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PubMed1993

Quality of life in patients with upper gastrointestinal symptoms. An improved evaluation of treatment regimens?

There is growing interest in measuring quality of life (QoL) in medicine. Together with objective variables such as healing rate, as recorded with endoscopy, this is believed to give a better basis for evaluation of treatment regimens in patients with upper gastrointestinal diseases. A strategy for the assessment of QoL in patients with upper gastrointestinal symptoms is presented here. The QoL evaluation was based on a battery of questionnaires, covering both general and specific aspects of life. General well-being was evaluated with the Psychological General Well-being Index (PGWB), and subjective symptoms with two specific questionnaires, the Gastrointestinal Symptom Rating Scale (GSRS) and the Ulcus Esophagitis Subjective Symptoms Scale (UESS). This new strategy was applied clinically in a study including 146 outpatients with suspected peptic ulcer. Initially, the patients reported a low degree of general well-being as evaluated with the PGWB, but the values returned to those found in normal populations within 4 weeks. Evaluation of the GSRS and UESS with regard to internal consistency, construct validity, and the ability to detect changes showed them to be satisfactory. The psychometric documentation of the measures indicates that they may give reliable and clinically valid information when used for evaluation of medical treatments in upper gastrointestinal disease. Further documentation of the methods is, however, needed to establish a generally acceptable QoL assessment in gastroenterology.

Dyspepsia↗
PubMed1993

Assessment of Quality of Life among patients with suspected duodenal ulcer.

Quality of Life was investigated in patients with suspected duodenal ulcer. In self-administrated questionnaires general well-being was evaluated with the Psychological General Well-Being Index (PGWB). Patients were required to fill out the questionnaires before endoscopy. This was done by 1526 patients who, after endoscopy, were divided into five groups; esophagitis (192), gastric ulcer (109), duodenal ulcer (426), duodenitis/gastritis (296) and negative endoscopy (401). Another 70 patients were found to have other diagnoses. Endoscopy was not performed in 32 patients who filled out questionnaires. All five patient groups reported low general well-being with the PGWB index. No statistical significant differences could be seen between the different groups. This study shows that patients complaining of gastrointestinal symptoms have a low degree of general well-being. Among patients with symptoms suspected for duodenal ulcer other diagnoses were common.

Adult↗
PubMed2001

Insulin-treated diabetes patients with fear of self-injecting or fear of self-testing: psychological comorbidity and general well-being.

OBJECTIVE: To examine psychological functioning and self-management behaviours of Dutch adult patients with insulin-requiring diabetes mellitus suffering from extreme fear of self-injecting (FSI) and/or fear of self-testing (FST). METHODS: A cross-sectional survey was performed in a sample of insulin-treated diabetes patients (n=1275; 51.1% male; age 49.7+/-15.8 years; 58.0% Type 1 diabetes), assessing FSI and FST. Patients completed the questionnaires concerning trait/state anxiety, depression, fear of hypoglycemia, diabetes-related distress, diabetes self-care activities, and general well-being. Comparisons were made on these measures between patients with extremely high scores on FSI and/or FST (> or = 95th percentile) and the other patients. Patients with extreme scores on FSI and/or FST were invited to take part in a second survey to assess the prevalence of major depression, common fears/phobias, and psychoneuroticism. RESULTS: People with extreme FSI/ FST scores, as compared to the other patients, reported higher levels of trait/state anxiety and depression. This group also reported more fear of hypoglycaemia and diabetes-related distress, had lower levels of general well-being, and reported less frequent self-monitoring of blood glucose. The second survey showed 11.1% of patients with extreme FSI/FST reporting scores indicating major depression. Prevalence of scores greater than or equal to the high scores on phobias (38.0-63.3%) and psychoneuroticism (27.8%) were consistently higher than norm group prevalences. DISCUSSION: Extreme levels of FSI and/or FST are associated with high diabetes-related distress, poor general well-being, and psychological comorbidity, as well as poorer adherence to the diabetes treatment regimen. It is concluded that patients with extreme FSI/FST are often burdened with more than this specific phobia.

Adult↗
PubMed1989

Essential hypertension: the relationship of psychological factors to the severity of hypertension.

165 hypertensive patients attending one general practice in Portugal were found to report significantly higher scores on measures of neuroticism, anxiety, depression and general psychological distress than 152 normotensive patients at the same practice. Hypertensive patients with evidence of organ damage exhibited significantly higher depression scores than those without such damage. These differences between normotensives and hypertensives, and between hypertensive with and without organ damage are discussed and previous research in this area is reviewed.

Adult↗
PubMed2005

From philosopher to psychologist: the early career of Edwin Ray Guthrie, Jr.

Edwin R. Guthrie rose to prominence as a psychologist in the 1930s. His theoretical outlook was behavioristic. This approach came from his conviction that an objective method could be applied to a scientific treatment of mind. Prior to becoming a psychologist, he was a philosopher of mathematics. Guthrie was initiated into psychology by Stevenson Smith, from whom he learned a psychology of adjustment informed by comparative research, Columbia functionalism, and clinical psychology. Guthrie's first step into psychology was in collaboration with Smith on Chapters in General Psychology (S. Smith & E.R. Guthrie, 1921). To synthesize their own unique position on learning from the contemporary theory and research, they used the principle of association. This articles focuses on Guthrie's origin and his development into a learning theorist.

History, 20th Century↗
PubMed1995

Counselling in general practice. A structured approach to the management of stress.

Many patients currently taking psychoactive drugs or being referred to psychiatrists for the outpatient treatment of general psychological distress could be offered effective management in a general practice setting, with or without inclusion of pharmaceutical supports. This article offers practical guidelines for practitioners in counselling emotionally distressed patients in a general practice setting.

Cognitive Behavioral Therapy↗
PubMed1964

STIMULUS GENERALIZATION OF THE EFFECTS OF PUNISHMENT.

Three pigeons were trained to respond to seven spectral stimulus values ranging from 490 to 610 mmu and displayed in random order on a response key. After response rates had equalized to these values, a brief electric shock was administered when the subject (S) responded to the central value (550 mmu) while positive reinforcement for all values was maintained. Initially, there was broad generalization of the resulting depression in response rate, but the gradients grew steeper in the course of testing. When punishment was discontinued, the rates to all values recovered, and equal responding to all stimuli was reattained by two of the Ss. Stimulus control over the effects of punishment was clearly demonstrated in the form of a generalization gradient; this probably resulted from the combined effects of generalization of the depression associated with punishment and discrimination between the punished value and neutral stimuli.

Animals↗
PubMed1964

STIMULUS GENERALIZATION AND THE RESPONSE-REINFORCEMENT CONTINGENCY.

Generalization gradients along a line-tilt continuum were obtained from groups of pigeons that had been trained to peck a key on different schedules of reinforcement. In Exp. I, gradients following training on a differential-reinforcement-of-low-rate (DRL) schedule proved to be much flatter than gradients following the usual 1-min variable interval (VI) training. In Exp. II, the value of the VI schedule itself was parametrically studied; Ss trained on long VI schedules (e.g., 4-min) produced much flatter gradients than Ss trained on short VI schedules (30-sec; 1-min). The results were interpreted mainly in terms of the relative control exerted by internal, proprioceptive cues on the different reinforcement schedules. Several implications of the results for other problems in the field of stimulus generalization are discussed.

Animals↗
PubMed1989

[Research on accidents in a tire-producing plant].

In the autumn of 1987 the U.S.L. health service (prevention, hygiene and occupational safety section) began a study about the accidents in a firm manufacturing tyres, placed in its own area. The retrospective enquiry starts from the analysis of typology, diffusion and seriousness of occupational accidents. The firm's accident register has been analyzed and integrated with other necessary information provided by the firm, by I.N.A.I.L. and by the air force metereological service. The study has been carried out on data concerning the following years: 1984-1985-1986. The accidents considered, implied absence from work and were divided as follows: for absence up till 3 days (in franchise), and more than 3 days (indemnified), applying the average value calculated on one year of the three analyzed. Every accident has been analyzed per year, month, day, hour of event. According to the classes: circumstances, kind of lesion, site of lesion, period of absence from work. The indices of: frequency, seriousness, incidence, mean duration have been calculated. The average monthly values of temperature: max and min. of the area and to the average monthly amount of processed elastomer (rate of production). The statistics we obtained, justified the study and showed the operative solution. The aspect of sanitary education and the general psychological aspect regarding the accident have been considered. Moreover the general operative solutions for the firm and specific ones for every department and for every position have been shown and faced up to. In this way, according to the risks that have emerged from the enquiries on previous accidents and thanks to direct inspection. it was possible to prevent accidents.

Accidents, Occupational↗
PubMed2001

Women with Turner syndrome: psychological well-being, self-rated health and social life.

Psychological well-being, self-rated health and social situation were investigated in a cross-sectional multidisciplinary study of 63 women with Turner syndrome (TS; mean age 31.5 years, range 18-59 years). The psychological examination included a semi-structured interview, and use of two standardized self-rating scales, the Psychological General Well-being Index (PGWB) and the Nottingham Health Profile (NHP). Psychological well-being and self-rated health were similar in the women with TS and Swedish female normative data, matched for age. However, the women with TS reported more social isolation than the normative group. Within the TS group, the oldest women reported more psychological distress and poorer health than the youngest. Those with impaired self-rated health reported more emotional distress. The women with TS were studying or in employment to the same degree as the general population, although fewer were cohabiting. In the interview, both negative and positive consequences of TS were reported. This study did not find any evidence for impaired psychological well-being, although it did indicate that women with TS experience more difficulties in the area of social and partner relationships.

Adolescent↗