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PubMed1979

A field study of the stress response syndrome. Young women after hysterectomy.

The symptom pattern previously delineated as the stress response syndrome in a mental health setting was hypothesized to be useful in conceptualizing reactions to a traumatic event in a nonpsychiatric patient population. The experience of loss resulting from nonelective hysterectomy for benign disease in women of childbearing age was selected as a relevant field study model. Twenty-eight women were studied one year after hysterectomy, using extensive psychological interviewing by women clinicians and experiential rating scales. Twelve subjects had a mild stress response syndrome, and five subjects had a serious level of intrusive and avoidant symptoms. Increasing severity of response was associated with persisting child-wish, deterioration in sexual functioning, and change in self-concept. Women who did well postoperatively generally had no future wish for children and were actively committed to achievement outside of the home.

Adaptation, Psychological↗
PubMed1993

Diagnosing dissociative disorders.

The increasing prevalence of dissociative disorders has spawned a range of diagnostic tools. The authors describe the use of several current methods--screening instruments, structured interviews, psychological testing, and hypnosis--and they advocate enlisting the patient as an active collaborator in the diagnostic process.

Amnesia↗
PubMed1994

Psychological problems in chronic prostatitis patients with pain.

OBJECTIVE: Men with chronic prostatitis are frequently seen in urological practice and are difficult to treat with standard antimicrobial medications. This pilot study was designed to take a different perspective in assessing chronic prostatitis patients with pain by evaluating them using a standard chronic pain clinic psychological approach. DESIGN: Twenty men, 27% of the referred group of patients with chronic prostatitis and pain, completed the MMPI and a structured psychological interview. Their findings were compared to age- and education-matched men seeking treatment for chronic low back pain. SETTING: Data were collected at the Pain Clinic within the Department of Anesthesiology at the University of Washington Medical Center. PATIENTS: Patients were 20 men referred from a urology-based Prostatitis Clinic and 20 men referred to the Pain Clinic for chronic low back pain. RESULTS AND CONCLUSIONS: The two groups differed in the impact of their pain problem on their lives. Prostatitis patients were employed but reported that their symptoms greatly interfered with their sexual/romantic relationships. Back pain patients reported that their pain interfered primarily with work; most of these patients had long-term marital relationships, whereas few prostatitis patients did. Half of the prostatitis patients met criteria for major depression, but back pain patients were more somatically focused, depressed, and anxious. The constellation of relationship problems, disruptions in sexual functioning, levels of depression, along with failure of multiple previous medical treatments in men with chronic prostatitis indicates that continued antimicrobial therapy is unlikely to provide the "cure" these patients seek. Psychological evaluation, couples' counseling, individual counseling, and medications for depression all may play a role in a comprehensive approach to these patients. These results must be considered as preliminary and as representative of a possibly skewed sample of prostatitis patients since only those men who accepted the referral to a pain clinic psychologist for an evaluation were assessed. Clearly, they are likely to be among the patients who are most psychologically and sexually impaired by the chronic prostatitis and associated pain. A further study with less self-selection is indicated.

Adult↗
PubMed1979

Platelet MAO activity and evoked potentials in the identification of subjects biologically at risk for psychiatric disorders.

Individuals potentially at risk for psychiatric disorders were identified by screening 375 college student volunteers for low platelet monoamine oxidase (MAO) activity levels. The lower and upper 10% in MAO activity were administered a personal and family history interview, psychological tests and average evoked response (AER) electroencephalographic procedures. Results indicated that low MAO males and females were socially more active, had more psychiatric contact, and had relatives who were psychiatrically more disturbed than high MAO subjects. Low MAO males had more convictions, experimented more with illegal drugs and had elevated scores on the MMPI. AER criteria further defined a high risk group of low MAO-AER augmenters which had more suicides among their relatives and higher scores on the schizophrenia scale of the MMPI.

Adolescent↗
PubMed2005

Improving decision making in forensic child sexual abuse evaluations.

Mental health professionals can assist legal decision makers in cases of allegations of child sexual abuse by collecting data using forensic interviews, psychological testing, and record reviews, and by summarizing relevant findings from social science research. Significant controversy surrounds another key task performed by mental health professionals in most child sexual abuse evaluations, i.e., deciding whether or not to substantiate unconfirmed abuse allegations. The available evidence indicates that, on the whole, these substantiation decisions currently lack adequate psychometric reliability and validity: an analysis of empirical research findings leads to the conclusion that at least 24% of all of these decisions are either false positive or false negative errors. Surprisingly, a reanalysis of existing research also indicates that it may be possible to develop reliable, objective procedures to improve the consistency and quality of decision making in this domain. A preliminary, empirically-grounded procedure for making substantiation decisions is proposed.

Child↗
PubMed1999

Analysis of Minnesota Multiphasic Personality Inventory-2 profiles of prospective anonymous oocyte donors in relation to the outcome of the donor selection process.

OBJECTIVE: To examine the scores of prospective anonymous oocyte donors on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in four outcome groups. DESIGN: Chart review. SETTING: Academic medical center. PATIENT(S): One hundred fifty prospective anonymous oocyte donors who underwent a preliminary screening and a 1-hour structured psychological interview and who completed the MMPI-2. INTERVENTION(S): Psychological evaluation prior to donation. MAIN OUTCOME MEASURE(S): Scores on the MMPI-2 and outcomes of the donor selection process. RESULT(S): Seventy (47%) women were accepted as donors and completed one donation cycle; 30 (20%) were accepted as donors but did not donate because of medical reasons or relocation; 18 (12%) were accepted as donors but were noncompliant; and 32 (21%) were rejected as donors because of psychological concerns. Statistically significant differences were found between outcome groups on scales F, K, 1, 2, 7, 8, and 0. Although these differences were statistically significant, all group subscale mean scores were in the average to low-average range and differences between group means were small. CONCLUSION(S): The MMPI-2 differentiates between prospective donor outcome groups, but psychologists need to interpret the results of the MMPI-2 carefully in the context of clinical interview information.

Female↗
PubMed1983

The alcoholic brain: CT scan and psychological findings.

One hundred male alcoholics without overt clinical signs of brain damage were interviewed, psychologically tested and scanned by means of a CT 1010 EMI scanner. Fifty age-matched controls, lifelong abstainers or light drinkers, were used for comparison. Fifty-six alcoholics from the initial sample were followed up after periods varying from 30 to 152 weeks, and radiological changes during the follow-up were assessed. The main results of the study can be summarized as follows: (1) All CT scan indices were significantly different in alcoholics and controls. Alcoholics had larger ventricles, wider cerebral sulci and wider Sylvian and interhemispheric fissures. Cerebellar sulci were visible only in alcoholics. These differences were greater for older alcoholics and controls, but were also present in the younger subjects. (2) In the alcoholic group the size of the ventricular system, and the width of the sulci, Sylvian and interhemispheric fissures were positively and significantly correlated with age. The duration of the drinking history and the age of onset were not significantly correlated with CT scan indices. (3) In those alcoholics whose age was greater than the mean for the whole group, the size of the ventricular system and width of the Sylvian fissure were significantly and negatively correlated with the duration of abstinence prior to scanning. (4) Other features such as decreased tolerance, a positive family history of alcoholism and 'social decline' were not significantly related to the severity of CT scan abnormalities. (5) When the effects of age and premorbid intelligence were controlled, alcoholics showed significant cognitive impairment when compared with controls. The differences in the scores of psychological tests and CT scan indices were greater between alcoholics and controls of high IQ than between those of low IQ. This discrepancy is likely to be due to a selection bias. (6) No significant correlations were found between the degree of cognitive impairment and clinical features. The size of the ventricular system was positively and significantly correlated with the discrepancy between immediate and delayed recall of verbal material. There were no other significant correlations between cognitive impairment and CT scan indices. (7) Those subjects who had remained abstinent during the follow-up period, when considered as a group, showed a significant reduction in the size of the ventricular system. When cortical indices and V/B ratio were combined, patients whose scans had improved at follow-up differed from the rest with regard to the length of abstinence prior to re-scanning.

Adult↗
PubMedDate not supplied

[Post-abortion counseling].

Faced with the silence that follows an abortion, we have established an individual, post-abortion counseling program based on psychological interviews with women who have recently had an abortion. These interviews begin in the second week following the abortion when the woman returns to the hospital for a post-abortion medical examination. The point of these interviews is to listen to what has been experienced--notably a certain ambivalence that arises from the act of having the abortion, which is constructed as having been a decision freely taken. The aim of these sessions is to help the woman through the process of mourning. Whether due to the failure of a contraceptive or a failed relationship, the resulting sorrow is produced by an underlying wish to have children. The periodic interviews have, over the weeks, helped to restore a certain psychological balance.

Abortion, Legal↗
PubMed1984

Some preliminary psychological observations on narcissism, the cosmetic rhinoplasty patient and the plastic surgeon.

From the point of view of the clinical psychologist, one important dimension of the psychological experience of the typical cosmetic rhinoplasty (CR) patient that has been underemphasized in the psychological and plastic surgery literature is the patient's narcissism. The author's aim is to facilitate the plastic surgeon's understanding and management of these patients by putting the disparate aspects of their behaviour into a unifying theoretical framework. A total of 41 CR patients from the UK, who had been referred through the National Health Service, were interviewed, psychologically tested and clinically assessed at varying times before and after surgery. A control group of patients undergoing wisdom teeth extractions were also interviewed and tested. The CR patient's narcissism was manifest, for example, in their self-absorption, inadequate self-esteem and fantasies of ideal beauty which was observed in his/her pre- and postoperative behaviour. Some suggestions on the management of the CR patient with narcissistic problems are offered to surgeons and hospital staff in order to maximize the clearly beneficial psychological and behavioural effects of CR.

Adult↗
PubMed2006

[Neonatal cleft lip repair: psychological impact on mothers].

AIM: To investigate the psychological impact on mothers of an early neonatal cleft lip repair. METHODS: Between January and December 2004 mothers of 24 infants born with a cleft lip completed psychological interviews and questionnaires 1 month after neonatal repair. We evaluated the psychological impact on mothers of antenatal and postnatal diagnosis. We noted the parental preferences for the timing of cleft repair and their satisfaction after neonatal repair. RESULTS: Stress, incomprehension and anxiety were often noted. Most mothers preferred their infant to receive neonatal repair. We noted a great satisfaction after neonatal cleft lip repair. DISCUSSION: We are currently encouraging early repair in the full-term baby as the optimum, reliable and safe method of management of newborns with cleft lip. Mothers expressed a preference for and greater satisfaction with neonatal repair. Parental preferences should routinely be considered in deciding the timing of this procedure.

Adolescent↗
PubMed1995

Chronic nonprogressive headaches in children and adolescents.

Chronic nonprogressive headaches are common in adolescents. The features of this syndrome are distinct from those of migraine. Chronic nonprogressive headaches have received less attention and study than migraine headaches. The prevalence of this syndrome is not clear. A structured psychological interview with the patient and the parents of the patient coupled with psychological testing of the patient will usually identify factors playing a role in the continuing headache. Counseling, biofeedback, and cognitive training, combined with judicious use of medication, will frequently lead to resolution of the headache.

Adolescent↗
PubMed1987

Psychosexual outcome of assigned females and males with 46,XX virilizing congenital adrenal hyperplasia.

Seven genotypic female (46,XX) patients with congenital adrenal hyperplasia, four reared as girls and three reared as boys were evaluated at 16-26 years of age with psychological interviews and testing. A small penis in the three young men produced a practical and psychological barrier that severely injured their personality. In spite of some degree of pre-adolescent tomboyism and a somewhat injured body image, the girls adjusted to their feminine gender identity. It is concluded that in cases of both early and late diagnosis, the genotypic female sex should be preferred.

Adaptation, Psychological↗
PubMedDate not supplied

Wish for a child and infertility: study on 116 couples. I. Interview and psychodynamic hypotheses.

The authors wish to stress the importance of the psychosomatic approach in the investigation of infertility. Following the hypothesis that infertile patients may present emotional conflicts with regard to the wish of having a child, psychodynamic interviews were carried out with 116 infertile couples concomitantly with their first consultation at the Sterility Department. The psychological findings show that severe conflicts with regard to wish of parenthood were present in the majority of the female patients and especially in those without clinically defined organic infertility factors. The relationship between clinical diagnosis and psychological outcome was less evident in the male partners. The 11 pregnancies which occurred in the study group are also discussed with regard to the motivational quality of the wish of child of these patients. A recommendation is made that psychological interviews should be included in any infertility investigation as a matter of routine and that therapeutic procedures should take into account both the clinical and psychological diagnosis to prevent unsuccessful situations.

Adult↗
PubMed2001

Physician support and patient psychologic responses after surgery for nonsmall cell lung carcinoma: a prospective observational study.

BACKGROUND: In patients with cancer, depression and coping have been suggested to be important psychologic responses that may be associated with quality of life. Social support, especially from physicians, is considered important for cancer patients during their illness. The authors have investigated the impact of physician support on psychologic responses, including depression, psychologic distress and coping (such as fighting spirit and helplessness/hopelessness) in a cohort of patients with early-stage lung carcinoma. METHODS: After curative resection for nonsmall cell lung carcinoma, 226 patients were enrolled in a longitudinal study. The extent of social support, including physician support, was measured in structured interviews conducted 1 and 3 months after surgery. During the interviews, psychologic responses were measured using the Structured Clinical Interview for DSM-III-R, the Profiles of Mood States, and the Mental Adjustment to Cancer scale. Univariate and multivariate analyses were used to examine the impact of physician support on psychologic responses. RESULTS: Physician support had no effect on depression, but correlated negatively with psychologic distress (P < 0.05) and helplessness/hopelessness (P < 0.05), and positively with fighting spirit (P < 0.01). Multivariate analyses controlling for confounding biomedical and psychosocial variables revealed only physician support had a significant impact on fighting spirit, independently. However, this effect was limited to female patients or patients with no history of depression. CONCLUSION: In postoperative patients with nonsmall cell lung carcinoma, physician support may have a significant impact on fighting spirit, but this effect appears to be limited to female patients or patients with no history of depression.

Adaptation, Psychological↗
PubMed1999

Informed consent and patient participation in the medical encounter: a list of questions for an informed choice about the type of anaesthesia.

The present study was undertaken to evaluate the impact of a new procedure for eliciting informed consent by patients undergoing minor surgical procedures, in which the choice between general anaesthesia (GA) and regional anaesthesia (RA) was possible. In this prospective study, two randomly selected groups of patients were compared: study group (SG), 52 patients, received from the nurse before the preoperative interview, a list of seven questions, which they were invited to ask the anaesthetist; while the control group (CG), 73 patients, did not receive any suggested questions. There were two end points: the proportion that chose RA and the number of questions actually addressed to the doctor at the preanaesthetic interview. Psychological aspects were taken into account by collecting the Hospital Anxiety and Depression (HAD) scale before the preanaesthetic interview. Satisfaction with the interview was recorded using a telephone questionnaire 2 weeks after the operation. The results from the two groups were compared by calculating the odds ratio according to Mantel-Haenszel and by logistic analysis. Altogether, 71.2% of the patients chose RA without any difference between the groups. The average number of questions asked by each SG patient was higher than for the CG (1.67 vs. 0.96). The satisfaction level was similar in the two groups. Our list of questions was designed to facilitate patient autonomy. It offered an aid to those requesting more information and assisted communication. The method did not change the proportion who chose a specific kind of anaesthesia, but does seem to improve patient participation in the decision-making process.

Adult↗
PubMed1987

Who has nightmares? The personality of the lifelong nightmare sufferer.

Twelve lifelong nightmare sufferers, 12 vivid dreamers who had no nightmares, and 12 persons who had neither nightmares nor vivid dreams were studied in a series of structured interviews, psychological tests, and other tests. The group with nightmares had significantly higher scores on the "psychotic" side of the Minnesota Multiphasic Personality Inventory profile than the other two groups, scored higher on a "boundary deficit" score of the Rorschach test, and had more first- and second-degree relatives with nightmares, psychological problems, and psychiatric hospitalization. There were no significant differences between the groups with vivid and nonvivid dreams. On interview, the frequent nightmare sufferers were a group of sensitive, open persons who had features of the "schizophrenic spectrum disorders," but who also had artistic and creative tendencies and interests, in contrast to the other groups. These results confirm and extend our previous findings in a group of 38 frequent nightmare sufferers.

Adult↗