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Sociodemographic, disease status, and illness perceptions predictors of global self-ratings of health and quality of life among those with coronary heart disease--one year follow-up study.

This one-year follow-up study (n = 130 at baseline, n =2745 at follow-up, aged 45-74 years) examined the relationship of patients' perceptions of coronary heart disease (CHD) and illness-related factors with global health status and global quality of life (QOL) ratings. The independent variables were CHD history (myocardial infarction, revascularisation), CHD severity (use of nitrates, CHD risk factors and co-morbidities) and illness perceptions. In multivariate regression analysis, CHD history and severity explained 13% of variance in global health status and 8% in global QOL ratings at the baseline. Illness perceptions increased the share of explained variance by 18% and 16% respectively. In the follow-up, illness perceptions explained a significant but modest share of variance in change in health status and QOL when baseline health status and QOL and CHD severity were adjusted for more symptoms being attributed to CHD, severe perceived consequences of CHD, as well as a weak belief in the controllability of CHD were related to poor global health status and QOL ratings. In structural path models associations of CHD severity factors were mediated by illness perceptions. The association of disease severity with dependent variables was weaker after controlling for illness perceptions. Cognitive representations of CHD contribute to both global health status and QOL ratings and they also mediate the associations between CHD severity and well-being. No gender differences were found in associations of illness perceptions with health status or QOL ratings.

Aged↗

Cortical evoked potentials and somatosensory perception in chronic spinal cord injury patients.

The correlation between somatosensory evoked potentials (SEPs) and sensory perception was studied in 110 patients with traumatic chronic spinal cord lesions. Perception thresholds over the legs for light touch, vibratory sensibility, temperature and thermal pain were tested together with recordings of tibial and peroneal SEPs. Tibial nerve SEPs correlated better with sensory perception than peroneal nerve SEPs. Normal tibial nerve SEPs were not present with absent or trace vibratory sensibility and vice versa. However, we found many exceptions to the correlation between temperature and pain perception and SEPs. Light touch, vibratory sensibility, and SEPs were highly correlated between each other, while temperature and pain perception correlated poorly to these other modalities. This represents an evident segregation of touch perception, vibratory sensibility and SEPs, which are thought to share dorsal columns as a common ascending pathway, and temperature and pain perception known to be related to the spinothalamic system.

Adolescent↗

Suppression of cutaneous perception by magnetic pulse stimulation of the human brain.

We have demonstrated that magnetic pulse stimulation of the sensorimotor cortex suppresses perception of threshold electrical stimuli to the fingers of the contralateral hand. Maximum suppression of perception occurs when the fingers are stimulated 30-90 msec after the magnetic pulse. Thereafter, errors in perception of the cutaneous stimulus decrease to control levels by 300-400 msec after the magnetic pulse. The period of maximum suppression of perception coincides with the period during which cortically generated somatosensory evoked potentials (SEPs) are enhanced following magnetic pulse stimulation of the brain. The duration of suppression of perception, however, outlasts the duration of SEP enhancement. When the magnetic pulse is delivered after finger stimulation there is also suppression of perception. The suppression of perception is maximal when the magnetic pulse occurs 20-30 msec after finger stimulation. This interval coincides with the arrival of the afferent volley at the primary sensory cortex.

Electric Stimulation↗

Perceptions of risk during pregnancy amongst urban women in northeast Brazil.

The aim of the study was to explore the influences on the perceptions of potential risks of pregnancy in a developing country. The perceptions were analyzed in order to construct a local explanatory model of health which could be compared to the activities promoted by the health services. The relationship of perceptions of risk to women's reported motivation for using the health services is assessed. The findings are presented in relation to four specific research questions: 1, How do women view the state of being pregnant? 2, What potential risks are associated with being pregnant? 3, How are these risks explained? 4, What are women's motivations for using prenatal care services? The paper discusses the influence of the local explanatory model on women's perceptions of health risks during pregnancy, the compatibility with the biomedical model and the influence of either on the use of health services by women. In the course of analysing the findings, a number of questions emerged concerning the assumptions often underlying this kind of study. First, the results suggested that seeking one coherent explanatory medical model for local perceptions of risk may not be appropriate. Secondly, different explanations for perceived risks does not necessarily mean a conflict with the activities of the health services. Thirdly, the explanatory model is only part of the influences on women's perceptions of health risks. The socio-economic context of their lives and the structure and practices of the local health system are equally important factors. An approach based on different assumptions which locates individual experiences within the influences of explanatory medical models, the socio-economic circumstances and the structure and practices of the health system provides a better understanding of how perceptions of health risks are formed, how they influence use of the health services and how they change over time.

Abortion, Spontaneous↗

Perceptions among pathological and nonpathological gamblers.

This study evaluated the perceptions of individuals while gambling on a Video Lottery Terminal. The primary goal was to compare the frequency of erroneous perceptions and of gambling-related perceptions among pathological and nonproblem gamblers. The degree of conviction in these perceptions was also evaluated. Each participant was assessed by a clinical psychologist using the DSM-IV criteria. Results showed that, contrary to the first hypothesis, no significant differences emerged between problem and nonproblem gamblers on the percentage of erroneous perceptions. But, pathological gamblers verbalized significantly more gambling related perceptions and were more convinced in the truth of their perceptions than the nonproblem gamblers. The theoretical and clinical implications of these results are discussed in order to improve the effectiveness of treatment interventions for pathological gamblers.

Adult↗

Do daughters with eating disorders agree with their parents' perception of family functioning?

OBJECTIVE: The current study compared the perceptions of family functioning between daughters with eating disorders (EDs) and their parents. This investigation was an expansion of the Fornari et al (Compr Psychiatry 1999;40:434-441) study, which investigated the relationship between the perceived family functioning and depressive symptoms in individuals with ED patients receiving outpatient services. METHOD: One hundred twenty-six female subjects, ranging in age from 13 to 34 years (mean 18.3 years) completed the Beck Depression Inventory (BDI) (Arch Gen Psychiatry 1961;4:561-571) and the Family Assessment Device (FAD) (J Marital Fam Ther 1983;9:171-180) on admission to an outpatient ED program. The patient's parent(s) (118 mothers and 96 fathers) also completed the FAD. Eating disorder subgroup diagnosis and major depressive disorder diagnosis were established according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , criteria, using the Schedule for Affective Disorders and Schizophrenia-Lifetime (Arch Gen Psychiatry 1987;35:837-844). Repeated measures analysis of covariance was performed comparing family members on each of the 7 subscales of the FAD with BDI entered as the covariate. RESULTS: Statistically significant differences were found between patient and parental perceptions of overall family functioning. Mothers rated family functioning as significantly healthier and less chaotic than their daughters did. There were fewer significant differences between maternal and paternal perceptions of family functioning, and no significant differences between fathers' and daughters' perceptions of the family. Eating disorder diagnosis did not contribute to these differences in perception of family functioning. In addition, high self-reported depressive symptoms of the daughters were related to the perception of high family dysfunction for all 3 informants; depressive symptoms did not, however, alter the differences in perception between family members. DISCUSSION: Differences in viewpoints between parents and daughters regarding the family environment may contribute to the continuation of a dysfunctional family pattern and maintenance of the ED and/or impact negatively on the course of treatment. Possible implications for treatment are discussed, particularly because of the differences of the mothers' views. The results of this study strongly support the importance of including the patient's family in the initial evaluation, regardless of the patient's age.

Adolescent↗

Perception of drinking water in the Quebec City region (Canada): the influence of water quality and consumer location in the distribution system.

The purpose of every water utility is to provide consumers with drinking water that is aesthetically acceptable and presents no risk to public health. Several studies have been carried out to analyze people's perception and attitude about the drinking water coming from their water distribution systems. The goal of the present study is to investigate the influence of water quality and the geographic location of consumers within a distribution system on consumer perception of tap water. The study is based on the data obtained from two surveys carried out in municipalities of the Quebec City area (Canada). Three perception variables were used to study consumer perception: general satisfaction, taste satisfaction and risk perception. Data analysis based on logistic regression indicates that water quality variations and geographic location in the distribution system have a significant impact on the consumer perception. This impact appears to be strongly associated with residual chlorine levels. The study also confirms the importance of socio-economic characteristics of consumers on their perception of drinking water quality.

Adolescent↗

Factors influencing health perceptions in patients with panic disorder.

Subjective perceptions of health have been found to be related to a variety of consequential variables including health care utilization and mortality. A number of studies have found that patients with panic disorders generally perceive themselves as having poor health. However, factors underlying self-perceptions of health are largely unexplored in this population. The present study examined three factors believed to contribute to health perceptions: (1) presence of comorbid medical conditions, (2) tendency to somaticize or worry about health, and (3) level of co-occurring depression. The sample consisted of 81 patients who met DSM-III-R criteria for panic disorder. An assessment battery that determined self-perceptions of health, level of depression, and the major clinical dimensions of panic disorder (i.e., panic attacks, anxiety, and phobic avoidance) was administered to all participants. As predicted, analyses indicated that each of the hypothesized factors was significantly related to poorer perceived health. Setwise hierarchical multiple regression analyses controlling for demographic variables indicated that health perceptions are strongly and independently associated with depression and the presence of a medical condition. Subjective health perceptions in panic disorder are multifactorial and are related to both realistic appraisals of health and distorted perceptions caused by depressed mood.

Comorbidity↗

Parents' perceptions of medical diagnoses and related issues for their high-risk infants.

INTRODUCTION: The objectives of this study were (a) to compare maternal and paternal perceptions of infant medical diagnoses with hospital-chart diagnoses, (b) to examine whether parental perceptions of infant medical condition (using three variables) were related to eight other parental perceptions, and (c) to determine what medical diagnoses were associated with parental expectations that neonatal diagnoses were having current effects of would have future effects on their infant. METHOD: With a questionnaire format 76 parents reported information about medical diagnoses and their perceptions about eight other issues for their infants who had been hospitalized in an NICU. RESULTS: Parents reported approximately 62% of the medical diagnoses for their infants during NICU hospitalization; these significantly differed from hospital-chart diagnoses. Parents who reported current or future effects of neonatal diagnoses also (a) had fears for their infants while in the hospital or currently, (b) perceived prematurity as having current or future effects, (c) reported restrictions for their infants caused by neonatal diagnoses, and (d) gave less optimal ratings for their infants' current health status. Parents' perceptions of current or future effects of neonatal diagnoses appeared to be inaccurate given the actual diagnoses for their infants. DISCUSSION: The underreporting of diagnoses by parents raises several issues as to how accurately parents are perceiving their infants. Parents who perceived continued effects of neonatal diagnoses also had less optimal perceptions of other related issues. Parent's perceptions of continued effects of neonatal diagnoses appeared to be unwarranted with respect to the actual diagnoses assigned to their infants.

Adult↗

Generative character of perception: a neural architecture for sensorimotor anticipation.

The basic idea of our anticipatory approach to perception is to avoid the common separation of perception and generation of behavior and to fuse both aspects into a consistent neural process. Our approach tries to explain the phenomenon of perception, in particular, of perception at the level of sensorimotor intelligence, from a behavior-oriented point of view. Perception is assumed to be a generative process of anticipating the course of events resulting from alternative sequences of hypothetically executed actions. By means of this sensorimotor anticipation, it is possible to characterize a visual scenery immediately in categories of behavior, i.e. by a set of actions which describe possible methods of interaction with the objects in the environment. Thus, the competence to perceive a complex situation can be understood as the capability to anticipate the course of events caused by different action sequences. Starting from an abstract description of anticipatory perception and the essential biological evidence for internal simulation, we present two biologically motivated computational models that are able to anticipate and evaluate hypothetically sensorimotor sequences. Both models consider functional aspects of those cortical and subcortical systems that are assumed to be involved in the process of sensory prediction and sensorimotor control. Our first approach, the Model for Anticipation based on Sensory IMagination (MASIM), realizes a sequential search in sensorimotor space using a simple model of lateral cerebellum as sensory predictor. We demonstrate the efficiency of this model approach in the light of visually guided local navigation behaviors of a mobile system. The second approach, the Model for Anticipation based on Cortical Representations (MACOR), is actually still at a conceptual level of realization. We postulate that this model allows a completely parallel search at the neocortical level using assemblies of spiking neurons for grouping, separation, and selection of sensorimotor sequences. Both models are intended as general schemes for anticipation based perception at the level of sensorimotor intelligence.

Journal Article↗

Perception of traffic accident risk and decision to drive under light alcohol consumption--a double-blind experimental study.

PURPOSE: Public traffic safety campaigns in Germany have focussed on the changing risk perception of young drivers. While there is some consensus that perceptions of risk affect driving, less is understood about the relationship and interaction of alcohol consumption and risk perception on the decision to drive. We examined the influence of light alcohol consumption on risk perception and decision to drive, and the interaction of alcohol consumption and cognitive feedback on the handicapping effect of alcohol on risk perception and decision to drive. METHOD: In a double-blind block-randomized experimental study of 104 young drivers between 19 and 24 years of age, with two experimentally manipulated independent factors of alcohol consumption (three levels: 0% BAC, 0.015% BAC, 0.03% BAC) and feedback (positive or negative), we assessed three dependent variables: perception of traffic accident risk, subjective judgement about driving-relevant cognitive performance, decision to drive a car. Analyses of variance and covariance were used to analyze differences between levels of experimental factors. RESULTS: We found that persons with 0.015 BAC performed better than persons in both other alcohol conditions on the standardized risk perception task. Perceived handicap of driving was significantly more pronounced for negative feedback compared to positive feedback with no influence of the level of alcohol consumption. No significant influence on decision to drive was found of either level of alcohol consumption, feedback or sex. IMPLICATIONS: Decision to drive in young drivers could not be influenced by feedback or light consumption. Public health approaches have to find better determining factors.

Accidents, Traffic↗

Psychological influences on the perception of immune function.

BACKGROUND: Perception of deficiencies in immunity are common in a number of patient complaints. However, little is known about the way in which individuals form perceptions about the competence of their immune system. In two studies we examined the relationship between subjects' perceptions of their immune functioning, physical symptoms, mood and measures of immunity. METHODS: In Study 1, 20 healthy volunteers completed global ratings of their immune system functioning, as well as mood and symptom reports, twice a week for 5 weeks. At the same time, blood samples were taken to assess serum IgA, IgG, and IgM antibodies. In Study 2, another sample of 58 subjects completed the same measures weekly for 5 weeks and their blood was tested for concentrations of CD3, CD4, CD8, and CD16 lymphocytes. RESULTS: We found perceptions of immune functioning to be unrelated to the concentrations of serum antibodies or blood lymphocytes. Immune perceptions were strongly related to mood and in particular, feelings of fatigue and vigour. The experience of recent physical symptoms, while not as strong as mood variables, was also important in perceptions of immune functioning. CONCLUSIONS: Mood seems to be an important determinant in the perception of immune function, and complaints about immune dysfunction in clinical situation should be investigated with this possibility in mind.

Adult↗

Interpersonal perception and mode of resolution in marital conflict.

The present study examined the relationship between changes in couples' perceptions of each other during a conflictual interaction and their mode of conflict resolution. Thirty-three volunteer married couples were videotaped while recreating a conflictual interaction that had occurred previously. During a subsequent replaying of the videotape, husbands' and wives' verbal descriptions of perceptions of self and spouse were elicited at three different stages of the conflict, using a method for eliciting perceptions derived from Laing. Phillipson, and Lee's multiperspective interpersonal perception technique. The interpersonal perceptions of couples who resolved the conflict by engaging the issue at hand were contrasted with those of couples who resolved the conflict via avoidance. Statistically significant differences were found between the groups, suggesting that engaging the issue was associated with an increase in spouses' access to one another's interpersonal perceptions, whereas avoidance was associated with decreases in consensually valid perceptions. Substantive and methodological implications of the study are discussed.

Adult↗

Children's perceptions of smokers and nonsmokers: a longitudinal study.

In a longitudinal study we investigated 5th- and 7th-grade children's perceptions of smokers and nonsmokers, changes in perceptions from 5th to 7th grades, and the degree to which these perceptions predict smoking in 9th grade. The participants were 1,663 students from 14 school districts in Washington state. The results showed large developmental shifts from 5th to 7th grade in children's perceptions of both smokers and nonsmokers: Students at 7th grade saw smokers in a much more positive light and nonsmokers in a much more negative light than they did at 5th grade. Children's positive perceptions at 5th grade of smokers predicted smoking 4 years later at 9th grade and were stronger predictors than positive perceptions at 7th grade. The results suggest that smoking prevention interventions must begin before 5th grade to counter perceptions predictive of subsequent smoking.

Adolescent↗

Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment.

AIMS: To explore the impact of bracing on the perceptions of body image, happiness and satisfaction of adolescents with scoliosis. DESIGN: The study was designed as compare of 134 girls and 16 boys who wore a Boston type brace for scoliosis treatment and a control group of 99 healthy girls and 51 healthy boys. All them were secondary school pupils living in Athens Greece and were interviewed. A semi-structured schedule included general questions, and the Piers-Harris scale was used. Data were analysed using the SPSS/PC+ software, and descriptive statistics, factor analysis and the non-parametric Mann-Whitney U-test. Statistical significance was set at P=0.05 or less. RESULTS: The scoliosis group had a poorer perception of body image in comparison to the control group (P=0.048), while boys with scoliosis (P=0.030) had a better perception of body image than girls with scoliosis. Girls with scoliosis had a statistically significant difference (P=0.0388) in perception of happiness and satisfaction, in comparison with girls in the control group. Cohabitation with the mother seemed to be negatively correlated with body image, happiness and satisfaction perceptions because adolescents with scoliosis who were not living with their mother had a better body image perception (P=0.027) as well as better perceptions of happiness and satisfaction (P=0.047). Nevertheless, only 5% of those with scoliosis declared that they had opportunities to discuss their feelings and problems with health professionals, while 90% of them declared that they wanted to have more opportunities to do this. CONCLUSION: Adolescents with scoliosis face problems during bracing and they need to be supported by health care professionals.

Adolescent↗

Thermal perception thresholds recorded using method of limits change over brief time intervals.

Quantitative Sensory Testing (QST) of thermal perception thresholds assesses small afferent nerve function. QST has also been widely used to investigate the effects of interventions on the perception of activity within these nerve fibres, often over brief time periods. The natural variation in perception thresholds over brief time periods has not been determined, however, complicating accurate identification of induced changes. The present study therefore investigated changes in thermal perception threshold values within a 1-h period. Twenty-four healthy women volunteers aged 18-28 years (mean 20.6, SD 2.8) undertook cold sensation (CS), warm sensation (WS), cold pain (CP), and hot pain (HP) perception threshold measurements on the thenar eminence of the dominant hand during six 8-min experimental cycles. The order of stimulus presentation was randomized within pre-selected criteria. An adaptation temperature of 32 degrees C, a rate of temperature change of 0.5 degrees C/s, a 3 cm x 3 cm thermode, and a method of limits algorithm were used. Separate two-way ANOVAs with repeated measures showed statistically significant changes over time for WS, CS, and HP (p < 0.05), but not for CP (p = 0.232). The results indicate that WS, CS, and HP perception thresholds change significantly with repeated testing over a 1-h period. These results should be carefully considered when assessing the importance of observed changes in thermal perception thresholds. In research trials exclusion of a control group would be a fundamental flaw.

Adolescent↗

Negative self-perceptions and sexual risk behavior among heterosexual methamphetamine users.

This research examined the relationship between negative self-perceptions and sexual risk behavior in a sample of 156 heterosexually identified, methamphetamine users from San Diego, California. The Beck Depression Inventory and the Self Esteem Rating Scale, respectively, were used to assess depression and negative self-perceptions. Measures of sexual risk behavior and methamphetamine use were developed specifically for this research. Data were gathered in 2001-2002. Participants were primarily male (76%), Caucasian (56%), never married (51%), and unemployed (73%), with a mean age of 39.1 years. Participants with high levels of negative self-perceptions evidenced the greatest degree of sexual risk behavior, including significantly more unprotected vaginal sex and a larger number of sexual partners as compared to individuals with low levels of negative self-perceptions. In cross-sectional analyses, negative self-perceptions predicted intensity of methamphetamine use and depressive symptoms. However, neither of these variables were found to mediate the relationship between negative self-perceptions and sexual risk behavior. Findings are discussed in relation to the need for further research into the role of negative self-perceptions as a determinant of sexual risk behavior among methamphetamine users.

Adolescent↗

Self-perceptions of health: a prospective analysis of mortality, control, and health.

A growing number of studies show that self-perceptions of health are an important predictor of mortality. The present study was designed to extend this research by examining the relation between health perceptions and a range of other outcome measures besides mortality, including control beliefs and morbidity. The results show that older adults who rated their health as "bad/poor" and "fair" were more than twice as likely to die within three to three-and-a-half years following the initial survey than those who perceived their health as "excellent." However, although health perceptions assessed in 1991/92 were related to health perceptions four years later, they did not predict morbidity. Health perceptions also predicted perceived control and use of control-enhancing strategies in dealing with age-related challenges, as assessed in 1995. These findings contribute to our understanding of the benefits of positive health perceptions by showing that they are connected to an adaptive psychological profile including perceptions of control and use of control-enhancing strategies that are linked to health and well-being.

Activities of Daily Living↗