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Biomedical subjects

T R Elliott

Publications and source records attributed to T R Elliott.

At least 19 recordsLinked to original sources
PubMed2001

Social problem-solving abilities and personality disorder characteristics among dual-diagnosed persons in substance abuse treatment.

We examined the relation of self-appraised social problem-solving abilities and personality-disorder characteristics to the adjustment and compliance of persons with dual diagnoses in substance-abuse treatment. It was hypothesized that elements of the problem-orientation component would remain predictive of depressive behavior and distress after considering personality-disorder characteristics among 117 persons receiving inpatient-substance-abuse treatment. Furthermore, self-appraised problem-solving abilities were expected to predict the occurrence of "dirty" drug and alcohol screens during treatment and compliance with the first scheduled community follow-up visit. Results supported predictions concerning the relation of problem-solving confidence to depressive behavior, distress, and substance-use screens; however, a paradoxical relation was observed between the problem-orientation variables and compliance with the first outpatient visit. The results are interpreted within the context of contemporary models of social problem solving and the implications for cognitive-behavioral assessment and intervention are considered.

Adult↗
PubMed2001

Social problem-solving telephone partnerships with family caregivers of persons with stroke.

As individuals with significant functional deficits are discharged earlier from the hospital, health care professionals are challenged to develop cost-effective intervention programmes that will assist family members to manage caregiving problems in the home. The literature suggests that social problem-solving can positively influence the physical and psychological well-being of individuals. This paper describes a social problem-solving training procedure provided primarily by telephone to assist family caregivers to manage caregiving issues in the home.

Aged↗
PubMed2000

Self-appraised social problem solving abilities, emotional reactions and actual problem solving performance.

Self-report measures of social problem solving abilities have yet to be associated with objective problem solving performance in any consistent manner. In the present study, we investigated the relation of social problem solving abilities--as measured by the Social Problem Solving Skills Inventory--Revised (SPSI-R [Maydeu-Olivares, A. & D'Zurilla, T. J. (1996). A factor analytic study of the Social Problem Solving Inventory: an integration of theory and data. Cognitive Therapy and Research, 20, 115-133])--to performance on a structured problem solving task. Unlike previous studies, we examined the relation of problem solving skills to performance curves observed in repeated trials, while controlling for affective reactions to each trial. Using hierarchical modeling techniques, a negative problem orientation was significantly predictive of performance and this effect was not mediated by negative affectivity. Results are discussed as they pertain to contemporary models of social problem solving.

Adolescent↗
PubMed1998

Dynamic processes in health outcomes among caregivers of patients with spinal cord injuries.

The developmental trajectories of health outcomes in caregivers of patients with spinal cord injuries (SCIs) were studied as a function of caregiver and patient characteristics. Hierarchical linear modeling analysis examined (a) intraindividual developmental patterns of depressive behavior, anxiety, and physical symptoms over the 1st year of the caregiving career and (b) correlates of heterogeneity in the developmental patterns among 62 caregivers of persons with SCIs. Physical symptoms and anxiety were highly interdependent. Anxiety was a salient predictor of initial levels of and the rate of change in physical symptoms of caregivers. Physical symptoms and younger patient age were significantly predictive of initial levels of anxiety. Physical symptoms and positive affect predicted initial levels of depressive behavior among caregivers. Expressive support predicted the rate of change in anxiety and depressive behavior over time. These findings illustrate the value of studying caregiving as a developmental process.

Adaptation, Psychological↗
PubMed1996

Depression following spinal cord injury.

Although depression has been widely studied among persons with spinal cord injury, the ubiquitous and unsophisticated use of the term and presumptions about its manifestations in the rehabilitation setting have needlessly encumbered the understanding and treatment of depression. Major themes and issues in the study, measurement, and treatment of depression among persons with spinal cord injury are reviewed. Greater precision is recommended in distinguishing diagnosable depression from displays of negative affect, anxiety, distress, and dysphoria. Correlates of depressive behavior among persons with SCI are surveyed, and guidelines for research and practice in the SCI setting are explicated.

Depression↗
PubMed1994

Negative affectivity, social support, and the prediction of depression and distress.

In the work we present in this article, we examined the contaminating effects of trait negative affectivity (TNA) on the relations between social support and psychological distress among college undergraduates. In the first study, it was suspected that controlling for TNA would substantially alter the associations between social support (as measured by the Social Provisions Scale) and depression at the initial assessment and later with negative mood prior to a course examination. Actual results from cross-sectional hierarchical regression analyses revealed that controlling for TNA reduced--but did not nullify--associations between reassurance of worth support and depression. TNA did not mediate the relation of reliable alliance support to state NA measured 2 weeks later prior to a course examination. Finally, a second study controlling for TNA found reassurance of worth support remained a significant prospective predictor of depression during the week of final examinations. Results are integrated with theoretical and measurement issues in social support research.

Adaptation, Psychological↗
PubMed1992

Efficient pain assessment in clinical settings.

The need for efficient and practical assessment techniques of the multidimensional nature of chronic pain remains paramount in clinical settings. Visual analogue scales (VASs) and simple behavioral observation methods have been proposed as efficient, reliable, and valid measures of the subjective (sensory and affective) and overt behavioral aspects of the pain experience. The relationships among VASs and the UAB Pain Behavior Scale were examined among 48 chronic pain patients. Ratings of overt behavior were significantly related to both the VAS sensory and VAS affective ratings. Regression analysis indicated that the VAS scores accounted for significant amount of the variance (27.7%) in UAB scores. Moreover, the affective dimension of self-reported pain tended to be more strongly related to the visible manifestations of pain than were ratings of pain intensity.

Adult↗
PubMed1992

Dysphoria: a major symptom factor in persons with disability or chronic illness.

Depression frequently is diagnosed in persons with chronic illness or following the onset of disability. The overlap of symptoms of many chronic illnesses and disabling conditions with depression may lead to an overestimation of depression in such populations. Some investigators have proposed revised criteria for diagnosing depression in these conditions without an understanding of the contribution of diagnostic criteria in disabling conditions. This study investigated the nature of depressive symptom criteria constellations by individually factor analyzing the Inventory to Diagnose Depression (based on DSM-III diagnostic criteria) in spinal cord injury (n = 134), rheumatoid arthritis (n = 78), student (n = 140), and community (n = 150) groups. A four-factor solution emerged, with the first factor labeled "dysphoria" being represented by symptoms of negative self-evaluations, depressed affect, and suicidal ideation. The results indicate that a core element of the syndrome of depression is dysphoria, which suggests that the contribution of somatic items may be less important to the identification of the depressive syndrome in chronic illness.

Adaptation, Psychological↗
PubMed1992

Pain assessment in spinal cord injury.

Pain management is a serious problem for individuals with spinal cord injury (SCI). Recent developments in pain assessment indicate that multiaxial approaches, assessing medical, psychosocial, and behavioral/functional dimensions, are necessary to measure adequately the impact of chronic pain. The application of this multiaxial system to persons with SCI and chronic pain is presented. A review of the literature indicates that the psychometric properties and test utility for most pain measures have not been established for persons with SCI. The assessment task is further confounded by the functional limitations and psychosocial impairments that may accompany SCI. Recommendations are made for adapting established pain measures for use with SCI individuals. The choice of assessment tools for these patients is guided by the multidimensional nature of the pain experience, functional limitations, and the goals of treatment.

Humans↗
PubMed1991

Assertiveness, social support, and psychological adjustment following spinal cord injury.

Tested predictions that assertiveness and social support would be significantly predictive of psychological adjustment. Furthermore, it was anticipated that assertiveness and certain types of social relationships would differentially interact to predict adjustment, since positive and negative effects of both variables have been noted in prior research. Trained raters interviewed 156 persons receiving either in-patient or out-patient care for cord injuries and administered measures of assertiveness, social support, depression and psychosocial impairment. Persons who reported a keen sense of responsibility for the welfare of another reported more depression and impairment. Persons reporting higher levels of support facilitating social integration and reassuring personal worth were less depressed. Several significant interactions between assertiveness and different social support relationships revealed beneficial and deleterious effects on depressive behavior and impairment secondary to the disability. Results are discussed as they advance theoretical understanding of the effects of assertiveness and social support. Implications for discriminate cue learning in assertion training for persons with physical disability are proposed.

Adaptation, Psychological↗
PubMed1991

Negotiating reality after physical loss: hope, depression, and disability.

The utility of different reality negotiation strategies among 57 persons who had traumatically acquired severe physical disabilities was examined. It was predicted that a sense of goal-directed determination ("agency"; Snyder, 1989) would predict lower depression and psychosocial impairment scores soon after injury. To meet the demands of rehabilitation and social integration, however, it was hypothesized that a sense of ability to find ways to meet goals ("pathways") would predict lower depression and psychosocial impairment among persons who had been disabled for a longer period. The expected interaction was significant in the prediction of psychosocial impairment but not of depression. The sense of pathways was predictive of impairment and depression regardless of the time since injury. Results suggest that in the reality negotiation process the different components of hope as defined by Snyder have salient effects on perceptions of ability to function in social capacities.

Activities of Daily Living↗
PubMed1991

Adjustment to spinal cord injury: stage theory revisited.

To better understand adjustment following spinal cord injury (SCI), 106 subjects from two samples (N = 53 each) were administered the SCL-90-R, a symptom checklist, and the Multidimensional Health Locus of Control scales. Sample 1 subjects were admitted for rehabilitation during 1981 to 1982 and sample 2 subjects were admitted during 1984 to 1986. Sample 2 subjects entered rehabilitation programs more quickly after injury and reported more anxiety, phobic anxiety, and hostility than sample 1 subjects. Within each sample, there was no evidence for a relationship between age or time since injury and health beliefs or psychological distress. This study does not support stage theory for adjustment after catastrophic injury, but does suggest the importance of understanding the impact of social policy changes in adjustment following spinal cord injury.

Adaptation, Psychological↗
PubMed1989

Spinal cord injury and health locus of control beliefs.

Individual beliefs about control over their health were assessed in 53 patients with spinal cord injury. Patients who believed they exercised control over their health were less depressed than patients who were fatalistic. A significant number of patients were found to be higher in their internal attributions of health control (N = 31) than those who believed in chance (N = 5) and those who believed medical personnel were in control of their health (N = 11). The results are integrated with a past study of depression following spinal cord injury and locus of control beliefs.

Adolescent↗
PubMed1988

Age as a factor in response to spinal cord injury.

Previous studies examining the role of age in the mediation of psychological response to a catastrophic injury, such as spinal cord injury, have yielded equivocal results. To further examine the role of age in the response to catastrophic injury, 53 patients with spinal cord injury were administered a battery of tests assessing life stress, depression and general psychological functioning. Two groups were derived from negative ratings of life events and subject's age. Younger patients, who reported higher levels of life stress, also reported more depressive symptomatology; younger patients with lower levels of life stress reported fewer depressive symptoms. Both young and old patients with high stress reported higher levels of depressive symptomatology. Psychological disturbance was greater in the high life stress group as indicated by significant elevations on the global severity index of the Symptom Checklist-90 and elevations on somatization, obsessive compulsive, interpersonal sensitivity, depression, anxiety and psychoticism subscales. Age effects were not found for the Symptom Checklist-90.

Adaptation, Psychological↗
PubMed1988

Antidepressant analgesia in rheumatoid arthritis.

Forty-seven patients with definite rheumatoid arthritis (RA) were treated in a 32 week, double blind, crossover trial of amitriptyline, desipramine, trazodone, and placebo. All drug regimens produced significant changes on pain measures relative to baseline, but only amitriptyline exceeded placebo. Amitriptyline was associated with a significant reduction in the number of painful/tender joints. Our study supports the efficacy of a moderate dose of amitriptyline as an adjunct drug for the treatment of pain in both depressed and nondepressed patients with RA.

Aged↗
PubMed1988

Depression in rheumatoid arthritis.

Operationalized diagnostic criteria for depression were used to assess 137 (76% male, 24% female) patients with rheumatoid arthritis (RA). Forty-two percent met criteria for some form of depression. Discriminant function analysis revealed a significant relationship between the presence or history of depression and higher levels of pain, but not between current depression and common indicators of RA activity or severity. These results suggest that depression is a frequent disorder among persons with RA. The importance of patient appraisal of disease and assessment of repeated depressive episodes is discussed. Attention to specific interventions for depression in conjunction with the treatment of the RA is suggested.

Arthritis, Rheumatoid↗