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To assess how hysterectomy was psychologically overcome we refer to the results obtained from a questionnaire given to 40 patients. The questionnaire was divided into 3 parts: one statistic-epidemiologic, one to evaluate the patients' level of information, and a third aimed at studying post-operative psychological and sexual adaptability.
In their efforts to understand the psychological impact of life-threatening illness upon individuals, researchers, for the most part, have focused on the distress associated with dying rather than the influences that promote adaptation. Early studies report relationships between the mental state of the dying and variables of age, religiosity, family relationships, and physical discomfort. This article analyzes and compares the influences of social support, pain, and age, which were confirmed in a causal model study, as direct predictors of an outcome of psychological adaptation. The data from a sample of 97 home hospice subjects is compared with other healthy, recovering ill, advanced ill, and psychiatric populations.
Family functioning and child temperament variables were investigated as predictors of psychologic and social adaptation in 42 children with congenital or acquired limb deficiencies. Higher psychologic and social adaptation were seen when there was more family cohesion and moral-religious emphasis and organization, in combination with less family conflict. With regard to child temperament, more emotionality predicted greater internalizing and externalizing behavior problems and less social competence. In addition to the main effects of the family functioning and child temperament predictor variables, the interaction between family cohesion and child emotionality significantly predicted both internalizing and externalizing behavior problems. The findings are discussed in terms of the risk and protective effects of family functioning domains and temperament on the psychologic and social adaptation of children with visible physical handicaps.
Thirty patients selected at random from a pacemaker clinic were interviewed to gain an understanding of how psychological symptoms in these patients related to their cardiac condition. In 20% veiled depression or even a wish to die was elicited. Joking, fantasies, and denial were common psychological mechanisms used to adapt to their illness and the pacemaker itself. A dramatic example of attempted suicide in which the patient tried to cut the subcutaneously implanted pacemaker leads is presented and illustrated.
Treatment under conditions of gnotobiotic isolation can augment the stress of adaptation to a diagnosis of leukaemia. Identification of the psychological problems experienced in isolator treatment can contribute to the effective maintenance of therapy. Individual patterns of adjustment to treatment relate to the psychological mechanisms of defence employed to contend with the dependent position enforced by isolation. Psychiatric assessment can assist both patients and nursing staff with the management of their separate difficulties in this unfamiliar treatment situation. Psychological features of isolator treatment in ten patients with acute leukaemia are described and suggestions proposed for psychological management of patients under isolator conditions.
Studies of the psychological adjustment of physically healthy siblings to their sibling's chronic illness indicate that there is no one-to-one correspondence between the presence of a chronic illness and risk for psychological disturbance in nonafflicted children. Although the presence of a chronic illness may increase siblings' subjective distress, effects of a chronic illness on the psychological adjustment of siblings are selective and vary with age, sex, and type of illness. Chronic illness is a stressor which, in interaction with other variables, may contribute to increased risk of psychological disturbance for some siblings. Although the variables which mediate the effects of a chronic illness on siblings are as yet poorly understood, the quality of family functioning and relationships has both direct and indirect effects on siblings and deserves primary consideration in the comprehensive care of chronically ill children. Future research might profitably focus on individual differences in sibling adaptation, especially on factors which contribute to positive adjustment, the role of the family context as a mediating influence, and evaluation of preventive interventions designed to enhance sibling adaptation.
By Fisher's fundamental theorem, selection depletes additive genetic variation. However, moderate heritabilities are invariably obtained for psychological traits, even those that have been under intense selection. Examples include sociosexuality (interest in emotionally uncommitted sex), schizophrenia and sexual orientation, which have all been subject to strong sexual selection. A number of factors can help maintain (or at least slow depletion of) genetic variation. These include antagonistic pleiotropy; geographic or temporal variability in optimal phenotypes (and hence genotypes); mutational pressure (especially in the context of parasite resistance dynamics); and existence of heritable strategic variation or morphs. I discuss the likelihood that these factors maintain heritable variation for intelligence. I then review some evolutionary hypotheses regarding variation in some specific psychological traits.
This study investigated differences in psychological distress and coping styles between fathers and mothers of pediatric cancer patients, over a 1-year time period. Also examined were (dis)similarities in couples in distress and coping, and the relationship between (dis)similarities in coping and psychological functioning of both members of a couple. Parents (n = 124, 62 couples) were assessed at diagnosis, at 6 and 12 months. Fathers and mothers experienced higher levels of psychiatric symptomatology and psychological distress at diagnosis than men and women of a normgroup. Distress declined significantly with time. Although parents did not report more symptoms than the normgroup 12 months post-diagnosis, they still were psychologically out of balance. Contrary to findings in the general population, no differences were found between fathers and mothers in psychiatric symptoms or psychological distress on any of the measurements. Only a few gender differences in coping were found. Fathers used more active-problem focusing at diagnosis and a less palliative reaction pattern at 12 months than did mothers. Mothers used more social-support seeking on all measurements. A tendency for similarity in the use of the coping styles within couples was found. Discrepancies in coping in couples were positively related to distress in fathers at diagnosis. However, 12 months later, the more discrepant the couples were in their coping preferences the more distress the mothers indicated.
Thirty-four adult men operated upon for hypospadias in childhood and 36 controls were examined by interview and psychological tests. During childhood hypospadiacs had enuresis, showed shyness, and were mobbed more often than controls. Hypospadiac's sexual debut, but not the first ejaculation, was delayed. Most hypospadiacs had a satisfactory sexual life, albeit restricted to fewer partners. Socially, hypospadiacs showed normal adjustment but had less qualified professions than controls. Hypospadiacs showed a more doubtful sexual identity and greater castration anxiety combined with lesser utilization of cognitive and emotional resources than controls. Early operated hypospadiacs had a more infantile sexual identity than those operated later (less than 5 yr).
In the present study, the author examined 3 theoretical perspectives--family values, acculturation strategies, and social group identity--as predictors of the psychological well-being of adolescents from immigrant backgrounds. The 3 perspectives share the view that immigrants' successful adaptation involves the balancing of their heritage culture and the culture of the society of settlement. The participants were 506 adolescents from 4 backgrounds--Vietnamese, Pakistani, Turkish, and Chilean--who were living in Norway. The 3 theoretical perspectives together accounted for between 12% and 22% of the explained variance of mental health, life satisfaction, and self-esteem. The predictive powers of the different perspectives, however, were dependent on which outcome was predicted. On the whole, social group identity showed the strongest predictive power.
Bone marrow transplantation, used with increasing success over the past ten years, is recognized as highly stressful. Physiological and psychological rehabilitation after treatment is often difficult. This paper outlines the psychological issues encountered by adult patients with haematological malignancies through a review of the adjustment disorders associated with bone marrow transplantation, their prevalence, symptomatology and predictive factors. Some guidelines are proposed for the prevention of the stresses associated with hospitalization.
OBJECTIVES: To analyze the quality of life and psychological adjustment after surgical therapy for localized renal cell carcinoma. METHODS: Postal questionnaires including measures of quality of life (SF-36) and the impact of the stress of cancer (Impact of Events Scale) were completed by 97 patients who had undergone radical or partial nephrectomy for localized renal cell carcinoma. Data were analyzed for the group as a whole and comparing the partial nephrectomy and radical nephrectomy groups. The variables examined included the impact of the type of partial nephrectomy (elective versus mandatory) and the amount of self-reported renal tissue remaining. RESULTS: The quality of life for the group as a whole was good, with no significant differences between the sample and U.S. norms for an age and sex-matched community sample on both the mental and physical health composite scores. Having undergone a partial versus a radical nephrectomy did not influence the patients' overall quality of life. Multiple linear regression modeling demonstrated that having more remaining renal parenchyma was an independent predictor of better self-reported physical health on the SF-36 (P <0.001). The entire sample had low mean scores on both avoidance and intrusion on the Impact of Events Scale, suggesting a lack of daily anxiety about cancer. Multiple linear regression modeling showed that patients who reported having more remaining renal parenchyma had lower intrusion and avoidance scores (P = 0.002 and 0.01, respectively). Multiple logistic regression modeling also demonstrated that the patients' perception of their remaining renal parenchyma was associated with less concern about cancer recurrence (P = 0.018) and less impact of cancer on patients' overall health (P <0.001). CONCLUSIONS: Most survivors of localized kidney cancer have normal physical and mental health regardless of the type of nephrectomy performed. The quality of life is better for patients with more renal parenchyma remaining after surgery for localized renal cell carcinoma.
The long-term effects of the Cognitive Adaptation Theory Index (CATI) on psychological and physical health outcomes among men (n = 199) and women (n = 99) treated for coronary artery disease with percutaneous transluminal coronary angioplasty were examined. The CATI reflects a positive view of the self, a positive view of one's future, and a sense of personal control over daily life. This index was created from questionnaires administered during hospitalization for the initial angioplasty. Four years later, the CATI predicted positive adjustment to disease, even when initial adjustment was taken into consideration. In addition, the CATI predicted a reduced likelihood of sustaining a subsequent cardiac event over 4 years. This association was more robust for men.
Adaptation to breast cancer depends on two parameters: one derived from the patient and one from the disease. The first comprises the psychological and social factors that are determined by the patient and her surroundings: the psychologic adjustment the patient had before illness, her social supports, especially her spouse, and her social context which will contribute to her need to hide her illness or encourage her sharing the loss with others, especially those who have had a similar experience. The other factor determining psychologic adjustment is contributed by the disease itself: the extent of spread, surgical operability, need for adjuvant therapy, the full application of rehabilitative measures, including plastic reconstruction when appropriate, and the psychologic management by the surgeon in the doctor-patient relationship. Each of these variables contributes to the emotional resources available to the woman and to the stresses that must be surmounted in adaptation to breast cancer; each can serve as a positive force or a negative one. At times, one strongly positive factor, such as family support, can counter several exceptionally negative aspects and result in a positive adjustment despite severe illness. Each variable will be discussed in relation to its contribution to an "adaptive readaptation" and optimal psychologic well-being despite illness, versus those factors that create a "maladaptive readaptation" with less than optimal psychologic well being.
OBJECTIVE: To investigate levels of support and the concurrent and prospective effects of support on the psychological functioning of parents of children with cancer in a prospective longitudinal study. METHODS: Parents' (n = 128) self-perceived level of psychological distress, quantity of support, and dissatisfaction with support were assessed, at diagnosis, at 6, and at 12 months. RESULTS: Parents received most support at diagnosis. Self-perceived quantity decreased with time, but parents indicated they remained equally satisfied. Support significantly predicted concurrent and prospective distress of fathers, but not of mothers. Dissatisfaction with support and negative interactions were consistent risk factors for fathers. Mothers who adjusted well psychologically received more support and were less dissatisfied than mothers who remained clinically distressed. Nevertheless, no persisting effect of support was found. CONCLUSIONS: Findings illustrate that social support varies with the stress situation and with gender. Identification of vulnerable parents at diagnosis on the basis of their perception of received quantity of and dissatisfaction with support seems difficult. Intervention efforts aimed at mobilization of needed support may be efficacious.
A growing body of research suggests that a cancer diagnosis reverberates throughout the family system. The majority of studies provide evidence of the psychological distress experienced by family members at the time of diagnosis and during terminal and early bereavement stages. Increasingly, however, patients survive a cancer diagnosis. Therefore, their experience and that of family members more closely approximates living with a chronic illness. In this longitudinal study of 143 pairs of patients and significant others it was found that a substantial minority of significant others experienced psychological distress up to one year after the patient's initial diagnosis. The psychologically vulnerable group of significant others included an initially poor functioning group who remained so over time as well as a group whose mental health status declined over time. Personal and social resources were more important factors in declining mental health than illness-related factors.
Peripheral blood serum A, M and G immunoglobulins were measured in 123 pilots, 22 to 42 years of age, distributed in groups as to the degree of frustrational tension (FT), related frustrational tension (RFT) and frustrational intolerance (FI). Inverse correlation was found between the indices of psychic adaptation (FT, RFT and FI) and the M immunoglobulin content. No evident correlation was traced between the levels of the circulating A and G immunoglobulins and the psychological peculiarities assessed in the pilots.
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