PubMed Health⌕ Search

Biomedical subjects

J W Reich

Publications and source records attributed to J W Reich.

At least 19 recordsLinked to original sources
PubMed1995

Spouse encouragement of self-reliance and other-reliance in rheumatoid arthritis couples.

Studying and helping couples burdened with a major life stressor such as rheumatoid arthritis (RA) can be enhanced by employing well-understood conceptual and empirical frameworks, in our research person/environment fit (P x E) models. We measured P x E effects in a sample of 62 rheumatoid arthritis (RA) patients with locus of control beliefs, age, and the health status of the subjects as the Person variables and their spouses' control encouragement as the Environment variable. As predicted, externals were most sensitive to their spouses' behavior. Health status and age moderated the effects of the subjects' control beliefs and spouses' control efforts. Control encouragement showed positive benefits, but only for the younger and healthier subjects; it was related to increased psychological distress for externals in poorer health. Although many models of therapy suggest the benefits of increasing personal control, these data suggest the necessity of employing a more complex model integrating both person and social environment variables in understanding mental health.

Activities of Daily Living↗
PubMed1991

Predicting the everyday life events of older adults.

Predicting the everyday life events of people is a relatively unexplored topic, although several major theoretical approaches deal with related issues. The dispositional approach would assign a causal role to personality, while the situational approach would locate causation in the person's environment. Variations on these two extreme themes invoke an interactionist interpretation. Beyond this, a genuinely transactional approach focuses on the enduring person-environment relationship established as people deal with major and everyday life events. This study investigated a wide range of predictors of daily positive, negative, and ill-health events over time in a sample of 206 older adults. Results showed that personality variables played only a minor role in predicting daily events, although an interaction between extraversion and social network size was significant. Background demographic variables and the major stressors of recent conjugal bereavement and physical disability played a role in daily event occurrences. Overall, the strongest degree of predictability of events came from the events themselves: The high degree of event stability over time indicated the value of a genuinely transactional model in understanding the occurrence of everyday events.

Activities of Daily Living↗
PubMed1991

Analyzing the trait of routinization in older adults.

This article reports on the development and validation of a scale designed to assess a postulated psychological trait in older adults--routinization. Some older adults are thought to be motivated to maintain the daily events of their lives in relatively unchanging and orderly patterns of regularity. Those older adults may resist change, rejecting attempts to alter patterns of daily living, and experience distress at events that require change. This trait of routinization was explored with a 20-item self-report scale. Factor analysis revealed two underlying factors: 1) Having Order and Routine in daily living, and 2) Disliking Disruption. Relationship of the instrument to other standard personality instruments was assessed; it was found that the instrument was only modestly related to other scales. Validity of the scale was tested by relating it to the frequency of occurrence of desirable and undesirable small, everyday events. Also, its relationship to two factors of mental health reported by participants in a multisession experimental intervention to increase personal control and mastery was assessed. Evidence for validity of the scale in both sets of tests was found. Further exploration of the properties of the trait measure appears warranted.

Activities of Daily Living↗
PubMed1990

Some everyday life consequences of disability and bereavement for older adults.

The study analyzed daily event differences between groups experiencing the major stressors of conjugal bereavement and physical disability, and analyzed the association of everyday events with self-reports of mental health for different groups across a 3-month time span. Monthly interviews were conducted with 61 recently conjugally bereaved, 62 recently physically disabled, and 123 matched-comparison older adults between the ages of 60 and 80. The purpose of these interviews was to obtain a comprehensive assessment of the monthly frequencies of everyday life events. Self-reports of mental health were obtained from paper-and-pencil measures filled out after each interview. Causal models were used to analyze the best-fitting structure of event/mental health relationships for the first 3 monthly interviews. Undesirable events showed uniformly adverse effects on mental health. Desirable events benefited the psychological well-being of the disabled the most and had no positive effects on the mental health of the bereaved. The bereaved also evidenced less stability over time than other groups in the frequency of small undesirable events.

Adaptation, Psychological↗
PubMed1990

Dispositional control beliefs and the consequences of a control-enhancing intervention.

Two traditions of research on the concept of control have developed. One tradition involves the experimental manipulation of control, usually with a focus on enhancing control and thus improving adjustment and well-being. The other tradition regards control as a personality or trait variable and has been concerned with the development and validation of scales to measure it. Linking these two traditions would help determine if people differentially react to control-enhancing manipulations because of control predispositions. This study reports on an investigation into this topic. A sample of 209 subjects responded to the Levenson I-E scale and a control-enhancing manipulation (vs placebo contact and no contact control samples) within the context of a longitudinal assessment of stress and mental health in older adults. Variables assessed included personal mastery and mental health. The results showed significant interactions of the trait and manipulated variables. Control enhancement was most effective for those high in control beliefs. Some positive benefits of the placebo contact also were found. Subjects low in control beliefs did not respond strongly to control manipulations, while those high in control did. Directions for additional research are discussed.

Adaptation, Psychological↗
PubMed1989

Relationship among physical impairment, distress, and well-being in older adults.

The relationship between activity limitation and self-report on a variety of mental health measures was investigated through a longitudinal study of 124 noninstitutionalized older adults between 60 and 80 years of age, recruited either as recently disabled (N = 62) or as a matched control (N = 62). Fifty-five of these respondents (disabled, n = 28; controls, n = 27) selected persons who could be contacted to provide informant informations. Results showed the relationship between disability and mental health measures to be highly significant and stable across time. Further older adults classified as severely disabled experienced higher levels of anxiety, suicidal ideation, and overall distress than did the moderately disabled participants. Evidence was found for reciprocal causal relationships between health and mental health. Informants' reports supported findings based on self-report.

Activities of Daily Living↗
PubMed1989

Positive and negative social ties among older adults: measurement models and the prediction of psychological distress and well-being.

The factor structure of positive and negative social ties was studied among 246 older adults who were either recently physically disabled, recently conjugally bereaved, or matched controls. Covariance structure analyses were carried out on a network measure to determine whether positive and negative social ties represent independent domains of social experience, and to assess the degree to which their structure is invariant across groups undergoing major loss transitions. Positive and negative social ties were found to be independent and there was substantial similarity in their factor structure across the three groups. Hierarchical regression analyses revealed that, whereas positive social ties were related to psychological well-being, negative social ties were predictive of both psychological well-being and distress. These results demonstrate the importance of assessing both positive and negative ties in explaining the psychological adjustment of older adults.

Affective Symptoms↗
PubMed1989

Effects of disability and bereavement on the mental health and recovery of older adults.

We investigated the role of two major stressors, recent disability and conjugal bereavement, in older adults' self-reports of mental health and recovery from stress. A sample of 246 older adults between the ages of 60-80 was interviewed monthly for 3 months by trained elderly interviewers; Month-10 interview data were also analyzed. Control subjects, who were not experiencing the stressors, were carefully selected from a sample of adults matched on age, sex, and socioeconomic status. Dependent variables were psychological distress and psychological well-being, each with component subscales. The disabled group evidenced significantly lower positive well-being and significantly greater distress than did the other groups. Bereaved subjects demonstrated high levels of depression compared with the disabled subjects, but showed less anxiety. Bereaved subjects showed recovery on several indicators of mental health, but disabled subjects continued to show considerable psychological upset in comparison with the other groups.

Adaptation, Psychological↗
PubMed1989

A perceived control intervention for at-risk older adults.

Models of event causation and affective processes were used to design an experimental intervention for older adults. Ss were 2 at-risk populations, recently disabled and recently bereaved, each with matched nonrisk controls. Ss were randomly assigned to a placebo-contact group, a no-contact control group, or a 4-session, 10-week intervention focused on enhancing perceived control. Dependent variables assessed were personal mastery, psychological well-being and distress, positive and negative affect, and measures of daily events and activities. The intervention was nested within a 16-month longitudinal assessment of stress and adaptation processes in a large sample of community residents. The intervention had mixed effects on reports of personal mastery, but it significantly increased engagement in desirable activities and significantly decreased psychological distress and negative affect. Effects tended to be short-lived, however. Effects of the intervention tended to be particularly significant for the disabled group.

Adaptation, Psychological↗
PubMed1987

Activity, event transactions, and quality of life in older adults.

A multidimensional assessment of activity and subjective well-being based on a cognitive model of event causation was tested in a sample of 60 older adults. Activity was conceptualized as involving the occurrence of an event, the presence or absence of a response to that event, and the hedonic tone of the outcome of that transaction. Events were categorized as to whether the environment or the individual initiated them: demands or desires, respectively. Well-being was conceptualized as having two independent components, positive and negative, assessed by positive and negative mood scales and general well-being and quality-of-life scales. Analyses showed that older adults who were responsive to events reported more positive well-being, but high responding was also associated with negative aspects of well-being. Demands interacted with desire responding and outcome; affective outcomes of desired actions were significantly influenced by the occurrence of demand events. Results are interpreted in an expanded model of activity theory.

Activities of Daily Living↗
PubMed1987

Life event and treatment attributions in drug abuse and rehabilitation.

How positive and negative life events are perceived by drug abusers in nearly unexplored, yet attribution theory specifies ways in which such perceptions might differentiate drug abusers from nonabusers; it also suggests how attributions might relate to treatment effects and to rehabilitation. This study tested attributions about life events by drug abusers and matched controls as the drug abusers first entered residential treatment, and again later during treatment. Attributions about success and failure in treatment were also assessed. Results showed that attribution processes significantly differentiated drug abusers from controls and that those processes were related to ultimate rehabilitation outcome. Ways in which treatment might be made more effective by focusing on attribution processes are suggested.

Female↗
PubMed1986

Heparin-associated thrombocytopenia: a prospective comparison of bovine lung heparin, manufactured by a new process, and porcine intestinal heparin.

Heparin-associated thrombocytopenia has been reported most commonly with bovine lung preparations. We prospectively evaluated the incidence of thrombocytopenia in 43 patients receiving intravenous continuous infusions of either bovine lung heparin, manufactured by a new process, or a standard porcine intestinal mucosa heparin for a minimum of five days in a double-blind, randomized fashion. The decision to continue heparin therapy beyond five days was made by the patient's primary physician. All patients had documented acute thromboembolic disease, pretherapy platelet counts greater than 150 000/mm3, and no evidence of prior coagulation disturbance. No patients had undergone cardiopulmonary bypass or hemodialysis within seven days previous to the initiation of heparin therapy. Thrombocytopenia was defined as a decline in platelet count from the normal range of 150 000-350 000/mm3 to less than 100 000/mm3. Thrombocytopenia occurred in one patient (4.6 percent) receiving bovine lung heparin on day nine of therapy and in no patients (0 percent) receiving porcine intestinal mucosa heparin. Adverse reactions occurred in nine patients (42.9 percent) receiving porcine intestinal heparin and five patients (22.7 percent) receiving bovine lung heparin. This difference was not statistically significant. The results of this study indicate that the incidence of thrombocytopenia is low (less than five percent) with both bovine lung heparin, manufactured by a new process, and porcine intestinal mucosa heparin when therapy is limited to short therapeutic courses (less than 1 week).

Aged↗
PubMed1985

Diethylstilbestrol, genetics, teratogenesis, and tumor spectrum in humans.

Diethylstilbestrol (DES) is the first example of transplacental carcinogenesis in humans, as evidenced by an excess of clear cell adenocarcinoma of the vagina and cervix in exposed women. We hypothesize that: 1) in utero DES exposure will be responsible for a broader spectrum of cancer with variable age of onset as a function of latency effects in exposed humans of both sexes; 2) teratogenicity of DES will be more far-reaching than currently recognized and will harbor cancer implications in the face of known associations between teratogenesis and carcinogenesis; and 3) genetic heterogeneity will be a critical etiologic discriminant in DES associated cancer. This hypothesis embraces a prodigious body of data at the infrahuman level, as well as extant pharmacogenetic and ecogenetic observations in humans which signify heritable variations in response to environmental carcinogenic exposures. This hypothesis has important implications for drug testing with appropriate preventive strategies. Herein, particular restraints with monitoring through governmental legal channels must be employed. Past experience has clearly indicated negligence in shouldering this responsibility by both the pharmaceutical industry and government regulatory bodies.

Adenocarcinoma↗
PubMed1983

Tocainide kinetics in congestive heart failure.

Our subjects were 20 patients with life-threatening or symptomatic ventricular arrhythmias refractory to standard oral antiarrhythmic drugs but responsive to intravenous lidocaine. After evaluation of arrhythmias and treatment with intravenous lidocaine, oral tocainide dosage regimens were based on age, weight, and clinical status. During initial tocainide treatment, six plasma tocainide concentrations were recorded within a single dosing interval in 17 of 20 patients, by which standard kinetic parameters were calculated. Eventual trough steady-state tocainide plasma concentrations were predicted from the derived patient-specific kinetic parameters. Mean daily tocainide dose was 1800 mg (1200 to 2400). Mean daily tocainide doses (milligram per kilogram) did not differ significantly among responders and nonresponders or among patients with or without congestive heart failure. Mean peak and trough plasma concentrations 48 hr after initiation of therapy were 9.8 and 7.5 mcg/ml. Tocainide plasma concentrations did not correlate with responders and nonresponders or identify patients who were developing adverse reactions to tocainide. There were no significant differences in any of the calculated kinetic parameters as a function of response to tocainide or the presence of congestive heart failure, but there was a trend toward smaller volumes of distribution and higher average plasma concentrations at steady state in patients with congestive heart failure. There were no significant kinetic differences among patients with and without congestive heart failure, but a trend toward higher plasma concentrations in patients with congestive heart failure and the small number of patients suggests that further data collection is necessary before dosage recommendations can be made.

Adult↗
PubMed1982

Attribution theory: a fit with substance abuse problems.

How substance-abusing individuals early and late in treatment explain the problem behavior of other substance abusers is analyzed in attributional terms. Alcoholism was chosen as the problem of interest. Subjects were 42 male alcoholics newly enrolled in a treatment program, 41 male alcoholics nearing the completion of the program, and 46 male nonalcoholic controls. All subjects viewed a videotape interview with an actor who was identified as an alcoholic or not identified. As predicted, early-treatment alcoholics made greater situational attributions to the "alcoholic" and greater dispositional attributions to the "nonalcoholic" actor in comparison to the late-treatment alcoholics and controls. Early-treatment alcoholics, more than late-treatment alcoholics or controls, rated the actor labeled as alcoholic to be more similar to themselves. Discussion focuses on the applicability of attribution theory to problems of substance abuse.

Attitude to Health↗
PubMed1981

Life events and personal causation: some relationships with satisfaction and distress.

The factors that generate happiness or distress in people are not well understood, nor are factors that change such states. This study attempted to show that accounting for people's sense of personal causation could provide a clear understanding of the relationship between live events, personal activity, and measures of psychological well-being. After pretesting, three randomly selected groups of college students were given instructions either to (a) engage in 12 activities from a self-selected list of pleasurable activities, (b) engage in 2 activities from that list, or (c) return after 1 month for retesting only. Covariance analyses revealed that subjects instructed to engage in either 2 or 12 pleasurable activities reported greater pleasantness and a higher quality of life than controls; there were no differences between groups on reports of psychiatric distress. Prior negative life change was treated as a factor in the design and was found to interact with the activity instructions: Subjects reporting many prior negative changes exhibited less psychiatric distress along with greater pleasantness when instructed to engage in 12 activities rather than 2 or none. The results suggested that engaging in pleasant activities increases positive aspects of well-being in general, but may reduce distress only for subjects who are experiencing considerable life stress.

Female↗