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PubMed2001

Similar psychological characteristics in mild and severe asthma.

OBJECTIVE: Psychological factors have been implicated as potentially contributing to asthma severity. In the present study, we investigated whether patients with mild and severe asthma differ with regard to several psychological characteristics. METHODS: Ninety outpatients with severe asthma (74% female, mean [S.D.] age: 46.5 [13.7] years) and 37 outpatients with mild asthma (73% female, age: 39.4 [13.9] years) were compared with respect to general psychological health, anxiety sensitivity, hyperventilation symptoms, personality, and locus-of-control orientation, all measured by well-validated self-report questionnaires. Analysis of (co)variance (ANCOVA) was used to assess between-groups differences. RESULTS: No significant differences in psychological characteristics were found between patients with mild and severe asthma. Only on the subscale for external locus-of-control orientation, severe asthmatic patients differed from those with mild disease (P=.005) in showing less trust in physicians and medication with regard to influencing their asthma. CONCLUSION: The results suggest that mild and severe asthmatic patients cannot be differentiated on the basis of psychopathology or personality. Whether or not the observed lack of confidence in the influence of physicians or medication on asthma course is cause or consequence of disease severity, remains to be established.

Adult↗

PubMed2002

Spouses of first-ever stroke victims: sense of coherence in the first phase after stroke.

According to Antonovsky, the individual's sense of coherence is assumed to be crucial in coping with stressful life events. The purpose of this study was to investigate the associations between the sense of coherence of the spouses of stroke victims, the objective severity of the stroke and the spouses' perception of life satisfaction, psychological well-being and cognitive image of life in the future in the first phase after stroke. Eighty-three consecutively enrolled spouses to first-ever stroke victims < 75 years participated. Multiple correlations were done to study the association between Antonovsky's 29-item Sense of Coherence scale and the objective impairments of the stroke victim, the Life Satisfaction Checklist, the "view of the future" and the Psychological General Well-being Index. The sense of coherence was significantly associated with satisfaction with life as a whole before stroke (p < 0.001), partnership (p = 0.002), sexual life (p = 0.005), family life (p < 0.001) and financial situation (p = 0.001). The severity of the impairments of the stroke victims was not significantly associated with the spouses' sense of coherence. However, the sense of coherence was significantly associated with the perception of the future life situation (p = 0.006). The sense of coherence was also significantly associated with the perception of positive well-being (p = 0.007), self-control (p = 0.009), general health (p = 0.009) and vitality (p = 0.002) at the present, whereas the association with anxiety and depressed mood were not statistical significant. In the experience of a stressful life event such as stroke, satisfaction with general life, close relationships and the socio-economic situation were significantly associated with the spouse's sense of coherence. Spouses with a low sense of coherence were more likely to have low psychological well-being and a more pessimistic view of their life in the future.

Activities of Daily Living↗

PubMed1982

The superordinate self in psychoanalytic theory and in the self psychologies.

The concept of the self has been used in several attempts to resolve the epistemological problems of what is subjective and what is objective, what is personal and what is organismic. In addition, it has been used to mediate between the hermeneutic and natural-science approaches to psychoanalytic explanation, between the motivational and causal dimensions of our theory and experience. In the case of Kohut, the self was initially invoked to deal with clinical difficulties associated with the analysis of patients with narcissistic personality disorders more recently, it has become the central article in a "self psychology" that addresses presumed deficiencies in the traditional psychoanalytic picture of psychopathology. But the concept of the self is not suited to be a panacea for resolving theoretical or clinical difficulties. The self as person refers to an entity that is both enduring and changing; it describes continuity in the face of change and change in the face of continuity. Abend (1974) comes closest to capturing this attribute of the self in his image of the tidal beach with a configuration that changes but an essence that remains the same. Eisnitz (1980) evokes something similar in his figure-ground conception of the self-representation. The crux of the matter is that the notion of self-experience includes a variety of phenomena that cannot be contained within a single self-construct--be it normal pathologic, grandiose, or otherwise. As a result of these considerations, I have argued against the use of the self as a superordinate concept in psychoanalytic theory and have focused on the shortcomings of three self psychologies that use the self in this way. I believe that Klein, Gedo, and Kohut all offer the self as a kind of conceptual tranquilizer for the philosophical, theoretical, and clinical dualities that are inherent in psychoanalytic work. Grossman addressed himself to these dualities as far back as 1967 and elaborated on the problems with Simon (1969) in a pathbreaking paper on anthropomorphism in psychoanalysis. Grossman and Simon contended that the controversy about anthropomorphism in psychoanalytic theory pertains to the basic confusion in psychology between meaning and causality. They submitted that until this confusion was dispelled and until some superordinate concept was found that could "encompass both kinds of discourse", attempts to transform psychoanalysis into a general psychology would result in failure.(ABSTRACT TRUNCATED AT 400 WORDS)

Drive↗

PubMed1981

[Various principles in the psychological rehabilitation of alcoholics].

In recent-year literary publications dealing with the problem of alcoholism treatment the authors exhibit a revival of the interest of the patient's personality. The thesis on principal insufficiency of medicinal treatment only recognized now by most researchers leads one to a conclusion that the alcoholic's personality should be an object of a special study aimed at its subsequent correction. On the basis of a psychological analysis of the two known phenomena of alcoholism a hypothesis on the decisive role of the thought orientation in determining the essence of an alcoholic's personality is suggested. The author describes general principles and special approaches to the post-correction work with alcoholics. These principles and approaches are aimed at acting upon the alcoholic's personality by way of reforming its activity. General psychological aspects of the problem of correcting the alcoholic's personality are discussed from the standpoints of L. S. Vygotsky's school.

Alcoholism↗

PubMed2001

Psychological factors in sport performance: the Mental Health Model revisited.

The Mental Health Model (MHM) of sport performance purports that an inverse relationship exists between psychopathology and sport performance. The model postulates that as an athlete's mental health either worsens or improves performance should fall or rise accordingly, and there is now considerable support for this view. Studies have shown that between 70 and 85% of successful and unsuccessful athletes can be identified using general psychological measures of personality structure and mood state, a level superior to chance but insufficient for the purpose of selecting athletes. Longitudinal MHM research indicates that the mood state responses of athletes exhibit a dose-response relationship with their training load, a finding that has shown potential for reducing the incidence of the staleness syndrome in athletes who undergo intensive physical training. The MHM also has implications for the general care of athletes as support services have traditionally been limited to preventing or treating physical problems. Despite its simple premise and empirical support, the MHM has often been mischaracterised in the sport psychology literature and recently some authors have questioned its validity. This overview will summarise MHM research, including the more recent work involving the model's dynamic features in an effort to resolve disputes surrounding the model.

Affect↗

PubMed1983

Reactions to the implantation of an inflatable penile prosthesis among psychogenically and organically impotent men.

We evaluated 17 nondepressed and psychologically stable recipients of an inflatable penile prosthesis who had been either organically or psychogenically impotent and 12 of their sexual partners several months after surgical implantation. The men were evaluated for changes in general psychological adjustment, sexual satisfaction and sexual activity. The partners were assessed separately on similar instruments. Two scales of the Minnesota Multiphasic Personality Inventory were found to have potential for initially discriminating organic and psychogenic impotence. The hypothesis that psychogenic recipients would manifest more psychological difficulties and would be less satisfied was only partially supported. While neither group suffered significant disturbance in psychological adjustment a consistent pattern was noted in which psychogenic patients were somewhat less satisfied with the results and experienced more postoperative complications. However, over-all reactions were positive, including increases in frequency of sexual over-all reactions were positive, including increases in frequency of sexual intercourse and duration of sexual play for patients and their partners.

Coitus↗

PubMed2005

Is maternal psychopathology related to obesigenic feeding practices at 1 year?

OBJECTIVE: To investigate the relationship between maternal psychopathological symptomatology during pregnancy and at 6 and 12 months postnatally and maternal use of controlling and restrictive feeding practices at 1 year. RESEARCH METHODS AND PROCEDURES: Eighty-seven women completed a measure of psychological distress during pregnancy and at 6 and 12 months postpartum, and at 12 months postnatally these women reported their usage of controlling and restrictive feeding practices and were observed feeding their infants. RESULTS: General psychological distress, particularly anxious psychopathology, during pregnancy and at 6 and 12 months postnatally was significantly associated with maternal use of restrictive feeding practices at 1 year, even when controlling for length of breast-feeding and the infants' weights at 1 year. Contrary to expectations, depression and eating psychopathology as measured by the SCOFF eating disorder measure during pregnancy or at 6 or 12 months postnatally were not associated with the use of controlling or restrictive feeding practices at 1 year. DISCUSSION: These findings indicate that anxious maternal psychopathology may partially explain the development of maternal use of restriction when feeding.

Adult↗

PubMed2001

Ocular dominance reverses as a function of horizontal gaze angle.

Ocular dominance is the tendency to prefer visual input from one eye to the other [e.g. Porac, C. & Coren, S. (1976). The dominant eye. Psychological Bulletin 83(5), 880-897]. In standard sighting tests, most people consistently fall into either the left- or right eye-dominant category [Miles, W. R. (1930). Ocular dominance in human adults. Journal of General Psychology 3, 412-420]. Here we show this static concept to be flawed, being based on the limited results of sighting with gaze pointed straight ahead. In a reach-grasp task for targets within the binocular visual field, subjects switched between left and right eye dominance depending on horizontal gaze angle. On average, ocular dominance switched at gaze angles of only 15.5 degrees off center.

Adult↗

PubMed2002

Effects of a telephone-based psychosocial intervention for patients awaiting lung transplantation.

STUDY OBJECTIVES: To test the efficacy of a tailored telephone-based intervention consisting of supportive counseling and cognitive behavioral techniques for individuals awaiting lung transplantation on measures of quality of life and general well-being. METHOD: Patients were randomly assigned to either a telephone-based special intervention (SI; n = 36) for 8 weeks (average session length, 16.3 min) or a usual care (UC) control condition (n = 35) in which subjects received usual medical care but no special treatment or phone calls. At baseline, and immediately following the 8-week intervention, patients completed a psychometric test battery. SETTING: Duke University Medical Center, Pulmonary Transplantation Program. PATIENTS: Seventy-one patients with end-stage pulmonary disease listed for lung transplantation. PRIMARY OUTCOME MEASURES: Measures of health-related quality of life (both general and disease-specific), general psychological well-being, and social support. RESULTS: Multivariate analysis of covariance, adjusting for pretreatment baseline scores, age, gender, and time waiting on the transplant list, revealed that patients in the SI condition compared to the UC reported greater general well-being (p < 0.05), better general quality of life (p < 0.01), better disease-specific quality of life (p < 0.05), and higher levels of social support (p < 0.0001). CONCLUSION: A brief, relatively inexpensive, telephone-based psychosocial intervention is an effective method for reducing distress and increasing health-related quality of life in patients awaiting lung transplantation.

Counseling↗

PubMedDate not supplied

[The hemodialysed patient and his/her family caregiver. Comparison of perceptions of the chronic illness].

BACKGROUND: According to health psychology, the family caregiver (fc), i.e. the person who takes care of a hemodialysed patient, plays a pivotal role in coping with dialysis. This study explored and compared the lifestyle and the main needs of a cohort of hemodialysis patients, with reduced personal autonomy, to their fc, evaluating some psychological functional parameters, such as the perception of familial and social support, the psychological quality of life, the disability due to chronic illness, and the communication style. METHODS: An anonymous multiple versions questionnaire, administered according to the caregiver's family relationship, was given for self assessment to 54 couples of patients and related fc (spouse, son/daughter and brother/sister), mean age 66 and 60, respectively; mean dialytic patients' age: 8 years and 6 months. The questionnaire consisted of three different sections, demographics, renal disease and psychological evaluation, with 4 standard scales (Social Support Satisfaction, Marital Communication, Psychological General Well-Being Index and Evaluation of Needs). A multivariate variance analysis (MANOVA) was subsequently performed. RESULTS: Women have a higher perception of their lifestyle change after dialysis, and, in general, patients communicate more easily with their fc than vice versa. Communication problems are more common in patients with a recent diagnosis. Patients and fc mostly need a better dialogue with their nephrologists and urge some psychological help. CONCLUSIONS: The quality of the relationship between physicians, patients and their families is a key element in the process of healing.

Adult↗

PubMed1993

[Factorial construct validity of a measurement scale of fatigue in junior high school students].

To investigate factorial construct validity of a measurement scale of fatigue symptoms in junior high school students, a questionnaire which consisted of Cumulative Fatigue Symptoms Index (CFSI) and Psychological Condition Test (PCT) was administered on 289 students in Okinawa. Reliability coefficients were 0.607-0.811 for CFSI scales. A principal factor analysis with varimax rotation was applied to CFSI. In boys, 4 factors were extracted; general psychological symptoms, fatigue, emotional instability, and decreased morale and vitality. In girls, 4 factors were extracted; depression and anxiety, decreased morale and vitality, fatigue, and irritability. The same procedure was applied to PCT. In boys, 4 factors were extracted; negative feeling, vigor, inferiority complex, and fatigue. In girls, 4 factors were extracted; negative feeling, anger, vigor, and fatigue. Among factors derived from CFSI and PCT, the fatigue factor of CFSI was correlated with that of PCT. The factors concerning psychological symptoms of CFSI were correlated with those of PCT. However, the vigor factor of PCT was not correlated with any other factors. These results suggest that CFSI in junior high school students had factorial construct validity.

Adolescent↗

PubMed1968

Intelligence has three facets. There are numerous intellectual abilities, but they fall neatly into a rational system.

In this limited space I have attempted to convey information regarding progress in discovering the nature of human intelligence. By intensive factor-analytic investigation, mostly within the past 20 years, the multifactor picture of intelligence has grown far beyond the expectations of those who have been most concerned. A comprehensive, systematic theoretical model known as the "structure of intellect" has been developed to put rationality into the picture. The model is a cubical affair, its three dimensions representing ways in which the abilities differ from one another. Represented are: five basic kinds of operation, four substantive kinds of information or "contents," and six formal kinds of information or "products," respectively. Each intellectual ability involves a unique conjunction of one kind of operation, one kind of content, and one kind of product, all abilities being relatively independent in a population, but with common joint involvement in intellectual activity. This taxonomic model has led to the discovery of many abilities not suspected before. Although the number of abilities is large, the 15 category constructs provide much parsimony. They also provide a systematic basis for viewing mental operations in general, thus suggesting new general psychological theory. The implications for future intelligence testing and for education are numerous. Assessment of intellectual qualities should go much beyond present standard intelligence tests, which seriously neglect important abilities that contribute to problem-solving and creative performance in general. Educational philosophy, curriculum-building, teaching procedures, and examination methods should all be improved by giving attention to the structure of intellect as the basic frame of reference. There is much basis for expecting that various intellectual abilities can be improved in individuals, and the procedures needed for doing this should be clear.

Cognition↗

PubMed1998

Visual search of driving situations: danger and experience.

Previous research on visual search in driving suffers from a number of problems: small sample sizes, a concentration on mundane situations, and a failure to link results to more general psychological theory. The study reported in this paper addresses these issues by recording the eye movements of a large sample of drivers while they watched films of dangerous driving situations and comparing the findings with those from more general studies on scene perception. Stimuli were classified according to the types of road shown and the degree of danger present in the scenes. Two groups of subjects took part, fifty-one young novice drivers who had just gained a full driving licence and twenty-six older more experienced drivers. Dangerous situations were characterised by a narrowing of visual search, shown by an increase in fixation durations, a decrease in saccade angular distances, and a reduction in the variance of fixation locations. These effects are similar to the concept of 'attention focusing' in traumatic situations as it is described in the literature on eyewitness memory. When road types are compared, the least visually complex rural roads attracted the longest fixation durations and the shortest angular saccade distances, while the most visually complex urban roads attracted the greatest spread of search but the shortest fixation durations. Differences between the groups of subjects were also present. Novices had longer fixation durations than experienced drivers, particularly in dangerous situations. Experienced drivers also fixated lower down and had less vertical variance in fixation locations than novices.

Adolescent↗

PubMed1997

[Quality of life after implantation of a cardioverter-defibrillator (ICD)--results of an empirical study of 132 ICD patients].

All 181 patients with malignant arrhythmias who have been provided with an implantable cardioverter-defibrillator (ICD) at the University Clinics of Muenster during the last 3 years, were investigated by a clinical questionnaire on quality of life (QOL). 132 patients answered and could be included in the study (response rate 73%). The mean age of the patients was 55 +/- 11.8 years, 73% males, 60% had already retired. In the general view 51% of the patients reported fair to excellent quality of life, while 24% gave a negative description of their QOL. 26% of the patients suffered from side-effects of the treatment, primarily from unspecific psychological complaints and ICD-related disturbances. "Unrest" was the predominant psychological complaint (64% of the patients), followed by rumification, shortness of breath, weakness and sleep disturbances. Somatic function and sex life were the functional areas primarily affected (more than half of the patients complaining about these). The "Psychological General Well-Being Index (PGWB)" showed reduced well-being in 61% of the patients. Comparing with the literature and regarding the PGWB-scales well-being, anxiety, and depression no significant differences could be found in comparison with other cardiologic samples after bypass-surgery or valve replacement. The results indicate the need of individual counseling and offers of psychosocial support for this highly strained group to reduce anxiety and to improve the quality of life in order to help the patient to gain greater overall benefit from the new ICD-therapy.

Activities of Daily Living↗

PubMed2004

Fatigue in patients with primary sclerosing cholangitis.

BACKGROUND: The occurrence of fatigue in primary sclerosing cholangitis (PSC), its impact on quality of life and the role of concomitant inflammatory bowel disease (IBD) and coexisting irritable bowel syndrome (IBS) is unexplored. METHODS: Ninety-three patients with PSC, associated with IBD in 80% of cases and 77 patients with IBD alone, were enrolled in the study. The patients completed the following questionnaires: the Fatigue Impact Scale (FIS), the Psychological General Well-Being Index (PGWB), the Gastrointestinal Symptom Rating Scale (GSRS), the Beck Depression Inventory (BDI) and diagnostic criteria for IBS. Questionnaire data were related to liver tests and the latest liver biopsy in the PSC patients. Two sex- and age matched controls from the general population (GP) were assigned to each PSC patient and these controls completed the FIS and the BDI. RESULTS: Total fatigue score did not differ significantly between patients with PSC and IBD alone. Median total fatigue score among GP subjects was 39 (13-72), which was higher than in PSC (19 (6-52) (P = 0.02)) and in IBD patients (19 (5-35) (P < 0.0001)). PGWB and GSRS scores did not differ between patients with PSC and IBD alone. Depression and general health (PGWB) were independent predictors for total fatigue score in PSC. No correlation was observed between fatigue in PSC and the severity of the liver disease. CONCLUSIONS: Fatigue in patients with PSC is related to depression but not to the severity of the liver disease. Both the PSC and IBD patients had lower total fatigue scores than subjects from the general population. This argues against fatigue as a specific symptom of PSC and IBD patients.

Adaptation, Psychological↗

PubMed1987

Personality, imaginative involvement, and self-reported somatic complaints: relevance to the concept of alexithymia.

Forty-five undergraduate students were investigated to determine the relationship between personality dispositions, capacity for imaginative involvement, and self-reported physical symptoms. The results showed that somatic complaints were associated with variables reflecting psychological vulnerability and dysphoric affect (e.g. anxiety and worry/depression). Imaginative involvement, and especially the Absorption Scale, correlated positively with self-reported somatic symptoms. Factor analyses revealed that Absorption Scale and the Creative Imagination Scale loaded on a general psychological distress factor. Moreover, self-reported somatic symptoms correlated negatively with 'inner directedness' and 'sociable' coping style, and positively with the coping styles 'sensitive' and 'inhibited', thus suggesting a link between emotional expressiveness and somatic complaints. The relevance of these results to the concept of alexithymia is discussed.

Adult↗

PubMed1988

Stress and coping in relatives of burn patients: a longitudinal study.

Standardized psychological assessment of 48 close relatives of patients hospitalized for burns revealed that the relatives experienced high levels of distress during the acute phase of the patient's hospitalization. At six-month follow-up, the relatives' general psychological symptomatology had receded to within the normal range, but 25 percent continued to show specific stress syndromes characterized by intrusive and avoidant responses to the past burn trauma. Intrusive-avoidant stress responses could not be predicted by demographic information, severity of the burn, facial disfigurement, or actual responsibility for the burn, but blaming oneself for the injury to the patient was a significant predictor. Evaluating stress responses of close relatives after burn trauma can lead to more successful intervention for those who remain stressed and may enhance patient and family compliance with the treatment and rehabilitation regime.

Adaptation, Psychological↗

PubMed1998

Sex differences in the prevalence and detection of depressive and anxiety disorders in general health care settings: report from the World Health Organization Collaborative Study on Psychological Problems in General Health Care.

BACKGROUND: Understanding the relevance of biological and social factors to sex differences in the prevalence and detection of depressive and anxiety disorders has been impaired by the lack of standardized research methods across cultures. METHOD: Prevalence rates of depressive and anxiety disorders were assessed using a 2-stage design from 26,969 patients attending for primary care in 15 centers from 4 continents. Logistic regression analysis was used to examine sex differences in prevalence and detection across centers. RESULTS: Odds ratios for women compared with men of current depression (1.60; 95% confidence interval [CI], 1.37-1.86) and agoraphobia or panic (1.63; 95% CI, 1.18-2.20) were consistent across centers. The odds ratio for generalized anxiety varied among centers: 3 groups of centers were identified with odds ratios of 0.46 (95% CI, 0.27-0.78), 1.34 (95% CI, 1.08-1.66), and 3.09 (95% CI, 1.60-5.89). There was no sex difference in the detection of depressive and anxiety disorders by physicians across centers. CONCLUSIONS: The absence of a sex-by-center effect for current depression and agoraphobia or panic disorder is consistent with biological and psychosocial factors, either interacting or working alone, that have a similar final effect across cultures. It does not support the idea that sex differences in prevalence are caused by local psychosocial factors that vary from country to country. The variation in the odds ratio for generalized anxiety disorder offers some support to the idea that there are local differences between the centers contributing to the sex difference in rates. Patients' sex does not appear to affect the likelihood of current depression and anxiety being detected by primary care physicians.

Agoraphobia↗