Search PubMed⌕ Search

Biomedical subjects

H Tennen

Publications and source records attributed to H Tennen.

At least 55 records · Page 3Linked to original sources
PubMed1995

Reactions to impaired fertility: the vicissitudes of primary and secondary control appraisals.

Recent formulations about how perceived control influences adaptation to chronic medical conditions suggest that although a sense of personal (primary) control may decline over time, there are ample opportunities for individuals to make other adaptation-enhancing "secondary control" appraisals such as construing benefits or finding meaning in their threatening circumstance. We describe a longitudinal study of men and women with impaired fertility that evaluates a dynamic relation between primary and secondary control--one in which anticipated benefits increase over time as failed efforts to achieve a desired pregnancy lead to declines in primary control. Forty-six men and women with impaired fertility rated their sense of personal control over fertility outcomes, the extent to which they anticipated benefits in this situation and their outcome expectancy on two occasions separated by 14 months. As predicted, perceived control diminished over time. Changes in anticipated benefits were unrelated to changes in personal control. Anticipating benefits, however, was inversely related to changes in outcome expectancy, such that a more pessimistic expectancy over time was associated with an increase in anticipated benefits. This relation was independent of perceived control and was not mood dependent. We discuss these findings in terms of current theories of control, the need for further longitudinal investigations to evaluate the temporal relations between primary and secondary control appraisals, and implications for infertility research.

Adaptation, Psychological↗
PubMed1994

Unique clinical and psychological correlates of fibromyalgia tender points and joint tenderness in rheumatoid arthritis.

OBJECTIVE: We investigated the relationship of fibromyalgia (FM) tender points to other manifestations of rheumatoid arthritis (RA). METHODS: Sixty-seven RA patients completed questionnaires at study entry and described symptoms, emotionally significant events, and mood every evening for 75 days. Joint and tender point examinations were conducted every 2 weeks. RESULTS: Controlling for joint tenderness, the tender point count correlated with the degree of daily stress. Depression was not significantly related when daily stress was controlled for. CONCLUSION: We conclude that FM tender point counts correlate uniquely with RA patients' reports of daily stress.

Adult↗
PubMed1994

Person and contextual features of daily stress reactivity: individual differences in relations of undesirable daily events with mood disturbance and chronic pain intensity.

We examined the mood-related and pain-related consequences of daily stressors among 74 individuals with rheumatoid arthritis who supplied daily reports for 75 days. Meta-analyses of time series regression coefficients disclosed a significant same-day relation between events and mood but no consistent effects of events on same-day pain, next-day mood, or next-day pain. With distributional characteristics of the daily data controlled, Ss with more active inflammatory disease showed a greater positive relation of events with same-day and next-day pain, those with a recent history of more major life stressors showed a greater positive relation of events with next-day pain, and those with less social support showed a greater positive relation of events with next-day mood disturbance. Implications of these and other findings for theories of stress and adaptation and the methodological challenges of daily experience research are discussed.

Adult↗
PubMed1994

Hassles and uplifts and generalized outcome expectancies as moderators on the relation between a family history of alcoholism and drinking behaviors.

The present study examined 85 adult offspring of alcoholics (FH+) and 68 comparison subjects without a family history of alcoholism (FH-) in order to address three questions: (1) Does the relation between hassles and uplifts and drinking differ by gender and/or family history of alcoholism? (2) Do hassles and uplifts and/or generalized outcome expectancies (dispositional optimism and pessimism) moderate the relation between having a family history of alcoholism and drinking behaviors? (3) Do hassles and uplifts and outcome expectancies interact to influence drinking behaviors? The pattern of relations between hassles and uplifts and drinking behaviors and between outcome expectancies and drinking behaviors differed by family history and gender. Hassles were related to increased alcohol consumption for FH+ men only, whereas outcome expectancies were related to indicators of problem drinking for FH+ women only. When the moderating influences of hassles and uplifts and outcome expectancies were examined, both hassles and pessimism were found to moderate the relation between family history and drinking behaviors. In addition, hassles and uplifts and outcome expectancies interactively influenced this relation. These results emphasize the need to examine further both individual and contextual processes in studies examining the risk of the development of alcoholism.

Adult↗
PubMed1993

Temporal covariation of soluble interleukin-2 receptor levels, daily stress, and disease activity in rheumatoid arthritis.

OBJECTIVE: To examine synchronous changes in soluble interleukin-2 receptor (sIL-2R) levels, daily indicators of emotional stress, joint inflammation, and reported pain in patients with rheumatoid arthritis (RA). METHODS: Fourteen patients were studied on each of 6 occasions, 2 weeks apart. Measures included daily ratings of mood disturbance, undesirable events, and joint pain; clinical examination of joint swelling; and serum assays of sIL-2R. Pooled within-person correlations among these variables were calculated. RESULTS: Consistent with the results of previous research, joint inflammation covaried directly with sIL-2R levels. Changes in mood disturbance were unrelated to changes in joint inflammation, but increases in mood disturbance were linked with decreases in sIL-2R levels and increases in reported joint pain. CONCLUSION: These findings provide preliminary evidence that psychoimmune processes may be implicated in short-term changes in RA disease activity.

Adult↗
PubMed1993

The relative importance of dispositional optimism and control appraisals in quality of life after coronary artery bypass surgery.

Similar mechanisms have been proposed to explain the stress-buffering effects of both dispositional optimism and perceived control. Yet dispositional optimism as a personal resource should function independently of situational control appraisals. To evaluate the unique and additive contributions to adaptation of control appraisals and optimism, we followed 49 individuals scheduled for coronary artery bypass surgery. One month before surgery dispositional optimism was associated with neither health locus of control nor specific expectancies about the outcomes of surgery. Dispositional optimism, however, was associated with perceived control over the course of the illness and with quality of life appraisals. Although presurgery optimism predicted life quality 8 months after surgery, this was not the case when general and specific control appraisals and specific expectancies were included in the prediction. These findings are discussed as they relate to current conceptions of trait optimism.

Adaptation, Psychological↗
PubMed1992

Coping and cognitive factors in adaptation to in vitro fertilization failure.

Characteristics were identified that predict adaptation following an unsuccessful attempt at in vitro fertilization (IVF). Forty-one women and their husbands were interviewed and administered questionnaires prior to IVF and 2 weeks after notice of a positive or negative pregnancy test. Of the 36 couples who failed to conceive as a result of IVF, 6 of the women studied developed clinical depressive symptoms. Those women who reported poorest adaptation to IVF failure were more likely to have reported depressive symptoms prior to IVF, were more likely to have reported feeling a general loss of control over their lives as a result of infertility, tended to use escape as a coping strategy, and reported having felt some responsibility for their IVF failure. Dispositional optimism, as well as a sense of being partially responsible for the infertility, was protective of distress following IVF failure.

Adaptation, Psychological↗
PubMed1992

Neuroticism and the pain-mood relation in rheumatoid arthritis: insights from a prospective daily study.

For 75 consecutive days, 54 Ss with rheumatoid arthritis supplied daily reports of their mood and joint pain. After aggregating daily reports, the relation between chronic mood and chronic pain remained statistically significant when controlling for neuroticism, depression, disease activity, disability, and characteristic responses to increasing pain. Findings of a path analysis suggest that (a) individuals higher in neuroticism experience more chronic distress regardless of their responses to pain, their pain intensity, and depressive symptomatology, and (b) the relation between neuroticism and chronic pain is mediated by the propensity of high-neuroticism individuals to catastrophize their pain. Within-subject analyses that controlled for autocorrelation and linear trends in the time series revealed that 40% of the Ss experienced significantly worse moods on more painful days. Although individuals higher in neuroticism reported more intense pain and more negative mood, their daily mood was less strongly linked to their daily pain.

Adaptation, Psychological↗
PubMed1992

Types of alcoholics: concurrent and predictive validity of some common classification schemes.

This study evaluated the discriminative power and predictive validity of five common typological schemes used to classify alcoholics for theoretical or clinical purposes. A heterogenous sample of 321 alcoholics was classified according to primary vs secondary alcoholism, parental alcoholism, Fellinek's gamma-delta distinction, gender, and subtypes derived from MMPI profiles. A prospective longitudinal cohort design was employed to compare the relative ability of these typologies to differentiate alcoholics according to natural history, alcohol-related consequences, response to treatment, and post-treatment adjustment. The findings indicate that while 'one-dimensional' typologies discriminate subgroups in terms of etiological variables, presenting symptoms, and drinking patterns, none of the classification systems emerges as a strong predictor of outcome status. In addition, these typologies do not discriminate well with respect to the alcoholic's drinking patterns and presenting symptoms, except in areas closely connected with the model (e.g. alcoholics with antisocial personality (ASP) indicate more social problems related to alcohol use than do primary alcoholics). Because there is a great deal of overlap among certain subtypes identified within different typological models (e.g. alcoholics with primary ASP tended to have a positive family history and a gamma pattern of impaired control), we hypothesize that empirical clustering techniques that search for naturally occurring commonalities among alcoholics may be a better way to identify homogeneous subtypes.

Adult↗
PubMed1991

Individual differences in the day-to-day experience of chronic pain: a prospective daily study of rheumatoid arthritis patients.

Explored the distribution and temporal patterning of daily pain reported by 47 patients with rheumatoid arthritis (RA) for 75 consecutive days. Approximately half the pain series were significantly positively skewed, trended significantly across the recording period, or both. One fourth of the sample had relatively painful "outlier" days that clustered together. Most series displayed a significant autocorrelation in pain intensity across successive days even when the series were detrended. Patients with more active disease had pain that was more intense but more predictable from day to day and reported fewer painful outlying days and briefer episodes of atypically severe pain. Patients describing themselves as more depressed on the Center for Epidemiological Stress Depression Scale also reported more intense pain across the recording period, independent of their level of disease activity and disability. Implications for daily process studies of RA pain are discussed.

Activities of Daily Living↗
PubMed1991

Cognitive appraisal and adjustment to infertility.

We examine adults' cognitive appraisals of their infertility and how these appraisals relate to each other and to psychological adjustment. In two samples, 76 women and 54 men rated their appraisals of threat, challenge, and control connected with infertility and completed measures of global and infertility-specific distress. Couples appraised their infertility as both harmful and beneficial, and as relatively uncontrollable. Partners did not differ in their appraisals or global distress, although wives reported more infertility-specific distress than their husbands. Women who were more threatened by their infertility were more distressed, as were those who felt less challenged and those who perceived less control over infertility outcomes. Males' appraisals were unrelated to distress, although men whose wives were more challenged by their impaired fertility were less distressed than their counterparts.

Adaptation, Psychological↗
PubMed1990

Mothers' remembrances of newborn intensive care: a predictive study.

Six months after discharge, 94 mothers described their memories of their infant's hospitalization on an NICU. Mothers of sicker infants, those who had claimed difficulties with NICU staff, and those who felt less attached to their infant more often described painful reminders of this crisis. Pleasurable reminders were reported more often by mothers who had perceived greater personal control over their infant's recovery and had construed a purpose in this crisis. Mothers described several benefits of their memories and were more likely to do so when they had perceived a purpose in their misfortune.

Adaptation, Psychological↗
PubMed1989

Effects of formal support on mothers' adaptation to the hospital-to-home transition of high-risk infants: the benefits and costs of helping.

94 mothers were randomly assigned to a control group or to a group who received a formal support program designed to aid their adaptation to the transition from hospital to home care of high-risk infants. Mothers' predischarge need for support and the severity of infants' predischarge medical problems moderated program effects assessed 6 months after NICU discharge. Positive effects of the program on mothers' sense of competence, perceived control, and responsiveness were evident for mothers who had needed the most support. But at low levels of need for support, participation in the program had negative effects on these outcomes. A similar pattern was found for the effects of the program on mothers' positive mood as a function of the severity of infants' medical problems. Secondary findings suggest why some mothers may benefit from formal support after NICU discharge and others may experience at least temporary disruptions in their adaptation from such support.

Cost-Benefit Analysis↗
PubMed1988

Adaptational features of mothers' risk and prevention appraisals after the birth of high-risk infants.

Sixty-seven mothers were interviewed at the time of their child's discharge from a newborn intensive care unit and 6 months after hospital discharge. After 6 months, mothers who had done more to prevent adverse pregnancy outcomes, had been more optimistic about the outcomes of their pregnancy, and saw their infant's complications as more avoidable reported greater concurrent mood disturbance and/or more distress ensuing from their child's hospitalization. Mothers' risk and prevention appraisals also played a role in their attitudes toward future childbearing, independent of mothers' reproductive history, the severity of the infants' medical condition, and the infant's behavioral difficulty at 6 months. The single most important predictor of mothers' expectations of future pregnancies, however, was whether the child was first born.

Adult↗
PubMed1987

Attributional processes in rheumatoid arthritis patients.

In a study of 92 patients with rheumatoid arthritis, we examined patients' beliefs about the causes of their illness, disease flares, and disease remissions, and about the selective incidence of the disease. Numerous self-report measures were used to elucidate the patients' attitudes and perceptions; the tendency of patients to present themselves in socially desirable ways was taken into account and was found not to influence the study results. The causes for the illness that were most frequently cited by patients were heredity (34.7%), autoimmune factor (24.4%), personal behaviors (22.8%), and psychological stress (22.8%). Patients who were more actively searching for the causes of the illness and who continued to ask "Why me?" reported greater functional problems and a greater sense of helplessness. The most frequently cited causes for symptom flares were psychological stress (45.5%), changes in weather (34.0%), and excessive physical activity (34.1%). Symptom remissions were most frequently believed to be related to medication changes (49.4%) and the absence of psychological stress (21.0%). Several of these causal beliefs were related to perceptions of helplessness and the illness' predictability and to health care providers' assessments of disease severity and patients' psychosocial adjustment.

Adult↗
PubMed1987

Depression, self-esteem, and the absence of self-protective attributional biases.

Previous research has demonstrated a relation between depression and attributional style. In the present study we evaluated the extent to which self-esteem may be an important determinant of attributional style. Subjects completed measures of self-esteem, depression, and anxiety and responded to the Attributional Style Questionnaire. Maximum R2 analyses revealed that for significant one-variable and multivariable regression models, self-esteem accounted for the variation in attributional style on the majority of outcome measures. Depression and anxiety added little beyond the contribution of self-esteem. These findings were consistent for both positive and negative events. In addition, self-esteem accounted for variation in attributional evenhandedness. Results are discussed in terms of the role of self-esteem maintenance in attributional style.

Anxiety↗