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Personality attributes of attention deficit hyperactivity disorder (ADHD) using the Rorschach Inkblot Test.

This study investigated Rorschach Inkblot Test response patterns in a group of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and compared them to matched samples of clinical control and normal control groups. The findings indicated that the ADHD and clinical control groups both demonstrated markedly limited coping capacities, an avoidance of affect-laden stimuli, difficulties with self- and interpersonal perceptions, problems in perceiving reality accurately, and a vulnerability to depression. The ADHD group demonstrated significantly more intense feelings of isolation and discomfort, less social involvement, avoidance of decision-making, and more dependence, while the clinical control group demonstrated a significantly higher level of psychological disorganization and thinking problems.

Adaptation, Psychological↗

On the connection between physical defects and the character type of the "exception".

A clinical and theoretical study is presented of the effects of physical defects on character structure, especially on its narcissistic aspects. The basic thesis of this paper is that there are two differentiable responses to awareness of a physical disability: various forms of denial, and a clinging to narcissistic overgratifications as a compensation for negative feelings about the self. The first response, of overusing denial, is universal, and of course leaves its mark on a person's character. However, only the second sort of response, of clinging to overgratifications, leads to the character type of the "exception" (Freud 1916). The distinction between moral ideals, embodied in the ego ideal narrowly defined, and nonmoral ideals, embodied especially in the wishful self-image, is presented as a useful tool in understanding various psychological effects of physical disabilities.

Achievement↗

Communication in the cancer 'bad news' consultation: patient perceptions and psychological adjustment.

The purpose of this study was to explore relationships between breast cancer survivors' experiences during the diagnostic consultation and their subsequent long-term psychological adjustment. Sixty women (M age=53 years) who had been diagnosed with local or regional breast cancer (Stage 0-IIIA) an average of 28 months prior were interviewed by telephone. Measures included: Cancer Diagnostic Interview Scale, Anxiety subscale of the Hospital Anxiety and Depression Scale, Posttraumatic Stress Disorder Checklist - Civilian Version, Center for Epidemiologic Studies Depression Scale, and ad hoc items regarding memory for, and satisfaction with, the diagnostic consultation. After controlling for demographic and clinical variables, the three CDIS subscales accounted for 12% of the variance in women's PCL-C scores (F change=3.46, p<0.05). The CDIS-Caring subscale was a significant predictor in the 'best-fit' regression model for each of the three indices of long-term distress (all B's>-0.23, p<0.05). In contrast, the CDIS-Competence subscale was not a significant predictor in any of the 'best-fit' models. Additionally, women's satisfaction with physician behavior during the diagnostic consultation was unrelated to all adjustment measures (r's<0.10, p's>0.50). Findings suggest that women's perceptions of physicians' interpersonal skills during the diagnostic consultation are associated with later psychological adjustment.

Adaptation, Psychological↗

The impact of rape: social support as a moderator of stress.

This study investigated 25 victims' reactions to sexual assault and the role of social support in their subsequent adjustment. Victims were interviewed 3 months after the assault to gather information about the assault, the type of support they received, and the effects of the assault as measured by two scales of psychological stress: Impact of Events scale and SCL-90-R. Our major findings were that (a) victim's scale scores were significantly elevated, reflecting the considerable distress they were still experiencing; (b) there were significant differences in the availability of support from specific categories of people (e.g., police received significantly high ratings, whereas physicians' ratings were significantly low); (c) the amount of perceived support varied with the stressfulness of the assault; (d) however, contrary to initial hypotheses, the amount of overall support did not predict subsequent adjustment; (e) support from physicians did correlate significantly with both scales of psychological adjustment.

Adaptation, Psychological↗

[The psychosomatics of chronic back pain. Classification, aetiology and therapy].

An overview is given on the current classification, description and treatment of chronic pain with causally relevant psychological factors. It is based on the "practice guidelines on somatoform disorders" and on a thematically related meta-analysis. The classificatory problems, especially of the demarcation of somatoform and other chronic pain, are presented. Additional descriptive dimensions of the relevant psychosocial factors are: pain description, other organically unexplained pain- and non-pain-symptoms, anxiety and depression, disease conviction and illness behaviour, personality and childhood abuse. A modified psychotherapy for (somatoform) chronic pain is outlined. Finally, this aetiologically oriented psychosomatic-psychiatric approach is compared to psychological coping models for chronic pain.

Adaptation, Physiological↗

Recurrent uncomplicated urinary tract infection: a review of psychological factors.

Urinary tract infection (UTI) is a very common medical disorder among women, and is a chronic, recurrent problem for a cluster of sufferers. The factors involved in the aetiology of recurrent UTI are not adequately understood. Most research and treatment has focused on the influence of medical factors, although clinical impressions suggest that psychological factors (behavioural and personality variables) may play an important role. Evidence is reviewed for the involvement of psychological factors in the aetiology and treatment of recurrent UTI in women. It is difficult to draw any clear conclusions concerning the role of such factors in recurrent UTI, given the relatively small amount of research to date and a number of methodological issues. Suggestions for appropriate methodology and research concerning the interplay of physical and psychological factors are made.

Adaptation, Psychological↗

Perpetrator status and the personality characteristics of molested children.

The personality and intellectual characteristics of three groups of children, one molested by a teacher (n = 16), a second group (n = 16) where the offender was a member of the child's family, and a non-molested control group (n = 16) were contrasted. The children were evaluated using the Personality Inventory for Children (PIC), the Children's Personality Questionnaire (CPQ), and the Wechsler Intelligence Scale for Children (WISC-R). There were few differences between the two molested groups or between boys and girls. However, comparisons of molested and non-molested children showed significant differences on 23 of 34 scales on the PIC and CPQ combined. WISC-R verbal IQs were also lower for the molested groups. While the lack of differences between the two molested groups may have been due to the parent-like relationship between the teacher and the children he molested, the results suggest that a relatively noncoercive style of abuse can still produce significant psychological impairment.

Adaptation, Psychological↗

A retrospective study of long-term methods of coping with having been sexually abused during childhood.

Methods of coping with childhood sexual abuse were retrospectively studied in a community sample of 54 adult women who had been sexually abused in childhood. From the time the abuse ended until the present, "denial" and "emotional suppression" were the coping methods most commonly employed of the nine methods measured. One purpose of this study was to determine if the methods used to cope with the aftermath of being sexually abused during childhood were associated with current psychological adjustment beyond what could be predicted by the characteristics of the abusive experience per se. A partial correlation analysis and a multiple regression analysis suggested that avoidant/emotion suppressing coping strategies although frequently used and rated by subjects as helpful, were in fact associated with poorer adult psychological adjustment.

Adaptation, Psychological↗

Unemployment and psychiatric distress: social resources and coping.

Unemployment is viewed as one of the more stressful of life events that an adult can experience. Job loss leads to decreased social status, disrupts family and social roles, produces financial strain, and loss of self esteem, all of which have detrimental consequences for mental health. We studied psychiatric symptoms in 269 unemployed adults with dependent children in Baltimore; one-half of the sample had returned to work 1 year following unemployment. A comparison group of 92 community residents who were continuously employed were also interviewed. Using a stressful life events perspective, we examined three models of how life events relate to psychiatric distress suggested by Dohrenwend and Dohrenwend [1. Social Status and Psychological Disorder: A Causal Inquiry. Wiley, New York, 1969. 2. Am. J. commun. Psychol. 9, 128, 1981]. Our results support an 'additive burden' model of the stress process, which also shows recovery in mental health functioning upon subsequent reemployment. We suggest that the models tested did not take into account the meaning of the life event in terms of failure and that this meaning may influence its impact on psychological distress.

Adaptation, Psychological↗

Distressed binge eaters as a distinct subgroup among obese individuals.

This study was conducted to examine the degree to which binge eating and psychological distress among obese adults are associated with a variety of behavioral patterns and competencies that could substantially affect weight control. Subjects were 167 obese people who sought help in a long-term cognitive behavioral treatment program. Subjects were divided into three groups depending on their level of psychological distress and severity of binge eating. Subjects were also assessed on coping style, subjective distress, weight history, and exercising and eating patterns. Results demonstrated substantial differences between those reporting relatively few problems with binge eating or psychological distress as opposed to those with noteworthy problems in both. The presence of either severe binge eating or psychological distress was associated with problems in regulating food-related behavior and, more generally, to problematic coping styles. These findings support the importance of in-depth assessment when treating obesity, more intensive treatment for some subgroupings, and long-term studies that incorporate comprehensive pretreatment process measure of eating style and psychological distress.

Adaptation, Psychological↗

A broader view of trauma: a biopsychosocial-evolutionary view of the role of the traumatic stress response in the emergence of pathology and/or growth.

The main goal of this paper is to articulate a biopsychosocial evolutionary approach to understanding the traumatic stress response. The secondary goal of this paper is to draw out the general clinical implications of this approach. I articulate seven interconnected and overlapping empirically grounded theoretical conclusions: (1) Stress is best understood as a prerational form of biopsychological feedback regarding the organism's relationship with its environment; (2) The normal outcome of traumatic stress is growth, rather than pathology; (3) Most psychopathology is a function of the maladaptive modulation of the stress response; (4) Trauma always leaves the individual transformed on a biological, as well as psychological, level; (5) The general biological process underlying stress responses is universal, but the specific dynamics are always a function of the unique sociocultural environment and psychological makeup of the individual; (6) The biology underlying stable psychopathological symptoms may change even as the psychological symptoms remain the same; and (7) Rationality is humanity's evolutionarily newest and most sophisticated stress-reduction behavioral mechanism, and the most important aspect of restoring psychological health to the trauma victim.

Adaptation, Psychological↗

Correlates of fatigue in older women with heart failure.

OBJECTIVE: To examine the relative contribution of psychologic factors and physical symptoms to the variance in fatigue in older women with heart failure. METHODS: Eighty women who had been hospitalized in the previous 12 months for heart failure were interviewed. Fifty-seven women completed second interviews 18 months after the first interview. RESULTS: Fatigue was the most frequently occurring physical symptom at both measurement times, and it significantly increased with time. Other physical symptoms contributed uniquely to the variance in fatigue at both measurement times, but psychologic factors did not. At time 1, sleep difficulties, chest pain, and weakness each explained unique variance in fatigue. At time 2, dyspnea was the only variable that explained unique variance in fatigue (9%). Dyspnea also explained a significant portion of the variance (7%) in time 2 fatigue, when time 1 fatigue was controlled. CONCLUSIONS: Fatigue in older women with heart failure is related more to other physical symptoms than psychologic factors.

Adaptation, Psychological↗