Psychometric assessment of cardiac transplantation candidates

Psychometric assessment protocols were used to chart the course of 287 end-stage cardiac patients' psychological adjustment at pretransplantation and, again, in 34 who were subsequently transplanted. The regression and repeated-measures analyses suggested that psychological distress is typical of the adult transplantation candidate, although impaired cognitive functioning is more typical of the acute postoperative stage. Negative affect, cognitive, personality, and coping measures are interrelated at pretransplantation; depression and mental control show significant decreases at 2 weeks posttransplantation. Whereas the transplantation process is inherently distressing, psychological testing may identify cognitive and personality features that require more specific clinical attention.     

Current status of psychological research in organ transplantation

Research addressing the psychological concomitants of organ transplantation is reviewed. Specifically, cognitive, behavioral, and psychosocial correlates of kidney, heart, liver, and bone marrow transplantation in both children and adults are discussed. Despite several conceptual and methodological shortcomings of the psychologically-based research in this area, results seem to indicate that organ transplantation is associated with many psychological issues at pretransplantation, posttransplantation, and follow-up periods. Implications of these general findings for the advancing roles of the health psychologist in organ transplantation are discussed.     

Body-image,quality of life and psychological distress: a comparison between kidney transplant patients and a matching healthy sample

The purpose of the current study was to assess the uniqueness of the condition of kidney transplant recipients in comparison to a sample of matching healthy peers in relation to body-image dissatisfaction and identification, quality of life and psychological distress. Participants were 45 kidney transplant recipients who were under follow-up care at a Transplant Unit of a major Medical Center, and a sample of 45 matching healthy peers. Measures were taken using self-report questionnaires [Body-Image Ideals Questionnaire (BIIQ), Body Identification Questionnaire (BIQ), Brief Symptoms Inventory (BSI), and the SF-12]. The major findings were the following: (i) kidney transplant recipients reported lower levels of quality of life and higher levels of PsD when compared to their healthy peers; (ii) no difference in body-image dissatisfaction was found between the two studied groups; (iii) significant correlations between body-image dissatisfaction quality of life and PsD were found only in the kidney transplant recipients. The kidney transplantation condition has a moderating effect in the association between body-image dissatisfaction PsD but not in the association between body-image dissatisfaction and quality of life; (iv) kidney transplant recipients experienced higher levels of body identification than did their healthy peers. Taken together, these findings highlight the unique condition of kidney transplant recipients, as well as the function that body-image plays within the self.     

Health-related quality of life in chronic fatigue syndrome: predictors of physical functioning and psychological distress

This study investigated health-related quality of life (HRQoL; physical functioning and psychological distress) in an Australian chronic fatigue syndrome (CFS) population. The aims of the study were to compare HRQoL in those with CFS to the normal population, and to investigate the extent to which sociodemographic (age, gender, partner status, education), illness-related (illness duration, symptom frequency), and fatigue severity (physical, mental) variables predicted HRQoL. A total of 139 people meeting CFS criteria completed questionnaires. HRQoL was assessed using standardised measures of distress and physical functioning. Compared with norms, those with CFS obtained significantly lower scores on all physical functioning areas, whereas 63% of participants reported clinically significant psychological distress. Hierarchical regression analyses indicated that physical fatigue severity and symptom frequency were the strongest predictors of deficits in physical domain HRQoL. Physical HRQoL outcomes were also predicted by mental fatigue severity, older age, and female gender. All predictors were unrelated to psychological distress apart from weak positive associations with physical fatigue and symptom frequency. Results identify a potent set of predictors of HRQoL and show that CFS has a pervasive negative impact on quality of life, particularly physical and psychological functioning.     

Relationships between stigma-identity constructs and psychological health outcomes among adults who stutter

PurposeIn the current study, stuttering was conceptualized as a concealable stigmatized identity (CSI). The purpose of this investigation was to determine if four specific stigma-identity constructs that contribute to variability in psychological distress among people in other CSI groups also contribute among adult who stutter (AWS).Method505 AWS completed an online survey that included measures of four stigma-identity constructs in addition to general demographics and measures of self-rated stuttering severity, distress, and adverse impact of stuttering on quality of life. Hierarchical regression was performed to determine the extent that stigma-identity constructs explained variability in psychological health outcomes among AWS. Self-rated stuttering severity was investigated as a moderator in these relationships.ResultsThe stigma-identity constructs accounted for a significant proportion of the variability in distress (∼25 %) and adverse impact of stuttering on quality of life (∼30 %) among AWS. Further, the constructs of salience, centrality, and concealment were positively predictive of distress and adverse impact of stuttering after controlling for demographics and neuroticism. Compared to the other predictor variables (self-rated stuttering severity, demographic characteristics, neuroticism, and the three other stigma-identity constructs), concealment was the strongest predictor of adverse impact of stuttering on quality of life. Finally, self-rated stuttering severity was a moderating variable.ConclusionsThe results from this study suggest that there are useful applications in conceptualizing stuttering as a type of CSI. Speech-language pathologists should be aware of the relationships that stigma has with psychological health outcomes among AWS and should consider the implications for intervention.     

Psychological assessment of quality of life following liver transplantation

Administered measures of functional status, psychological distress, and quality of life to a consecutive series of 48 liver transplant recipients in follow-up clinic. Results showed that nearly total functional recovery was the norm. Thirty-six patients (75%) had a Karnofsky Performance Status (KPS) score of 80–100. Twelve transplant recipients had KPS scores below 80; none were employed, and most had been transplanted within 1 year. In spite of their impaired financial status, eight of these 12 reported being mostly satisfied on the self-report Quality-of-Life Scale (QLS). For the posttransplant sample as a whole, 83% were mostly satisfied with their quality of life. Pre- and posttransplant patient samples were not significantly different in reporting mild emotional distress. Results for the small subgroup with significant objective or subjective problems in achieving acceptable quality of life following liver transplantation were reviewed. Higher than normal emotional distress on the Symptom Checklist (SCL-90-R) was consistently reported by these patients. Prospective studies are needed to identify predictor variables of quality-of-life problems and to develop prevention and rehabilitation interventions.     

Perceived self-other differences in life events and mental health among Mexicans and Americans

The social context of reported stressful life events was examined as a determinant of psychiatric symptoms in four cultural groups: Anglo-Americans (n = 132), Mexican-Americans (n = 108), Mexicans in El Paso (n = 90), and Mexican nationals (n = 133). The perceived difference between life events experienced by the self and spouse or by the self and significant others constituted preliminary operational definitions of the social context of life events. Ten Psychiatric Epidemiology Research Interview (PERI) psychiatric symptom scales as well as a suicidal tendency scale and a hopelessness index constituted the measures of the dependent variables. The potential predictive value of the social contextual measures of life-event stress for mental health variables was generally supported by the findings. Results indicated a rank ordering of predicted effects, with Mexican nationals most susceptible to the psychological effects of the social context of life events and Anglo-Americans least susceptible.     

Socioprofessional and psychological variables that predict job finding

The predictive power of socioprofessional and psychological variables on job finding was investigated with a cohort of 384 unemployed people in Luxembourg. The aim was to assess whether, in statistical profiling, some psychological variables have incremental validity over and above the more commonly used socioprofessional dimensions. For the period from 0 to 6 months and the period from 0 to 12 months, socioprofessional variables measured at the beginning of the unemployment period, allowed classification of three quarters of the subjects. Adding significant psychological dimensions did not improve the prediction in either case. Further analysis was done on persons still unemployed at 6 months (i.e. those who found it more difficult to find a job). For the period from 6 to 12 months, age and sex allowed correct classification of 62.6% of the subjects. Adding five psychological variables (openness, self-efficacy, social anxiety, symptom reduction coping, intelligence) significantly improves this percentage by 12.1 points. In the proposed model, psychological factors therefore only play a role in job finding for unemployed people who have more difficulty in finding a job. Results are discussed in terms of labour market mechanisms.     

Quality of Life in Heart Transplant Candidates

Research on quality of life with heart transplant patients is complicated by the physical and psychological variables associated with heart failure. This study examined quality of life with several instruments in order to sample more general and more idiosyncratic aspects of quality of life in this particular patient population. We also examined the relationship between various aspects of quality of life and several psychosocial variables, including sensitivity to social desirability effects. The quality of life measures used in this study were found to be significantly correlated with each other and with measures of psychological distress. Implications of these findings are discussed.     

Positive factors associated with quality of life among Chinese patients with renal carcinoma: a cross-sectional study

Quality of life and positive psychological variables has become a focus of concern in patients with renal carcinoma. However, the integrative effects of positive psychological variables on the illness have seldom been reported. The aims of this study were to evaluate the quality of life and the integrative effects of hope, resilience and optimism on the quality of life among Chinese renal carcinoma patients. A cross-sectional study was conducted at the First Hospital of China Medical University. 284 participants completed questionnaires consisting of demographic and clinical characteristics, EORTC QLQ-C30, Adult Hope Scale, Resilience Scale-14 and Life Orientation Scale-Revised from July 2013 to July 2014. Pearson’s correlation and hierarchical regression analyses were performed to explore the effects of related factors. Hope, resilience and optimism were significantly associated with quality of life. Hierarchical regression analyses indicated that hope, resilience and optimism as a whole accounted for 9.8, 24.4 and 21.9% of the variance in the global health status, functioning status and symptom status, respectively. The low level of quality of life for Chinese renal carcinoma patients should receive more attention from Chinese medical institutions. Psychological interventions to increase hope, resilience and optimism may be essential to enhancing the quality of life of Chinese cancer patients.     

Psychache and suicidality in adult mood disordered outpatients in Brazil

Shneidman (e.g., 1998) has theorized that psychache--general psychological and emotional pain that reaches intolerable intensity--is an important suicide-related variable, and indeed, represents a source of suicidal behavior. This conceptualization, while prominent and clinically and intuitively appealing, has received relatively little empirical scrutiny. In this study, we determined whether an index closely related to psychache, psychological quality of life, would display a special and resilient association to suicidality among 60 adult psychiatric outpatients in Brazil. All patients underwent structured clinical interviews and completed various clinical and quality-of-life measures. We found that the association between psychological quality of life and suicidality remained, even when depression, hopelessness, and other domains of quality of life were controlled. Psychache appears to deserve its place among key suicide-related variables, and deserves the attention of clinicians working with suicidal people.     

Extending Psychometric Norms for Pre-Cardiac Transplantation Evaluations: The Florida Cohort, 1990–1996

Multidisciplinary pre-cardiac transplantation evaluations determine an individual's ability to benefit from potential transplantation. Psychologists are routinely consulted to perform psychological evaluations and testing to examine the candidate's current functioning and to forecast future functioning in the event of transplantation. The establishment of appropriate norms for psychological tests is an ethical imperative to provide high quality psychological consultations that maximize the utility of information gathered. The purpose of this paper is to present pre-cardiac transplant norms for a battery of psychological tests in a large population of consecutive transplant candidates. Together with other recently published norms on alternative test batteries, these norms allow the transplant psychologist to select from a range of psychological tests that span multiple domains of critical importance including the affective, behavioral, coping, cognitive, and health related quality of life domains. These norms appear to set a standard of practice for the use of psychological tests by a consulting transplantation psychologist.     

The Relationship Between Religion, Spirituality, Psychological Adjustment, and Quality of Life Among People with Multiple Sclerosis

The present research was comprised of two studies that aimed to explore the role of religious and spiritual variables in the psychological adjustment and quality of life of people with Multiple Sclerosis (MS). In study 1, religious behavior and objective levels of spirituality and religiosity were not significantly related to psychological adjustment or quality of life among people with MS. Positive religious coping was negatively related to psychological adjustment and quality of life. In study 2, Intrinsic religious orientation and Quest religious orientation were related to poor psychological adjustment. Implications of the present research for people with MS and other chronic illnesses are discussed.     

Patterns of coping in rheumatoid arthritis

Abstract

One hundred and fifty eight outpatients were assessed on a 36 item coping questionnaire in order to examine the impact of coping on the disability and psychological well being of individuals with rheumatoid arthritis. To consider the total pattern of coping strategies accepted and rejected by these individuals, the data was subjected to a cluster analysis. Hierarchical clustering techniques suggested the four group solution as optimum. Following a k means iterative solution external validity for the four groups was considered. The main findings indicate that the pattern of coping exerts a significant influence on symptom perception, disability and psychological well being. The findings are discussed in relation to two approaches to the impact of coping on chronic illness.     

The association between self-consciousness about appearance and psychological adjustment among newly diagnosed breast cancer patients and survivors: the moderating role of appearance investment

This study examined the moderating role of two facets of appearance investment (self-evaluative salience (SES) and motivational salience (MS)) in the relationship between self-consciousness about appearance and psychological adjustment (depression, anxiety and psychological quality of life (QoL)) in a sample of 134 breast cancer patients (68 newly diagnosed patients and 66 survivors). No significant differences were found between groups on body image variables. Among survivors, the associations between self-consciousness about appearance and the outcome variables were only significant at high (depression, psychological QoL) levels and at moderate (psychological QoL) levels of SES. Self-consciousness about appearance contributed to poor adjustment in both groups. This study demonstrates that appearance investment plays a key role in patients' adjustment and highlights the SES-MS distinction. SES seems to be a vulnerability factor for poor adjustment, and MS seems to be a protective factor that helps women cope with changes in appearance.     

Quality of Life and Mental Health Comparisons Among Liver Transplant Recipients and Cirrhotic Patients with Different Self-Perceptions of Health

Our aim was to analyze the differences in quality of life and mental health among liver transplant recipients with better (G₁) and worse (G₂) perceived health and decompensated cirrhotic patients (G₃). We selected two groups of patients: 168 liver transplant recipients and 75 cirrhotic patients. The Hospital Anxiety and Depression Scale and SF-36 Health Survey were used. Statistically significant differences showed that cirrhotic patients (G₃) suffered the highest impairment, and liver transplant recipients with better self-perceived health (G₁) had the lowest impairment, whereas patients with worse self-perceived health (G₂) were in an intermediate position between both groups. Moreover, very striking differences, based on large effect sizes, were found among groups on some quality of life dimensions: physical-role, general health, vitality, and physical functioning. In conclusion, the biopsychosocial well-being of liver transplant recipients is better than that of cirrhotic patients, even if the former do not perceive their health positively.     

心理干预在化疗患者中的应用

本研究针对化疗患者常见的恶心呕吐、烦躁不安等副作用．运用心理行为技术．采用病例对照研究方法,对129名化疗患者进行了比较研究。结果为：各项情绪指标和总的情绪状况以及恶心呕吐反应。干预组患者比对照组改善明显;生活质量各指标在组问和组内比较中,有不同程度的改善,角色、社会、认知功能和疼痛症状在两组比较中改善不明显。由此认为,对化疗患者实施恰当的心理行为技术．干预效果是明显的     

Effects of short-term psychological stress on the time and frequency domains of heart-rate variability

The purpose of this study was to test the hypothesis that short-term psychological stress produces significant changes in sympathovagal activity. A simple, noninvasive method was used measuring the timing and frequency of heart-rate variability (HRV). 30 normal healthy subjects were assigned into two age- and sex matched groups. In the experimental condition a 5-min. psychological stress test, predominantly based on the Stroop Word Color Conflict Test, was employed in a competitive setting and included a financial inducement to produce psychological strain. Analysis showed that during psychological stress a significant reduction in the timing and frequency of heart rate variability was observed. The standard deviation of interbeat intervals decreased. A significant increase in heart rate was also observed. Within the frequency domain, a significant reduction in the high frequency component of HRV and a significant increase in the low frequency component were observed. There was also a significant increase in the low frequency to high frequency ratio. Self-evaluation of physical tension and emotional state measured by visual analog scales also showed significant increases following psychological stress. No significant differences were observed on any variables within the control group. The results indicate a shift towards sympathetic predominance as a result of parasympathetic withdrawal and demonstrates that this psychological stress test is effective in provoking a characteristic defence-arousal reaction. This simple, cost-effective method of analysing heart rate variability is suitable for detection of short-term changes in sympathovagal balance.     

Optimism, self-mastery, and symptoms of depression in women professionals

The construct validity and predictive utility of dispositional optimism were examined in a sample of 192 women professionals. By using covariance structure modeling with latent variables, opotimism (Scheier & Carver, 1985) and self-mastery (Pearlin & Schooler, 1978) were found to be empirically distinct, although substantially correlated, constructs. Furthermore, although optimism and self-mastery were significant and negatively correlated with symptoms of depression, only self-mastery was independently associated with symptom levels. In addition, no evidence was found that optimism and self-mastery interact to influence depressive symptoms. These results suggest that the apparent predictive power of optimism may derive from its substantial overlap with self-mastery. Implications for the assessment and interpretation of optimism and self-mastery are discussed.     

Personality,life events and the course of anxiety and depression

Using data from the Netherlands Study of Depression and Anxiety, we examined among 1322 participants with a DSM‐IV diagnosis of depression or anxiety: (i) whether positive and negative life events influence 1‐year course of anxiety and depressive symptoms; (ii) whether personality traits (neuroticism and extraversion) predict symptom course and moderate the impact of life events on symptom course; and (iii) whether life events mediate relationships of neuroticism and extraversion with symptom course. Negative life events were predictive of both anxiety and depressive symptoms, while positive life events predicted the course of depressive symptoms only. Personality traits had significant predictive and moderating effects on symptom course, though these effects were rather small. Copyright © 2011 John Wiley & Sons, Ltd.