The self-serving function of hypochondriacal complaints: physical symptoms as self-handicapping strategies

The present experiment tested the hypothesis that hypochondriacal individuals commonly use reports of physical illness and symptoms as a strategy to control attributions made about their performances in evaluative settings (i.e., self-handicapping strategies). Specifically, it was predicted that hypochondriacal individuals would report more recent physical illness and complaints and more current physical symptoms in an evaluative setting in which poor health could serve as an alternative explanation for poor performance than would either individuals in an evaluative setting in which poor health was precluded as an excuse or individuals in a nonevaluative setting. As predicted, results supported this self-protective pattern of complaints in a hypochondriacal sample but not in a nonhypochondriacal group. The self-protective role of hypochondriacal behavior is discussed in relation to other theory and research on the nature and treatment of hypochondriasis.     

Physical illness and symptoms of depression among elderly outpatients.

Elderly outpatients were assessed to clarify relations between symptoms of depression and physical illness, disability, pain, and selected psychosocial variables. Three types of assessments were made: (a) medical evaluations by physicians, (b) self-reported symptoms of depression and physical health, and (c) demographic and psychosocial data relating to participants' life circumstances. Both objective (physician-rated illness symptoms) and subjective (self-reported health, activity restriction, and use of pain medications) indicators of health accounted for independent variance in symptoms of depression. After controlling for these factors, additional variance was explained by health-related concerns (e.g., health care expenses, service needs), social support, and "other worries" (e.g., feeling useless, becoming a burden to others).     

A critical review of the literature on academic self-handicapping: theory,manifestations, prevention and measurement

Academic self-handicapping is a very popular subject of research in educational psychology, in which a growing number of related findings are reported. However, apart from a recent meta-analysis (Schwinger et al. in J Educ Psychol 106(3):744–761, 2014), the last comprehensive review of the subject was published 17 years ago (Urdan and Midgley in Educ Psychol Rev 13(2):115–138, 2001). This paper integrates relevant findings accumulated since then, which are discussed in a coherent interpretive framework. The first part of the paper discusses the definition and theoretical grounds of academic self-handicapping, then its manifestations in an academic context are enumerated. The second part of the study focuses on the self-protective function of stereotypes based on self-handicapping as well as on the impressions self-handicapping students may make on others at school. A summary of the contributions of goal orientation theory is provided in relation to self-handicapping, and the effects of various goal orientations and goal structures on academic performance are analysed. Based on an analysis of interactions between self-handicapping and academic performance, the authors argue for the importance of prevention and suggest possible ways to prevent self-handicapping. In conclusion, measurement issues of academic self-handicapping and the methodological paradox inherent in questionnaire measures are discussed.     

Self-reported versus behavioral self-handicapping: empirical evidence for a theoretical distinction.

The present study was an investigation of how Ss would respond when given 2 self-handicapping options, 1 behavioral (withdrawal of practice effort) and 1 self-reported (reporting high levels of stress). Ss anticipating a diagnostic test of intellectual ability were given different instructions regarding the effects of stress and practice on test performance. Ss were told that (a) stress only, (b) practice only, (c) both stress and practice, or (d) neither stress nor practice affected test scores. Ss were then given the opportunity to self-report a handicap on a stress inventory and to behaviorally self-handicap by failing to practice before the test. High self-handicapping men and women showed evidence of self-reported handicapping, but only high self-handicapping men behaviorally self-handicapped. However, when both self-handicaps were viable, both high self-handicapping men and women preferred the self-reported over the behavioral self-handicap.     

The role of uncertain self-esteem in self-handicapping

In this article, the hypothesis that some individuals confronted with an intellectual evaluation use a lack of preparation as a "self-handicapping" strategy (Jones & Berglas, 1978) was studied. Sex and both level and certainty of self-esteem were examined in regard to the self-handicapping strategy of lack of effort. Subjects were 54 men and 54 women, certain and uncertain, high and low self-esteem college students, who believed that the experiment was designed to update local norms for a nonverbal test of intellectual ability. After subjects' level of state anxiety was assessed, they were instructed in the benefits of practicing for the evaluation. Subsequently, subjects' state anxiety and preparatory efforts (the primary dependent variables) were measured. Subjects' practice, self-protective attributions, and related affect supported a self-handicapping interpretation for uncertain males but not for uncertain females.     

Imagery and psychotic symptoms: a preliminary investigation

Recent cognitive accounts of psychotic symptoms have suggested that processes involved in the maintenance of emotional disorders may also be implicated in the maintenance of hallucinations and delusions, and particularly emphasise the appraisals of such symptoms as important. Imaginal appraisals have been identified in emotional disorders, and many studies have reported spontaneously occurring images in patients with anxiety disorders. Such images appear to be linked to affect, beliefs and memories. This study examined the occurrence of imagery, using a semi-structured interview, in 35 patients who were experiencing hallucinations and/or delusions and receiving cognitive therapy. The majority of patients (74.3%) reported images, and most of these were recurrent and associated with affect, beliefs and memories. Common themes included images about feared catastrophes associated with paranoia, traumatic memories, and images about the perceived source or content of voices. The theoretical and clinical implications of these findings are discussed and directions for further research considered.     

Effects of a weight maintenance diet on bulimic symptoms in adolescent girls: an experimental test of the dietary restraint theory.

It is widely accepted that dieting increases the risk for bulimia nervosa, but there have been few experimental tests of this theory. The authors conducted a randomized experiment with adolescent girls (N=188) to examine the effects of a weight maintenance diet on bulimic symptoms. A manipulation check verified that the diet intervention resulted in weight maintenance and significantly reduced the risk for obesity onset and weight gain observed in assessment-only controls. As hypothesized, the diet intervention resulted in significantly greater decreases in bulimic symptoms and negative affect than observed in controls. These experimental findings, which converge with those from a weight loss diet experiment, appear antithetical to dietary restraint theory and suggest instead that dietary restriction curbs bulimic symptoms.     

The incremental validity of passive-aggressive personality symptoms rivals or exceeds that of other personality symptoms in suicidal outpatients

We examined the incremental validity of passive-aggressive and other personality symptoms, by determining personality syndromes' ability to account for unique variance in distress and impairment as indexed by several Axis I-related symptoms. Two hundred fifty young adults, referred for suicidal behavior or ideation, completed the Millon Clinical Multiaxial Inventory (Millon, 1983) as well as several other symptom measures. The personality syndromes varied considerably in their ability to account for unique variance in Axis I-related symptoms. Several syndromes, including schizoid, schizotypal, and compulsive symptoms, showed relatively low incremental validity, whereas the incremental validity of passive-aggressive symptoms exceeded all others. The criterion of incremental validity represents an inclusive and persuasive means to evaluate personality disorder validity. On this criterion, passive-aggressive symptoms display high validity, and passive-aggressive personality disorder, in some form, may deserve inclusion on Axis II of future editions of Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association).     

Panic symptoms in asthma and panic disorder: a preliminary test of the dyspnea-fear theory.

Ley's (Behaviour Research and Therapy, 27, 549-554, 1989) dyspnea-fear theory was tested on three groups of subjects: 10 with panic disorder, 24 with asthma, and 12 who were nonanxious and nonasthmatic, using measures of pulmonary function, muscle tension; and self-report measures of generalized anxiety, dyspnea, and psychopathology. Results are supportive of dyspnea-fear theory for asthmatics but not for individuals with panic disorder. Differences between groups on panic/fear measures were explained by a combination of general anxiety and dyspnea. Within-group regression analyses showed that only generalized anxiety symptoms contributed significantly to scores on the Asthma Symptom Checklist scale of panic/fear within the panic disorder group; while only dyspnea contributed to panic/fear among asthmatics. Additional results show that panic disorder subjects performed normally on pulmonary function tests but reported respiratory symptoms as severe as did asthmatics. Compared with normal subjects, both patient groups displayed lower correlations between self-rated symptoms of bronchoconstriction and objective pulmonary measures. Panic disorder subjects showed a negative relationship between pulmonary function and hyperventilation symptoms, suggesting a heightened sensitivity to, and discomfort with, sensations associated with normal pulmonary function. Asthmatics displayed a significant relationship between degree of airway obstruction and both trapezius surface EMG and ratings of hyperventilation symptoms.     

Depressive symptoms in outpatients with heart failure: Importance of inflammatory biomarkers,disease severity and personality

Objective: Depressive symptoms are highly prevalent in heart failure (HF) patients, however the underlying etiology of depression in HF patients remains yet unclear. Hence, the goal is to examine the relative importance of inflammation, disease severity and personality as predictors of depression in HF patients. Design: Depressive symptoms (Hospital Anxiety and Depression Scale, depression subscale) were assessed at baseline and one-year follow-up in 268 HF patients (75.6% men; mean age?=?66.7?±?8.7). Markers of inflammation (TNFα, sTNFr1, sTNFr2, IL-6 and IL-10), disease severity (e.g. New York Heart Association (NYHA) classification) and personality (Type D personality, loneliness) were assessed at baseline. Results: At baseline, NYHA class, body mass index, educational level, Type D personality and loneliness were significantly associated with depression. Higher NYHA class (B?=?2.25; SE?=?.83), higher educational level (B?=?1.41; SE?=?.48), Type D personality (B?=?2.56; SE?=?.60) and loneliness (B?=?.19; SE?=?.05) were also independently associated with higher depression levels at one-year follow-up (all p-values?<?.005). Inflammation, brain natriuretic peptide and left ventricular ejection fraction were not related to depression over time. Conclusions: Personality factors, but not inflammation, were independent concomitants of depressive symptoms in patients with HF. Gaining more insight into the etiology of depression in HF patients is important in order to identify potential targets for novel interventions.     

From theory to application and back again: implications of research on medical expertise for psychological theory.

Research directed at an understanding of medical expertise is about 30 years old, and many developments in this literature parallel progress in cognitive psychology. Over the past 15 years or so, this research became much more closely identified with particular psychological theories. Initial forays into medicine were essentially direct applications of methods developed in the psychology lab to the more natural domain of medicine, with varying degrees of success. These attempts were followed by a second wave that took the psychological theories themselves more seriously in a more thoughtful application of psychological methods to the medical domain. I will argue in the present paper that the methods and theories used in the study of medical expertise have advanced to the point that there is some reverse flow and they are providing a unique and valuable perspective on the nature of thinking.     

Symmetry, repetition, and figural goodness: an investigation of the weight of evidence theory

Considerable evidence has accumulated on the superiority of symmetry over repetition in the study of figural goodness. The Weight of Evidence theory of figural goodness (WoE) provides a mathematically rigorous, elegant, and testable account of how factors like symmetry and repetition affect figural goodness. In this study we investigate implications of the WoE approach. More specifically, we examine (1) embedded patterns versus simple elements, (2) the number of elements in a pattern, and (3) long-range dependencies within a pattern. Data from two experiments illustrate cases in which figures made of simple repetitions have higher figural goodness than some kinds of symmetrical patterns; thus, the generality of the symmetry over repetition phenomenon is questioned. We discuss our results with respect to WoE and suggest ways to further develop the theory.     

Identity status of black adolescents: an empirical investigation.

The purpose of this study was to assess the identity status of a group of 237 black adolescents. The major finding--that the majority of these adolescents were engaged in the identity-searching process rather than experiencing identity foreclosure--differed from previous research on the black adolescent identity process.     

Beck Depression Inventory-II items associated with self-reported symptoms of ADHD in adult psychiatric outpatients

The Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) and the Conners' Adult ADHD Rating Scale-Self-Report: Screening Version (CAARS-S:SV; Conners, Erhardt, & Sparrow, 1999) were administered to 371 (64%) female and 204 (36%) male adult (> 18 years old) outpatients who were diagnosed with various psychiatric disorders to determine whether any of the 21 items or subsets of items in the BDI-II were related to symptoms of attention deficits and hyperactivity as measured by the CAARS-S:SV DSM-IV Total ADHD Symptoms scale (attention-deficit/hyperactivity disorder [ADHD] Symptoms). Stepwise multiple-regression analyses found that the BDI-II Concentration Difficulty explained 30% of the variance in these total scores. Ratings > 1 for the BDI-II Concentration Difficulty item were discussed as being useful for ruling out possible symptoms of ADHD.