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PubMedDate not supplied

Effects of alcohol and expectancy on self-disclosure and anxiety in male and female social drinkers.

To study the effects of alcohol consumption and expectancy on self-disclosure and self-reported anxiety during a social interaction, 32 male and 32 female social drinkers were assigned to one of four groups comprising a 2 x 2 factorial balanced-placebo design. Alcohol expectancy reduced the intimacy level of self-disclosure but not the amount of self-disclosure. Alcohol consumption had no effect. Thus, in contrast to the common view that alcohol functions as a "social lubricant," it served to inhibit social interaction. There was a three-way interaction among alcohol consumption, expectancy, and gender of subjects, such that the largest increase in anxiety was reported by male subjects who expected but did not receive alcohol. Thus, the previously reported inverse relationship between anxiety and self-disclosure was not confirmed, and alcohol's effect on anxiety seems unrelated to its effect on self-disclosure.

Adult↗

PubMed2006

The Sorry Works! Coalition: making the case for full disclosure.

BACKGROUND: The Sorry Works! Coalition, an organization of doctors, lawyers, insurers, and patient advocates, is dedicated to promoting full disclosure and apologies for medical errors as a "middle-ground solution" in the medical liability crisis. If a standard of care was not met (as shown by a root cause analysis) in a bad outcome or adverse event, the providers (and their insurer) should apologize to the patient/family, admit fault, provide an explanation of what happened and how the hospital will ensure that the error is not repeated, and offer compensation. The Sorry Works! protocol is based on the disclosure program developed at the Department of Veterans Affairs Hospital in Lexington, Kentucky. GOALS: The coalition's goals are to (1) educate all stakeholders in the medical liability debate, (2) serve as an organizing force for the full-disclosure movement, and (3) advocate for legislative incentives, including pilot programs. OVERCOMING CULTURAL AND LEGAL OBSTACLES: In large part, the coalition's educational efforts are intended to overcome cultural and legal barriers to full disclosure, which often represent emotional, knee-jerk responses within the medical, insurance, and legal communities. Perhaps the greatest hurdle of all is the culture of the medical profession; considerable changes are needed if doctors are to enjoy the benefits of Sorry Works! and other full-disclosure programs. CONCLUSION: Sorry Works! entails changing the culture of medicine, medical risk management, and the associated insurance and legal support structure.

Attitude↗

PubMed2005

The impact of diagnostic disclosure in dementia: a qualitative case analysis.

OBJECTIVE: The aim of this study was to give an in-depth description of the impact of disclosure of the diagnosis of dementia on a patient and the patient's partner. METHODS: Grounded theory interview study. RESULTS: Analysis of the interviews revealed that disclosure had an impact on three key domains: awareness of dementia, interpersonal relationship and social relationships. Disclosure was perceived as a confirmation of the pre-test ideas of both patient and carer. Formal disclosure of dementia was especially relevant for the carer in reconsidering her response to the patient's changed behavior. DISCUSSION: Receiving the diagnosis of dementia can be considered as a crucial moment in the process of becoming aware of the changes in one's life. Moreover, disclosure marks a new phase in the process of caring by the caregiver.

Aged↗

PubMed1986

Adolescent loneliness, self-disclosure, and private self-consciousness: a longitudinal investigation.

This study builds on an earlier investigation of the causal relations that exist among loneliness, self-disclosure, and private self-consciousness (Franzoi & Davis, 1985). Using structural equation techniques and a longitudinal (Year 1-Year 2) design, the present investigation tested a theoretical model that links these variables. Participants were 406 high school students. As in the previous study, results generally indicated a good fit between the theoretical model and the observed relations. In particular, however, this investigation provided new evidence concerning two alternative interpretations of the original Franzoi and Davis study. First, this study supports the original hypothesis that private self-consciousness leads to greater self-disclosure to peers, but it offers no support for the alternative view that such disclosure in turn increases private self-consciousness. Second, this investigation is somewhat equivocal with respect to the original hypothesis that greater self-disclosure reduces loneliness. Both this hypothesis and the alternative view that greater loneliness reduces self-disclosure, receive some support from the data in this study. Finally, the difficulty in obtaining significant longitudinal paths (from Year 1 to Year 2) suggests that the time lags in the variables' effects on one another are relatively short rather than long.

Adolescent↗

PubMed2004

A closer examination of the structured written disclosure procedure.

The current study examined psychological and physical health outcomes of the written disclosure paradigm and the hypothesis that the principles of therapeutic exposure account for the beneficial effects of the paradigm. Participants were randomly assigned to either a written disclosure condition or a control condition. Reactivity to the writing sessions was examined using both subjective and physiological measures. Measures of psychological and physical health were completed before and 1 month after the sessions. Participants assigned to the disclosure condition reported fewer psychological and physical symptoms at follow-up compared with control participants, though reductions were clinically significant for only 1 outcome measure. Physiological activation to the 1st disclosure session was associated with reduced psychological symptoms at follow-up for disclosure participants. Subjective reports of emotional responding corresponded with physiological reactivity. Implications of these findings are discussed.

Adolescent↗

PubMedDate not supplied

Cross-cultural issues in the disclosure of cancer.

PURPOSE: To increase awareness of cultural differences in the disclosure of a cancer diagnosis or prognosis, the author reviews several surveys of patients and physicians from around the world. OVERVIEW: The Western medical community is increasingly emphasizing full truthful disclosure of cancer diagnoses or prognoses and respect for autonomy as necessary prerequisites to ethical practice. However, surveys of European, Japanese, Native American, and various ethnic American (including Korean, Chinese, Mexican, Hispanic, African, and European American) cancer patients and physicians reveal that many cultures consider complete and accurate disclosure of cancer undesirable. Cultural differences in the rates of disclosure of a cancer diagnosis or prognosis; the physician's use of euphemisms to give a true or false diagnosis; as well as considerations of how to disclose a cancer diagnosis are described. CLINICAL IMPLICATIONS: Developing an awareness about cross-cultural practices regarding cancer disclosure issues allows the clinician to become more sensitive to the expectations of culturally and individually diverse cancer patients. To this end, all healthcare professionals should be informed about how the patient would like to be informed of a diagnosis and how involved he or she would like family members to be. In addition, an awareness of the use of nonverbal communication in some cultures and the psychosocial impact of certain terms, such as "cancer," is essential. Often, phrases such as "malignant tumor" or "growth" are less inflammatory and are more readily accepted. In ascertaining a knowledge of various cultural preferences and developing a sensitivity to these preferences, clinicians are better able to provide effective care to individuals from a variety of cultural and individual backgrounds.

Attitude to Health↗

PubMedDate not supplied

Relationship between self-disclosure and serious suicidal behavior.

The ability to predict which suicidal patient is at high risk for a serious attempt is an important clinical problem. On the basis of our clinical research, we hypothesized that self-disclosure may be an important personality variable differentiating suicide attempters and completers. We assessed 80 patients with depressive disorder, divided into four groups of 20 each: suicidal ideation only, nonserious suicide attempts, severe suicide attempts, and no suicidal behavior. Comparisons were also made with 20 healthy controls. All subjects completed Jourad's Self-Disclosure Questionnaire (JSDQ), as well as scales measuring depression/anxiety and hopelessness. The lack of willingness for self-disclosure significantly differentiated the serious attempters from the suicide ideators and mild attempters. The relationship of self-disclosure and more lethal suicide attempts did not appear to be mediated by depression, anxiety, or hopelessness. This preliminary study indicates that self-disclosure may be a promising field for assessment, therapy, and prevention in suicidal patients. Further studies are needed to investigate related variables, wider patients groups, and the use of different instruments.

Adult↗

PubMedDate not supplied

Disclosure of HIV diagnosis to children: when, where, why, and how.

Despite recent recommendations by the American Academy of Pediatrics that strongly encourage disclosure of human immunodeficiency virus (HIV) infection to school-age children, health care providers vary widely in their actual disclosure practices. Concrete guidelines for accomplishing disclosure are not currently available. Nondisclosure can result in a variety of problems, including anxiety, depression, phobias, and exclusion from peer support groups and medical camps. This article reviews the available literature on disclosure of HIV infection to children and describes the disclosure process used in a large, urban pediatric HIV clinic.

Adaptation, Psychological↗

PubMed1999

Perceived understanding and self-disclosure in the stepparent-stepchild relationship.

The relationship between self-disclosure and perceived understanding in the stepparent-stepchild relationship was investigated. Stepchildren (N = 165) completed a questionnaire about their communication with their stepparents. Participants reported on their self-disclosure (intentionality, amount, positiveness, depth, and honesty) and their feelings of being understood by their stepparents. The results showed that self-disclosure was positively related to perceived understanding. This was especially true for the relationship between honesty of self-disclosure and perceived understanding. Analyses involving gender of the individuals in the stepchild-stepparent dyad showed several differences. The relationship between self-disclosure and perceived understanding was more significant for stepdaughters than for stepsons.

Adoption↗

PubMed1993

Empathy and aggression: effects of self-disclosure and fearful appeal.

On the basis of the familiarity-empathy assumption that self-disclosure evokes empathy for the speaker, it was predicted that a victim's self-disclosure would inhibit aggression against the victim. Female Japanese subjects were asked to give electric shocks to a female victim who disclosed information about herself, was not given an opportunity to do so, or rejected disclosure. Independently of self-disclosure, another empathy arousal was introduced, that is, whether or not the victim expressed her fear of shocks before they were delivered. Consistent with our hypothesis, subjects selected less severe shocks when the victim disclosed information about herself than when she was not given an opportunity to do so or when she rejected self-disclosure. The victim's expression of fear was also very effective in reducing subjects' aggression, suggesting that drawing subjects' attention to the victim's negative emotional state evoked empathy for her and reduced their aggression.

Aggression↗

PubMedDate not supplied

Family responses to disclosure of self-as-lesbian.

Disclosure or nondisclosure of self-as-lesbian to family is a difficult task. Eleven lesbians aged 25-47 years old described their experiences of disclosure or nondisclosure to family. The primary source of data collection was focus groups. Family disclosure was preceded by recognition of self-as-lesbian. Five story patterns of lesbians and their families related to disclosure or nondisclosure were derived from text analysis. The participants also described missing sociocultural landmarks and symbols for lesbian lives. Implications are included for lesbians who are contemplating disclosure and their health care providers.

Adaptation, Psychological↗

PubMed2001

First incest disclosure.

Despite the pivotal importance of disclosure to incest treatment and healing, disclosure has never been studied from the victim's perspective. How do incest victims move from keeping the secret to speaking about their abuse? Nine adult women were asked to talk about the first time they each told about the incest. They often spoke, not of "telling" in the commonly understood sense (i.e. giving information to someone who understands one's meaning), but instead of a time when some form of knowledge of the incest first entered an interaction with another person. Colaizzi's (1978) phenomenological method was used to analyze the interviews. Seven themes emerged: (1) living in the silencing home; (2) I am totally and particularly alone; (3) my mother, the focus of need; (4) incest as burden; (5) the secret must be kept; (6) disclosure: trying to balance above a chasm; and (7) disclosure as loss: no matter what, I still lose. The themes were then integrated into an essential description of first incest disclosure. Implications for nursing practice are explored.

Adolescent↗

PubMedDate not supplied

Experiences of disclosure in women infected with HIV.

In this qualitative focus group study, we explored issues of disclosure for women infected with HIV. The sample included 19 women who participated in one of four focus group sessions. Participants talked about and described their experiences sharing information about their HIV infection with others. Content analysis was used to code the data and identify major issues. Participants uniformly expressed concern about disclosing their HIV status because they expected and feared negative responses from others. Descriptions of disclosure revealed an evaluative process involving an analysis of potential risks and benefits. Three themes that represent concerns about disclosure were identified: discrimination, confidentiality, and the context of disclosure. Based on the findings, we concluded that these concerns are important factors influencing disclosure decisions and the use of supportive services and resources. The findings have implications for designing interventions to assist women in coping with the diagnosis of HIV and to promote their quality of life.

Adaptation, Psychological↗

PubMed2003

Parental views on disclosure of diagnosis to their HIV-positive children.

Parents of HIV-positive children are known to delay disclosure of diagnosis. This study examines the concerns parents attending a South London family clinic had about disclosure of diagnosis to school-aged children with HIV, to establish the stages they were at in terms of the disclosure process and to find out what plans they had regarding further disclosure. Thirteen families with vertically-infected children who did not know their HIV diagnosis were included in the study. Findings showed that parents generally partially disclose information about the illness without naming it and delay full disclosure. The most frequently given reason for delay in talking to their child about HIV was fear that the child may accidentally reveal their diagnosis, thereby simultaneously revealing maternal HIV status and exposing the family to potential stigmatization, discrimination and prejudice.

Adaptation, Psychological↗

PubMed1998

The role of disclosure in coping with HIV infection.

A qualitative investigation was conducted to explore the role of disclosure in HIV infection. Forty homosexual and bisexual men completed a short demographic questionnaire and participated in a one-to-one, semi-structured interview. The interview was designed to address a variety of personal, interpersonal and organizational issues related to their HIV status and participants were invited to talk about their personal experiences from immediately prior to their diagnosis to the time of the interview. The results from the interviews are presented in three sections: immediately post-diagnosis, asymptomatic phase and symptomatic/AIDS phases. The data revealed that disclosing one's HIV status was an acute and recurrent stressor. Immediately post-diagnosis, individuals were more likely to adopt a policy of non-disclosure and this provided them with an opportunity to come to terms with their diagnosis before having to contend with the reactions of others. After this phase, there was evidence that individuals increasingly used disclosure as a mechanism for coping with the disease. Disclosure of one's status was used to increase both practical and emotional support, share responsibility for sex and to facilitate self-acceptance of one's condition. The results from this investigation revealed that disclosure has a dual role in HIV infection acting as both a stressor and a mechanism by which individuals contend with their infection.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Public disclosure of a child's HIV infection: impact on children and families.

As an increasing number of children infected with HIV live to older ages, the question of disclosure of the diagnosis (to the child and to others) becomes more crucial. Disclosure of a child's HIV diagnosis is a controversial and emotionally laden issue. One reason that families avoid disclosure is their fear of the negative impact on the child and family that the stigma associated with AIDS can bring. At the other end of the spectrum, are those families that choose to publicly disclose an HIV diagnosis. There are a number of reasons that a family may choose to go public with their child's diagnosis, although this has never been systematically assessed. The dearth of literature and research regarding the emotional impact of public life on a child as well as the interest of a number of non-public HIV-infected children to "go public" served as an impetus to conduct a study that directly examined the impact public disclosure has on the HIV-infected child and family. Specifically, findings pertaining to the decision making process, the impact public disclosure has had on the child's family, and the child's sense of self-worth at the time of the study and then again 4 years later are reviewed. Findings and implications for future research as well as interventions and strategies aimed at counseling families considering "going public" and helping to normalize the public child's life are discussed.

Adaptation, Psychological↗

PubMed1999

Disclosure, stress, and psychological adjustment among mothers affected by HIV.

This study examined patterns of disclosure and psychological adjustment among mothers infected or affected by HIV. All participants were followed through a family AIDS clinic at a midwestern children's hospital. With respect to disclosure, results indicated that high perceived stress (r = 0.50, p = 0.001) and low efficacy related to managing parenting demands (r = -0.42, p = 0.01) were significantly associated with disclosure of seropositive status. Neither time since diagnosis, psychological adjustment, AIDS knowledge, nor health status as indicated by CD4 count were related to disclosure. Results also indicated that 51% of the mothers met DSM-IV diagnostic criteria for a psychological disorder in the preceding year. The most common diagnoses included posttraumatic stress disorder and major depression. Analyses suggested that perceived stress accounted for a significant 43% of the variance in psychological adjustment. Neither disclosure, time since diagnosis, nor CD4 count were related to adjustment. Findings are discussed in terms of mothers' mental health needs and provision of services to families affected by HIV/AIDS. Although the results of this study must be considered preliminary due to a limited number of participants and correlational analyses, they point to several avenues for future research.

Adaptation, Psychological↗

PubMedDate not supplied

Effect of verbal self-disclosure on natural killer cell activity: moderating influence of cynical hostility.

One objective of the present research was to examine the immunological effects of self-disclosing personal information regarding a traumatic or stressful experience. A second objective was to examine the hypothesis that the effect of self-disclosure on immune function is moderated by individual differences in cynical hostility. Forty-three male college undergraduates, classified as high or low on the Cook-Medley Hostility scale were randomly assigned to either a verbal self-disclosure or a nondisclosure discussion condition. Task-induced change in natural killer (NK) cell activity (i.e., cytotoxicity) served as the dependent variable. As predicted, a significant interaction between discussion condition and hostility was obtained. Among subjects in the self-disclosure condition, high hostility subjects exhibited a significantly greater increase in NK cell cytotoxicity than low hostility subjects. The effect of self-disclosure on NK cell activity is moderated by an individual's level of cynical hostility. The greater short term enhancement in NK cell activity observed for hostile persons is a likely correlate of a more pronounced acute arousal response elicited by the self-disclosure task.

Anxiety Disorders↗