linear multivariate analysis showed the data regarding value attached to the teeth to contain two dimensions, of which the second one was deleted due to extreme answer patterns (skewed distributions) on the pertinent variables. Repetition of the analysis, including a plot of the respondents, made it possible to discern four subsamples, characterized by specific answer patterns. In the discussion attention was given firstly to the separate variables estimating the value attached to the teeth, and next to the four subsamples, taking into consideration the dental attendance pattern, oral health status, and dental anxiety. It was concluded that the multivariate approach reveals that the respondents are of a rather high heterogeneity.

Adult↗

Development of a short instrument for the measurement of self-aggression. Preliminary results in female migraine patients.

The development of a short, 15-item inventory for the measurement of self-aggression (SAL) is described. The reliability and validity of the SAL were evaluated in 31 female migraine patients and 31 matched control subjects. The findings indicate that the SAL is a promising instrument for future research into migraine patients, which might also be extended to other study groups.

Aggression↗

Why men with hair loss go to the doctor.

Consultations, motives, experience, and attitudes were explored in 201 men with alopecia androgenetica who had two years before shown interest in hair treatment using minoxidil. During the past two years, one-third consulted a professional on account of hair loss. General practitioners were consulted by 60% and other professionals by about 75%. The main motive for the consultation was hair treatment, which was offered to half of the consulting subjects. Medical professionals were generally considered to be more suitable than other professionals for consultation on minoxidil treatment. The perceived chance of the treatment being successful and the amount of hair problems experienced seemed more important factors for consulting than the views on the suitability of a professional or the extent of baldness. There were indications that subjects who consulted both general practitioners and other professionals had also more general problems.

Alopecia↗

Migraine and defense mechanisms: psychophysiological relationships in young females.

Two psychological defense mechanisms, repression and self aggression, were studied in 23 young female migraine patients who had not been receiving treatment for their complaints and in 23 relatively headache free matched controls. All subjects were psychology students. Each subject was classified as high or low on repression and self aggression using the defense mechanism inventory. During three separate sessions: adaptation, intelligence test and real-life stress (an examination which was part of the psychology curriculum) pulse amplitudes of the temporal and digital arteries, frontal, temporal and corrugator EMGs, forehead temperature, skin conductance, and heart and respiration rate were measured. The migraine patients showed a trend towards more repression of their emotions and significantly more self aggression than the controls. Self aggression appeared to be positively associated with the headache frequency in the migraine group. With regard to the physiological measurements, in both groups repressors showed a modest tendency to enhanced sympathetic activity. Self aggression was not found to be related to any physiological measure of sympathetic activity, but, instead, related to less temporal blood flow. In general, associations were found between psychological defense mechanisms and physiological activity, which is suggestive of the existence of physiological pathways along which emotional inhibition might contribute to an attack of migraine after a stressful situation.

Adult↗

Relationship between general practitioners' attitudes and methods of dealing with psychosocial problems.

The relationship between general practitioners' attitudes and the methods they use when dealing with psychosocial problems was investigated using a questionnaire that was answered by a group of 30 general practitioners. The results showed that: (1) the doctor's desire to help is in general associated with the need to be appreciated; (2) when treating sexual problems, the giving of information is associated with a desire to change the patient; (3) when dealing with problems associated with chronic illness, the giving of encouragement to the patient is accompanied by a desire to give advice. The findings suggest that the way in which a general practitioner treats psychosocial problems depends partly on the type of problem and partly on his own attitude.

Adult↗

Personality traits of patients suffering extreme dental anxiety.

In order to investigate the relationship between dental anxiety and some personality traits, a group of 103 patients suffering extreme dental anxiety and therefore enrolled in a special treatment program were compared with controls sampled at random. The mean scores of the controls on dental anxiety measurements and on questionnaires dealing with personality traits were transformed into 50 with standard deviation equal to 10 to make them mutually comparable, and these subsequently were used as reference points, from which the likewise transformed mean scores of the anxiety group have to differ substantially if both groups stem from different populations. The mean scores were tested for difference with ANOVA. It appears that the anxious patients are more neurotic, i.e. more unstable, than the controls. Moreover, the patients feel themselves more uncertain with regard to having control, are less decisive, have a lower self-esteem, are less inclined to act and are, in general, anxious persons. These findings may have implications for selecting the most appropriate approach for amelioration of their anxiety or support of their coping capacity.

Adolescent↗

Cardiac events after myocardial infarction: possible effect of relaxation therapy.

Comprehensive cardiac rehabilitation aims primarily at improving quality of life, but an effect on morbidity and mortality may also be expected, especially when changes in behaviour and life-style are induced. The value of relaxation therapy and exercise training in post myocardial infarction (MI) patients was investigated. A group of 90 post MI patients were randomly assigned to either exercise training plus individual relaxation and breathing therapy (treatment A), or exercise training only (treatment B). The occurrence of cardiac events, consisting of cardiac death and of readmission to hospital for unstable angina pectoris, coronary artery bypass grafting (CABG) or recurrent infarction, differed significantly for the two treatment groups in the 2-3 years after infarction. Seven out of 42 patients in treatment group A (17%) experienced a cardiac event, in contrast to 17 out of 46 (37%) patients in treatment group B, (P = 0.05, two-tailed). The results suggest that a combination of a behavioural treatment such as relaxation therapy with exercise training is more favourable for the long-term outcome after myocardial infarction than is exercise training alone.

Adult↗

Effect of a special dental program upon extreme dental anxiety.

Dental anxiety of 60 extremely anxious dental patients enrolled in a special program, was measured multioperationally before and immediately after treatment, and 6 months later. The mean anxiety level was substantially lowered during the course of treatment, indicating a favourable effect of the program. After 6 months dental anxiety was still at the lower level.

Anxiety↗

Denial and overcompensation in male patients with myocardial infarction. An explorative study of the measurement of defense mechanisms by interpersonal comparison.

In psychoanalytic literature it is asserted that in patients with acute myocardial infarction (AMI) the period prior to the infarction is characterized by denial of resentment, dependency, anxiety and vital exhaustion. AMI patients overcompensate these characteristics by means of aggressive and active behavior. In the present study an instrument was constructed to measure these defense mechanisms. 122 male AMI patients and their partners completed a questionnaire for the purpose of judging the afore-mentioned characteristics in the AMI patients. The judgement related to the 3 months prior to the infarction. The study showed that the questionnaire was internally consistent (reliable) and valid. It was found that AMI patients saw themselves as having been less resentful, dependent, anxious and exhausted than their partners judged them to have been. The AMI patients did not judge themselves to have been more aggressive or active than their partners judged them to have been. The results indicate the potential usefulness of the method of comparing scores (patients vs. partners) in measuring defense mechanisms. Methodological problems and problems regarding the interpretation of scores are critically discussed.

Adult↗