Search PubMed⌕ Search

Biomedical subjects

A Mathews

Publications and source records attributed to A Mathews.

At least 73 records · Page 4Linked to original sources
PubMed1983

Progress in the treatment of female sexual dysfunction.

Over a decade of research since the publication of Human Sexual Inadequacy by Masters and Johnson has confirmed the effectiveness of psychological treatment for sexual problems, but has not advanced our understanding of aetiology very much. It is generally assumed that anxiety blocks normal function in sexual disorders such as impotence or frigidity, although hormonal changes have also been suggested. Evidence for either proposition is lacking. Our own attempts to understand mechanisms have included the use of a dismantling strategy to investigate the effective components of psychological treatment, and latterly the role of exogenous androgens. In our first study, brief treatment modelled on that of Masters and Johnson proved superior to another version of graded practice in sexual contact which lacked the counselling component. Similarly, the fuller version had more effect than did imaginal desensitization, suggesting that sexual dysfunctions cannot be treated like phobic anxiety. A second study focused on women complaining of little sexual interest or enjoyment. The use of a minor tranquillizer was compared with that of androgen (testoral) in the hope that different treatments would be shown to be best for different types of disorder. Unexpectedly, the androgen proved best overall while another variable, monthly vs weekly sessions, did not produce any differences in effect. In the most recent study, a further 48 women were given androgens or placebo, and were seen weekly or monthly for four months by either one or two therapists. There were few significant differences, the most consistent being greater subjective improvement by the women being seen at weekly intervals. The failure to find a positive hormone effect in comparison with placebo raises the possibility that the anxiolytic used earlier may have been counter-productive. If so, it seems unlikely that either excessive anxiety or simple androgen deficiency is an adequate aetiological explanation for female sexual dysfunction.

Anxiety↗
PubMed1983

Psychological and hormonal factors in the treatment of female sexual dysfunction.

Forty-eight couples with a presenting problem of female sexual unresponsiveness were treated in a controlled study using a balanced factorial design. The factors varied in this design were medication (testosterone or placebo), treatment frequency (weekly or monthly sessions), and the number of therapists involved (one female or a male/female pair). All counselling was adapted from that described by Masters & Johnson (1970) and Heiman et al. (1976). Results were assessed before and after a 3-month treatment period, and again 6 months later. Contrary to expectations from earlier work, there was no benefit attributable to testosterone or to the use of two therapists; self-ratings favoured weekly sessions with one therapist. It was concluded that testosterone (at least in the dosage used) is unlikely to have a useful place in the treatment of sexually unresponsive women, but that weekly counselling sessions with a single therapist is a reasonably effective and economic form of sex therapy. Findings from this research suggest the need for a clearer understanding of aetiological and treatment mechanisms.

Adult↗
PubMed1983

Negative self-schemata in clinical depression.

Predictions from a negative self-schema model of depression were tested using decision speed and recall measures for self and other person-referent positive and negative adjectives. Clinical depressives, compared to non-psychiatric controls, recalled more negative than positive self-referent adjectives, although there were no differences between groups in decision speed. Depressives' negative bias in recall applied only to the self-referent conditions; in the other referent conditions they exhibited the normal tendency towards positive recall bias. The self-referent recall bias in depressives did not relate significantly to either duration or intensity of depression. The results appear to be consistent with expectations derived from a negative self-schema model of depression, but alternative explanations remain to be investigated.

Decision Making↗
PubMed1982

Psychological preparation for surgery: a comparison of methods.

Sixty hysterectomy patients were randomly assigned to one of three types of psychological preparation prior to surgery, while an additional 10 patients declined psychological help. Twenty patients received information about the surgical procedure and its effects, another 20 were instructed in a cognitive coping technique, and the remainder were given general information about the ward. Interventions were shown to have different effects on a number of pre- and post-surgical measures; notably on knowledge about hysterectomy, analgesic usage, reported days of pain after discharge, and belief in the usefulness of intervention methods. Whereas information about surgery enhanced knowledge and usefulness ratings, cognitive coping appeared to have most effect on indices of recovery. Patients declining preparation responded badly immediately after surgery, but made a satisfactory recovery after discharge. Cognitive coping methods seem to be an effective way of managing specific worries about the operation, and it is suggested that this underlies differences in patterns of recovery following surgery.

Adaptation, Psychological↗
PubMed1981

Personality and surgical recovery: a review.

Studies concerned with the influence of personality variables on recovery from surgery are critically reviewed. There is some evidence that high levels of neuroticism or trait-anxiety are associated with more distress and slower recovery from surgery. Evidence concerning other personality variables is less conclusive, and those positive associations that have been found may be attributable to overlap between the assessments used and trait-anxiety measures. Further research should involve patient groups that are more homogeneous in terms of sex and type of surgery. Progress in the field would also be furthered by the use of factorially grounded personality measures and standard recovery variables such as pain ratings, respiratory complications or resumption of normal activities. The links which have been found between personality and clinical outcome measures can be explained in terms of effects on subjective distress, or on the patients' involvement in behaviour which may promote recovery, or on physiological and immunological mechanisms.

Adaptation, Psychological↗
PubMed1978

Myotonia dystrophica: unusual features in a Labrador family.

A large family with myotonia dystrophica has been recognized in an isolated area of Labrador. The complete family tree showed 29 of 108 members to be affected, including an infant with the congenital form of the disease. The propositus presented with epiphora and reduced frequency of blinking, with incomplete closure--features that have not previously been stressed. Ten of the younger affected persons had no lens opacities, although most had systemic muscle signs. Slit-lamp examination was therefore not a valuable method of early detection of the disease in the family. Many of the women affected by myotonia dystrophica had obstetric complications, particularly hydramnios, premature onset of labour, necessity for cesarean section, postpartum hemorrhage and neonatal death. Hydramnios was associated in each instances with perinatal death. The fetus in each case of hydramnios may have had the gene for myotonia dystrophica. Immunoglobulin A concentrations were reduced significantly in 27 affected persons in comparison with 77 unaffected family members. There were no such differences for the other immunoglobulin classes.

Adolescent↗
PubMed1978

Combination of hormonal and psychological treatment for female sexual unresponsiveness: a comparative study.

Thirty-two couples with the presenting problem of female sexual unresponsiveness were treated in a controlled study using a balanced factorial design. Treatment involved a combination of drug therapy and counselling. Half the subjects received testosterone and half diazepam, half received weekly and half monthly counselling. They were assessed before treatment, at the end of treatment and at six months follow-up. Those receiving testosterone did significantly better on a number of behavioural and attitudinal measures than the diazepam group. There were no notable differences in outcome between the two counselling regimes. There were no undesirable side-effects with the testosterone. Further work is needed to establish the indications for testosterone therapy for unresponsive women.

Adult↗
PubMed1977

Attitude change during behavioural treatment of sexual inadequacy.

Attitudes towards 'self' and 'partner' were studied in couples undergoing three different behavioural treatments for sexual inadequacy: systematic desensitization with counselling; guided practice with counselling; and practice with minimal counselling. Factor analysis of semantic differential scales identified five components--general evaluation, anxiety, and three factors relevant to sexual evaluation designated as 'loving', 'sexually attractive' and 'easy to arouse'. Differences in derived factor scores were found which related to sex of rater, identity of complainant, and treatment received; with the treatment combining guided practice with counselling being followed by significantly greater attitude changes.

Anxiety↗