Chest pain without coronary artery disease: An exploratory comparison with panic disorder

Recent reports have indicated similarities between patients with persistent chest pain of nonorganic origin and patients with panic disorder. In order to explore this association further, we administered a structured interview and three self-report measures (State-Trait Inventory, Beck Depression Inventory, and SCL90-R) to three subject groups: (1) a sample with persistent chest pain (CP; n=14) who had been screened and found to have normal coronary arteries, (2) a sample of patients with panic disorder (PD; n=14), and (3) a sample of matched normals (n=14). CP patients were considered to be free of coronary artery disease (CAD) following normal cardiac catheterization and/or normal thallium stress tests and were not diagnosed initially with panic disorder. PD patients were diagnosed with a standardized psychiatric interview and were free of organic causes of panic. Using an exploratory data analytic approach, the results indicated that both CP and PD samples reported increased levels of state and trait anxiety (p <.0001), depression (p <.01), and somatization (p <.0001) compared with normals. CP patients differed from PD patients in their less frequent use of anxiolytic medication (p <.01) and lower levels of reported panic anxiety and phobic avoidance (p <.0001). These data suggest that persistent chest pain in the absence of CAD shares some features with panic disorder, yet differs from panic in key ways as well. The results are discussed in light of the role of anxiety in contributing to symptom labeling.This research was supported by Grant 86G-491 from the American Heart Association, Texas Affiliate, to J.G.B. H.T. is the recipient of USPHS Research Career Development Award K04-HL-0122246.     

The social phobia and anxiety inventory: Construct validity

The Social Phobia and Anxiety Inventory (SPAI) is a new instrument composed of social phobia and agoraphobia subscales. The latter scale is used to detect social anxiety that may result from agoraphobia. The SPAI's construct validity was assessed through several procedures. First, confirmatory factor analyses were conducted to validate the existence of the two subscales. Second, exploratory factor analyses examined the underlying structure of the social phobia subscale. Third, a Q factor procedure determined if different anxiety diagnostic groups could be differentiated by their SPAI response pattern. The results confirmed the utility of the two SPAI subscales and identified a number of dimensions contained within the social phobia subscale which differed depending upon the specific subject sample. In addition, the complaints of social phobies appeared more homogeneous than those of an agoraphobic comparison group. The results are discussed in terms of construct validity and the sensitivity of the SPAI to various dimensions of social phobia fears.This study was supported in part by NIMH Grants 41852, 30915, 18269, and 16884.     

Incorporating Lesbian and Gay Issues Into Counselor Training: A Resource Guide

In order for counselors to facilitate the growth of their lesbian and gay clients, they must be familiar with and become sensitive to the special needs of this population. However, most counselors and counselor trainees have had little exposure to these needs. One way of increasing their awareness and sensitivity is to incorporate lesbian and gay issues into counselor training programs. The focus of this article is to present a limited list of strategies and resources that can be used to supplement materials in traditional courses in counselor training so as to better prepare counselors for dealing with lesbian and gay clients.     

Why Are Self-Disclosing Counselors Attractive?

Despite much evidence that counselor self-disclosure tends to be favorably received by clients, it is unclear which component is more influential: the act of revealing personal information or the information itself, especially when it implies client-counselor similarity. Based on the social influence model, we contrasted, in a quasicounseling analogue, (a) counselors who disclosed personal material that was similar to the client's problem, (b) counselors who disclosed problematic but irrelevant information, (c) counselors who disclosed nothing, and (d) counselors whose similarity to the client was revealed by someone else. Results show no differential effects on participants' perceptions of the counselor, but postresearch structured interviews indicated that both the disclosures and the similarity information had a considerable impact on participants' experience as clients during the counseling session.     

Self-Involving Versus Self-Disclosing Counselor Statements During an Initial Interview

This study examined the hypothesis that positive self-involving and self-disclosing counselor responses would be rated more favorably by subjects than negative self-involving and self-disclosing counselor responses (Andersen & Anderson, 1985). The differential effectiveness of the counselor responses during the initial interview was discussed, and some implications of the findings for counseling practice were considered.     

Age differences in memory performance and memory ratings as measured in a sample survey

Age differences in memory performance were studied in a probability sample of a cross-section of 1,491 adults living in the Detroit metropolitan area, with an oversample of those age 60 and older. Both a recall and a recognition measure were adapted to the survey context by querying respondents about the nature of the questions asked in an immediately preceding interview. Subjective memory assessment was also measured, using global memory ratings performed by the respondent, his or her spouse, and the interviewer. A clear, age-related decline in memory performance was found in this population sample. Subjective memory assessment also declined across age groups, but the relation was weaker. On the basis of multiple regression analyses of the recognition measure and the respondent's self-rated memory, which were judged to have the best measurement qualities, a substantial part of these age differences can be accounted for by differences in sociodemographic composition between age groups, by cognitive functioning and physical health.     

Verbal and visuospatial recall by younger and older subjects: use of matched tasks

In this study, 18 older (over age 65, M = 75.61 years) and 18 younger (below age 40 and over age 17, M = 26.44 years) healthy volunteers were tested on verbal and visuospatial recall. Tasks were matched on discriminating power. Older Ss performed worse than younger Ss on both tasks. The older Ss also showed a larger deficit in visuospatial than in verbal recall, relative to the younger Ss. These results are consistent with the theory of aging according to which verbal tasks are more resistant to deterioration than are nonverbal tasks. A psychological explanation based on lifetime experience with verbal material is preferred over the physiological explanation advocating faster aging of the right hemisphere.     

Age deficits in recall under optimal study conditions

Young and older adults studied lists of words under both standard and optimal study conditions for subsequent free recall. Under optimal conditions, the participants studied each word for as long as they wished, were allowed to take notes, and were encouraged to actively use whatever strategies they thought would maximize recall. Both age groups recalled more words under optimal study conditions than under standard conditions, but the improvement was greater for the young adults. This increase in the age-related recall deficit was not due to differences in study time. The results suggest that standard laboratory memory tasks do not overestimate the memory deficits of older adults because of a failure to provide either optimal learning conditions or sufficient study time.     

A perceived control intervention for at-risk older adults

Models of event causation and affective processes were used to design an experimental intervention for older adults. Ss were 2 at-risk populations, recently disabled and recently bereaved, each with matched nonrisk controls. Ss were randomly assigned to a placebo-contact group, a no-contact control group, or a 4-session, 10-week intervention focused on enhancing perceived control. Dependent variables assessed were personal mastery, psychological well-being and distress, positive and negative affect, and measures of daily events and activities. The intervention was nested within a 16-month longitudinal assessment of stress and adaptation processes in a large sample of community residents. The intervention had mixed effects on reports of personal mastery, but it significantly increased engagement in desirable activities and significantly decreased psychological distress and negative affect. Effects tended to be short-lived, however. Effects of the intervention tended to be particularly significant for the disabled group.     

Age differences in the acculturation process

Age differences were assessed in a conceptual model that seeks to explain how acculturation affects psychological well-being among Mexican Americans. The data were from a national probability sample of 859 persons of Mexican decent. It was hypothesized that low acculturation creates financial stress. Moreover, low acculturation and financial stress were in turn predicted to erode feelings of personal control and self-esteem. Finally, diminished feelings of control and low self-esteem were hypothesized to exert a negative impact on psychological well-being. When data from respondents of all ages was assessed, empirical support was found for all of the hypotheses except the linkage between acculturation and financial stress. However, few age differences emerged in the model. The authors conclude that older Mexican Americans may not be more vulnerable to the stressors associated with acculturation.