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PubMed1996

Anger management style, hostility and spouse responses: gender differences in predictors of adjustment among chronic pain patients.

This study examined whether relationships between anger management style (anger suppression; anger expression) and adjustment variables for patients with chronic pain depend on patient hostility, and/or depend on a patient's gender. A 'spouse response model' was also evaluated to test whether patient expression of hostile anger is linked to infrequent positive and frequent negative responses from spouses, and hence to poor adjustment. The sample of 127 married chronic pain patients was assessed prior to entry into a multidisciplinary pain treatment program. Hierarchical multiple regressions revealed significant 'Anger Expression x Hostility x Gender' interactions for pain severity, activity interference and activity level: High Anger Expressor/Low Hostile women reported the lowest pain and highest activity; Low Anger Expressor/High Hostile men reported the highest pain and highest interference. Among men, support was also found for a spouse response model: pain severity and activity interference for High Anger Expressors was partly accounted for by negative spouse responses. Results suggest that discriminations among patients may be made based on anger management style in interaction with level of hostile attitude and the patient's gender, and that these distinctions may have implications for understanding mechanisms of pain and disability, and for designing appropriate treatment.

Adaptation, Psychological↗
PubMed2001

Differences in rates of depression in schizophrenia by race.

The purpose of this study was to determine whether demographic and clinical factors are associated with a diagnosis of depression among persons with schizophrenia and to determine the association of depression with subjective quality of life. A consecutively admitted sample of psychiatric inpatients diagnosed with schizophrenia (n = 123) were assessed for depression and quality of life. Logistic regression was used to determine factors associated with a diagnosis of depression. Multiple regression analyses were used to determine the relationship between depression and quality of life. The odds of being diagnosed with depression were seven times greater in Caucasians than in African-Americans, and three times greater in persons who were ever married. Depression was significantly associated with reduced life satisfaction in Caucasians but not African-Americans. This suggests the importance of race as a predictor of a diagnosis of depression in schizophrenia and the possibility of underdiagnosis of depression among African-Americans. The absence of the expected association between depression and quality of life in African-Americans casts doubt on the validity of the depression diagnosis using conventional diagnostic tools.

Adult↗
PubMed1980

The spatial distribution of depressive illness in Plymouth.

Diagnostic and demographic data were collected from all 2,298 psychiatric hospital admissions for affective illnesses from private households in the City of Plymouth for the six-year period 1970-1975 inclusive. Intercorrelations of diagnostic subtypes were performed, together with a multiple regression analysis against spatial and ecological data from the 1971 Census. Rate differences were related to the geographic structure of Plymouth. With psychotic illnesses, ecological correlations were low for male and female first admissions and for male readmissions. However, important correlations relating to socio-economic status, housing tenure and structure, population instability, and other sociodemographic features emerged in varying degrees of specificity for reactive and neurotic illness in males, and for all readmissions in females, largely irrespective of diagnostic subtype. Explanations for the processes underlying these patterns are offered in terms of population structure, particularly the differing vulnerability of age and marital status groups, the referral and diagnostic process, social and physical stresses in the lower socioeconomic groups, and urban drift.

Adult↗
PubMed1992

Young women's antisocial behavior and the later emotional and behavioral health of their children.

OBJECTIVES: Antisocial and criminal behavior are increasing among US youth, especially among females. Thus, questions arise concerning whether youthful female deviant behavior eventually will have negative behavioral and emotional consequences for the later children of these women. METHODS: Associations between the severity of early female antisocial behavior (including both drug-related and non-drug related offenses) and the later behavioral and emotional health of the children of these women were examined among 1425 mother-child pairs of the National Longitudinal Survey of Youth. RESULTS: Multiple linear regression procedures indicated a significant positive relationship between the severity of the mothers' early non-drug-related offenses and the later severity of the children's scores on the Antisocial, Hyperactive, Anxious/Depressed, Headstrong, Peer Conflict/Social Withdrawal, Immature Dependency, and Total Problem subscales of the Behavior Problem Index. CONCLUSIONS: This study demonstrated an association between the antisocial behavior of female youth and the later behavioral and emotional problems of the children of these women. Future research needs to determine the mechanisms underlying the intergenerational transmission of these types of problems so that effective preventive and therapeutic public health practices may be designed and implemented.

Adolescent↗
PubMed1995

The place of children in the history of couples.

"Does the multiplication of families outside wedlock increase poverty and aggravate the 'social problems' that emerge during adolescence, or does it normalize the position of children brought up in nontraditional families?...[The author] observes the place of children in the history of couples [in France].... The increase in the risk of breakdown of unions corresponds to a logic that is independent of fertility behaviour. Children are increasingly conceived by parents who already live [together], and the time of their birth is more and more often planned, but the presence of children thereafter has only a weak influence on the solidity of the union, except when the children are very young; children are no stronger a guarantee of the solidity of a union now than [they were] in the past."

Child↗
PubMed1992

[Pregnancy, labor and partnership relations in a family with a "retort baby". Follow-up of "IVF couples" and their children].

Nowadays, in vitro fertilisation can be judged as a relatively successful treatment in special cases of sterility. Success cannot be defined only by induction of pregnancy, but must also be taken into consideration the couple's and the "IVF-children's" personal situation. The main problem of IVF is the high multiple rate of nearly 20%, resulting in a higher frequency of preterm deliveries. This leads to higher perinatal mortality and more longterm deficiencies in these children. The women's attitude during pregnancy can be considered to be responsible. From a psychosomatic point of view (the husband's presence during delivery, breast feeding etc.) there are favourable preconditions for the "birth of the family." In most cases, the couples give a contented or good view of their partnership (self-assessment). Nearly 5% of them seem to be "disappointed" after the birth of the baby. The method of IVF is positively assessed from an overall point of view. But only half of the women do not keep this special method of procreation secret.

Adaptation, Psychological↗
PubMed1991

Relationship between panic attacks and health locus of control.

BACKGROUND: Health locus of control has significant implications for treatment response, compliance, patient education, and health maintenance. Because of the association between locus of control and anxiety, this study was conducted to determine the health locus of control (HLOC) in patients with panic attacks, changes in HLOC through treatment of panic attacks, and the relationship between HLOC and phobic avoidance. METHODS: The HLOC and panic screening questionnaires were administered to 50 patients complaining of a panic-related symptom or condition known to be associated with panic, and to 119 randomly selected patients. Nineteen patients with panic attacks were later reevaluated to determine if there had been a change in locus of control. RESULTS: Stepwise multiple regression demonstrated that panic attacks, educational level, and being divorced significantly predicted HLOC (F = 5.66, P less than or equal to .0001). An analysis of covariance (ANCOVA) showed that resolution of panic attacks was associated with a greater decrease in the HLOC score (F = 4.68, P less than or equal to .05). Phobic avoidance was also associated with greater levels of externality (r = .48, P less than or equal to .05) and correlated with HLOC in response to treatment. CONCLUSIONS: This study suggests there is a significant relationship between HLOC and panic attacks, and between HLOC and phobic avoidance. Panic resolution is associated with a decrease in externality. Measurement of HLOC may be helpful in assessing the treatment response of patients who have panic attacks.

Adult↗
PubMed2000

The use of historical and anthropometric data as risk factors for screening of low mBMD & MCI.

To evaluate the risk factors which affect bone loss in screening for osteoporosis, interview of anamnestic data (age, marriage status, pregnancies, menopausal age, intake of calcium, vegetables, protein and coffee, excessive use of alcohol and smoking, sedentary habits, family history), medical data, surgical data, followed by measurement of anthropometric variables [weight, height, antero-posterior (AP) thickness at xiphoid level], blood examination (calcium, inorganic phosphorus, alkaline phosphatase), both postero-anterior (PA) hands and lateral thoraco-lumbar radiography were done in 1,182 normal volunteers aged 17-83. From PA hands radiographs, metacarpal bone mineral density (mBMD) and metacarpal index (MCI) were measured by computed X-ray densitometry (CXD) (Bonalyzer, Teijin Ltd., Tokyo). The results showed that the mean of menopausal age in Thai females was 48.86 +/- 3.09 years ranging from 39 to 55 years. The average number of children in their family was 2.10. Correlation among anthropometric variables, AP thickness was positive linear correlation to weight/height ratio (r = 0.7878, p-value < 0.005). Weight, AP thickness and body mass index (BMI) significantly increased with aging (r = 0.2456, 0.4489 and 0.3484, p-value < 0.005, 0.001 and < 0.005), but decreased with height (r = -0.1030, p-value = 0.001). Lower mBMD and MCI were associated with increased age, married female, increased pregnancies, increased AP thickness, decreased vegetable intake, increased protein intake and increased years after menopause. From a multiple regression analysis, the significant factors that can predict the MCI were years after menopause, sex, daily vegetable intake and hormonal replacement. The incidence rate of high risk of developing osteoporosis in females, no vegetable intake and no hormonal replacement subjects occurred 7.50, 2.22 and 2.63 times greater than in males, vegetable intake and hormonal replacement subjects, respectively. In postmenopausal women since 1-2, 3-5, 6-10, 11-15 and > 15 years, the incidence rate were 5.24, 14.51, 17.01, 20.86 and 29.76 times greater than the rate of premenopausal women. Concerning perimenopausal women, only 2 of all factors influenced the measured mBMD and MCI. The incidence rate of high risk of developing osteoporosis in women who intake protein > 30 g/d and intake medicine (corticosteroid) was 2.96 and 6.16 times greater than < 30 g/d protein intake and no medicine intake subjects.

Absorptiometry, Photon↗
PubMed1983

Multisystem-Multimethod family assessment in clinical contexts.

A framework for assessing multiple levels of the family system by using multiple methodologies is proposed in this paper. This approach for measuring family phenomena is referred to as Multisystem-Multimethod (MS-MM) family assessment. Ideas from systems theory, measurement theory, and clinical application are used to describe the measurement strategy. A clinical case example is offered illustrating one way in which a MS-MM procedure can be implemented with families. Several currently available assessment tools are utilized to assess the individual, marital, and family levels of the family system. This diversity of measurement techniques provides convergent and divergent information within and across system levels. An MS-MM procedure has the capacity to assess the wholistic qualities of systems as well as specific issues within the boundaries of particular family subsystems.

Adolescent↗
PubMed1989

Genital ulcers and transmission of HIV among couples in Zimbabwe.

Seventy-five married men found to be positive for HIV-1 in Harare, Zimbabwe, were interviewed in order to define behaviours associated with acquisition of infection and to determine factors associated with transmission of infection to their wives. The majority of infected men reported sexual intercourse with multiple heterosexual partners and female prostitutes, and gave a history of sexually transmitted diseases (STDs). All subjects denied homosexual activity and parenteral drug abuse. Serological testing of the wives of seropositive men showed that 45 (60%) were HIV-antibody-positive. Wives of men with AIDS and AIDS-related complex (ARC) and wives of men who gave a history of genital ulcer disease were more likely to be seropositive. The study demonstrates that HIV-1 infection in Zimbabwe occurs through heterosexual intercourse and is associated with other STDs. In addition, the study shows that male to female transmission of HIV-1 is facilitated by the presence of genital ulcers in infected men.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Family constellation factors and parent suicide potential.

This study assessed if, in fact, family constellation was one of the multiple etiological factors of parent suicide potential. Durkheim's proposition was examined, that married men and women, and especially women, are protected against suicide risk in direct proportion to the number of children they have. The sample consisted of 145 families, comprising 243 parents and 392 children under age 18, which form the subject of this study. A partial correlation approach was taken. Family size and density were significantly related to parent suicide potential. The effects of the family constellation factors were sex-specific. For married women, and to a lesser extent for married men, suicide potential declined with the number of children and density. Sibling spacing proved not significant in predicting parent suicide potential. The findings were discussed in terms of the social integration hypothesis, marital status, sex roles, and depression.

Adult↗
PubMed1998

Gender difference in persistent at-risk sexual behavior after a diagnosed sexually transmitted disease. ACSF-Investigators.

BACKGROUND AND OBJECTIVES: There are few data on sexual behavior after an episode of sexually transmitted disease (STD). GOALS: To examine association between a history of STD and subsequent at-risk sexual behavior in the general population. STUDY DESIGN: In the French National Survey of Sexual Behavior, current sexual behavior was compared between heterosexuals who reported an STD in the 4 years prior to the last year and those who reported no STD (n = 2517). RESULTS: Reporting of STD was associated with a high rate of past multiple partnership among both sexes, but was associated with current at-risk behavior in men only. Men with a previous history of STD were 2.8 times (95% confidence interval [CI]: 1.4-5.6) more likely to report high-risk unprotected sex as a current behavior. No such association was observed in women (adjusted odds ratio [OR]: 1.0; 95% CI: 0.5-2.0). Conversely, in women, a previous episode of STD was significantly associated with reporting of behavior changes (adjusted OR: 3.4; 95% CI: 1.6-7.1). CONCLUSION: A self-reported history of STD is a marker of current high-risk sexual behavior among heterosexual men that could be used to target prevention programs. In contrast, it may be associated in women with subsequent adoption of STD and HIV risk reduction strategies.

Adult↗
PubMed2004

Marital status and cancer risk in Italy.

BACKGROUND: Marital status has long been related to cancer incidence and mortality rates. However, only few analytical studies have been conducted on this issue considering known or potential confounding factors. METHODS: We systematically examined the relation between marital status and cancer risk using data from a network of case-control studies conducted between 1983 and 2001, including a total of 17,976 incident cases with the following cancer sites: oral cavity and pharynx, esophagus, stomach, colon, rectum, liver, gallbladder, pancreas, larynx, breast, endometrium, ovary, prostate, bladder, kidney, thyroid, Hodgkin's disease, non-Hodgkin's lymphomas, multiple myelomas, and sarcomas. Controls were 15,345 patients admitted to the hospital for non-neoplastic conditions. RESULTS: As compared to married subjects, never married ones were at significantly increased risk of oral cavity and pharyngeal cancers and at reduced risk of cancer of the colon, liver, bladder, kidney, and thyroid. However, for other cancer sites considered, most odds ratios were close to unity. Likewise, there was no consistent excess risk for divorced or widowed subjects. CONCLUSIONS: Despite some significant associations, our study suggests that marital status is not materially associated with cancer risk. Thus, the evidence that married subjects are at lower risk of several other major diseases may not be applicable to cancer.

Case-Control Studies↗
PubMed1992

Developing the construct of role integration: a narrative analysis of women clerical workers' daily lives.

There is a gap in nurses' knowledge about how women integrate their multiple roles on a daily basis amidst the economic, social, political, and cultural contingencies of their environments. Quantitative results from a triangulated study of work, maternal, and spousal role experiences of 87 women clerical workers from five ethnic/racial groups indicated that role integration was important in predicting health outcomes. This prior work is extended in this article with an indepth secondary analysis of the qualitative interview data from the same study to develop a theoretical understanding of the construct of role integration. Using techniques of narrative analysis, a theoretical framework was derived to identify and relate aspects, processes, and patterns of role integration as they are experienced in women's everyday lives. Concepts are identified, defined, and visually represented, propositions are elaborated, and implications for further research and practice are suggested.

Adaptation, Psychological↗
PubMed2005

Multidimensional assessment of resilience in mothers who are child sexual abuse survivors.

OBJECTIVE: There has been relatively little attention given to positive adaptation following childhood sexual abuse (CSA), and typically such resilience has been explored primarily in the intrapersonal domain. This study explored questions about later resilience following CSA within a multidimensional framework by assessing resilience across intrapersonal, interpersonal, and intrafamilial domains. METHOD: This community sample consisted of 79 mothers with a history of CSA who had a child living at home with them. Participants completed four outcome measures (Center for Epidemiologic Studies--Depression Scale, Parenting Stress Index [PSI] Health Scale, PSI Parenting Competence Scale, and a measure of marital satisfaction). Risk and protective factors examined in relation to outcome included mother's age, socioeconomic status, severity of the CSA experience, coping strategy (avoidance, seeking social support, and problem solving), child characteristics, and spousal/partner support. RESULTS: Results indicated that when multiple adaptational domains were assessed, mothers showed discrepancies in how adequately they functioned across domains. While severity of the CSA experience was only weakly associated with outcome, use of avoidant coping emerged as a significant risk factor and was strongly and consistently associated with negative outcome across domains. Spousal/partner support was a strong protective factor and buffered the relationship between depressive symptoms and parenting competence. Difficult child characteristics were significantly associated with mothers' perceptions of physical health and parenting competence. CONCLUSIONS: The findings suggest the importance of comprehensive multimethod assessments of resilience and extend the knowledge of factors associated with positive outcome. The results highlight the need for further research exploring current contextual risk and protective factors associated with resilience in each domain.

Adaptation, Psychological↗
PubMed2003

Congenital heart disease and associated malformations in children with cleft lip and palate in Pakistan.

Children with cleft lip and palate often have other associated malformations. The reported incidence and types of associated malformations vary between different studies. There is a great paucity of literature on the subject from the region in general and none from Pakistan at all. The purpose of this study was to assess the frequency of associated malformations, particularly congenital heart disease, in children with cleft lip and palate presenting to the Aga Khan University (AKU) and Murshid Hospital (MH). From 1st October 1999 to 31st March 2002, all children with cleft lip and palate who presented to AKU and MH were prospectively enrolled in the study group. Socio-demographic characteristics and a number of other variables were documented. All children underwent a thorough clinical examination and an echocardiogram as part of the study protocol. 123 children formed the study group. Thirty-five (29%) of these children were found to have associated malformations. The most common of these was congenital heart disease, which accounted for 51% of all associated malformations. Thirty percent of cleft palate children had associated anomalies while 27% of cleft lip, with or without cleft palate, children had associated anomalies. There was a significant association between children born of a consanguineous marriage and the risk of associated malformations (p-value: 0.001). Consanguinity was present in 74% of children with associated anomalies as compared to 40% of children with no associated anomaly. Dysmorphic features and the presence of associated anomalies were also significantly associated (p-value: 0.009). Dysmorphic features were present in 46% of children with anomalies as compared to 21% of children with no associated anomaly. Fifty percent of children with associated anomalies had a low birth weight compared to 34% of children with no anomalies, but the difference was not statistically significant. The presence of consanguinity in a child with dysmorphic features should raise the suspicion of an associated anomaly. The likelihood of this being a cardiac defect is high and should be ruled out with a thorough clinical examination, supplemented with an echocardiogram in certain cases.

Abnormalities, Multiple↗
PubMed1997

Always single and single again women: a qualitative study.

What is it like to be a single woman today? Are the experiences of women who have always been single different from those who find themselves single again after having been married? How can family therapists promote the development of single women both individually and relationally? The purpose of this phenomenological, multiple-case study was to investigate perceptions of being single among heterosexual single women between the ages of 30 and 65. Nine focus group interviews and a semistructured, mailed questionnaire were used to collect the data. Constant comparative analyses were used to develop the findings. The findings were organized around the most salient theme that emerged from the analyses: single women have unresolved or unrecognized ambivalences about being single. This overarching theme was supported by three subassertions: (a) single women are aware of both the advantages and the drawbacks of being single; (b) single women are ambivalent about the reasons for their singleness; (c) although content with being single, many women simultaneously experience feelings of loss and grief. Implications for the clinical practice of family therapy and future research on single women are discussed.

Adult↗
PubMed1986

Computer simulation of Freud's counterwill theory: extension to elementary social behavior.

A model is presented describing decision processes of a living system at the level of the individual, together with its interpersonal relationship context (organism, subsystems, and suprasystem). The beginning point was the 1977 system dynamics model of Wegman, which was itself characterized by quantitative cross-level hypotheses concerning both physiological and psychological levels of functioning within the individual personality system. The extension process was accomplished by synthesizing concepts from many different theories in personality and social psychology into equations linking two multiple-loop feedback systems to form a suprasystem. Each individual model was found to have several distinct operational modes, and the dyadic model had a number of interesting combinations of these modes which correlated with clinical descriptions of steady-state behavior and subjective experience in human marital dyads. For example, under certain conditions an individual operating in an unstable mode could achieve personal system stability within a dyadic relationship. In some cases, two unstable individuals could form a stable system. The process of extending the original model supports the utility of a synthetic approach to the construction of quantitative theories concerning small social systems. This process also suggests new approaches to planning future empirical research on small social systems using methods more appropriate to the study of complex, dynamic systems.

Computers↗