Autonomic activity, pain, and perceived health in patients on sick leave due to stress-related illnesses

Objective: The aim of the present study was to compare autonomic activity, pressure-pain thresholds, and subjective assessments of health and behavior between patients with stress-related illnesses and healthy control subjects.Methods: Twenty sick-listed patients with stress-related illnesses and 20 age- and gender-matched healthy subjects performed tests of autonomic regulation and algometric tests, and completed questionnaires about physical and mental health and behavioral patterns.Results: Patients exhibited higher autonomic reactivity to cognitive and physical laboratory tasks (p<0.05), and had lower pressure-pain thresholds in the shoulders and lower back than healthy control subjects (p<0.05). Furthermore, the patients rated considerably poorer health and health behavior than the control subjects (p<0.05).Conclusions: The results indicate an engagement of the autonomic nervous system in stress-related illnesses. Furthermore, they show that patients with stress-related illnesses experience symptoms of musculoskeletal pain, and it is therefore recommended that assessments of musculoskeletal pain be incorporated in the clinical examinations and the rehabilitation of patients with stress-related illnesses.     

The Defence Mechanism Test (DMT) revisited: experimental validation using threatening and non‐threatening pictures

Although the Defence Mechanism Test (DMT) has been in use for almost half a century, it is still unclear what it actually measures. The psychodynamic theory on which the test is based states that the threatful DMT pictures activate various defence mechanisms. To test this proposition, the original DMT pictures were redrawn by a professional artist, changing the emotional content without altering the structural properties. In this way, a neutral and a friendly variant were shaped. Sixty participants were randomly assigned to the threatful, neutral, and friendly stimulus conditions. In contrast to predictions made from psychodynamic theory, that the threatful picture would activate more ‘signs of defence’ than the others, the results disclosed that the three conditions activated the same amounts of ‘signs of defence’ and the same levels of various perceptual thresholds. Thus, rather than capturing psychodynamic defence mechanisms, our results suggest that the DMT taps perceptual or information‐processing difficulties in correct identification of brief stimulus exposures regardless of their emotional contents. Copyright © 2002 John Wiley & Sons, Ltd.     

Influences of Affect Associated with Routine Out-of-Home Activities on Subjective Well-Being

A survey of a random sample of 1,330 Swedish residents assessed the relationships between affect associated with performance of routine out-of-home activities, mood, and judgments of life satisfaction (cognitive subjective wellbeing, CSWB). Regression analyses showed that sociodemographic variables accounted for most variance in CSWB (7%) and least in mood (2%). In agreement with previous research, CSWB increased with income, employment, and cohabiting with a spouse, and had a U-formed relationship with age. Affect associated with routine activities accounted for more variance than the socio-demographic variables in mood (30%) and in CSWB (13%). Mood partially mediated the effect on CSWB of affect associated with the activities. The results suggest that future policy-related research should consider the possibility that community-provided resources that facilitate performance of routine out-of-home activities would increase life satisfaction.     

Pre- and Postpartum Fear of Childbirth in Nulliparous and Parous Women

The link between fear of childbirth and theories of anxiety in general is discussed. A possible expression of trait (T-fear) and state (S-fear) aspects of fear of childbirth was investigated in 77 nulliparous and 85 parous women based on data from gestational week 32, at 2 hours and at 5 weeks after childbirth. Data are based on the State Trait Anxiety Inventory and the Wijma Delivery Expectancy/Experience Questionnaire. According to their scores on the Wijma Delivery Expectancy/Experience Questionnaire during late pregnancy, women were divided into 3 groups: high, moderate and low levels of fear of childbirth. In gestational week 32, women in the low level of fear of childbirth group had lower trait anxiety than those in the moderate level of fear of childbirth group, who had lower trait anxiety than the women in the high level of fear of childbirth group. Nulliparous women had a higher level of fear of childbirth but a lower level of trait anxiety than did parous women. There was a significant decreasing trend in fear of childbirth from 2 hours to 5 weeks after delivery, in a parallel way for all 3 groups. Differences in fear of childbirth between nulliparous and parous women disappeared after delivery. These findings suggest that fear of childbirth comprises a considerable part of T-fear, with the risk of a vicious cycle, i.e. that during labour women experience what they are afraid of, which also influences the women's postpartum cognitive appraisal of the delivery.     

Changing caring behaviours in rehabilitation after a hip fracture – A tool for empowerment?

Different rehabilitation programs after surgery have been presented to improve the outcome for patients with a hip fracture. Empowerment has been suggested as useful, but requires a change in the caring behaviours of health professionals. The aim with this study was to evaluate if training and supervision of the nursing staff could alter caring behaviours. A case-control study of nursing staff treating hip fracture patients was performed at a hospital with two sites. Training and supervision was given to the nursing staff at the intervention site. The intervention focused on creating positive care interaction by using eight guidelines. The evaluation was performed with recordings of a constructed caring situation before training, and observations of care situations at the ward before and after intervention. The results showed no differences at baseline between the two sites in the caring behaviours. After intervention, significant effects of caring behaviours were seen in seven out of eight guidelines, the effect sizes ranged from medium to large. The findings indicate that the nursing staff can change caring behaviours and facilitate the empowerment of patients with a hip fracture.     

Assessing Patients’ Beliefs About Their Cancer-Related Fatigue: Validation of an Adapted Version of the Illness Perception Questionnaire

Cancer-related fatigue (CRF) is a common and distressing side-effect of cancer treatment. The present study developed a brief version of the Illness Perception Questionnaire (IPQ) for assessing patients' representations of CRF. Cancer patients and survivors (n?=?155) completed a revised version of the IPQ as well as measures of fatigue severity at two different time-points. Confirmatory factor analysis at both Time 1 and 2 showed that the seven-factor solution based on the Self-Regulation Model fit the data adequately and factorial invariance over the two time-points was supported. The resulting subscales exhibited good internal consistency and test-retest reliability. The adapted version of the IPQ shows promise for the assessment of patient perceptions regarding CRF. The scale may be able to be used clinically to identify if patients have inaccurate or unhelpful representations of CRF and to help tailor interventions for persistent fatigue in cancer survivors.     

Work environment and health in different types of temporary jobs

The aim of the study was to compare and analyse differences in work conditions and health between workers in permanent and temporary employment. The study group consisted of a representative, stratified sample of the Swedish working population (n = 2767). The data support the main hypothesis of the study, i.e., that temporary employed differ from permanent employed in control over their working life. With some exceptions, there were clear differences between these two categories with respect to a number of variables that can be regarded as central to both the individual's success at work and protection against job loss and exclusion from working life. Health differences were in favour of the permanent employed. There were also considerable differences between different sub-groups of temporary employees of such amplitude and consistency that they formed a distinct centre-periphery structure.     

A structural equation model of pre‐service teachers' perceptions of future goals and current course‐related motivation

This study examined relationships between pre‐service teachers' perceptions of future goals and motivation to complete current tasks required in teacher education courses. Using 351 pre‐service teachers' survey responses from two southern universities in the USA, a full‐structural modeling was conducted. Results showed pre‐service teachers' perceived endogenous instrumentality (value of the current course “content” to attain future goals) had a direct effect on their intrinsic motivation, and their perceived exogenous instrumentality (value of the current “grade” to attain future goals) had a direct effect on their extrinsic motivation. This research suggests students' understanding of a relationship between their course content and future goal encourages their motivation to learn for enjoyment. Furthermore, students' understanding of a relationship between the course grade of the current course and their future goal encourages their motivation to get a high course grade, not necessarily because they enjoyed the course content. This study contributes to understanding pre‐service teachers' cognitive/motivational characteristics and to developing appropriate learning environments of teacher education that align with pre‐service teachers' learning characteristics to promote their effective learning.     

Musculoskeletal pain complaints and performance on cognitive tasks over the adult life span

The present study aimed at comparing participants with and without self reported musculoskeletal pain in a normal population with regard to performance on a range of tests for episodic memory, semantic memory, and other cognitive functions and to see if expected differences interacted with age. The results showed that participants with pain performed worse on a range of tasks as compared to participants without pain, and that these differences occurred regardless of age. The most robust effects of pain were displayed on tests for vocabulary and construction ability as these were the only effects that remained significant after controlling for years of education and reported depression in separate analyses. When depression and education were controlled for in the same analysis, even these effects were eliminated, suggesting interplay between pain, depressive status, and educational level in the negative effects on cognitive functioning.