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Use of the SADS diagnostic interview in evaluating legal insanity.

Examined clinical usefulness of the SADS diagnostic interview in evaluations of criminal responsibility. Findings, based on 78 SADS evaluations from a specialized forensic clinic, indicated that SADS successfully differentiated between sane and insane evaluatees. These differences were found primilarily in the severity of psychotic symptoms and overall level of psychological impairment. In addition, preliminary data on institutionalized and outpatient Ss suggested the potential applicability of the SADS for assessing the general psychological functioning of insane patients in treatment.

Adaptation, Psychological↗

The effect of fatigue, sleep deprivation and onerous working hours on the physical and mental wellbeing of pre-registration house officers.

The potential deleterious effects of doctors' long and arduous shifts have received relatively scant attention. This study addressed the effect of a 32 h on-call shift on 16 pre-registration medical house officers in St. James's Hospital, Dublin. We assessed 5 psychological parameters (Tension-Anxiety, Depression-Dejection, Vigour-Activity, Fatigue-Inertia and Confusion-Bewilderment) as well as 5 simple tests of alertness and concentration both pre- and post-call. The doctors were randomly assigned to be tested either pre- or post-call. On average the doctors got 4.5 hours sleep during a 32 h shift. This long shift had an adverse effect on all the psychological parameters (p < 0.05) except Depression-Dejection. The total mood disturbance score, which has been shown to correlate well with general psychological well-being, deteriorated significantly after the 32 h shift, p < 0.005. Two of the simple tests of alertness and concentration (Trail-making test and Stroop Color-Word test) also showed a significant fall-off in performance with sleep deprivation, p < 0.05, although the remaining tests (Delayed Story Recall, Critical Flicker Fusion and Three Minute Grammatical Reasoning Test) were not significantly impaired by the 32 h shift. This study shows that prolonged periods of duty without sleep adversely affect junior doctors, both in their psychological well-being and in their ability to carry out simple tasks.

Adult↗

Psychological sequelae of cancer diagnosis: a meta-analytical review of 58 studies after 1980.

OBJECTIVE: In a review of the literature from 1980 to 1994 on psychological and psychiatric problems in patients with cancer, the prevalence, severity, and the course of these problems (i.e., depression, anxiety, and general psychological distress) were studied with the help of meta-analyses and qualitative analyses. Apart from this, qualitative analyses were also applied with respect to other relevant variables. METHOD: A literature search in MEDLINE was conducted and cross-references of articles identified via MEDLINE. Meta-analysis was applied when possible. RESULTS: There seemed to be a wide variation across studies in psychological and psychiatric problems. Meta-analysis showed no significant differences between cancer patients and the normal population with respect to anxiety and psychological distress. However, cancer patients seemed to be significantly more depressed than normals. Compared with psychiatric patients, cancer patients were significantly less depressed, anxious, or distressed. Compared with a sample of other medical patients, cancer patients showed significantly less anxiety. With respect to course, a significant decrease was found in the meta-analysis for anxiety, but not for depression. Further meta-analyses showed significant differences among groups of cancer patients with regard to tumor site, sex, age, design of the study, and year of publication. From the qualitative analyses, it seemed that medical, sociodemographic, and psychological variables were related inconsistently to psychological and psychiatric problems. CONCLUSION: With the exception of depression, the amount of psychological and psychiatric problems in patients with cancer does not differ from the normal population. The amount of psychological and psychiatric problems is significantly less in cancer patients than in psychiatric patients. The amount of anxiety is significantly less in cancer patients than in other groups of medical patients with mixed diagnoses, whereas depression is not. Future studies should aim at exploring possible causes for the sometimes impressive differences in psychological or psychiatric problems among patients with cancer.

Adaptation, Psychological↗

Antecedents and consequences of work-home interference among medical residents.

A cross-sectional field study is reported in which a comprehensive model of work-home interference (WHI) was developed and tested among 166 medical residents of an academic hospital in the Netherlands. It was hypothesized that WHI functions as a critical mediating pathway in the relationship between work and home characteristics on the one hand, and work-related and general psychological health indicators on the other. The results revealed that one home characteristic and three work characteristics put pressure on the interface between the work and home life, that is, (1) having a spouse who works overtime frequently, (2) an unfavorable worktime schedule, (3) a high quantitative workload and (4) a problematic dependency on the superior. The results further showed that WHI was positively associated with emotional exhaustion and depersonalization (i.e. work-related health indicators), as well as with psychosomatic health complaints and sleep deprivation (i.e. general health indicators). More importantly, the results strongly supported our basic hypothesis that WHI mediates the impact of some work and home characteristics on psychological health indicators. This seems to be particularly true for the general health indicators: none of the home and work characteristics just mentioned, had a direct impact on these general indicators, independent of WHI. With respect to the work-related health indicators, particularly depersonalization, the mediating role of WHI was also strong, though less consistent. The theoretical and practical implications of the findings are discussed.

Adult↗

Utility of the Psychological Screening Inventory: a review.

The Psychological Screening Inventory (PSI; R. I. Lanyon, 1970, 1973, 1978, 1993, 2006) was developed as a cost-effective screening device in identifying persons for whom a more complete psychological evaluation should be conducted. The author reviews data bearing on the utility of the PSI in this regard and in more general applications. The Alienation scale showed strong effect sizes in distinguishing psychiatric inpatients from controls, the Social Nonconformity scale in distinguishing incarcerated groups from control, and the Discomfort scale in identifying persons with general psychological distress. These findings were supported by correlational data with comparable scales, and by a variety of smaller comparison studies. Meaningful discriminations were also shown for adolescents and for college-age young adults. Findings in studies of substance abusers and medical problems were also reviewed. Response Distortion scales showed effectiveness similar to that of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) validity scales. Validity was also shown for several of the seven available foreign language translations. It was concluded that the PSI is effective for the tasks for which it was designed.

Adolescent↗

Auditory attention to frequency and time: an analogy to visual local-global stimuli.

Two priming experiments demonstrated exogenous attentional persistence to the fundamental auditory dimensions of frequency (Experiment 1) and time (Experiment 2). In a divided-attention task, participants responded to an independent dimension, the identification of three-tone sequence patterns, for both prime and probe stimuli. The stimuli were specifically designed to parallel the local-global hierarchical letter stimuli of [Navon D. (1977). Forest before trees: The precedence of global features in visual perception. Cognitive Psychology, 9, 353-383] and the task was designed to parallel subsequent work in visual attention using Navon stimuli [Robertson, L. C. (1996). Attentional persistence for features of hierarchical patterns. Journal of Experimental Psychology: General, 125, 227-249; Ward, L. M. (1982). Determinants of attention to local and global features of visual forms. Journal of Experimental Psychology: Human Perception and Performance, 8, 562-581]. The results are discussed in terms of previous work in auditory attention and previous approaches to auditory local-global processing.

Adult↗

The prospects for a Jungian psychology in China.

The possibility of a Jungian psychology developing in China is considered by a brief historical excursion through the early translations of psychoanalytical works. Translation problems and the contentious nature of some of Freud's ideas have made for their difficult reception in China. The inattention to Jung's ideas in universities in the west in the past, and a reliance on science based subjects by Chinese students studying abroad, have meant little opportunity to study Jung, and, by implication, to translate him. The turbulent political climate in China over the course of the past century has also hindered developments in psychology generally. In addition, certain traditional practices of understanding mind-body relationships and reporting 'illnesses' have precluded the possibility of any psychotherapeutic psychology emerging. However, the present climate looks more favourable for the dissemination of Jungian knowledge, but the question of an appropriate context and a receptive readership remains. Certain Jungian notions can be seen to fit comfortably within traditional systems of Chinese thought but the present day psychology department in China is no more a congenial environment for Jungian psychology than its counterpart in the west. It may be that the success of importing Jungian ideas into China rests with those with a predilection towards arts and cultural sciences, and with the innovations of the organizers of conferences.

China↗

Sleep quality subtypes in midlife women.

Eighty-two midlife women (40-59 years) were classified as poor or good sleepers according to either self-reported sleep quality or a sleep efficiency index (SEI) criterion, for comparison of wakefulness, fragmentation and other somnographic sleep variables; as well as psychological (SCL-90) and somatic symptom distress. When classified solely by self-report, the good and poor sleeper groups did not differ on any somnographic variables but self-declared poor sleepers had higher psychological distress scores than good sleepers (p less than or equal to 0.01). When classified solely by the SEI criterion, the good and poor sleepers did not differ on psychological distress but, as expected, differed on various somnographic wakefulness as well as rapid eye movement and stage 2 sleep variables. Further analysis of four subgroups derived by combining objective and subjective, good and poor sleep scores indicated that 15% of this sample (n = 12) perceived but had no objective evidence of poor sleep, and this group scored highest in psychological distress. Only seven women perceived poor sleep in concert with demonstrating low SEI. They scored highest in menopausal symptoms but not in general psychological distress.

Adult↗

Psychological changes of Japan Self-Defense Forces personnel during selection and training for the peacekeeping mission in the Golan Heights.

We sought to determine whether a selection process for deployment had a measurable effect on psychological symptoms by comparing scores on the Yatabe-Guilford Personality Index, the Manifest Anxiety Scale, and the 30-item version of the General Health Questionnaire between deployed and nondeployed mission candidates from the Japan Self-Defense Forces. The studies were undertaken in Japan during education and training for the United Nations peacekeeping mission in the Golan Heights. The participants included 80 candidates for deployment. Personnel who were not deployed had significantly higher measures of manifest anxiety and general psychological distress than deployed personnel, whereas deployed personnel showed more symptoms suggesting somatization. The selection process and training for deployment appear to have been stressful for all personnel, whether deployed or not.

Anxiety↗

Fluctuations in mood and psychological distress during the menstrual cycle.

This paper examines fluctuations in mood and symptoms associated with psychological distress during the phases of the menstrual cycle in two samples of university women. The first (Study I) sample of women (N = 162) was randomly selected from the University population. The second sample (Study II) was women (N = 138) who attended a psychiatric clinic. The subjects completed a questionnaire which included measures of depression, anxiety and general psychological distress. Information about the menstrual cycle and contraceptive pills was elicited from the subjects who were unaware that affect during the menstrual cycle was being studied. In study I there were no significant differences in depression, anxiety or psychological distress between phases of the cycle. The results of study II indicated that even in a group of women with emotional problems, it was not possible to demonstrate an increase in the average severity of mood disturbance or psychological distress during any phase of the menstrual cycle. It was concluded that in general, university women between the ages of 18-30 who are mostly single, nulliparous, with or without significant psychopathology, seeking or not seeking psychiatric help do not experience significant or disruptive fluctuations in mood and symptoms of psychological distress during the phases of the menstrual cycle. Women who are afflicted with distressing and incapacitating cyclical fluctuations are best studied as a vulnerable subgroup.

Adolescent↗

Psychological effects of weight cycling in obese persons: a review and research agenda.

This review summarizes studies on the psychological effects of weight cycling (i.e., weight loss and regain) in obese persons and proposes an agenda for future research on this topic. Among general psychological constructs, the current literature suggests that weight cycling is not associated with depression, other psychopathology, or depressogenic cognitive styles. Weight cycling is associated with decreased perceptions of health and well-being, although the clinical significance of this relationship is uncertain. Among weight- and eating-related constructs, weight cycling does not appear to be related to restraint, hunger, or personality traits associated with eating disorders. Weight cycling, however, does appear to be associated with clinically significant reductions in eating self-efficacy and weak but consistent increases in binge eating severity. Definitive conclusions about the presence or absence of the psychological consequences of weight cycling are premature, given the small number of studies, as well as a variety of methodological and interpretive concerns. A new generation of research is necessary to determine the extent and nature of the psychological sequelae of weight cycling.

Eating↗

Correlates of post-traumatic stress at 30 months: the Herald of Free Enterprise disaster.

Although exposure to a traumatic event is thought to be the main aetiological factor in the development of post-traumatic stress disorder, there remain large unexplained individual differences in the severity and chronicity of symptoms. The aim of the present study was to assess the relative contribution of a number of social and psychological factors which are thought to determine symptoms. Crisis support and life-events subsequent to the disaster are the two best predictors of general psychological well-being, whereas a sense of helplessness during the disaster and bereavement are the two best predictors of intrusive symptomatology.

Adolescent↗

Patients with heart rhythm disturbances: variables associated with increased psychologic distress.

The spectrum of psychologic distress in patients with serious heart rhythm disturbances (HRD) has not been well defined. A survey of personal and clinical background data and general psychologic status was made of 136 patients with serious HRD defined as sustained or symptomatic ventricular tachycardia or fibrillation. Two questionnaires were used: the SCL-90-R, a standard self-report symptom inventory of present psychologic status, and a functional capacity and occupational status questionnaire developed by us. Of the 105 respondents, 89 completed both questionnaires, the results of which form the basis of this report. The patients with HRD were found to have significantly elevated SCL-90-R scores reflective of an increase in overall psychologic distress (Global Severity Index, Positive Symptom Distress Index, and Positive Symptom Total) as well as significantly higher scores on the specific constructs. Within the HRD population, univariate analysis revealed three variables significantly correlated with increased psychologic distress: (1) requiring long-term antiarrhythmic medication, (2) being forced to modify work status, and (3) having more advanced cardiac impairment. Patients who had two or more of these variables, termed risk factors, reported significantly more symptoms and greater psychologic distress than those with zero or one risk factor. We conclude that patients with serious HRD have greater psychologic distress than do normal subjects. Within the HRD group, patients requiring long-term medical treatment for their arrhythmia, those forced to modify work status, and those with more advanced cardiac impairment are at greater risk for emotional sequelae, and patients with two or more of the identified risk factors are more likely to have elevated psychologic distress.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Psychological health and trauma in male and female soldiers.

This study assessed the effect of premilitary and military trauma on the psychological health of more than 1,000 female and male active duty soldiers. Questionnaire data provided information on demographics, history of trauma exposure, and general psychological health as assessed by the Brief Symptom Inventory (BSI). The results indicated that females reported experiencing more sexual traumas and males reported more nonsexual traumas. BSI subscale scores indicated poorer psychological health among all of the subjects compared with BSI normative groups and other Army soldiers. The need for military norms for the BSI is discussed.

Adult↗