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PubMed1986

The treatment of emotional disorders in general practice: psychological methods versus medication.

This paper describes three recent trials in which psychological methods were evaluated in the treatment of emotional disorders in general practice. In the first trial, brief counselling by the general practitioner was found to be as effective as anxiolytic medication, was welcomed by patients and did not increase demands on doctors' time. In the second trial (still in progress), in which treatment is aimed at emotional disorders of poor prognosis, problem solving treatment by a psychiatrist is being compared with control treatment by the G.P. The third trial evaluated an anxiety management programme provided by clinical psychologists in health centres; substantial reductions in anxiety occurred rapidly and were maintained at follow-up.

Affective Symptoms↗
PubMed1998

The contribution of small life events to the psychological distress of married and widowed older women.

The contribution of small life events to the prediction of general psychological distress was examined for 50 married and 21 recently widowed older women. These two groups were contrasted as having or not having experienced an uncontrollable major life stressor (i.e., the recent death of a spouse). Negative small life events (i.e., daily hassles) contributed above and beyond general demographic factors; conjugal bereavement status; social support; other, non-conjugal bereavement, major life events; and the interaction of these life events and social support in the prediction of general psychological distress. Results support assessing negative small life events as well as major life events for both married and recently widowed older women.

Age Factors↗
PubMed1977

Psychological effects of symptoms associated with labyrinthitis. a case study.

The psychological effects of postviral labyrinthitis in a patient who had been undergoing intensive psychotherapy are reported. The mildness of the physiological symptome was in contrast to the magnitude of the psychological consequences. The general psychological effects of illness on the patient are differentiated from the specific psychological correlates of vertiginous symptoms. The factors that contributed to the psychological effects and the psychological impact of these symptoms are discussed. There is a special potency to the cited effects in patients with specific personality characteristics.

Adjustment Disorders↗
PubMedDate not supplied

Psychosocial sequelae of visual loss in diabetes.

This study evaluated whether degree of related visual impairment is associated with degree of psychological symptoms in general, and specifically more somatization, depression, anxiety, phobic anxiety, fear of hypoglycemia, and stress. A total of 49 volunteer subjects with diabetes-induced visual impairment were subdivided into totally blind and partially sighted groups, and were compared with 62 nonvisually impaired adults with diabetes. All were given the Brief Symptom Index, the Hypoglycemic Fear Survey, and the Perceived Stress Scale, along with a general questionnaire assessing demographic characteristics. Mean scores of the partially sighted group did not differ from the nonvisually impaired group, but the blind subjects reported more general psychological symptoms, somatization, anxiety, and phobic anxiety. Significantly more blind than sighted subjects exhibited clinical elevations on anxiety, phobic anxiety, and fear of hypoglycemia. Regression analysis confirmed the significant visual loss on psychological functioning and revealed large individual differences in how patients respond to visual loss. (ABSTRACT TRUNCATED)

Adaptation, Psychological↗
PubMed2001

Increased susceptibility to stress at a psychological assessment of stress tolerance is associated with impaired fetal growth.

BACKGROUND: This study aims to investigate the relationship between birthweight and psychological function, as evaluated by the results of a psychological conscript interview and assessment in young males, including an evaluation of stress susceptibility. METHODS: We performed a retrospective cohort study based on linked birth registry data and data from an assessment of psychological function during evaluation for military service. In all, 90 651 young males born 1973-1975, for whom birth record data were obtained from the Swedish Medical Birth Register, were investigated in addition to psychological stress susceptibility during their conscript evaluation in 1991-1994. The assessment of psychological functioning score, including the assessment of stress susceptibility, was used as the dependent variable in a multiple regression analysis in combination with the following independent variables: birthweight, adult weight, head circumference at birth, month of birth, gestational age, maternal parity, and maternal age. RESULTS: The mean value was 5.1 (SD 1.9) on the psychological assessment scale (range 1-9) of psychological level of functioning including evaluation of stress susceptibility, and 5.3 (1.6) on the general psychological performance (leadership) profile. A positive association was seen between birthweight and better assessment results up to a level of about 4000 g birthweight, but above that an inverse association was seen. Positive correlations (P < 0.001) were seen between psychological assessment score results and birthweight (r = 0.07), gestational age (0.03), head circumference (0.05), and maternal age (0.11), but inverse correlations with maternal parity (-0.11) and birth month of the offspring (-0.04). In multiple regression analyses, the strongest independent correlations were seen between increasing assessment scores and maternal age and birthweight (positive), as well as with maternal parity and offspring adult weight (negative). CONCLUSION: Young males at conscript testing show a better general psychological functioning score derived from psychological assessment, including evaluation of stress susceptibility, with increasing birthweight up to 4200 g. Above that birthweight an inverse association is noticed. Impaired fetal growth is predictive of suboptimal psychological functioning and increased stress susceptibility in males during early adult life.

Birth Weight↗
PubMed1990

Clinical psychology and general managers.

Peter Wilcock and Rowena Rossiter begin by describing changing responsibilities of clinical psychologists over the last 20 years. They show how some roles they undertake, which may seem far removed from client contact, have developed from psychologically based client-centred work, and this still lies at the root of the profession. They illustrate the current and potential contribution to be made to the NHS and general managers by clinical psychologists.

Administrative Personnel↗
PubMed1996

Psychological symptoms and disease-free and overall survival in women with stage II breast cancer. Cancer and Leukemia Group B.

BACKGROUND: The possible link between psychological factors and length of cancer survival has generated a literature of contradictory findings. Associations usually have not been found when general psychological symptoms are assessed. Associations usually have been found for predictors related to expressive versus repressive emotional coping (e.g., depression, "fighting spirit," hostility, and type C personality); however, even these associations have been relatively small, when compared with those for medical factors. Yet few studies have adequately controlled for medical and treatment-related factors. PURPOSE: Within a Cancer and Leukemia Group B (CALGB) national clinical trial of four adjuvant therapy regimens for stage II breast cancer (CALGB 8082), this study prospectively examined the contribution of potential psychological predictors to length of disease-free and overall survival over a 15-year period. METHODS: Subjects were 280 women with stage II breast cancer, out of a total of 899, who were randomly assigned to receive CMFVP (cyclophosphamide-methotrexate-fluorouracil-vincristine-prednisone) for two 6-week cycles or six 4-week cycles, then subsequently randomly assigned to receive or not to receive VATH (vinblastine-doxorubicin-thiotepa-fluoxymesterone). Subjects were recruited during the period between October 1980 and August 1984, inclusive, and followed until January 1996. Prior to chemotherapy, psychological symptoms were assessed using the Symptom Check List-90-Revised (SCL-90-R). SCL-90-R scores were trichotomized into categories representing high, medium, and low distress. Basic base-line sociodemographic data (including age, ethnicity, education, and marital status) and medical data (including lymph node status, estrogen receptor status, menopausal status, and performance status) were collected. Subjects with psychosocial data differed from those without psychosocial data solely in their higher percentage of classification in the mild limitation category of the Zubrod (Eastern Cooperative Oncology Group) performance status rating (subjects with psychosocial data: 14%; subjects without psychosocial data: 8%). RESULTS: In stepwise Cox regression analyses that controlled for sociodemographic and medical variables, there was no significant predictive effect of the level of distress (as measured by the SCL-90-R trichotomized scores) on length of disease-free and overall survival of the study subjects. Risk ratios for low versus high distress were 1.01 (95% confidence interval [CI] = 0.62-1.66) for disease-free survival and 1.03 (95% CI = 0.58-1.82) for overall survival. CONCLUSIONS: This study failed to provide evidence that psychological factors contributed to length of disease-free or overall survival of women who received adjuvant chemotherapy (either CMFVP alone or CMFVP followed by VATH) for treatment of stage II breast cancer. IMPLICATIONS: In the context of far more potent medical factors, the contribution of psychological factors to disease-free and overall survival is likely to be relatively small. Future research should focus on specific theory-driven predictors rather than on general psychological symptoms. Moreover, it should be based on clinical studies using a controlled, prospective design, in which the effects of medical factors may be distinguished and psychological predictors are clear antecedents of survival outcomes.

Adaptation, Psychological↗
PubMed1987

The effects of stress on the psychological well-being of army wives: initial findings from a longitudinal study.

This study examines the relationships between marital and military-specific stress and the general psychological well-being of army wives. These data come from an ongoing three-year longitudinal panel study. Study participants (N = 277) were assessed at two different times 12 to 15 months apart. It was predicted that current marital stress and military life stress would have significant negative (and independent) relationships to well-being, even when prior levels of stress and well-being were taken into consideration. A path model was utilized to analyze the data. These data support the view that both military life stress and marital stress have important independent relationships to the general psychological well-being of army wives. Furthermore, it appears that the relationship between marriage and well-being takes on added importance the longer one stays in the military system.

Adaptation, Psychological↗
PubMed2001

Dentists' perceived stress and its relation to perceptions about anxious patients.

Dentists' perceptions about the stressfulness of dental practice, their perceptions about dental anxiety and its management were surveyed in a descriptive study. A mailed questionnaire was completed by 216 randomly selected Danish private dentists. Of these, nearly 60% perceived dentistry as more stressful than other professions. Dentist perceptions of the most intense stressors were (ranked): 1) running behind schedule, 2) causing pain, 3) heavy work load, 4) late patients and 5) anxious patients. Bivariate odds ratio (OR) analyses were undertaken to check for associations of perceived stress and other dentist variables with perceptual outcomes about anxious patients. Signs of dental anxiety were reported to be less often spotted by older (> or = 52 yr) dentists (OR=3.1) who perceived their job stress to be greater than that of other professionals (OR=3.2). Perceived causes of dental anxiety (1st, 2nd or 3rd choices tallied and then ranked) were 1) fear of pain, 2) trauma in dental treatment, 3) general psychological problems, 4) shame about dental status and 5) economic excuses. Dentists who reported that dental anxiety was primarily the result of general psychological problems in patients, usually had solo (OR=2.4) practices older than 18 years (OR=2.6) and reported high perceived stress (OR=2.2). Adjusted odds ratios for these two dentist perception outcomes about anxious patients generally improved strength of associations and confidence intervals. There were no meaningful differences by practice location or perceived public image. Also, there was no significant association between the use of pharmacological strategies for anxiety and the perceived stress of dentists. Nearly all dentists talked with anxious patients as their main treatment strategy. It was concluded that psychosocial aspects of dental practice have meaningful and often adverse associations with dentist perceptions about anxious patients. Some dentists appeared to require more knowledge about dental anxiety and managing their own stress.

Adult↗
PubMed1997

Determinants of pain expression in hospitalized burn patients.

This study examines the relationship between extent of injury, degree and type of psychological distress and self-report of pain in burn survivors. One hundred eighty burn patients were interviewed within 2 weeks of their burn trauma. Using a visual analogue scale to assess subjective pain and pain relief, and self-report measures of post-traumatic stress symptoms and general psychological distress, we assessed the relationship between PTSD symptoms, general distress and pain. Subjective pain was unrelated to sex, ethnicity, or total body surface area burned. The most important correlate of subjective pain was general psychological distress. Intrusive PTSD symptoms had no independent power to predict the variance in pain scores. However, among women, more severe avoidant symptoms were associated with greater subjective pain.

Adaptation, Psychological↗
PubMed1994

Natural history of prostatism: worry and embarrassment from urinary symptoms and health care-seeking behavior.

OBJECTIVE: To assess the interrelationships among psychosocial symptoms of worry and embarrassment about urinary function, prevalent urinary symptoms, psychological well-being, and health care-seeking behavior in a population-based cohort of men. METHODS: A cohort of 2,119 men aged forty to seventy-nine years, randomly selected from the Olmsted County, Minnesota population between December 1989 and March 1991, were administered a previously validated questionnaire that elicited information about the frequency of urinary symptoms, the degree to which they were perceived as a bother, and if the participant had seen a doctor in the previous twelve months for evaluation of any of these urinary symptoms. Psychological well-being was assessed by a subset of the Psychological General Well-Being Index, and sociodemographic information was also sought. RESULTS: Urinary symptom indices (measured by American Urological Association frequency and bother scores and psychological general well-being subscales) were significantly associated with worry and embarrassment about urinary symptoms in bivariate analyses. Multiple logistic regression analyses demonstrated that men with moderate or severe urinary symptoms or impaired psychological well-being were more likely to be worried or embarrassed about their urinary symptoms than men with mild symptoms. Furthermore, men who were worried about their urinary function were more likely to have sought medical care for their symptoms than men who were not worried. The association between health care-seeking behavior and embarrassment was especially strong among men with little bother associated with their urinary symptoms. CONCLUSIONS: Worry and embarrassment about urinary symptoms reflect quality-of-life issues that appear important in the health care-seeking behavior of men with prostatism. The results underscore findings that prevalent urinary symptoms alone do not determine a man's health care-seeking behavior, and treatment for psychosocial symptoms may be beneficial in some men with symptoms of prostatism.

Adult↗
PubMed1991

A two-factor model of caregiving appraisal and psychological well-being.

Groups of spouse (N = 285) and adult child (N = 244) caregivers of elderly parents suffering from Alzheimer's disease were interviewed regarding their caregiving behaviors, evaluations of caregiving, and general psychological well-being. A model of caregiving dynamics where the objective stressor, caregiver resources, and subjective appraisal of caregiving (operationalized as caregiving satisfaction and burden) were studied as they affected both positive affect and depression was tested. For spouses, caregiving satisfaction was not related to aspects of the stressor, but was a significant determinant of positive affect. Among adult children, high levels of caregiving behavior resulted in both greater caregiving satisfaction and burden. Burden, in turn, was related to depression in both groups but, among adult child caregivers, positive affect was not affected by caregiving satisfaction. Limited support was found for the hypothesis that the positive and negative aspects of caregiving contributed to analogous aspects of generalized psychological well-being but not to the opposite-valence outcomes.

Aged↗
PubMed1999

Prevalence and impact of upper gastrointestinal symptoms in the Canadian population: findings from the DIGEST study. Domestic/International Gastroenterology Surveillance Study.

OBJECTIVE: The prevalence and impact of upper gastrointestinal (GI) symptoms in the general population are poorly defined. Most data are obtained from selected samples derived from patients presenting to health care providers. As part of a larger international effort (The DIGEST study), we examined the prevalence of upper GI symptoms among the general Canadian population, as well as their psychosocial and economic impact. METHODS: A sample of 1036 adults was studied, its demographic characteristics closely matching those of the general Canadian population. A validated detailed questionnaire measured the prevalence, severity, and frequency of 15 digestive symptoms, as well as demographic information, use of medication and medical resources, other illnesses, and dietary habits. The Psychological General Well-Being Index, a self-administered questionnaire, assessed the individual's subjective sense of well-being. RESULTS: Of the sample population, 28.6% reported substantial symptoms in the preceding 3 months, the majority (111/153 subjects) for >1 yr; 34.1% reported having never experienced significant GI symptoms. The most bothersome symptoms were primarily related to dysmotility-like symptoms in 54.9% of those with chronic symptoms, ulcer-like symptoms in 12.4%, and related to heartburn in 42.5%. Chronic upper GI symptoms were associated with a highly significant (p < 0.001) decrease in all facets of the Psychological General Well Being Index. CONCLUSIONS: Upper GI symptoms are very prevalent in the general Canadian population and substantially affect the quality-of-life and psychological well-being of those affected. Dysmotility-like symptoms, rather than heartburn, are the most common chronic upper gastrointestinal symptoms in the general population.

Adolescent↗
PubMed1987

Toward a universal law of generalization for psychological science.

A psychological space is established for any set of stimuli by determining metric distances between the stimuli such that the probability that a response learned to any stimulus will generalize to any other is an invariant monotonic function of the distance between them. To a good approximation, this probability of generalization (i) decays exponentially with this distance, and (ii) does so in accordance with one of two metrics, depending on the relation between the dimensions along which the stimuli vary. These empirical regularities are mathematically derivable from universal principles of natural kinds and probabilistic geometry that may, through evolutionary internalization, tend to govern the behaviors of all sentient organisms.

Behavior↗
PubMed2006

Negative congruency effects: a test of the inhibition account.

Masked priming experiments occasionally revealed surprising effects: Participants responded slower for congruent compared to incongruent primes. This negative congruency effect (NCE) was ascribed to inhibition of prime-induced activation [Eimer, M., & Schlaghecken, F. (2003). Response faciliation and inhibition in subliminal priming. Biological Psychology, 64, 7-26.] that sets in if the prime activation is sufficiently strong. The current study tests this assumption by implementing manipulations designed to vary the amount of prime-induced activation in three experiments. In Experiments 1 and 3, NCEs were observed despite reduced prime-induced activation. Experiment 2 revealed no NCE with at least similar prime strength. Thus, the amount of prime activation did not predict whether or not NCEs occurred. The findings are discussed with regard to the inhibition account and the recently proposed account of mask-induced activation [cf. Lleras, A., & Enns, J. T. (2004). Negative compatibility or object updating? A cautionary tale of mask-dependent priming. Journal of Experimental Psychology: General, 133, 475-493; Verleger, R., Jaskowski, P., Aydemir, A., van der Lubbe, R. H. J., & Groen, M. (2004). Qualitative differences between conscious and nonconscious processing? On inverse priming induced by masked arrows. Journal of Experimental Psychology: General, 133, 494-515].

Adult↗