Recommendations for the Treatment of Hypochondriac Patients

Hypochondriasis is a debilitating condition in which patients are persistently preoccupied with the possibility of being seriously ill. Its is a costly problem for the health care system whose treatment has not received systematic attention until recently. Although based on few controlled studies, results indicated that various brief cognitive-behavioral techniques produce significant changes in illness fears and attitudes. A list of therapeutic questions that require further study is presented and some indications for both therapists and patients are given.     

The Meaning vs. The Medical Model in the Empirically Supported Treatment Program: A Consideration of The Empirical Evidence

A review of the debate on the Empirically Supported Treatment Program is presented. It is argued that underlying the specifics of the debate are fundamentally incompatible paradigms: a meaning vs. a medical model. The findings from two gold standard multi-site studies are reviewed to conclude that the control condition meets requirements for an empirically supported treatment. The empirical finding of the failure of clinical training to improve treatment outcomes is explained by the focus on rational factors in training. It is recommended that training of therapists focus on enhancing experiential capacity rather than mastery of manualized treatment approaches.     

Is Workplace Harassment Hazardous to Your Health?

We examined cross-sectional and lagged effects of sexual harassment (SH) and generalized workplace harassment (GWH) on incidence of self-reported illness, injury, or assault in a sample of over 1,500 university employees. SH and GWH, but not other job stressors, were related to increased odds of illness, injury, or assault. This was true when SH, GWH, and illness, injury, or assault were measured at the same time point, as well as when SH and GWH were measured in year prior to illness, injury, or assault.The data presented here are part of an ongoing longitudinal study of workplace harassment conducted at the Department of Psychiatry of the University of Illinois at Chicago. This research was supported by the National Institute on Alcohol Abuse and Alcoholism (grants AA09989 and AA13332). Portions of this paper were presented at the annual meeting of the Society for Industrial and Organizational Psychology, April 2004, Chicago, Illinois. The data were collected by the Survey Research Laboratory at the University of Illinois at Chicago.     

Decoupling the Relation Between Risk Factors for Conduct Problems and the Receipt of Intervention Services: Participation Across Multiple Components of a Prevention Program

This study examined whether the link between risk factors for conduct problems and low rates of participation in mental health treatment could be decoupled through the provision of integrated prevention services in multiple easily-accessible contexts. It included 445 families of first-grade children (55% minority), living in four diverse communities, and selected for early signs of conduct problems. Results indicated that, under the right circumstances, these children and families could be enticed to participate at high rates in school-based services, therapeutic groups, and home visits. Because different sets of risk factors were related to different profiles of participation across the components of the prevention program, findings highlight the need to offer services in multiple contexts to reach all children and families who might benefit from them. Ellen Pinderhughes's and Karen Bierman's colleagues in the Conduct Problems Prevention Research Group are, in alphabetical order, John D. Coie, Duke University; Kenneth A. Dodge, Duke University; E. Michael Foster, University of North Carolina; Mark T. Greenberg, Pennsylvania State University; John E. Lochman, University of Alabama; and Robert J. McMahon, University of Washington.     

Parent and Adolescent Responses to PovertyRelated Stress: Tests of Mediated and Moderated Coping Models

We tested several models of the associations among economic strain, life stress, coping, involuntary stress responses, and psychological symptoms in a sample of 57 parent-adolescent dyads from rural, lower-income families. Economic strain and life stress predicted symptoms for both parents and adolescents. Stressor-symptom specificity was found for parents, such that economic strain uniquely predicted depression, whereas negative life events predicted hostility. Involuntary stress responses were associated with higher levels of symptoms for both parents and the adolescent children. Secondary control coping was associated with fewer symptoms for both parents and adolescents. Results support a mediational role of coping and responses to stress during adolescence, with a shift to moderational status in adulthood. Implications of these results are discussed with regard to developmental coping theory and potential interventions with at-risk families.     

Schizophrenia and the Developmental Moratorium

Jay B. Sisun is a Clinical Research Assistant at Taunton State Hospital. Glen A. Eskedal is the Chair and Professor of Education and Human Services at Suffolk University. Of challenge to developmental psychologists and mental health practitioners is the management of positive and negative symptoms associated with schizophrenia and their effects on mastering psychosocial developmental tasks. The intent of this article is to provide specific information pertinent to understanding this disorder, to understand the age-appropriate struggle for individuation, and to offer recommendations for effective treatment.     

Revisiting Hispanic Adolescents' Resilience to the Effects of Parental Problem Drinking and Life Stress

Two previous studies found that life stress and parental alcoholism were not as highly related to distress for Hispanic adolescents as they were for European American adolescents (M. Barrera Jr., S. A. Li, and L. Chassin, 1993, 1995). Those findings could be interpreted as evidence of Hispanic youths' resilience, but limitations of the stress measure and the homogeneity of the Hispanic sample threatened this interpretation. The present study improved on those previous studies by using a new measure of uncontrollable stressors and a more heterogeneous Mexican American sample. Participants in this study were 175 Mexican American and 59 European American adolescents and their parents. Unlike the previous studies, results did not show that Mexican American adolescents were more resilient to parental problem drinking or life stress than were European American adolescents. Overall, life stress was related to adolescents', mothers', and fathers' reports of adolescents' psychological distress above and beyond the effects of ethnicity and socioeconomic factors.     

Homeopathic remedies as placebo alternatives — verification on the example of treatment of menopause-related vegetative and emotional disturbances

With the example of treatment of menopause-related vegetative and emotional disturbances, the author verifies the effectiveness of the use of Ignatia amara containing complex homeopathic remedies (IACCHR) as an alternative to placebo. Substantial improvement in psychological and psychosomatic symptoms was observed. Climacteric complaints diminished or disappeared completely in the majority of women (95.7% by patient evaluation and 96.2% by physician evaluation). Compared to standard pharmaceuticals, IACCHR treatment was tolerated better and lower risk of side effects was observed. The results obtained in this work indicate the significant therapeutic potential of this group of treatments, which is in line with the therapeutic effect of the placebo. Nevertheless, the showing of specific effects in pharmacological tests disqualifies the investigated treatments from use in a clinical trial in place of a placebo. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.     

Predicting traumatic stress using emotional intelligence

The study investigated whether emotional intelligence (EI) can predict how individuals respond to traumatic experiences. A random sample of 414 participants (181 male, 233 female) were administered a measure of EI along with the Impact of Event Scale--revised [IES-R; Weiss, D. S. & Marmar, C. R. (1997). The Impact of Events Scale--revised. In J.P. Wilson & T.M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399-411). New York: Guilford Press], and the monitoring and blunting questionnaire [MBQ, Anxiety Stress Coping 7 (1994) 53]. The results showed that participants with higher NEIS scores report fewer psychological symptoms relating to their traumatic experiences, that monitors are more likely to have higher NEIS scores than blunters. Traumatic events had a greater impact on females than males, and males had higher EI than females. The implications of these findings for using EI as a predictor for individuals who may experience traumatic stress are discussed.     

The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors

This prospective longitudinal study was designed to investigate the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in a population of severely injured hospitalised trauma survivors. Symptoms of ASD were assessed just prior to discharge in 307 consecutive admissions to a Level 1 Trauma Centre, with PTSD assessments completed at 3 and 12 months post-injury. A well-established structured clinical interview was adopted for both assessments. Only 1% of the sample met criteria for an ASD diagnosis (at a mean of 8 days post-injury), while the incidence of PTSD was 9% at 3 months and 10% at 12 months. Although all ASD symptom clusters contributed to the prediction of subsequent PTSD severity, logistic regression indicated that only re-experiencing and arousal predicted a categorical PTSD diagnosis. The dissociative symptoms that form the core of ASD were rarely endorsed and showed high specificity but low sensitivity, resulting in a high proportion of false negative diagnoses. Reducing the number of dissociative symptoms required for a diagnosis ameliorated, but did not resolve, the problem. In this particular population, the low sensitivity of the ASD diagnosis renders it a poor screening test for use in identifying high risk individuals for early intervention and prevention strategies.