Psychological and social consequences of HIV exposure: Homosexuals in southern california

Abstract

The purpose of this study was to identify the psychological and social consequences experienced by apparently healthy homosexual men who learn that they have positive results on the HIV antibody test, but who have not yet developed AIDS or ARC. Employing a census survey of the male membership of three homophile organizations in a Southern California county (n=1905), 30 HIV positives and 55 negatives completed a biographical questionnaire, the IPAT Anxiety Scale Questionnaire, the IPAT Depression Scale, and the Coping Strategies Inventory. Results indicate that HIV positives show considerable disorganization after hearing test results, have clinically high levels of anxiety (n=10), and clinically high levels of depression (n=14) when compared to the normative samples. Positives also reported pervasive changes in their sexual activity (n=30), and experienced negative consequences in social (n=15) and occupational functioning (n=10). Twelve subjects reported suicidal ideation after they heard the results of their testing, with one subject reporting a suicide attempt. The methodological limitations of the study were examined, with an emphasis on the limitations of the survey method. Speculations to account for the reported behaviors were discussed.     

The role of goal adjustment in symptoms of depression,anxiety and fatigue in cancer patients receiving psychosocial care: A longitudinal study

Objective: This study examined whether cancer patients reported increases in their goal adjustment capacities while receiving psychosocial care and whether these increases were related to changes in symptoms of depression, anxiety and fatigue. Goal adjustment was conceptualised as two independent capacities: goal disengagement (i.e. disengage from unattainable goals) and goal reengagement (i.e. reengage into new goals).

Design: This naturalistic, longitudinal study focused on 241 cancer patients receiving psychosocial care at one of the seven psycho-oncology institutions in the Netherlands. Data was collected before the start of psychosocial care (T1) and nine months thereafter (T2). Hierarchical regression analysis was used to examine the research questions.

Main Outcome Measures: Goal adjustment, symptoms of depression, anxiety and fatigue.

Results: At group level, patients reported small increases in goal disengagement (d = .22) but no significant change in goal reengagement (d = .09). At an individual level, 34% of cancer patients reported an increase in goal disengagement and 30% reported an increase in goal reengagement. Increases in goal reengagement were significantly associated with decreases in both depressive and anxiety symptoms, but not to changes in fatigue.

Conclusion: Findings indicate that particularly improvements in goal reengagement are beneficial for cancer patients’ psychological functioning.     

Dental anxiety in the elderly

Abstract

This review of the literature shows that dental anxiety in the elderly has been estimated at a much lower level than that found in the general population. However, it is thought that the problem may have been underestimated because older persons may have masked their feelings by minimizing their needs for dental treatment. It is suggested that dentists need to address the special needs of the older dental patients if they wish to have them utilize their services. Older persons' needs can be met only with a greater understanding and tolerance of ageing processes than has been shown in the past. The decrease of dental anxiety with age found in cross-sectional studies needs to be confirmed by longitudinal studies.     

The effects of leader gender on self-presentational concerns in exercise

The present study examined the impact of the exercise leader's gender on the self-presentational concerns of women in a live exercise class. Eighty-seven college-aged non- or infrequent exercisers participated in a group exercise class led by either a female or male instructor. Participants completed measures of Self-Presentational Efficacy (SPE), State Social Anxiety (SSA) and State Social Physique Anxiety (SPA-S) prior to and following completion of a group exercise class. A repeated measures Multivariate Analysis of Variance (MANOVA), with time as the within-subjects factor and leader gender as the between-subjects factor, was conducted. A significant main effect for time was found (F(3, 80) = 19.65, p < 0.001). Estimated marginal means indicated that all participants reported significantly higher SPE and lower SSA and SPA-S post-exercise. Completing an exercise class may override any self-presentational concerns that can arise from the exercise environment. Future studies should adopt ecologically valid research designs to gain a clearer picture of self-presentational concerns in exercise classes.     

Predictors of distress following an acute stroke: Disability,control cognitions,and satisfaction with care

Abstract

Whilst clinical predictors of distress following acute stroke have been identified (e.g., lesion site), this study hypothesised that greater prediction would be achieved by addressing individual differences in patients' cognitions (e.g., perceived control, satisfaction with care, recovery confidence) and coping responses. We examined these relationships in a longitudinal study of 71 survivors of acute stroke. Measures were collected at three time points: 10-20 days after the stroke, and one month and six months after hospital discharge. Stepwise multiple regression analyses were performed using only significant bivariate correlates and where the dependent variables were residualised scores which controlled for baseline levels of anxiety and depression. Satisfaction with treatment and confidence in recovery at one month predicted anxiety outcome at six months, and satisfaction with advice and confidence in recovery at one month predicted depression outcome at six months. These results offer tentative suggestions for interventions targeting patient cognitions and improving patient satisfaction.     

The adaptive effect of personal control when facing breast cancer: Cognitive and behavioural mediators

This prospective study examines the cognitive and behavioural mediators of the relation between personal control and the initial response to a breast cancer diagnosis as well as subsequent psychological adjustment. A total of 143 patients participated immediately after diagnosis (T1), after surgery (T2) and 2 months after the end of treatment (T3), of whom 92 also completed a questionnaire pre-diagnosis (T0). The buffering effect of personal control on psychological distress shortly after diagnosis was mediated by cancer-specific cognitions, i.e. threat appraisal and coping self-efficacy. Moreover, a strong sense of personal control predicted lower levels of anxiety 2 months after the end of treatment, but was unrelated to distress at T3. The adaptive effect on anxiety was mediated by threat appraisal and active engagement in social life after surgery, but not by active patient participation or coping self-efficacy. These results confirm and explain the adaptive effect of control. Apparently, women with a low sense of control appraise cancer and their personal coping skills more negatively, which makes them vulnerable to distress in response to diagnosis. Furthermore, women with a strong sense of control might regulate anxiety by remaining engaged in social life.     

Depression,anxiety and social support in rheumatoid arthritic women without and with a spouse

Abstract

A comparison was made of income and physical, social and psychological aspects of health between 22 female patients who had never married, 127 patients living with a spouse and 53 patients who were widowed or divorced. No significant differences were found between never married patients and patients living with a spouse. The widowed or divorced patients however had a lower income, reported less potential support, more depression and anxiety than the patients who were never married and those living with a spouse. The relationship of social support to depression and anxiety was investigated in spouseless patients (n=75) and in those living with a spouse (n=127). In both groups of patients, less potential support was found to be related to more anxiety. In addition, pain was found to contribute significantly to depression and to anxiety only in the patients living with a spouse. With regard to the latter, it is suggested that the debilitating influence of pain on the relationship with the partner might have been the mediating factor.     

The effects of threatened social evaluation of the physique on cortisol activity

Social self preservation theory asserts that situations high in social-evaluative threat elicit increases in cortisol, a hormone released by the hypothalamic-pituitary-adrenal axis. Most tests of the theory have examined threats associated with social evaluation of a performance. Two experiments examined the effects of threatened social evaluation of one's physique. In Experiments 1 (n?=?50) and 2 (n?=?40), participants allocated to an experimental (threat) condition had significantly higher post-manipulation cortisol than participants in a control (no threat) condition. In Experiment 1, perceptions of social-evaluative threat were significantly correlated with post-manipulation cortisol levels. These results suggest that the threatened social evaluation of one's body can activate the cortisol response. Women who frequently experience such threats may be at increased risk for a variety of health conditions associated with chronic cortisol exposure.     

Pathways for psychological adjustment in breast cancer: A longitudinal study on coping strategies and posttraumatic growth

This longitudinal study examined the role of coping strategies and posttraumatic growth (PTG) on the psychological adjustment to breast cancer trajectory. The participants were 50 women assessed at the time of surgery (T1), during adjuvant treatment (T2) and six months after the end of treatment (T3). Women completed questionnaires assessing coping strategies, PTG and psychological adjustment (psychological quality of life, anxiety and depression). Results showed that the greatest impact of breast cancer on women's adjustment occurred at T1, when patients were significantly more anxious than in the other phases of the disease. The type of surgery and adjuvant treatment did not account for the course of PTG and adjustment. Coping through seeking social support and using cognitive strategies at T1 were linked to psychological quality of life and depression at T3 via PTG dimension of personal resources and skills at T2. Findings emphasise the value of promoting adaptive coping strategies and PTG in order to improve psychological adjustment in breast cancer patients.     

When Being Discrepant from One's Ideal or Ought Selves Hurts: The Moderating Role of Neuroticism

Self‐discrepancy theory posits that people experience emotional consequences when they perceive discrepancies between their actual and possible selves. However, the extent to which people react emotionally to these self‐discrepancies (i.e. ideal, ought and undesired) may be a function of individual differences in neuroticism. Across both experimental (Study 1; N = 155) and correlational designs (Study 2; N = 139) involving college students, the authors demonstrated that neuroticism moderated the discrepancy–emotion associations such that high‐neuroticism individuals showed elevated depression and anxiety symptoms when their self‐discrepancies were activated. The heightened symptoms were maintained over time. Negative repetitive thoughts (i.e. rumination and worry) were examined as potential mediating mechanisms between the discrepancy × neuroticism interaction and symptoms. Partial support was obtained in that rumination mediated between undesired discrepancy × neuroticism interaction and anxious/depressive symptoms. Implications and possible theoretical extensions for self‐discrepancy theory are discussed. Copyright © 2012 John Wiley & Sons, Ltd.