Specificity of MMPI cluster types to chronic illness

Abstract

Cluster analysis derived MMPI profile types were compared for three distinct illness populations: chronic low back pain (CLBP), mixed headache (HA), and cardiac disease (CD). Results replicated previous findings in the chronic pain and cardiac literatures. Differences between diagnostic groups and genders were found for the prevalence of the derived MMPI profile types. Results indicated that, in males, the two chronic pain groups had similar profile types and similar relative frequencies of these types, but both differed from the CD sample. The chronic pain groups tended to have a greater number of patients with pathological and distressed MMPI profile types and a lesser representation in the subclinical profile type compared to the CD sample. Similar findings were obtained for females, though the CLBP group tended to have a higher frequency of highly distressed, pathological profiles than either the HA or CD groups. Results suggested that the MMPI may be a measure of response to illness rather than reflecting predisposing personality types for any given illness and that the higher frequency of highly distressed profiles in the chronic pain samples reflects the increased suffering of those populations compared to other illnesses.     

Impact of genetic testing on causal models of heart disease and arthritis: An analogue study

Abstract

An analogue study investigated the impact of genetic testing on perceptions of disease. Using a 2 × 2 design, participants (n = 212) imagined receiving the information that they were at increased risk for either heart disease or arthritis. The type of risk information was either genetic or unspecified. Presentation of genetic risk information resulted in the condition being perceived as less preventable. Causal models of disease where investigated using principal components analysis. When hem disease was the stimulus condition, attributions to genes and chance were positively associated following unspecified risk information, and negatively associated following genetic risk information. When arthritis was the stimulus condition, presentation of genetic risk information was associated with attributions to genes becoming separated from the other attributions. One explanation for this is that providing genetic risk information may decrease perceptions of a sense of randomness or uncertainty in disease causation. The extent to which these effects occur in clinical populations. and their behavioural consequences. needs to be established.     

Understanding the impact of HIV diagnosis amongst gay men in Scotland: An interpretative phenomenological analysis

Objectives: Although a wide literature details the psychological impact of human immunodeficiency virus (HIV) diagnosis, it predates the introduction of effective treatment for HIV (i.e. anti-retroviral therapies, ARTs). This article explores the psychological impact of HIV diagnosis in post-ART accounts. This is important, given the recent policy developments which focus upon increasing HIV testing and thus diagnoses.

Design: This study presents a qualitative exploration of the experiential accounts of HIV-positive gay men living in Scotland. A total of 14 HIV-positive gay men took part in open-ended interviews.

Methods: Interpretative phenomenological analysis was employed to identify recurrent themes across the interviews.

Results: Our analysis focuses upon the participants’ struggles in adjusting to their HIV status. Diagnosis was a deeply shocking and unexpected experience. Stigma and fear of prejudice dominated their accounts. HIV was understood, variously, as a shameful, fatal and life-changing condition. Overall, within these accounts there was little sense of HIV normalisation.

Conclusions: In Scotland, where HIV prevalence is low, and where no accessible HIV-positive sub-culture exists, there is on-going psychological distress and morbidity amongst gay men testing HIV positive. As HIV-related policy increasingly focuses on increasing rates of antibody testing, there is a need to reduce the psychosocial costs associated with HIV-positive diagnoses.     

Depression as a Creative Illness: A South African Case Study

This case study presents a cultural perspective to supporting health and wellbeing in a young South African adult with depression and unresolved paternity issues. Issues around cultural identity appeared to influence the experience of depression and addressing the identifying aspects was helpful to recovery and wellbeing. Therapy facilitated the discovery of the client’s biological father and necessary ritual to reunite him with his African ancestry.     

The Illness/Injury Sensitivity Index: Validation of a German Version of the ISI-R

Three fundamental fears—anxiety sensitivity, fear of negative evaluation, and illness/injury sensitivity—are considered integral components of anxiety-related psychopathology and also bear connections with chronic pain. Scales measuring the first two fears, the Anxiety Sensitivity Index and the Fear of Negative Evaluation Scale, have been translated into German; however, the nine-item Illness/Injury Sensitivity Index-Revised (ISI-R) that measures fears of injury and illness has not been available in German language yet. The aim of this study therefore was a translation of the ISI-R into German language and an initial validation of the translated scale in two different samples. The German ISI-R was translated by both professionals and laypersons, and a final version was decided on by consensus. In Study 1, participants included 96 undergraduate students (85% women) who completed the German version of the ISI as part of a larger study. An exploratory factor analysis with oblique rotation was conducted and suggested a two-factor-solution with one factor representing fears of illness and the other fears of injury. This factor structure was confirmed via a confirmatory factor analysis (CFA) in Study 2. Participants included 117 community members (79% women). Convergent validity was supported using a visual analogue scale for fear of illness in both samples and the German translation of the Whiteley Index in Study. Overall, the results supported the German translation of the ISI-R. Comprehensive results, limitations, and directions for future research are discussed.     

Rehabilitative Beit Midrash as a means for advancing the community integration of Ultra Orthodox Jewish persons with severe mental illness

ABSTRACT

Religious Jews with severe mental illness often encounter barriers to involvement in religious activities in their community affecting their ability to become integrated into their community. Therefore, a study was conducted in Israel examining the contribution to community integration through a programme providing religious persons with mental illness an opportunity to participate in religious studies. An A-B research design was implemented among 42 Ultra-Orthodox Jewish persons with severe mental illness utilising a culturally-oriented structured instrument. The study showed that the opportunity for involvement in religious studies could advance the participants’ sense of social interaction in their community as well as their sense of psychological integration with other religious people. It also strengthened their confidence in their ability to further get involved in religious studies in the community. Rehabilitation services providing persons with severe mental illness an opportunity for involvement in religious studies can act as a springboard for advancing their community integration.     

Personality Dysfunction and the Management of Chronic Medical Illness: A Community Health Sample

The purpose of this study was to determine the influence of personality disorders on perceived health status, self-efficacy for management of the chronic illness, and physician perception of patient health. A total of 607 patients with self-identified chronicillness(es) volunteered to participate in the study. Out of this sample, 147 had collaborative physician data indicating a chronic illness. The final sample was 143 due to incomplete data. Results suggested that maladaptive personality characteristics, as measured by the Short-Form of the Coolidge Axis II Inventory (SCATI), were related to a number of important factors that influence self-management of chronic illnesses. When the personality constellations were broken into 3 groups (normal, subclinical, and clinical) significant differences were found on the 3 groups of dependent variables (Subjective Health, Self-Efficacy, Physician Appraisal) for the different personality disorders. These data provide useful information on several factors that influence effective disease management. Clinical implications and directions for future research are provided.     

Psychoeducational Interventions with Pediatric Cancer Patients: Part II. Effects of Information and Skills Training on Health-Related Outcomes

In Part I of this paper, we described a model that was used as a framework for reviewing studies of psychoeducational interventions intended to influence illness- and treatment-related behaviors and attitudes in pediatric cancer patients. In Part II, we distinguish between interventions that attempt to influence patients' behaviors just by providing information and interventions that specifically teach skills related to the behaviors they are trying to change. Many types of psychoeducational interventions appear to be effective and those that are training-based generally appear more effective than those that are information-based. Training-based interventions may face a barrier to wide adoption because they are resource-costly, but the development of digital-based training interventions may potentially overcome this barrier.     

Children's Adjustment to Parental Physical Illness

We review recent empirical literature examining the impact of parent physical illness on child functioning. We review studies of illness characteristics (n = 16), individual characteristics (n = 6), and family characteristics (n = 6). Although children's self-reports indicate heightened distress, parental reports do not suggest more problematic functioning. Child adjustment appears to be more closely related to perceptions of stressfulness rather than to objective illness severity indices. Adolescent girls seem to represent a group at heightened risk. Preliminary results suggest that family variables such as cohesion, conflict, and individual and family coping styles are important predictors of child adjustment.     

Health anxiety and hypochondriasis in the light of DSM-5

Background: In the DSM-5, the diagnosis of hypochondriasis was replaced by two new diagnositic entities: somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Both diagnoses share high health anxiety as a common criterion, but additonal somatic symptoms are only required for SSD but not IAD. Design: Our aim was to provide empirical evidence for the validity of these new diagnoses using data from a case–control study of highly health-anxious (n = 96), depressed (n = 52), and healthy (n = 52) individuals. Results: The individuals originally diagnosed as DSM-IV hypochondriasis predominantly met criteria for SSD (74%) and rarely for IAD (26%). Individuals with SSD were more impaired, had more often comorbid panic and generalized anxiety disorders, and had more medical consultations as those with IAD. Yet, no significant differences were found between SSD and IAD with regard to levels of health anxiety, other hypochondriacial characteristics, illness behavior, somatic symptom attributions, and physical concerns, whereas both groups differed significantly from clinical and healthy controls in all of these variables. Conclusion: These results do not support the proposed splitting of health anxiety/hypochondriasis into two diagnoses. Further validation studies with larger samples and additional control groups are warranted to prove the validity of the new diagnoses.