The Dissociative Factor in Symptom Reports of Rheumatic Patients with and Without Fibromyalgia

The main objective of this study was to investigate the prevalence of dissociation and its relationships to symptom reporting in fibromyalgia (FM) and other rheumatic disorders (non-FM). The participants were 73 women with FM and 85 relatively matched women with other rheumatic disorders. The participants were administered the Dissociative Experiences Scale (DES), the Profile Of Mood States (POMS), and a 50-item medical checklist. The prevalence of dissociation (DES q 25) was significantly higher in FM patients(30.1%) compared to other rheumatic disorders (7.0%). Symptom reporting correlated with measures of dissociation in both patient groups (FM:R = 0.42, p < .001; non-FM:R = 0.44, p < .001), when controlled for age, depression, and anxiety. A regression analysis confirmed the strong linkage between somatic variation and dissociation. The results suggest that dissociation is a problem for a substantial segment of patients with fibromyalgia and that dissociation is related to certain physical symptoms of fibromyalgia. Dissociation offers a different perspective on medically unexplained symptoms and may need to be addressed in future research.     

Development of the Mental Clutter Scale

Mental fog is a core symptom of fibromyalgia. Its definition and measurement are central to an understanding of fibromyalgia-related cognitive disability. The Mental Clutter Scale was designed to measure mental fogginess. In an exploratory factor analysis of two different samples (n=128 and n=170), cognitive symptoms of fibromyalgia loaded on 2 dimensions: cognition and mental clarity. The mental clarity factor comprised 8 items with factor loadings greater than .60 and was named the Mental Clutter Scale. The factor stability of the new scale was good, internal consistency was .95, and test-retest reliability over a median of 5 days was .92. The 8-item scale is a quick measure of mental fog that provides clinicians with information about cognitive functioning in fibromyalgia.     

“Authoritarianism” and Agreement with Things Authoritative

The use of personality and attitudinal questionnaires in private executive and military samples is briefly reviewed. The need for evidence regarding the factor similarity of such questionnaires in comparative studies is noted. Such a comparative factorial study of an abbreviated version of the Shure-Meeker (11) Personality/Attitude Schedule (PAS) is reported. In terms of the general scales examined, three of the four scales emerge in both samples. The order of emergence, as well as the number and item content of the factors, differs slightly between the two samples. Caution is suggested in assuming factor similarity across samples in comparative studies utilizing the PAS and other personality and attitudinal instruments.     

Use of verbal pain measurement in the detection of hidden psychological morbidity among low back pain patients with objective organic findings

Abstract

Patients with positive physical findings to explain low back pain arc believed lo belong to two organic subgroups. One group has organic disease alone: in the other, organic disease is accompanied by psychological disturbance. Separation of patients with medical findings into groups with varying levels of psychological disturbance is difficult, because emotional disturbance is often hidden. In this study, the pain report of 124 patients with organic findings alone, and 50 patients with organic and psychological findings was examined to determine whether pain measurement could he used to identify accurately patients belonging 10 the two groups. the pain groups differed in the use of 43 pain words from the Low Back Pain Symptom Check List. Using a set of weights derived From discriminant analysis. the 33 pain words predicted 99.2% of the patients with organic disease alone and 86.0% of the patients with organic disease and psychological disturbance. The results were replicated in a new sample of 140 patients. Cross-validation shrinkage in accuracy was 8.3%. The results of the two studies suggest that pain measurement may he a useful clinical indicator of psychological disturbance in patients with organic findings.     

Parenting Stress and Sexual Satisfaction Among First-Time Parents: A Dyadic Approach

The present paper reports on longitudinal associations between parenting stress and sexual satisfaction among 169 heterosexual couples in the first year after the birth of a first child. Actor Partner Interdependence Modeling (APIM) was used to model the effects of the mother’s and father’s parenting stress at 6 months after birth on sexual satisfaction at 1 year after birth. Based on social constructivist theory and scarcity theory, two hypotheses were posed: (a) mothers’ parenting stress will predict their own later sexual satisfaction whereas fathers’ parenting stress will not predict their own later sexual satisfaction (actor effects) and (b) mothers’ parenting stress will predict fathers’ later sexual satisfaction but fathers’ parenting stress will not predict mothers’ later sexual satisfaction (partner effects). On average, parents were only somewhat satisfied with their sex life. The first hypothesis was supported as greater parenting stress significantly predicted lower sexual satisfaction for mothers but not for fathers. The second hypothesis was also supported as mothers’ greater parenting stress significantly predicted less sexual satisfaction in fathers, whereas fathers’ parenting stress did not significantly predict mothers’ sexual satisfaction. We discuss how our results may be interpreted considering the social construction of gendered family roles.     

Psychological and social correlates of the back pain classification scale

The Back Pain Classification Scale (BPCS) identifies patients whose low back pain reflects a primary psychological disturbance. BPCS scores were related to the MMPI, State-Trait Anxiety Inventory, Multiple Affect Adjective Check List, and Social Readjustment Rating Scale scores; to distribution, intensity, and activities affecting pain; and to social characteristics of 116 patients. High scores on the BPCS (psychological disturbance) are associated with elevated MMPI profiles, and with more widely distributed and more intense pain. Stepwise multiple regression solutions indicate that the MMPI Hypochondriasis (Hs) scale accounts for 15.5% of the variance. No other variable accounts for as much as 3% of the variance. Scores on Hs relate primarily to words in the BPCS psychologically disturbed pole, supplying convergent validity to the BPCS. BPCS scores are unrelated to social characteristics, implying usefulness with the variety of patients seen for evaluation of low back pain.     

Rorschach and pain characteristics of patients with low back pain and "conversion V" MMPI profiles

Two studies examined the relationship between Rorschach determinants, MMPI scale scores, and pain reports in order to clarify the meaning of the MPI "conversion V" pattern among patients with low back pain. Study I showed that patients without demonstrable organic disease of the back produce Rorschach response summaries marked by lower F+%, lower Sum C, and higher F% than patients with demonstrable organic disease. Study 2 showed that only the increase in F% was associated with significant elevations of the MMPI Hs and Hy scales. The results suggest that elevated MMPI "conversion V" profiles are indicative of psychological disturbance among patients with low back pain. It is unlikely, however, that the disturbance is hysterical. Instead, the psychopathology is probably marked by tension and constraint rather than the over-reactivity of hysteria. The implications of these findings for diagnosis are discussed.     

Maternal illusory control predicts socialization strategies and toddler compliance

This study examined the relation between mothers' perception of their capacity for controlling infant crying and a later measure of parent-toddler social interaction-compliance with parental requests. Fifty-seven mothers participated in (a) a laboratory task when their children were 5 months old to assess mothers' perception of control and (b) a toy-cleanup task when their children were 24 months old to assess toddler compliance. Perception-of-control scores on the laboratory task reflected accuracy of perception and ranged from accurate to greatly overestimating control, with an overestimation referred to as an illusion of control. Mothers were categorized into three illusion-of-control groups: low, moderate, and high. Toddlers of mothers in the low and high illusion-of-control groups were more likely to be categorized as highly defiant than were toddlers of mothers in the moderate-illusion group. Mothers with high illusory control were most likely to use a high power-assertion strategy (negative control), and when negotiating, their toddlers' expression of autonomy was most likely to escalate into defiance.