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Biomedical subjects

G L Van Heck

Publications and source records attributed to G L Van Heck.

At least 19 recordsLinked to original sources
PubMed2005

Relationships between demographic variables and quality of life in a population of Dutch adult psychiatric outpatients.

BACKGROUND: Examinations of the role of demographic characteristics in quality of life (QOL) in psychiatric samples are not new. However, serious limitations of previous research have been that (1) QOL was not assessed according to current recommendations, (2) assessment of QOL was often hampered by a substantial overlap in content between symptoms and QOL measures, and (3) the majority of the study samples had quite specific characteristics hampering the generalizability of results, as a result of which clinical implications of the results remained unclear. The aim of the present study was to investigate explicitly the relationships between demographics and QOL in a sample reflecting the general population of psychiatric outpatients, QOL being assessed in a comprehensive, culturally sensitive, and subjective way, paying attention to the relative importance of its various facets. The main hypothesis was that these relationships would be rather weak. METHOD: From a population of 533 adult Dutch psychiatric outpatients, 495 participants completed the World Health Organization Quality of Life (WHOQOL)-Bref for assessing QOL. Furthermore, several demographic characteristics were recorded. RESULTS: Statistically significant correlations were found between partner relationship, habitual status, work, and sick leave and the WHOQOL-Bref domains social relationships and environment. Psychological health was associated to partner relationship, educational level, and sick leave. The total amount of QOL variance explained by demographics was rather low. CONCLUSION: Amongst factors determining QOL, demographic characteristics are relatively unimportant. Therefore, paying attention to demographics during psychiatric treatment will probably have little effect on improvement of QOL.

Adult↗
PubMed2003

Assessment of fatigue among working people: a comparison of six questionnaires.

AIMS: To compare the psychometric qualities of six fatigue questionnaires in a sample of working persons. METHODS: Internal consistency and test-retest reliability, content validity, convergent validity, and the dimensionality of the fatigue instruments were explored. RESULTS: All scales had a satisfactory internal consistency. Furthermore, based on factor analyses and Mokken scale analyses, all scales were unidimensional and appeared to measure an identical construct. The Fatigue Assessment Scale (FAS) had the highest factor loading on the one factor solution obtained in a factor analysis of the total scores of all scales. CONCLUSIONS: All the questionnaires were unidimensional and had good reliability and validity. The FAS was the most promising fatigue measure.

Adult↗
PubMed2001

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↗
PubMed2001

Measuring depression in women around menopausal age: towards a validation of the Edinburgh Depression Scale.

BACKGROUND: The relationship between menopause and depression is still rather unclear. Studies using different methodology - especially those lacking a clear definition of depression - are hardly comparable. Since the Edinburgh Depression Scale (EDS) is not influenced by (menopause-related) somatic symptoms, the validity of the Dutch version of this instrument was investigated in a large community sample of menopausal women. METHODS: In 951 women, aged between 47 and 56 years, depressive symptomatology was measured using the EDS, together with a syndromal diagnosis of depression using Research Diagnostic Criteria. RESULTS: Twenty-two percent of the subjects had scores of 12 or higher on the EDS. With this cut-off point, depression (major or minor) was detected with a sensitivity of 66%, a specificity of 89%, and a positive predictive value (PPV) of 62%. A cut-off score of 15 or higher detected half of the women with major depression (sensitivity 73%, specificity 93%, PPV 53%). LIMITATIONS: Screening of depressive symptomatology at menopausal age in women of the community can only partly detect women with clinical depression. The relation between menopausal status and depression should preferentially be investigated using a longitudinal rather than a cross-sectional design. CONCLUSIONS: The EDS, which is easy to implement in both community and clinical settings (e.g., General Practice), might be used as an effective screening tool for detecting women at menopausal age who are at risk for depression, followed by clinical evaluation in those with high scores.

Depressive Disorder↗
PubMed1999

Impairment of quality of life: rheumatoid arthritis versus sarcoidosis.

BACKGROUND: Quality of life (QOL) has become an important item in health care. QOL should be a major target of treatment in chronic diseases such as rheumatoid arthritis (RA) and sarcoidosis. The aim of this study was to compare the impact of RA and sarcoidosis on patients' QOL. We expected more serious impairment of QOL in the RA group than in the sarcoidosis group. METHODS: QOL was studied in RA patients (n = 32), sarcoidosis patients (n = 37), and a healthy control group (n = 37) employing the World Health Organization Quality of Life assessment instrument (WHOQOL-100). RESULTS: In both patient groups QOL was impaired with respect to Physical Health, Level of Independence (P < 0.001), and Overall QOL and General Health (P < 0.01). Moreover, RA patients appeared to have a lower QOL with respect to Pain and Discomfort (P < 0.001) and Mobility (P < 0.001). CONCLUSIONS: In RA and sarcoidosis, fatigue and sleep were major problems. In contrast to our expectations, with respect to activities of daily living and working capacity, the two patient groups did not show any difference. Impairment of QOL was more serious and included more aspects of QOL in RA than in sarcoidosis.

Adult↗
PubMed1999

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↗
PubMed1999

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↗
PubMed1999

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↗
PubMed1999

Gender differences in sarcoidosis: symptoms, quality of life, and medical consumption.

The aim of this study was to examine gender differences in quality of life (QOL) and in constitutional symptoms that coincide with sarcoidosis. The study population included 1026 sarcoidosis patients--all members of the Dutch Sarcoidosis Society--who completed the WHOQOL-100 and a symptom checklist. Women experienced more symptoms than men. With regard to QOL, male and female patients who suffered from symptoms differed in the broader domains of Physical Health and Psychological Health. Specific facets reflected pain, sleep, positive affect, appearance, mobility, and activities of daily living. Future studies should focus on the different experience of the disease between male and female patients more extensively. Studies are needed to evaluate whether the differences in the present study between male and female sarcoidosis patients are caused by a subject selection bias or life style differences; have a genetic, hormonal or biological base; or just are an epiphenomenon.

Adaptation, Physiological↗
PubMed1998

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↗
PubMed1998

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↗
PubMed1998

Quality of life in sarcoidosis: a comparison between members of a patient organisation and a random sample.

UNLABELLED: BACKGROUND AND AIMS OF THE WORK: Although it often has been suggested that members of patient organisations concerning a particular disease might not be representative of patients with that particular disease in general, this hypothesis has not been tested. Therefore, the aim of this study was to evaluate whether the quality of life (QOL) of members of the Dutch Sarcoidosis Society (DSS) is comparable with the QOL of a random non-member sample of the Dutch sarcoidosis population. SUBJECTS AND METHODS: The study included 64 out-patients (Group I), 192 DSS members matched for age and gender (Group II), and 192 DSS members matched for age, gender, as well as symptoms (Group III). All subjects filled in a questionnaire to make an inventory of physical symptoms and the World Health Organization Quality of Life assessment instrument (WHOQOL-100). The Student's t-test was used to evaluate the differences between (i) the two DSS groups and (ii) the non-member group. RESULTS: Group III differed significantly from Group I in only one QOL domain and five facets. Moreover, considering only the patients with symptoms from Group I and Group III, differences emerged on one domain and two facets. CONCLUSIONS: It appeared that more members of the DSS declared they suffered from physical symptoms than non-members. When the experience of symptoms was partialled out fewer QOL differences remained.

Adult↗
PubMed1997

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↗
PubMed1996

Hypertension and objective and self-reported stressor exposure: a review.

A review of the literature on the relationship between blood pressure and stressor exposure revealed a discrepancy between the results of studies based on objective measures of stressor exposure and studies based on self-reports. Whereas in the studies based on objective measures, a clear predominance of positive associations between blood pressure level and stressor exposure was found, in the studies based on self-reports, the results were highly inconsistent. Several moderator variables have been proposed that could explain the discrepancies found in the literature, such as awareness of hypertension and treatment. In studies in which these moderators were taken into account, inverse associations between blood pressure and self-reported stressor exposure have often been found. It is suggested that this result is brought about by altered appraisal of stressors in hypertensives.

Arousal↗
PubMed1996

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↗
PubMed1995

Alexithymia: a further exploration of its nomological network.

The present studies were designed in order to obtain a better understanding of the nomological network of the alexithymia concept. In study I, the links between alexithymia, coping, and self-rated health were explored. As predicted, strong negative correlations were found between alexithymia and the expression of emotions, daydreams and fantasies, and planful and rational actions. Contrary to expectations, no clear associations were found with self-reported health status. In study II, the focus was on links with personality, temperament, and self-reported (susceptibility to) homesickness. Although some correlations reached statistical significance, all were rather modest. The most remarkable finding was the independence of alexithymia and neuroticism. In study III, the associations between alexithymia and aspects of love experiences were examined, again yielding low correlations. It is concluded that alexithymia is relatively independent of temperament and personality. In addition, it is suggested that the association between alexithymia and the experience of positive emotions deserves further exploration.

Adaptation, Psychological↗
PubMed1990

Gender, coping and psychosomatic symptoms.

In this study gender differences in coping were explored, using the Ways of Coping Checklist (WCC; Folkman & Lazarus, 1980). In addition, the focus was on sex differences in the predictive value of coping strategies in relation to psychosomatic symptoms. Males preferred problem-focused coping strategies, planned and rational actions, positive thinking, personal growth and humour, day-dreaming and fantasies. Women preferred emotion-focused coping solutions, self-blame, expression of emotions/seeking of social support, and wishful thinking/emotionality. In spite of the gender differences the results of multiple regression analyses indicated congruous relationships between coping and complaints for both sexes. Stressors and coping factors contributed in much the same way to the explained variance of symptoms and the results were generally similar for males and females. The present data also emphasize the bidirectionality of the coping-symptoms link. This holds especially for self-blame, day-dreaming and fantasizing, and wishful thinking/emotionality. In contrast, distancing was found to be associated with self-reported psychosocial load. Future prospective studies should explicitly pay attention to this bidirectional relationship.

Adaptation, Psychological↗