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Biomedical subjects

M W Ketterer

Publications and source records attributed to M W Ketterer.

11 recordsLinked to original sources
PubMed1992

Denial specific to Friedman's pathogenic emotions in Jenkins Activity Survey Type A and angiography-referred males.

A pilot study of 27 firemen yielded a number of significant positive partial correlations between Type A Scale scores on the Jenkins Activity Survey and the spouse-or friend-reported frequency of items indicative of aggravation, irritation, anger, and impatience (AIAI), while controlling for subject self-reported frequency. A second study then assessed AIAI, depression, and anxiety with identical subjective (self-reported) and objective (spouse- or friend-reported) measures in 100 male angiography patients. Analysis of variance indicated that 1) angiographically normal or subclinical patients are psychologically distressed; 2) denial (as defined by diminished self-report vs. spouse- or friend-report) is specific to AIAI in this population; and 3) denial is observed with about equal intensity in both occluded and nonoccluded groups.

Adult↗
PubMed1991

Psychological factors related to prehospital delay during acute myocardial infarction.

BACKGROUND: Prior studies have had difficulty identifying factors that significantly explain patients' delay in responding to symptoms of acute myocardial infarction (AMI). METHODS AND RESULTS: We therefore examined factors affecting the time between symptom onset and hospital arrival for 103 AMI patients admitted to a Detroit metropolitan hospital between October 1989 and January 1990. Variables evaluated included demographic and medical history factors, psychological characteristics of somatic and emotional awareness, and type A behavior. The mean prehospital delay time was 9.0 +/- 10.8 hours (median, 5.0 hours; range, 0.25-62.0 hours). Delay time was not significantly associated with demographic or medical history categories or with type A behavior. Of study variables that can be identified prior to evolution of an AMI, somatic and emotional awareness were the only factors significantly predictive of delay time. Patients who were more capable of identifying inner experiences of emotions and/or bodily sensations sought treatment significantly earlier than patients with low emotional or somatic awareness (low emotional awareness median delay, 12.8 hours; high emotional awareness median delay, 3.8 hours; low somatic awareness median delay, 7 hours; high somatic awareness median delay, 4 hours). CONCLUSIONS: Variations in sensitivity to bodily sensations and emotions appear to play an important role in treatment seeking and thus potentially in treatment outcome for AMI patients. Assessment of these characteristics in patients with coronary risk factors could allow early identification of persons at risk of excessive delay in responding to symptoms of AMI.

Attitude to Health↗
PubMed1991

Psychological factors relevant to the prehospital and in-hospital phases of acute myocardial infarction.

Recognition and treatment of psychological factors relevant to the acute prehospital and in-hospital phases of myocardial infarction (MI) are reviewed. Various emotions and personality characteristics can be both risk factors for and consequences of acute MI. Components of the Type A behavior pattern and levels of somatic and emotional awareness have been linked with excessive treatment-seeking delay for MI patients. Psychiatric conditions such as panic disorder may mimic symptomatic presentation of MI and therefore have implications for differential diagnosis in the emergency room. Additionally, anxiety, depression, and neurobehavioral disorders such as delirium are relatively common during the hospitalization period and may contribute to potentially lethal complications of MI. Because psychological factors are associated with prognosis during each phase of MI, the identification and treatment of such factors are crucial in providing comprehensive care for MI patients.

Diagnosis, Differential↗
PubMed1990

The Ketterer Stress Symptom Frequency checklist: anger and the severity of coronary artery disease.

Recent research suggests that the most potent feature of the Type A behavior pattern for prospectively predicting cardiac disease is aggravation, irritation, anger, and impatience (AIAI). The present study examines psychometric properties of a new AIAI measure and its relationship to the severity of coronary artery disease (CAD). Subjects included 61 males undergoing coronary angiography. Comparisons were made of mean psychometric scores across groupings, defined by number of vessels occluded. These comparisons showed that the normal or subclinically occluded coronary angiographic group had high levels of depression and anxiety. Higher levels of AIAI were observed in patients with multivessel CAD compared to those with single vessel disease. Because of their psychological abnormality, the normal and subclinically occluded angiographic patients are an inappropriate control group for AIAI studies intended to address the etiology of CAD. Nonetheless, evaluation of these patients for the presence of depressive and anxiety disorders frequently has clinical importance.

Anxiety Disorders↗
PubMed1989

Somatization disorder.

Somatization disorder (SD) is a syndromatic classification that allows a physician to identify more easily patients with a lifelong history of chronic subjective physical complaints that are unverified by objective examinations either at the time of initial presentation or during the subsequent five years. The somaticizing process is believed to be an expression of emotional distress. The most common complaints of SD patients include recurrent pain (site and quality vary), conversion (pseudoneurologic) symptoms, nervousness or depression (or both), sexual and marital discord, and, often, menstrual difficulties. Such patients will generally have a history of repeated hospitalization or surgery. These symptoms are not perceived as mild or unimportant but lead to physician consultation, prescription drug use, and modification of life-style. Such patients are prone to "doctor-shopping" and self-medication and are at risk for many iatrogenic illnesses. Because they generally are resistant to psychologic explanations for their condition, management aimed at protecting them from the consequences of their behavior is important. A heightened threshold for instituting aggressive diagnostic and treatment procedures is necessary.

Humans↗
PubMedDate not supplied

Affect cognizance and the type A behavior pattern: labeling, cognitive effort or phenomenological loss?

Forty-eight subjects were requested to remember three idiosyncratic emotion-laden memories (eliciting Anger, Anxiety and Contentment). Objective (change in tonic skin conductance) and subjective (rated success at achieving each emotion) measures of arousal were taken for each condition as well as subjectively rated use of cognitive content (verbal and visuospatial modes). An "Affect Cognizance Index" (group-calculated T-score for objective arousal minus group-calculated T-score for subjective arousal) correlated positively with a measure of Type A Behavior during Anxiety and Contentment but not Anger, with or without cognitive effort statistically controlled. However, cognitive content may influence affect cognizance independent of its relationship with the Type A syndrome. Those subjects reporting greater verbal content showed augmented experience of affect-induced arousal during Anger. Visuospatial content augmented subjective experience of affect-induced arousal during Contentment.

Adaptation, Psychological↗