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PubMed1993

A critical review of dimension-specific measures of health-related quality of life in cross-cultural research.

This article reviews six dimension-specific health-related quality of life (HRQL) measures which have been used cross-culturally. The instruments reviewed are: the Beck Depression Inventory (BDI); the McGill Pain Questionnaire (MPQ); the Center for Epidemiologic Studies--Depression (CES-D); the Zung Self-Rating Depression Scale (SDS); the General Health Questionnaire (GHQ); and the Psychological General Well-Being Index (PGWB). These instruments primarily represent the psychological or emotional dimension of HRQL, and are scales that were developed and validated in the USA, Canada or the UK. The review of specific studies for each of the six instruments was not meant to be exhaustive, but rather to give an indication of the ways in which the instruments have been assessed or used in various countries. The focus throughout this article is on the psychometric properties (reliability, validity and responsiveness) of these scales in different cultures, as well as the processes used to translate the instruments from English into another language. Implications of the results of this review for cross-cultural use of dimension-specific HRQL instruments are drawn.

Cross-Cultural Comparison↗
PubMed2006

Body image, binge eating, and bulimia nervosa in male bodybuilders.

OBJECTIVE: Male bodybuilders (MBB) exhibit more severe body dissatisfaction, bulimic eating behaviour, and negative psychological characteristics, compared with male athletic and nonathletic control subjects, but few studies have directly compared MBB and men with eating disorders. This study compared men with bulimia nervosa (MBN), competitive male bodybuilders (CMBB), and recreational male bodybuilders (RMBB) on a broad range of eating attitudes and behaviours and psychological characteristics to more accurately determine similarities and differences among these groups. METHOD: Anonymous questionnaires, designed to assess eating attitudes, body image, weight and shape preoccupation, prevalence of binge eating, weight loss practices, lifetime rates of eating disorders, anabolic androgenic steroid (AAS) use, and general psychological factors, were completed by 22 MBN, 27 CMBB, and 25 RMBB. RESULTS: High rates of weight and shape preoccupation, extreme body modification practices, binge eating, and bulimia nervosa (BN) were reported among MBB, especially among those who competed. CMBB reported higher rates of binge eating, BN, and AAS use compared with RMBB, but exhibited less eating-related and general psychopathology compared with MBN. Few psychological differences were found between CMBB and RMBB. CONCLUSIONS: MBB, especially competitors, and MBN appear to share many eating-related features but few general psychological ones. Longitudinal research is needed to determine whether men with a history of disordered eating or BN disproportionately gravitate to competitive bodybuildin and (or) whether competitive bodybuilding fosters disordered eating, BN, and AAS use.

Adult↗
PubMed1999

Symptoms of depression are important to psychological adaptation and metabolic control in children with diabetes mellitus.

AIMS: Sixty-two children (37 girls, 25 boys) between 9 and 18 years of age were enrolled to investigate: (1) the relationship between adaptation to diabetes mellitus (DM) and psychological functioning; (2) if adaptation or psychological functioning was related to metabolic control; and (3) if the patients' ability to cope with diabetes as assessed by physicians, was correlated to adaptation or psychological functioning. METHODS: Psychological functioning was measured by three general psychological instruments for depressive symptoms, self-esteem and fear. Diabetes adaptation was evaluated by questionnaires and coping with diabetes by an assessment of the physicians. Metabolic control was expressed by the individual HbA1c measured during the last year. RESULTS: Adaptation to diabetes correlated to psychological functioning (depression, P<0.001; self-esteem, P<0.01; and fear, P<0.01). Multiple regression analyses showed that metabolic control was predicted by adaptation (P=0.0013) with monitoring of diabetes as the only significant aspect of the adaptation (P < or = 0.0001). In turn, adaptation was predicted by symptoms of depression and metabolic control (P<0.0001). In support of this observation, a depressed (n = 9) and a non depressed (n= 53) group showed significant differences in metabolic control (P < or = 0.01), adaptation (P < or = 0.001) and self-esteem (P < or = 0.001). The only significant variable for the physicians assessment was metabolic control, which explained 35 % of the variance (P < 0.001). CONCLUSIONS: The major conclusion is that symptoms of depression affect both adaptation and metabolic control. It should be of concern to identify patients with depressive symptoms, offer treatment for their emotional difficulties and increase the support for taking care of their diabetes.

Adaptation, Psychological↗
PubMed1986

Psychological variables and patient acceptance of complete dentures.

Psychological variables and tests used in general psychology have been used in the prediction of patient acceptance of dentures. However, a survey of the dental literature indicates that with the possible exception of a 'focused interview' on self-image, none of these methods are of clinical value, either for practical reasons or because their ability to predict denture acceptance is negligible. In the present study 74 individuals with newly made dentures were interviewed with a focused interview and 16 additional questions. No correlations of practical importance between these psychological variables and denture acceptance were found, indicating that useful indicators of patient acceptance of dentures will have to be designed for the prosthodontic problem specifically.

Aged↗
PubMed1995

Psychological response to HIV positivity in hemophilia.

OBJECTIVE: To compare the psychological and family adaptation of children and adolescents with hemophilia who were seropositive for human immunodeficiency virus type 1 (HIV-1) with an HIV-negative group of comparable age, demographic characteristics, and disease severity in a multi-site study. DESIGN: Cross-sectional, controlled study. SETTING: Thirty-three hemophilia treatment centers throughout the United States. SAMPLE: Ninety-one children and adolescents with hemophilia who were seropositive for HIV and 92 children and adolescents with hemophilia who were seronegative and of comparable age, demographic characteristics, and disease severity. RESULTS: HIV-seropositive children and adolescents reported less positive affect [(lower well being) (P < .05)], and more frequent hemophilia-related school absences were identified among HIV-infected patients (P < .005). However, the two groups demonstrated surprisingly comparable levels of psychological, social, hemophilia-related adjustment, general family relations, and hemophilia-related family adaptation, as reported by patients and parents. However, mothers of HIV-seropositive children and adolescents reported higher levels of general psychological distress (P < .008) and higher levels of distress related to hemophilia (P < .0002) than parents of HIV-negative children. CONCLUSIONS: Seropositive children and adolescents with hemophilia demonstrate psychological resilience and levels of psychological adjustment that were comparable to seronegative counterparts. However, mothers of seropositive children were more distressed than mothers of HIV-negative children. Practitioners should ensure that stressed mothers obtain necessary psychological support.

Adaptation, Psychological↗
PubMed1992

Assessment of psychological care in general practice.

OBJECTIVE: To pilot a method of assessing psychological care by general practitioners. DESIGN: Prospective examination of psychological care given in general practice by using general health questionnaire with predetermined quantifiable and case specific indices of outcome established at the original consultation. SETTING: Rural general practice in Clwyd, North Wales. SUBJECTS: 447 consecutive adult general practice attenders. MAIN OUTCOME MEASURES: Three month follow up consultation rates, one year retrospective consultation rates, continuity of care, changes in general health questionnaire scores at follow up, general satisfaction, and acceptability of outcome measures. RESULTS: The principal and trainee identified 72 patients with psychological problems, 46 of whom had new conditions. 133 patients scored over 6 on the 28 item general health questionnaire, 33 of whom were identified as new cases by the general practitioners. 62 patients were seen at follow up, including 23 patients identified by the questionnaire but not by the doctor. The doctors used diagnostic terms to describe the presenting condition in 38 cases. At three month follow up the general health questionnaire scores had fallen by more than 5 points in 22/39 patients identified and managed by doctors and 11/23 identified by the questionnaire. The agreed index of good outcome was almost or completely achieved by 20 of the 39 patients managed by doctors. CONCLUSION: Quantifiable methods of evaluating the quality of the structure, process, and outcome of psychological care can be achieved in general practice.

Community Mental Health Services↗
PubMed1991

Effects of parent training on families of children with mental retardation: increased burden or generalized benefit?

Parents of children with mental retardation have become increasingly involved in special education, including training programs to facilitate teaching at home. Although some writers have argued that families accrue generalized psychological benefits of such participation, others have cautioned that the result may be increasing the burden of child-rearing. Forty-nine families of children with mental retardation were assessed before and after a parent training program, on a variety of parent, marital, and family measures. Parents reported high satisfaction with the program and showed small but statistically significant decreases in reports of symptoms of depression, parent and family problems, overall family stress, and dissatisfaction with the family's adaptability. Family characteristics were also predictive of teaching at home one year following training. The families that reported doing the least productive teaching had entered training reporting greater child-related stress and lower satisfaction with the marriage and the family.

Adaptation, Psychological↗
PubMed2004

Frequency of consultations and general practitioner recognition of psychological symptoms.

BACKGROUND: General practitioners (GPs) are widely reported to 'miss' half of the psychological problems present in their patients. AIMS: To describe the relationship between frequency of consultations and GP recognition of psychological symptoms. DESIGN OF STUDY: Survey of GPs and their patients. SETTING: General practices in the southern part of New Zealand's North Island. METHOD: Participants were randomly selected GPs (n = 70), and their patients (n = 3414, of whom a sub-set of 386 form the basis of this study). The main measure was the comparison between GP and composite international diagnostic interview (CIDI) recognition of psychological problems. RESULTS: Of the GPs selected, 90% participated. The CIDI was completed by 70% of selected patients. In patients (n = 386) with a CIDI-diagnosed disorder, 63.7% (95% confidence interval [CI] = 53.3 to 74.1) were considered by the GP to have had psychological symptoms in the last year; 40.1% (CI = 31.0 to 49.2) to have had clinically significant psychological problems, and 33.8% (CI = 24.9 to 42.6) were given an explicit diagnosis. However, in those CIDI-diagnosed patients who had been seen five or more times during the previous year, these recognition figures increased to 80.2% (CI = 68.9 to 91.4), 59.4% (CI = 45.9 to 72.9) and 53.6% (CI = 40.1 to 67.1) respectively, and dropped to 28.8% (CI = 13.0 to 44.7), 13.6% (CI = 3.4 to 23.7), and 10.7% (CI = 1.4 to 19.9) among patients not consulting during the previous year. GPs often differed from the CIDI in their assessment of clinical significance and diagnosis. CONCLUSION: GP non-recognition of psychological problems was at a problematic level only among patients with little recent contact with the GP. Efforts to improve GP recognition of mental disorder may be more effective if they target new or infrequent attenders, and encourage patient disclosure of psychological issues.

Continuity of Patient Care↗
PubMed1981

Clinical psychology: emergent trends and future applications.

The scientist-professional model offers an important heuristic and functional perspective for clinical psychology as an independent, autonomous discipline within general psychology. Alternative models of training may be inadequate for preparing future generations of clinical psychologists of deal in a competent and innovative fashion with the expanding set of roles and emerging applications in research and practice. These include behavioral medicine, group technologies, and primary prevention. Practical implications of these developments are discussed from the perspective of a scientist-professional.

Behavior Therapy↗
PubMed2003

Psychological outcomes and gender-related development in complete androgen insensitivity syndrome.

We evaluated psychological outcomes and gender development in 22 women with complete androgen insensitivity syndrome (CAIS). Participants were recruited through a medical database (n = 10) or through a patient support group (n = 12). Controls included 14 males and 33 females, of whom 22 were matched to women with CAIS for age, race, and sex-of-rearing. Outcome measures included quality of life (self-esteem and psychological general well-being), gender-related psychological characteristics (gender identity, sexual orientation, and gender role behavior in childhood and adulthood), marital status, personality traits that show sex differences, and hand preferences. Women recruited through the database versus the support group did not differ systematically, and there were no statistically significant differences between the 22 women with CAIS and the matched controls for any psychological outcome. These findings argue against the need for two X chromosomes or ovaries to determine feminine-typical psychological development in humans and reinforce the important role of the androgen receptor in influencing masculine-typical psychological development. They also suggest that psychological outcomes in women with CAIS are similar to those in other women. However, additional attention to more detailed aspects of psychological well-being in CAIS is needed.

Adaptation, Psychological↗
PubMed2005

Does psychological stress affect the outcome of in vitro fertilization?

BACKGROUND: The aim of the study was to investigate the effect of psychological stress before and during IVF treatment on the outcome of IVF, controlling for known physiological predictors. METHODS: This is a prospective, longitudinal study. A total of 166 women were studied during their first IVF treatment. They answered questionnaires concerning psychological and social factors on two occasions. Psychological well-being was measured by the Psychological General Well-Being (PGWB) index and psychological effects of infertility were assessed by 14 items. RESULTS: In the analysis of the psychological variables, no differences were found between pregnant and non-pregnant women. The total number of good quality embryos, the number of good quality embryos transferred, and the number of embryos transferred were significantly higher in the pregnant than in the non-pregnant group. In a multivariate analysis, the number of good quality embryos transferred was the only variable that was independently associated with pregnancy. CONCLUSIONS: We found no evidence that psychological stress had any influence on the outcome of IVF treatment. When counselling infertile couples, it might be possible to reduce the stress they experience during the treatment procedure by informing them of these findings.

Adult↗
PubMed2006

How the mind understands other minds: cognitive psychology, attachment and reflective function.

Jung's epistemological relativistic attitude was very advanced for his time and very much in line with the contemporary philosophy of science. Further, Jung states that the patient's unconscious has the capacity to represent itself by creating metaphors which give the therapist all the help he might need in treating his patient. As such, Jungian analysts have not been encouraged to embark on theoretical work and as a result, the Jungian movement has been lacking those theories that connect general psychological principles with clinical practices. In an attempt to enlarge our 'middle-range theories', we shall discuss Peter Fonagy's concept of reflective function. In our opinion, the theoretical hypothesis regarding the instinct of reading the mind (Baron-Cohen 1995) and Fonagy's idea of reflective function are extremely useful in our Jungian clinical practice and these concepts are utilizable because they are not at odds with analytical psychology's general epistemological and theoretical framework.

Cognition↗
PubMed2001

Impact of sex and psychological factors on the water loading test in functional dyspepsia.

BACKGROUND: The pathogenesis of upper abdominal symptoms in patients with functional dyspepsia (FD) is still unclear. The water loading test (WLT) is a new method for evaluation of gastric function. Our aim was to determine the impact of sex, age and psychological factors on the results of WLT in FD patients, FD-subgroups and healthy controls (HCs), and to evaluate the safety of the test. METHODS: Fifty-six HCs and 35 consecutive patients with FD drank mineral water (100 ml/min) until intolerable. Serum samples for sodium, potassium and creatinine was taken before and after drinking. Water quantity was registered and symptoms were assessed after maximal water intake and 30 min later using a VAS scale. Participants also completed questionnaires measuring psychological general well-being (PGWB) and gastrointestinal symptoms (GSRS and Mearin score). RESULTS: Healthy men drank more than healthy women, 2350 +/- 105 ml versus 1860 +/- 100 ml (P < 0.01), and the same gender difference was noted in FD patients, 1770 +/- 115 ml versus 1180 +/- 110 ml (P < 0.01). Maximal water intake was significantly higher in HC than in FD patients, both in males (P < 0.001) and females (P < 0.0001). Age had no impact on drinking capacity. FD patients had more symptoms 30 min after maximal water intake than HCs. Serum sodium decreased from 141 +/- 0.3 mmol/l to 138 +/- 0.5 mmol/l. Two of the assessed psychological factors, general health and depressed mood, correlated with water intake in FD patients (Rho = 0.47, P < 0.01 respectively Rho = 0.41, P < 0.05). CONCLUSION: WLT is a useful, simple and safe test for evaluating symptoms in FD patients. Sex, but not age affects the results of the WLT. Furthermore, psychological factors must also be taken into consideration when interpreting the WLT.

Adult↗
PubMed1967

Free-operant compounding of variable-interval and low-rate discriminative stimuli.

Four rats were trained on a schedule containing stimuli associated with variable-interval 30-sec and differential-reinforcement-of-low-rate 20-sec schedules of reinforcement. Subsequently, a stimulus compounding test was administered that included individual presentations of two intensities of each stimulus plus compounds of these stimuli. In training, extremely high rates were emitted to the variable-interval stimulus, and very low rates to the differential-reinforcement-of-low-rate stimulus. Compounding the two training stimuli always produced an overall response rate intermediate between the rates controlled by the two stimuli separately presented. Essentially the same relationship held with different stimulus intensities. These results resolve the confounding of response and reinforcement variables present in previous conditioning studies reporting response averaging. They are discussed in terms of the incompatibility of the response chains associated with the individual stimuli compounded.

Animals↗
PubMedDate not supplied

Gender, psychological well-being and somatic cardiovascular risk factors.

The purpose of this study is to determine associations between cardiovascular risk factors and subjective experience of psychological general well-being with special reference to gender related differences. One-hundred fifty white-collar workers in a car manufacturing plant in Sweden participated in a health care screening program. Subjective experience of psychological well-being was significantly correlated with cardiovascular risk factors among both men and women. There were, however, marked differences between the genders. For men, the following specific psychological variables were correlated with different cardiovascular risk factors: estimation of general health and psychological well-being, anxiety, depression, self-control and vitality. For women, more complex significant relationships between the two sets of variables were found. Moreover, the direction of the correlations differed between the genders. For example, men with cardiovascular risk factors, such as increased waist-hip-ratio, age and cholesterol, reported significantly more positive estimation of their self-control and vitality. For women the relation was the opposite with a significantly positive correlation (p=3D0.008) between experience of good health and a low risk factor profile indicating the concordance between physiological and psychological parameters. Possible reasons for these sex differences are discussed.

Adult↗
PubMed2000

Measuring improved quality of life after laparoscopic Nissen fundoplication.

BACKGROUND: While the correction of pathologic gastroesophageal reflux by means of laparoscopic Nissen fundoplication (LNF) has been well documented, the psychological profiles of patients with this disease and the impact on their quality of life are less well understood. We obtained a baseline psychological profile and measured the impact of LNF on patients' quality of life with 2 standardized instruments: the psychological general well-being index (PGWB) and the gastrointestinal symptoms rating scale (GSRS). The study included 34 consecutive patients with typical symptoms of gastroesophageal reflux who underwent LNF in 1995 at a tertiary care university medical center. METHODS: Patients filled out PGWB and GSRS surveys preoperatively and at 2 weeks, 2 months, and 12 months postoperatively. Data were collected in a blinded fashion by a study nurse and analyzed after completion of the study. Data are expressed as mean +/- standard deviation. RESULTS: The mean preoperative PGWB score (69.6 +/- 17.3) of study patients with gastroesophageal reflux disease was lower than that expected for a healthy population. This was primarily attributable to low scores in the general health domain of the questionnaire, although LNF patients also had low scores in the vitality and positive well-being domains of the PGWB scale. LNF improved the PGWB score to a normal level (78.7 +/- 19.3) (P = .05 vs the preoperative PGWB score) at 12 months post surgery. The GSRS also showed improvement from 34.7 +/- 7.8 to 28.1 +/- 10 (P = .008). The improvement in GSRS was attributed to improvement in the heartburn (7.12 +/- 2.4 to 2.72 +/- 1.2, P < .001) and abdominal pain (6.58 +/- 2.5 to 4.92 +/- 1.6, P = .006) domains of the scale. LNF had no impact on the diarrhea, indigestion, and obstipation domains of the GSRS. CONCLUSIONS: Patients with gastroesophageal reflux disease who are candidates for LNF have low psychological and general well-being scores that are restored to normal levels by successful LNF. When compared with baseline measurements, LNF effectively relieved heartburn and did not cause significant new gastrointestinal complaints.

Adult↗