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Biomedical subjects

W E Haley

Publications and source records attributed to W E Haley.

At least 55 records · Page 3Linked to original sources

Age and health bias in practicing clinical psychologists.

Although ageism is widely cited as a problem in mental health delivery, it is unknown whether practitioner biases are related to factors such as physical health. A randomly drawn national sample of experienced practicing doctoral-level psychologists (N = 371) responded to detailed vignettes of a client presenting with symptoms of depression, in which age (35 years or 70 years) and health (unremarkable or poor) were manipulated. Respondents completed ratings involving professional and interpersonal judgments about the hypothetical client. Results revealed some evidence for age bias, but much stronger effects indicating health biases regardless of client age. Because depressed older persons often present with concomitant health problems, health bias among clinicians is especially relevant for older patients. Implications for service delivery to older adults, and individuals with health problems, are discussed.

Adjustment Disorders↗

Mental and physical health of male caregivers of a spouse with Alzheimer's disease.

Fifty-two male spouse caregivers of patients with Alzheimer's disease and 53 demographically equated controls completed multidimensional assessments of mental and physical health. Results indicate that compared with noncaregiving men, male spouse caregivers have poorer mental and physical health, but only within limited domains of health outcomes. In particular, caregiving men showed higher levels of depression, respiratory system symptoms, and poorer levels of health habits, but did not differ from noncaregiving men on other indexes of physical and mental health. The importance of focusing on understudied specific subgroups of caregivers, such as male spouses, as well as using multidimensional instead of summary measures of mental and physical health are emphasized.

Aged↗

Psychological, social, and health impact of caregiving: a comparison of black and white dementia family caregivers and noncaregivers.

Psychological, social, and health variables were compared in 175 Black and White family caregivers of patients with dementia and 175 Black and White noncaregivers. Caregivers and noncaregivers did not differ within race on demographic variables. Caregiving was associated with increased depression and decreased life satisfaction only in White families. However, caregiving appears to have similar social consequences for Black and White families, including restriction of social activity and increased visits and support by family from outside of the home. Race, but not caregiving, was associated with physical health variables. Methodological issues in comparing well-being in Black and White caregivers, in particular the importance of including noncaregiving comparison subjects are discussed.

Activities of Daily Living↗

Family caregiver satisfaction with medical care of their demented relatives.

Eighty-eight family caregivers were interviewed concerning their experience with medical care of their demented relatives. Although the majority of caregivers expressed overall satisfaction, they showed higher levels of dissatisfaction than are commonly found in studies of satisfaction with medical care. Greatest dissatisfaction was expressed in regard to receiving insufficient information about dementia; fewest concerns were expressed about inappropriate physician control. Families reported frequently receiving vague diagnoses and insufficient referrals for supportive services.

Aged↗

The effects of distraction on the perception of exercise-induced symptoms.

The purpose of this study was to investigate the effects of distraction tasks varying in attentional demand on the perception of exercise-induced symptoms and on exercise performance. Tasks were constructed to vary in attentional demand but not in emotional engagement in order to isolate the former. Sixty females rode a bicycle ergometer while they participated in one of three experimental conditions: high demand distraction, low demand distraction, or no systematic distraction. Measures of mood, perceived exertion during exercise, physical symptoms following exercise, and timed riding tolerance were collected and analyzed. Level of distraction had little effect on mood, which confirmed that the tasks were not differentially emotionally arousing. Contrary to theoretical predictions, level of distraction led to no differences in exercise performance or symptom reports across the three groups. Limitations of the 'competition of cues' explanation for the efficacy of distraction as an intervention to reduce symptom perception and increase exercise performance are discussed.

Attention↗

Relationship of severity of dementia to caregiving stressors.

In studies of individual differences and longitudinal changes in stress and coping among dementia caregivers, assessing severity of patient impairment is critically important. It is proposed that with the progression of dementia, cognitive impairment may steadily increase, but other stressful behavioral symptoms peak at various stages of dementia. Cross-sectional data from 49 caregiving families and longitudinal follow-up data from 48 families suggest that instrumental self-care deficits begin early in dementia, and basic self-care deficits increase with dementia severity, but that many distressing behavioral symptoms decrease in late dementia. Assessments of dementia patient severity should be multidimensional, and increases and decreases in various dementia patient stressors over time should be considered as factors influencing caregiver coping.

Activities of Daily Living↗

Group intervention for dementia family caregivers: a longitudinal perspective.

Reported here are longitudinal follow-up data from caregivers who participated in an experimental study of group intervention for dementia caregivers. Methodological and clinical issues evident from this long-term follow-up include differential attrition from treatment, issues in selection of participants, and need for measures appropriate to long-term outcome.

Caregivers↗

Discriminant and convergent validity of self-report measures of affective distress in patients with rheumatoid arthritis.

The discriminant and convergent validity of several self-report measures of affective distress commonly administered to patients with rheumatoid arthritis (RA) were examined. Fifty-two patients with RA completed the Arthritis Helplessness Index, the Beck Depression Inventory, Spielberger's State Anxiety and Trait Anxiety Inventories, and the Arthritis Impact Measurement Depression and Anxiety Scales. Correlational and factor analyses revealed that the measures of anxiety and depression demonstrated adequate convergent validity but poor discriminant validity. Our results suggest that these measures index a general feeling of distress rather than discrete affective difficulties. The ability of these measures to assess separate problems of anxiety and depression among RA patients is questioned.

Adult↗

Predicting individual differences in pain and functional impairment among patients with rheumatoid arthritis.

Objective measures of disease activity (erythrocyte sedimentation rate and joint swelling), disease severity (radiographic ratings), and psychological variables (coping strategies and affective states) were used to predict the degree of pain and functional impairment that would be experienced by a group of 53 patients who had rheumatoid arthritis. The severity of disease demonstrated no significant relationship to measures of outcome. Multiple regression analyses revealed that psychological variables explained a substantial proportion of the variance in outcome scores, even after disease activity was taken into account. Our study highlights the discrepancies between biomedical measures of disease severity and activity and patient outcome in a rheumatoid arthritis population, and our observations suggest that some of these discrepancies may be explained by psychological variables.

Activities of Daily Living↗

Radiographic assessment and psychologic variables as predictors of pain and functional impairment in osteoarthritis of the knee or hip.

Sixty-five outpatients with osteoarthritis of the knee and/or hip were assessed using radiographic ratings of disease severity, measures of psychologic coping, and multidimensional clinical outcomes of degree of pain and functional impairment. Disease severity accounted for little of the individual variability in clinical outcomes. Even after controlling for disease severity, psychologic variables remained strong predictors of individual differences in functional impairment and pain. Psychologic processes deserve greater clinical and research attention as potential mediators between disease severity and clinical outcome.

Adaptation, Psychological↗

Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers.

A stress and coping model was used to study predictors of individual differences in caregiver adaptation. A total of 54 family caregivers of elderly dementia patients completed interviews and questionnaires assessing the severity of patient impairment and caregiving stressors; caregiver appraisals, coping responses, and social support and activity; and caregiver outcomes, including depression, life satisfaction, and self-rated health. Correlational and regression analyses supported the utility of the stress and coping model. Appraisal, coping responses, and social support and activity were significant predictors of caregiver outcome, even when severity of caregiving stressors was statistically controlled. The importance of a multidimensional approach to assessing caregiver outcomes was supported by regression analyses indicating that each caregiver outcome was predicted by different patterns of stressors, appraisal, coping, and social support and activity. Results are discussed in terms of a stress and coping model of caregiving, and clinical implications for work with caregiving families.

Activities of Daily Living↗

Psychological, social, and health consequences of caring for a relative with senile dementia.

While providing home care for a family member with senile dementia is clearly extremely stressful, there has been little controlled research assessing the specific effects of this stress on caregiver psychological, social, and health functioning. To address this question, 44 primary caregivers of senile dementia patients and 44 matched controls completed a series of questionnaires and interview assessments. Caregivers reported significantly higher levels of depression and negative affect toward their relatives, and lower overall life satisfaction than controls. Caregivers also had significant impairment of their social activities, including visits with friends, vacations, and church attendance when compared with controls. Caregivers expressed less satisfaction with their social networks than did controls, but the groups did not differ in objective size of social network or number of network contacts. Caregivers reported poorer health, more prescription medication use, and higher utilization of health care than controls. Results clearly indicate the serious and wide-ranging effects of the stress of caregiving, and reinforce the importance of providing comprehensive services for caregiving families.

Aged↗

Interpersonal betrayal and cooperation: effects on self-evaluation in depression.

Despite numerous studies demonstrating that depressed people are generally self-critical, little is known about interpersonal stressors that may activate or increase this negative self-evaluation. In this study, the effect of interpersonal betrayal and cooperative social interaction on self-evaluation processes in depressed and nondepressed women was assessed. Depressed subjects who experienced interpersonal betrayal were more critical of their performance on a subsequent task than were nondepressed subjects or depressed subjects who had experienced a cooperative interaction. Depressed subjects in the betrayal condition also behaved more aggressively toward their betraying partner than did nondepressed betrayed subjects. Depressed subjects were more critical of their own personality characteristics than were nondepressed subjects, regardless of condition. Results suggest that some negative cognitive schema among depressed persons may be altered by interpersonal factors, although it is not clear whether such effects are secondary to increases in self-criticism after conflict or to decreases in self-critical tendencies after positive interaction. Given the variability in results with different measures of self-evaluation, researchers are urged to use multiple, diverse measures of self-evaluation in future efforts to study variability in self-appraisal.

Aggression↗

Social skills deficits and self-evaluation among depressed and nondepressed psychiatric inpatients.

Depressed psychiatric inpatients, nondepressed psychiatric inpatients, and nonpsychiatric controls role-played responses to 28 standardized interpersonal situations. Judges blindly rated these responses on overall social skill and component measures, and subjects rated their own social skills. Judges rated depressed and nondepressed psychiatric patients as having significant problems in social skills compared to normals. No differences were found between the two patient groups in judges' ratings of social skill. Depressed patients rated their own recent interpersonal behavior and optimal social skills significantly lower than did subjects in the other groups. Results suggest that social skills deficits are not specific to depression and that depressives and other psychiatric groups may differ primarily in their self-appraisals of social competence.

Adult↗