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PubMed1989

Psychosocial variables and hypertension: a new look at an old controversy.

This paper reviews the recent evidence (1979 to 1986) from investigations of whether there is a link between psychosocial variables and elevations in blood pressure. Forty-eight empirical studies are summarized, discussed, and contrasted with reviews and methodological criticisms of past investigations. Strong support is found for an association between hypertension and such psychosocial factors as the identification and expression of anger, the use of inhibiting defense mechanisms (i.e., denial and repression), and interpersonal anxiety. Even when criticisms of the older literature are taken into account, the current finding show surprising continuity with past theoretical statements about the hypertensive personality.

Adaptation, Psychological↗

PubMed1986

Specificity of personality traits in borderline hypertension.

Patients with borderline hypertension tend to suppress expression of anger and hostility. However, if anything, they are psychologically hyperresponsive. The blood pressure elevation is maintained neurogenically in many with borderline hypertension. Consequently, it is tempting to postulate that suppressed anger causes neurogenic increases in blood pressure. Available data are inadequate to substantiate this hypothesis. It is equally plausible that neurogenic factors affect emotions, behavior and blood pressure. The terms specificity and directionality are introduced and defined to facilitate a better understanding of this important area of research.

Anxiety↗

PubMedDate not supplied

Antagonistic behavior, dominance, hostility, and coronary heart disease.

PURPOSE: This study investigated the relationship between antagonistic behavior, dominance, attitudinal hostility, and coronary heart disease (CHD). METHODS: One hundred one men and 95 women referred for thallium stress testing were administered the Structured Interview and the Cook-Medley Hostility Scale. The Hostile Behavior Index, derived from the Structured Interview and developed by Haney et al., served as an index of antagonism, and the frequency with which interviewees interrupted their interviewer served as a measure of dominance. On the basis of their medical history and thallium stress test results, patients were classified as having (N = 44) or not having (N = 99) CHD. RESULTS AND CONCLUSIONS: Multivariate logistic regressions (with age, gender, disease, and lifestyle risk factors in the model) revealed that both the Hostile Behavior Index and dominance were significant independent risk factors for CHD (relative risk [RR] = 1.22 and 1.47, p < .03). Of the two Hostile Behavior Index component scores, indirect challenge and irritability, only the latter correlated significantly with CHD (RR = 1.27, p < .03). Separate logistic regressions for men and women suggest that subtle, indirect manifestations of antagonism confer CHD risk in women and that more overt expressions of anger confer risk in men. A significant univariate correlation between hostility scale scores and CHD became not significant when we adjusted for socioeconomic status.

Aged↗

PubMed1995

Attachment and learning disability: a theoretical review informing three clinical interventions.

Attachment theory makes sense of two phenomena observed in some people with learning disabilities: it provides a reason for their limited exploration of the world, and it explains discontinuities in the pattern and intensity of their expressions of anger. Applying this framework to three enmeshed relationships occurring between an adult with learning disabilities and a member of care staff achieved at least partial resolution of their problems. Attachment theory's critics have set a number of challenges for its proponents, including emphasizing an interactional rather than a unidirectional approach to relationships; prioritizing social context; and understanding the attachment dynamic dimensionally rather than as a set of categories. The latter issue is pertinent for residential services: facilitating secure attachment relationships for distressed clients may be difficult for professionals, but partial assuagement of their attachment needs is a realistic clinical goal.

Adult↗

PubMed1993

Influence of socially desirable responding in a study of stress and substance abuse.

Socially desirable responding is the reluctance to admit unpopular beliefs or behavior in order to avoid making a negative impression. It poses a problem for researchers who rely on self-report of heavy drinking and drug use. The Marlowe-Crowne Social Desirability Scale (SDS), which measures socially desirable responding, was administered to 1933 respondents in a general population survey. The relationships between SDS and various self-report measures were examined. SDS was not correlated with gender or race, it increased with greater age and decreased with higher socioeconomic status. With age and socioeconomic status controlled, SDS had a moderate negative relationship with alcohol and drug use, and a strong negative relationship with variables reflecting the expression of anger. Correlations between drinking/drug use and such variables as age, marital conflict, and stressful life events were not substantially changed by controlling for SDS. It was concluded that social desirability response bias probably results in underestimates of rates of heavy drinking and drug use, but does not compromise the study of predictors of heavy drinking or drug use.

Adaptation, Psychological↗

PubMed1994

A descriptive study of physically aggressive behavior in dementia by direct observation.

OBJECTIVE: To study, by direct observation, physically aggressive behavior (PAB) in a cohort of older persons with dementia. DESIGN: Cross-sectional survey. SETTING: A locked special care unit for Alzheimer's Disease and an ordinary skilled unit of two suburban nursing homes. PARTICIPANTS: Twenty men and women with a history of PAB. MEASUREMENTS AND MAIN RESULTS: Portable bar-code-readers and daily diaries were used to determine the frequency of PAB as well as to elucidate the antecedents and consequences of it. PAB was most often directed toward staff (23/28 episodes), usually in the context of personal care (15/23 episodes). In the majority of cases, verbal aggression or non-compliance preceded the PAB. Most often PAB was followed by a rapid return to non-aggressive behavior. CONCLUSIONS: Very little PAB was truly spontaneous, nor was it usually the participant's normal behavior. Most PAB occurred in response to intrusion into the participant's personal space by staff or other residents. The PAB is better understood as a defensive response than an expression of anger.

Activities of Daily Living↗

PubMedDate not supplied

Clinical validation of characteristics of the alcoholic family.

PURPOSE: To validate, from a client and family perspective, the defining characteristics for the nursing diagnosis altered family processes: alcoholism; and to identify demographic, family, and selected treatment information from clients and family members. METHODS: Subjects (N = 150) completed Fehring's (1987) Clinical Diagnostic Validation (CVD) Index for 110 defining characteristics of the nursing diagnosis altered family processes: alcoholism. FINDINGS: Alcoholic families display behaviors of alcohol abuse, loss of control of drinking, denial, nicotine addiction, impaired communication, inappropriate expression of anger, and enabling behaviors. Family feelings indicate the presence of unhappiness, hurt, frustration, guilt, moodiness, powerlessness, loneliness, mistrust, anger, anxiety, and hopelessness. CONCLUSIONS: These clinically validated characteristics will complete the assessment phase of this research and direct the path to future studies to determine appropriate goals/outcomes and interventions related to alcoholic families.

Adult↗

PubMed1989

The emotional reactions of HIV antibody positive men.

This study was concerned with the emotional reaction of men who are HIV antibody positive, and with whether their expression of enjoyment is better viewed as the result of rigid defending or flexible coping. A sample of these men was matched with samples of patients with other major illnesses and well controls. Enjoyment was found to be more frequently expressed in the two ill samples, as were anxiety, depression and helplessness. The HIV antibody positive patients expressed more anger, and yet more competence, than the other patients. These patterns of emotional reaction proved to be modified by different levels of enjoyment in a manner more indicative of coping than defending, because depressive emotions appeared to be reduced when some enjoyment of life was apparent. The implications of these findings for health professionals working with people who are HIV antibody positive are discussed.

AIDS Serodiagnosis↗

PubMed2006

Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues.

OBJECTIVES: To assess critical incident exposure among prehospital emergency services personnel in the developing world context of South Africa; and to assess associated mental health consequences. METHODS: We recruited a representative sample from emergency services in the Western Cape Province, South Africa, to participate in this cross sectional epidemiological study. Questionnaires covered critical incident exposure, general psychopathology, risky alcohol use, symptoms of post-traumatic stress disorder (PTSD), and psychological and physical aggression between co-workers. Open ended questions addressed additional stressors. RESULTS: Critical incident exposure and rates of general psychopathology were higher than in studies in the developed world. Exposure to critical incidents was associated with general psychopathology, symptoms of PTSD, and with aggression between co-workers, but not with alcohol use. Ambulance, fire, and sea rescue services had lower general psychopathology scores than traffic police. The sea rescue service also scored lower than traffic police on PTSD and psychological aggression. The defence force had higher rates of exposure to physical assault, and in ambulance services, younger staff were more vulnerable to assault. Women had higher rates of general psychopathology and of exposure to psychological aggression. Other stressors identified included death notification, working conditions, and organisational problems. CONCLUSIONS: Service organisations should be alert to the possibility that their personnel are experiencing work -related mental health and behavioural problems, and should provide appropriate support. Attention should also be given to organisational issues that may add to the stress of incidents. Workplace programmes should support vulnerable groups, and address death notification and appropriate expression of anger.

Adolescent↗

PubMed1981

Crisis intervention following severe psychological trauma in late pregnancy.

Following the violent death of a Lamaze group instructor, a team of three psychologists provided crisis intervention to the group members to help them deal with the sudden death. All of the women in the group were in the advanced stages of pregnancy at the time. The team constructed an environment of group and couple support, presented and encouraged specific cognitive discussion of the event, and helped develop a temporary safe community. During the intervention, group members were able to express their anger, fear, guilt, and anxieties caused by the death. Comments by group members and the new group leader over the following weeks indicate the intervention was successful.

Adaptation, Psychological↗

PubMed1999

Homeless veterans' satisfaction with residential treatment.

OBJECTIVE: Because little is known about homeless individuals' satisfaction with mental health services or the association between satisfaction and measures of treatment outcome, the study examined those issues in a group of homeless veterans. METHODS: Demographic and clinical data were obtained from intake assessments conducted before veterans' admission to residential treatment facilities under contract with the Department of Veterans Affairs Health Care for Homeless Veterans program, a national outreach and case management program. Clients completed a satisfaction survey and the Community-Oriented Programs Environment Scale, which asks them to rate dimensions of the treatment environment. Outcome data came from discharge outcome summaries completed by VA case managers. RESULTS: Overall satisfaction with residential treatment services was high among the 1,048 veterans surveyed. Greater satisfaction was associated with more days of drug abuse and more days spent institutionalized in the month before intake and with an intake diagnosis of drug abuse. Regression analyses indicated that satisfaction was most strongly related to clients' perceptions of several factors in the treatment environment. Policy clarity, clients' involvement in the program, an emphasis on order, a practical orientation, and peer support were positively related to satisfaction; staff control and clients' expression of anger were negatively related. Satisfaction was significantly associated with case managers' discharge ratings of clinical improvement of drug problems and psychiatric problems. CONCLUSIONS: Homeless veterans are more satisfied in environments they perceive to be supportive, orderly, and focused on practical solutions. The results indicate that client satisfaction is not related to treatment outcomes strongly enough to serve as a substitute for other outcome measures.

Adult↗

PubMed2001

Respiratory psychophysiology in hypertension research.

The pathogenesis of hypertension results from an interaction of genetic and environmental factors. Behavioral factors might participate in sodium sensitive forms of hypertension via a cascade of physiological responses triggered by conditioned inhibition of breathing. When an individual decreases ventilation sufficient to increase pCO2 but not sufficient to activate chemoreceptor reflexes, plasma pH decreases transiently to stimulate a renal mechanism that can expand plasma volume via sodium retention. The combination of high resting pCO2 and high sodium intake elevates resting blood pressure in laboratory animals and healthy human participants. In the natural environment, this mechanism seems to be more important for the development of hypertension in women than in men, perhaps due to differential expression of anger and aggression. Studies are needed to clarify the role of breathing pattern in individual differences in resting pCO2 and the effects of breathing interventions on salt sensitivity and sodium sensitive forms of hypertension.

Carbon Dioxide↗

PubMed1987

Stage discrepancy in male couples.

Any characteristic in the developmental stages of relationships has the potential for being at the core of a stage discrepancy problem. A few of the more frequently seen stage discrepancies are (a) reappearance of the individual in Stage Three in conflict with the merging of Stage One, (b) reappearance of the individual in Stage Three threatening the dependability of the partner in Stage Four, and (c) the high limerence of Stage One in sharp contrast with the loss of limerence in Stage Two. As a side issue, and as has been stated elsewhere, one of the most common causes for terminating male relationships toward the end of the first year is the loss of limerence. Examples of characteristics in conflict are as numerous as the characteristics in male couples. In some instances, characteristics of later stages appear earlier as symptoms of insecurity, dependency, or difficulty in managing the aging process. Stage discrepancies often appear as behavioral manifestations, or as symptoms of the difficulties that the couple or individual is having in resolving the stage discrepancy problem. However, the conflicts are often presented to the psychotherapy as problems of: (a) developing or maintaining intimacy; (b) power, competition, or control issues; (c) jealousy; or (d) differences in dealing with expressions of anger or tenderness. Utilizing the framework of stages of relationships and the possibility of discrepancy in the developmental characteristics can give the psychotherapist added understanding of the presenting complaints of male couples, which in turn can lead to a better assessment of the couples' difficulties and the development of new strategies of treatment intervention.

Adaptation, Psychological↗

PubMed2006

The politics of "disregarding": addressing Zainichi issues within the lesbian community in Japan.

This article discusses the difference in positionality between Japanese lesbians and Zainichi (literally, "resident in Japan") Korean lesbians. The author first presents a narrative written by a Zainichi Korean lesbian, in which she expresses her anger toward Japanese lesbians. Setting her narrative as a starting point, the author retraces the controversial incident that occurred during the second Asian Lesbian Network (ALN) conference that was held in Japan in 1992. Through a re-reading of a series of narratives with regard to the second conference, the author demonstrates how the unequal power relations between Japanese lesbians and Zainichi Korean lesbians operate in what she calls the politics of "disregarding," where Zainichi Korean lesbians are continuously omitted from the consciousness of Japanese lesbians. doi:10.1300/ J155v10n03_05.

Congresses as Topic↗

PubMed2003

Development of the overt-covert aggression inventory.

The expression of anger in Japanese people is different from that of other races. We developed a new brief inventory, the Overt-Covert Aggression Inventory, to assess aggressive behavior ofJapanese people by focusing on their uniqueness and examined its reliability and validity. This inventory, the Center for Epidemiological Studies Depression scale, the Japanese version of the Buss-Perry Aggression Questionnaire, and the Picture-Frustration Study were administered to 3,104 men and 316 women in a factory. Internal consistency, test-retest reliability, concurrent validity, and construct validity of the scale were examined. We confirmed that the Overt-Covert Aggression Inventory has adequate reliability and sufficient concurrent validity, however, further studies of the construct validity and discriminant validity are required.

Adult↗

PubMed1986

[Perceptual categorization of emotional expression cued by ones back posture].

Subjects looked at 8 mm motion pictures of the bodily movement from rear view perspective of male and female communicators, who faced to emotionally-toned scenes. If the subjects detected some sign of emotional expression, they rated the relevance of expression on five point scale. Varimax rotated factor analysis yielded three factors: F1 rejection-acceptance, F2 avoidance-approach, and F3 sadness. Rejection was categorized as expressions of anger, disgust, and contempt, while anger was categorized when a clenched fist with forward and extended arm were observed. Disgust and contempt were categorized when stationary posture was observed. Acceptance was categorized when the signs of affection, anticipation, and acceptance were observed. Avoidance was categorized when signs of fear and surprise were observed. A typical fear was categorized when signs of freezing was observed, surprise was categorized by stepping back, and sadness was categorized by crouching and self attachment.

Adult↗

PubMed1983

Activity group counseling for learning-disabled children with behavior problems.

One of the most difficult problems confronting occupational therapists, teachers, and parents in dealing with latency-age learning-disabled children is handling oppositional behavior. Pre-adolescent boys, in particular, frequently have difficulty working cooperatively in a group, relating to peers, staying with a task, and seeing the consequences of their actions. This paper provides a rationale for treatment of children in groups and describes the development and early results of an activity group approach to counseling learning-disabled children with behavior problems using Gazda's developmental model. Group members showed improved ability to relate with siblings and peers; more mature and cooperative behavior; greater independence and impulse control; and increased verbal expression of anger. Parent and teacher feedback on behavior changes was positive.

Adolescent↗

PubMed1996

Acute psychologic stress reactivity in blacks versus whites:relationship to psychologic characteristics.

OBJECTIVES: To determine relationships among ethnicity, reactivity to acute stress and psychologic characteristics. DESIGN: We measured cardiovascular parameters and catecholamine levels at rest and after stress in a group of black and white men and women (45 blacks and 40 whites). METHODS: Blood pressure, heart rate, stroke volume, total peripheral resistance and catgecholamine measures of reactivity to a speaking stressor task were recorded. Multiple regression analysis was used to examine relationships between stress responsivity and psychologic characteristics in black and white subjects. RESULTS: Repeated-measures analysis of variance indicated that systolic and diastolic blood pressure reactivity was lower in blacks than in whites (P < 0.01). A multiple regression model that treated reactivity as a function of psychologic attributes and ethnicity suggested that psychologic attributes differentially affect racial physiologic reactivity. For example, expression of anger was related to lower blood pressure changes in whites but higher blood pressure changes in blacks. Conversely, hostility was related to increased blood pressure reactivity in whites but lower blood pressure reactivity in blacks. Greater task-induced changes in heart rate and stroke volume were related to higher depression scores in blacks but lower depression scores in whites. In addition, the relationship between coping style, anger, anxiety, and stress and catecholamine reactivity in blacks and whites. CONCLUSION: Our findings support those of previous studies; we identified racial differences in stress reactivity and psychologic characteristics that affect reactivity differently in blacks and whites.

Journal Article↗