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PubMed1990

The relationship between situational stress and phantom limb pain: cross-lagged correlational data from six month pain logs.

This study reports the results of the first investigation into the relationship between situational stress and phantom limb pain. Twenty-seven male amputees recorded their pain and overall stress levels daily for 180 days using a 1-10 rating scale. Three possible relationships into the etiology and/or maintenance of phantom limb pain were examined using cross-lagged correlational techniques: an isomorphic relationship (same time increases in pain lead to same time increases in stress and vice versa), a consequence relationship (increases in pain precede increases in stress), and a precursor relationship (increases in stress precede increases in pain). Thirty-seven per cent of subjects demonstrated some significant precursor relationship. Although support was found for all three hypotheses, the most frequently observed relationship was the isomorphic one. Seventy-four per cent of subjects demonstrated some significant stress-pain relationship. The results lend support to the psychological theory underlying the use of psychophysiological interventions such as biofeedback and relaxation therapy in amputees with phantom limb pain.

Adult↗

PubMed1992

Social relationships and health: the relative roles of family functioning and social support.

The associations between social relationships and health have been examined using two major research traditions. Using a social epidemiological approach, much research has shown the beneficial effect of social supports on health and health behaviors. Family interaction research, which has grown out of a more clinical tradition, has shown the complex effects of family functioning on health, particularly mental health. No studies have examined the relative power of these two approaches in explicating the connections between social relationships and health. We hypothesized that social relationships (social support and family functioning) would exert direct and indirect (through depressive symptoms) effects on health behaviors. We also hypothesized that the effects of social relationships on health would be more powerfully explicated by family functioning than by social support. We mailed a pilot survey to a random sample of patients attending a family practice center, including questions on depressive symptoms, cardiovascular health behaviors, demographics, social support using the ISEL scale, and family functioning using the FEICS scale. FEICS is a self-report questionnaire designed to assess family emotional involvement and criticism, the media elements of family expressed emotion. Eighty-three useable responses were obtained. Regression analyses and structural modelling showed both direct and indirect statistically significant paths from social relationships to health behaviors. Family criticism was directly associated (standardized coefficient = 0.29) with depressive symptoms, and family emotional involvement was directly associated with both depressive symptoms (coefficient = 0.35) and healthy cardiovascular behaviors (coefficient = 0.32). The results support the primacy of family functioning factors in understanding the associations among social relationships, mental health, and health behaviors. The contrasting relationships between emotional involvement and depressive symptoms on the one hand and emotional involvement and health behaviors on the other suggest the need for a more complex model to understand the connections between social relationships and health.

Adult↗

PubMed1992

Exploring the influence of multiple variables on the relationship of age to quality of life in women with breast cancer.

This paper explores the relationship between age, psychosocial status and quality of life in a community based sample (n = 229) of newly-diagnosed breast cancer patients. A casement display methodology is used to examine the influence of demographic and medical variables on the outcome variables of interest (psychosocial status and quality of life) and their relationship to age. Based on the literature, a positive relationship between age and psychosocial status was predicted, but the relationship between age and quality of life was uncertain. For the whole sample, a weakly positive relationship between age and measures of psychosocial status and quality of life was observed. In the exploratory studies using the casement plots, the positive relationship between age and quality of life was most strong and significant in married women and in women who had received segmental mastectomy. Among sub-groups examined according to marital status and type of surgery, a positive relationship between age, psychosocial status and quality of life was observed only in married women who received segmental mastectomy. Additional preliminary observations were made about the relationship of household income and age to the outcome variables being studied. The casement plot methodology permits the simultaneous evaluation of multiple variables as a preliminary step before hypothesis development and should be considered when complex clinical problems are being evaluated.

Adolescent↗

PubMed2006

Family and friend closeness to adolescent sexual partners in relationship to condom use.

PURPOSE: The role of closeness of sexual partners to family and friends (i.e., how well the participant's family and friends knew their primary sexual partner) to a variety of relationship and sexual behavior measures was explored. METHODS: A sample of 151 adolescent females (aged 14-17 years) was assessed. Areas assessed include family and friend closeness, relationship intimacy, length of sexual relationship, and condom use. RESULTS: Bivariate correlations indicated that the integration of the sexual partner into the family and friend networks was related to greater relationship intimacy. Lowered condom use was related to a number of measures, including increased relationship intimacy and increased family closeness. A path analysis was conducted to assess for direct and indirect effects of family closeness, friend closeness, relationship length, and relationship intimacy on condom use. Social network closeness in family and friend networks was implicated in lowered condom use through higher relationship intimacy within adolescent dyads. CONCLUSIONS: Social network theory is useful in understanding adolescent health-related behavior. In particular, the integration of adolescent sexual partners into both family and friend networks is related to the expression of adolescent sexual behavior.

Adolescent↗

PubMed2006

Evidence for sex differences in the relationships of pain, mood, and disability.

UNLABELLED: Disability demonstrates strong univariate associations with pain and negative mood. These relationships are more complex at the multivariate level and might be further complicated by sex differences. We investigated sex differences in the relationships of pain and negative mood to overall disability and to disability in specific functional domains. One hundred ninety-seven consecutive patients with low back, myofascial, neck, arthritis, and fibromyalgia pain were recruited from university pain clinics and completed measures of disability and negative mood. Overall disability and disability in voluntary activities were significantly associated with pain and negative mood (factor score) for both sexes. Significant sex differences emerged in the strength of the disability-mood relationship, with women evincing a stronger relationship. Disability in obligatory activities was also significantly related to pain and negative mood for both sexes; however, there were no sex differences in the strength of these relationships. Mediation analyses indicated that, in men, negative mood partially mediated the relationship between pain and both overall disability and disability in voluntary activities; mediation was not supported for disability in obligatory activities. In women, negative mood fully mediated the relationship between pain and all 3 types of disability. These data suggest that disability is more directly related to pain in men. In women, the effect of pain on disability appears to operate through negative mood. PERSPECTIVE: Results of this study demonstrate that sex differences exist in the relationships of pain, mood, and disability. Men and women might thus benefit from treatment interventions that differentially target these variables.

Adult↗

PubMed2006

Impact of erectile dysfunction on confidence, self-esteem and relationship satisfaction after 9 months of sildenafil citrate treatment.

PURPOSE: The first double-blind, placebo controlled trial in the United States of the Self-Esteem And Relationship questionnaire revealed that treatment with sildenafil citrate improves erectile function and measures of quality of life in men with erectile dysfunction. We investigated long-term improvement, and correlations between improved erectile function and confidence, self-esteem and sexual relationship satisfaction in men with erectile dysfunction. MATERIALS AND METHODS: This was a 36-week open label extension of the double-blind, placebo controlled trial. The blind was not broken. Patients were 18 years or older with clinically diagnosed erectile dysfunction. Erectile function was assessed using the International Index of Erectile Function. Self-esteem, confidence and relationship satisfaction were assessed using the Self-Esteem And Relationship questionnaire. Correlations were determined using Pearson's product moment coefficients. RESULTS: A total of 204 participants were enrolled in the open label extension, including 108 on placebo and 96 on sildenafil. In men who received placebo in the double-blind, placebo controlled phase mean erectile function scores and self-esteem, confidence and relationship satisfaction scores were increased significantly at week 36 of the open label extension (p < 0.0001). Men who received sildenafil in the double-blind, placebo controlled phase maintained high scores in the open label extension. Correlations between improved erectile function, and self-esteem, confidence and relationship satisfaction were strong and positive (p < 0.0001). CONCLUSIONS: Open label extension sildenafil after double-blind, placebo controlled placebo significantly improved erectile function, self-esteem, confidence and relationship satisfaction. Following an initial 12 weeks of double-blind, placebo controlled sildenafil therapy for erectile dysfunction improvements were sustained an additional 9 months. Positive correlations between erectile function, and self-esteem, confidence and relationship satisfaction suggest that improved erectile quality can improve long-term psychosocial quality of life.

Adult↗

PubMed2006

Effects of multi-media partitioning of chemicals on Junge's variability-lifetime relationship.

Junge's variability-lifetime relationship describes the relation between the tropospheric residence time of a volatile trace gas and the coefficient of variation of the tropospheric mixing ratio at a remote location. However, no unique or universal quantification of this relationship exists. It can only be derived on a case-by-case basis for consistent data sets on substances with similar source and sink patterns. Using a multi-media model of the long-range transport of organic compounds, we determine variability-lifetime relationships for volatile substances. Next, we demonstrate how the variability-lifetime relationship can be obtained for semi-volatile organic compounds (SOCs) with the model and we investigate typical deviations from the Junge relationship for volatile compounds that are caused by the multi-media partitioning of SOCs. One cause of deviation from this relationship is substances undergoing significant transport in water so that their distribution in air is noticeably influenced by their distribution in water. The other, wider, deviation is caused by substances with a strong tendency for deposition and re-volatilization. Finally, we address the comparison of the model results with field data. Preliminary analyses of long-term monitoring data for polychlorinated biphenyls at remote sites have shown that the identification of Junge relationships in field data is not straightforward. We discuss possible strategies for the derivation of Junge relationships from field data on SOCs.

Air Movements↗

PubMed2005

Empirical uncertainty and moral contest: a qualitative analysis of the relationship between medical specialists and the pharmaceutical industry in Australia.

Alliances between the medical profession and the pharmaceutical industry have become increasingly widespread in recent years. While there are clearly benefits for doctors and their patients derived from the medical profession working with industry, concern has arisen that the commercial imperative of industry may conflict with physicians' independence and professional integrity. This paper reports the findings of an in-depth interview study with 50 Australian medical specialists undertaken to explore how and why they interact with the pharmaceutical industry and to gain insight into specialists' moral evaluation of the relationship and its consequences. Analysis of the qualitative data led to the categorizing medical specialists into three types--Confident Engagers, Ambivalent Engagers and Avoiders--based on their descriptions and evaluations of their relationship. The majority of interviewees believed that some relationship with the pharmaceutical industry was inevitable, that there were both risks and benefits associated with the relationship and that as individuals they were competent in minimizing the risks and maximizing the benefits. However, their views diverged on the extent and magnitude of the risks and benefits. The data suggested that there is considerable variance in specialists' judgments of what constituted appropriate industry largesse. Specialists' relationship with the pharmaceutical industry has inherent tensions that are managed by different doctors in different ways. Moral evaluation of the relationship and its consequences varies and the ethical concerns surrounding the relationship appeared as an area of contest. The findings suggest that in developing normative guidelines for academic and professional practice, policy makers should recognise and account for the complexity of the relationship and for the variation in medical specialists' views and feelings.

Australia↗

PubMed2004

Monophyly and relationships of wrens (Aves: Troglodytidae): a congruence analysis of heterogeneous mitochondrial and nuclear DNA sequence data.

The wrens (Aves: Troglodytidae) are a group of primarily New World insectivorous birds, the monophyly of which has long been recognized, but whose intergeneric relationships are essentially unknown. In order to test the monophyly of the group, and to attempt to resolve relationships among genera within it, sequences from the mitochondrial cytochrome b gene and the fourth intron of the nuclear beta-fibrinogen gene were obtained from nearly all genera of wrens, from their relatives as suggested by traditional taxonomy and DNA-DNA hybridization analyses, and from additional passerines. Maximum likelihood analysis of the two data sets yielded maximal congruence between independently derived estimates of relationship, outperforming a variety of weighted parsimony methods. Hierarchical likelihood ratio tests indicated that the two gene regions differed significantly in every estimated parameter of sequence evolution, and combined analysis of the two data sets was accomplished using a heterogeneous-model Bayesian approach. Independent and simultaneous analyses of both data sets supported monophyly of the wrens (excluding one recently added member, the monotypic genus Donacobius) and a sister-group relationship between wrens and the gnatcatchers (Polioptila). Additionally, strong support was found for paraphyly of the genus Thryothorus, and for a sister-group relationship between the genera Cistothorus and Troglodytes. Analyses of these data failed to resolve basal relationships within wrens, possibly due to ambiguity in rooting with a distant, species-poor outgroup. Analysis of the combined data for wrens alone yielded results which were largely congruent with relationships inferred using the complete data set, with the benefit of stronger support for relationships within the group. However, alternative rootings of this ingroup tree were weakly supported by nucleotide substitution data. Insertion-deletion events suggest that the genus Salpinctes may be sister to all other wrens.

Animals↗

PubMed1997

Modification of oral contraceptive relationships on breast cancer risk by selected factors among younger women.

In a case-control study of 1647 breast cancer cases and 1501 population controls under 45 years of age, potential modifying effects of other risk factors on the relationship of oral contraceptives to breast cancer were examined. Among the total series of study subjects, the relationship of extended pill usage was greater in non-white than white women. Oral contraceptive associations, however, did not appear to be substantially modified by other risk factors, including parity, body size, or family history of breast cancer (apart from a somewhat enhanced relationship among subjects who reported a sister with breast cancer. Further, oral contraceptive relationships did not vary by a history of benign breast disease, although the majority of subjects began pill usage prior to the development of benign breast disease. Among the women under the age of 35, in whom oral contraceptive relationships were heightened (over a twofold excess risk for use of 5 years or longer), pill relationships were less modified by race than in the total series. Although among these younger subjects there was no effect of pill usage in heavy women, and an enhanced relationship among heavier consumers of alcoholic beverages, these interactive effects were not statistically significant. The findings of this study generally support no substantial variation in oral contraceptive relationships by other breast cancer risk factors, although some further attention might be warranted regarding possible modifying effects of race, body size, type of relative with breast cancer, and alcohol consumption.

Adult↗

PubMed1999

Volume-outcome relationships in cardiovascular operations: New York State, 1990-1995.

BACKGROUND: It has been known for nearly 20 years that, in cardiovascular operations, a significant inverse relationship exists between clinical outcomes and the volume of procedures performed. Interestingly, this relationship persists 2 decades after it was recognized. OBJECTIVE: The purpose of this study was to examine the relationship between hospital volume and in-hospital deaths in 3 cardiovascular procedures: coronary artery bypass grafting, elective repair of abdominal aortic aneurysms, and repair of congenital cardiac defects. METHODS: The database includes all patients who were hospitalized in New York State during the years 1990 to 1995. Using standard logistic regression techniques, we analyzed the relationship between hospital volume and outcome. RESULTS: No correlation exists between hospital volume and in-hospital deaths in coronary artery bypass grafting. Statewide, 31 hospitals performed 97,137 operations over the 6-year period (overall mortality rate, 2. 75%). By contrast, most of the hospitals statewide (195 of 230 hospitals) performed 9847 elective abdominal aortic aneurysm repairs with an overall mortality rate of 5.5%. In abdominal aortic aneurysm operations, a significant inverse relationship between hospital volume and in-hospital deaths was determined. Sixteen hospitals performed 7199 repairs for congenital cardiac defects. A significant inverse relationship (which was most pronounced for neonates) was found between volume and death. CONCLUSIONS: The importance of these findings lies in the rather striking difference between the volume-outcome relationship found for operations for abdominal aortic aneurysms and congenital cardiac defects and the lack of such a relationship for coronary artery bypass grafting. This observation may be largely explained by the quality improvement program in New York State for bypass operations since 1989. If so, these results have important implications for expanding the scope of quality improvement efforts in New York State.

Adolescent↗

PubMed2003

Are therapeutic relationships in psychiatry explained by patients' symptoms? Factors influencing patient ratings.

OBJECTIVE: To investigate the therapeutic relationship and how it is influenced by sociodemographic and clinical factors. METHOD: This study analysed self-ratings of the therapeutic relationship in 90 first-admitted, 72 long-term hospitalised and 41 out-patients with schizophrenia along with 249 alcoholic and 42 depressive in-patients and their association with sociodemographic and clinical variables. In all the patients, the therapeutic relationship was assessed using a simple scale based on three items. RESULTS: The therapeutic relationship differed significantly across groups. It was rated most positively by alcoholic patients and least positively by long-term hospitalised schizophrenia patients. Increased observer-rated psychopathology was significantly associated with a poorer therapeutic relationship in all groups except the hospitalised schizophrenia patients. In this group, increased self-rated symptoms were associated with a poorer relationship. In multiple regression analyses, 3-28% of the relationship variance was explained by psychopathology. CONCLUSIONS; Patient ratings of the therapeutic relationship were partially explained by psychopathology, leaving the greater part of the variance to be explained by factors other than sociodemographic and clinical characteristics.

Adult↗

PubMed1999

How do vocational and relationship stressors and identity formation affect adolescent mental health?

PURPOSE: This article examines the effects of stressors in both the vocational and relationship career of youngsters in the formation of their identity; the effects of identity formation on adolescent mental health; the influence of career stressors on mental health, directly or via identity, and differences in these effects on boys and girls. METHODS: Data were used from the Dutch national panel study, Utrecht Study of Adolescent Development, a study of developmental processes as they occur in the life course of young people during the 1990s. Using LISREL, we tested hypotheses on two waves of a sample of 1222 respondents between 15 and 24 years of age in Wave 1 (1991). RESULTS: The correlation between relationship stressors and relationship identity can be neglected, while vocational stressors lead to a less achieved vocational identity, particularly in boys. Occupational and relationship identity have similar effects on mental health (i.e., the more achieved the identity, the better the person's mental health). Vocational and especially relationship stressors lead to poorer mental health, but did not affect the mental health of boys and girls differently. The same goes for the influence of relationship and vocational identity formation on mental health. CONCLUSIONS: Career stressors, especially stressors in the relationship domain, appear to have significant long-term effects on adolescent mental health. Vocational and relationship identity formation are also significant predictors for adolescent mental health.

Adolescent↗

PubMedDate not supplied

Negotiating trust: a grounded theory study of interpersonal relationships between persons living with HIV/AIDS and their primary health care providers.

This grounded theory study is an exploration of long-term interpersonal relationships between patients and their primary health care providers, including physicians and nurse practitioners, in an urban outpatient HIV/AIDS clinic. Many providers believe that the positive interpersonal relationship enhances the health care experience for the patient, but there is a scarcity of research in this area. Persons who are patients were interviewed (N = 14) to look at these relationships from their points of view and develop theory to guide clinicians in forming such relationships. Theoretical sampling was used to find patients in this clinic population involved in long-term relationships with their providers. Open-ended interviews were conducted. These data were coded using the grounded theory method of constant comparative analysis. A basic process of negotiating trust was identified. Trust in these relationships is a state that is dynamic, volatile, and constantly renegotiated during the trajectory of the relationship through time. The trusting relationship is personally supportive for patients and may be a factor in the satisfaction found among health care providers in this clinical field despite the nature of this epidemic.

Adult↗

PubMed2000

Task conflict and relationship conflict in top management teams: the pivotal role of intragroup trust.

Task conflict is usually associated with effective decisions, and relationship conflict is associated with poor decisions. The 2 conflict types are typically correlated in ongoing groups, however, which creates a prescriptive dilemma. Three explanations might account for this relationship--misattribution of task conflict as relationship conflict, harsh task conflict tactics triggering relationship conflict, and misattribution of relationship conflict as task conflict. The authors found that intragroup trust moderates the relationship between task conflict and relationship conflict in 70 top management teams. This result supports the "misattribution of task conflict" explanation. The authors also found a weak effect that is consistent with the argument that tactical choices drive the association between the 2 conflict types. We infer that trust is a key to gaining the benefits of task conflict without suffering the costs of relationship conflict.

Adult↗

PubMed2005

Giving up and giving in: the costs and benefits of daily sacrifice in intimate relationships.

This research provided the first empirical investigation of how approach and avoidance motives for sacrifice in intimate relationships are associated with personal well-being and relationship quality. In Study 1, the nature of everyday sacrifices made by dating partners was examined, and a measure of approach and avoidance motives for sacrifice was developed. In Study 2, which was a 2-week daily experience study of college students in dating relationships, specific predictions from the theoretical model were tested and both longitudinal and dyadic components were included. Whereas approach motives for sacrifice were positively associated with personal well-being and relationship quality, avoidance motives for sacrifice were negatively associated with personal well-being and relationship quality. Sacrificing for avoidance motives was particularly detrimental to the maintenance of relationships over time. Perceptions of a partner's motives for sacrifice were also associated with well-being and relationship quality. Implications for the conceptualization of relationship maintenance processes along these 2 dimensions are discussed.

Adaptation, Psychological↗

PubMed2005

Sibling relationships in early/middle childhood: links with individual adjustment.

The overarching goal of the study was to identify links between sibling relationship quality in early/middle childhood with children's adjustment, having accounted for the effects of parent-child relationship quality. The sample consisted of 101 working and middle-class 2-parent English families with 2 children ages 4-8 years. Parents provided reports of sibling relationship quality, the parent-child relationship, and the children's prosocial and problematic behaviors. The children also provided reports of their familial relationships with a puppet interview. Results indicated that sibling relationship quality was associated with the older siblings' adjustment, controlling for the children's relationships with parents. In addition, the pattern of findings suggested that positivity within the sibling relationship was more strongly linked with child adjustment than was sibling conflict.

Adaptation, Psychological↗

PubMed2006

Work-to-relationship conflict: crossover effects in dual-earner couples.

To better understand the outcomes for couples whose work interferes with their relationships, with an emphasis on the crossover effects that can occur in close relationships, we examined experienced work-to-relationship conflict and perceptions of partner's work-to-relationship conflict for both members of 113 dual-earner couples. Outcomes of interests included relationship tension, health symptoms, and relationship satisfaction. Results indicate that personal work-to-relationship conflict and perceptions of partner's work-to-family conflict were related to personal as well as partner outcomes; a variety of direct crossover effects were demonstrated. The actor-partner interdependence model was incorporated to account for issues of interdependent data that naturally occur in relationship dyads, a methodological issue not typically addressed and accounted for in the dyadic work-family interface literature.

Adult↗