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Biomedical subjects

D K Wellisch

Publications and source records attributed to D K Wellisch.

At least 37 records · Page 2Linked to original sources
PubMed1985

Psychosocial correlates of immediate versus delayed reconstruction of the breast.

Two groups of consecutive patients from two different plastic surgical practice populations were evaluated to determine psychosocial differences between those who underwent immediate (n = 25) versus delayed (n = 38) breast reconstruction. Psychological assessment consisted of a standardized symptom inventory (BSI) and a specially designed self-report questionnaire investigating reactions unique to mastectomy and reconstruction. Both groups were extremely equivalent with regard to sociodemographic data, with the typical subject being a well-educated and employed Caucasian wife. Verbal reports of physical complaints revealed no significant differences between the two groups except for difficulty with arm movement, which was statistically higher for the immediate group (p = 0.006.). This difference most likely was due to the axillary dissection being performed simultaneously at the time of reconstruction. The relationship between timing of reconstruction and self-reported distress over the mastectomy experience revealed that only 25 percent of the women who underwent immediate repair reported "high distress" in recalling their mastectomy surgery compared with 60 percent of the delayed reconstruction group (p = 0.02). In reference to the two scales measuring psychological symptoms, a general trend was present, with the delayed group scoring higher (although not statistically significantly) on 9 of our 12 scales. Ninety-six percent of the immediate group and 89 percent of the delayed group reported satisfaction with results.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast↗
PubMed1985

The sooner the better: a study of psychological factors in women undergoing immediate versus delayed breast reconstruction.

Patients who had reconstructive breast surgery at the time of mastectomy (immediate) or within 1 year (early) had significantly less recalled distress about their mastectomy than those who had it more than 1 year later (delayed). Women who had immediate or delayed reconstructive surgery had similar levels of psychological symptoms, which were slightly lower than those reported by women in the early reconstructive group. The wish to wear a wider range of clothes and the wish to be rid of the external prosthesis were common motivations for reconstructive surgery. The desire to improve sexual relations or one's marital state was less common and should be viewed with caution when presented as the primary motivation for this procedure.

Adaptation, Psychological↗
PubMed1985

Drinking patterns and problems among female children and adolescents: a comparison of abstainers, past users, and current users.

The sociopsychological factors that underlie drinking behavior among 197 young girls, ages 9 through 17, are explored. Three groups-youthful abstainers, former users, and current users-were interviewed, as were their parents. These comparison groups are contrasted on 110 variables. The relative merits of four competing explanations of youthful drinking behavior-deprivation, personal deficiency, hedonistic peer culture, and family pathology-are assessed.

Adolescent↗
PubMed1984

Implementation of psychosocial services in managing emotional stress.

Psychological services for breast cancer patients call for several elements in the inpatient, outpatient, and home settings. In the inpatient setting, comprehensive services include Reach-to-Recovery, social work, and psychiatric consultation services, and structured psychological support available to the staff. In the outpatient setting, comprehensive services include social work and psychiatric consultation and support for the staff, but in addition programming for the patient's family is crucial, with a balance of services which include both education and emotional support in regard to the patient's disease. In the home setting, when dying breast cancer patients are to be considered, the needs for psychological consultation and emotional support for the visiting nursing personnel becomes paramount.

Breast Neoplasms↗
PubMed1984

Psychosocial issues in breast reconstruction. Intrapsychic, interpersonal, and practical concerns.

Because the decision to have or not to have breast reconstruction is multiply determined, in-depth inquiry should be made into the patient's intrapsychic (self-directed) motives and interpersonal factors that contribute to her choice. This article discusses five major variables that enter into the final decision. These include knowledge of the procedure, economic resources, medical conditions, psychological dynamics, and reactions of significant others in the patient's life, including spouse, physicians, and mother.

Body Image↗
PubMed1983

Preventing nursing burnout: a challenge for liaison psychiatry.

The authors conducted a study to assess and compare the level of job satisfaction among five groups of registered nurses working at UCLA Hospital. Fifty-seven female nurses completed the MMPI, Locus of Control Test, Work Environment Scale, and a questionnaire designed to assess job satisfaction. Results showed that there were no significant personality differences among the five groups of nurses. Significant differences between some of the groups were found in demographic variables and in work-related variables such as involvement, task orientation, work pressure, sense of authority on the job, and perceived communication with peers or other groups in the work environment. Nurses on the Medicine unit tended to have lower overall job satisfaction than those in the other units. The involvement of the Psychiatric Liaison Service on the five nursing units is described and discussed as a possible method for providing psychosocial support to the nurses and reducing high turnover rates.

Adult↗
PubMed1983

A comprehensive psychological approach to obesity.

Many different treatments for obesity have proven somewhat successful, with none emerging as clearly superior to the others. Surgical approaches, although usually successful at achieving and maintaining weight loss, are accompanied by varied and often harmful side effects. Unless new, safer procedures are developed, treatment may continue to be as hazardous as the obesity itself. Because medical treatment alone has not achieved beneficial, lasting results, research aimed at finding new procedures should be encouraged. Our five-year experience in working with obese patients has led us to the following conclusions: 1. The management of obesity must be a joint venture between psychiatry and medicine. Because of the complex nature of this illness, neither discipline alone can successfully and safely achieve significant initial weight loss coupled with successful long-term maintenance. The use of adjunctive psychological programs in a medical setting can be a successful alternative. 2. Fasting, weight loss, and realimentation must be accompanied by an effort at lifestyle change. Otherwise, patients will continue their self-destructive habits, which will ultimately lead to failure in yet another attempt at sustained weight reduction. The behavioral approach has provided a fairly effective treatment of obesity, sometimes with immediate results. Recent studies support the maintenance effect of behavioral treatments. However, longer studies with follow-ups are needed to better assess the overall effectiveness of these treatments. 3. Despite much false optimism that weight loss is a simple road to happiness, most patients experience some very real problems during the fasting part of the program. Crisis intervention can prove very helpful in terms of reducing stress and preventing dropouts. Group therapy, individual therapy, family therapy, and hypnosis have attained some very limited positive results when used alone; greater success has been reported from combining therapies. Patients generally became more socially effective, physically active, and mentally proficient when exposed to individual therapy together with group and family therapies. 4. Family environment appears to significantly affect compliance and completion. A conflict-laden family environment hampers the patient's ability to deal with the psychological changes encountered in weight loss programs. 5. Many obese patients lack a fundamental knowledge of nutrition, exercise, and health. In addition, most are poorly socialized and require assistance in learning assertiveness and other interpersonal skills. A behaviorally oriented component is very effective in providing these skills.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1981

Serum gastrin and the family environment in duodenal ulcer disease.

The study investigated the relationships between specific demographic, psychosocial, and physiological variables and the severity of duodenal ulcer disease in a population of patients with proved duodenal ulcer. Intercorrelations between psychosocial and physiological variables were also studied. The study design was cross sectional and retrospectively assessed life change units and DUD severity during the previous 6 months in 39 male ulcer clinic outpatients. Anxiety, depression, life change units, the family environment, ABO blood type, secretor status, serum pepsinogen, and serum fasting gastrin were evaluated. A DUD severity score was calculated from self-reported ulcer pain symptoms and ulcer complications. Gastrin levels correlated significantly with three Family Environment Scale (FES) subscales, including: (a) independence, (b) achievement orientation, and (c) expressiveness. Duodenal ulcer disease severity scores correlated with Zung SDS scores, but not with state or trait anxiety, life change units, or the FES.

Achievement↗
PubMed1980

Parenting attitudes of addict mothers.

Parenting attitudes of female heroin addicts were investigated in a single factor design which compared addict mothers, addict non-mothers, nonaddict mothers, and nonaddict nonmothers. A principal components factor analysis was performed on the PARI and used as the dependent measure. A factor labeled "authoritarian overinvolvement" emerged which significantly differentiated between groups. Further, the effects of mothering and addiction proved to be additive such that addict mothers were extremely high on this scale. This result was discussed in terms of the parental home environment of addict women.

Adolescent↗
PubMed1979

Phantom breast syndrome.

In this study of 41 women who underwent mastectomy, over half (54%) experienced phantom breast syndrome (PBS). Of these, 80% had phantom breast pain. The majority of women (58%) did not report their symptoms to their physicians, despite the considerable interference in their lives from these symptoms. Six variables were found to differentiate the women who had phantom breast syndrome from those who did not. All of these factors were closely related to the psychological aspects of mastectomy. Significant among these was that women who experienced PBS perceived both that they did not receive much emotional support from their surgeons, and that most of their emotional problems were secondary to the mastectomy. In these respects, they differed from women not reporting PBS. By early evaluation of each patient who is to undergo mastectomy, it should be possible to identify those at risk, to develop means to prevent the development of the syndrome, and to treat those women in whom the preventive attempts are unsuccessful.

Adult↗
PubMed1979

Psychology interns on a consultation-liaison service.

This paper develops a rationale for training psychology interns on a consultation-liaison service to deal with the psychologic problems of medically ill patients and to work with their health care providers. General and specific goals are delineated to summarize training objectives for these interns at the end of three and six months on the service. The overall objective of the service in offering such a program is to train psychologists to feel competent and comfortable in meeting the psychologic needs of the medically ill. The service seeks to train psychologists primarily as clinicians and secondarily as researchers in the health care area.

Curriculum↗
PubMed1979

Coercive persuasion (brainwashing), religious cults, and deprogramming.

Psychiatric interviews and psychological testing were conducted with 50 members of former members of a variety of religious cults who contacted the authors about the issue of deprogramming. The subjects were divided into four groups: cult members who feared deprogramming, those who had returned to the cult after deprogramming, ex-cult members who had left after deprogramming, and those who had left without deprogramming. There were significant differences between these groups on length of time in the cult, perception of and resistance toward the deprogramming experience, status of parental marriage, and who became a deprogrammer. No evidence of insanity or mental illness in the legal sense was found.

Attitude↗