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PubMedDate not supplied

Brief report: a cognitive behavioral intervention for distressed adolescents with type I diabetes.

OBJECTIVE: To examine the impact of a cognitive behavioral intervention for distressed adolescents with Type I diabetes. METHODS: Six youths with elevated levels of anxiety, anger, or diabetes stress received training in cognitive restructuring and problem solving in individual sessions. A multiple baseline design across participants was used. Treatment effectiveness was assessed through measures of anxiety, anger expression, and diabetes stress. RESULTS: Four youths displayed some improvement on one or more variables for which they had elevated levels during baseline, while others showed no impact. CONCLUSIONS: Cognitive behavioral interventions show some promise for distressed youths with Type I diabetes. Individual youths responded to treatment differently. Further research is needed in developing procedures to better meet the needs of youths, improve youth participation, and enhance treatment effectiveness.

Adaptation, Psychological↗

PubMed1997

Whiplash-associated chronic headache treated with home cervical traction.

The subject of this case report was a 56-year-old woman who sustained a whiplash-associated disorder as a result of a motor vehicle accident. Within a few hours after the accident, she developed a headache, which became chronic, creating disability and hindering the quality of her life. In the following year, a variety of diagnostic tests, medications, and physical therapy were unsuccessful in determining the cause of her complaints or in relieving them. After this year, she expressed anger, frustration, and a reluctance to undergo additional physical therapy. By listening to her explain how she coped with her problem and observing that she lacked the ability to reduce her cervical lordosis, the therapist developed and implemented a home program of supine cervical traction and exercise. After 30 days of treatment, she was able to reduce and control her headache. This treatment and the approach used to develop the treatment may benefit other patients who have whiplash-associated chronic headache.

Cervical Vertebrae↗

PubMedDate not supplied

Coping and emotional adjustment following traumatic brain injury.

OBJECTIVES: To examine the association between coping style and emotional adjustment following traumatic brain injury. PARTICIPANTS: Thirty three individuals who had sustained a traumatic brain injury (mean duration of posttraumatic amnesia = 32 days) between 1(1/2) months and almost 7 years previously. MEASURES: Coping Scale for Adults, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, State-Trait Anger Expression Inventory, and the Sickness Impact Profile. RESULTS: Approximately 50% of the sample reported clinically significant levels of anxiety and depression. Coping characterized by avoidance, worry, wishful thinking, self-blame, and using drugs and alcohol was associated with higher levels of anxiety, depression, and psychosocial dysfunction and lower levels of self-esteem. Coping characterized by actively working on the problem and using humor and enjoyable activities to manage stress was associated with higher self-esteem. Lower premorbid intelligence (measured via the National Adult Reading Test) and greater self-awareness (measured via the Self-Awareness of Deficits Interview) were associated with an increased rate of maladaptive coping. CONCLUSIONS: The strong association between the style of coping used to manage stress and emotional adjustment suggests the possibility that emotional adjustment might be improved by the facilitation of more adaptive coping styles. It is also possible that improving emotional adjustment may increase adaptive coping. The development and evaluation of interventions aimed at facilitating adaptive coping and decreasing emotional distress represent important and potentially fruitful contributions to enhancing long-term outcome following brain injury.

Adaptation, Psychological↗

PubMedDate not supplied

Dimensions of hostility in men, women, and boys: relationships to personality and cardiovascular responses to stress.

Ratings of Potential for Hostility and Hostile Style based on responses during the Type A Structured Interview (SI) are related to incidence of coronary heart disease morbidity and mortality. As there are very limited data on what precisely the SI ratings of hostility mean, the present study evaluated, in a sample of middle-aged men and women, and adolescent boys, a) the distributions of SI ratings of hostility according to gender and age group; b) their relationships to other hostility and personality scores; and c) their relationships to heightened cardiovascular responses to psychological stressors, which are thought to be a major mechanism linking behavior and coronary heart disease. Results showed that men are higher than women and boys in Potential for Hostility and Hostile Style ratings, which are, by and large, unrelated to standardized questionnaire measures of hostility and anger expression. Men (but not women or boys) who exhibited elevated systolic blood pressure during standardized laboratory stressors tended to be rated as high on Hostile Style. We conclude that SI Hostile Style ratings are measuring a unique aspect of personality, one with apparent importance for coronary heart disease and perhaps for men's cardiovascular responses during stress.

Adolescent↗

PubMedDate not supplied

Psychosocial factors associated with cardiovascular reactivity in older adults.

This study examined associations of psychosocial factors with cardiovascular reactivity in two groups of men and women--spouse caregivers of individuals with Alzheimer's disease (M age = 69.4 N = 82) and controls (M age = 68.5, N = 78) group-matched for age and gender. Cardiovascular responses to an emotional task (speech sample about one's spouse) yielded higher systolic and diastolic blood pressures (SBP, DBP) than a spoken cognitive task, which in turn yielded higher BPs and heart rate (HR) than the baseline rest period. HR was greater in response to the two tasks than in response to the baseline period, but it did not differ across tasks. Regression models of SBP, DBP, and HR reactivity in response to the two tasks demonstrated that after controlling for hypertension and gender, combinations of hostility, anger expression, avoidance coping, Type A behavior and Expressed Emotion (criticism) explained more reactivity in response to the emotional (8-12%) than the cognitive task (4-7%). Caregivers were more reactive than controls only if they were hypertensive. Psychosocial factors may be as important in explaining reactivity in older adults as in younger adults.

Adaptation, Psychological↗

PubMedDate not supplied

Psychological variables in hypertension: relationship to casual or ambulatory blood pressure in men.

OBJECTIVE: The evidence linking hypertension with personality or psychological characteristics, such as anger, anxiety, or depression, remains equivocal. This may be due in part to limitations of personality theory, confounding by awareness of hypertension, and/or inherent difficulties in measuring blood pressure. This study was designed to investigate the association between mild hypertension as defined by both ambulatory and casual (clinic) blood pressure measurements and various measures of personality and psychological characteristics. METHODS: We examined this association in a population-based sample of 283 men between the ages of 30 and 60 years from eight work sites in New York City, using an ambulatory blood pressure monitor and controlling for age, race/ethnicity, and body mass index. RESULTS: We found no consistent difference between participants with mild hypertension and those with normal blood pressure on any of the psychological variables assessed, including Type A behavior pattern, state and trait anger, anger expression, anxiety, symptoms of psychological distress, locus of control, or attributional style. Results were not due to the use of antihypertensive medication by some of the participants with hypertension nor to the dichotomization of blood pressure into those with and without mild hypertension. This contrasts with previous findings from this study showing a sizable association of ambulatory blood pressure and hypertension with job strain (a situational measure), age, and body mass index. CONCLUSIONS: These null results suggest that situational, biological, and perhaps behavioral factors are the primary determinants of mild hypertension and that the predictive significance of psychological or dispositional factors is low or negligible in those without overt cardiovascular disease.

Adult↗

PubMedDate not supplied

Anxiety and hostility are associated with reduced baroreflex sensitivity and increased beat-to-beat blood pressure variability.

OBJECTIVE: The purpose of this study was to determine whether psychological factors are associated with heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity (BRS) among healthy middle-aged men and women. METHODS: A population-based sample of 71 men and 79 women (35-64 years of age) was studied. Five-minute supine recordings of ECG and beat-to-beat photoplethysmographic finger systolic arterial pressure and diastolic arterial pressure were obtained during paced breathing. Power spectra were computed using a fast Fourier transform for low-frequency (0.04-0.15 Hz) and high-frequency (0.15-0.40 Hz) powers. BRS was calculated by cross-spectral analysis of R-R interval and systolic arterial pressure variabilities. Psychological factors were evaluated by three self-report questionnaires: the Brief Symptom Inventory, the shortened version of the Spielberger State-Trait Anger Expression Inventory, and the Toronto Alexithymia Scale. RESULTS: Psychological factors were not related to HRV. Anxiety was associated with decreased BRS (p = 0.001) and higher low-frequency (p = 0.002) power of systolic arterial pressure variability. These associations were independent of age, gender, other psychological factors, heart rate, and systolic and diastolic blood pressures. Hostility was an independent correlate of increased low-frequency power of diastolic arterial pressure (p = 0.001) and increased high-frequency power of systolic arterial pressure (p = 0.033) variability. CONCLUSIONS: Anxiety and hostility are related to reduced BRS and increased low-frequency power of BPV. Reduced BRS reflects decreased parasympathetic outflow to the heart and may increase BPV through an increased sympathetic predominance.

Adult↗

PubMed2004

Patterns of self-cutting: a preliminary study on differences in clinical implications between wrist- and arm-cutting using a Japanese juvenile detention center sample.

The present study was aimed to clarify the differences in clinical implications between wrist- and arm-cutting. Subjects were 201 delinquent adolescents (178 males and 23 females) who had been admitted to a detention center from February to March 2003. A self-reporting questionnaire and the Adolescent Dissociative Experience Scale (ADES) were given. Traumatic events and other self-injurious behavior were compared among four groups. In total, 33 (16.4%) subjects reported wrist- and/or arm-cutting. Of the females, 60.9% (n = 14) had experienced self cutting behaviors compared to 10.7% of males (n = 19). Subjects were divided into four groups; 'non-cutting' (NC: n = 168, 83.6%), 'wrist-cutting' (WC: n = 5, 2.5%), 'arm-cutting' (AC: n = 19, 9.5%), and 'wrist- and arm-cutting' (WAC: n = 9, 4.5%). WC, AC, and WAC groups reported early separation, bulling in school, and histories of sexual/physical abuse more frequently than NC group. WC and WAC groups reported suicidal ideation and suicide attempts more frequently than NC and AC groups. The ADES scores in AC and WAC groups were significantly higher than in those in NC group (P < 0.001), while the scores in WC were not different from NC groups. WC and WAC groups self-cut due to suicide idea more frequently than the AC group, while AC group self-cut due to anger expression more frequently than WC or WAC groups. Self-cutters experienced early separation, bullying in school, and sexual/physical abuse more frequently than-non-self-cutters. Arm-cutting behavior may predict dissociation, while wrist-cutting may involve with suicidality.

Adolescent↗

PubMed1985

Gender and victimization by intimates.

Recent data demonstrate that, although gender has an impact upon the experience of being a victim of an intimate's violence, there is no particular personality pattern that leads one to become a victim. Rather, women--who are socialized to adapt and submit, and who are likely to become victims of men's sexual violence or physical abuse--may not develop adequate self-protection skills as children, especially if they come from childhood homes in which females are victimized, leading to a later vulnerability to physical and sexual abuse. Men, however, socialized to express anger and aggression in an outward manner, learn to model the abuse witnessed or experienced in childhood and often learn that women are the "appropriate" recipients of this violence. Social learning theories of modeling and aggression are used to explain how such personality patterns develop, and the theory of learned helplessness is used to explain battered women's coping responses to their partners' abusive behavior. The extreme situation, in which a battered woman kills her partner in self-defense, is analyzed in order to understand women victims' sense of desperation and entrapment in severely abusive relationships and the extent to which their behaviors are in reaction to the abuse perpetrated by the mate.

Adult↗

PubMed1993

Patients' responses to postponement of coronary artery bypass graft surgery.

The purpose of this study was to determine the thoughts and feelings of patients (n = 24) awaiting coronary artery bypass graft (CABG) surgery and, in particular, the thoughts and feeling of those patients (n = 17) whose surgical procedure was postponed. On average these patients waited four additional days before the surgery could be performed. Patients reported that the most difficult part of CABG surgery was the wait itself. Those whose CABG surgery was postponed expressed anger and disappointment, had additional tests, procedures and medication, extended hospital stays and increased costs.

Adaptation, Psychological↗

PubMedDate not supplied

Personal and family impact of premenstrual symptoms.

An exploratory study of premenstrual symptomatology, coping strategies, personal and family impact, and alterations in family functioning attributed to premenstrual symptoms was conducted. A sample of 83 women and 32 men completed a questionnaire before an evening lecture on premenstrual syndrome. Women reported a total of 74 different recurrent premenstrual symptoms, with the most frequently reported category being the "tension states." Men used multiple coping techniques to deal with their spouse's symptoms with offering support and expressing anger as the most frequently reported. Recurrent negative family impact themes emerged from the content analysis: increased conflict, decreased family cohesion, and disrupted communication among family members. Nursing implications are discussed.

Adaptation, Psychological↗

PubMed1995

Temperamental vulnerability in attempted suicide.

The aim of this study was to explore and describe features of suicidal temperament and to describe the psychological domains of vulnerability in attempted suicide. Thirty-two suicide attempters were compared with 32 sex- and age-matched convalescent surgical controls on self-report personality inventories; the Eysenck Personality Questionnaire, the Chapman Scales, the Beck Hopelessnes Scale and the Karolinska Scales of Personality. Suicide attempters showed higher scale scores on neuroticism, psychoticism, interpersonal aversiveness, perceptual aberration, nonconformity, hopelessness, somatic anxiety, muscular tension, indirect aggression, suspicion and lower socialization. The features of suicidal temperament include hopelessness and anhedonia, anxiety, hostility and undirected anger expression, psychosis proneness, antisocial traits and interpersonal difficulties. These temperamental features might render the suicidal individual particularly vulnerable to suicidal behavior.

Adolescent↗

PubMedDate not supplied

Assaultive behavior intervention in the Veterans Administration: psychodynamic group psychotherapy compared to cognitive behavior therapy.

PURPOSE: To compare the efficacy of a psychodynamic psychotherapy group (PPG) and a cognitive-behavior group (CBG) for male veterans with a history of assault. METHODS: Data collected included the Addiction Severity Index, the Overt Aggression Scale, and the State-Trait Anger Expression Inventory. Subjects (N = 27) were assigned randomly to a central group, PPG, or CBG. Analyses included an overall comparison of the groups as well as repeated-measures analyses and adjustments for covariates. FINDINGS: The PPG showed a trend toward improvement of overt aggression and significant improvement of trait aggression compared with CBG. There were no differences in state aggression or efforts to control aggression. CONCLUSIONS: Both the PPG and CBG are effective treatments for aggression.

Cognitive Behavioral Therapy↗

PubMed1989

An evaluation of personal construct therapy for the elderly.

Short-term personal construct therapy was implemented with a group of elderly people, and its effects on their psychological states evaluated using content analysis scales. The states of these elderly were compared with those of two groups, one of well-functioning elderly and the other a group of elderly who were matched with the psychotherapy group for age, sex and type of chronic illness. Neither control group had psychotherapy. When compared with the fully functioning group immediately after therapy, the psychotherapy group showed less anxiety and depression. When compared with the matched group on follow-up 12 weeks later, they showed less anxiety, depression and indirectly expressed anger, and more feelings of competence as well as other good feelings.

Adaptation, Psychological↗

PubMed1989

Origins of psychogenic vaginismus.

Case histories of 22 women seeking psychotherapy for psychogenic vaginismus were examined for family patterns. Nearly all of the women had domineering, threatening fathers who were moralistic but also sexually seductive. The parents of these women had high levels of conflict and verbal and/or physical abuse in their marriages. The women with vaginismus were the 'good girls' of their families; obedient, unable to express anger and in constant need of approval. These women tend to choose partners who appear to be the opposite of their fathers; they seem kind, gentle and often passive. Both the women and their partners fear aggression. Women with vaginismus see intercourse as violation or invasion. The symptom serves to protect against violation. Most of the women either witnessed or experienced actual physical violation in their histories.

Adult↗

PubMed1995

Psychosocial risk factors and nonfatal myocardial infarction.

BACKGROUND: Numerous psychosocial factors have been hypothesized to play a role in coronary heart disease. However, existing studies have yielded inconsistent results. METHODS AND RESULTS: The relations between type A personality as well as suppressed versus expressed anger and risk of nonfatal myocardial infarction (MI) were studied in 340 patients and 340 age-, sex-, and community-matched control subjects. Subjects were interviewed at home to assess behavioral and medical cardiovascular risk factors, and fasting blood samples were obtained. Type A personality was associated with nonfatal MI in crude matched-pair analysis (OR, 1.57; 95% CI, 1.12 to 2.20; P = .008). Adjusting for known cardiovascular risk factors (including treated hypertension, body mass index, treated diabetes, family history of premature MI, physical activity, smoking, alcohol, total calories per day, and saturated fat) did not substantially change the magnitude of the point estimate, although the finding was no longer statistically significant (OR, 1.43; 95% CI, 0.97 to 2.09; P = .069). Further adjustment for lipids, including total cholesterol, total HDL, its subfractions (HDL2, HDL3), LDL, VLDL, and triglycerides, markedly attenuated the association (OR, 1.12; 95% CI, 0.66 to 1.90; P = .687), an effect due almost entirely to HDL cholesterol. Suppressed anger was positively but not statistically significantly associated with increased risk of MI in crude matched-pair analysis (OR, 1.33; 95% CI, 0.98 to 1.81; P = .065), in analysis adjusted for behavioral and medical cardiovascular risk factors (OR, 1.26; 95% CI, 0.89 to 1.78; P = .193), or after adjustment for lipids (OR, 1.11; 95% CI, 0.67 to 1.82; P = .695). CONCLUSIONS: These findings suggest a possible association of type A but not suppressed anger with risk of nonfatal MI that may be mediated by alterations in HDL cholesterol level. If decreases in HDL are not in the same causal pathway, then the apparent association between type A personality and risk of MI is due to confounding, principally by HDL.

Anger↗

PubMed1987

Psychiatric aspects of AIDS.

Acquired immune deficiency syndrome (AIDS) has neuropsychiatric and psychopathological complications: anxiety, depressive symptoms, and suicidal ideation are common. Patients may express anger toward ineffective medical care and perceived public discrimination, guilt about sexual practices or drug abuse, reactions to social isolation, and uncertainty about the implications of an AIDS diagnosis. CNS dysfunction and subsequent neuropsychiatric impairment are common and are initially characterized by decreased acuity, slowed mentation, and psychomotor retardation that can resemble depression. Marked global cognitive deficits, disorientation, and delusions ensue. The author discusses case management and outlines future clinical and research activities.

Acquired Immunodeficiency Syndrome↗

PubMed1988

Sex differences in recurrent depression: are there any that are significant?

The authors report on sex differences in a group of 230 patients with recurrent depression. Male and female patients were similar in clinical characteristics and baseline measures of severity. Some sex differences in depressive symptoms were apparent, especially as reflected by self-report instruments. The women reported more appetite and weight increase, more somatization, and expressed anger and hostility. The men demonstrated a more rapid response to treatment. Various interpretations of these findings are discussed.

Adult↗