Psychological functioning after severe closed head injury

The residual effects of severe closed head injury on psychological functioning, as determined by data from the Rorschach test, were examined. Thirty-five young adult patients with severe closed head injury were compared to a nonpatient, non-head injured matched group sample of 36 subjects. The utility of the Rorschach test in distinguishing the characteristic psychological functioning of inpatients who have suffered from severe closed head injury was outlined. The apperceptive disturbance, affective/cognitive problems, and interpersonal difficulties were discussed.     

Stress processes in HIV-positive African American mothers: moderating effects of drug abuse history

This study examined the mechanism by which stressors, dissatisfaction with family, perceived control, social support, and coping were related to psychological distress in a sample of HIV-positive African American mothers. Additional analyses explored whether women who had a history of a drug abuse or dependence diagnosis differed either on levels of the study variables or the model pathways. The results indicated that HIV-positive African American mothers who had higher levels of stressors perceived their stressors as a whole to be less controllable. Coping resources, available social support and perceived control, were positively associated with active coping and negatively associated with psychological distress. Avoidant coping was the most important predictor of psychological distress. Furthermore, the effect of avoidant coping on psychological distress was stronger for mothers with a history of drug diagnosis. The implications of these findings for targeting interventions are discussed.     

癌症病人心理干预的效果及其影响因素

研究的主要目的是探讨对癌症病人实施心理干预的效果及其影响因素。运用病例对照实验设计 ,采用多因素综合分析统计方法 ,对 2 89名放化疗住院病人进行了比较研究。结果为 :干预组病人的生活质量、躯体功能状况比对照组有明显改善。肿瘤临床分期和诊断告知方式是影响干预效果的两个主要因素 ;合并症及其影响、治疗前有无心理准备、病前生活事件在化疗病人中影响明显 ;医疗费、教育水平以及治疗经历对放疗病人影响明显 ;因素间交互作用显著。由此认为 ,影响心理干预效果的因素随治疗方式不同而各有侧重 ,并以综合作用模式为主     

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     

Inner-City Children Living with an HIV-Seropositive Mother: Parent–Child Relationships, Perception of Social Support, and Psychological Disturbance

Despite ongoing concern about the well-being of HIV-seronegative children living in urban poverty with a seropositive mother, very little is known about this expanding population of children. In this cross-sectional study, the psychosocial adjustment of 60 ethnic minority children 11 to 16 years of age who were living with an HIV-seropositive mother was compared with that of 108 children attending public school in the same community. Results of three multivariate analyses of covariance indicated that, after allowance for differences associated with age, gender, ethnicity, and family structure, the HIV-affected group confirmed (a) greater disturbance in the parent–child relationship, (b) less social support, and (c) greater disturbance in psychological functioning. Secondary analysis of the multivariate findings indicated that the differences were characterized primarily by (a) perception of more indifference and hostility in the mother–child relationship, (b) perception of less social support available from parents, friends, and teachers, and (c) less self-esteem. The findings suggest that HIV infection and concurrent problems may compromise parent–child relationships and perception of social support in ways that leave older, seronegative children living with an infected mother at risk for psychological disturbance.     

Incidence of infantile cerebral lesions in children with behavioral disorders]

The delimitation of behavioural disturbances predominantly due to organic brain lesions from those caused by reactions due to environmental factors has practical importance for drug therapy and pedagogic guidance. Figures on the incidence of infantile brain lesions among children with behavioural disorders range from between 20 to 90%. However, comparison of the results is difficult, because different authors followed different aspects for the evaluation of their material. The authors have collected data from 497 children from the 3 to 15 year-old age group who suffer from behavioural disturbances: history, neurological and psychological findings, electroencephalogram, native x-ray picture of the skull, pneumo-encephalogram and echoencephalogram were reviewed for signs and findings suggesting infantile brain damage. Certain signs of intantile brain lesion were found in 28.6% of the children. Among the apparative diagnostic procedures without impairment to the patients, the electroencephalogram proved particularly suited for the support of the diagnosis. The most accurate data on the localization and extent of the lesion are provided by the pneumo-encephalogram. However, its performance is not possible or justified in each child.     

Use of verbal pain measurement in the detection of hidden psychological morbidity among low back pain patients with objective organic findings

Abstract

Patients with positive physical findings to explain low back pain arc believed lo belong to two organic subgroups. One group has organic disease alone: in the other, organic disease is accompanied by psychological disturbance. Separation of patients with medical findings into groups with varying levels of psychological disturbance is difficult, because emotional disturbance is often hidden. In this study, the pain report of 124 patients with organic findings alone, and 50 patients with organic and psychological findings was examined to determine whether pain measurement could he used to identify accurately patients belonging 10 the two groups. the pain groups differed in the use of 43 pain words from the Low Back Pain Symptom Check List. Using a set of weights derived From discriminant analysis. the 33 pain words predicted 99.2% of the patients with organic disease alone and 86.0% of the patients with organic disease and psychological disturbance. The results were replicated in a new sample of 140 patients. Cross-validation shrinkage in accuracy was 8.3%. The results of the two studies suggest that pain measurement may he a useful clinical indicator of psychological disturbance in patients with organic findings.     

A pilot study of the effects of expressive writing on psychological and behavioral adjustment in patients enrolled in a Phase II trial of vaccine therapy for metastatic renal cell carcinoma.

Forty-two patients with metastatic renal cell carcinoma who were participating in a Phase II clinical trial were randomly assigned to an expressive writing (EW) or neutral writing (NW) group. Patients in the EW group wrote about their cancer, and patients in the NW group wrote about health behaviors. No statistically significant group differences were found in symptoms of distress, perceived stress, or mood disturbance, except for the Vigor subscale of the Profile of Mood States. However, patients in the EW group reported significantly less sleep disturbance, better sleep quality and sleep duration, and less daytime dysfunction compared with patients in the NW group. The results suggest that EW may have sleep-related health benefits in terminally ill cancer patients.     

Suicide in rural communities

The public image of rural areas being characterized by social stability, integration, and supportive interpersonal networks has been challenged with recent evidence showing a large increase in the suicide rate in these areas. Increases have been reported for a number of European countries, including Sweden, Denmark, Scotland, and Ireland. This paper reviews the evidence relating to those groups at risk of suicide. The group at most risk of committing suicide in rural areas is males between the ages of 25 and 60, who are unemployed and live alone, and who have a history of psychological disturbance. These findings are discussed in relation to the psychological implications of socio-economic changes brought about by changes in the Common Agriculture Policy of the European Community.     

On historical consciousness: A pilot investigation

Philosophers of history posit a class of concepts known as colligatory concepts that contribute to historical consciousness and that refer specifically to historical events. Although analysis has identified colligatory concepts in historical discourse, these concepts have not yet been investigated empirically. We present a new methodology for studying these concepts and historical consciousness more broadly, as well as pilot data supporting the methodology. Our aim in the pilot study was to establish whether colligatory concepts are processed differently from control concepts when subjects are asked to judge historical statements. We compared judgments of colligatory concepts in healthy participants and in a patient group with impaired working memory cognitive processing capacity. Forty healthy, college-educated participants and 25 patients with Parkinson's disease were asked to rate narrative sentences containing historical content and an equal number of identically constructed narrative sentences of equal length but devoid of historical content. All participants rated their pre-test interest in history as relatively low (mean 5 out of 7). Though no group differences emerged, historical sentences were judged by both groups (total N = 65) to be significantly different from non-historical sentences across dimensions of interestingness, meaningfulness, likeability, complexity, thought provoking-ness, and truth content. Interestingly, historical sentences were judged to be truer than control sentences even though participants were not interested in and presumably knew little about history. The neurocognitive system appears to process sentences with historical content separately from sentences without historical content. The methodology described here appears to be a valid approach for study of processing of historical content of sentences.     

Childhood trauma and parental bonding among Japanese female patients with borderline personality disorder

The present study explored the relationship between borderline personality disorder (BPD) and childhood trauma and perceived parental behaviours among a sample of Japanese female outpatients. Participants were 45 female patients who were diagnosed with BPD and 45 female patients with a diagnosis of other nonorganic psychological disorders (aged 19 to 53). The participants completed surveys that assessed recollection of childhood abuse and neglect, perceived parental-rearing behaviours, and symptoms of BPD. MANOVAs and logistic regression analyses were conducted in order to analyse the data. The results showed that the patients with BPD reported more severe forms of childhood traumas, including emotional, physical, and sexual abuse and emotional and physical neglect, than did the non-BPD patients. This is consistent with previous findings in North America that have reported higher prevalence and greater severity of various childhood traumas in individuals with BPD compared with those with non-BPD disorders or nonclinical samples. This study also found that the patients with BPD recalled both of their parents as more overprotective/controlling and less caring than did the non-BPD patients. Last, logistic regression analyses found significant predictors of BPD diagnosis were reported emotional abuse and neglect as well as perceived paternal overprotection. Overall, these results indicate that whereas psychological risk factors in Japan are similar to those reported elsewhere, the same pathology can emerge from somewhat different causal pathways.     

Psychosocial characteristics of pregnant and nulliparous adolescents

A case control study was carried out with 19 pregnant and 20 nulliparous fifteen- and sixteen-year-old black teenage women patients at an adolescent clinic. Both groups were measured on twenty-one variables, which included personal and family history information as well as scores on twelve scales of adolescent psychosocial adjustment. A stepwise discriminant analysis was carried out comparing both groups. The first analysis using only psychosocial adjustment variables did not significantly discriminate between the two groups. The second analysis used family history and psychosocial adjustment variables and had a multiple correlation of .65, with p = .008. The discriminant function generated was able to correctly classify 89.5% of the pregnant group and 80% of the nulliparous group. The pregnant group had lower maternal educational level, later sex education, more brothers, better family adjustment, but poorer vocational adjustment. The study suggests that distinct characteristics do exist for the pregnant adolescent in the population studied, but that such characteristics do not indicate family or psychological disturbance in pregnant adolescents. Further, the importance of the meaning of adolescent pregnancy within different cultural and socioeconomic contexts is discussed.     

Retrospective Denial as A Coping Method

Worldwide, gastric cancer is one of the most common and fatal cancers. The majority of patients present with an advanced stage of disease. Even with use of palliative chemotherapy most patients die within 1?year after diagnosis. Medical psychological attention after a diagnosis of incurable cancer is focused on end of life support. This paper presents the care of a patient treated with palliative intent with chemotherapy for an irresectable histologically confirmed gastric cancer. When, unexpectedly prolonged symptom free survival followed, the reaction of the patient came as a surprise to the attending medical team. In this case history we urge those who care for incurable cancer patients, that the rare patient who survives against all odds may require special psychological care.     

Discriminating Clinical From Nonclinical Manifestations of Test Anxiety: A Validation Study

Test anxiety, although being a very common, severe, and impairing psychological disorder, is not coded as a separate diagnosis in the DSM or ICD. In the present study we investigated whether the Test Anxiety Inventory can be used to discriminate clinical and subclinical levels of test anxiety by comparing patients who seek treatment for their test anxiety in an outpatient clinic with carefully matched students with normal test anxiety. The data from 47 test-anxious patients as well as 41 healthy university students were examined. Results show that a cutoff score of ≥ 80 in the Test Anxiety Inventory can discriminate the clinical group from the control students. The symptom pattern of test anxiety was very consistent in the clinical group regardless of the principal diagnosis allocated by the treating clinician. Comorbid depression did not affect the severity of test anxiety. The motivation to avoid failure was one of the most important differences between patients who sought help for their test anxiety and students with nonclinical levels of test anxiety.     

Parental Inconsistency: A Third Cross-Cultural Research on Parenting and Psychological Adjustment of Children

Inconsistency in parenting is a factor that may influence children’s mental health. A questionnaire, measuring three parental inconsistencies (temporal, situational, and father-mother inconsistency) was administered to adolescents in nine countries to assess its association with adolescents’ psychological disorders. The results show that parental inconsistency varies across cultures. Temporal inconsistency is not correlated with the other two inconsistencies. Temporal and father–mother inconsistencies, but not the situational inconsistency, were associated with adolescents’ psychological disorders. The associations between parental inconsistency and psychological disorders differed across cultures.     

The cultural narratives of Francophone and Anglophone Quebecers: using a historical perspective to explore the relationships among collective relative deprivation, in-group entitativity, and collective esteem

Responding to calls to contextualize social psychological variables in history, the present research examines the relationship between collective relative deprivation and collective esteem using a historical perspective. We hypothesized that collective relative deprivation perceived to be experienced during an important low-point in a group's history serves to define the group's current collective identity, which is in turn associated with collective esteem. In Study 1, cultural narrative interviews were conducted with Francophone and Anglophone Quebecers in order to identify key historical chapters for these groups and to examine the extent to which historical low-points were identity-defining features of their narratives. In Study 2, using the information obtained from these narratives, collective relative deprivation was explored across group members' perceived histories and related to current in-group entitativity and collective esteem. The relationship between collective relative deprivation thought to be experienced by one's group during a historical low-point and collective esteem was positive for both Anglophone and Francophone Quebecers and was mediated by in-group entitativity. Collective relative deprivation perceived to be experienced during a historical low-point serves to define one's collective identity, which is in turn associated with greater collective esteem.     

Psychological and Socio-cultural Adjustment during Cross-cultural Transitions: A Comparison of Secondary Students Overseas and at Home

The study further explores the distinction of psychological and socio-cultural adjustment during cross-cultural transitions. One hundred and seventy-eight New Zealand American Field Service (AFS) students residing in 23 different countries completed questionnaires which contained assessments of the following: Personality (extraversion and locus of control); life changes (Social Readjustment Rating Questionnaire); homesickness, cultural distance, acculturation (cultural identity and cultural integration—separation); attitudes toward host country; language ability; amount of contact with host and co-nationals; relationship satisfaction with co-nationals, host nationals and host family; and outcome measures of socio-cultural (social difficulty) and psychological adjustment (Profile of Mood States). Stepwise regressions revealed that homesickness, external locus of control, life changes, and social difficulty accounted for 55% of the variance in psychological adjustment. In contrast, cultural distance, language ability, satisfaction with host national contact, cultural separation and mood disturbance explained 52% of the variance in socio-cultural adaptation. In the second part of the research, psychological and socio-cultural adjustment of AFS students was compared with a sample of 142 home-based New Zealand secondary school students. Although there were no significant differences in psychological adjustment between the two groups, the students who were resident abroad experienced greater socio-cultural difficulties than the students resident in New Zealand (P < 0.0005), and, as hypothesized, the correlation between psychological and socio-cultural adjustment was significantly greater in the home-based students compared to the AFS group (P < 0.0001).     

Combined pharmacological and behavioural treatment of depression

Sixty-four depressed subjects received one of three psychological therapies (task assignment, relaxation training, minimal contact) in combination with either amitriptyline or placebo medication for a 2-month period. Depression and anxiety were assessed prior to treatment, at midtreatment, immediately following treatment, and during a 6-month follow-up period. Sleep disturbance, phobic symptoms and receipt of reinforcement were assessed less frequently. Marked improvement was observed on most measures during treatment independently of the type of treatment received. Treatment effects were maintained at the follow-up assessment. More rapid improvement was found for subjects who received amitriptyline as compared with placebo medication. No other advantages were found for the use of amitriptyline in combination with psychological treatments. Subjects who received either task assignment or relaxation training sought less additional treatment during the follow-up period than those who received minimal contact.     

Psychological effects of running loss on consistent runners

This study examined the psychological effects of running loss upon consistent runners. We compared a group of 30 "Prevented Runners" who were unable to run for at least two weeks with a group of 30 "Continuing Runners" who ran without interruption on the Profile of Mood States (POMS), Rosenberg Self-esteem Scale, Zung Depression Scale, and a Running Information questionnaire. We found that Prevented Runners displayed significantly greater symptoms of psychological distress, including depression, anxiety, confusion, over-all mood disturbance, and lower self-esteem than did Continuing Runners. Deprivation of running may result in withdrawal symptoms of psychological distress for consistent runners who rely on running as a coping strategy for stress reduction and who feel dependent upon the psychological reinforcements of running.