Biomedical subjects

J M Ussher

Publications and source records attributed to J M Ussher.

6 recordsLinked to original sources

PubMed2002

A randomized comparison of psychological (cognitive behavior therapy), medical (fluoxetine) and combined treatment for women with premenstrual dysphoric disorder.

This study examines the relative effectiveness of cognitive behavior therapy (CBT) (ten sessions), fluoxetine (20 mg daily) and combined therapy (CBT plus fluoxetine) in women with premenstrual dysphoric disorder (PMDD). This was a randomized pragmatic treatment trial with three treatment cells. Treatment lasted for 6 months; a naturalistic follow-up was undertaken 1 year post-treatment. One hundred and eight women, satisfying the DSM-IV criteria for PMDD with 2 months' prospective confirmation were recruited into the study; sixty of these had completed 6 months of treatment and all measures before and after treatment. The main outcome measures were premenstrual scores on the Calendar of Premenstrual Experiences (COPE) and percentage of PMDD cases (DSM-IV diagnostic criteria). Significant improvement occurred in all three treatment-groups after 6 months' treatment, assessed by the COPE. Fluoxetine was associated with a more rapid improvement. There were no group differences in the percentage of DSM cases of PMDD post treatment, but at follow-up CBT was associated with better maintenance of treatment effects compared with fluoxetine. In conclusion, CBT and fluoxetine are equally effective treatments for PMDD, but the treatments have some differential effects that can be considered in treatment decisions. There appears to be no additional benefit of combining the treatments.

Adult↗

PubMed1995

The nature and long-term effects of childhood sexual abuse: a survey of adult women survivors in Britain.

The nature and long-term effects of childhood sexual abuse (CSA) were examined in 775 women survivors who responded to a survey in a women's magazine. Compared to existing research, there was a high rate of CSA involving sexual intercourse (46%), a high rate of intra-familial abuse (80%), a younger age of onset of abuse (8.5 years), and a longer duration of abuse (5.2 years). In univariate analyses, the reporting of a range of long-term psychological effects was significantly related to experience of abuse involving sexual intercourse or sexual contact, abuse perpetrated by a father or stepfather, abuse which was repeated or prolonged, presence of threats or violence, blaming of the child, saying disclosure would split the family, and a younger age of onset. In logistic and multiple regression analyses, the most important predictor variables were presence of threats or violence, and verbal coercion, followed by abuse being repeated or prolonged. It is suggested that future researchers should use a range of assessment instruments and multivariate analyses to examine the nature and long-term effects of child sexual abuse in both women and men.

Adult↗

PubMed1994

Restraint and perception of body weight among British adults.

A sample of 533 adults (268 women and 265 men) representative of the general population of Great Britain were interviewed so that the extent and effects of restraint, using the Dutch Eating Behaviour Questionnaire (DEBQ; Van Strien, Frijters, Bergers, & Defares, 1986) and the extent of overestimation of body weight could be examined. High-restraint subjects reported more guilt about food and eating and a greater likelihood of overeating in reaction to dysphoric mood, and they were more apt to overestimate their body size. Women reported significantly higher restraint, more guilt after eating in various types of social situations, and more overeating in reaction to dysphoric mood. Higher social class was associated with reports of guilt about a greater number of foods and with reports of more overeating when under stress or tired. Age was positively associated with guilt and negatively associated with overeating in reaction to being under stress, tired, or depressed.

Adult↗

PubMed1992

Research and theory related to female reproduction: implications for clinical psychology.

Reproduction has been proposed as a cause of debilitation and psychological disturbance for centuries, recently reified through the three reproductive syndromes, the premenstrual syndrome, postnatal depression and the menopausal syndrome. The evidence for the existence of these syndromes is critically reviewed, and the different aetiological theories examined, with particular reference to biological and psychological theories. It is argued that whilst bio-medical therapies presently dominate the literature, their efficacy is questionable owing to the lack of clear evidence for a hormonal substrate underlying symptomatology. Psychological interventions are reviewed, and multifactorial or individualized interventions recommended for adoption by clinical psychologists. The role of preventative work, through education, information provision and development of self-help strategies, is discussed. It is concluded that whilst menstruation, childbirth and the menopause do not inevitably have a deleterious effect on women, and the validity of the reproductive syndromes may be questioned, reproduction does act as a salient source of attribution and is a possible contributory factor to distress. Reproduction thus needs to be considered by clinical psychologists, but not privileged above other factors which may contribute to difficulties which individual women may experience.

Arousal↗

PubMed1991

Performance and state changes during the menstrual cycle, conceptualised within a broad band testing framework.

Using a broad band testing framework, indices of performance and state were examined in 10 women during one menstrual cycle, over six separate testing sessions. Indices of state were heart rate, the Cruickshank self-report questionnaire and time to basal skin potential. Results showed that self reported arousal was increased premenstrually. There was dissociation between indices of state, supporting the contention that simple models of arousal are inadequate. Performance tests of cognitive processing, tracking skill, reaction time and vigilance, dual task, speed and accuracy, and short term memory capacity showed only one significant result: semantic processing on a word matching task improved premenstrually. There was no significant relationship between state and performance: with high individual differences found between subjects. It was concluded that menstruation was not acting as a stressor for these subjects, and that there was no evidence for a decrement in performance in the menstrual or premenstrual phases of the cycle. Results are discussed in terms of coping with perceived increase in demand premenstrually, resulting in utilisation of compensatory effort and it is suggested that future work should examine womens ability to cope with perceived increase in demand and attribution of arousal during the menstrual cycle. The implications of the findings in terms of the critique of PMS as a valid construct are discussed, and it is concluded that future work should be carried out within an integrated multi-variate framework.

Adult↗

PubMed1990

Cognitive behavioural couples therapy with gay men referred for counselling in an AIDS setting: a pilot study.

Counselling and psychological therapy is now an established part of health care in most AIDS settings, yet intervention has thus far tended to focus on the individual. It is argued that there is a need for greater development of therapy for couples in the AIDS field, based on the results of a pilot study of cognitive-behavioural couples therapy with 10 couples referred to a clinical psychologist working in an AIDS setting. Results suggest that satisfaction with the relationship significantly improved over the course of therapy, and the problem for which the clients were initially referred were resolved. One individual case report of a couple is presented, in order to illustrate the method of therapy used. The limitations in this pilot study, in addition to general problems in carrying out research in this area, which make generalisations from the data difficult, are discussed. It is concluded that there is preliminary evidence to illustrate the efficacy of cognitive-behavioural couples therapy for gay couples in an AIDS setting, and that counselling interventions should not solely focus on the individual.

Acquired Immunodeficiency Syndrome↗