Gender differences in patterns of emotional distress following heart transplantation

The study provides the first empirical evaluation of gender differences in psychological symptomatology and DSM-III-R major depressive disorder (MDD) across the first year following heart transplantation. An important goal was to identify physical health-related and psychosocial factors that could account for, or mediate, any association between gender and psychological distress. The sample for the present analyses was drawn from a larger cohort of 172 heart recipients and included all 28 women in the cohort plus 118 men who were matched demographically with the group of women. Detailed patient assessments were completed at 2, 7, and 12 months posttransplant. As expected, women's symptom levels were consistently higher than men's. However, while men's symptom levels in all areas declined with time posttransplant, women's distress in the area of depression initially improved but then worsened by the 12-month assessment. The distribution of episodes of MDD showed a temporal pattern of gender differences similar to that of depressive symptoms. The most important mediators of the gender-depression relationship were factors related to early posttransplant daily functional limitations: women reported more impairments in daily activities. Higher levels of such impairments, in turn, predicted subsequently higher depression levels by 12 months posttransplant. Several additional variables pertaining to transplant-related concerns and a low sense of personal mastery—while not serving as mediators—exerted their own independent effects on 12-month depression levels. The findings are relevant to the tailoring of educational and clinical interventions to the individual needs of women and men who receive heart transplants.Roberta G. Simmons, Ph.D., died on February 15, 1993, during data collection for this paper.     

A longitudinal study on transactional relations between parental marital distress and adolescent emotional adjustment

Using a cross-lagged effect model with 3 waves of data from a 6-year longitudinal study with 3-year intervals, transactional relations between parental marital distress and adolescent emotional adjustment were examined. The sample consisted of 531 parent-adolescent dyads. Results showed that marital distress as reported by parents and emotional adjustment as reported by adolescents were reciprocally related in a transactional model over time. This was principally true for girls and for late adolescents and young adults. For older adolescent girls, an almost full transactional model was found, whereas associations between marital distress and emotional adjustment were less strong for younger girls and were absent for boys.     

Differential ability and attainment in language and arithmetic of Dutch primary school pupils

Background . In preschool and primary education, pupils differ in many abilities and competences (giftedness). Yet mainstream educational practice seems rather homogeneous in providing age‐based or grade–class subject matter approaches. Aims . To clarify whether pupils scoring initially at high ability level do develop and attain differently at school with respect to language and arithmetic compared with those displaying other initial ability levels. To investigate whether specific individual, family, or educational variables covary with the attainment of these different types of pupils in school. Samples . Data from the large‐scale PRIMA cohort study including a total of 8,258 Grades 2 and 4 pupils from 438 primary schools in The Netherlands. Methods . Secondary analyses were carried out to construct gain scores for both language and arithmetic proficiency and a number of behavioural, attitudinal, family, and educational characteristics. The pupils were grouped into four different ability categories (highly able, able, above average, average or below average). Further analyses used Pearson correlations and analyses of variance both between‐ and within‐ability categories. Cross‐validation was done by introducing a cohort of younger pupils in preschool and grouping both cohorts into decile groups based on initial ability in language and arithmetic. Results . Highly able pupils generally decreased in attainment in both language and arithmetic, whereas pupils in average and below‐average groups improved their language and arithmetic scores. Only with highly able pupils were some educational characteristics correlated with the pupils' development in achievement, behaviour, and attitudes. Conclusions . Preschool and primary education should better match pupils' differences in abilities and competences from their start in preschool to improve their functioning, learning processes, and outcomes. Recommendations for educational improvement strategies are presented at the end of the article.     

A multi-modal investigation of the roles of distress tolerance and emotional reactivity in obsessive-compulsive symptoms

Emerging evidence implicates important roles of poor distress tolerance and heightened emotional reactivity in obsessive-compulsive disorder. To date, investigations have relied mostly on self-report measures, and we sought to extend the literature by examining the relationship between OC symptoms and distress tolerance, as well as emotional reactivity, using three laboratory assessments. Nonclinical participants (N=167) viewed emotional films associated with four different negative emotions and also completed mirror tracing and handgrip persistence tasks. Greater obsessions scores were predictive of poorer emotional tolerance for a sad film and shorter persistence on the mirror tracing task. Among men only, obsessions were negatively correlated with persistence on the handgrip task. Associations between increased emotional reactivity and washing symptoms also emerged. These findings provide further evidence for the role of poor distress tolerance in obsessions and suggest heightened emotional reactivity may play a role in compulsive washing.     

A qualitative analysis of emotional effector patterns and their feedback

This paper is devoted to the study of the relationship between the subjective component (feelings) and the behavioral aspect of emotions. The following emotions were studied: fear-anxiety, anger-aggression, joy-laughter, love-eroticism, love-tenderness, and sadness-tears. The observations were performed with three different groups of people: patients with anxiety neurosis, students under hypnosis, and drama students. Each emotion was characterized by a specific set of reactions in the respiratory pattern, heart activity, muscular activity, and facial expression. The feelings were correlated with the behavioral patterns and each time the behavioral patterns were interfered with a concomitant modification of the subjectivity component was observed. The direct performance of the behavioral emotional patterns in the absence of the emotogenic stimulus produced the feeling corresponding to the mimicked emotion. If the subjects were stimulated with an emotogenic stimulus during the direct performance of the behavioral patterns of another emotion, they confessed to have the feeling corresponding to the mimicked emotion, and not to the emotion belonging to the emotogenic stimulus. The role played by the feedback from the effector organs in the determination of the subjective emotional states is discussed.     

A cross-cultural study of suicide intent in parasuicide patients

As part of the WHO/EURO Multicentre Study on Parasuicide, the level of suicide intent among female and male parasuicide patients from various European regions was compared. From nine regions, a total of 1,212 parasuicide patients, 752 females and 460 males, were included in the study. Although some statistical significant differences in level of suicide intent between the regions and genders were found, the effect sizes of these relationships were so small that the differences have neither theoretical nor practical significance. As far as level of suicide intent is concerned, the WHO study has succeeded in recruiting a relatively homogeneous group of self-harming patients across borders of region, culture, and country.     

Coping strategies: A prospective study of patterns,stability, and relationships with psychological distress

The aims of this article are: (1) to explore patterns (clusters) of coping strategies; (2) to examine the stability of individual coping strategies and patterns of coping over time; and (3) to establish long term associations between coping and psychological distress. Coping strategies were assessed with the Brief Cope questionnaire, whereas psychological distress was measured with the ten‐item version of the Hopkins Symptom Checklist, in a two‐year prospective sample comprising 3,738 employees. Based on TwoStep cluster analysis of the Brief Cope, three different coping patterns were identified: low coping, engagement coping, and disengagement coping. Analyses of long‐term stability indicated malleable properties for the individual coping strategies as well as the three clusters. Disengagement coping strategies in the form of self‐blame and self‐distraction were most strongly associated with distress at follow‐up, whereas baseline distress was related to increased use of these strategies two years later. Coping patterns at baseline had no main effects on later levels of distress, but levels of distress at baseline predicted subsequent use of engagement and disengagement coping patterns. The finding that specific coping strategies are malleable suggests that it is possible to modify and develop dysfunctional strategies. The associations between disengagement coping strategies and distress indicate that this kind of coping is especially problematic with regard to mental health problems. A main contribution of this study is that it establishes cluster analytic techniques as beneficial in the assessment of coping.     

Metacognition and mindreading in young children: A cross-cultural study

Prior studies document cross cultural variation in the developmental onset of mindreading. In particular, Japanese children are reported to pass a standard false belief task later than children from Western countries. By contrast, we know little about cross-cultural variation in young children’s metacognitive abilities. Moreover, one prominent theoretical discussion in developmental psychology focuses on the relation between metacognition and mindreading. Here we investigated the relation between mindreading and metacognition (both implicit and explicit) by testing 4-year-old Japanese and German children. We found no difference in metacognition between the two cultural groups. By contrast, Japanese children showed lower performance than German children replicating cultural differences in mindreading. Finally, metacognition and mindreading were not related in either group. We discuss the findings in light of the existing theoretical accounts of the relation between metacognition and mindreading.     

Self‐esteem,perception of relationships,and emotional distress: A cross‐cultural study

This study examined the relative importance of self‐esteem, family cohesion, and support from friends in predicting depressed mood and anxiety in Japanese and American college students. Contrary to expectations, self‐esteem was the strongest predictor of emotional distress in both groups of students. Nevertheless, consistent with predictions derived from Markus and Kitayama's theory of self‐construals, family cohesion accounted for a significantly larger percentage of the variance in predicting emotional distress in Japan than in the United States. In both countries, the relations between support from friends and the measures of emotional distress were entirely mediated by self‐esteem. However, among Japanese students, family cohesion accounted for additional significant variance in predicting the measures of emotional distress, even after controlling for self‐esteem.     

A cross-cultural study of the test anxiety levels in Iranian and Indian students

This study compared the test anxiety levels of Iranian (N = 160) and Indian (N = 160) school and college students. Significant main effects of Culture, Educational Level and Sex indicated that the Iranian students had higher Test Anxiety scores than their Indian counterparts, and females reported higher test anxiety than males. A significant Culture x Educational Level x Sex interaction revealed, however, that level of education had opposite effects within the Indian culture: Indian school females reported more test anxiety than their college counterparts; Indian college males had higher test anxiety than their school counterparts. Iranian school males and females both reported higher test anxiety than their college counterparts. Tricultural differences in the test anxiety levels of comparable student groups in Iran, India and the U.S. were interpreted as reflecting East-West cultural factors that influenced reactions to objective examinations, resulting in greater test anxiety in Eastern cultures.     

A cross-cultural, long-term outcome evaluation of the ISTAR Comprehensive Stuttering Program across Dutch and Canadian adults who stutter

There is a need to evaluate the effectiveness of stuttering treatment programs delivered in domestic and international contexts and to determine if treatment delivered internationally is culturally sensitive. Evaluation of the effectiveness of the ISTAR Comprehensive Stuttering Program (CSP) within and across client groups from the Netherlands and Canada revealed generally positive results. At 2 years post-treatment both groups were maintaining statistically significant reductions in stuttering frequency and improvements in attitudes, confidence, and perceptions as measured by the Revised Communication Attitude Inventory (S24), Perceptions of Stuttering Inventory (PSI), and the approach scale of the Self-Efficacy Scaling by Adult Stutterers (SESAS). Data pooled across the groups on these measures gave evidence of a global treatment effect with standardized effect sizes ranging from typical to larger than typical in the behavioural sciences. Only two differences between the groups emerged: differences in speech rate and perception of self. Given that these groups represent two distinct cultures, differences were discussed in terms of whether they could be due to cultural, methodological, or other variables. Overall, results suggest that, the CSP appears to be similarly effective in both cultures and thus, sufficiently sensitive to the culture of Dutch adults who stutter.

Educational objectives: The reader will be able to (a) describe a methodology that can be used in a clinical setting to evaluate the long-term effectiveness of stuttering treatment with adults, (b) describe some of the challenges in developing a model of clinically meaningful outcome, (c) explain the rationale for the need for cross-cultural investigations of treatment outcome, and (d) summarize speech and self-report results of the cross-cultural evaluation of an integrated stuttering treatment program.     

A developmental study of handedness in Down syndrome pupils.

Assessed hand preference in 7- to 9-yr.-old and 13- to 15-yr.-old pupils with Down syndrome (n = 41) was compared with control schoolchildren (n = 50) of the same ages. A significant increase in left-handedness and mixed-handedness was noted in Down syndrome groups compared with the normal population. Younger Down syndrome pupils were less consistent in their hand preference than the older pupils and the normal controls.     

Coping and emotional distress in a sample of Swedish unemployed.

The study investigated the associations between coping and symptoms of emotional distress within a sample of 166 unemployed men and women (mean age 40 +/- 10 years, range 22 to 63 years, 52% males). All variables were measured with a questionnaire comprising sociodemographic background, length of unemployment, financial strain, coping style ("Ways of Coping Checklist"), and emotional distress (Hopkins Symptom Check List-25). Emotional distress was positively related to financial strain and more common among younger subjects, divorced subjects and those with foreign background, but less frequent among subjects who had been unemployed for more than three years. After controlling for age, gender, education, foreign background, length of unemployment and financial strain, hierarchical regression analyses showed that emotion-focused coping, i.e. self-blame and wishful thinking, was positively related to emotional distress. Problem-focused coping and cognitive restructuring were negatively associated with emotional distress. Younger subjects and divorced subjects made frequent use of both emotion-focused and problem-focused coping. Female subject and subjects with mandatory school made frequent use of emotion focused coping, if exposed to high financial strain. Problem-focused coping was less frequent among subjects with a low education coupled with low financial strain. Cognitive restructuring was less common among subjects who had been unemployed for more than three years. Younger subjects who were also divorced made less use of both problem-focused coping and cognitive restructuring. The results confirm that coping style has importance for the mental health of the unemployed, and indicate a differential use of coping strategies among subjects with different sociodemographic backgrounds and different levels of financial strain.