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Biomedical subjects

G Affleck

Publications and source records attributed to G Affleck.

At least 37 records · Page 2Linked to original sources
PubMed1998

Levels and patterns of alcohol consumption using timeline follow-back, daily diaries and real-time "electronic interviews".

OBJECTIVE: This study was designed to compare the Timeline Follow-Back (TLFB) to daily and real-time assessments of drinking. Our purpose was to evaluate overall correspondence and day-to-day agreement between these two methods among both problem and moderate drinkers. METHOD: In Study 1, problem drinkers (n = 20) reported their alcohol consumption daily during 28 days of brief treatment. In Study 2, moderate drinkers (n = 48), recruited from the community, used a palm-top computer to record their drinking for 30 days. In both studies participants completed the TLFB covering the recording period. RESULTS: Participants in Study 1 reported fewer drinking days, fewer drinks per drinking day and fewer total drinks per day on the TLFB, and those in Study 2 reported fewer drinks per drinking day, fewer ounces per drinking day, fewer total drinks per day and fewer total ounces per day. The magnitude of the difference, however, was modest. There was considerable between-person variation in day-to-day correspondence of TLFB and the daily and real-time reports. Neither person characteristics (gender, education and income) nor the distributional characteristics of drinking (including average consumption, variation) predicted concordance between TLFB and real-time reports. CONCLUSIONS: The Timeline Follow-Back method captured overall levels of drinking quite well compared to a 28-day daily diary and a 30-day electronic interview. Vast individual differences in day-to-day correspondence suggest that the TLFB may be less useful for detecting patterns of consumption.

Adult↗
PubMed1997

A dual pathway model of daily stressor effects on rheumatoid arthritis.

This study evaluated the initial promise of a dual-pathway conceptual model linking daily event stressors to rheumatoid arthritis (RA) disease activity through changes in immune system activation and mood. Fifty individuals, who were studied on five occasions two weeks apart, reported daily event stressors on the Daily Life Experience Checklist, daily mood on an abbreviated version of the Profile of Mood States-B, and daily joint pain on the Rapid Assessment of Disease Activity in Rheumatology. Serial clinical examinations comprised ratings of joint tenderness and swelling, and blood drawn during exams was analyzed for sedimentation rate (an indicator of systemic inflammation) and soluble interleukin-2 receptors (a marker of immune system activation known to correlate with RA disease activity). Across-person analyses failed to establish links from daily event stressors to either disease activity or composites of joint pain and joint inflammation when associations were adjusted for the effect of neuroticism on self-report measures. Pooled within-person analyses, however, were generally consistent with the relations predicted by the dual-pathway model. Increases in daily event stressors during the week preceding each clinical exam were associated with increased joint pain (regardless of changes in mood). At the same time, increased daily stressors were indirectly associated with decreased joint inflammation through reduction in levels of soluble interleukin-2 receptors. The dual-pathway model, which may be limited to short-term psychological and psychoimmunologic processes, underscores the importance of distinguishing potentially opposing effects of stress on pain versus inflammation in individuals with rheumatoid arthritis.

Activities of Daily Living↗
PubMed1997

Perception of airway obstruction in asthma: sequential daily analyses of symptoms, peak expiratory flow rate, and mood.

BACKGROUND AND OBJECTIVE: Studies have demonstrated a weak correlation between the degree of airways obstruction and the severity of asthma symptoms. Although the causes for this disparity are probably multiple, mood has been hypothesized to modulate symptoms. This investigation was designed to evaluate the effect of mood and other patient characteristics on the perception of airways obstruction. METHODS: We compared mood variables, symptom severity, albuterol use, and peak expiratory flow rate (PEFR) measured three times daily over a 21-day period in 21 adults with moderate to severe asthma. Electronic equipment was used for data collection. Analyses included both individual patient assessments and a within-subjects, time series, pooled regression of concurrent and time-lag data. RESULTS: After pooling 1323 observations, there was a weak concurrent relationship between symptoms and PEFR (beta = -0.17, p < 0.001). Only five patients (24%) were accurate perceivers, defined by a statistically significant relationship between symptoms and PEFR across time. Higher forced expiratory flow at 25% to 75% of capacity predicted perception accuracy (p = 0.004); active mood was marginally associated with accuracy (p = 0.06). These two variables together explained 41% of the variation in perception accuracy (p = 0.004). Mood did not independently predict symptoms, but conversely, increased symptoms predicted less pleasant mood (beta = 0.08, p < 0.001), less active mood (beta = -0.11, p < 0.001), and less active-pleasant mood (beta = 0.06, p < 0.001). PEFR did not predict mood, and only pleasant mood independently predicted higher PEFR (beta = 0.04, p < 0.05). Symptoms, but not PEFR, were concurrently associated with albuterol use (beta = 0.24, p < 0.001). CONCLUSION: The relationship between changes in PEFR and symptoms over time was generally poor. Those patients with lower FEF25-75 values tended to be less accurate perceivers. Mood states were influenced by asthma symptoms, but the converse was not true.

Adolescent↗
PubMed1997

Pain coping strategies and coping efficacy in rheumatoid arthritis: a daily process analysis.

Data from daily diaries were used to analyze pain coping processes in rheumatoid arthritis patients. For 30 consecutive days, 53 individuals described the pain coping strategies they used that day and rated the efficacy of their coping, joint pain, and positive and negative mood. Relations among variables were examined across-persons and within-persons over time. At the across-persons level of analysis, (i) daily coping efficacy was unrelated to pain coping or pain intensity, and (ii) the more frequent daily use of a wide variety of pain coping strategies was correlated with greater pain. Within-person analyses provided unique information about the relations among coping, pain, and mood not apparent in the across-persons results. Specifically, these analyses showed that increases in daily coping efficacy were not only related to decreases in pain, but also to decreases in negative mood and increases in positive mood. Time-lagged effects of coping and coping efficacy were also found. Individuals who reported high levels of coping efficacy on one day had lower levels of pain on the subsequent day. The daily use of pain reduction efforts and relaxation strategies also contributed to an improvement in next-day pain and an enhancement of positive mood. The implications of these findings for the assessment of pain and coping in rheumatoid arthritis patients are discussed.

Adaptation, Psychological↗
PubMed1996

Sequential daily relations of sleep, pain intensity, and attention to pain among women with fibromyalgia.

Fifty women with fibromyalgia syndrome (FS) recorded their sleep quality, pain intensity, and attention to pain for 30 days, using palm-top computers programmed as electronic interviewers. They described their previous night's sleep quality within one-half hour of awakening each day, and at randomly selected times in the morning, afternoon, and evening rated their present pain in 14 regions and attention to pain during the last 30 min. We analyzed the 30-day aggregates cross-sectionally at the across-persons level and the pooled data set of 1500 person-days at the within-persons level after adjusting for between-persons variation and autocorrelation. Poorer sleepers tended to report significantly more pain. A night of poorer sleep was followed by a significantly more painful day, and a more painful day was followed by a night of poorer sleep. Pain attention and sleep were unrelated at the across-persons level of analysis. But there was a significant bi-directional within-person association between pain attention and sleep quality that was not explained by changes in pain intensity.

Adult↗
PubMed1996

Construing benefits from adversity: adaptational significance and dispositional underpinnings.

The discovery of benefits from living with adversity has been implicated in psychological well-being in numerous investigations, is pivotal to several prominent theories of cognitive adaptation to threat, and can be predicted by personality differences. This article summarizes the prevalence and adaptive significance of finding benefits from major medical problems, locates the place of benefit-finding in stress and coping theories, and examines how it may be shaped by specific psychological dispositions such as optimism and hope and by broader personality traits such as Extraversion and Openness to Experience. The distinction between beliefs about benefits from adversity (benefit-finding) and the use of such knowledge as a deliberate strategy of coping with the problem (benefit-reminding) is underscored and illustrated by daily process research on coping with chronic pain.

Adaptation, Psychological↗
PubMed1995

Depression research methodologies in the Journal of Personality and Social Psychology: a review and critique.

Personality and social psychological studies of depression and depressive phenomena have become more methodologically sophisticated in recent years. In response to earlier problems in this literature, investigators have formulated sound suggestions for research designs. Studies of depression published in the Journal of Personality and Social Psychology (JPSP) between 1988 and 1993 were reviewed to evaluate how well these recommendations have been followed. Forty-one articles were examined for adherence to 3 suggestions appearing consistently in the literature: (a) multiple assessment periods, (b) multiple assessment methods, and (c) appropriate comparison groups. The studies published in JPSP have not adhered well to these standards. The authors recommend resetting minimum methodological criteria for studies of depression published in the premier journal in personality and social psychology.

Anxiety Disorders↗
PubMed1995

Reactions to impaired fertility: the vicissitudes of primary and secondary control appraisals.

Recent formulations about how perceived control influences adaptation to chronic medical conditions suggest that although a sense of personal (primary) control may decline over time, there are ample opportunities for individuals to make other adaptation-enhancing "secondary control" appraisals such as construing benefits or finding meaning in their threatening circumstance. We describe a longitudinal study of men and women with impaired fertility that evaluates a dynamic relation between primary and secondary control--one in which anticipated benefits increase over time as failed efforts to achieve a desired pregnancy lead to declines in primary control. Forty-six men and women with impaired fertility rated their sense of personal control over fertility outcomes, the extent to which they anticipated benefits in this situation and their outcome expectancy on two occasions separated by 14 months. As predicted, perceived control diminished over time. Changes in anticipated benefits were unrelated to changes in personal control. Anticipating benefits, however, was inversely related to changes in outcome expectancy, such that a more pessimistic expectancy over time was associated with an increase in anticipated benefits. This relation was independent of perceived control and was not mood dependent. We discuss these findings in terms of current theories of control, the need for further longitudinal investigations to evaluate the temporal relations between primary and secondary control appraisals, and implications for infertility research.

Adaptation, Psychological↗
PubMed1994

Unique clinical and psychological correlates of fibromyalgia tender points and joint tenderness in rheumatoid arthritis.

OBJECTIVE: We investigated the relationship of fibromyalgia (FM) tender points to other manifestations of rheumatoid arthritis (RA). METHODS: Sixty-seven RA patients completed questionnaires at study entry and described symptoms, emotionally significant events, and mood every evening for 75 days. Joint and tender point examinations were conducted every 2 weeks. RESULTS: Controlling for joint tenderness, the tender point count correlated with the degree of daily stress. Depression was not significantly related when daily stress was controlled for. CONCLUSION: We conclude that FM tender point counts correlate uniquely with RA patients' reports of daily stress.

Adult↗
PubMed1994

Person and contextual features of daily stress reactivity: individual differences in relations of undesirable daily events with mood disturbance and chronic pain intensity.

We examined the mood-related and pain-related consequences of daily stressors among 74 individuals with rheumatoid arthritis who supplied daily reports for 75 days. Meta-analyses of time series regression coefficients disclosed a significant same-day relation between events and mood but no consistent effects of events on same-day pain, next-day mood, or next-day pain. With distributional characteristics of the daily data controlled, Ss with more active inflammatory disease showed a greater positive relation of events with same-day and next-day pain, those with a recent history of more major life stressors showed a greater positive relation of events with next-day pain, and those with less social support showed a greater positive relation of events with next-day mood disturbance. Implications of these and other findings for theories of stress and adaptation and the methodological challenges of daily experience research are discussed.

Adult↗
PubMed1994

Hassles and uplifts and generalized outcome expectancies as moderators on the relation between a family history of alcoholism and drinking behaviors.

The present study examined 85 adult offspring of alcoholics (FH+) and 68 comparison subjects without a family history of alcoholism (FH-) in order to address three questions: (1) Does the relation between hassles and uplifts and drinking differ by gender and/or family history of alcoholism? (2) Do hassles and uplifts and/or generalized outcome expectancies (dispositional optimism and pessimism) moderate the relation between having a family history of alcoholism and drinking behaviors? (3) Do hassles and uplifts and outcome expectancies interact to influence drinking behaviors? The pattern of relations between hassles and uplifts and drinking behaviors and between outcome expectancies and drinking behaviors differed by family history and gender. Hassles were related to increased alcohol consumption for FH+ men only, whereas outcome expectancies were related to indicators of problem drinking for FH+ women only. When the moderating influences of hassles and uplifts and outcome expectancies were examined, both hassles and pessimism were found to moderate the relation between family history and drinking behaviors. In addition, hassles and uplifts and outcome expectancies interactively influenced this relation. These results emphasize the need to examine further both individual and contextual processes in studies examining the risk of the development of alcoholism.

Adult↗
PubMed1993

Temporal covariation of soluble interleukin-2 receptor levels, daily stress, and disease activity in rheumatoid arthritis.

OBJECTIVE: To examine synchronous changes in soluble interleukin-2 receptor (sIL-2R) levels, daily indicators of emotional stress, joint inflammation, and reported pain in patients with rheumatoid arthritis (RA). METHODS: Fourteen patients were studied on each of 6 occasions, 2 weeks apart. Measures included daily ratings of mood disturbance, undesirable events, and joint pain; clinical examination of joint swelling; and serum assays of sIL-2R. Pooled within-person correlations among these variables were calculated. RESULTS: Consistent with the results of previous research, joint inflammation covaried directly with sIL-2R levels. Changes in mood disturbance were unrelated to changes in joint inflammation, but increases in mood disturbance were linked with decreases in sIL-2R levels and increases in reported joint pain. CONCLUSION: These findings provide preliminary evidence that psychoimmune processes may be implicated in short-term changes in RA disease activity.

Adult↗
PubMed1993

The relative importance of dispositional optimism and control appraisals in quality of life after coronary artery bypass surgery.

Similar mechanisms have been proposed to explain the stress-buffering effects of both dispositional optimism and perceived control. Yet dispositional optimism as a personal resource should function independently of situational control appraisals. To evaluate the unique and additive contributions to adaptation of control appraisals and optimism, we followed 49 individuals scheduled for coronary artery bypass surgery. One month before surgery dispositional optimism was associated with neither health locus of control nor specific expectancies about the outcomes of surgery. Dispositional optimism, however, was associated with perceived control over the course of the illness and with quality of life appraisals. Although presurgery optimism predicted life quality 8 months after surgery, this was not the case when general and specific control appraisals and specific expectancies were included in the prediction. These findings are discussed as they relate to current conceptions of trait optimism.

Adaptation, Psychological↗
PubMed1992

Coping and cognitive factors in adaptation to in vitro fertilization failure.

Characteristics were identified that predict adaptation following an unsuccessful attempt at in vitro fertilization (IVF). Forty-one women and their husbands were interviewed and administered questionnaires prior to IVF and 2 weeks after notice of a positive or negative pregnancy test. Of the 36 couples who failed to conceive as a result of IVF, 6 of the women studied developed clinical depressive symptoms. Those women who reported poorest adaptation to IVF failure were more likely to have reported depressive symptoms prior to IVF, were more likely to have reported feeling a general loss of control over their lives as a result of infertility, tended to use escape as a coping strategy, and reported having felt some responsibility for their IVF failure. Dispositional optimism, as well as a sense of being partially responsible for the infertility, was protective of distress following IVF failure.

Adaptation, Psychological↗
PubMed1992

Neuroticism and the pain-mood relation in rheumatoid arthritis: insights from a prospective daily study.

For 75 consecutive days, 54 Ss with rheumatoid arthritis supplied daily reports of their mood and joint pain. After aggregating daily reports, the relation between chronic mood and chronic pain remained statistically significant when controlling for neuroticism, depression, disease activity, disability, and characteristic responses to increasing pain. Findings of a path analysis suggest that (a) individuals higher in neuroticism experience more chronic distress regardless of their responses to pain, their pain intensity, and depressive symptomatology, and (b) the relation between neuroticism and chronic pain is mediated by the propensity of high-neuroticism individuals to catastrophize their pain. Within-subject analyses that controlled for autocorrelation and linear trends in the time series revealed that 40% of the Ss experienced significantly worse moods on more painful days. Although individuals higher in neuroticism reported more intense pain and more negative mood, their daily mood was less strongly linked to their daily pain.

Adaptation, Psychological↗
PubMed1991

Individual differences in the day-to-day experience of chronic pain: a prospective daily study of rheumatoid arthritis patients.

Explored the distribution and temporal patterning of daily pain reported by 47 patients with rheumatoid arthritis (RA) for 75 consecutive days. Approximately half the pain series were significantly positively skewed, trended significantly across the recording period, or both. One fourth of the sample had relatively painful "outlier" days that clustered together. Most series displayed a significant autocorrelation in pain intensity across successive days even when the series were detrended. Patients with more active disease had pain that was more intense but more predictable from day to day and reported fewer painful outlying days and briefer episodes of atypically severe pain. Patients describing themselves as more depressed on the Center for Epidemiological Stress Depression Scale also reported more intense pain across the recording period, independent of their level of disease activity and disability. Implications for daily process studies of RA pain are discussed.

Activities of Daily Living↗
PubMed1991

Cognitive appraisal and adjustment to infertility.

We examine adults' cognitive appraisals of their infertility and how these appraisals relate to each other and to psychological adjustment. In two samples, 76 women and 54 men rated their appraisals of threat, challenge, and control connected with infertility and completed measures of global and infertility-specific distress. Couples appraised their infertility as both harmful and beneficial, and as relatively uncontrollable. Partners did not differ in their appraisals or global distress, although wives reported more infertility-specific distress than their husbands. Women who were more threatened by their infertility were more distressed, as were those who felt less challenged and those who perceived less control over infertility outcomes. Males' appraisals were unrelated to distress, although men whose wives were more challenged by their impaired fertility were less distressed than their counterparts.

Adaptation, Psychological↗