The effect of questionnaire design on reported prevalence of psychoactive medication.
Explore the source record for details and available documents.
Drug Utilization↗
SEARCH · Search PubMed
Results for “Self Disclosure”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A model for communication skills development for family practice residents.
The purpose of this paper is twofold: (1) to demonstrate the need for including interpersonal communication skills training in family practice residency programs, and (2) to present a communication model that can be used for such training. Interpersonal communication skills are important in almost all areas of contact with patients: history taking, physical examination, prescription writing and patient education, counseling, and psychotherapy. Presentation of the communication model includes definition of the interpersonal communication skills that would be stressed in family practice residency programs. These skills include empathy, respect, warmth, concreteness, genuineness, self-disclosure, confrontation, immediacy, and behavior modification. Examples of how a family physician may communicate each of these skills are also included. The implementation of the communication model in a department of family practice for training residents and faculty in the use of these communication skills is also described.
Communication↗
Adolescents as victims of family violence. Council on Scientific Affairs, American Medical Association.
Adolescents experience maltreatment at rates equal to or exceeding those of younger children. Recent increases in reported cases of maltreatment have occurred disproportionately among older children and adolescents. However, adolescents are less likely to be reported to child protective services and are more likely to be perceived as responsible for their maltreatment. Adolescent girls are reported as victims more often than boys, especially in sexual abuse. However, boys may be less likely to be identified or reported and often are abused by nonfamily members. Parents of adolescent victims have higher average income and educational levels and are less likely to have a parental history of abuse than parents of younger children. A wide range of serious adolescent risk behaviors is associated with maltreatment. These include increased risk of premature sexual activity, unintended pregnancy, emotional disorders, suicide attempts, eating disorders, alcohol and other drug abuse, and delinquent behavior. Incarcerated youth, homeless or runaway youth, and youth who victimize siblings or assault parents have been shown to have high rates of prior maltreatment. Signs of maltreatment are often ambiguous for adolescents. Screening questions have been effective in prompting self-disclosure of abuse. Adolescents also experience problems in the child welfare system that offers fewer and less appropriate services for this age group. Recommendations are made regarding screening of adolescents for maltreatment, the development of better services for adolescents, research on parenting to prevent maltreatment, and training of school staff to identify and refer victims of maltreatment.
Adolescent↗
Suicide prevention: a classroom presentation to adolescents.
The increase in attention given to adolescent suicide has led to a proliferation of suicide prevention programs in schools throughout the United States. Concern is mounting over the benefits of these programs. The author, with the same concern about his own suicide prevention program, subjects his program to a statistical analysis of effectiveness. Results show that a disturbingly high proportion of adolescents had undesirable attitudes about suicide in the baseline period. The program appears to have caused a significant shift from undesirable to desirable attitudinal responses in six of eight targeted areas. In addition, the results seem to dispel a commonly held belief that associating mental illness with suicide will diminish self-disclosure.
Adolescent↗
Safety, danger, and the analyst's authority.
The concepts of safety and danger as they pertain to the psychoanalytic situation are examined, with a special interest in casting aside familiar unquestioned presumptions about the therapeutic effects of the analyst and the setting as safe and therefore facilitating of self-disclosure, insight, and change. The merit of viewing the situation as in itself neither safe nor dangerous is argued, and problems are noted in the uncritical acceptance of the illusion of safety and attempts to use it for therapeutic purposes. Such an illusion denies the psychological and biological vulnerability of all human beings, especially in relation to aggression. In the clinical setting, working from an unexamined presumption of safety interferes with full transference expression and the analysis of aggression, often in the service of sparing the analyst from fully experiencing the analysand's adult aggressive potential. Contemporary interest in the analyst's authority, particularly efforts to undo it, can profitably be viewed as helping to maintain an illusion of safety during treatment in order to avoid the real dangers that are experienced as present and that are therefore available for exploration and mastery.
Adult↗
HIV seroprevalence, risk behaviors, and cognitive factors among Asian and Pacific Islander American men who have sex with men: a summary and critique of empirical studies and methodological issues.
The goals of this article are to (a) summarize and discuss published empirical studies addressing HIV seroprevalence rates and HIV-related behaviors and cognitive factors among Asian and Pacific Islander American (API) men who have sex with men (MSM) in the United States, (b) examine existing population-based research methodologies for studying HIV and AIDS prevention, (c) describe a conceptual framework to facilitate the identification of ecologically sound or culturally appropriate and competent methodologies for studying HIV prevention among API MSM, and (d) discuss methodological issues and recommend alternative methodologies to better understand this population in HIV prevention. A total of eight published empirical studies reported the HIV seroprevalence rates, HIV-risk behaviors, and attitudes toward HIV and AIDS among API MSM. Specifically, seven studies reported HIV seroprevalence rates that were based on either self-disclosure of HIV status or HIV test results among the study participants. Four studies also reported findings about the relationships between HIV-related behaviors and cognitive factors. There are five population-based databases on HIV and AIDS epidemiology and surveillance which have been managed by the Centers for Disease Control and Prevention. Findings from the seven studies indicate that API MSM are as likely to engage in HIV-risk behaviors as other groups. The present analysis reveals that conventional surveillance or epidemiological techniques (e.g., random digit telephone dialing), based on a singular model of populations, are not appropriate to address culturally, linguistically and racially/ethnically diverse groups of API MSM. To address the diversity of this group, ecologically sound or culturally appropriate and competent research methodologies are needed. Thus, a conceptual framework for such methodologies with examples was reviewed. Two alternative methodologies, network analysis and venue-based sampling, were briefly discussed.
Asian↗
The good, the bad, and the healthy: impacts of emotional disclosure of trauma on resilient self-concept and psychological distress.
This study examined the impact of disclosing traumas on resilient self-perceptions and psychological distress. Participants (N = 50) wrote about a traumatic life event or their plans for the next day and completed measures of resilience and distress before disclosing (pretest) and 3 months later (posttest). Results revealed that trauma participants increased in positive self-perceptions (mastery, personal growth, self-acceptance) and decreased in distress (depression, interpersonal sensitivity, anxiety, somatization) from pretest to posttest. Control participants showed no changes except for autonomy, on which they decreased. Results suggest that in addition to reducing psychological distress, disclosing traumas change self-perception, resulting in a more resilient self-concept.
Adaptation, Psychological↗
A preliminary study of self-esteem, stigma, and disclosure in adolescents who stutter.
UNLABELLED: This study examined the self-esteem, perceived stigma, and disclosure practices of 48 adolescents who stutter divided into two age cohorts: younger (13, 14, and 15 years) and older (16, 17, and 18 years) adolescents. Results revealed that 41 (85%) of the participants scored within 1 S.D. from the mean on a standardized measure of self-esteem, indicative of positive self-esteem. Results also showed that stuttering did not present a stigmatizing condition for the majority (65%) of adolescents who stutter. However, 60% of participants indicated that they "rarely" or "never" discussed their stuttering. The younger adolescents perceived stuttering as a more negative and stigmatizing condition than older adolescents. Implications for understanding stuttering in adolescents are discussed. EDUCATIONAL OBJECTIVES: Readers will learn about and understand (a) the role of stigma, disclosure, and self-esteem in stuttering; (b) the methods used to evaluate stigma, disclosure, and self-esteem in adolescents; and (c) the similarities between adolescents who stutter and normative data on self-esteem and stigma scales.
Adolescent↗
An examination of willingness to self-disclose in women with bulimic symptoms considering the context of disclosure and negative affect levels.
OBJECTIVE: This study explored the relationship between bulimic symptoms and self-disclosure. It examined whether women who reported greater bulimic symptomatology were generally less willing to self-disclose in intimate relationships or whether reluctance to disclose was confined to eating and weight concerns. METHOD: Women with high and low scores on the Bulimia Test Revised (BULIT-R) were compared on self-disclosure about three topics (daily activities, eating, and weight) and sexual and relationship issues to three targets (mother, friend, and partner). RESULTS: There were significant main and interaction effects for BULIT-R score, target, and topic of self-disclosure. When depression was controlled for, it partially explained the association between bulimic behavior and self-disclosure. DISCUSSION: Results supported a contextual model of self-disclosure. Compared with nonbulimic women, women with bulimic symptoms were less willing to self-disclose certain topics to particular targets. Levels of depression explained low willingness to disclose on topics unrelated to eating and weight to some targets.
Adult↗
Litigation, legislation, and ethics. Disclosure and self-determination.
Explore the source record for details and available documents.
Aged↗
Psychiatric "survivors" and testimonies of self-harm.
UK "Psychiatric Survivors"-a variety of activist groups comprising individuals who have been on the "receiving end" of psychiatric treatment-have, since the mid-1980s, mounted a challenge to the psychiatric system. "Survivors" have formulated their own knowledge-base concerning a range of human problems hitherto regarded as the province of "official" psychiatry only. "Official" knowledge stresses scientific classification, professional expertise, and statistical evidence: "Survivor" knowledge, by contrast, emphasises individual experience, the traumas of the life-course, and the personal testimony of the survivor as itself expert data. This paper focuses upon the truth-claims enacted by the "testimony of the survivor" and the relation of "testimony" to political practice. Specifically, I analyse a key text containing the testimonies of female survivors whose behaviour has been officially labelled as "deliberate self-harm"; that is, women who harm themselves, through self-poisoning or self-laceration, and subsequently receive medical/psychiatric treatment. The main focus is upon the political functions of testimony in theory and practice-the ways in which "survivors" challenge the power of psychiatry.
Female↗
Sex differences in the endorsement of MMPI critical items.
Explore the source record for details and available documents.
Acting Out↗
Comparison of alternative methods of collection of service use data for the economic evaluation of health care interventions.
Economic evaluation of health care interventions usually requires the collection of service use data to estimate the total cost of participants in an evaluation. There are a number of methods available to measure the quantity of services used but little is known about the relative accuracy of alternative methods. In a multicentre randomised controlled trial of interventions for the treatment of adults with recurrent episodes of deliberate self-harm (the POPMACT trial), health service data were collected by patient self-report after six and twelve months and also from GP records by independent investigators. Agreement for overall costs was relatively high. However, this hides substantial variation in agreement between the two sources of information for different services. The results suggest that GP records provide more accurate data on the use of general practice-based contacts than patient report, but less reliable information on contacts with other health services. Thus reliance on GP records for data on hospital services and other community health services based outside of general practice surgeries is not recommended. Future research should explore the level of agreement between patient report and other providing sector records, such as hospital records.
Adult↗
Eating disorders and emotional and physical well-being: associations between student self-reports of eating disorders and quality of life as measured by the SF-36.
OBJECTIVE: To assess health-related quality of life (HRQoL) in subjects with eating disorders in terms of eating disorder type and in relation to self-reports of longstanding illness, depression and self-harming behaviours. METHOD: Data on eating disorder history, SF-36 health status, longstanding illness, and self-reported frequencies of depression, self-harming behaviour, and suicidal thoughts or acts were collected during 1996 as part of a UK postal survey of students' health. Completed questionnaires were returned by 1439 of 3750 students (response rate 42%). RESULTS: Eighty-three respondents (5.8%; 8.9% of females) reported a probable eating disorder history: 54 (3.8%) bulimia nervosa, 22 (1.6%) binge eating disorder, and 7 (0.5%) anorexia nervosa. Eating disorder subjects reported more impairment in SF-36 emotional than physical well-being, with significantly lower mental (p < 0.001) but not physical (p = 0.21) component summary scores. This was most evident in bulimia nervosa and binge eating disorder subjects. Anorexia nervosa subjects reported fewer SF-36 emotional limitations although they were significantly more likely to report depression, self-harming behaviour, and suicidal ideation. DISCUSSION: An eating disorder history is accompanied by HRQoL impairment primarily in emotional well-being. Anorexia nervosa subjects perceive fewer limitations than subjects with other eating disorders. While this is consistent with previous reports of better SF-36 emotional well-being in those with restrictive eating behaviours, it may also suggest that the SF-36 is insensitive to emotional distress in anorexia nervosa.
Adult↗
Hypertension labeling and well-being: alternative explanations in cross-sectional data.
We attempted to replicate recent cross-sectional findings suggesting that the process of being labeled a hypertensive may result in reductions in the perception of well-being among normotensives. From a community survey, 1849 normotensives were categorized by the presence or absence of either a provider message about hypertension (history) or the belief that they have hypertension (self-diagnosis). Normotensives with any label reported greater numbers of depressive and medical symptoms, poorer self-perceived health and more disability than those with neither label. Multiple regression analysis showed that whereas a history was significantly associated only with symptoms, a self-diagnosis was more strongly associated with measures of morbidity. In addition, there was a significant positive relationship between a hypertensive history and the number of physician visits in the previous year. Because the described associations are cross-sectional, labeling may undermine one's sense of well-being, or, individuals with greater self-perceived morbidity may visit physicians more frequently and, as a result, have a greater opportunity for a blood pressure elevation to be detected.
Adult↗
Implications of self-monitoring for smoking treatment: effects on adherence and session attendance.
The reactive effects of three self-monitoring procedures were evaluated with respect to compliance with the self-monitoring requirements and session attendance. A total of 50 smokers who agreed to participate in a smoking cessation program were randomly assigned to one of five conditions: three self-monitoring conditions and two no self-monitoring control conditions. Results indicate that groups were initially equal on the variables of age, sex, pack year history, estimated rate of consumption, and alveolar carbon monoxide level. Drop-out rates for the no self-monitoring control groups were equal at the second session (10% each) and significantly lower than those of the self-monitoring groups (40%, 40%, and 60%). This significant difference was still present at the sixth treatment session. The implications of increased drop-out rates in smoking cessation programs resulting from self-monitoring are discussed.
Adult↗
Long-term follow-up (3-4 years) of treatment for smoking reduction.
The present paper reports the 3- and 4-year follow-ups of two smoking reduction clinics (n = 103) employing a comprehensive, non-aversive, behavioral treatment using stimulus control and self-control techniques. Most of the data were gathered via phone contact, while some clients were interviewed in person with corroborative carbon monoxide measurements taken at that time. While the general findings were similar to those reported for other long-term follow-ups of smoking programs, unlike earlier reports, the overwhelming majority of subjects were contacted (an average of 90% for all follow-up periods). The average percentage of baseline for smoking subjects was equal to 56% and average percentage abstinent equal to 24% at final follow-up. Data are also presented which suggest greater attention be paid to the potential efficacy of controlled smoking when assessing the effectiveness of smoking reduction programs.
Adult↗