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[The leukemic child after therapy. Psychological aspects].

Thirty children in remission, at least one year after completing chemotherapy for Acute Lymphoblastic Leukemia, were assessed using general psychological measures. The Wechsler Intelligence tests were administered to evaluate their intellectual function: no significant reduction was found in overall IQ score. Only four of the patients, who presented neurological complications during the treatment, performed at lower levels. The group as a whole functioned poorly on tasks involving speeded performances and long-term memory. The age at diagnosis, the duration of the illness, the cranial irradiation and/or intrathecal-chemotherapy did not show any negative effects on the intellectual performance. Psycho-social adaptation was satisfactory: our patients do not show neurotic or psychotic disorders, but only affective disturbances (insecurity, irritability, poor self-perception, instability and depression). Familial adaptation was disturbed in 60% of the children and difficulty in socializing with peers was present in 57% of cases: the latter, in our experience, is related to poor self perception, present in 75% of our patients. We have found a more inadequate psycho-social adaptation in children who have not received any communication of their illness. Psychologic support can be of value for the child and his family in adapting to their difficult situation and in promoting a normal personality development of the child.

Child↗

[Impact of duration of caregiving on stress among primary caregivers of elderly].

This study examined (1) the direct effect of the duration of caregiving on caregiver psychological distress, and (2) two- or three-way interactions between duration, stressors (elderly's physical and cognitive impairments), and personal (caregiver's economic or work status) or social (informal or formal supports) resources. We interviewed 833 primary family caregivers of non-institutionalized frail elderly who had been selected through a screening process of all residents aged 65 and over (21,567 persons) in a suburban area of Tokyo. Caregiver psychological distress was evaluated by "Caregiving Burden Scale" as a caregiving-specific psychological measurement, and "Center for Epidemiologic Studies Depression Scale (CES-D)" as a general psychological measurement. The results were as follows. 1. For Caregiving Burden, duration showed a direct effect, as those who had been providing care for a longer duration of time reported higher burden. We found no interactions between duration, stressors, and resources on caregiving burden. 2. For CES-D, duration had interactions, but no direct effect. (1) Two-way interactions were observed between duration and caregiver's economic or work status, as caregivers with a low economic status or who were unemployed showed a stronger negative impact from duration of caregiving. (2) Three-way interactions were observed between duration, the elderly's ADL impairment, and informal support. Informal support, such as a secondary caregiver, buffered the negative impact of the elderly's ADL impairment in cases with a shorter duration of caregiving, but not for those with longer duration. (3) Three-way interactions were observed between duration, the elderly's cognitive impairment, and formal emotional support. Formal emotional support buffered the negative impact of the elderly's cognitive impairment for those with a longer duration of caregiving, but not for those with a shorter duration. These findings suggest that stress-buffering resources differ according to duration of caregiving.

Activities of Daily Living↗

The importance of heritability in psychological research: the case of attitudes.

It is argued that differences in response heritability may have important implications for the testing of general psychological theories, that is, responses that differ in heritability may function differently. For example, attitudes higher in heritability are shown to be responded to more quickly, to be more resistant to change, and to be more consequential in the attitude similarity attraction relationship. The substantive results are interpreted in terms of attitude strength and niche building. More generally, the implications of heritability for the generality and typicality of treatment effects are also discussed.

Adult↗

The relevance of recurrent brief depression in primary care. A report from the WHO project on Psychological Problems in General Health Care conducted in 14 countries.

This report from the WHO project on Psychological Problems in General Health Care examines the relevance in primary care of the concept of recurrent brief depression (RBD) proposed by Jules Angst. RBD refers to brief, severe depressive episodes that recur frequently, i.e. nearly once a month over a 1-year period, according to Angst. Using a structured interview (CIDI), RBD was assessed in patients not meeting the criteria for depressive episodes lasting at least 2 weeks, as defined in the ICD-10 (DE). A substantial proportion of primary care seekers were identified as presenting RBD without other depressive disorders, 3.7% with a formal RBD diagnosis and 2.7% with frequent but not monthly depressive episodes. These two subgroups were found to differ very little in terms of sociodemographic characteristics, severity, disability, and comorbidity with other diagnoses. However, in patients with a formal diagnosis of RBD, a higher rate of history of suicide attempts was found (14.0%), similar to that observed in patients meeting the criteria for DE. Most of the severity and disability indicators show that RBD is a severe condition, associated with substantial impairment, even if they show a higher degree of severity for DE. About one RBD patient out of three is recognized by general practitioners as presenting a psychological disorder, a majority of whom are actually treated. Our results confirm the relevance of the concept of RBD in primary care, and the need to further explore the pertinence of the restrictive recurrence criterion proposed by Angst.

Adolescent↗

Psychological well-being in patients with primary Sjögren's syndrome.

OBJECTIVES: To evaluate quality of life and psychological symptoms in patients with primary Sjögren's syndrome and to compare this with patients with rheumatoid arthritis. METHODS: A standardised questionnaire, the Psychological General Well-Being Index (PGWB), was used to examine the quality of life and psychological symptoms in patients with primary Sjögren's syndrome (pSS; n = 34). Patients with rheumatoid arthritis (RA; n = 32) were used as patient controls. RESULTS: The total mean score +/- SD for PGWB was 84.9 +/- 16.2 in pSS patients and significantly lower (p = 0.001) than in RA patients (97.7 +/- 17.5). Patients with pSS had an increased propensity for depressed mood (p = 0.0009), and suffered from reduced well-being (p = 0.002) and impaired vitality (p = 0.003). CONCLUSION: The results suggest that patients with pSS have a reduced quality of life, a higher degree of distress and a lower sense of well-being than patients with RA.

Adult↗

Job-related tension, self-esteem and psychological distress in rehabilitation professionals.

We examined perceptions of job-related tension among a non-random sample of 52 New Zealand rehabilitation service providers. We considered the relations between job tension and psychological distress and the extent to which feelings of self-esteem moderated this relationship. Major findings are that (a) there is a consistent positive relationship between job tension and general psychological distress; (b) there is a consistent negative relationship between self-esteem and both job tension and general distress; (c) self-esteem moderates the effect of job tension on general distress in that high levels of job tension were associated with increases in psychological distress among respondents with low self-esteem while among respondents with high-self esteem, job-related tension had little negative impact on feelings of psychological distress. Despite a number of limitations, the findings have a number of important implications for professional functioning among rehabilitation service providers and highlight the need for appropriate staff development and training initiatives which focus specifically on service provider wellbeing.

Adult↗

Inferring psychological significance from physiological signals.

A century has passed since the publication of William James's Principles of Psychology, yet most of the questions James raised about the relation between physiological events and molar psychological or behavioral processes, such as emotion, remain unanswered. The sluggish progress in capitalizing on physiological signals to address general psychological questions is due in part to shortcomings in the quantification of physiological signals in humans and, perhaps more important, to the way in which investigators have been thinking about the relation between physiological signals and psychological operations. In this article, we illustrate these points, and we provide a conceptual framework to foster research and analysis of psychological phenomena based on physiological signals. Psychological operations and physiological responses are defined in terms of configural and temporal properties, and psychophysiological relations are conceptualized in terms of their specificity (e.g., one-to-one versus many-to-one) and their generality (e.g., situation or person specific versus cross-situational and pancultural). This model yields four classes of psychophysiological relations: (a) outcomes, (b) concomitants, (c) markers, and (d) invariants. Finally, the model specifies how to determine whether a psychophysiological relation is an outcome, concomitant, marker, or invariant, and it describes important limitations in inferences of psychological significance based on physiological signals when dealing with each.

Behavior↗

Psychological distress in patients with gastroesophageal reflux disease.

BACKGROUND: Psychological factors play a role in a variety of gastrointestinal illnesses, including esophageal diseases. The role of psychological factors in gastroesophageal reflux disease (GERD) is not known. The purpose of this study was to determine if psychological distress is present in patients with reflux disease. METHODS: We performed psychological assessments in 51 patients with documented gastroesophageal reflux disease and in 43 age-matched controls using a battery of instruments. RESULTS: Patients with reflux differed from controls on scales of depression, somatization, anxiety, and intensity of reporting symptom distress. However, a secondary analysis revealed that it was a subset of reflux patients (30%) that accounted for the differences between the two groups. CONCLUSIONS: These results suggest that although most patients with GERD are psychologically similar to patients without GERD, a subset of psychologically distressed patients are more likely to be found among patients with GERD. They suffer from general psychological distress rather than a specific psychiatric disorder. This psychological factor could affect the clinical manifestations of reflux disease in these individuals. Recognition and management of psychological distress in this subgroup may aid in the management of reflux disease.

Gastroesophageal Reflux↗

[Quality of life in patients with essential arterial hypertension. Part II: The effect of clinical factors].

The aim of the study was to evaluate the effect of clinical factors on variation in the health-related quality of life (HRQoL) of patients with arterial essential hypertension. An open questionnaire study was performed among 1539 subjects (775 men and 764 women) aged from 18 to 88 years (mean age 51.7 +/- 14.6 years) with arterial hypertension diagnosed at least 3 months earlier. The patients had been treated (86.2%) or started treatment (17.4%) in municipal outpatient units and in the Antihypertensive Outpatient Center of the I Cardiac Department. The following data were analyzed: systolic and diastolic blood pressure, heart rate, body mass, target organ complications and number of hypotensive drugs. All patients completed a standardized Psychological General Well-Being questionnaire (PGWB) to evaluate the general quality of life and its six dimensions: anxiety, depressive mood, well-being, self-control, general health and vitality. Irrespective of the patients' gender the general quality of life was poorer in those patients in whom systolic blood pressure exceeded 140 mmHg. The highest general quality of life was observed in patients with diastolic blood pressure between 74 and 90 mmHg. In patients with BMI > 30 kg/m2 the HRQoL was significantly lower. In obese patients as compared with normal and overweight patients the following scales of the PGWB were significantly lower: general health and vitality, whereas the score of depressive mood was higher (p < 0.05). Furthermore obese patients had significantly higher SBP and DBP than slim subjects. Both in men and women with arterial hypertension there was a negative relationship between the quality of life and the presence of target organ complications and the number of drugs used. Among the patients treated with 4 and more hypotensive drugs the proportion of subjects with controlled blood pressure was lower as compared with those receiving 1, 2 or 3 drugs. Multiple regression analysis showed that the clinical factors independently affecting the general quality of life in patients with arterial hypertension were systolic and diastolic blood pressure, obesity, target organ complications and the number of hypotensive drugs used. These factors accounted for 37.1% of variance in the general quality of life.

Adaptation, Psychological↗

Psychological distress of rescue workers eight and one-half years after professional involvement in the Amsterdam air disaster.

This study examined specific and general psychological distress 8.5 years following the 1992 cargo aircraft crash in Amsterdam. Participants included 334 occupationally exposed fire fighters and 834 occupationally exposed police officers compared with reference groups of 194 fire fighters and 634 police officers who were exposed to duty-related stressors other than the disaster. On the standardized instruments of psychological distress, exposed fire fighters reported more somatic complaints and fatigue, while exposed police officers reported higher psychological distress on all aspects. The degree and type of exposure at the disaster site and other background factors were associated with several outcomes of psychological distress levels of exposed rescue workers. The disasters' aftermath of rumors about potential health consequences due to toxic exposure likely contributed to the long-lasting psychological distress of some of the rescue workers as well.

Accidents, Aviation↗

Comprehensive assessment of chronic low back pain patients and controls: physical abilities, level of activity, psychological adjustment and pain perception.

A comprehensive functional evaluation designed for patients with chronic low back pain (CLBP) is described. The evaluation includes measures from 4 domains of the CLBP syndrome; physical abilities, level of activity, psychological adjustment and pain perception. New measures for standardized assessment of physical abilities and employment of body mechanics are introduced. Evaluation data from 68 CLBP subjects and 35 age-matched, pain-free, controls is presented. Results indicate important deficits in physical abilities and psychological adjustment for the CLBP group compared to the controls. Factor analysis of the evaluation measures yielded a general conditioning factor and a general psychological adjustment factor but complicated factor structures for report of pain and time in activities. Further analysis demonstrated a strong relationship between objective disability and psychological and psychosocial adjustment but little relationship between level of pain and other disability measures.

Activities of Daily Living↗

Connecting stuttering measurement and management: II. Measures of cognition and affect.

BACKGROUND: To the person who stutters, there are other experiences than the somatic ones of stuttered speech. These are experiences of cognition and affect: in other words, experiences of thought and emotion. For several reasons, it is quite difficult to determine and recommend core measures of cognition and affect for clinicians to consider using. AIMS: To catalogue some of the many instruments that may be regarded by clinicians as worthwhile for use in measuring cognition and affect in clinical practice. MAIN CONTRIBUTION: The presentation of measures of cognition and affect is organized according to those that have appeared in recent clinical trials of stuttering during roughly the last decade, and those that have not featured in clinical trials. CONCLUSIONS: Measures that have featured in the clinical trials literature might be looked on favourably, along with those for whom there are more than one data source in support. The various measures from the discipline of clinical psychology generally fall into the latter category. The notions of cognition and affect emerge from the discipline of clinical psychology, and therefore it makes sense to look to that discipline for measures of those constructs. Seeking such tools outside the discipline of speech pathology, especially those with established reliability and validity, seems to hold potential in contributing to one's understanding of affective and cognitive functioning in people who stutter.

Affect↗

Psychological well-being of spouses of stroke patients during the first year after stroke.

OBJECTIVE: To investigate whether spouses' psychological well-being changed between the first weeks after their partner's stroke and four months and one year later, and to study the relationship between spouses' psychological well-being and objective characteristics of the stroke patients. DESIGN: Prospective, longitudinal study. SETTING: Hospital care and follow-ups. SUBJECTS: Sixty-seven consecutively enrolled spouses to first-ever stroke patients < 75 years. MAIN MEASURES: The Psychological General Well-Being (PGWB) Index. Clinical examination of the stroke patients. The Barthel Index. RESULTS: The spouses' psychological well-being was significantly lower in the first weeks after their partner's stroke as compared with norms. At four months, it had increased significantly. Between four months and one year, individual changes were observed in both positive and negative directions; thus, the mean level of the group remained constant. The spouses' psychological well-being in the first weeks was significantly related to the patients' sensorimotor impairments, while it was related at four months to cognitive impairment and the patients' abilities in self-care. At one year, psychological well-being was related to remaining sensorimotor and cognitive impairments. A significant relationship was also seen between the spouses' and the stroke patients' emotional health. CONCLUSIONS: The spouses' psychological well-being increased after the first chaotic weeks. The presence of visible impairments initially seemed to affect spouses' emotional health, while cognitive and emotional impairments became more evident in everyday life. In the long term, however, the spouses' individual life situations and coping abilities seem to be of relatively increasing importance for their continued well-being.

Adaptation, Psychological↗

A content analysis of hiv/aids information in psychology textbooks: implications for education, training, and practice.

Early in the pandemic, psychologists who engaged in HIV/AIDS research and practice or care relied more on their "general" psychological knowledge and training than on HIV/AIDS-specific information or training for combating the disease. In the past two decades much has been gained from the contributions of psychologists working in the areas of HIV/AIDS prevention and intervention. However, little is known regarding how the discipline prepares its students for a career in HIV/AIDS research and practice/care. One important venue for educating future psychologists is college-level textbooks because they are often the students' gateway to the scientific literature in psychology. Therefore, presentation of adequate and accurate information in these texts is critical. The present study involved a review and content analysis of introductory, clinical/counseling, health, human sexuality, and social/community psychology textbooks. It revealed that some level of information regarding HIV/AIDS was found in the majority of most college-level psychology texts that were reviewed. However, many books do not present a comprehensive overview or review of this problem, and do not adequately address the role psychology and behavior change can play in abating it. Implications for education, training, and practices are discussed.

Curriculum↗

[Cognitive disturbances in schizophrenia - experimental psychological examination and explanation in the frame of cognitive information processing].

The concern of the paper is, by using the example of schizophrenia, to show in a survey that it is possible and necessary to base the examination of cognitive disturbances and their exaplanation on the methodological concept of information processing. Departing from the stage reached in cognition-psychological schizophrenia research, a survey is given of such studies of cognitive disturbances in schizophrenia that are based on general psychological concepts of cognitive information processing. The approach to an identification of the defect within the frame of a model of the cognitive information processing is explained by two examples (performance of recognition, reproduction deficit).

Cognition Disorders↗

Clinical meaning of the Keane PTSD Scale.

A correlational study that included 82 male inpatient alcoholics was conducted to determine the clinical meaning of the Keane PTSD Scale of the MMPI. The PTSD Scale was correlated with the variables of the Shipley Institute of Living Scale, the Life Purpose Questionnaire, the Existential Depression Test, and the standard MMPI measures, plus the A, R, Es and MacAndrew Scales. The pattern of correlations suggested that the PTSD scale measures general psychological maladjustment and dysphoric feelings rather than any specifiable syndrome. The strong correlation with the Welch A, which measures a general level of maladjustment, suggests that the PTSD and Welch A scales are measuring the same factor. The PTSD scale, therefore, appears to provide very little information about this population beyond that available from the overall clinical profile and the Welch A scale.

Adult↗

The relation between methods of coping during adulthood with a history of childhood sexual abuse and current psychological adjustment.

With a community sample of 192 women who had been sexually abused during childhood, the investigators determined if methods of coping in adulthood with the aftermath of child sexual abuse were associated with current symptoms of psychological distress. Multiple regression analyses indicated that disengagement methods of coping with the sexual abuse accounted for unique variance in general psychological distress even after controlling for characteristics of the abuse and methods of coping with other stressors. Disengagement methods of coping were also used more often to deal with the stressful aspects of having been sexually abused than to deal with other stressful events. In contrast, engagement methods of coping were used more often to deal with the other stressors than with sexual abuse.

Adaptation, Psychological↗

The relationship between weight and psychological functioning among adolescent girls.

This study investigated whether Body Mass Index (BMI) was associated with various aspects of psychological functioning in a sample of largely Caucasian adolescent girls. Three hundred sixty-five adolescent girls ranging from ages 14 through 19 were assessed for general psychological functioning utilizing the Symptom Checklist-90-Revised (SCL-90-R), and functioning specific to eating, shape and weight utilizing the Eating Disorders Inventory (EDI). Excess weight was associated with higher scores on the Bulimia, Body Dissatisfaction and Drive for Thinness subscales of the EDI. Excess weight was not, however, associated with general psychopathology or any of the subscales of the SCL-90-R. The results suggest that excess weight may carry risk for pathology specifically related to eating, shape and weight in adolescent girls, but not for general forms of psychopathology.

Adolescent↗