PubMed Health⌕ Search

Biomedical subjects

S M Auerbach

Publications and source records attributed to S M Auerbach.

At least 19 recordsLinked to original sources
PubMed2001

Depression, pain, exposure to stressful life events, and long-term outcomes in temporomandibular disorder patients.

PURPOSE: This study investigated the role of psychological factors in temporomandibular disorders (TMD). Orofacial pain patients' pretreatment levels of depression, disability caused by pain, and exposure to stressful life events were measured, and differences on these variables between temporomandibular joint (TMJ) disease patients and patients whose pain was of muscular origin (MPD) were evaluated. The use of these variables and patient diagnostic status in predicting response to treatment in a subsample of these patients was also evaluated. PATIENTS AND METHODS: Before undergoing treatment, 258 patients were administered the Beck Depression Inventory (BDI), the Pain Disability Index (PDI), and the Social Readjustment Rating Scale (SRRS). Follow-up data on pain disability, current level of pain, depression, and satisfaction with treatment were obtained on 48 of these patients who were contacted at varying intervals after completing treatment. RESULTS: BDI scores obtained at the outset of treatment were significantly elevated and were positively correlated with SRRS and PDI scores. MPD patients had higher SRRS, BDI depression, and PDI pain disability scores than TMJ patients, and differences between the 2 groups in pain disability were greatest in areas that are often sources of interpersonal stress. Among follow-up patients, PDI scores declined after treatment, with MPD patients showing greater decreases than TMJ patients. Independent of patients' diagnostic status, their pretreatment PDI scores were predictive of their pain level at follow-up and were inversely related to their degree of satisfaction with treatment at follow-up; their pretreatment BDI scores were predictive of their depression level at follow-up. CONCLUSIONS: The findings are consistent with previous research indicating a link between emotional dysfunction and TMD and are largely supportive of the conclusion that psychological factors play a more pronounced role when pain is of muscular origin. Promising behavioral interventions are available for TMD patients in whom psychological factors appear to be playing a significant role.

Chronic Disease↗
PubMed2000

Should patients have control over their own health care?: empirical evidence and research issues.

Available research indicates that purported patient insufficiencies in ability to process information and make rational and reliable decisions have likely been overestimated. Furthermore, data indicate that nonscientific factors often play a role in physician decision-making and that physicians may not value different health outcomes in the same way as patients. Though the data on patient cognitive functioning are limited because of heavy reliance on patient responses in hypothetical versus actual decision-making situations, these findings lend credence to arguments that patients should have increased control over their own health care. Research on the effects of interventions designed to enhance patient control indicates that: (a) patients generally respond positively to increased information, but few studies have evaluated the effects of information as a precursor to decision-making; (b) the few studies using simple behavioral control interventions have shown generally positive effects on a range of patient outcomes; and (c) studies of decisional control (with breast cancer patients) have had experimental confounds which prohibit conclusions regarding effectiveness. Areas in greatest need of research include: (a) further exploration of the utility of noninvasive behavioral control interventions in different settings; (b) measuring the impact of control manipulations on patient perception of control as well as patient control-related behaviors; (c) matching patient differences in desire for control to experimental conditions and to physician differences in receptiveness to patient control; and (d) clinical trials in which patients facing critical decisions in trade-off situations are actually given a choice.

Attitude to Health↗
PubMed1990

Reminiscence interviews as stress management interventions for older patients undergoing surgery.

A standard reminiscence interview and one that focused on successfully met challenges reduced state anxiety and enhanced coping self-efficacy when measured against both attention-placebo and no-intervention control groups in a sample of 104 elderly male patients facing surgery. Age-peer interviewers did not elicit significantly greater overall reductions in state anxiety or increases in coping self-efficacy scores than younger interviewers (nonpeers), but did produce significantly higher coping self-efficacy scores than nonpeers when administering the challenge reminiscence interview.

Adaptation, Psychological↗
PubMed1989

Stress management and coping research in the health care setting: an overview and methodological commentary.

I argue that stress management and coping studies in the health care setting have not been sufficiently theoretically grounded. In particular, in formulating and evaluating intervention strategies, researchers have not adequately taken into account the nature of the stressor under study in terms of the degree to which it poses emotion-focused versus problem-focused coping demands for the individual. This theme is explored in examination of research in five essential areas: (a) effectiveness of problem- versus emotion-focused coping strategies, (b) effectiveness of interventions, (c) the role of individual difference variables, (d) timing of interventions, and (e) evaluation of treatment impact.

Adaptation, Psychological↗
PubMed1988

Adjustment to the stress of simulated captivity: effects of emotion-focused versus problem-focused preparation on hostages differing in locus of control.

We instructed 57 subjects about to be exposed to a simulated abduction and 4 days of captivity in either problem- or emotion-focused coping techniques, or we gave them a control orientation presentation. Retrospective self-report data obtained on the Ways of Coping Checklist indicated that subjects tended to use coping processes consistent with the type of prestress preparation they had received. Dramatic fluctuations in State Anxiety scores over the course of captivity indicated that the simulation was perceived to be highly stressful. Subjects given emotion-focused preparation reported the lowest anxiety and emotional distress levels and were rated as exhibiting the lowest levels of behavioral disturbance during captivity. Externals engaged in more emotion-focused coping than internals, but externals given problem-focused preparation responded the most poorly of all subgroups on all response measures. Overall, locus of control differences were of secondary impact (vs. situational variables) in influencing anxiety and adjustment. We discuss the characteristics of the stressor that may have accounted for the major findings and the stressful circumstances under which emotion-focused versus problem-focused coping may be of differential utility.

Adaptation, Psychological↗
PubMed1987

Cognitive, affective, and behavioral effects of reminiscence group therapy on demented elderly.

Twenty-seven demented elderly nursing home residents were given either reminiscence group therapy or supportive group therapy or were assigned to a no-treatment control group. The self-reported level of depression in participants given reminiscence therapy was positively affected compared to participants in the supportive therapy and control groups, but no significant effects were found for cognitive or behavioral functioning. Results are discussed in terms of the issue of the applicability of reminiscence therapy for cognitively impaired persons, the appropriateness of the measures used in this study to assess depression, cognitive ability and behavioral functioning, and in conjunction with clinical observations made during the process of therapy.

Aged↗
PubMed1986

Psychological factors in recurrent genital herpes infection: stress, coping style, social support, emotional dysfunction, and symptom recurrence.

The relationship among stress, coping style, emotional dysfunction, social support, and severity of symptoms (frequency of recurrence, and pain, duration, and bother of recurrences) was investigated in 35 females and 32 males suffering from severe cases of genital herpes infection. Level of emotional dysfunction as measured by the SCL-90 approached two standard deviations above the mean as compared with non-patient normals, and frequency, pain, and bother of recurrences were associated with level of emotional dysfunction. Negative life stress (as measured by the Life Experiences Survey) was unrelated to psychopathology, and was associated only with duration among the symptom measures. Regression analyses indicated that higher frequencies of recurrence and greater discomfort associated with symptoms were associated with an external locus of control orientation and with a tendency to use emotion-focused wishful thinking and to avoid using cognitive strategies to cope with the stress associated with herpes. It was suggested that stress management procedures involving teaching of problem-focused coping strategies and provision of social support would be most effective for this population.

Adaptation, Psychological↗
PubMed1984

Axisymmetric finite element analysis of tourniquet application on limb.

An axisymmetric finite element model of cuff on limb was developed. The model was used to simulate a clinical experiment by others in which the fluid pressure was measured at various points under a blood pressure cuff; the distribution of calculated hydrostatic stress was consistent with the clinical results. Simulations involving varying degrees of rounding at the edges of a tourniquet suggested that ensuring such rounding decreases maximum octahedral shear stress; this finding was consistent with studies by others using a two-dimensional physical model. The calculated stresses were highest at the tourniquet edges; this was consistent with nerve conduction and photomicrographic studies by others of damage caused by tourniquet use.

Humans↗
PubMed1984

Psychological factors in adjustment to orthognathic surgery.

The psychological adjustment of 30 orthognathic surgery patients was evaluated before and on three occasions after surgery. Results of preoperative testing showed the group to be well adjusted, and there were no major changes in psychological functioning as a result of surgery. Motivation for surgery included both functional and esthetic goals, and the majority of patients were satisfied with the results of surgery. The patient's perception of the surgeon was significantly related to pre- and postoperative adjustment. Two of the measures used, the Health Opinion Survey and the Impact Message Inventory, have potential as brief early screening devices to identify patients who may experience problems in psychological adjustment to orthognathic surgery.

Adolescent↗
PubMed1983

Anxiety, information, interpersonal impacts, and adjustment to a stressful health care situation.

Forty patients scheduled for dental extraction surgery were given either specific or general preparatory information, and this information was presented in either a personalized or relatively impersonal fashion using nonverbal cues. Changes in state anxiety over the course of the experiment were accounted for by individual differences in the Dental Anxiety Scale. The most important determinant of adjustment during surgery was the congruence between specificity of information received and individual differences in preference for information as measured by the Information subscale of the Krantz Health Opinion Survey (KHOS; Krantz, Baum, & Wideman, 1980). Findings with the KHOS and the Dental Anxiety Scale are examples of the growing importance of situation-specific personality-trait measures. The finding that high levels of presurgery anxiety are associated with poor adjustment is discussed in terms of Janis's (1958) model. Patients' perceptions of information-giver hostility and dominance were also significantly (inversely) related to adjustment; the differential impact of informational versus interpersonal variables is discussed in terms of moderating characteristics of health care settings.

Adaptation, Psychological↗
PubMed1978

Sex differences in anxiety response and adjustment to dental surgery: effects of general vs. specific preoperative information.

Monitored anxiety level by the State-Trait Anxiety Inventory and Corah's (1969a) dental anxiety scale and evaluated adjustment via behavioral ratings, in 32 female and 31 male dental surgery patients who were presented general or specific information prior to surgery. The findings indicated that dental surgery is a stressful procedure that elicits comparably high levels of state anxiety in males and females. For most patients, even those high in dental anxiety, state anxiety level returns to "normal" levels just after the completion of surgery. The dental anxiety scale administered well before surgery is a good predictor of patient anxiety level in the dental situation, especially for males. Females responded to an informational tape received prior to surgery with increased anxiety, and were rated as showing poorer overall adjustment in surgery than males. The general and specific information tapes did not differentially affect adjustment, but informational input and related variables such as patient expectancies and prior level of information are factors that need further investigation in terms of their potential relevance for the reduction of patient anxiety and enhancement of patient adjustment during dental procedures.

Adaptation, Psychological↗
PubMed1977

The effects of surgery-induced stress on anxiety as measured by the Holtzman Inkblot Technique.

Form A of the Holtzman Inkblot Technique (HIT) was administered to 45 subjects approximately 24 hours prior to a surgical operation and Form B of the HIT was administered after surgery. A-State and A-trait were monitored by the State-Trait Anxiety Inventory (STAI) pre- and postsurgery. STAI A-State scores declined and STAI A-Trait scores remained stable from pre- to postsurgery. Among selected HIT variables, only Barrier scores remained stable and correlated (negatively) with STAI A-Trait scores. No HIT variables changed across periods and were correlated with STAI A-State scores obtained concurrently. Employing a multiple regression approach, a three-variable prediction model was derived for A-State and six-variable model was derived for A-Trait. In addition, the implications of the high number of rejected cards obtained in this study were discussed in terms of the possible inappropriateness of the HIT as an assessment tool under conditions of high situational stress.

Adult↗