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PubMed2000

Eating self-efficacy and weight cycling: a prospective clinical study.

Previous retrospective studies have not identified global psychosocial consequences of weight cycling. These lack of findings may be due to limitations associated with retrospective research or with using general psychological measures rather than weight-specific measures. This prospective study examined changes in a weight-specific measure, eating self-efficacy, using an obese clinical population who returned to a multidisciplinary weight management program subsequent to weight regain. Subjects did not demonstrate any change in eating self-efficacy despite experiencing weight loss and then weight regain. Individuals returning for treatment may be a select population, thus suggesting that there may not be negative psychological effects of weight cycling for all individuals. Implications for further research are discussed.

Journal Article↗
PubMed2001

Post-traumatic stress disorder in primary-care settings: prevalence and physicians' detection.

BACKGROUND: Little is known about the prevalence of PTSD in primary-care settings and regarding the ability of primary-care physicians to detect PTSD. The current study examines prevalence of PTSD in a national sample of primary-care attenders and primary-care physicians' detection of PTSD and general psychological distress in PTSD patients. METHODS: Data are from a national study of 2975 primary-care attenders in Israel. Demographic data, responses to the GHQ-28, PTSD Inventory and physicians' diagnoses were examined. RESULTS: Twenty-three per cent of all patients who attended clinics (N = 684) reported traumatic events, 39% of whom (males 37%, females 40%) met criteria for PTSD on the PTSD Inventory. Eighty per cent of the males and 92% of the females with PTSD were distressed according to the GHQ. According to physicians, 37% of persons who reported trauma (40% of the women, 32% of the men) suffered from psychological distress. Only 2% of patients meeting PTSD criteria on the self-report measure were given a diagnoses of PTSD by physicians. CONCLUSIONS: Many primary-care patients suffer from PTSD, which is usually accompanied by major psychological distress. Attention by primary-care physicians to a history of trauma could improve physicians' detection of this disabling disorder.

Diagnosis, Differential↗
PubMed2002

Emotion regulation: affective, cognitive, and social consequences.

One of life's great challenges is successfully regulating emotions. Do some emotion regulation strategies have more to recommend them than others? According to Gross's (1998, Review of General Psychology, 2, 271-299) process model of emotion regulation, strategies that act early in the emotion-generative process should have a different profile of consequences than strategies that act later on. This review focuses on two commonly used strategies for down-regulating emotion. The first, reappraisal, comes early in the emotion-generative process. It consists of changing the way a situation is construed so as to decrease its emotional impact. The second, suppression, comes later in the emotion-generative process. It consists of inhibiting the outward signs of inner feelings. Experimental and individual-difference studies find reappraisal is often more effective than suppression. Reappraisal decreases emotion experience and behavioral expression, and has no impact on memory. By contrast, suppression decreases behavioral expression, but fails to decrease emotion experience, and actually impairs memory. Suppression also increases physiological responding for suppressors and their social partners. This review concludes with a consideration of five important directions for future research on emotion regulation processes.

Affect↗
PubMed1998

Reliability and validity of the Gastrointestinal Symptom Rating Scale in patients with gastroesophageal reflux disease.

The objective of this study was to evaluate the reliability and validity of the gastrointestinal Symptom Rating Scale (GSRS) in US patients with gastroesophageal reflux disease (GERD). Five hundred and sixteen adults with predominant heartburn symptoms of GERD were recruited from gastroenterologist and family physician practices and treated with 6 weeks of 150 mg ranitidine twice daily to identify poorly responsive symptomatic GERD. The GSRS, the Medical Outcomes Study Short Form-36 (SF-36) Health Survey and the Psychological General Well-being (PGWB) scale were administered at baseline and after 6 weeks of treatment. Reported ratings of GERD-related symptoms from physician and patient diaries were measured. The GSRS contains five scales: reflux syndrome, abdominal pain, constipation syndrome, diarrhoea syndrome and indigestion syndrome. The internal consistency reliabilities for the GSRS scales ranged from 0.61 to 0.83 and the intraclass correlation coefficients ranged from 0.42 to 0.60. The GSRS scale scores were correlated with the SF-36 and PGWB scales and with the number and severity of heartburn symptoms. Patients with two or three clinician-rated GERD-related symptoms reported worse GSRS scale scores compared with patients with fewer symptoms (p < 0.0001). Statistically significant differences in the mean GSRS scale scores were observed between treatment responders and non-responders (p < 0.0001) and patients showing a response to treatment had larger mean changes in their GSRS scales than patients not showing a response to treatment (p < 0.0001). The standardized response means ranged from 0.42 to 1.43 for the GSRS scale scores. It was concluded that the GSRS is a brief, fairly comprehensive assessment of common gastrointestinal symptoms. The GSRS has good reliability and construct validity and the GSRS scales discriminate by GERD symptom severity and are responsive to treatment. The GSRS is a useful patient-rated symptom scale for evaluating the outcomes of treatment for GERD.

Adult↗
PubMed2001

A review of the health-related quality of life literature in bipolar disorder.

This paper reviews the existing literature on health-related quality of life assessments conducted in bipolar disorder patients, and provides recommendations for the use of specific scales to measure health-related quality of life in this population. A comprehensive review of the literature revealed only a handful of studies in bipolar disorder that had incorporated quality of life assessments. While instruments from the medical outcomes study (MOS) were the most frequently used to measure health-related quality of life, a number of other instruments like the psychological general well being scale (PGWB), the streamlined longitudinal interview clinical evaluation from the longitudinal interval follow-up evaluation (SLICE/LIFE), the Euroqol, (EQ-5D), the Lehman's quality of life interview (QLI), and the quality of life in depression scale (QLDS) were also used. Only three studies out of ten reported the psychometric properties of the measures used. In the absence of a disease-targeted measure, a combination of the SF-36 and the PGWB is presently recommended as the battery of choice to assess the health-related quality of life of individuals with bipolar disorder. There is also the need to develop a disease-targeted health-related quality of life measure for bipolar disorder, which will obviate the use of a burdensome battery of generic quality of life instruments.

Bipolar Disorder↗
PubMed1997

Discriminative aspects of two generic and two asthma-specific instruments: relation with symptoms, bronchodilator use and lung function in patients with mild asthma.

The objective of this study was to compare the two most frequently used asthma-specific quality of life (QOL) questionnaires and two generic QOL questionnaries with clinical data in order to establish their ability to discriminate in asthma severity, also referred to as cross-sectional construct validity. We conducted a multicentre, randomized, placebo-controlled study investigating the long-term effects of the long-acting beta 2-agonist formoterol in asthma patients using inhaled corticosteroids and short-acting beta 2-agonists. Before randomization, the peak expiratory flow (PEF) and use of beta 2-agonists for relief of symptoms were recorded twice daily for 1 month. At the end of the run-in period, the forced expiratory volume in 1 s (FEV1), airway hyper-responsiveness (PC20 methacholine) and QOL were measured, using two asthma-specific questionnaires, the Asthma Quality of Life Questionnaire (AQLQ) and the Living with Asthma Quality of Life Questionnaire (LWAQ), as well as two generic questionnaires, the Short Form 36 (SF-36) and the Psychological General Well Being (PGWB) index. The quality of life of the patients (n = 110) was only mildly impaired. The mean symptom score was 3.6 on a scale of 0-21 and the mean FEV1 was 65% of that predicted. The correlations between the QOL parameters and objective measures of asthma severity, such as the FEV1, PEF and PC20, were low (0.01-0.37). The correlations between the QOL parameters and subjective measures of asthma severity, such as symptom scores (range 0.26-0.65) and beta 2-agonist use for the relief of symptoms (0.09-0.39), were higher. The correlations of the activity and symptoms domains of the AQLQ with diary-obtained symptom scores were r = 0.50 (p < 0.0001) and r = 0.65 (p < 0.0001), respectively. The correlation between the physical construct of the LWAQ and symptom scores was r = 0.42 (p < 0.001) and that between the physical sumscore of the SF-36 and symptom scores was r = 0.50 (p < 0.001). The correlation between the PGWB and symptom scores was r = 0.41 (p < 0.001). The relation between the FEV1, PEF and PC20 and QOL was very low. The QOL measurements related well to the symptom scores. The AQLQ had a better cross-sectional construct validity than the LWAQ. The cross-sectional construct validity of the SF-36 was surprisingly high for this group of patients and the SF-36 performed better than the PGWB and LWAQ.

Adrenergic beta-Agonists↗
PubMed1998

Women in a prenatal care/substance abuse treatment program: links between domestic violence and mental health.

OBJECTIVES: This study examines the prevalence of violence experienced by patients enrolled in the Step by Step program, a combined prenatal care/substance abuse treatment program at the Wake County Health Department in North Carolina. In addition, potential associations between violence and sociodemographic characteristics, substance use, and mental health are investigated. METHOD: All prenatal care/substance abuse treatment patients who met study eligibility criteria (N = 84) were assessed by health care providers. Descriptive statistics and bivariate analyses were used to compare victims of violence and nonvictims on a wide range of variables. Multiple linear regression analysis estimated the impact of the women's experiences of violence on their levels of mental health symptoms while controlling for confounding factors. RESULTS: Forty-two percent of patients had been victims of both sexual and physical violence, and 30% had been victims of physical violence alone. The combination of sexual and physical violence was significantly less common among African-American women compared with other women. No other significant differences were found between victims and nonvictims in terms of sociodemographics or substance use. Compared with nonvictims, victims of the combination of sexual and physical violence had significantly elevated levels of general psychological distress as well as elevated levels of hostility, depression, anxiety, interpersonal sensitivity, and somatization. However, no significant differences in levels of mental health symptoms were observed among women who had experienced physical violence in the absence of sexual violence. CONCLUSIONS: Questions concerning experiences of violence, including sexual victimization, should be incorporated into the clinical history-taking procedures of professionals working within prenatal care/substance abuse treatment programs so that effective interventions that take experiences of violence into account can be put into place for these high-risk women.

Adult↗
PubMed2003

Attraction and social coordination: mutual entrainment of vocal activity rhythms.

To investigate factors that affect the mutual entrainment of vocal activity rhythms, female general psychology students paired according to attitude similarity questionnaires engaged in 40-minute introductory conversations. Fourier analyses performed on speakers' on-off vocal activity demonstrated periodic oscillations in talkativeness. Although some dyads coordinated their vocal activity rhythms, speech accommodation was not predicted by attitude similarity or attraction and did not affect ratings of conversation quality. These rhythms of dialogue appear resistant to change, their behavioral momentum rooted perhaps in an underlying chronobiology.

Adolescent↗
PubMed1998

Effects of psychotherapeutic treatments for PTSD: a meta-analysis of controlled clinical trials.

This meta-analysis synthesized the results from controlled, clinical trials of psychotherapeutic treatments for posttraumatic stress disorder (PTSD). Psychotherapeutic modalities included behavioral, cognitive, and psychodynamic treatments, in group and individual settings. Participants in the studies included combat veterans from the Vietnam and Lebanon Wars, crime-related victims, and severe bereavement sufferers. The impact of psychotherapy on PTSD and psychiatric symptomatology was significant, d = .52, r = .25, when measured immediately after treatments were administered. Similarly, there was no decay in the effect of treatment at follow-up, d = .64, r = .31. Moreover, for target symptomes of PTSD and general psychological symptomes (intrusion, avoidance, hyperarousal, anxiety, and depression), effect sizes were significant, ranging from r's of .2-.49. Results suggest substantial promise for improving psychological health and decreasing related symptoms for those suffering from PTSD.

Clinical Trials as Topic↗
PubMed1999

Psychometric properties of a hurricane coping self-efficacy measure.

This brief report describes the psychometric properties of an instrument designed to measure Hurricane Coping Self-Efficacy (HCSE). Survivors of Hurricane Andrew (n = 165) and Hurricane Opal (n = 63) completed the HCSE and assessments of optimism, social support, distress, and resource loss. Principal components factor analyses revealed a unidimensional structure for the HCSE. Internal consistency of the HCSE was strong. In both samples, HCSE was positively associated with optimism and social support, but negatively associated with general psychological distress, trauma related distress, and resource loss. Finally, hierarchical regression analyses demonstrated that the HCSE explained a significant amount of experimental variance for intrusive thoughts and avoidance after controlling for social support, lost resources, and optimism.

Adaptation, Psychological↗
PubMed2000

Relationships between occupant personality and the sick building syndrome explored.

Increasing evidence shows that certain personality traits, such as negative affectivity (trait NA), are strongly associated with the reporting of symptoms. The role of personality in sick building syndrome (SBS) symptom reporting is therefore explored with the aid of a questionnaire completed by occupants living in apartments with indoor climate problems. A good fit to empirical data was obtained for a path model in which somatization intervenes between a general psychological factor (predominated by trait NA) and SBS. Occupants with "normal" and "aberrant" NA profiles were classified by cluster analysis and further divided according to frequency of symptoms. For occupants with 5 or more SBS symptoms, those with "aberrant" NA profiles have very similar SBS symptom profiles to those with "normal" NA profiles. This indicates that an occupant's trait NA score cannot be used for predicting his or her SBS symptom profile or frequency of SBS symptoms. An unexpected finding was that the occupants with "aberrant" NA profiles also perceived factors in the indoor (air) environment as less adverse than the 5 or more symptom reporting occupants with "normal" NA profile. Pennebaker and Brittingham's competition of external and internal cues model may explain the results for the occupants with "aberrant" NA profiles, however, our empirical data indicate that, unexpectedly, these occupants may not over-report SBS symptoms but rather under-report adverse environmental perceptions.

Adolescent↗
PubMed1993

Adult marijuana users seeking treatment.

In an effort to study the efficacy of attracting and intervening with adult marijuana users, 290 men and 92 women were screened for participation in a treatment-outcome study focused on marijuana cessation. The well-educated, self-referred sample reported using marijuana on 79 of the past 90 days before testing. Indices of the severity of marijuana abuse and general psychopathology were in the clinical range for a majority of Ss. Ss who did not report evidence of alcohol or other drug abuse (n = 144) reported less severe consequences of marijuana use and experienced less general psychological distress than Ss who also reported lifetime (n = 165) or current abuse (n = 73) of other substances in addition to marijuana. The findings indicate the need for clinical research targeting adults who are dependent on marijuana.

Adult↗
PubMed1988

Academic stress, social support, and secretory immunoglobulin A.

We examined the relation of academic stress and social support to salivary concentrations of secretory immunoglobulin A (S-IgA), an antibody class that plays an important role in mucosal defense against acute upper respiratory tract infections. We assayed whole, unstimulated saliva samples collected from 15 healthy undergraduates 5 days before their final exam period, during their exam period, and 14 days after their last final exam for S-IgA concentrations by single radial immunodiffusion. The students rated the university's general psychological climate as being more stressful during the exam period compared with the two other periods. Paralleling this, their salivary concentrations of S-IgA were lower during the exam period. Students who reported more adequate social support at the preexam period had consistently higher S-IgA levels than did their peers reporting less adequate social support. This latter finding is consonant with the social support direct effects hypothesis, which states that social support enhances health outcomes irrespective of whether the individual is exposed to stressful experiences.

Achievement↗
PubMed1993

"Judgable" people: personality, behavior, and competing explanations.

"Judgability" discriminates people who are open and knowable from those who are closed and enigmatic. The current study investigated this individual difference characteristic and its personality and behavioral correlates. Subjects (N = 164) were videotaped interacting with a partner of the opposite sex. They completed several personality measures, and each subject was described by 2 friends. Three indices--subject-peer agreement, peer-peer agreement, and peer-behavior agreement--formed a reliable composite index of judgability. The correlates of judgability included extraversion, agreeableness, conscientiousness, emotional stability, and, more generally, psychological adjustment.

Adult↗
PubMed2000

Perceptual independence of whole length, partial length, and hand position in wielding a rod.

Previous investigations of dynamic touch have shown that, in wielding an occluded rod, the nonvisible perceptions of total rod length, hand position, and fractional rod length above or below the hand are different functions of the eigenvalues and eigenvectors of the inertia tensor. The implication that the 3 perceptions are independent covariants of the inertia tensor of a wielded object was tested with the complete identification experimental procedure using the statistical prescriptions of F. G. Ashby and J. T. Townsend (1986). The confirmed independence is discussed in the context of the generalized psychological or perception-information hypothesis.

Adult↗
PubMed1997

The development of an empirical psychosocial taxonomy for patients with diabetes.

The main purpose of this study was to develop and to cross-validate an empirically derived psychosocial taxonomy of patients with diabetes. In the first study, 101 patients with Type I or Type II diabetes completed the Multidimensional Diabetes Questionnaire. Cluster analysis identified three clusters, labeled adaptive copers, low support-low involvement, and spousal overinvolvement. In the second study, the taxonomy was cross-validated using an independent sample of 132 patients with long-standing Type II diabetes. The results confirmed that the multivariate classification system was unique and highly accurate. External validation, using general psychological as well as diabetes-specific measures, supported the validity and distinctiveness of the patients' profiles. These findings help establish a multiaxial psychosocial taxonomy of diabetes and may have significant implications for the management of patients with diabetes.

Adaptation, Psychological↗