Correlates of pain interference in multiple sclerosis.

Objectives: To describe pain interference and explore its associations with several indexes of health and psychosocial functioning among veterans with multiple sclerosis (MS). Study Design: Cohort study linking computerized medical records and survey questionnaire. Participants: Four hundred fifty-one veterans with MS. Outcome Measures: Pain Effects Scale, Patient Health Questionnaire, Modified Social Support Survey, items from the Short Form Health Survey and the North American Research Consortium on MS Registry Survey (NARCOMS) Performance Scales. Results: Participants reported a moderate level of overall pain interference. Increased fatigue, poorer general health, and greater depression symptom severity each were significantly associated with higher levels of pain interference. Conclusions: Pain interference in MS is associated with a variety of other clinically meaningful indexes of functioning. Pain in MS should be treated aggressively to minimize functional impairment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social relationships and PTSD symptomatology in combat veterans.

The primary purpose of this study is to determine if recent combat veterans discriminate between different sources of social support, and then preliminarily investigate the relationship of social support source on posttraumatic stress disorder (PTSD) symptomatology. Participants included 83 married male combat veterans. Principal-axis factor analysis with equamax rotation observed four distinct latent factors for each source of support examined. ANOVAs were performed to determine the relationship of each source of support from the distinct latent factors on the level of PTSD. Results indicate that the level of PTSD is related to support received from a significant other, F(1, 81) = 30.36, p F(1, 81) = 8.10, p = .006, and military peers, F(1, 81) = 6.70, p = .011, but not friends, F(1, 81) = 1.79, p = .18. In general, higher levels of support from each category were associated with lower levels of PTSD in combat veterans. The results suggest that combat veterans distinguish between specific sources of social support, which may have a protective effect on the level of PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A critical examination of gender differences in nutritional risk for rural adults with disability.

Objectives: To examine gender differences in nutritional risk for rural adults with disability. To identify specific perceived nutrition barriers that intervention programs might target among rural adults with disability. Study Design: Telephone interviews. Participants: One hundred twenty-four rural adults from Meals-on-Wheels and Center for Independent Living programs (46 men, 78 women; mean age = 57.7 years, 96% Caucasian). Outcome Measures: Nutrition Screening Initiative, Nutritional Risk Index, Perceived Nutrition Barriers Scale. Results: Women reported greater nutritional risk on all measures, but gender differences appeared mediated by age and disability. Top barriers were identical for men and women. Conclusions: Rehabilitation psychologists should consider age and disability first, rather than gender-related assumptions about nutritional risk. Nutrition intervention should encourage shared food cost, transportation, preparation, and new tastes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in positive well-being: A consideration of emotional style and marital status.

This article reviews all published studies reporting tests for sex differences in well-being. Women were found to report greater happiness and life satisfaction than men. This sex difference was explained in terms of men's and women's social roles: The female (vs. male) gender role specifies greater emotional responsiveness. Furthermore, past role-related experiences provide women with appropriate skills and attitudes. Women's (vs. men's) greater well-being was also found to hold for married but not unmarried Ss: For both sexes the married state (vs. unmarried) was associated with favorable well-being, but the favorable outcomes proved stronger for women than men. Given that most Ss were married, the overall sex difference in well-being can be attributed to Ss' marital status. These findings were discussed in the context of prior research on sex differences in negative well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression, working models of others, and relationship functioning.

Two studies examined depressives' working models of others and the relative contribution of these models and depression to relationship functioning. Respondents reported on their childhood relationships, adult attachment style, and relationship functioning. Study 1 compared 163 mildly depressed and nondepressed college women (aged 17–48 yrs), and Study 2 compared 25 married women recovering from clinical depression with 23 nondepressed married women (mean age 40 yrs for both groups). Mildly depressed college women evidenced greater preoccupation and fearful avoidance in romantic relationships than did nondepressed women; recovering depressed women evidenced greater fearful avoidance. In both studies, relationship functioning was predicted more strongly by adult attachment style than by depression status. Among college women, positive experiences with mother also were linked to better relationship functioning; however, attachment style and depression status mediated this effect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accounting for changes in social support among married older adults: Insights from the MacArthur Studies of Successful Aging.

Using longitudinal, community-based data from the MacArthur Studies of Successful Aging, the authors examined determinants of changes in social support receipt among 439 married older adults. In general, social support increased over time, especially for those with many preexisting social ties, but those experiencing more psychological distress and cognitive dysfunction reported more negative encounters with others. Gender affected social support receipt: Men received emotional support primarily from their spouses, whereas women drew more heavily on their friends and relatives and children for emotional support. Discussion centers on the importance of social support provision to those with the greatest needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Dyadic Investigation of Exercise Support Between Cardiac Patients and Their Spouses.

The authors examined married partners' similarity in reported exercise behavior as a moderator of the association between social support for exercise provided and received by extending an actor-partner dyadic effects model. Participants were married cardiac rehabilitation patients and their spouses (N=99 couples). For couples similar in their reported exercise behavior, a significant association was found between both partners' independent reports of providing exercise support to and receiving exercise support from one another (n=49 couples). However, for couples differing in their reported exercise behavior (n=50 couples), no association was found between either partner's provision and receipt of support for exercise. Findings have the potential to inform practitioners of patients who may not be receiving adequate social support for their recommended exercise. Future interventions may consider implementing dyadic educational or motivational strategies with patients and their spouses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adherence to disease-modifying therapies in multiple sclerosis: Does caregiver social support matter?

Objective: To evaluate the relationship between caregiver-specific social support and adherence to disease-modifying therapies (DMT) for multiple sclerosis (MS). Design: Telephone survey with 6 monthly follow-up assessments. Setting: Veterans Health Administration. Participants: 54 veterans with MS who identified a primary caregiver and who were currently prescribed DMT. Measures: Demographic information. Caregiver supportive and conflictual qualities were assessed with the Quality of Relationships Inventory--Short Form. Medication-specific support was assessed with 4 items developed from qualitative focus groups. DMT adherence was assessed with a single item that requested missed doses in the past month. Results: Adherence in this population of ongoing DMT users was relatively high, with 85.1% (95% confidence interval = 75.6%-94.8%) reporting adherence ≥80% of prescribed doses. Using logistic regression adjusting for disability, type of DMT, and length of time on current DMT, the authors predicted longitudinal adherence by supportive qualities of the caregiver-care recipient relationship but not by conflictual qualities or medication-specific support. Conclusion: Supportive qualities of the caregiver-care recipient relationship represent an important predictor of DMT adherence and a potential target in adherence-based interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Well-being and posttraumatic growth in unrelated donor marrow transplant survivors: A nine-year longitudinal study.

Objective: To study posttraumatic growth and psychological and physical well-being among 25 cancer survivors (12 men, 13 women) 9 years after receiving a hematopoietic stem cell transplant from an unrelated donor. Measures: Participants completed measures of well-being (e.g., depression, physical function) and posttraumatic growth at the 9-year follow-up. Prior to treatment, optimism, social support, and well-being had been assessed. Results: Findings reveal high levels of physical and psychological well-being. Survivors reported posttraumatic growth in several domains, including increased personal strengths and enhanced interpersonal relationships. Higher levels of growth were significantly related to gender and age: Women reported more total posttraumatic growth, and older survivors reported more enhanced spirituality, one domain of growth. Posttraumatic growth and well-being after treatment were predicted by 2 psychosocial variables assessed prior to treatment: dispositional optimism and social support. Implications: Although long-term survivors report ongoing physical limitations, they also experience well-being in both physical and psychological domains. Posttraumatic growth is an area of well-being deserving of additional research and clinical attention. In particular, there may be reason to assist survivors to articulate growth as part of ongoing care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Illness intrusiveness, uncertainty, and distress in individuals with multiple sclerosis.

Objective: To examine the relation of illness intrusiveness and illness uncertainty to psychological distress in patients with multiple sclerosis (MS). Study Design: Participants were recruited from regional support groups and local neurologists. Participants completed self-report measures of illness intrusiveness, illness uncertainty, and psychological distress. Disease status was assessed by administration of a mental status exam and an index of ambulation. Participants: The sample included 78 (55 women, 23 men) individuals diagnosed with MS. Main Outcome Measure: The Symptom Checklist—90—Revised Global Severity Index. Results: Hierarchical regression analyses indicated that illness intrusiveness and illness uncertainty independently predicted adjustment problems above and beyond demographic and illness variables. No mediator or moderator relationships were found for illness intrusiveness. Conclusions: Psychological appraisals of illness are salient predictors of adjustment even after statistically controlling for the influence of age, education, and objective indices of physical and cognitive impairment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapeutic abortion and its psychological implications: the Canadian experience

Approximately 9 months after a legal therapeutic abortion, 188 Canadian women were interviewed. One half were single and the rest were married, separated or divorced. They were matched closely for a number of demographic variables with control women who had not had abortions. Neurotic disturbance in several areas of personality functioning was assessed from questionnaire responses. Out of 27 psychological scales, differences between the abortion and control groups were found on only 3: in general, women who had had abortions were more rebellious than control women, abortion tended to be associated with somewhat greater depression in married women, and single women who had had abortions scored higher on the shallow-affect scale. However, all the personality scores were well within the normal range. Perceived social support was strongly associated with favourable psychological reactions after abortion. Use of contraceptives improved greatly after the abortion, when over 90% of women reported using contraceptives regularly.     

Hope, coping, and social support in combat-related posttraumatic stress disorder

Dispositional hope, coping, and perceived social support were assessed among Vietnam combat veterans upon admission to and discharge from inpatient treatment for posttraumatic stress disorder (PTSD). Veterans reported lower dispositional hope than any previously described sample, and hope did not increase at discharge from treatment. At admission, higher hope was correlated with greater perceived social support coming from family (this relationship persisted when controlling for depression and PTSD symptoms). At discharge, higher hope was associated with greater perceived social support coming from family and friends and the use of adaptive coping strategies. Results indicate that hope confers a beneficial effect once veterans undergo treatment for combat-related PTSD, a finding that suggests that hope may be "gone but not lost" for these individuals.     

Graphing the order of the sexes: Constructing, recalling, interpreting, and putting the self in gender difference graphs.

Graphs seem to connote facts more than words or tables do. Consequently, they seem unlikely places to spot implicit sexism at work. Yet, in 6 studies (N = 741), women and men constructed (Study 1) and recalled (Study 2) gender difference graphs with men’s data first, and graphed powerful groups (Study 3) and individuals (Study 4) ahead of weaker ones. Participants who interpreted graph order as evidence of author “bias” inferred that the author graphed his or her own gender group first (Study 5). Women’s, but not men’s, preferences to graph men first were mitigated when participants graphed a difference between themselves and an opposite-sex friend prior to graphing gender differences (Study 6). Graph production and comprehension are affected by beliefs and suppositions about the groups represented in graphs to a greater degree than cognitive models of graph comprehension or realist models of scientific thinking have yet acknowledged. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analytic review of research on gender differences in sexuality, 1993–2007.

In 1993 Oliver and Hyde conducted a meta-analysis on gender differences in sexuality. The current study updated that analysis with current research and methods. Evolutionary psychology, cognitive social learning theory, social structural theory, and the gender similarities hypothesis provided predictions about gender differences in sexuality. We analyzed gender differences in 30 reported sexual behaviors and attitudes for 834 individual samples uncovered in literature searches and 7 large national data sets. In support of evolutionary psychology, results from both the individual studies and the large data sets indicated that men reported slightly more sexual experience and more permissive attitudes than women for most of the variables. However, as predicted by the gender similarities hypothesis, most gender differences in sexual attitudes and behaviors were small. Exceptions were masturbation incidence, pornography use, casual sex, and attitudes toward casual sex, which all yielded medium effect sizes in which male participants reported more sexual behavior or permissive attitudes than female participants. Most effect sizes reported in the current study were comparable to those reported in Oliver and Hyde’s study. In support of cognitive social learning theory, year of publication moderated the magnitude of effect sizes, with gender differences for some aspects of sexuality increasing over time and others decreasing. As predicted by social structural theory, nations and ethnic groups with greater gender equity had smaller gender differences for some reported sexual behaviors than nations and ethnic groups with less gender equity. Gender differences decreased with age of the sample for some sexual behaviors and attitudes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in predicting loneliness from social network characteristics.

Examined gender differences in predicting loneliness from measures of social network structure and a measure of perceived social support. Study 1 (including 179 undergraduates and 124 students [mean age 29 yrs]) used the traditional measure of network density in which the number of relationships among network members was determined. Study 2 (including 143 undergraduates [17–46 yrs]) used an index of density that assessed the extent of closeness of relationships between pairs of network members. Uniformly, male Ss with more highly interconnected, cohesive sets of friends reported themselves to be less lonely, whereas density had little relation to loneliness in females. Results are discussed as possibly indicating that men and women use different standards in evaluating whether they are lonely. It is suggested that men may use more group-oriented criteria in evaluating loneliness, whereas women focus more on the qualities of dyadic relationships. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Clinical Trial to Test the Feasibility of a Telehealth Psychoeducational Intervention for Persons With Schizophrenia and Their Families: Intervention and 3-Month Findings.

Objective: To evaluate the feasibility of a telehealth psychoeducation intervention for persons with schizophrenia and their family members. Study Design: Randomized controlled trial. Participants: 30 persons with schizophrenia and 21 family members or other informal support persons. Interventions: Web-based psychoeducation program that provided online group therapy and education. Main Outcome Measures: Measures for persons with schizophrenia included perceived stress and perceived social support; for family members, they included disease-related distress and perceived social support. Results: At 3 months, participants with schizophrenia in the intervention group reported lower perceived stress (p = .04) and showed a trend for a higher perceived level of social support (p = .06). Conclusions: The findings demonstrate the feasibility and impact of providing telehealth-based psychosocial treatments, including online therapy groups, to persons with schizophrenia and their families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The responsive bystander: How social group membership and group size can encourage as well as inhibit bystander intervention.

Four experiments explored the interaction of group size, social categorization, and bystander behavior. In Study 1, increasing group size inhibited intervention in a street violence scenario when bystanders were strangers but encouraged intervention when bystanders were friends. Study 2 replicated and extended these findings to social category members. When gender identity was salient, group size encouraged intervention when bystanders and victim shared social category membership. In addition, group size interacted with context-specific norms that both inhibit and encourage helping. Study 3 used physical co-presence and gender identities to examine these social category effects. Increasing group size of women produced greater helping of a female victim, but increasing group size of men did not. Additionally, increasing numbers of out-group bystanders resulted in less intervention from women but more intervention from men. Study 4 replicated these findings with a measure of real-life helping behavior. Taken together, the findings indicate that the bystander effect is not a generic consequence of increasing group size. When bystanders share group-level psychological relationships, group size can encourage as well as inhibit helping. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Feasibility of a Cognitive Restructuring Intervention for Treatment of Chronic Pain in Persons With Disabilities.

Objective: To determine the feasibility of a cognitive restructuring intervention relative to an education intervention for treatment of pain in persons with chronic pain secondary to disability. Study Design: Quasi-experimental. Participants: 18 adults with chronic pain and disability. Interventions: Cognitive restructuring (n = 13) or education (n = 5) group intervention. Main Outcome Measure: Average pain intensity. Results: Participants in the cognitive group reported greater pre- to posttreatment decreases in pain than those in the education group. Participants rated both interventions positively and expressed enthusiasm for psychosocial interventions for pain. Conclusions: Preliminary findings suggest that decreases in pain can occur as a result of a cognitive restructuring intervention and support the feasibility of conducting intervention trials in persons with disability-related chronic pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical activity and quality of life in multiple sclerosis: Possible roles of social support, self-efficacy, and functional limitations.

Objective: Quality of life (QOL) is compromised among individuals with multiple sclerosis (MS). Physical activity has been positively associated with QOL, but little is known about the factors that explain and/or confound the relationship in those with MS. On the basis of a social-cognitive perspective and previous research, the authors tested the hypothesis that physical activity would be indirectly associated with QOL through a mediated pathway that included self-efficacy and functional limitations, after controlling for perceived social support. Participants: Participants were 196 individuals with a definite diagnosis of MS living in the Midwest region of the United States who completed a battery of questionnaires and wore a pedometer and accelerometer for a 7-day period. Results: Covariance modeling analyses indicated that physical activity was indirectly associated with QOL through a pathway that included self-efficacy and functional limitations, and the pattern of relationships was independent of the perception of social support. Conclusions: The findings support physical activity as a possible modifiable behavior for mitigating reductions of QOL in those with MS and suggest that a social-cognitive model aids in the understanding of physical activity's relationships with QOL. (PsycINFO Database Record (c) 2010 APA, all rights reserved)