The use of psychological models in medical education.
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Education, Medical, Undergraduate↗
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Age-related changes in social and psychological models predicting dental care in children.
Social and psychological factors associated with dental care were examined in two groups of children ages 6-8 and 9-11 years. Level of surface plaque, measures of dental health status (that is, total number of primary teeth decayed, missing, and filled [dmft] and total number of permanent teeth decayed, missing, and filled [DMFT] ), and frequency of dental visits were used as indicators of preventive behavior. The importance of social and psychological factors associated with these indicators was shown to vary with age group and with the specific preventive behavior indicator. Perceived level of dental anxiety and dental vulnerability were significantly associated with dental care, with dental anxiety being an important factor only in the lower group. Accessibility to a free school dental service was an important predictor of dental health status (DMFT) in the older age group, however, the data indicate that only when this service was offered within an organized structure of referral and transport was there an optimal effect on subsequent dental health.
Age Factors↗
The bereavement model, stroke and rehabilitation: a critical analysis of the use of a psychological model in professional practice.
PURPOSE: This pilot study aimed to explore with stroke survivors, carers and professionals, the impact of stroke and the process of recovery and rehabilitation. One theme that emerged in interviews with professionals was their use of the bereavement model in relation to recovery from stroke. The purpose of this paper is to explore the ways in which professionals use the bereavement model to explain and manage the rehabilitation of stroke survivors. METHOD: A person-centred study using qualitative research methods, semi structured interviews and self report diaries to explore with stroke survivors and carers the impact of stroke on their lives. Twenty-five interviews with stroke survivors, 23 individual or with carers and seven in two focus groups. Evidence from four self- report diaries provided more detailed examples of the everyday experiences of the survivors. A set of parallel interviews involving 17 professionals involved in the care and support of such individuals, nine individual and one group interview involving a community rehabilitation team. RESULTS: The bereavement model can be identified in the literature aimed at professionals, and was evident in some professional accounts of stroke but was absent from survivors' and carers' accounts of stroke. In over half the interviews, professionals made reference to the bereavement model to explain a process of loss and readjustment. While survivors in their accounts of life after a stroke did acknowledge the ways in which stroke disrupted every-day life and resulted in losses and disabilities, their perception of such losses and disruption was shaped by the context of their every-day life. Most survivors sought to actively manage their recovery by setting goals. They wanted professional support in achieving their goals. The bereavement model appeared to be used by professionals in situations where there was a conflict over goals and professionals felt that survivors had become 'stuck' and their goals unrealistic. CONCLUSIONS: Following stroke, people try to make sense of what has happened and normalize their lives by setting themselves goals to progress towards recovery. It is important that professionals communicate effectively so that their interventions are grounded in and support the survivors' goals and strategies.
Adult↗
When subgroups secede: extending and refining the social psychological model of schism in groups.
This article is about a field study (N=1,080) concerning the secession of a subgroup from the Church of England, and it is aimed at extending and refining the existing social psychological model of schisms in groups. It was found that the first step toward a schism is the belief that the group identity has been subverted. This belief will prompt negative emotions (i.e., dejection and agitation) and decrease both group identification and perceived group entitativity (i.e., cohesion, oneness). In turn, low group entitativity will reduce the level of group identification. Finally, low group identification and high negative emotions will increase schismatic intentions. It is also demonstrated that the negative impact of group identification, and the positive impact of negative emotions, on schismatic intentions is moderated by the perceived ability to voice dissent (i.e., the greater the perceived voice, the weaker the impact).
Adult↗
Voluntary childlessness: a social psychological model.
This research compares a nonprobability, precision-matched sample of 27 female undergraduates wishing to remain childless with 27 female undergraduates desiring to have children. The purpose was to test 8 hypotheses in an effort to explain the desire for a childless lifestyle at a relatively early age. A social psychological model is presented that elucidates some of the influential factors. The basic idea of the model is that such a choice can be analyzed in terms of 3 basic concepts: 1) family background factors; 2) self-other attitudes; and 3) reference groups. The data in this study, although collected at only 1 point in time, support the argument that these concepts play a central role in the decision to remain voluntarily childless. The family background factors are seen as instigative in the development of autonomy and achievement orientation. These 2 factors, accompanied by a belief that the advantages associated with childlessness outweigh the advantages associated with childbearing, predispose an individual to desire a childless lifestyle, particularly when these various attitudes are sustained through reference group support.
Attitude↗
Child abuse: a black perspective utilizing a social-psychological model.
The majority of models utilized in the formulation of the dynamics of child abuse rely upon an individual psychopathological frame of reference. Not only is this approach limited, but it renders primary preventive approaches virtually impossible. The author presents a social-psychological model, with the recommendation that it be applied among blacks. Essential to the model's applicability is the vulnerability of blacks to institutionalized racism and to the universal and destructive institutional abuse to which blacks are subjected. While often quite covert, this abuse is nonetheless extremely noxious, and serves to potentiate the view blacks have of themselves as undervalued individuals, and as individuals who have no alternative other than to commit abuse to others. Child abuse in blacks is viewed as reactive in nature-reactive to societal abuse. This adaptational model of child abuse, rather than precluding an individual psychopathological model, complements it. Use of this model should facilitate primary prevention with respect to child abuse. Current approaches to child abuse are comparable to "an ambulance service at the bottom of a cliff." What is lacking is an approach that will "fix the road on the cliff that causes the accidents." Only by examining the intricate interplay between individual and society can the factors that lead to child abuse be modified.
Black or African American↗
An empirical investigation of the 'Biopsychosocial Disease Consequence model': psychological impairment, disability and handicap in chronic pain patients.
The purpose of this study is to emphasize the meaningfulness of a global, functional rather than a narrow medical view in the efficacy evaluation of chronic pain treatment. Therefore, the 'Biopsychosocial Disease Consequence (BPSDC) model' to assess function more globally than before, is presented in this article. The model is based on two theories: (1) the biopsychosocial approach and (2) WHO's classification of impairments, disabilities and handicaps. In addition to the presentation of the conceptual model, the development of the hypothetical criteria and assessment models for psychological impairments, disabilities and handicaps, and the validity testing of the psychological assessment axis are described. Within each of the three classes, i.e. psychological impairments, disabilities and handicaps, the results supported the independence of the hypothetical criteria from each other. On the other hand, results suggested that some changes to the hypothetical assessment models for some of the criteria might be valuable. It was concluded that although the most adequate psychological assessment models for function, found in this study, can be considered as robust and recommendable as one set of tools for functional assessment, the main aim of this article is to encourage multidisciplinary team efforts to develop and systematize the assessment procedures of function in patients suffering from chronic diseases.
Adult↗
An investigation of the relationship between anxiety and depression and urge incontinence in women: development of a psychological model.
OBJECTIVES: The study investigated the association between anxiety and depression and urge incontinence and the direction of causal pathways between these variables. DESIGN: A prospective longitudinal postal survey. METHOD: A random sample of women aged 40 years or more, registered with a general practitioner in Leicestershire or Rutland, was mailed a postal questionnaire. The questionnaire included questions on general health, urinary symptoms and the Hospital Anxiety and Depression Scale (HADS). In total, 12,568 women responded to the baseline postal survey (65.3% response rate) and 9,596 to the first annual follow-up (79.8% response rate). The prevalence and one-year incident rates of these symptoms were compared and contrasted, whilst controlling for confounding variables. RESULTS: A significant proportion of women with urge incontinence reported symptoms of anxiety (56.6%) and depression (37.6%). Anxiety and depression were associated with a number of urinary symptoms and were not exclusive to urge incontinence. Incident cases of anxiety and depression were predicted by the presence of urge incontinence at baseline. Incident cases of urge incontinence were predicted by anxiety at baseline, but not depression. Anxiety, urge incontinence and frequency appeared to interact and exacerbate each other. CONCLUSIONS: The findings demonstrated the relevance of emotional factors in the development and maintenance of urge incontinence. Currently, assessment and treatment protocols for urge incontinence concentrate on physical symptoms and toilet behaviours. A more integrated psychological model of urge incontinence is proposed.
Adult↗
A psychological model of individual participation in formal voluntary organizations: application to some Chilean data.
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Adolescent↗
A psychological model of adjustment in gynecologic cancer patients.
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Adaptation, Psychological↗
A psychological model of social control and stigmatization: evolutionary background and practical implications.
The strengths and limitations of three main theoretical approaches to social control and stigmatization are discussed, originating from social psychology, sociology and anthropology, and evolutionary psychology, respectively. A theoretical model is proposed that integrates universal (evolutionary derived) psychological aspects of social control and the great variation that can be observed in responding to deviance within and between cultures and historical periods. Practical implications of the model are discussed.
Humans↗
The impact of behavior and addiction on psychological models of cigarette and alcohol use during pregnancy.
This prospective study of 241 women investigated the impact of past behavior and psychological factors on cigarette and alcohol use during pregnancy. Smokers' cigarette use was compared with their alcohol consumption during pregnancy, and drinking among smokers was compared with that of nonsmokers. Only prior smoking directly predicted smokers' cigarette use later in pregnancy, whereas smokers' alcohol use was related to both their previous drinking and their drinking self-efficacy. Among nonsmokers, neither drinking before nor early in pregnancy was related to alcohol use later in pregnancy; only subjects' self-efficacy and their beliefs about the consequences of drinking during pregnancy predicted their subsequent alcohol use. These results are consistent with the notion that greater addictive potential lessens the direct impact of psychological factors on substance use during pregnancy. Further implications of these findings for interventions and other health-related behaviors are also discussed.
Adolescent↗
Modeling psychological empowerment among youth involved in local tobacco control efforts.
The American Legacy Foundation funded 13 state health departments for their Statewide Youth Movement Against Tobacco Use in September 2000. Its goal was to create statewide tobacco control initiatives implemented with youth leadership. The underlying theory behind these initiatives was that tobacco control efforts can best be accomplished by empowering youth. To evaluate these initiatives, the authors developed a conceptual framework for youth empowerment that was used as a guide in developing standardized cross-site measures. This article describes the domains and attributes used to operationalize psychological empowerment as an outcome of youth involvement in these initiatives and presents results of our two-stage structural equation modeling. We conclude with a summary of lessons learned to date and recommendations for applying these findings to work in the field.
Adolescent↗
Equality of the psychological model underlying depressive symptoms in patients with temporal lobe epilepsy versus heterogeneous neurological disorders.
Controversy surrounds the question of whether there is a specific pattern of psychopathology or personality style observed in patients with temporal lobe epilepsy (TLE) or whether the symptoms of psychological distress reflect a common disorder such as depression. Measurement equivalence was examined to test the hypothesis that the latent variable model underlying scores on the Beck Depression Inventory (BDI) was equivalent across samples of patients with TLE (n = 187) and patients with heterogeneous neurological disorders (n = 150). A well-replicated model of depression or psychological distress comprising three related variables, negative attitude, performance difficulty, and somatic elements, displayed a pattern of strict metric invariance. This result suggests that the same set of latent variables is measured with the same metric relationship between item scores and latent variables in patients with TLE and in patients with heterogeneous neurological disorders.
Adult↗
A conceptual overview of a proactive health psychology service: the Tripler Health Psychology Model.
The military patient population, the demanding environment in which medical services are provided, and the rigors of the operational environment create a unique challenge for service members as well as military health care providers. Within the military medical system, the subspecialty of clinical health psychology may provide patient care and consultation interventions necessary to meet the demands of the unique Army medical and military communities. As funding and other resources decrease, military health psychologists can provide high-quality care to difficult-to-manage patients while increasing outcome efficacy and decreasing costs to the hospital. This paper provides a definition of clinical health psychology and a description of its unique interventions and applications and how these unique skills augment medical services. Moreover, we offer a conceptual model for an innovative health psychology program that will assist other military treatment facilities in designing programs to increase outcome efficacy and concurrently reduce costs and utilization of services.
Clinical Competence↗
Towards a psychological model of midlife crisis.
Midlife crisis in men is seen as a process of intensive and subjectively difficult transition of the self dealing with a reinterpretation of time perspective, the confrontation with death as a future personal event, the re-evaluation of life values and goals, and planning the second half of life. Midlife crisis arises on the relationships between the changing sociopsychological situation and internal predispositions. This study was conducted in Poland, using a sample of 144 men (aged 35-45 years). Measures were the Midlife Crisis Questionnaire, the Time Orientation Scale, the Adjective Check List, the modified version of the Ways of Coping Checklist, and the Value crisis Questionnaire. The findings indicated that the midlife crisis consists of three relatively independent dimensions, extracted by factor analysis, namely, (i) intensity of symptoms focused on changes in the self-concept, (ii) psychological maturity, and (iii) acceptance of time passing and death. Necessary and sufficient conditions of the crisis appeared to be (1) value crisis, understood as difficulties in hierarchization, integration, and realization of values, (2) emotion-focused coping versus problem-focused coping, (3) past versus future time orientation and lack of goals for the future, (4) sense of time pressure, (5) some conscientiousness, introversion, and openness to experience.
Adaptation, Psychological↗
The approval of suicide: a social-psychological model.
This article develops and tests a model that seeks to explain individual variation in the approval of suicide. The model draws on the three leading theories of crime/deviance: strain, social learning, and social control theories. It is predicted that individuals will be most approving of suicide when (1) they have had major life problems that could not be solved through conventional channels, (2) they were taught or exposed to beliefs that favored or were conducive to suicide, and (3) they are not strongly attached or committed to conventional individuals and groups. These predictions are explored with data from the 1990 and 1991 General Social Surveys, based on a nationally representative sample of adults in the United States. The results provide partial support for the predictions, especially the second prediction, with the strongest correlates of suicide approval being education, political liberalism, and a set of religion variables.
Adaptation, Psychological↗
[The value of child development psychological models for child and adolescent psychiatry].
The literature on personality research, developmental psychology and psychopathology has consistently revealed two types of personality. According to different theoretical and methodological approaches these types are considered as prototypes of a personality dimension, or as behavioral patterns in psychopathology. In the research on adult personality, they are known as extraversion and introversion. Child psychiatrists refer to these prototypes as externalizing and internalizing disorders. However, there are few empirical studies on the congruency between adult personality types and childhood disorders. Longitudinal studies from the USA and New Zealand give evidence that adult personality types can predict coping styles of school age children in stressful and challenging situations. Research on infant attachment to caregivers, revealing consistently different qualities of interaction patterns, may also be predictive for different coping styles in children of preschool age. Interdisciplinary discussions will focus on the question, whether early behavior patterns should be seen as predictors for adult traits (homotypic continuity) or as developmentally determined indicators for underlying functions (heterotypic continuity). Possibly, in early developmental stages behavior patterns have adaptive functions and in later stages become chronic strategies over time. Another topic concerns the relation between personality traits and pathologic behavior patterns and whether chronic strain may be influential.
Adaptation, Psychological↗