Conditioned heart rate as a function of manifest anxiety and drug action.
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Anxiety↗
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Results for “Generalization, Psychological”
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Further psychometric evaluation of the Fear Questionnaire: responses of college students.
This study presents evidence for the factor structure and psychometric properties of the Fear Questionnaire for college undergraduates. Fit indices of the 4- and 5-factor models identified previously were inadequate. Exploratory principal components analysis identified three factors, using data from Sample 1 (n = 208). LISREL confirmatory factor analyses supported generalizability of the three-factor model to Sample 2 (n = 200). Satisfactory reliability coefficients were obtained for the factor-derived subscales. Significant gender differences were obtained on 4 of the 15 items but not on the factor subscales. Finally, we examined the correlations between scores on the scale and on other measures of social anxiety, social desirability, and general psychological distress of the Brief Symptom Inventory. Present results suggest that the Fear Questionnaire is a valuable research instrument for a nonclinical sample.
Adolescent↗
On Clark-Watson's tripartite model of anxiety and depression.
Clark and Watson's tripartite model of anxiety and depression symptoms is reinterpreted using their data. It is suggested that a parsimonious view of the factor loadings is a three-factor structure of "general psychological distress," "high positive affect," and "somatic anxiety."
Adult↗
Integration among psychotherapies and the future of psychotherapy.
As society as a whole and the scientific world have begun to expect that the validity of psychotherapy be verified, a scientific and integrated approach to psychotherapy is the only possible answer. The development of operational definitions and the use of scientific designs represent the most effective way to generate empirical data and the only way to integrate psychotherapy objectively into general psychology.
Forecasting↗
Quality of Life assessments in patients with peptic ulcer during treatment and follow-up.
Quality of Life (QOL) has traditionally not been evaluated in patients with peptic ulcer disease. In this study, QOL was evaluated before treatment (day 0), during treatment (day 15), 14 days after treatment stopped (mean day 38), after 6 months and 1 year. Investigation was done by using a questionnaire which was mailed to the patient and mailed back within a few days. Psychological General Well-Being (PGWB) was used as a QOL base. Patients were treated with effective acid reduction. A total of 392 patients were included and the questionnaire response rate was 95%. The general QOL score for PGWB, which initially was low, increased significantly during treatment to a maximum two weeks post-treatment. At the six and twelve-month follow-up the scores dropped slightly. It is concluded that QOL assessments seem useful in the evaluation of medical regimens for peptic ulcer disease. The scores follow the clinical state, which enables future comparisons of different regimens.
Follow-Up Studies↗
Well-being and gastrointestinal symptoms among patients referred to endoscopy owing to suspected duodenal ulcer.
BACKGROUND: Few studies have evaluated quality of of life (QoL) in patients with upper gastrointestinal diseases, and there is a lack of validated measures for use in gastroenterology. METHODS: The applicability and relevance of self-administered questionnaires such as the Psychological General Well-Being (PGWB) index and the Gastrointestinal Symptoms referred to endoscopy because of suspected duodenal ulcer were evaluated. RESULTS: In total, 1526 patients with suspected duodenal ulcer were screened for inclusion in a clinical study. On the basis of medical history and endoscopy, 1424 patients who completed the questionnaire before endoscopy were classified in five diagnostic groups: oesophagitis, gastric ulcer, duodenal ulcer, negative endoscopy, and gastritis duodenitis. Irrespective of diagnosis, all patient groups reported a considerable decrease in their general well-being (mean score, 85, compared with 105 in healthy populations) with no significant differences between the groups. The results of the GSRS, however, showed statistically significant differences between the groups in dimensions depicting Abdominal pain, Reflux, Indigestion, and Diarrhoea Syndrome. CONCLUSIONS: The results of the study showed that, irrespective of endoscopic findings, patients complaining of upper gastrointestinal symptoms have a low degree of general well-being. The symptoms profiles in the different diagnostic groups vary considerably.
Duodenal Ulcer↗
Quality of Life assessments in the evaluation of gastroesophageal reflux and peptic ulcer disease before, during and after treatment.
BACKGROUND: It has recently been suggested that Quality of Life (QOL) be used in the evaluation of new medical treatment regimens together with cost-benefit, efficacy and safety. In this overview we point out some aspects of use of the Psychological General Well-Being Index (PGWB) in patients with peptic ulcer and reflux disease gained from our own investigations in later years. METHODS: QOL was assessed using questionnaires before diagnosis, during medical healing treatment and at a 1-year follow-up in peptic ulcer disease or before and after surgery in reflux disease. RESULTS: Untreated patients with unknown diagnosis had low QOL scores. With treatment, scores increased rapidly to supernormal values and fell off to normal values during the follow-up year. CONCLUSION: QOL evaluations seem sensitive and reflect the patient's subjective feeling of disease. They add another new aspect of treatment effect not earlier included in treatment evaluations.
Female↗
Quality of life assessment after laparoscopic and open fundoplications. Results of a prospective, clinical study.
BACKGROUND: In the evaluation of different treatment alternatives, assessment of the patients' own perceived situation can give important clinical information in addition to the conventional efficacy variables used. METHODS: Fifty patients with chronic gastroesophageal reflux disease (GERD) were operated on with either an open fundoplication (n = 25; 17 men; mean age, 51.5 years) or with a fundoplication through the laparoscope (n = 25; 16 men; mean age, 49.8 years). In each case adequate control of the GERD was achieved with the operation, also when objectively assessed. Twelve months after surgery the quality of life was studied by using a battery of self-administered questionnaires (the Psychological General Well-being (PGWB) index and the Gastrointestinal Symptom Rating Scale (GSRS), and a visual analogue scale, depicting specific reflux-related symptoms (RVAS). RESULTS: After antireflux surgery the overall PGWB scores were normalized with no obvious difference between the two procedures. In the GSRS scale, however, differences were shown between the two procedures, with more dyspeptic and indigestion symptoms in patients having a laparoscopic total fundic wrap. CONCLUSION: These data emphasize the clinical efficacy of antireflux surgery, with normalization of the quality of life in terms of well-being after these procedures. It should be noted that these instruments are sensitive enough to pick up significant differences between different antireflux procedures and should therefore be frequently used in the attempt to refine and optimize long-term therapeutic alternatives in reflux disease.
Female↗
Relevance of norm values as part of the documentation of quality of life instruments for use in upper gastrointestinal disease.
This article presents the relevance of norm values to a battery of Quality of Life questionnaires for use in upper gastrointestinal disorders. The derivation of reference values offers an important contribution by confirming the ability of the questionnaires to differentiate patients from healthy controls. Two self-administered questionnaires, the Psychological General Well-being (PGWB) index and the Gastrointestinal Symptom Rating Scale (GSRS) were used. The norm values were derived in a randomly selected sample from a Swedish population consisting of 4624 individuals (reference group). The patients comprised more than 900 patients with gastroesophageal reflux disease (GORD) included in clinical trials. In the reference group, males reported significantly higher values on well-being as compared with women, whereas women reported more pronounced gastrointestinal symptoms than men. Generally, the younger persons and the group aged 60-70 years reported the highest well-being. Among gastrointestinal patients women scored lower and reported more symptoms than men. With increasing age, well-being improved and symptoms declined. Even though the well-being and symptoms scores differed between patient and the reference group similar patterns in terms of age and gender were observed. In summary, the results show that there are differences with respect to gender and age among normal controls as well as in GORD patients. These aspects have to be considered in clinical studies. The results also support the discriminative ability of the Quality of Life instruments.
Adult↗
Quality of life in patients with different types of functional constipation.
BACKGROUND: Little information is available about the health-related quality of life (QoL) in patients with different types of chronic constipation. METHODS: We used two self-administered questionnaires, the Psychological General Well-Being (PGWB) index and the Gastrointestinal Symptom Rating Scale (GSRS) to assess QoL and gastrointestinal symptoms in 102 consecutive patients with chronic constipation. The type of constipation was determined from transit time, electrophysiologic investigation of sphincter function, anorectal manometry, and defecography. RESULTS: Overall, our patients with constipation reported low scores for general well-being (mean score, 85.5, compared with 102.9 in a healthy population). Patients with normal-transit constipation (n = 49) reported considerably lower scores in the PGWB than those with slow-transit constipation (n = 35). The symptoms increased frequency of defecation, loose stools, and urgent need for defecation were commoner in normal-transit constipation, which indicates that this group may have a relation to the irritable bowel syndrome. The overall PGWB index was strongly correlated with the total GSRS (P < 0.001). CONCLUSIONS: The general well-being of patients with chronic constipation is lower than that of a comparable normal population. Symptom severity correlates negatively with perceived quality of life.
Adolescent↗
Schematic maps: cognitive tools for enhancing the early stages of counseling.
The purpose of the present studies was to explore the utility of schematic maps as tools for the early stages of both peer and self-counseling. In experiment 1 (self-counseling), 42 students from undergraduate general psychology classes participated to fulfill course requirements. Participants were assigned to either a schematic map or essay group. They first extracted information about their alcohol-related behavior patterns and then analyzed the patterns from the perspective of a counselor. In experiment 2 (peer counseling), 38 students from upper-division psychology courses participated for extra credit. Participants were asked to evaluate behavior patterns, in the form of maps or essays, which were presented either in the same form as they were extracted or were transposed to the other format. In both studies, assessment consisted of questionnaires that addressed the usefulness of the tools in the counseling process. Schematic maps are potentially powerful tools for both self- and peer counseling. For self-counseling, maps were preferred over traditional essay writing. In addition, the subjective reaction to maps as tools for peer counseling was positive.
Alcohol Drinking↗
The Fibromyalgia Impact Questionnaire, a Swedish translation of a new tool for evaluation of the fibromyalgia patient.
The American Fibromyalgia Impact Questionnaire (FIQ) was translated into Swedish. The FIQ is a brief 10-item self-administered instrument designed to evaluate the special problems bothering fibromyalgia patients. After the translation procedure, 73 Swedish women fibromyalgia patients answered the translated FIQ. The questionnaire was fast and simple to handle both for the patients and the investigators. There was a good level of correspondence between FIQ items and related items in the Health Assessment Questionnaire, the Nottingham Health Profile and the Psychological General Well-Being Index. There were no significant differences in a test-retest analysis. The study has provided evidence that the translated and slightly modified Swedish version of the American Fibromyalgia Impact Questionnaire has the validity and sensitivity to be able to function as a relevant and comprehensible tool to monitor FMS-patients.
Adult↗
Does lowering the blood pressure improve the mood? Quality-of-life results from the Hypertension Optimal Treatment (HOT) study.
Nine-hundred-and-twenty-two hypertensive patients were included in a substudy to the Hypertension Optimal Treatment study, which aimed to investigate the impact on quality of life of lowering the pressure and of intensified therapy. Seven-hundred-and-eighty-one patients completed both baseline and follow-up questionnaires (intention-to-treat population), while 610 patients were included in a per protocol analysis. Patients were randomized to three diastolic BP levels (DBPs), i.e. < or =90 mmHg, < or =85 mmHg and < or =80 mmHg. Two self-administered validated questionnaires, the Psychological General Well-Being index and the Subjective Symptoms Assessment Profile (SSA-P) were completed at baseline and after 6 months. The lower the DBP achieved, the greater the improvement in well-being (p < 0.05). The increase in well-being from baseline to 6 months was significant in target groups < or =80 mmHg (p < 0.01) and < or =85 mmHg (p < 0.05). The SSA-P domains, cardiac symptoms and dizziness improved in all groups but the sex life score deteriorated in the < or =80 and < or =85 mmHg groups in male patients. In all target groups, headaches were reduced (p < 0.001), while swollen ankles (p < 0.001) and dry cough in the < or =80 mmHg group (p < 0.001) increased. Although more intensive antihypertensive therapy is associated with a slight increase in subjective symptoms, it is nonetheless still associated with improvements in patients' well-being.
Affect↗
Quality of life varies with pain during treatment in adolescents with cancer.
Pain is one of the most feared problems for adolescents with cancer. Pain produces stress with negative physiological and psychological effects. Therefore, effective pain management during cancer treatment may influence the outcome. This study investigates variations in pain and quality of life during treatment in adolescents with cancer, and whether there is a co-variation between the two. In a prospective longitudinal questionnaire investigation, quality of life in eight adolescents with cancer was assessed with the psychological general well-being index (PGWB) and compared with the patients' experiences of pain according to repeated structured interviews. Pain troubled the adolescents most in the beginning and in the end of the treatment period, but troubled them less in-between. During treatment, quality of life was low in the beginning, higher in the middle and lower in the end. Pain co-varied inversely with quality of life and the adolescents thus seemed to have higher quality of life when pain-relieved. This finding emphasizes the importance of pain management in children and adolescents with cancer.
Adolescent↗
[Quality of life: attitudes and perspectives of doctors in a thoracic oncology regional care network].
BACKGROUND: The evaluation of health-related quality of life (HRQOL) of lung cancer patients is significant given their poor prognosis. Consequently, HRQOL is often currently assessed throughout clinical trials and sometimes in daily medical practice. The objective here was to determine physicians' perspectives on evaluating HRQOL. MATERIAL AND METHODS: The team carried out a prospective study of physicians belonging to a thoracic oncology network using an original questionnaire of 33 items. RESULTS: 102 physicians were questioned and 51 responded. Physicians' knowledge on HRQOL was frequently of a low level and incomplete, but most of them considered HRQOL as important HRQOL assessment in daily practice was often done intuitively. Many physicians noted that they lacked adequate time to explore and integrate all of the fields which should be covered by HRQOL in their clinical practice, but they felt overall that the HRQOL study improved doctor/patient communication and interaction. Physicians described an "ideal" HRQOL questionnaire as one containing 10-15 items within 6 domains (physical, psychological, general health, respiratory symptoms, family and social) and which could be completed in 5-8 minutes. In addition, such a questionnaire might integrate an opportunity for patients to isolate and identify items and issues that they consider to be most important to them. CONCLUSIONS: Physicians' will to consider and integrate the evaluation of HRQOL in the management of lung cancer patients is strong but meets some structural challenges (related to HRQOL assessment and interpretation of data) but also conjectural difficulties (with respect to a lack of knowledge). Training efforts are needed as well as the development of easier tools to facilitate the evaluation of HRQOL.
Adult↗
Olanzapine versus risperidone in the treatment of manic or mixed States in bipolar I disorder: a randomized, double-blind trial.
OBJECTIVE: To compare olanzapine and risperidone in the treatment of nonpsychotic acute manic or mixed episodes. METHOD: This 3-week, randomized, controlled, double-blind, parallel multicenter study compared olanzapine (5-20 mg/day; N = 165) and risperidone (1-6 mg/day; N = 164) among hospital inpatients who met DSM-IV criteria for bipolar I disorder, manic or mixed episode, without psychotic features. The study was conducted at 30 sites in the United States between July 2001 and June 2002. The primary outcome measure was the mean change in the Young Mania Rating Scale (YMRS) total score. Secondary measures included the 21-item Hamilton Rating Scale for Depression (HAM-D-21), the Montgomery-Asberg Depression Rating Scale (MADRS), the Clinical Global Impressions-Bipolar Version (CGI-BP) severity of illness scale, and the Cognitive Test for Delirium (CTD). Quality of life (Short Form Health Survey [SF-12]), psychological well-being (Psychological General Well-Being [PGWB] inventory), and sexual functioning were also compared. RESULTS: Mean modal doses for olanzapine and risperidone were 14.7 mg/day and 3.9 mg/day, respectively. Between treatments, there was no difference in mean change in the YMRS, MADRS, CTD, PGWB, or SF-12 measures or in remission or response rates. Significantly more olanzapine-treated patients completed the study compared with risperidone patients (78.7% vs. 67.0%; p = .019). Olanzapine-treated patients had greater HAM-D-21 (p = .040) and CGI-BP (p = .026) score improvement across the study. Olanzapine-treated patients experienced greater elevations in liver function enzymes (p < .05) and increase in weight (2.5 kg vs. 1.6 kg; p = .004), while risperidone-treated patients were more likely to experience prolactin elevation (51.73 ng/mL vs. 8.23 ng/mL; p < .001) and sexual dysfunction (total score increase of 1.75 vs. 0.64; p = .049). CONCLUSION: Both olanzapine and risperidone treatment yielded similar improvements in mania. The olanzapine group had significantly greater improvements in secondary measures of severity and depressive symptoms and better study completion rates but experienced more weight gain.
Adult↗
[Principal elements of the psychosocial readaptation program in the hospital setting].
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Adaptation, Psychological↗
The Domestic/International Gastroenterology Surveillance Study (DIGEST): design, subjects and methods.
BACKGROUND: The Domestic/International Gastroenterology Surveillance Study (DIGEST) was designed to examine the 3-month prevalence of upper gastrointestinal (GI) symptoms internationally and the impact of these symptoms on healthcare usage and quality of life. METHODS: The study sample was derived from the urban, adult (> or = 18 years) population of Canada, Italy, Japan, The Netherlands, Switzerland, the USA and the Nordic countries (Denmark, Finland, Norway and Sweden). Subjects were randomly recruited on a house-to-house basis in all countries except the USA and Italy, where telephone recruitment was carried out. Participants were interviewed in their own homes (house-to-house recruitment) or at a central location (telephone recruitment). The DIGEST questionnaire consisted of two sections. The first was a newly developed questionnaire consisting of 27 questions examining the prevalence, frequency and severity of upper GI symptoms, and their impact on healthcare use and daily activities. It also examined a number of demographic and socioeconomic variables. This part of the questionnaire was evaluated and pilot-tested before commencement of the survey. The second part of the questionnaire consisted of the local language version of the Psychological General Well-Being Index (PGWBI), a validated generic quality-of-life scale. Following completion of the survey, subjects with upper GI symptoms were classified on the basis of their most bothersome symptom into three symptom groups: gastro-oesophageal reflux-like, ulcer-like or dysmotility-like. CONCLUSIONS: Rigorous design, standardization of interview techniques and prior evaluation of the DIGEST questionnaire, provided a firm foundation for reliable data collection, analysis and interpretation.
Adult↗