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Risk factors and correlates of dating violence: the relevance of examining frequency and severity levels in a college sample.

To determine whether categorizing levels of violence along dimensions of frequency and severity would result in informative distinctions among individuals using dating violence, reported use of physical violence, along with variables theorized to be related to use of force in intimate relationships, was assessed in a sample of 617 college students (males = 290; females = 327). When participants' scores were analyzed by dichotomizing them along the lines of ever versus never using dating violence, numerous past findings were replicated. However, participants using a higher frequency of force were distinguished by needing to control their partner and by less inhibition in expressing their anger. Higher severity of force by an individual was predicted only by a need to control his/her dating partner. Implications for these findings were discussed.

Adaptation, Psychological↗

Psychotherapy and honoring parents.

This paper raises halachic issues regarding psychotherapy and honoring parents. A recognized halachic authority was asked to respond to a clinical case that involved the psychological treatment of a college student sexually abused by her father, where an important aspect of treatment focused on helping her discover and express her anger towards the offending parent instead of suppressing and internalizing it. Ramifications of the rabbi's ruling are summarized by an halachic scholar.

Adolescent↗

Unsuitable anger.

Explore the source record for details and available documents.

Adaptation, Psychological↗

EMOTIONAL REACTIONS TO DISFIGUREMENT FROM CANCER THERAPY.

Disfigurement not only produces current anxieties but reactivates childhood conflicts. The emotional reaction depends upon the disturbance to the patient's major adaptations to life as well as the meaning of the organ to the patient. Fear of isolation and rejection by others may be more terrifying than fear of death. Emotional reactions include regression with marked dependency, anxiety, depression, hostility and, if severe, paranoid states, hypochondriasis, denial, counterphobic behaviour, obsessive-compulsive reactions and schizophrenic reactions. Management basically involves early establishment of a positive doctor-patient relationship. In such a relationship the physican should educate his patient, undercut guilt, accept transient regression and expression of anger, set limits on counterphobic behaviour, either support or gently question denial of reality, and support, without being overly sympathetic, a depressed patient. The nurse, social worker, psychiatrist and the patient's family may be valuable members of the therapy team. Disfigurements of various body areas pose individual problems of management.

Amputation, Surgical↗

Breast cancer--a woman's perspective.

This paper is bound to arouse controversy. It already has. No article in this special issue has been more thoroughly reviewed or had more widely divergent opinions. Some reviewers thought it expressed unrelieved anger; others felt it described the experience, perceptions, and feelings of many women with breast cancer. The paper seemed important to publish, however, because breast cancer is the second most common tumor occurring in American women. It is important to note that the author is a successful teacher and health professional who has a full and active family and social life. She describes encounters with breast cancer in an uncommonly fervent and articulate way. These encounters have clearly left deep scars. The essay is not scientific and not balanced in this issue by a paper by a women who had a wonderful experience with breast cancer. Such a paper may never be written. Read on!

Adaptation, Psychological↗

Rape--victiminological and psychiatric aspects.

Rape is a violent crime in which sexuality is used to express power, anger, and aggression. The nature of the victim's reactions, which resembles those of other violent crimes, is discussed in relation to its origin in the doctrine of victimology. The distress experienced by victims of rape should entitle them to the same standards of care and sympathy as victims of other life crises.

Counseling↗

Non-organic failure to thrive: a developmental perspective.

Like other segments of the child's development, eating behavior follows a sequential pattern. To understand the infant's or child's feeding problems which can lead to failure to thrive or dwarfism we propose that a child's progression be studied through three stages of development: homeostasis, attachment and separation-individuation. Specific feeding problems can arise at each of these stages of development and consequently impede the child's weight gain. During the period of homeostasis the infant learns to regulate himself, to suck, to swallow and to time the onset and termination of feedings by giving signals of hunger and fullness. If he is unable to master these, he cannot be fed effectively. Failure to master these basic feeding skills interferes with the next developmental task of attachment and also impedes development of motor skills, language and affective engagement. During the period of attachment, the infant establishes distinct interactional patterns with his caretakers. Lack of engagement between mother and infant leads to lack of pleasure and lack of appetite or even to severe dysfunctional feeding patterns like vomiting and rumination. Feeding problems in the third developmental stage of separation and individuation can arise because of maladaption in the attachment phase or because of new difficulties which center around issues of autonomy vs. dependency. At this stage, the infant learns means-end differentiation and begins to understand that his actions elicit certain consequences. If the infant's struggle between autonomy and dependency gets caught in the feeding situation, the infant's emotional needs can dictate his eating behavior. The infant refuses to eat either to have his emotional hunger for mother's attention met or to assert his autonomy and to express his anger toward her. In order for the infant to learn to differentiate between his physiological feelings of hunger and his emotional need states, the caregiver needs to give contingent responses by offering food when the infant is hungry and comfort when the infant is distressed. Feeding problems which can create, co-exist with, or result from a growth problem must be considered within a developmental context. As the infant progresses through the developmental stages of homeostasis, attachment, and separation, he masters phase-appropriate feeding skills which help him to progress from reflex sucking to autonomous feeding. Early identification of maladaptive feeding behavior will assist the pediatrician in making timely interventions.

Child↗

Coping with AIDS and AIDS-risk reduction efforts among gay men.

Because AIDS has been identified as a major source of stress among gay men, coping models may contribute to an understanding of factors related to changes in and failure to change sexual behavior. Gay men in Long Beach, California, were surveyed to determine whether appraisal and coping are factors in efforts to reduce transmission risk for the human immunodeficiency virus (HIV). Factor analysis of the appraisal and coping items yielded factor structures similar to those reported by earlier coping investigators and that were differentially associated with reported reductions in risk for HIV transmission and with reported intent to engage in high- and low-risk sexual behaviors. Risk-reduction efforts and intent were associated with health-threat (to self or to partner) primary appraisals, secondary appraisals that respondents could change or do something about AIDS, and the coping factors of self-control, seeking social support, and confrontive coping (expression of anger). In addition, intent to engage in relatively high-risk behavior was associated with passive coping (acceptance). These results are discussed in terms of their relevance for risk-reduction education programs and for future research.

Acquired Immunodeficiency Syndrome↗

[Family emotional climate of pain patients].

Personal clinical experiences in an interdisciplinary pain clinic and their integration into family interaction theories led to a concept of an explorative study of chronic pain patients. Therefore 32 patients and their spouses were investigated with the "family-environment-scale" (by Moos and Moos 1981, adapted by Schneewind et al. 1985). Most of the couples showed agreement with regard to familial solidarity, combined with few expressions of anger and conflict and low achievement orientation. The typical profile of these factors led to one group with the "positive-emotional family climate", in contrast to one group with the "normative-authoritative family climate". In addition, a potentially new factor was described as a so-called "symbiotic family climate". The latter constellation was on the one hand quite similar compared to the "positive-emotional climate", but differed on the other hand because of the small amount of structural control. The interference of these family climate profiles with the process of chronification for pain patients is discussed.

Adult↗

Cardiovascular risk and responsivity to mental stress: the influence of age, gender and risk factors.

BACKGROUND: Exaggerated cardiovascular and neuroendocrine responses to mental stress may enhance cardiovascular disease risk. Coronary heart disease and hypertension increase in prevalence with advancing age, whereas the excess male/female ratio declines in later middle age. Psychosocial factors may contribute to these changing risk profiles. The hypothesis that cardiovascular and neuroendocrine stress responses are associated with age and gender differences in cardiovascular disease risk was tested. METHOD: 132 healthy men and women from younger (30-40 years) and older (55-66 years) age bands were selected at random from general practice lists. They performed a series of mental stress tests during which blood pressure, heart rate, cardiovascular baroreflex sensitivity, cortisol, respiration patterns and electrodermal activity were monitored. A submaximal exercise test was performed and psychological characteristics were assessed by questionnaire. RESULTS: At rest, systolic and diastolic blood pressure was higher in men than in women, while cardiac baroreflex sensitivity was greater in younger than in older participants. Blood pressure responses to tasks were substantial, with changes from the baseline averaging 18.6/8.11, 26.0/13.5 and 40.7/19.0 mmHg for computerized problem solving, mirror drawing and speech tasks, respectively. Men and women in the older age band did not differ from each other in blood pressure, heart rate or baroreflex sensitivity responses. Systolic blood pressure responses (mean +/- SEM) were larger in older than in younger women (mean peak difference 6.87 +/- 2.67 mmHg), and in the younger male compared with the younger female groups (mean peak difference 7.20 +/- 2.97 mmHg). Diastolic blood pressure and heart rate responses to mental stress were larger in younger than in older age participants of both sexes. Baroreflex sensitivity was inhibited during behavioural tasks, with significantly greater suppression in younger than in older groups (5.28 +/- 0.52 and 2.62 +/- 0.35 ms/mmHg, respectively). Cortisol responses were greater in men than in women, but did not vary with age. Across the entire sample, systolic blood pressure responsivity was negatively related to the expression of anger. Among older men, heightened blood pressure responses were associated with elevated fasting low-density lipoprotein cholesterol levels, and with lower concentrations of high-density lipoprotein cholesterol. CONCLUSIONS: Systolic blood pressure stress responsivity increases with age in women but not in men. Other data do not support the notion that stress responsivity mediates age and gender differences in cardiovascular disease risk. However, in middle-aged men, ex-aggerated cardiovascular stress responsivity is associated with an unfavourable risk profile.

Adult↗

Psychological factors and survival in the cardiac arrhythmia suppression trial (CAST): a reexamination.

BACKGROUND: Evaluating the independent effects of psychosocial and physiological factors on survival of cardiac patients is difficult because it requires obtaining extensive physiological and psychosocial data and long-term follow-up of high-risk patients. OBJECTIVES: To examine the independent contributions of psychosocial and physiological status to survival of patients who had had myocardial infarction. METHODS: The sample consisted of 348 patients in the Cardiac Arrhythmia Suppression Trial who had asymptomatic ventricular arrhythmias after myocardial infarction. Psychosocial status was assessed with the Social Support Questionnaire-6, Social Readjustment Rating Scale, State-Trait Anxiety Inventory, Self-Rating Depression Scale, Jenkins Activity Survey, and Expression of Anger Scale. Physiological data included measurement of left ventricular ejection fraction; history of previous myocardial infarction, congestive heart failure, and diabetes; and results of Holter monitoring. RESULTS: At the first follow-up, after the effect of the physiological predictors was controlled for, psychosocial factors were significant independent predictors of survival. Among men in the nonactive medication group (n = 263), higher state anxiety, lower anger outward, more past life events, and lower expectations of future life events were predictors of mortality. Data suggested that the relationship of anger to mortality might differ for men and women. Increases in past life events and depression from baseline to first follow-up were greater among those who died than among those who lived. CONCLUSION: Among patients who had asymptomatic ventricular arrhythmias after myocardial infarction, psychological status during the period after infarction contributed to mortality beyond the effect of physiological status. The results reaffirm the critical interrelationship between mind and body for cardiovascular health.

Adult↗

Anxiety, depression and anger suppression in infertile couples: a controlled study.

BACKGROUND: Although several authors have suggested an important pathogenic role for psychosocial factors in 'functional' infertility, the extent to which depression, anxiety and expressed emotional patterns correlate to infertility is not yet clear. METHODS: This study included 156 infertile couples (recruited at intake) and 80 fertile couples, whose personal characteristics were recorded. They were examined using scales for the evaluation of the degree of psychopathology [Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D)], and anger expression [State-Trait Anger Expression Inventory (STAXI)]. The 156 infertile couples were then subdivided into groups based on the cause of infertility ('organic', 'functional' or 'undetermined'). The psychometric evaluation was double-blind with respect to the causes of infertility. RESULTS: Differences emerged in the degree of psychopathology between 'organic' and 'functional' infertile subjects and fertile controls. In women, logistic regression identified three variables able to predict the diagnosis subtype; these variables are HAM-A, HAM-D, and tendency toward anger suppression. In men, anger did not emerge as a predictor for diagnosis, whereas HAM-A and HAM-D did. CONCLUSIONS: The 'functional' infertile subjects of this sample showed particular psychopathological and psychological features, independent from the stress reaction following the identification of the cause of infertility.

Adult↗

A differential neural response to threatening and non-threatening negative facial expressions in paranoid and non-paranoid schizophrenics.

Several studies have demonstrated impaired facial expression recognition in schizophrenia. Few have examined the neural basis for this; none have compared the neural correlates of facial expression perception in different schizophrenic patient subgroups. We compared neural responses to facial expressions in 10 right-handed schizophrenic patients (five paranoid and five non-paranoid) and five normal volunteers using functional Magnetic Resonance Imaging (fMRI). In three 5-min experiments, subjects viewed alternating 30-s blocks of black-and-white facial expressions of either fear, anger or disgust contrasted with expressions of mild happiness. After scanning, subjects categorised each expression. All patients were less accurate in identifying expressions, and showed less activation to these stimuli than normals. Non-paranoids performed poorly in the identification task and failed to activate neural regions that are normally linked with perception of these stimuli. They categorised disgust as either anger or fear more frequently than paranoids, and demonstrated in response to disgust expressions activation in the amygdala, a region associated with perception of fearful faces. Paranoids were more accurate in recognising expressions, and demonstrated greater activation than non-paranoids to most stimuli. We provide the first evidence for a distinction between two schizophrenic patient subgroups on the basis of recognition of and neural response to different negative facial expressions.

Adult↗

"Missed, dissed, and pissed": making meaning of neighborhood risk, fear and anger management in urban black youth.

The risk factor, stress engagement, and coping experiences of African American youth are not well understood. Given the stressors of racism, hopeless perceptions of urban youth, and violence experience and exposure, anger experience and expression are reasonable resilient and risky reactions to this atmosphere of hostility. This study analyzed the impact upon the anger management of adolescents when calamity fears, neighborhood social capital, and kinship social support are known. The findings suggest that when the calamity fears of youth are high, their anger experience and expression is minimized. This finding was prominent for adolescents living in high-risk neighborhoods. Kinship social support showed a positive relationship to anger suppression for youth in high-risk environments. Implications for understanding the phenomenological stress and coping experiences of African American youth are discussed.

Adaptation, Psychological↗

Gender and the expression of schizophrenia.

The expression of schizophrenia was examined in 169 DSM-III diagnosed schizophrenics. Restricted maximum likelihood factor analysis was used to test the invariance of the hypothesized symptom model across gender. Findings indicated that schizophrenic women not only expressed more impulsivity and affective symptomatology than did men, but their psychotic symptoms covaried consistently with the expression of impulsivity, anger and other affective symptomatology. Men's expression of schizophrenia covaried positively with withdrawal/isolation and an inability to function, suggesting a possible negative symptom pattern. Gender differences were not attributable to misclassification, differences in diagnostic subtypes, nor to selection. Results are discussed in light of their implications for understanding the heterogeneity of schizophrenia.

Adult↗

Image control and symptom expression in posttraumatic stress disorder.

Despite the devastating impact of affective dysregulation in posttraumatic stress disorder (PTSD), there has been little research on how trauma relates to affect regulation. This study examines the relationship between the cognitive capacity to control mental images and symptoms of individuals with (N = 23) and without (N = 23) PTSD after exposure to SCUD missile attacks during the Gulf War. The capacity to control mental images, symptoms of posttrauma, anxiety, and anger were assessed. PTSD subjects with a high image control reported a higher capacity to control anger, lower levels of anger state and expression, and lower levels of intrusive symptoms compared with PTSD subjects with low image control. In individuals without PTSD, results show that the better the image control, the lower the control of anger and the higher the expression of anger. Image control seems to play different functions in the emotional regulation of normal subjects (facilitatory) and PTSD patients (protective).

Affect↗

Experiences of anger in people who have recovered from depression and never-depressed people.

Previous research has linked anger suppression with depression. This study extended prior research by comparing people who had recovered from a major depression (RD) with those who had never been depressed (ND). The RD group significantly exceeded the ND group in the degree to which they reported holding anger in and being afraid to express it. Also, RD participants were more likely to endorse attitudes consistent with silencing the self theory, believing they must hide their feelings to preserve relationships. They were also more likely to have experienced an anger attack. Both silencing the self and a history of anger attacks were significantly correlated with fear of anger expression; future longitudinal or experimental studies are needed to determine whether these variables play a causal role in anger inhibition and in recurrence of depression.

Adaptation, Psychological↗

A method for obtaining 3-dimensional facial expressions and its standardization for use in neurocognitive studies.

Facial expressions of emotion are increasingly being used in neuroscience as probes for functional imaging and as stimuli for studying hemispheric specialization for face and emotion processing. Available facial stimuli are 2-dimensional and therefore, their orientation is fixed and poorly suited for examining asymmetries, they are often obtained under poorly specified conditions, usually posed, lack ethnic diversity, and are of restricted age range. We describe a method for accurately acquiring and reconstructing the geometry of the human face and for display of this reconstruction in a 3-dimensional format. We applied the method in a sample of 70 actors and 69 actresses expressing happiness, sadness, anger, fear and disgust, as well as neutral expressions. Each emotion was expressed under three levels of intensity and under both posed and evoked conditions. Resulting images are of high technical quality and are accurately identified by raters. The stimuli can be downloaded in digital form as 'movies' where angle and orientation can be manipulated for inclusion in functional imaging probes or in tests that can be administered as measures of individual differences in facial emotion processing. The database of emotional expressions can also be used as a standard for comparison with clinical populations.

Adolescent↗