Biomedical subjects

I C Siegler

Publications and source records attributed to I C Siegler.

At least 19 recordsLinked to original sources

PubMed2001

The relationship between hostility and behavioral risk factors for poor health in women veterans.

BACKGROUND: While previous research has generally supported a relationship between hostility and health risk behaviors, the majority of this research has been conducted in predominately male, highly educated, Caucasian samples. The current study was designed to further examine the relationship between hostility and health risk behaviors in a sample of women. METHODS: Measures of health risk behavior and scores from the Cook-Medley hostility scale were obtained from 409 women veterans. Linear and logistic regression analyses were used to examine the relationship between hostility and health behaviors including tobacco smoking, alcohol use, body-mass index, caffeine use, and level of physical activity, after sociodemographic factors were accounted for. RESULTS: In a cohort of women veterans using VA health care, ages 35-81, hostility was significantly associated with tobacco smoking (OR = 2.10; 95% CI = 1.34 to 3.30), caffeine use (OR = 2.12; 95% CI = 1.16 to 3.85), and the number of alcoholic beverages consumed by women who drink alcohol. Hostility was not associated with body mass index (OR = 1.15; 95% CI = 0.77 to 1.72) or a lack of physical exercise (OR = 0.89; 95% CI = 0.55 to 1.43). CONCLUSIONS: Results are generally consistent with previous research and support the relationship between hostility and health risk behaviors. Awareness that hostility contributes to risk behaviors and disease may help in the design of interventions aimed at risk reduction.

Adult↗

PubMed2001

Racial differences in physician recommendation of hormone replacement therapy.

PURPOSE: Previous studies have suggested that black women may be less likely than white women to be offered and to take hormone replacement therapy (HRT). Thus, race and other factors associated with physician recommendation of HRT that may influence women's decisions about HRT were examined. METHODS: Data were from a baseline assessment of participants in a randomized controlled trial designed to evaluate the efficacy of a tailored decision-aid on HRT decision-making. We telephone interviewed 581 Durham women ages 45-54. The association of race and other factors with reported physician recommendation of HRT was tested using chi(2) and logistic regression analysis. RESULTS: Overall, 45% of women surveyed reported that their physician recommended HRT; black women were significantly less likely than white women to report being advised about HRT (35% vs. 48%, respectively, P < 0.005). Additional factors associated with being recommended HRT included older age, being postmenopausal, having had a hysterectomy, having thought about the benefits of HRT, and being satisfied with information about HRT. CONCLUSIONS: Black women are less likely than white women to receive physician recommendation of HRT. Racial differences in patient-provider communication about HRT exist and thus require greater diligence on the part of health care providers to minimize such a gap.

Black or African American↗

PubMed2001

Personality and coping with a common stressor: cardiac catheterization.

The association between coping and personality was examined in a sample of 204 cardiac catheterization patients who were asked to evaluate the use of specific coping strategies used to deal with their cardiac catheterization. Personality, as measured by the NEO Five-Factor Inventory (FFI), was moderately correlated with coping measures. In multivariate analyses, after considering confounding factors, Neuroticism was positively and Extraversion was negatively related to avoidance coping and Neuroticism was negatively associated with counting one's blessings as a coping strategy. Personality was not related to either problem solving or seeking social support coping strategies for individuals experiencing a cardiac catheterization. However, important covariates were associated with coping strategies. Not being married was negatively correlated with use of seeking social support and not having a confidant was negatively related with seeking social support and positively with avoidance. These results suggest that there are specific relationships between personality and coping, but these relationships are, for the most part, moderate in persons coping with a cardiac catheterization, and that coping processes are associated with individual differences in available social resources.

Adaptation, Psychological↗

PubMed2001

Are the salutogenic effects of social supports modified by income? A test of an "added value hypothesis".

Older adults (54 men, 113 women; M age = 69.5 years) were examined to test the hypothesis that social supports would be more salutogenic (health promoting) for persons with lower incomes than for persons with higher incomes. Interactions of income and social supports (mean of 3 emotional scales of the Interpersonal Support Evaluation List) at study entry predicted changes 15-18 months later in a cardiovascular composite (linear combination of high-density lipoproteins-mean arterial pressure; p < .05), and natural killer cell activity (p < .05). For both outcomes, emotional supports were salutogenic for persons with lower incomes (< or =$29,000/year), but not for persons with higher incomes (>$29,000/year). In contrast, interactions of the Tangible Support Scale with income did not occur. Persons with lower incomes may derive benefits from social supports that go beyond tangible assistance.

Aged↗

PubMed2000

Moderators of the effect of social support on depressive symptoms in cardiac patients.

Social support and depression have been shown to affect the prognosis of coronary patients, and social support has been found to influence depression in community and patient samples. We investigated the characteristics of coronary patients whose depressive symptomatology was most likely to improve with social support. We predicted that social support would be most beneficial for the most severely depressed, the old, the poor, the most severely ill, and those with poor functional status. Patients (n = 590) with documented coronary artery disease were assessed for depressive symptoms, social support, and functional status while in hospital. They were reassessed for depression 1 month later during a home visit. Depression scores were lower at follow-up (p = 0.001), and improvement was more marked among those reporting more support (p <0.001). The social support effect was strongest among those with high levels of depression at baseline (p <0.001) and those with lower income (p = 0.01). Unexpectedly, social support was more strongly associated with improvement in younger patients (p = 0.01). Social support did not interact with gender, disease severity, or functional status. These findings are partially consistent with the notion that social support is most effective for those who are most vulnerable and/or have few coping resources. These findings also have implications for the design and interpretation of psychosocial interventions.

Aged↗

PubMed2000

Anger proneness predicts coronary heart disease risk: prospective analysis from the atherosclerosis risk in communities (ARIC) study.

BACKGROUND: Increased research attention is being paid to the negative impact of anger on coronary heart disease (CHD). METHODS AND RESULTS: This study examined prospectively the association between trait anger and the risk of combined CHD (acute myocardial infarction [MI]/fatal CHD, silent MI, or cardiac revascularization procedures) and of "hard" events (acute MI/fatal CHD). Participants were 12 986 black and white men and women enrolled in the Atherosclerosis Risk In Communities study. In the entire cohort, individuals with high trait anger, compared with their low anger counterparts, were at increased risk of CHD in both event categories. The multivariate-adjusted hazard ratio (HR) (95% CI) was 1.54 (95% CI 1.10 to 2.16) for combined CHD and 1.75 (95% CI 1.17 to 2.64) for "hard" events. Heterogeneity of effect was observed by hypertensive status. Among normotensive individuals, the risk of combined CHD and of "hard" events increased monotonically with increasing levels of trait anger. The multivariate-adjusted HR of CHD for high versus low anger was 2.20 (95% CI 1.36 to 3.55) and for moderate versus low anger was 1.32 (95% CI 0.94 to 1.84). For "hard" events, the multivariate-adjusted HRs were 2.69 (95% CI 1.48 to 4.90) and 1.35 (95% CI 0.87 to 2.10), respectively. No statistically significant association between trait anger and incident CHD risk was observed among hypertensive individuals. CONCLUSIONS: Proneness to anger places normotensive middle-aged men and women at significant risk for CHD morbidity and death independent of the established biological risk factors.

Aged↗

PubMed2000

Measurement of dietary intake in the UNC Alumni Heart Study. University of North Carolina.

BACKGROUND: Research needs to identify diet and disease associations to provide direction about effecting change in individuals with dietary behaviors that increase risk of chronic disease. Inclusion of dietary assessment in the University of North Carolina Alumni Heart Study (UNCAHS) provides the opportunity to prospectively investigate dietary intake and chronic disease associations with measures of personality and behavioral risk factors. METHODS: Development of the UNCAHS food frequency questionnaire and nutrient intake of 4,443 middle-aged men and women is provided stratified by total fat and vitamin A intake within demographic and health behavior categories. RESULTS: Alumni consume diets close to that recommended by current dietary guidelines. Both men and women have low calcium intake. Thirty-nine percent of the alumni consume diets with 30% of kilocalories from fat or less and 88% meet the RDA for vitamin A. Never smokers had lower fat diets and greater intakes of vitamin A than former or current smokers. Over 54% of alumni currently took vitamin/mineral supplements. CONCLUSIONS: UNCAHS participants will be tracked as they approach older ages with apparently less risk for diet-related chronic diseases than many Americans. The psychosocial correlates of these eating behaviors will be evaluated as disease endpoints occur.

Attitude to Health↗

PubMed2000

Relation of subjective and received social support to clinical and self-report assessments of depressive symptoms in an elderly population.

BACKGROUND: The authors sought to evaluate the associations between depressive symptoms and social support in a sample drawn from a relatively understudied population - depressed elderly patients. The present study also used a multi-measure approach to assess both depressive symptomatology and social support. METHODS: In this prospective study of 115 patients we examined: (1) the baseline relations among a self-report measure of depressive symptoms, two clinical assessments of depressive symptoms, and subjective and received social support, and (2) the ability of social support to predict changes in clinical assessments of depressive symptoms at 6 months and 1 year. Education level, financial concerns, activities of daily living ratings, and gender were controlled for. RESULTS: Baseline subjective support was negatively related to self-reports of depressive symptoms, but unrelated to clinical assessments at baseline or follow-up. Conversely, received support was unrelated to self-reported depressive symptoms, but positively related to both clinical assessments at baseline. However, higher ratings of received support at baseline predicted decreases in clinical ratings of depressive symptoms at 6 months and 1 year. LIMITATIONS: These data were gathered in a primarily Caucasian sample, thus the findings may not generalize to more diverse ethnic populations. Potential confounding due to treatment mode and setting was not controlled in the present analyses. CONCLUSIONS: These results have important implications for interpreting clinical data in elderly depressed patients. Specifically, when depressive symptoms are assessed using clinician ratings, the most informative aspect of social support with respect to future clinical status appears to be received, rather than perceived, support measures.

Aged↗

PubMed2000

Hostility in marital dyads: associations with depressive symptoms.

We examined the relations of hostility (of self and spouse) with self-ratings of depressive symptoms in 898 spouse pairs. Self-ratings of hostility were initially examined as predictors of depression. Next, spouse self-ratings of hostility were added to the model. Finally, the interaction of self x spouse hostility was investigated. These relations were explored for three components of hostility (Cynicism, Aggressive Responding, and Hostile Affect). Age and education were controlled in all models and effects were examined separately for women and men. Self-ratings of Hostile Affect were positively related to depressive symptoms for both women and men. Self-ratings of Cynicism were also significantly related to depression, but only for men. All three components of spouse's hostility were positively related to one's own symptoms of depression for women. For men, however, spouse's hostility was not related to symptoms of depression. These findings highlight the need to study psychosocial risk factors in social units and have potential implications for intervention.

Adult↗

PubMed2000

Hostility predicts magnitude and duration of blood pressure response to anger.

The hypothesis that hostile and nonhostile individuals would differ in both magnitude and duration of cardiovascular reactivity to relived anger was tested. Participants were 66 older adults (mean age, 62; 38 women and 28 men; 70% Caucasian American, 30% African American). Each took part in a structured interview scored using the Interpersonal Hostility Assessment Technique. Later each relived a self-chosen anger memory while heart rate and systolic and diastolic blood pressures were measured continuously using an Ohmeda Finapres monitor. Hostile participants had larger and longer-lasting blood pressure responses to anger. African Americans also showed longer-lasting blood pressure reactivity to anger. Health and measurement implications are discussed.

Adult↗

PubMed2000

Social support and quality of life in patients with coronary artery disease.

The relationship between perceived social support and domain-specific health-related quality of life (HRQOL) was examined in a sample of cardiac catheterization patients after considering age, gender, race, education, and coronary artery disease (CAD) severity. Data was collected on 4,278 cardiac catheterization patients (63% males) and included 1,215 patients with non-significant CAD and 3,063 patients who had significant CAD ( > or = 75% stenosis of at least one major coronary artery). Among the patients with significant CAD, 2,721 were classified as low disease severity and 342 were considered high disease severity. Regression models indicated that a lack of social support was associated with significantly lower levels of HRQOL across all eight SF-36 HRQOL domains after considering disease severity and other demographic factors. The models also indicated that social support and other relevant variables interacted across various HRQOL domains. Physical function and physical role function were lower with age, whereas mental health, emotional role function, and vitality were higher with age. Females reported lower HRQOL than males across all domains. Minority patients reported lower levels of HRQOL than white patients across four domains. Increased disease severity was related to lower levels among four of the eight HRQOL domains. The observed interactions of social support with minority status, disease severity, and education suggest that a subset of individuals may suffer lower levels of HRQOL. These individuals may subsequently require the greatest degree of care and potentially benefit most from intervention.

Adult↗

PubMed2000

Associations among NEO personality assessments and well-being at midlife: facet-level analyses.

The association between well-being and personality was examined in 2,379 middle-aged adults. Measures that parallel C. D. Ryffs (1989) psychological model were selected to assess well-being. The 30 facet scales of the NEO-PI-R were used to measure personality. More than 83% of the facet-well-being correlations within the domains of Neuroticism, Extraversion, and Conscientiousness reached statistical significance, whereas, less than half of the correlations within the domains of Agreeableness and Openness were significant. The facets within each domain demonstrated different patterns of associations with the well-being measures, indicating that facet-level assessments yield additional information.

Attitude↗

PubMed2000

Personality at midlife: stability, intrinsic maturation, and response to life events.

Although developmental theories and popular accounts suggest that midlife is a time of turmoil and change, longitudinal studies of personality traits have generally found stability of rank order and little or no change in mean levels. Using data from 2,274 men and women in their 40s retested after 6 to 9 years, the present study examined two hypotheses: (a) that retest correlations should be no higher than about .60 and (b) that there should be small decreases in Neuroticism, Extraversion, and Openness, and small increases in Agreeableness and Conscientiousness. The study also explored the effects of recalled life events on subsequent personality scores. Results did not support the first hypothesis; uncorrected retest correlations uniformly exceeded .60. This was true for all personality traits, including facets of Agreeableness and Conscientiousness not previously included in longitudinal studies. The hypothesized decreases in Neuroticism, Extraversion, and Openness were found, but Conscientiousness showed a small decrease instead of the predicted increase. Life events in general showed very little influence on the levels of personality traits, although some effects were seen for changes in job and marital status that warrant further research.

Aging↗

PubMed2000

Self-perceptions of stability and change in personality at midlife: the UNC Alumni Heart Study.

The finding of personality stability in adulthood may be counterintuitive to people who perceive a great deal of change in their own personality. The purpose of this study is to determine whether self-reported perceived changes in personality are associated with actual changes based on a 6- to 9-year follow-up of 2,242 middle-aged male and female participants of the UNC Alumni Heart Study (UNCAHS). Respondents completed the Revised NEO Personality Inventory on two occasions and were asked to reflect back over a 6-year period and assess changes in their personality. The majority of respondents (n = 1,177; 52.5%) reported they had "stayed the same," while 863 (38.5%) reported they had "changed a little" and 202 (9%) reported they had "changed a good deal." Coefficients of personality profile agreement computed to evaluate global personality change for the three perceived change groups were essentially equivalent. Further, directional analyses of domain-specific changes in personality showed that perceived changes were weak predictors of residual gain scores. In an absolute sense, perceptions of stability or change were discordant in 8 of 15 (53%) comparisons. Self-perceptions of change are not an adequate substitute for objective assessments.

Aging↗

PubMed2000

Reliability of interview-assessed hostility ratings across mode of assessment and time.

These studies addressed 2 questions concerning interview-based hostility assessments: whether they are affected if the interview is conducted face-to-face versus telephone and whether they are stable across an extended time period. In Study 1A, 54 students were interviewed face-to-face and by telephone in a laboratory setting. Half the sample was reinterviewed in the laboratory 6 weeks later. The other half was reinterviewed by telephone at home. With 1 exception, all intraclass correlation coefficients (ICCs) comparing interview modes were above .62. In Study 1B, 48 adults were interviewed face-to-face in a laboratory and by telephone in their homes with a 2-week intervening interval. The ICC comparing interview modes was .78. In Study 2, 100 adults were interviewed face-to-face in a laboratory and approximately 4 years later by telephone in their homes. The ICC across interviews was .69. Thus, support was found for the stability of interview-based hostility assessments across interview methods and extended periods of time.

Adult↗

PubMed2000

Coronary catherization patient and wife's perceptions of social support: effects due to characteristics of recipient, provider, and their interaction.

This investigation explored relationships between coronary catherization patient and wife's characteristics and their perceptions of social support. Participants were 124 male patients undergoing diagnostic catherization to detect coronary artery disease (CAD) and their wives. Patients and wives' mean ages were fifty-nine and fifty-six years, respectively. While visiting the hospital both patient and wife independently completed a brief questionnaire that assessed psychological and physical health characteristics and perceptions of social support. Congruent with the interdependent and overlapping contexts, and reciprocal relationships assumptions of Revenson's (1994) ecological/contextual framework, results suggested characteristics of patients and wives (e.g., age, mental health, social functioning, hostility, depression, general perceived health) to interactively moderate their perceptions of social support. Overall, perceptions of social support were found to be influenced by characteristics of the perceiver, the support provider, and their interaction. Concerns for supportive and helpful caregiving are discussed.

Adult↗

PubMed2000

Relation between informant-rated personality and clinician-rated depression in patients with memory disorders.

OBJECTIVE: The goal of this study was to examine the convergent validity of informant-rated changes in depressive and related personality traits with clinician-assessed depression in memory-disordered patients. BACKGROUND: Depressive symptoms are frequent complications in persons with dementias such as Alzheimer disease, and caregiver informants consistently report changes in depression and related neurotic traits on the NEO Personality Inventory (NEO-PI) in dementia patients. METHODS: In 78 patients undergoing evaluation of memory complaints at an Alzheimer disease clinic, depression was characterized by clinical diagnosis, a clinician-rated scale, and informant ratings of premorbid versus current depression, anxiety, vulnerability, and neuroticism on the NEO-PI. RESULTS: The diagnostic groups differed in meaningful patterns on the NEO-PI measures. Those with a diagnosis of major depression differed from never-depressed patients in all personality areas, although those with depressed mood differed only on NEO-PI depression. The clinician-rated depression scale correlated modestly with current personality and change from baseline personality. CONCLUSIONS: The NEO-PI provides a useful measure of informants' perspectives on depressive personality changes in patients with memory disorders but does not correspond fully with a clinical syndrome of depression.

Aged↗

PubMed2000

Relationships among breast cancer perceived absolute risk, comparative risk, and worries.

When trying to predict breast cancer screening, it may be important to understand the relationships between perceived breast cancer risks and worries about getting breast cancer. This study examines the extent to which women's worries about breast cancer correlate with perceptions of both absolute (assessment of own) and comparative (self versus other) 10-year and lifetime risks. As part of a larger randomized intervention trial concerning hormone replacement therapy, 581 women participated in a telephone baseline survey to assess their perceptions of breast cancer risks and worries. Worries about getting breast cancer in the next 10 years and in one's lifetime were related positively to both absolute and comparative 10-year and lifetime risks. The magnitude of these relationships did not differ by time frame. Worry about breast cancer is a function of both how a woman views her own risk and how she compares her risk with that of other women. Some practitioners may encourage women to get screened for breast cancer by using emotional appeals, such as heightening women's worries about breast cancer by using risk information. Our data suggest that they should give careful consideration how best to combine, if at all, information about absolute and comparative risks. For example, if the motivation to screen is based on a sequential assessment of risk beginning with comparative and then absolute risk, creating communications that heighten perceived risk on both of these risk dimensions may be needed to evoke sufficient worry to initiate breast cancer screening.

Age Factors↗