Type D personality predicts poor medication adherence in myocardial infarction patients

Type D personality, the combination of negative affectivity (NA) and social inhibition (SI), is an emerging risk factor in cardiovascular disease. This study aimed to examine one possible behavioural mechanism to explain the link between Type D and ill-health. It was hypothesised that Type D personality would predict medication adherence in myocardial infarction (MI) patients. In a prospective study, 192 MI patients (54 females and 138 males) completed measures of Type D personality and provided demographic and medical information 1 week post-MI, and then 131 patients went on to complete a self-report measure of medication adherence 3 months post-MI. It was found that Type D personality predicts adherence to medication, after controlling for demographic and clinical risk factors. Critically, the constituent components of Type D, NA and SI, interact to predict medication adherence, after controlling for the effects of each component separately. Poor adherence to medication may represent one mechanism to explain why Type D cardiac patients experience poor clinical outcome, in comparison to non-Type D patients. Interventions, which target the self-management of medication, may be useful in these high-risk patients.     

Homelessness and the problem of containment

Homelessness is a problem that is hardly spared to any society in our modern world. Usually discussed by people concerned with social policy, sociology, public health and politics, homelessness has only quite recently begun to command the attention of professionals concerned with psychological and psychotherapeutic processes. Following from the author's experience of working therapeutically with homeless people, as well as in discussions with homeless services, the paper follows a line of thinking around homelessness that is explicitly psychodynamic in orientation. The central argument here is that homelessness is an experience that is, so to speak, waiting to happen. Homelessness is portrayed as a natural extension of an underlying experience of the sister states of uncontainment and alienation. I argue that the homeless person not only experienced a lack of containment in his earliest interactions, but has grown through life with significant difficulties in this area. Homelessness then is an extreme response to a deeper psychological reality that projects into a part of the person's life the agonies associated with uncontainment. Homelessness is the realization of an internal situation –a shifting of a personal struggle into a new and more visible stage. This view of homelessness is designed to provide an amendment to current views that privilege the roles of poverty and social exclusion in the origins of homelessness rather than as an alternative account of the origins of homelessness.     

Staff survey results and characteristics that predict assault and injury to personnel working in mental health facilities

The purpose of this study was to complete a mental health staff opinion survey to identify patient and staff characteristics associated with staff assault and injury in psychiatric treatment settings and to develop a model of prediction for staff assault and injury utilizing these survey variables. The data consisted of opinion surveys sent to staff of 15 child, adolescent, and adult psychiatry inpatient units in the United States. Multivariate logistic regression was used to determine the level of assault and staff‐reported injury prediction that could be obtained from the staff‐completed opinion survey. Responses indicated a high prevalence of reported aggression, with 62.3% of staff endorsing verbal and physical aggression, property destruction, and self‐injurious behavior as being prevalent at their site, whereas only 4.1% rated none of these as prevalent. Staff working with children and adolescents in settings with high rates of psychiatric diagnoses reported increased frequency of assault and injury compared with those working with adults. Younger, less experienced staff reported higher rates of assault and injury. Staff working with female patients reported similar rates of assault and injury to those working with males. A logistic regression analysis using staff‐reported survey results of both staff and patient characteristics predicted assault correctly 73.7% of the time and injury 66.1% of the time. Resources for violence prevention and staff training programs in violence prevention are needed in child and adolescent psychiatry wards. Results are consistent with theories emphasizing the importance of negative emotions and affects, impulsivity, and frustration in goal‐directed activities in human aggression. Aggr. Behav. 29:31–40, 2003. © 2003 Wiley‐Liss, Inc.     

Type A behavior, attentional style, and symptom reporting among adult men and women

Type A behavior and its components (measured on the JAS) were examined in relation to attentional style and symptom reporting in 294 healthy adult men and women. The results showed that for both men and women the JAS Type A, Job Involvement, and Hard Driving factors were all associated with self-reported attentional effectiveness as measured by the Nideffer Test of Attentional and Interpersonal Style. However, a fourth JAS factor, Speed and Impatience, was associated with Nideffer measures of cognitive overload. For both men and women, the Type A, Speed and Impatience, and Hard Driving factors were all positively associated with the number of medical and psychological symptoms reported on the Cornell Medical Index. In addition, acute psychological distress (Hopkins SCL-90R) was associated with Type A behavior for men and with Speed and Impatience for both sexes. Attention differences did not account for the observed positive relationships between Type A factors and symptom reporting with one exception; attentional overload (internal) appeared to partially explain the relationships between symptom reporting and Speed and Impatience in women. In summary, Type As described themselves as having a broader attentional focus and reported more naturally occurring physical and psychological symptoms than did Type Bs.     

The Role of Non-Numerical Stimulus Features in Approximate Number System Training in Preschoolers from Low-Income Homes

Recent findings have suggested that adults’ and children’s approximate number system (ANS) acuity may be malleable through training, but research on ANS acuity has largely been conducted with adults and children who are from middle- to high-income homes. We conducted 2 experiments to test the malleability of ANS acuity in preschool-aged children from low-income homes and to test how non-numerical stimulus features affected performance. In Experiment 1, mixed-effects models indicated that children significantly improved their ratio achieved across training. Children’s change in probability of responding correctly across sessions was qualified by an interaction with surface area features of the arrays such that children improved their probability of answering correctly across sessions on trials in which numerosity conflicted with the total surface area of object sets significantly more than on trials in which total surface area positively correlated with numerosity. In Experiment 2, we found that children who completed ANS acuity training performed better on an ANS acuity task compared with children in a control group, but they only did so on ANS acuity trials in which numerosity conflicted with the total surface area of object sets. These findings suggest that training affects ANS acuity in children from low-income homes by fostering an ability to focus on numerosity in the face of conflicting non-numerical stimulus features.     

Positive and negative mood following imaging-guided core needle breast biopsy and receipt of biopsy results

Positive and negative mood are independent psychological responses to stressful events. Negative mood negatively impacts well-being and co-occurring positive mood leads to improved adjustment. Women undergoing core needle breast biopsies (CNB) experience distress during CNB and awaiting results; however, influences of mood are not well known. This longitudinal study examines psychosocial and biopsy- and spirituality-related factors associated with mood in patients day of CNB and one week after receiving results. Ninety women undergoing CNB completed questionnaires on psychosocial factors (chronic stress, social support), biopsy experiences (pain, radiologist communication), and spirituality (peace, meaning, faith) day of CNB. Measures of positive and negative mood were completed day of CNB and one week after receiving results (benign n = 50; abnormal n = 25). Multiple linear regression analyses were conducted. Greater positive mood correlated with greater peace (β = .25, p = .02) day of CNB. Lower negative mood correlated with greater peace (β = ?.29, p = .004) and there was a trend for a relationship with less pain during CNB (β = .19, p = .07). For patients with benign results, day of CNB positive mood predicted positive mood post-results (β = .31, p = .03) and only chronic stress predicted negative mood (β = .33, p = .03). For women with abnormal results, greater meaning day of CNB predicted lower negative mood post-results (β = ?.45, p = .03). Meaning and peace may be important for women undergoing CNB and receiving abnormal results.