PubMed · 7981264
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R W Reed. Lessons in perseverance.. https://doi.org/10.1097/00001610-199409000-00008
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Vulnerability-stress models suggest that training in specific stress management techniques should yield benefits to those suffering from schizophrenia and related disorders. In this paper, we describe an evaluation of the impact of adding a stress management program to other medical and psychosocial interventions for such patients. Outcomes were compared for 121 patients randomly assigned to receive either a 12-week stress management program with follow-up sessions or participation in a social activities group. The two treatment conditions did not differ in levels of symptoms, perceived stress or life skills immediately after completion of treatment or at 1-year follow-up. Patients who received the stress management program did have fewer hospital admissions in the year following treatment. This effect of stress management was most apparent for those who showed high levels of attendance for treatment sessions. It was concluded that training in stress management may provide patients with skills for coping with acute stressors and reduce the likelihood of subsequent acute exacerbation of symptoms with need for hospitalization.
OBJECTIVE: Parents' disclosure of their HIV serostatus to all of their children is described over time and the impact of disclosure is examined for their adolescent children. DESIGN A representative cohort of parents living with HIV (n = 301) and their adolescent children (n = 395) was recruited and assessed repeatedly over 5 years. METHODS: Disclosures by parents living with HIV of their HIV status to their children were examined in three ways: (i) trends in disclosure over 5 years to all children; (ii) factors associated with parental disclosure; and (iii) the impact of disclosure on adolescent children (not younger children). RESULTS: Parents were more likely to disclose to older (75%) than to younger children (40%). Mothers were more likely to disclose earlier than fathers and they disclosed more often to their daughters than to their sons. Parents were more likely to disclose over time to children of all ages; disclosure did not vary according to parents' ethnicity, socio-economic status, self-esteem, or mental health symptoms. Disclosure was significantly more common among parents with poor health, more stressful life events, larger social networks, and those who perceived their children experiencing more HIV-related stigma. Over time, poor health status and a self-destructive coping style were associated with higher rates of disclosure. Parental disclosure was significantly associated with more problem behaviors and negative family life events among their adolescent children. CONCLUSION: Parental disclosure of HIV status is similar to disclosures by parents with other illnesses. Clinicians must assist patients to make individual decisions regarding disclosure.
STUDY OBJECTIVES: To explore the relationship between psychologic variables measured prior to continuous positive airway pressure (CPAP) treatment and subsequent CPAP compliance. DESIGN: Participants were assigned to a CPAP treatment group. Psychologic questionnaires administered prior to the start of treatment assessed depression, anxiety, stress, anger or hostility, social support, social desirability, and coping. Polysomnography was performed on admission (prior to start of treatment) and at the end of 1 week of treatment. Compliance was measured nightly by an intemal clock counter in the CPAP unit and averaged over the 1-week treatment period. SETTING: N/A. PARTICIPANTS: Twenty-three CPAP-naive patients with obstructive sleep apnea were enrolled in a study of the effects of CPAP on sympathetic nervous system functioning, quality of life, and psychologic functioning. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Objectively measured average daily compliance was significantly associated with a measure of coping strategies. Multiple regression analyses revealed that Active Ways of Coping accounted for a significant amount of variance in CPAP compliance, even after the respiratory disturbance index, daytime sleepiness, and Passive Ways of Coping were taken into account. No other psychologic variable assessed prior to CPAP treatment was associated with subsequent CPAP compliance. CONCLUSIONS: These results suggest that individuals who engage in active coping strategies with new and difficult situations used CPAP more. It may be that encouraging patients to use coping techniques, such as planful problem solving, will help to improve compliance with CPAP.