Potential for hostility and dimensions of anger

Recent reviews have linked Potential for Hostility derived from the Structured Interview (SI) to coronary artery disease, independent of the global Type A pattern. The present study examined the construct validity of Potential for Hostility ratings by correlating Potential for Hostility with 21 scales from four widely used anger/hostility measures: 7 scales from the Anger Self-Report, 8 scales from the Buss-Durkee Hostility Inventory, the total score from the Novaco Anger Inventory, and 5 scales from the Multidimensional Anger Inventory. The pattern of correlations revealed that Potential for Hostility was significantly related to scales reflecting awareness and arousal of anger, particularly the verbal expression of anger. To identify underlying anger dimensions, the 21 scales were factor-analyzed. Examination of two and three rotated principal components confirmed previous solutions. The first component, representing anger-arousing and -eliciting situations and anger awareness, was labeled Experience of Anger. The second component, consisting of scales dealing with either physical assault or verbal expression of anger, was labeled Expression of Anger. When a third factor was retained, it contained scales of suspicion, mistrust-suspicion, and guilt: It was therefore labeled Suspicion-Guilt. Potential for Hostility was correlated only with the Expression of Anger factor in the two-factor solution; in the three-factor solution, Potential for Hostility was correlated equally with the Experience of Anger and Expression of Anger factors but was not correlated with the Suspicion-Guilt factor. The implications of these results for the assessment of hostility are discussed.     

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.     

Lesbian Partner Abuse: Implications for Therapists

Silence surrounds the issue of lesbian battering. Lesbian victims of partner abuse are even less likely than are their heterosexual counterparts to seek help in shelters or from counselors because of the overlay of homophobia that exists both in the battered women's movement and among mental health professionals. In addition, many lesbian and many lesbian-supportive therapists hold an idealized and unrealistic picture of the nature of lesbian relationships, leading them to deny the existence of buttering among lesbian couples. The nature, severity, and prevalence of abuse in lesbian relationships is addressed; current counseling and treatment models dealing with battering relationships are analyzed; and a counselor advocacy model for working with lesbian partner abuse, drawing from the experience of activists in the battered women's movement and our clinical experience, is suggested.     

Combating Homophobia in AIDS Education

Homophobia is a central theme in response to the AIDS epidemic. In this article we review literature explicating the connection between homophobia and AIDS and then call for the integration of antihomophobia elements into AIDS education. We discuss negative messages in portrayals of gay and bisexual men and in discussions of safer sexual practices, as well as materials and educational strategies that explicitly contradict such homophobic messages. We then discuss the emerging trend to exclude lesbian women and gay men in education and programs, suggest guidelines for countering such exclusion, and give examples of creative approaches to inclusion.     

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 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.     

Relationship of severity of dementia to caregiving stressors

In studies of individual differences and longitudinal changes in stress and coping among dementia caregivers, assessing severity of patient impairment is critically important. It is proposed that with the progression of dementia, cognitive impairment may steadily increase, but other stressful behavioral symptoms peak at various stages of dementia. Cross-sectional data from 49 caregiving families and longitudinal follow-up data from 48 families suggest that instrumental self-care deficits begin early in dementia, and basic self-care deficits increase with dementia severity, but that many distressing behavioral symptoms decrease in late dementia. Assessments of dementia patient severity should be multidimensional, and increases and decreases in various dementia patient stressors over time should be considered as factors influencing caregiver coping.     

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.