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Biomedical subjects

H Tennen

Publications and source records attributed to H Tennen.

At least 73 records · Page 4Linked to original sources
PubMed1987

Appraisals of control and predictability in adapting to a chronic disease.

In a sample of 92 patients with rheumatoid arthritis, we examined interrelations among various control appraisals, illness predictability, psychosocial adjustment, mood, and illness status. Perceiving greater personal control over the disease and symptoms and perceiving greater health-care-provider control over symptoms were associated with greater illness predictability. Patients reported more personal control over their symptoms than over the course of the disease and thought that their health care providers had more control over disease course than they did themselves. Multiple regression analyses showed that perceiving greater personal control over one's medical care and treatment was associated with positive mood and psychosocial adjustment. Negative mood was also associated with the belief that providers have greater control over the patient's daily symptoms. Patients who had a more severe disease and expressed greater personal control over its course reported greater mood disturbance and were rated as exhibiting less positive adjustment, but those who had more severe daily symptoms and expressed greater personal control over their symptoms reported less mood disturbance. These findings are discussed in terms of the possible benefits of patients' active participation in their care and the implications of perceiving personal and others' control over more or less controllable aspects of the illness, especially when the illness is more severe.

Activities of Daily Living↗
PubMed1987

The costs and benefits of optimistic explanations and dispositional optimism.

Explanatory style and dispositional optimism have been linked to physical health. In this issue, Peterson and Seligman and Carver and Scheier review an impressive series of studies which together suggest that there may be health risks associated with attributing bad outcomes to internal, stable, and global causes and with failing to maintain a generalized expectancy for good outcomes. We attempt to broaden the scope of these studies by describing the situational constraints on the observed relations and by presenting evidence that there may be health risks, as well as benefits, associated with dispositional optimism and an optimistic explanatory style.

Adaptation, Psychological↗
PubMed1987

Depressive attributional style: the role of self-esteem.

Two studies evaluate the role of self-esteem in the depressive attributional style. In the first study, college students completed four measures of depression, four measures of self-esteem, and the Attributional Style Questionnaire (ASQ). Regression analyses revealed that across measures, self-esteem was a better predictor of attributional style for negative events than was depression. In study two, psychiatric inpatients completed a measure of self-esteem, a measure of depression, and the ASQ. In this clinical sample, self-esteem and depression were highly correlated and both predicted ASQ scores. But when variation in depth of depression and social desirability were removed statistically from the association between self-esteem and attributions for negative outcomes, there remained a significant association between self-esteem and internal, stable, and global attributions for negative outcomes. Controlling for the variation in self-esteem eliminated the relation between depression and depressive attributional style. These findings demonstrate the importance of self-esteem in depressive attributional style in both normal and clinical populations, as well as potential differences in the relations among self-esteem, depression, and attributional style in clinical versus normal samples.

Adult↗
PubMed1986

Self-blame among parents of infants with perinatal complications: the role of self-protective motives.

According to the literature on defensive attribution, behavioral self-blame can bolster a sense of personal efficacy and is more likely to occur when victims perceive their misfortune as severe. In this study, mothers of infants with severe perinatal complications rated the severity of their child's condition, were asked about its causes, and completed a measure of emotional adaptation. As predicted according to the defensive attribution hypothesis, behavioral self-blame was associated with greater perceived severity and preventability of recurrence. The pattern of correlations suggests that greater perceived severity may produce greater self-blame, which in turn may play an indirect role in adaptation through its association with the belief that a recurrence could be prevented. Results of a post hoc path analysis were consistent with this hypothesis. These findings are discussed in terms of the adaptive features of behavioral self-blame, its relation to perceived control, methodological issues in the study of coping with victimization, and implications for helping professionals.

Adaptation, Psychological↗
PubMed1985

Comparison of three systems for diagnosing borderline personality disorder.

The authors assessed three systems for diagnosing borderline personality disorder: DSM-III, the checklist criteria of Spitzer et al., and the Diagnostic Interview for Borderline Patients. In an inpatient sample of 51 patients, 43 (84%) met the criteria of at least one of these systems; analyses were carried out on 28 of these patients. Twelve (43%) of these 28 patients met criteria for all three systems, seven (25%) for two systems, and nine (32%) for only one system. Kernberg's structural criteria showed reasonable overlap with the other diagnostic criteria. Affective disorders were prominent across diagnostic measures in this sample of borderline patients.

Adolescent↗
PubMed1985

Cognitive adaptations to high-risk infants: the search for mastery, meaning, and protection from future harm.

Cognitive adaptations suggesting orientations to primary or secondary control over stress were explored in a sample of 42 mothers who were interviewed shortly after discharge of their infant from a newborn intensive care unit. Mothers reported how much the infant's current recovery and future developmental status was or is dependent on personal actions and the degree to which they thought they could prevent perinatal complications in future deliveries (primary control). Also, they were asked whether there were gains or advantages from the crises of newborn intensive care and whether they had answered the question: "Why me?" (secondary control). Standard measures of mood state and stress reactions to aversive events were also administered. Results showed that each of the control cognitions was related to one or more measures of adaptational outcome. Findings were discussed in the context of theory and research on cognitive adaptations to threatening occurrences.

Adaptation, Psychological↗
PubMed1984

Perspectives on borderline subtypes--overview of current research.

This paper has reviewed recent efforts to subtype patients within the borderline group. An overview of current definitions of the borderline syndrome was followed by a critical evaluation of recent empirical investigations designed to subtype within the larger domain of borderline pathology. Studies of borderline patients have, in large part, been based on the descriptive-phenomenological approach. It has been argued that while establishing a reliable diagnosis based on signs and symptoms provides internal validation for current theories of the borderline syndromes, studies providing external validating criteria are sorely needed.

Borderline Personality Disorder↗
PubMed1983

Control orientation and the illusion of control.

Tested the hypothesis that individuals with an external locus of control are sensitive to the occurrence of noncontingency and will not display the illusion of control. Internals, who view outcomes as response dependent, should succumb to the illusion. One hundred thirty-eight students were asked to judge the amount of control they had over the onset of a noncontingent green light in one of two conditions: 25% green light onset and 75% green light onset. Both internals and externals demonstrated the illusion of control: they rated themselves as having more control when they received a green light on 75% of the trials, despite the fact that green light onset was response independent. These findings suggest that externals are doubly impaired. Their bias toward perceived response-outcome independence is given up when it would be most helpful, that is, when environmental cues suggest control in an objectively uncontrollable situation.

Journal Article↗
PubMed1983

Affective disorder in alcoholism.

In an attempt to explore the relationship between alcoholism and depression, family history data were examined in a sample of 90 alcoholic patients, 39 of whom were also depressed. Although subtypes of depression could not be distinguished on the basis of family history data, patients with depression were almost twice as likely to have a depressed biological relative and were more likely to have depression in two consecutive generations than nondepressed alcoholics. The implications of these results are discussed in terms of differential diagnosis, treatment, and future research.

Adult↗
PubMed1982

The debilitating effect of exposure to noncontingent escape: a test of the learned helplessness model.

Two studies were conducted to test the hypothesis that exposure to noncontingent escape leads to performance deficits similar to those observed when subjects are exposed to noncontingent aversive outcomes from which there is no escape, and that causal attributions mediate these deficits. Previous attempts to produce "appetitive helplessness" (deficits resulting from exposure to noncontingent positive events) have been plagued by subjects' tendency to believe that they are responsible for positive events. In Experiment 1, 40 subjects were exposed to contingent or noncontingent noise escape trials. As predicted by the learned helplessness model, subjects who received inescapable noise performed less well on a subsequent anagram task than subjects exposed to escapable noise. Similarly, subjects who escaped from the noise owing to the benevolence of a powerful other rather than because of their own efforts, showed performance deficits paralleling those of the inescapable noise subjects. In Experiment 2, subjects who escaped an aversive tone through no effort of their own showed subsequent performance deficits, but globality of their self-reported attributions did not predict subsequent anagram performance. The results of these studies provide support for the hypothesis that uncontrollability, independent of the valence of a particular outcome, is responsible for helplessness deficits, but do not support the mediational role of attributions, at least in the laboratory.

Achievement↗
PubMed1982

Learned helplessness and the detection of contingency: a direct test.

Two studies tested a basic hypothesis of the learned helplessness model: That performance deficits associated with exposure to uncontrollable outcomes are directly mediated by an individual's perception of response-outcome independence. In the first experiment 48 subjects were exposed to noise bursts. For one experimental group, the termination of the noise was response-contingent. For five other groups, noise-burst termination was independent of subjects' responses. These five groups varied in the number of trials on which they received positive feedback: As predicted, subjects over-estimated the amount of control they had over noise termination as a positive linear function of the amount of noncontingent positive feedback they received. Although subjects exposed to either noncontingent positive or negative feedback showed subsequent performance deficits on an anagrams task, the expected relation between perceived control and subsequent performance failed to emerge. These findings were replicated in a second experiment. In addition, subjects' locus, stability, and globality attributions failed to predict subsequent performance. These results call into question the central premises of helplessness theory: That perceived uncontrollability and causal attributions mediate learned helplessness.

Achievement↗
PubMed1982

A re-view of cognitive mediators in learned helplessness.

The findings of Oakes and Curtis (1982), Tennen, Drum, Gillen, and Stanton (1982), and Tennen, Gillen, and Drum (1982) provide a challenge to learned helplessness theory's focus on cognitive mediators of the helplessness phenomenon. In response to these findings, Alloy (1982) argues that these studies do not challenge helplessness theory because they do not measure expected control and because they confuse necessary and sufficient causes of learned helplessness. Silver, Wortman, and Klos (1982) contend that these studies provide an inadequate test of the model because subjects are confronted with experiences which are unlike those in their natural environment. The present article argues that by Alloy's (1982) criteria, an adequate test of the learned helplessness model has not yet been conducted. Previous studies which measured expected control have not supported the model's predictions. Moreover, if perceived response-outcome independence is a sufficient, but not a necessary cause of learned helplessness, the model loses much of its heuristic value. In response to the argument that these studies lack ecological validity, this article clarifies the distinction between experimental realism and mundane realism. While real-world studies have discovered intriguing relations between perceptions of control, attributions, and coping with illness or victimization, they have not tested predictions of the learned helplessness model.

Affect↗
PubMedDate not supplied

Depression among patients with a chief complaint of chronic fatigue.

The prevalence of mood disorders among patients with chronic fatigue was examined in a group of 100 adults who had experienced fatigue symptoms for an average of 13 years. Patients received a comprehensive history, physical and laboratory evaluation and completed the National Institute of Mental Health Diagnostic Interview Schedule and the Beck Depression Inventory (BDI). Among 44 patients with depressive illness, the onset of their first depressive episode was strongly associated with and preceded the onset of chronic fatigue. The BDI, fatigue history, demographic factors, and findings from the physical examination and laboratory had only modest success in discriminating those patients with depressive illness from other patients. We conclude that depressive illness is an important precursor of chronic fatigue.

Adult↗
PubMedDate not supplied

Targeted naltrexone treatment of early problem drinkers.

Naltrexone is approved for daily use in the treatment of alcohol dependence. We evaluated the feasibility of using targeted naltrexone (i.e., on an "as-needed" basis) to treat early problem drinkers. Twenty-one subjects (52% male) received brief coping skills training weekly for 4 weeks, along with naltrexone (50 mg), which they were instructed to use 2 to 5 times per week in anticipation of high-risk drinking situations. During treatment, statistically and clinically significant declines were observed across a variety of drinking-related outcomes, including the intensity of drinking, the decline in which was correlated with medication use. Beneficial effects of the intervention were still evident during the 3-month posttreatment period. Further research, including a placebo-controlled evaluation of targeted naltrexone, is needed to determine the optimal treatment strategy for early problem drinkers, many of whom are seen in the primary-care medical setting.

Adaptation, Psychological↗