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Biomedical subjects

B G Link

Publications and source records attributed to B G Link.

54 records · Page 3Linked to original sources
PubMed1990

Problems in measuring role strains and social functioning in relation to psychological symptoms.

The problems that people experience in social roles can be regarded as either causes or consequences of psychological symptoms. To reflect one of these possibilities, Pearlin et al. (1981) developed measures of "role strains" which are considered sources of psychopathology. To reflect the other position, Dohrenwend et al. (1981) constructed measures of "role functioning" which are seen as consequences of psychopathology. We show that the measures developed by these two teams of investigators are similar in content and show substantial empirical overlap despite the different meanings attributed to them. In an effort to understand whether these highly correlated measures assess, "role strain" or "role functioning," we conduct an exploratory analysis of marital and housework role problems, using a small panel sample of New York City residents. Specifically, we use instrumental variables to identify reciprocal effects between psychological distress and each role area. We find that the relationship between housework role problems and distress is more consistent with Pearlin et al.'s interpretation, whereas the relationship between marital problems and distress is more consistent with that of Dohrenwend et al. Investigators interested in measuring either role strain or role functioning must bear in mind the strong possibility of contamination from the other construct.

Educational Status↗
PubMed1989

Feelings of stigmatization in patients with psoriasis.

The concept of stigma, defined as a discrediting mark that sets a person off from others, is used in a systematic, in-depth examination of how 100 adults with psoriasis experience their illness. Information on demographic and illness variables that might predict feelings of being stigmatized were obtained. Through factor analysis of a specially designed questionnaire, six dimensions of the stigma experience were identified: anticipation of rejection, feeling of being flawed, sensitivity to others' attitudes, guilt and shame, secretiveness, and positive attitudes. There was marked variability in the presence and magnitude of these feelings. Different predictors emerged for different dimensions of the stigma experience, the most frequent being age at onset, extent of bleeding, employment status, duration, and rejection experience. Of all the aspects of the illness, bleeding proved the strongest predictor of stigma feelings and of despair, which correlates highly with stigma. Despair and feeling stigmatized may lead to noncompliance with treatment, possibly worsening the status of the psoriasis.

Adult↗
PubMed1989

The 'well control' artefact in case/control studies of specific psychiatric disorders.

An appropriate choice of controls in case/control studies of specific psychiatric disorders is crucial for valid risk-factor assessment. One suggested approach to control-group selection, the use of a well control group, is the focus of this paper. While using well controls has intuitive appeal, this paper shows that such a procedure can lead to ambiguous and biased results.

Anxiety Disorders↗
PubMed1989

Characterizing life events as risk factors for depression: the role of fateful loss events.

Empirical associations between life events and health are often weak, in part because event exposure measures may group together very different kinds of experiences within a single event category. Attempts to refine the measures (by using respondents' subjective appraisals of event stressfulness or by taking into consideration situational and personal factors that influence the contextual threat of the events) may strengthen the association, but they cloud the clarity of any causal inference by confounding the measure with extraneous variation. Instead, the use of descriptive information about what actually happened before, during, and after each event is recommended to define exposure to potent, fateful life events. In a comparison of 96 patients with major depression and 404 community residents with no apparent depression, the odds that a person would have experienced one or more events meeting criteria for fatefulness and disruptiveness was 2.5 times greater in the depressed group.

Adult↗
PubMed1988

Gender and the expression of schizophrenia.

The expression of schizophrenia was examined in 169 DSM-III diagnosed schizophrenics. Restricted maximum likelihood factor analysis was used to test the invariance of the hypothesized symptom model across gender. Findings indicated that schizophrenic women not only expressed more impulsivity and affective symptomatology than did men, but their psychotic symptoms covaried consistently with the expression of impulsivity, anger and other affective symptomatology. Men's expression of schizophrenia covaried positively with withdrawal/isolation and an inability to function, suggesting a possible negative symptom pattern. Gender differences were not attributable to misclassification, differences in diagnostic subtypes, nor to selection. Results are discussed in light of their implications for understanding the heterogeneity of schizophrenia.

Adult↗
PubMed1988

Toward construct validity for DSM-III Axis V.

This study investigates the construct validity of DSM-III Axis V ratings, made in diverse clinical settings, by means of independent assessments of adaptive functioning. Three hundred and sixty-two patients received supervised multiaxial assessments and were then blindly reinterviewed with the Psychiatric Epidemiology Research Interview, which contains scales measuring various aspects of social and occupational functioning. A subsample of 154 patients received a second independent interview that assessed characteristics of the individuals' social networks. The results indicate that Axis V ratings (1) demonstrate predictable diagnostic and demographic group differences, and (2) are determined by both social and occupational variables, but occupational factors predominate. The significance of the results for defining the adaptive functioning construct, for methods of assessment, and for the revisions of Axis V in DSM-III-R, is discussed.

Adaptation, Psychological↗
PubMed1988

The revision of axis V in DSM-III-R: should symptoms have been included?

The authors studied the relationship of psychological symptoms to clinicians' ratings on DSM-III's axis V. A total of 355 patients received multiaxial assessments and were reinterviewed under blind conditions with the Psychiatric Epidemiology Research Interview, which contains scales to measure aspects of social and occupational functioning and various symptom dimensions. The majority of symptom scales were correlated significantly with axis V ratings. Axis I diagnosis explained 19.0% of the variance in axis V; demographics, 6.5%; and symptoms, 7%. Symptoms had a larger effect, in terms of explained variance, than adaptive functioning variables and tended to detract from the latter's significance. These results have implications for axis V in DSM-III-R and for planning DSM-IV.

Adolescent↗
PubMed1987

Life stress and psychopathology: progress on research begun with Barbara Snell Dohrenwend.

This is a progress report on some of the research that was planned and begun with Barbara Dohrenwend before she died in 1982. The main focus is on two of the studies. One was conducted in New York City; the other is still underway in Israel. The New York study is a retrospective case/control study of social and psychological factors that may put people at risk for developing schizophrenic episodes and episodes of major depression. The Israel research consists of epidemiological, case/control, and family studies of these two disorders together with other types of psychopathology that are inversely related to social class. Preliminary findings from both studies are reported, and their implications for primary prevention are discussed.

History, 20th Century↗
PubMed1987

Stigma perceived by patients attending modern treatment settings. Some unanticipated effects of community psychiatry reforms.

In recent years reforms were instituted in the Federal Republic of Germany that were designed to facilitate the integration of psychiatric services and psychiatric patients into community life. One goal of this reform was to reduce patients' feelings of stigmatization. Because such feelings were thought to arise through patients' tenure at large, isolated state hospitals, we hypothesized that patients sent to such hospitals would feel more stigmatized than would patients assigned to a modern, integrated university hospital. Further, we hypothesized that patients in the two settings would adopt different strategies to cope with the stigma they perceived and that staff members in the two settings would share patients' views concerning these matters. Although we found that the staff in both hospitals shared our prediction that state hospital patients would perceive more stigmatization, our findings showed just the opposite. State hospital patients were significantly less likely than university hospital patients to believe that most people would devalue and discriminate against mental patients. Nor did we find strong evidence of different styles of coping with stigma among patients in the two settings. Taken together, our results suggest that in the realm of stigmatization well-intentioned efforts of reforms may have had undesirable unanticipated consequences. Given this, we suggest approaches for intervening more directly with patients in the form of "Daily Living Groups," which are designed to explicitly discuss actual and feared stigmatization.

Adaptation, Psychological↗
PubMed1986

Self-reported physical and psychological effects following a malathion pesticide incident.

To assess effects attributed to malathion which escaped from an overheated tank at a chemical plant in Linden, New Jersey, researchers surveyed seamen subjects (n = 22) on board a nearby tanker and seamen control subjects (n = 21). Self-report measurement strategies included a medical review of body systems, the "demoralization" scale reflecting psychological symptoms of distress, demographics, and factors that may buffer stress, specifically, social support and knowledge regarding toxic chemicals. Self-reported postincident physical health differences between the two groups of seamen were noted. There were no differences between subjects and control subjects on demoralization levels. Further analysis indicated higher levels of demoralization among less knowledgeable seamen subjects.

Adult↗
PubMed1985

Vulnerability to stress among women with in utero diethylstilbestrol (DES) exposed daughters.

In utero exposure to diethylstilbestrol (DES) was initially linked to vaginal-cervical cancer and subsequently to reproductive difficulties. These unanticipated and ongoing health risks to female offspring may constitute a chronic source of stress for DES mothers. We interviewed 60 mothers of exposed daughters and 30 acquaintance controls. Two hypotheses were tested in regard to DES mothers: DES discovery and its aftermath have a direct, long-term, negative effect on psychological health and the DES experience intensifies the negative psychological effects of other adverse life circumstances. To operationalize psychological health, we measured symptoms of "demoralization" and positive health practices--the latter as a behavioral indicator of mastery and personal control. We also measured adversities that may mediate the threat posed by DES, including stressful events, medical problems, and chronic burdens. We found DES history to be associated with poorer psychological health only when mothers encountered other losses and threats to themselves and their families. We concluded that DES mothers may manifest increased vulnerability to subsequent stresses in their lives.

Adaptation, Psychological↗
PubMed1983

Reconsidering the social rejection of ex-mental patients: levels of attitudinal response.

Public attitudes are conceptualized as involving four levels: the ideal level, the level of expressed attitudes, the level of attitudes as acted upon, and the deep level. While direct assessments of these attitude levels are not possible, three indicators are developed to serve as preliminary assessments. An experiment was conducted in which labeling information (labeled a mental hospital patient vs. not labeled), behavior ("normal man" vs. "anxiety neurotic" vignettes), and the three indicators of attitude level were varied. A sample of 153 persons in a small midwestern city was asked to assess the vignette material presented to them by answering five social distance questions. The results showed that when an individual is labeled, ideal attitudes are more positive than attitudes as expressed. These are, in turn, more positive than an indicator of attitudes as acted upon and deep attitudes. Future research should develop strategies which assess these deeper attitudes before conclusions are made about the public's acceptance of former mental patients.

Attitude↗
PubMedDate not supplied

Characteristics and treatment of homeless, mentally ill, chemical-abusing men.

Comparing two types of treatment modalities in treating homeless, mentally ill, chemical-abusing (HMICAs) men and studying their characteristics, 723 HMICAs were interviewed on their childhood and family background and their psychiatric and substance abuse disorders, and then randomly assigned into either therapeutic community (TC) or community residence (CR) programs. The TC and CRs were found to differ from one another in their intake and admission procedures, their preadmission and postadmission dropout rates, and the effects of treatment on psychological status. The TC admitted their clients into treatment faster, tended to take more impaired clients, and had a lower preadmission dropout rate than the CRs did. The CRs had a lower postadmission dropout rate and were able to retain clients longer than the TC did. Comparing clients who stayed in treatment one year or longer, the TC appears to be more effective than the CRs in reducing depressive, psychotic, and functional symptoms. HMICAs' childhood and family background reveal severe parental deprivations and high prevalence of alcohol and other drug abuse, mental illness, and criminal behavior among the clients' parents. HMICAs' characteristics suggest that these men are completely outside mainstream society. They are severely impaired psychiatrically, chronically addicted, and often involved with the criminal system, thus occupying multiple deviant roles.

Adult↗