Healing words: emotional expression and disease outcome.
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Adaptation, Psychological↗
Biomedical subjects
D Spiegel
Publications and source records attributed to D Spiegel.
Psychologists' beliefs about the prevalence of childhood sexual abuse: the influence of sexual abuse history, gender, and theoretical orientation.
OBJECTIVE: This study examined the influence of sexual abuse history, gender, theoretical orientation, and age on beliefs about the prevalence of childhood sexual abuse among clinical and counseling psychologists. METHOD: A mail survey design was used in this study. Participants were randomly selected from the American Psychological Association membership database. There were 615 psychologists who completed self-report measures on beliefs about the prevalence of childhood sexual abuse and demographic characteristics. RESULTS: Overall, clinicians' scores on the prevalence of childhood sexual abuse were moderate. There were significant gender differences on beliefs, suggesting that women were more likely believe that childhood sexual abuse is a common occurrence compared to men. Multiple regression analysis indicated that clinician characteristics (history of sexual abuse, gender, and theoretical orientation) were significantly related to beliefs about the prevalence of childhood sexual abuse. However, these characteristics only accounted for a small amount of the overall variance predicting beliefs. CONCLUSIONS: These results suggest that clinicians do not hold extreme beliefs regarding the prevalence of childhood sexual abuse. Moreover, certain clinician characteristics are associated with their beliefs, which in turn, may impact their clinical judgment and treatment decisions. Furthermore, much of the variance was unaccounted for in the model indicating that psychologists' beliefs are complex and are not unduly influenced by their personal characteristics. Implications for clinical practice and future research are discussed.
Child↗
Low-frequency, low-intensity ultrasound accelerates thrombolysis through the skull.
Systemic thrombolysis of acute ischemic stroke with recombinant tissue plasminogen activator (rt-PA) has been established recently. Whereas the delay to and the rate of vessel recanalization are unknown, they are likely slower and smaller than for local application of rt-PA. This may contribute to the small benefits of recovery reported and stimulate further investigations to improve clot lysis. Pilot studies indicate that continuous-wave low-frequency ultrasound (US) can accelerate rt-PA-mediated recanalization of peripheral thrombotic vessel occlusion. For the hypothesized therapeutical purpose in stroke treatment, we measured the attenuation of ultrasound through the skull at different frequencies and intensities (33.3 and 71.4 kHz; 0.5 and 3.4 W/cm2), and investigated thrombolysis in vitro (n = 125 clots). Attenuation was lowest by transtemporal insonation of 33.3 kHz, 0.1 dB (0.9). Thrombolysis (artificial fibrin-rich clots) was significantly increased after 1 h (p < 0.025) and after 3 h (p < 0.01) for US treatment in combination with rt-PA vs. rt-PA alone. Results suggest that US increases rt-PA-mediated thrombolysis through the skull and may improve benefits of thrombolytic stroke treatment in vivo.
Brain Ischemia↗
Improving the quality and quantity of life among patients with cancer: a review of the effectiveness of group psychotherapy.
Cancer patients suffer from a number of psychosocial problems related to the progression of their disease as well as standard medical interventions. Fortunately, there is empirical evidence suggesting that group psychotherapy is effective at ameliorating psychological distress and in some cases improving survival. For this literature review we examined the psychological morbidity, particularly anxiety and depression, among cancer patients. Further, we conducted a critical examination of the current evidence regarding the effectiveness of group psychotherapy for improving the quality as well as the quantity of life in cancer patients. Finally, we explored the specific components of effective group psychotherapy, which has been associated with enhanced survival. We conclude that there is compelling evidence indicating that group psychotherapy improves the quality of life of cancer patients. Furthermore, there is a growing body of evidence suggesting that group psychotherapy improves survival of cancer patients.
Humans↗
Traumatic stress, life events, and emotional support in women with metastatic breast cancer: cancer-related traumatic stress symptoms associated with past and current stressors.
This study examined levels of intrusion and avoidance symptoms and their relationships to past life stress, current emotional support, disease-related variables, and age in 125 women with metastatic breast cancer. The results indicate that a sizable proportion of these women experienced clinically significant levels of intrusion and avoidance symptoms related to their cancer, particularly those with both more stressful past life events and higher current levels of aversive emotional support. Additionally, both types of symptoms were associated with shorter time since recurrence, and avoidance symptoms were associated with smaller emotional support networks. These results indicate that metastatic breast cancer is an emotionally traumatic event for a significant proportion of women, particularly those with past life stressors and unsupportive social environments.
Adult↗
Embodying the mind in psychooncology research.
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Adaptation, Psychological↗
[Comparison of postoperative recovery after trabeculectomy for pseudoexfoliation glaucoma and chronic primary open angle glaucoma].
BACKGROUND: A former study showed an increased biochemical and tyndallometrical concentration of proteins in the anterior chamber in eyes with pseudoexfoliation glaucoma (PEX). This may induce an increased healing process, which may reduce the effectiveness of a trabeculectomy. To evaluate the intraocular pressure (IOP) lowering effect of trabeculectomy over time in eyes with PEX and primary open angle glaucoma (POAG) a retrospective study was conducted. METHODS: Thirty eyes of 30 patients with PEX were matched to 30 eyes of 30 patients with POAG in terms of age, glaucoma medication, and visual field loss. All patients underwent primary trabeculectomy by one surgeon without the use of antimetabolites. Maximum IOP and the duration of antiglaucomatous therapy before trabeculectomy was evaluated. IOP readings were analyzed before and 1 day, 1, and 2 years after trabeculectomy. Statistical evaluation was performed by Mann and Whitney's U-test. RESULTS: Patients with PEX showed a significant higher maximum IOP and a significant shorter duration of antiglaucomatous therapy before trabeculectomy. Both groups showed no significant differences in IOP before and after trabeculectomy. In the group with PEX a tendency to a lower IOP was found 1 year (p(U) = 0.13) and 2 years (p(U) = 0.16) after trabeculectomy. There was no significant difference in antiglaucomatous therapy after trabeculectomy. CONCLUSIONS: This study did not find a reduced IOP lowering effect of trabeculectomy in eyes with PEX in comparison to eyes with POAG over time.
Aged↗
Commentary: deconstructing self-destruction.
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Body Image↗
Creatine kinase MB isoenzyme of noncardiac origin in elderly patients.
Increased activity of creatine kinase MB (CKMB) isoenzyme is regarded as highly diagnostic for acute myocardial infarction. We report two cases of elderly patients with increased levels of CKMB but no evidence of cardiac injury. We conclude that numerous factors influence CKMB activity and that the suitability of this test for the diagnosis of cardiac muscle damage in the elderly should be viewed with caution.
Aged↗
Age and stimulus dependency of visually evoked cerebral blood flow responses.
BACKGROUND AND PURPOSE: During visual stimulation, the increased metabolic demand is coupled with an increase of cerebral blood flow velocity (pCBFV) in the posterior cerebral artery (PCA). Investigation of the visually evoked flow responses (VEFR, expressed as percentage of increase from baseline pCBFV values) was suggested for different conditions of vasoneuronal disorders in the absence of any systematic investigation in healthy subjects. METHODS: We investigated VEFRs from both PCAs to various increasingly complex paradigms (diffuse light, alternating checkerboard patterns, and a color video movie stimulation; 5, 10, 20, and 30-second intervals) in 60 healthy volunteers (mean age, 41.5+/-14.9 years; range, 24 to 80 years; 28 male, 32 female) at different recording sites (P1 versus P2 segments of PCAs). RESULTS: With increasing complexity of stimulation, the VEFRs increased significantly (24.3+/-10.3%, 28.5+/-13.5%, and 43.4+/-10.7%, respectively). Twenty-second stimulation intervals yielded maximal responses (41.5+/-13.2%) compared with 5-, 10-, and 30-second intervals (22.6+/-14.1%, P=0.001; 34.4+/-11.7%, P=0.0042; and 35.5+/-9.9%, P=0.0032, respectively). Significantly higher responses were gained from P2 segments than from P1 segments (42.7+/-7.2% versus 28.2+/-7.1%). Although VEFRs tended to decrease in amplitude with age (mean, 41. 7+/-10.5% [20 to 40 years], 35+/-9.2% [40 to 60 years], and 33.9+/-8.6% [60 to 80 years]); without significant sex-related differences, only the percentage decrement of the pulsatility indices during stimulation were significant (mean, 24+/-10.7% [20 to 40 years], 20+/-7.3% [40 to 60 years], and 13+/-11.2% [60 to 80 years]). CONCLUSIONS: For optimal stimulus conditions for maximum VEFRs, a colored video stimulation of 20-second intervals should be used to combine responses not only from the primary visual projection fields (V1 and V2) but also from temporal lobe areas (V3 through V5) often supplied by the PCA.
Adult↗
Effects of hypnotizability on performance of a Stroop task and event-related potentials.
The effect of hypnotizability on verbal reaction times and event-related potentials during performance of a Stroop color-naming task was studied. The Stroop stimuli (colored words) were randomly presented to 5 high and 5 low hypnotizable subjects in the right and left peripheral visual fields during both waking state and hypnotic induction conditions. Unlike studies in which the Stroop stimuli were foveally presented to the subjects, the highly hypnotizable subjects did not show prolonged verbal reaction times in either waking or hypnotic conditions. There was a marked deterioration in performance accuracy, however, for highly hypnotizable subjects during hypnosis. Event-related potentials indicated that the highly hypnotizable subjects showed a reduced P3a amplitude and a decreased N2b latency to the visual stimuli in both waking and hypnotic conditions, suggesting a lack of orienting to or disengagement from peripherally occurring stimuli.
Attention↗
Schlemm's canal implant: a new method to lower intraocular pressure in patients with POAG?
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Glaucoma Drainage Implants↗
Effects of psychosocial treatment in prolonging cancer survival may be mediated by neuroimmune pathways.
Research has provided growing evidence of links between the social environment and cancer progression. Indeed, social support in the form of marriage, frequent daily contact with others, and the presence of a confidant may all have protective value against cancer progression. Furthermore, retrospective data suggest that major stressful life events are more prevalent in patients with relapse or malignancy, and thus may contribute to cancer morbidity. Initial studies of the effects of psychosocial intervention with cancer patients have provided some promising results. In three randomized prospective trials, protective effects of psychosocial interventions on cancer progression have been confirmed, while one matching and one randomized study showed no survival effect after psychosocial treatment. Though more research is clearly needed in this area, this body of evidence suggests that psychosocial factors have potentially powerful modulating effects on the course of disease. Here we review evidence of one possible mechanism whereby psychosocial factors may influence disease-resistance capabilities: the neuroimmune connection. Suppressive effects of stress on immune function are well documented, and these effects have been shown to be modulated by social support. Thus, it is reasonable to hypothesize that supportive social relationships may buffer the effects of cancer-related stress on immunity, and thereby facilitate the recovery of immune mechanisms that may be important for cancer resistance. Data addressing this hypothesis are reviewed.
Humans↗
[Ab externo erbium YAG laser sclerostomy versus conventional trabeculectomy. Treatment of glaucoma patients].
PURPOSE: This study was conducted to compare the efficacy of the Er-YAG laser sclerostomy ab externo versus trabeculectomy in the treatment of primary open-angle glaucoma. METHODS: Twelve patients with POAG underwent ab externo laser sclerostomy using an Er-YAG laser (Sklerostom 2.9; lambda = 2940 nm, t = 200 microseconds, 2 Hz, 400 microns, 15 mJ). Only local medication was used, and there were no risk factors for failure. As a control group 12 patients out of 248 standardized trabeculectomies were matched in terms of age, sex, diagnosis and local medications. No antimetabolites were used in either group. RESULTS: After a follow-up of 9 months in the sclerostomy group 53%; (7/12; P = 0.03) showed a patent fistula in comparison of 100% in the trabeculectomy group. There was a significantly lower mean IOP during the first postsurgical week in the group of sclerostomies (3.6 +/- 1.5 mmHg versus 7.5 +/- 2.7 mmHg; P = 0.0001) with a higher incidence of choroidal detachments (9/12 versus 2/12; P = 0.004). The choroidal detachments lasted longer in the sclerostomy group (3.5 months versus 0.3 months; P = 0.014). Iris incarcerations were found only in sclerostomies (7/12; P = 0.05). CONCLUSIONS: Based on these findings, Er-YAG laser sclerostomy prooved to be less effective than trabeculectomy in the treatment of glaucoma patients. Er-YAG laser sclerostomies were associated with a higher incidence of postsurgical complications such as hypotony, choroidal detachments and iris incarcerations. At this point Er-YAG laser sclerostomy is not superior to conventional trabeculectomy.
Aged↗
Representations of self in women sexually abused in childhood.
OBJECTIVE: This exploratory study examined the self representations of 27 women sexually abused in childhood and their association with symptomatology. METHOD: Twenty-seven self-identified female survivors of childhood sexual abuse completed the Trauma Symptom Checklist-40, Beck Depression Inventory, State-Trait Anxiety Inventory and a measure designed to elicit subjects' self-generated descriptors of selves. RESULTS: Discrepancies in views of current self when compared to ideal or future selves were positively correlated with all symptom measures. Discrepancies in representations of current self compared to views of who they were when they were with their perpetrator were negatively correlated with trait anxiety. Self integration, as defined in this study, was negatively correlated with symptoms. CONCLUSIONS: This study suggests that cognitive representations of self are an important indicator of adjustment in survivors of childhood sexual abuse.
Adult↗
From courtroom to couch. Working with repressed memory and avoiding lawsuits.
Hundreds of lawsuits have been filed during the last decade against therapists who work with patient having repressed memories. These lawsuits claim that therapists are engaged in "repressed memory" therapy, which does not retrieve memories, but instead actually imparts false beliefs, which serve as "pseudo-memories". This article explores the issues of repressed, false, and implanted memories. Advice is given concerning good therapeutic practice and the avoidance of legal liability.
Adolescent↗
Hypnosis and implicit memory: automatic processing of explicit content.
Kenneth S. Bowers, in whose honor this issue is written, was, in his own words, "seriously curious" (Bowers, 1983 (originally published 1976)) about hypnosis throughout his career. He brought a lively intellect and an engaging and lucid writing style reminiscent of Freud's (forgive me, Ken, I'm referring to style, not content), and a set of serious questions to the phenomenon of hypnosis. We are indebted to him for his many contributions to the field.
Awareness↗
Imagery and hypnotizability revisited.
The objective of this study was to correlate computer-generated imagery tasks and a self-report measure of imagery ability with hypnotizability, hypothesizing that computer-generated imagery tasks would be better predictors of hypnotizability than will the self-report measure. Hypnotizability of 43 subjects was assessed using the Hypnotic Induction Profile and the Stanford Hypnotic Susceptibility Scale, Form C. Imagery ability was assessed by the Visual Vividness Imagery Questionnaire (VVIQ) and by computer-generated imagery tasks measuring the ability to generate, maintain, and transform images. Although there was no correlation between the VVIQ and hypnotizability, the less hypnotizable subjects made twice as many mistakes in the spatial imagery tasks than did the more hypnotizables, but this difference was not statistically significant. The relationships among hypnotic performance, hypnotizability, and imagery functions are complex.
Adolescent↗