bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological distress and coping in the partners of gay men with HIV‐related disease
Authors: Gray James , Hedge Barbara
Published: February 2003

Objectives. This study explored the levels of distress in a UK sample of partners of gay men with HIV disease. The relationship between coping style and other variables to this distress was also investigated. Design and methods. A cross‐sectional questionnaire design was used with measures of psychological distress (Hospital Anxiety and Depression Scale, General Health Questionnaire), coping style (the COPE scale), social support, relationship quality and physical health. Results. Thirty‐five HIV‐negative partners made up the final sample. High levels of distress were found with 54% scoring as psychiatric cases (GHQ). Coping strategies of acceptance, behavioural disengagement, mental disengagement, focusing on emotions and suppression of competing activities were significantly (p<. 05) correlated with psychological distress. Significant but smaller correlations were also found between distress and satisfaction with social support, and distress and measures of the infected person's health. Conclusions. Distress in the partners of people with HIV infection was associated with a number of factors, some amenable to change. This study suggests that psychological therapy aimed at modifying coping style would be a useful adjunct to treatment of the anxiety and depression directly.
Mood as a predictor of disability and survival in patients newly diagnosed with ALS/MND
Authors: Johnston Marie , Earll Louise , Giles Mark , Mcclenahan Roshan , Stevens David , Morrison Val
Published: February 2003

Objectives. To investigate whether poor psychological status predicts shorter survival, faster progress of disease and greater disability in patients with ALS/MND (amyotrophic lateral sclerosis/motor neurone disease). Design. A prospective study of mood as a predictor of 6‐month outcome in a consecutive cohort of patients with ALS/MND. Methods. A cohort of 38 consecutive patients completed mood, self‐esteem, wellbeing and disability measures at the time of diagnosis and 6 weeks later. Survival and disability were assessed at 6 months. Results. The 10 patients who died had poorer overall mood at the 6‐week interviews. Low mood early in disease also predicted greater disability at 6 months. The poor outcomes of patients with poor psychological well‐being were not due to confounding associations between mood and disease severity. Conclusions. The data confirm McDonald, Weidenfeld, Hillel, Carpenter & Walter's (1994) finding that poor psychological status predicts poor survival in ALS/MND. This study also extend their findings by (a) recruiting patients at the point of diagnosis and therefore controlling for effects due to the duration of disease, and (b) demonstrating that mood also predicts disease progression and disability. The findings are unlikely to be due to simple spurious association of the psychological status measures with recognized indices of disease or of expected survival. Explanations for the results can be considered in the context of other findings of mood predicting outcomes of life‐threatening disease and the possible value of psychological interventions may be considered.
The role of patients' illness representations in coping and functioning with Addison's disease
Authors: Heijmans Monique
Published: February 2003

Objective. To examine the relationship between illness representations, coping behaviour and adaptive outcome in patients with Addison's disease (AD). Design. Cross‐sectional. Following Leventhal's self‐regulation model (Leventhal, Meyer & Nerenz, 1980), it was hypothesized that illness representations are directly associated with coping and, via coping, with adaptive outcome. Method. The illness representations held by 63 patients with a diagnosis of Addison's disease were explored using a questionnaire and a comprehensive interview, including questions on beliefs about the identity, course, cause, treatment possibilities and consequences of their illness, the coping strategies they use, and their physical and psychological well‐being. Results. AD patients differ highly in the subjective experience of their disease. Patients who view their illness as a serious condition with both frequent and serious symptoms and consequences, patients who believe their illness is chronic, and patients who consider their illness uncontrollable were found to engage more in passive coping strategies and to report higher levels of disability with regard to physical functioning, social functioning, mental health and general vitality than those who believed the opposite. Regression analyses indicated that illness representations were better predictors of adaptive outcome than were coping scores. Conclusion. Illness representations seem to play an important role in functioning in Addison's disease. The implications of these findings for the design of health carerelated interventions for AD patients are discussed.
Motivational processes and the persistence of weight‐loss dieting
Authors: Strong K. G. , Huon G. F.
Published: February 2003

Objectives. The principal aim was to determine whether ‘controlled’ motivation can account for differences in persistence with weight‐loss dieting. The study also investigated whether goal‐setting attributes moderated or mediated the relationship between controlled motivation to diet and persistence with dieting. Design. A 2 × 2 between‐subjects design was used, with controlled motivation (low versus high), and type of feedback (positive versus negative) as the independent variables. This design enabled the investigation of their separate and interactive effects. Method. In a vignette study, 100 females were told to imagine they wanted to lose 3 kilograms. They then answered questions concerning their individual weight‐loss goals. Controlled motivation was assessed via a questionnaire. Two predetermined schedules of reinforcement for the dieting created a positive and a negative feedback group. The number of weeks for which the participants indicated they would continue dieting provided the index of dieting persistence, or the outcome measure. Results. The findings revealed that those with highly controlled dieting motivation persisted with dieting for longer than those whose motivation was less controlled, irrespective of whether weight was lost. Goal specificity moderated the effect of controlled motivation on persistence, and commitment to weight‐loss goals partially mediated the contribution of controlled motivation to persistence. Conclusions. To understand variability in the persistence of weight‐loss dieting, we need to invoke differences in the nature of motivation to diet and specific weight‐loss goal attributes. Prevention strategies should aim to encourage autonomous decision making among young females, especially in relation to weight‐loss dieting.
Stress, social support and fear of disclosure
Authors: Forbes Angela , Roger Derek
Published: February 2003

Purpose. This study was aimed at developing a measure of the capacity to use social support effectively. Methods. The responses of 329 participants to a preliminary 130‐item scale derived from a ‘scenario’ study were subjected to principal axis factoring. This resulted in a 48‐item Interpersonal Trust Questionnaire (ITQ) comprising three factors labelled fear of disclosure (FOD), social coping (SC) and social intimacy (SI). A second sample of 380 participants then completed the final form of the ITQ together with the rehearsal (rumination) and emotional inhibition scales from the Emotion Control Questionnaire (ECQ; Roger & Najarian, 1989), the Social Support Questionnaire (SSQ; Sarason, Levine, Basham & Sarason, 1983) and the Inventory of Socially Supportive Behaviours (ISSB: Barrera, 1981). Data on deterioration in health status over a period of adaptation were also available for a subsample of these participants. An additional sample provided scores on the ITQ and the Network Orientation Scale (NOS; Vaux, Burda & Stewart, 1986). Results. The scales were found to correlate in predictable ways with measures of both social support and emotion control. However, there were gender differences confirming the preference amongst women for emotional rather than informational support. Regression analyses using deterioration in health status as the dependent variable showed an effect for FOD, but this was significant only amongst women. Conclusions. The findings indicate the importance of taking both individual differences and availability of support into account, and it is hoped that the new ITQ scale will offer the means for including relevant individual differences in future studies of the role of social support in moderating stress responses.
The big five personality traits and reporting of health problems and health behaviour in old age
Authors: Jerram Kathryn L. , Coleman Peter G.
Published: February 2003

Objectives. To assess whether the ‘big five’ personality traits are related to health behaviour among British older people. Design. The NEO Five Factor Inventory, together with questions on medical problems, perceived health status, positive health behaviours, and frequency of visits to general practitioners were administered to people aged between 75 and 84 years. Method. Fifty people (21 men and 29 women) were interviewed, drawn from four GP lists in Southampton. Results. Neuroticism was associated with a number of reported medical problems, negatively perceived health status and frequency of visits to the GP. Extraversion was associated with positive health behaviours. Openness to experience and agreeableness were associated with positive health perceptions. There were some striking differences between associations found within the male and female groups. Agreeable women reported fewer medical problems and less frequent visits to the GP than antagonistic women, whereas conscientious men reported more positive health perceptions and more visits to the GP than non‐conscientious men. Conclusion. Since associations are evident for each of the personality traits, all of the ‘big five’ personality traits should be included in research on health behaviour to investigate their relevance for clinical practice.
Motor neurone disease: A review of its emotional and cognitive consequences for patients and its impact on carers
Authors: Goldstein Laura H. , Leigh P. Nigel
Published: February 2003

Objectives. Motor neurone disease (MND) has been regarded primarily as a disorder of the motor system. The current review sets out toprovide a summary of what is known about the cognitive and psychological consequences of this neurodegenerative disorder, and how this disease impacts on those caring for a person with MND. Method. A Medline and PsycLit search was undertaken, for the years 1983‐1997 supplemented by a manual search, to extract literature on the cognitive and emotional changes described in MND, as well as on styles of coping by MND patients. In addition, articles relating to the reactions of carers of MND patients were reviewed. Results. A consistent body of data is reported indicating the presence of subtle cognitive deficits (of a predominantly fronto‐temporal type) in MND patients who do not demonstrate clinical dementia. Emotional disorders (e. g. anxiety and depression), as well as emotional lability, have been documented in patients in cross‐sectional studies despite the limited availability of systematic research. Although reactions to the disease and coping skills of carers have been poorly studied, some carers demonstrate difficulty in dealing with physical and emotional stress posed by the disease. Conclusions. The atheoretical nature of much of the research into emotional disorder and coping skills in MND patients and their carers means that as yet it is difficult to predict who will be at particular risk of developing psychopathology during the course of the illness. Research to date also fails to elucidate the role of the patients' possible cognitive dysfunction in determining their coping behaviour. Future research, preferably longitudinal in design, should seek to determine whether aspects of the emotional response to MND by patients and their carers are specific to the disorder or characteristic of chronic, terminal neurological disease in general.
Cognitive‐behaviour therapy for the management of sickle cell disease pain: An evaluation of a community‐based intervention
Authors: Thomas V. J. , Dixon A. L. , Milligan P. , Thomas Nicky
Published: February 2003

Objectives. To evaluate the immediate effectiveness of a cognitive‐behavioural group therapy intervention for the management of sickle cell disease SCD pain. Design. This study is taken from an ongoing longitudinal, multi‐centred, randomized controlled trial. Method. Ninety‐seven patients with SCD recruited from seven London hospitals were randomly allocated to one of three treatment conditions after giving written consent: a CBT pain management group, an attention placebo group and a nointervention control. All participants completed a number of measures at baseline and post‐intervention to assess psychological well‐being, pain and coping. Results. Results are presented for the 59 participants who met the study entrance criteria, attended treatment group sessions above the cut‐off point selected for treatment completion, and completed sessions both baseline and post‐intervention assessments. Significant post‐intervention treatment group differences in favour of the CBT intervention were identified for nearly all of the psychological measures using the Kruskal‐Wallis test. Within‐group significant differences over time were also found for the CBT condition for the majority of the measures. Following the identification of centre differences in baseline measures, two‐way ANCOVAs were conducted with centre and condition for the ranked data of each psychological measure using ranked baseline scores as covariates. Observation of the adjusted means indicated that most of the post‐intervention effect was accounted for by centres 1 and 2, with centre 4 having a minimal effect and, for centre 3, some of the measures showing a reverse effect to that predicted. Conclusions. Overall, the cognitive‐behavioural approach employed appears to be immediately effective for the management of SCD pain in terms of reducing psychological distress and pain, and improving coping. Further analysis of longitudinal and cost‐effectiveness data currently being collated will indicate whether long‐term and financial benefits are to be gained.
Affective status following myocardial infarction can predict long‐term heart rate variability and blood pressure reactivity
Authors: Thornton E. W. , Hallas C. N.
Published: February 2003

Objectives. The study describes cardiovascular reactivity to challenge 18 months post‐episode in primary myocardial infarct patients. Reactivity during laboratory tests was compared to changes induced by self‐reported stressful events and related to measures of anxiety and depression. Design. Prospective changes of mood states were documented between the postepisode period and an 18‐month follow‐up. Cross‐sectional bivariate correlations and regression analyses were used to relate mood states to cardiovascular responses. Method. Questionnaires were used to document anxiety, depression, more general negative and positive mood status, and patients'general appraisal of stressorsin 30 postmyocardial infarct patients. Responses were collated 4 weeks following their episode and again 18 months post‐episode at psychophysiological assessment. Systolic and diastolic blood pressure and heart rate were measured under four conditions: baseline rest in the laboratory, laboratory challenge tests, ambulation over a 12‐hour period, and self‐reported stressors during this period. A time domain assessment of heart rate variability was also collected over the ambulatory period. Results. Heightened reactivity was significantly greater to self‐reported stressors compared with laboratory challenge. Depression assessed in the immediate post‐episode period proved the best predictor of heightened reactivity to stressors of relevance to patients, and of heart rate variability. Mood status was not a strong predictor of responses to arbitrary laboratory challenge. Conclusions. The data are consistent with the hypothesis that an increased probability of subsequent episodes in post‐myocardial infarct patients suffering depression may be related to reactive vascular responses to self‐perceived stressors and changes in autonomic control.
Affective and social‐cognitive predictors of behavioural change following first myocardial infarction
Authors: Bennett Paul , Mayfield Tansy , Norman Paul , Lowe Rob , Morgan Michelle
Published: February 2003

Objectives. To assess the utility of measures of affect and social‐cognitive variables in predicting risk behaviours for coronary heart disease in post‐myocardial infarction (MI) patients. Design. A longitudinal design was adopted with predictor variables measured while participants were in hospital and dependent variables (exercise, alcohol consumption, diet and smoking) measured 3 months following discharge. Method. A random sample of 43 patients with a first MI were identified on the wards and given a questionnaire measuring anxiety and depression, and measures of outcome and self‐efficacy expectancies and intentions relevant to each risk behaviour. Thirtyseven participants completed further behavioural measures at 3‐month follow‐up (excluding those who died in the follow‐up period), a 90% completion rate. Results. Social cognition measures were predictive of later behaviour, and in particular light exercise. Here, intentions accounted for 51% of the variance in behaviour explained after partialling out pre‐MI levels of exercise. Affect was less predictive, explaining only 7% of the variance in light exercise. Conclusions. Beliefs and intentions about future risk behaviour are formulated in the immediate post‐infarction period. Future rehabilitation programmes would benefit from some intervention, probably educational, at this early stage.
Measures of perceived work characteristics for health services research: Test of a measurement model and normative data
Authors: Haynes Clare E. , Wall Toby D. , Bolden Richard I. , Stride Chris , Rick Jo E.
Published: February 2003

Objectives. The aim of this paper is to describe the development and refinement of nine measures of perceived work characteristics for use in studies of the psychological wellbeing of health services employees. The constructs measured are: autonomy/control, feedback, influence, leader support, professional compromise, role clarity, role conflict, peer support and work demands. Design. The study was a large scale cross‐sectional survey. Methods. National Health Service Trust staff were selected from seven major occupational groups (nurses, doctors, administrative staff, managers, professions allied to medicine, professional and technical staff, and ancillary staff) within a sample of Trusts chosen to be representative of those in England. Questionnaires incorporating the scale items were completed by over 9,000 staff. The fit with the a priori nine‐dimensional measurement model was tested using confirmatory factor analysis. Scale internal reliabilities and norms were calculated, and aspects of construct validity were examined. Results. The findings show a good fit to the measurement model for the sample as a whole and across occupational groups. All the scales exhibit acceptable internal reliabilities; and normative data is provided for all seven occupations (with norms for more specific job categories available on request). Analyses suggest good construct validity, showing the scales discriminate as anticipated across occupational groups and job categories, and they have the expected relationships with job satisfaction and psychological strain. Conclusions. The measures developed are usable for research purposes across the major occupational groups, with the possible exception of ancillary staff. Further work is desirable to confirm the measurement properties and extend the normative database.
Communication in Dental Settings Scale (CDSS): Preliminary development of a measure to assess communication in dental settings
Authors: Newton J. T. , Brenneman D. L.
Published: February 2003

Objectives. To examine the inter‐rater reliability of a newly developed measure of the communication process in dental settings. To assess the relationship between the measure of communication process and patient satisfaction with the consultation. Design. An observation‐based assessment scale for dentist‐patient consultations was developed, based upon a theoretical model of dentist‐patient communication. Behavioural definitions for each item were developed on the basis of observations of five video‐recorded consultations. Inter‐rater reliability for the scale was then assessed by observation of 34 student dentist‐patient consultations. Validity of the scale was assessed by examining the correlation between the scale and other measures of the dentist‐patient consultation and with patient satisfaction. Results. All items on the scale showed acceptable levels of inter‐rater reliability. The scale correlates well with other measures of communication and with patient satisfaction with the interview. Conclusions. The CDSS proved to be a reliable and valid measure for the assessment of communication processes in the limited sample studied. Further research is required to assess its applicability in a broader range of settings.
Mindset, optimistic bias about personal risk and health‐protective behaviour
Authors: Weinstein Neil D. , Lyon Judith E.
Published: February 2003

Objectives. Taylor & Gollwitzer (1995) suggested that optimistic biases about risk are not an impediment to precaution adoption. Their ‘mindset hypothesis’ proposes that such biases are suspended during deliberation over new behaviours and reappear only later during thoughts about implementing these behaviours. This paper examines the research on which the mindset hypothesis was based and presents new data on this issue from an experiment designed to encourage home radon testing (Weinstein, Lyon, Sandman & Cuite, 1998). Method. Homeowners (N = 1346) in an area of high radon risk watched either a ‘risk’ video that gave information about the need to test, a ‘how to test’ video that focused on the implementation of testing decisions, or both. Risk perception biases were assessed before and after viewing the videos and purchases of radon test kits were determined. Results. No support was found for the mindset‐illusions predictions. In contrast, the data indicated that optimistic biases about personal risk are barriers to action. Conclusion. There are several methodological problems in the design used to support the mindset‐illusions hypothesis. In contrast to this hypothesis, it appears that acceptance of personal vulnerability is an important aspect of progress toward precaution adoption. The adaptiveness of optimistic biases about risk is also discussed.
Health habits and psychological well‐being among young, middle‐aged and older Australian women
Authors: Lee Christina
Published: February 2003

Objectives. To assess health habits, and their relationship with psychological wellbeing, among Australian women; in particular to examine the relationship between health habits and the Women's Health Questionnaire (WHQ; Hunter, 1992). Design. A cross‐sectional postal survey of women in three age groups was carried out. Methods. Questionnaire responses from a representative sample of 612 women from three age groups (18‐23, 45‐50 and 70‐75) were analysed. Data included the WHQ, 12‐item General Health Questionnaire, Medical Outcomes Study SF‐12 and self‐reports of smoking, height and weight, alcohol use and exercise status. Results. Young women had the highest rates of smoking and drinking and were most likely to be underweight, while middle‐aged and older women were most likely to be overweight or obese. Psychological distress was highest in the youngest group; the middle‐aged group were most likely to report vasomotor symptoms and difficulties with memory and concentration; and the older women difficulty in sleeping. Health habits were related to psychological well‐being; smoking, unhealthy body weight and lack of exercise were most closely related to the depression subscale of the WHQ. Conclusions. Young adulthood appears the time of greatest distress for women. Distress, particularly depression, is associated with behaviours which predispose to later disease, suggesting that psychological interventions with young women may be particularly important for long‐term physical health. The WHQ appears a useful measure of well‐being and a good predictor of health‐related behaviour across a range of ages.
The application of a shortened version of the profile of mood states in a sample of breast cancer chemotherapy patients
Authors: Dilorenzo Terry A. , Bovbjerg Dana H. , Montgomery Guy H. , Valdimarsdottir Heiddis , Jacobsen Paul B.
Published: February 2003

Objectives. The Profile of Mood States (POMS) is a 65‐item mood measure with demonstrated reliability and validity; however, its length can be of concern to researchers. The present study investigated the utility of a 37‐item shortened version of the POMS (SV‐POMS) developed by Shacham (1983). Design. In samples of breast cancer chemotherapy patients (patient group 1) and healthy volunteers, correlations between the subscales of the measures and internal consistencies were examined; these samples were also used to compare mood ratings of healthy women and patients. In another sample of breast cancer chemotherapy patients (patient group 2), the sensitivity to changes in mood of the measures was investigated. Methods. Patient group 1 comprised 114 women; patient group 2 comprised 48 women. Healthy volunteers were 55 women recruited through newspaper advertisements. Results. The correspondence between the measures was demonstrated by significant correlations of the shortened with the full‐length scales. Internal consistencies of the measures were comparable. Both measures demonstrated mood differences between patients and volunteers. The responsiveness of the measures to change were comparable as demonstrated by changes in distress scores across chemotherapy infusions. Conclusions. Results suggest that the SV‐POMS can be used when participant burden is of concern.
Chronic fatigue syndrome and susceptibility to upper respiratory tract illness
Authors: Smith Andrew , Thomas Marie , Borysiewicz Leszek , Llewelyn Meirion
Published: February 2003

Objectives. First, to determine whether chronic fatigue syndrome (CFS) patients report increased susceptibility to upper respiratory tract illnesses (URTIs) compared with healthy volunteers. Second, to determine whether symptom severity and use of medication is greater in CFS patients. Finally, to assess the impact of the URTIs on the subsequent clinical state of the patients. Design. A 10‐week diary study. Methods. The frequency and severity of URTIs were recorded over a 10‐week period by CFS patients (N = 62) and healthy controls (N = 44). The patients were selected according to the Oxford criteria and had previously been assessed at the Cardiff Chronic Fatigue Clinic. One group of patients and controls carried out the diary study from October to December, and another group from January to March. At the end of each of the 10‐week periods the volunteers completed standard questionnaires about the frequency and severity of symptoms of colds and influenza and their general clinical condition. Results. CFS patients reported more cold and influenza illnesses than the controls. The patients also reported greater symptom severity and use of medication for the URTIs; these differences were still observed when trait anxiety was covaried. There was little evidence of the URTIs leading to longer term changes in the primary symptoms of CFS. Conclusions. CFS patients report more URTIs, greater symptom severity and greater use of medication for these illnesses than healthy controls. Further studies are now necessary to determine whether these results reflect greater susceptibility to infection or differences in symptom reporting. The present findings also suggest that acute infections do not play a major role in the pathogenesis of CFS.
An examination of the self‐regulation model in atrial fibrillation
Authors: Steed L. , Newman S. P. , Hardman S. M. C.
Published: February 2003

Objectives. To examine the role of the presence of symptoms on illness representations. To examine the success of the Self‐Regulation Model in explaining psychosocial adjustment in patients with atrial fibrillation (AF). Design. A cross‐sectional study of 62 AF patients attending either specialized AF or cardiac out‐patient clinics. Method. Individuals were classified as symptomatic or asymptomatic and completed the Illness Perception Questionnaire (IPQ), COPE, and Psychosocial Adjustment to Illness Scale (PAIS). Comparisons between groups and explanation of psychosocial adjustment were examined. Results. Symptomatic and asymptomatic participants did not differ on subscales of the IPQ, with the exception of identity. Both symptom status and IPQ subscales explained independent and significant amounts of variance in PAIS domains. In contrast the COPE accounted for minimal amounts of variance in all PAIS domains. Conclusions. The presence of symptoms is not directly influential in the elaboration of the illness representation. Both symptoms and illness representations should be targeted in interventions to improve adjustment to AF.
Assessing quality of life in persons with severe neurological disability associated with multiple sclerosis: The psychometric evaluation of two quality of life measures
Authors: Murrell Rachel C. , Kenealy Pamela M. , Beaumont J. Graham , Lintern Tracey C.
Published: February 2003

Objectives. To examine the psychometric properties of two conceptually different quality of life (QoL) measures, the SEIQoL‐DW (a person‐centred measure) and the SF36 (a health‐based measure), in a severely disabled population of individuals with multiple sclerosis (MS). Design. A factorial repeated measures design was used. Method. The two QoL measures were administered at baseline to 30 individuals with MS at the Royal Hospital for Neuro‐disability, Putney; participants were aged between 20 and 65 years and selected on the basis of their communication ability, years since diagnosis and extent of physical disability (using EDSS ratings). Administration of the SEIQoL‐DWand the SF‐36 was repeated on five fortnightly occasions on a subset of 22 participants 10 months after baseline. On each of the five re‐test occasions, participants also rated their QoL ‘today’ and ‘generally’ on visual analogue scales, and reported significant positive/negative life changes that had affected their QoL. Results. The SF‐36 was more reliable by traditional re‐test standards than the SEIQoL‐DW, but several floor and ceiling effects were observed. Only the SEIQoLDW was significantly related to QoL today (average correlation 0. 52) and QoL generally (average correlation 0. 52) (p < .05) ratings and analyses using ANOVA suggested that the measure was also more sensitive to life changes reported (F (2, 36)= 7. 57, p <. 01). Conclusion. The SEIQoL‐DW is recommended as a suitable person‐centred measure for use with the current population, because it appears to have good face validity and is capable of reflecting individual reports of life change between assessments. It has potential use in other severely disabled samples who obtain low scores on health‐based measures because of their physical status, providing a more holistic view of individual QoL than the SF‐36.
Religious orientation and psychological well‐being: The role of the frequency of personal prayer
Authors: Maltby John , Lewis Christopher Alan , Day Liza
Published: February 2003

Objectives. The aim of the present study was to examine the role of religious acts within the relationship between measures of religious orientation and psychological well‐being, to examine the theoretical view that religion can act as a coping mechanism. Design. Correlational statistics, principal components analysis with oblimin rotation and multiple regression were used to examine the relationships between a number of religiosity and psychological well‐being measures. Method. A sample of 474 UK students (251 males, 223 females) were administered questionnaire measures of three aspects of religious orientation (intrinsic, extrinsic, Quest), frequency of personal prayer and church attendance, alongside measures of depressive symptoms, trait anxiety and self‐esteem. Results. Though a number of significant correlations were found between measures of religiosity and psychological well‐being, a multiple regression analysis using identifiable religious components suggests that frequency of personal prayer is the dominant factor in the relationship between religiosity and psychological well‐being. Conclusions. The results suggest two points: (1) that the correlations between a number of measures of religiosity and psychological well‐being may be mediated by the relationship between frequency of personal prayer and psychological well‐being; (2) that personal prayer may be an important variable to consider within the theory of religious coping.
Lessons from psychotherapy research for psychological interventions for people with schizophrenia
Authors: Paley Graham , Shapiro David A.
Published: February 2003

This article argues that psychological interventions for people with schizophrenia could be developed by being informed by research from the wider psychotherapy literature. We specifically argue that research on these interventions has ignored two key themes from this wider literature: first, the contention that differing models of intervention broadly result in similar outcomes, known as the ‘equivalent outcomes paradox’ and second, the phenomenon of ‘investigator allegiance’ whereby the conclusions that may safely be drawn from comparative research are compromised by researchers' unwitting bias. We present evidence indicating that both these themes from the wider literature may be applicable to the literature on psychological interventions for schizophrenia and that schizophrenia treatment research should incorporate some of the lessons already learned in studies of other disorders. We conclude by arguing that psychological interventions for people with schizophrenia should be based on unbiased evidence and that interpretation of the evidence base should not be hindered by dogma or ideology from any quarter.
Aberrant social relations in the personality disorders
Authors: Haslam Nick , Reichert Therese , Fiske Alan P.
Published: February 2003

Research on the interpersonal aspects of personality disorders (PDs) has generally sought to describe them in terms of behavioural dispositions, often mapping these dispositions onto the interpersonal circumplex. The present study, in contrast, tested a theory that accounts for PDs as systematic disturbances in relationships between people. Self‐reports of 57 participants experiencing significant interpersonal difficulties showed many predicted associations between PD symptoms and aberrant enactment of four elementary forms of social relationships (Fiske, 1991). Symptoms were associated with aberrant motivations for, and cognitive implementations of, these ‘relational models’, and with difficulties conducting them. These associations were comparable in strength to, but largely independent of, those obtained with a circumplex measure. Aberrations of authority‐ and equality‐based relationships were central to many PDs, but not captured well by the circumplex. A relational analysis affords a fruitful and largely unexplored perspective on Ps.
Psychometric validation of the State Scale of Dissociation (SSD)
Authors: Krüger Christa , Mace Chris J.
Published: February 2003

Although dissociative phenomena are often transient features of mental states, existing measures of dissociation are designed to measure enduring traits. A new present‐state self‐report measure, sensitive to changes in dissociative states, was therefore developed and psychometrically validated. Fifty‐six items were formulated to measure state features, and sorted according to seven subscales: derealization, depersonalization, identity confusion, identity alteration, conversion, amnesia and hypermnesia. The State Scale of Dissociation (SSD) was administered with other psychiatric scales (DES, BDI, BAI, SCI‐PANSS)to 130 participants with DSM‐IV major depressive disorder schizophrenia, alcohol withdrawal, dissociative disorders and controls. In these sample populations, the SSD was demonstrated as a valid and reliable measure of changes in and the severity of dissociative states. Discriminant validity, content, concurrent, predictive, internal criterion‐related, internal construct and convergent validities, and internal consistency and split‐half reliability were confirmed statistically. Clinical observations of dissociative states, and their comorbidity with symptoms of depression and psychotic illness, were confirmed empirically. The SSD, an acceptable, valid and reliable scale measuring state features of dissociation at the time of completion, was obtained. This is a prerequisite for further investigation of correlations between changes in dissociative states and concurrent physiological parameters.
Dissociative experiences and their correlates in young non‐patients
Authors: Modestin Jiri , Lötscher Katharina , Erni Thomas
Published: February 2003

The relationship between dissociation and some of its potential correlates and antecedents was explored. Young medical students (N = 276) completed the Dissociative Experiences Scale (DES), Parental Bonding Instrument (PBI), 20‐item Toronto Alexithymia Scale (TAS‐20) and Munich Personality Test (MPT). The findings indicate that both personality characteristics (such as alexithymia and neuroticism)and, to a modest degree, environmental factors in terms of the lack of parental care contribute to the dissociation variance.
Families of homicide victims: Psychiatric responses and help‐seeking
Authors: Mezey Gill , Evans Chris , Hobdell Kathy
Published: February 2003

The number of homicides in the UK is increasing: 850 homicides were recorded in England and Wales last year, but little is known about their impact on surviving family members. This study describes their psychological and social effects. Relatives seeking help from Victim Support were surveyed about their experiences, responses and help‐seeking and asked to complete a number of psychological measures. Victim Support workers provided additional information. High levels of post‐traumatic stress symptomatology and generalized distress were identified, as well as an increase in prescribed psychotropic medication Other effects included increases in anger and irritability, cigaretteconsumption and loss of employment. However, few family members had been referred forprofessional treatment.
Adult attachment: What are the underlying dimensions?
Authors: Stein Helen , Koontz A. Dawn , Fonagy Peter , Allen Jon G. , Fultz Jim , Brethour John R. , Allen Darla , Evans Richard B.
Published: February 2003

Using a community sample of 115 young adults, this study applied a range of statistical techniques to five measures of adult attachment to gain a better understanding of what they assess. First, we determined comparability of measures, using both categorical and dimensional approaches to model the association. Agreement among classifications was modest. Next, we examined the relation of attachment classifications and attachment measure subscale scores to criterion variables (i.e. dyadic adjustment, interpersonal sensitivity and severity of psychiatric symptoms). Classification predicted severity of psychological symptoms better than it predicted other measures of adjustment. Finally, using a principal components analysis, we mapped the relationship among underlying constructs, the subscales of the five measures and three criterion measures of psychological adjustment. We discuss our findings from the perspective of underlying constructs of attachment insecurity and strategy for coping with insecurity in relationships, noting implications for further research.
Made of stone: A view of Parkinson ‘off’ periods
Authors: Matson Neil
Published: February 2003

Parkinson's disease is a neurological condition, managed symptomatically by medications aimed at the underlying dopaminergic deficit. After several years of treatment, some sufferers experience marked fluctuations in symptom control, including akinetic o‘off’ periods. A sample of 15 Parkinson disease sufferers who experienced off periods participated in a small‐scale study examining their experience and the coping strategies used. There was a trend for those experiencing significant levels of distress to make more frequent use of ‘attempted activity’ coping strategies, responses that may inadvertently exacerbate distress. Clinical implications for adjuvant psychological techniques are discussed.
Illness understanding, causal attributions and emotional reactions in wives of myocardial infarction patients
Authors: Arefjord Kjersti , Hallaråker Eli , Havik Odd E. , Mæland John Gunnar
Published: February 2003

This study addresses lay illness understanding and attributions, including attribution of blame, in wives of myocardial infarction (MI) patients concerning the causes of MI. The present study also investigates the association between illness attributions and emotional adjustment, and the associations of relevant third variables with illnessattributions. A sample of 37 wives were interviewed during the acute phase of the illness, three months and 10 years post‐index MI. Attributions of the MI to multiple causes were common with an strong emphasis on psychosocial risk factors, but attributionalcontent showed alow consistency over time. In retrospect, the wives believed they couldhave done more to prevent the MI, but self‐blame wasnot a significant issue. However, they blamed the patient for not taking preventive actions. Attributions were not related to background and illness characteristics or denial in any strong and consistentmanner. In a short‐term perspective, attributing the MI to stress causes and husbands'personality was associated with worse emotional adjustment. Also, the use of magicalexplanations and blame of the patient were related to a poorer emotional outcome for the wife. The causal attributions made by the wives during the acute phase did not influence the emotional adjustment after 10 years.
Obsessive compulsive disorder in ultra‐orthodox Jewish patients: A comparison of religious and non‐religious symptoms
Authors: Greenberg David , Shefler Gaby
Published: February 2003

Of 28 ultra‐orthodox Jewish psychiatric referrals with obsessive compulsive disorder, 26 had religious symptoms, while 18 had non‐religious symptoms. On average, each patient had three times more religious symptoms than non‐religious symptoms. In only nine cases did the patients view their non‐religious symptoms as the main difficulty, andall of these nine cases were ultra‐orthodox from birth. There was no significant difference between the distress, resistance, sense of irrationality and hours spent daily of religious and non‐religious symptoms. Further, there was no significant difference between the age of onset, age when felt to be a disturbance, and duration until help was sought. They were more likely to turn for help initially to a religious authority for a religious symptom and a mental health worker for a non‐religious symptom. It may be concluded that the religious and non‐religious symptoms of obsessive compulsive disorder in ultra‐orthodox Jews are not experienced in markedly different ways by the sufferers. Two limitations to the study are the sample size, and the selection bias in that all had sought professional help, of itself likely to reflect their attitude to obsessive compulsive disorder.
The Psychological Mindedness Scale: Factor structure, convergent validity and gender in a non‐psychiatric sample
Authors: Shill Merton A. , Lumley Mark A.
Published: February 2003

Although the concept of psycholoical mindedness (PM) originated in the psychoanalytic literature, its use has been expanding beyond the realm of assessing suitability for, or psychic change following, psychotherapy or psychoanalysis. For example, since PM bespeaks a capacity to tolerate psychological conflict and stress intrapsychically rather than by regressive means of conflict management or resolution such as somatization, its role, like that of alexithymia, in the genesis of psychosomatic illness is becoming evident. The Psychological Mindedness Scale (PMS), a 45‐item self‐report instrument intended to measure PM, was administered to a non‐clinical sample of 397 undergraduates to assess the stability of its previously reported item‐factor loadings and factor structure. Two main factors emerged, viz. Belief in the benefits of discussing one's problemsand Access to feelings. Lower‐order factors were Willingness to discuss problems with others, Interest in meaning and motivation of own and others' behaviourand Openness to change. Convergent validity of the PMS was alsodemonstrated by the negative correlations obtained between its total and factor/subscale scores with those of the Toronto Alexithymia Scale. Thef PMS needs further development to increase the congruence between itsfactor structure and the concept of PM. Females were also found to be more psychologically minded than males. The implications of these findings and the potential uses of this scale are discussed.
The properties of self‐report research measures: Beyond psychometrics
Authors: Blount Claire , Evans Chris , Birch Sarah , Warren Fiona , Norton Kingsley
Published: February 2003

Self‐report measures pertinent for personality disorder are widely used and many are available. Their relative merits are usually assessed on nomothetic psychometrics and acceptability to users is neglected. We report reactions of lay, patient and professional groups to the Personality Diagnostic Questionnaire (PDQ‐IV); Millon Clinical Multiaxial Inventory (MCMI‐III); the Borderline Syndrome Index (BSI); Rosenberg's Self‐Esteem Scale (RSE) and the Social Functioning Questionnaire (SFQ). These were sent to 148 professionals, ex‐patients and lay people for comment. Thirty‐six per cent were returned. Pattern‐coding by three raters revealed problematic themes across all measures, including inappropriate length, vague items and language, cultural assumptions and slang, state‐bias and response‐set. Measures can be depressing and upsetting for some participants (both patients and non‐patients), hence administration of measures should be sensitive. Treatment may make people more self‐aware, which may compromise validity for outcome research. This evaluation raises issues and concerns, which are missed in traditional psychometric evaluation.