Preparation for undergoing an invasive medical procedure: interacting effects of information and coping style

Four reagent formulations (three provided by a manufacturer; one prepared in-house by mixing equal volumes of two commercial reagents) are used for the assay of phencyclidine (PCP) in urine samples. Performance characteristics evaluated included assay precision and sensitivity at and near the assay cutoff concentration. Data resulting from the reagent prepared in-house are better than those using then commercially available formulations, and are comparable with those obtained using the recently available new commercial formulation.     

Puppet modeling technique for children undergoing stressful medical procedures: Tips for clinicians.

Films of puppet models have been found effective in reducing anxiety levels in children facing medical stressors. Unfortunately, films that address the specific medical stressors faced by a given child are not always available. The current work describes how individual clinicians can use puppets as models to alleviate children's anxiety when they face medical stressors. The elements of this technique are presented and discussed with an illustrative case history. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of hypnosis and distraction in severely ill children undergoing painful medical procedures.

An ethnically diverse sample of high and low hypnotizable children (N?=?27) suffering from cancer or blood disorders and their parents were trained to use both distraction and hypnosis to reduce pain and anxiety. Measures of pain and anxiety were obtained from the children and their parents. Independent raters also judged participants' video-taped distress responses. Data were collected during painful medical procedures, for baseline, distraction, and hypnosis conditions. Supporting E. R. Hilgard's (1977, 1992) neodissociation theory, hypnotizable children showed significantly lower pain, anxiety, and distress scores in response to hypnosis in contrast to low hypnotizable children. Distraction produced significant positive effects for observer-rated distress scores for the low hypnotizable children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Primary process in children as a function of age.

Extending Freud's formulation with regard to the nature of the primary process, it was posited that language should reflect Freud's content that "contraries are not kept apart from each other, but are treated as though they were identical." Hypothesizing that secondary process thinking is a function of development, 3rd graders and 6th graders were compared on the basis of a paper-and-pencil test wherein the task was to select a synonym word from a group containing the synonym, an antonym, and an irrelevant word. Primary process thinking, as measured above, was found to be more characteristic of the younger group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preparation for a stressful medical procedure: Effect of amount of stimulus preexposure and coping style.

Studied anxiety during the stressful medical procedure of endoscopy as a function of the number of prior viewings of an explicit preparation videotape and of repression–sensitization coping style. 60 naive patients aged 22–80 yrs viewed a videotaped endoscopy either 0, 1, or 3 times. Dependent measures included heart rate, behavioral ratings, tranquilizer required, and self-report (State–Trait Anxiety Inventory and Post-Endoscopy Interview Schedule). On each dependent measure, 3 viewings generally resulted in the least distress; 1, more distress; and 0, the most distress. Most comparisons reached significance. Results are interpreted as resulting from extinction and/or habituation of anxiety. The repression–sensitization factor interacted with heart rate change. Sensitizers showed a monotonic decrease in heart rate as a function of number of tape exposures. Repressors showed an inverted-U-shaped function, with 1 viewing producing the highest heart rate; this is interpreted as resulting from a disruption of repressing defenses by 1 tape exposure followed by extinction of fear by 3 exposures. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping by children undergoing stressful medical procedures: Some conceptual, methodological, and therapeutic issues.

Because coping is postulated to change across persons, time, and stressors, the study of coping is inherently complex. These complexities are magnified in children's coping because a child's ability to effectively appraise a stressor and the coping resources that are available is dependent on the child's rapidly shifting developmental level. A small set of recent pediatric psychology studies describes children's active, informative-seeking coping versus avoidant or information-denying coping as an example of current trends in research on children's coping. Review of these studies highlights the need for tighter, more complete conceptualizations and improved methodologies. There are many therapeutic implications of this research, not the least of which is the problem of how (or even if) avoidant children should be prepared for medical procedures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preparation to reexperience a stressful medical examination: Effect of repetitious videotape exposure and coping style.

36 22–80 yr old patient volunteers, experienced in the stressful endoscopy examination, were prepared to reexperience that examination by viewing an explicit videotaped endoscopy either 0, 1, or 3 times. All Ss were given the State–Trait Anxiety Inventory, a Modified Repression-Sensitization Scale (Epstein & Fenz, 1967), and the Post-Endoscopy Interview Schedule. Patients were classified as having either a repressing or sensitizing coping style. On dependent anxiety measures including heart-rate change, behavioral ratings, and self-report, tape viewing generally resulted in decreased anxiety in sensitizers, and had no effect or produced increased anxiety in repressors. When the data were analyzed ignoring repression-sensitization coping style, tape viewing produced little effect. Results are discussed in terms of the accurate information and extinction theories of preparation effects. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A stress inoculation program for parents whose children are undergoing painful medical procedures.

The efficacy of a stress inoculation intervention program was compared with that of a child-focused intervention program in helping parents cope with their children's painful medical procedures. Ss included 72 parents (79% mothers) of pediatric leukemia patients (aged 3–12 yrs) who were undergoing either bone marrow aspirations (n?=?28) or lumbar punctures (n?=?44). Parents were assessed during a baseline procedure and then were randomly assigned to either a stress inoculation group or a child-focused intervention group. In the child-focused intervention, parents merely observed their child's participation in a cognitive behavior therapy program. Assessment of parents included an observation measure of parent behavior, self-reported measures of anxiety and coping, and physiological measures. Results indicate that parents in the stress inoculation program reported lower anxiety scores and higher positive self-statement scores than did parents in the child-focused intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributional style and depressive symptoms among children.

The reformulation of helplessness theory proposes that an insidious attributional style accompanies and predisposes depressive symptoms. The present study investigated predictions of the reformulation among 96 8–13 yr olds who completed the Children's Attributional Style Questionnaire (ASQ) and Children's Depression Inventory twice, 6 mo apart. 83 of their parents completed the adult ASQ and the Beck Depression Inventory at their children's 2nd testing. Children who attributed bad events to internal, stable, and global causes were more likely to report depressive symptoms than were children who attributed these events to external, unstable, and specific causes. This depressive attributional style predicted depressive symptoms 6 mo later, suggesting that it may be a risk factor for depression. Children's attributional style for bad events and their depressive symptoms converged with those of their mothers but not their fathers. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Externality as a function of obesity in children: Pervasive style or eating-specific attribute?

The developmental sources of the link between stylistic externality and food-related externality found in the obese by S. Schachter and his associates (e.g., Schachter and J. Rodin, 1974) were explored by testing whether the externality phenomena that have been found to differentiate obese and normal adults are also discriminators of obese and normal children. Based on teacher ratings of obesity, 28 distinctly overweight and 28 normal weight Ss in Grades 2–5 were selected. Ss were assessed on 3 measures (a) the eating of shelled or unshelled peanuts, (b) their estimations of the length of a boring or interesting film, and (c) their rod-and-frame test-measured field dependence. Results suggest that obese children as young as 7–22 yrs of age show an external responsiveness to salient food cues but do not yet show a generally external perceptual style. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catecholamine secretion as a function of perceived coping self-efficacy.

Hypothesized that perceived coping self-efficacy mediates the effects of environmental events on catecholamine secretion. Differential levels of perceived self-efficacy were induced in 12 female phobic Ss, aged 19–40 yrs, through modeling. Their level of catecholamine secretion was then measured as they were presented with coping tasks in their high, medium, and low ranges of perceived self-efficacy. High perceived self-efficacy was accompanied by low levels of plasma epinephrine and norepinephrine during interaction with a phobic object, whereas moderate perceived self-inefficacy gave rise to substantial increases in plasma catecholamines. Both catecholamines dropped sharply when Ss declined tasks for which they judged themselves completely inefficacious. In contrast, dihydroxyphenyl-acetic acid was released maximally by mere apperception of task demands that Ss regarded as overwhelming their coping capabilities. After perceived self-efficacy was strengthened to the maximal level by S modeling, all of the tasks were performed without any differential catecholamine responses. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On fighting versus accepting stressful circumstances: Primary and secondary control among HIV-positive men in prison.

The primacy of primary control over secondary control and ethnic differences in control processes were tested in HIV-positive male state prison inmates. They rated their perceptions of control and psychological distress at an initial interview (N?=?95) and 3 months later (N?=?78). Regression analyses revealed that primary control had primacy as it had greater adaptive value. However, secondary control did not function as a backup to primary control, and temporal differences in control were not found. No mean differences due to ethnicity (African American vs. White) were found, but there was a strong ethnic difference in the effects of primary control. White participants showed the expected negative relationship between distress and primary control, but African American participants did not. The idea that the benefits of primary control would be the same across various subcultures was not supported. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Interaction among retarded children as a function of their relative language skills.

It has long been recognized that the quality of interpersonal relations affects the behavior of individuals with mental retardation. The question to be assessed here was the effect of the skill of individual reacting with the mental retardate upon the behavior of the retardate. This study is a modified replication of an earlier one (Rosenberg, 1959). Ss of an institution for mental retardates were categorized re: verbal facility. Group of Ss was then formed containing pairs of Highs and Lows on this test, and interpersonal behavior was assessed in a play room situation. The results indicate that Lows and Highs interact with each other effectively, whereas heterogeneity of grouping inhibits social interaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive strategies, expectancy, and coping style in the control of pain.

Measures of tolerance, self-reported pain threshold, and overall discomfort of cold-pressor pain were obtained from 114 male undergraduates in a pretest–training–posttest experiment. Training consisted of brief practice in 1 of 4 cognitive strategies: rational thinking, compatible imagery, incompatible imagery, and task-irrelevant cognition. Analyses of covariance indicated that (a) cognitive-imaginal strategies facilitated endurance of pain and raised self-reported threshold, (b) rational thinking and compatible imagery were generally the most effective treatments, (c) expectancy alone was not a significant pain-attenuating factor, (d) treatments did not affect discomfort ratings, and (e) individual differences in imaginal ability and coping style did not correlate with changes in any of the dependent measures. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Generalization of self-discrepant information as a function of defensive style.

Administered the Byrne's Repression-Sensitization scale to 203 male undergraduates. 24 repressors and 24 sensitizers were selected and then presented with self-discrepant information (low maturity scores) in a microcounseling interview under conditions that made denial difficult. Ss subsequently interacted with a counselor using either a cognitively or an affectively oriented style to help gain acceptance of the self-discrepant information. Generalization effects of the self-discrepant information presented were studied on ratings of 4 personality dimensions (openness, sensitivity, masculinity, and acceptance) not discussed in the microcounseling interview. Analysis revealed significant generalization effects on self-attribute ratings resulting from counseling approach and a significant interaction of defensive style with counseling approach. No significant generalization effects were found on analysis of counselor attribute ratings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships among Minuchin's structural family model, identity achievement, and coping style.

Examined S. Minuchin's (1974) contention that a balance between enmeshment and disengagement in the family is associated with healthy adolescent development. 182 college students completed the Structural Family Interaction Scale—Revised, the Adolescent-Coping Orientation for Problem Experiences Scale, and the Ego Identity Scale. The results of canonical analyses suggested that clear boundaries and the expression and resolution of conflict, in conjunction with the absence of cross-generational alliances, are associated with identity achievement and positive coping strategies (e.g., confronting problems and seeking help from family members). Gender differences emerged in the analyses. The results of hierarchical regression suggested that coping style is a mediator between family structure and identity achievement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client behavior as a function of therapist style and client resources.

Examined the therapy career of 27 males and 21 females from pretherapy characteristics to outcome, focusing on the 3 issues: (a) degree to which each member of the dyad influenced the process level of the client at different stages, (b) interaction effects between therapist style and client personal resources, and (c) relationships between outcome and client process levels at different time points. The effect of client resources on client process level proved significant both early in therapy and at the midpoint. The therapist style effect was significant at the midpoint but not in early therapy. No significant Client * Therapist interactions were found. Client process in the 10th interview correlated significantly with outcome of therapy viewed from 3 perspectives: The client's, the therapist's, and that of a Rorschach diagnostician. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment to multiple sclerosis: Application of a stress and coping model.

This study examined the use of a stress and coping model of adjustment to multiple sclerosis (MS). A total of 122 MS patients were interviewed and completed self-administered scales at Time 1 and 12 months later, Time 2 (n?=?96). Predictors included stressful life events, illness (duration, severity, and disability), social support, appraisal (threat and control/challenge), and coping (problem focused and emotion [wishful thinking, self-blame, and avoidance] focused). Adjustment outcomes were Time 2 depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that after controlling for the effects of Time-1 adjustment, better Time-2 adjustment was related to less disability, greater reliance on problem-focused coping, and less reliance on emotion-focused coping. There was limited support for the stress buffering effects of coping and social support. Findings offer some support for the use of a stress and coping model of adaptation to MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of sensory and procedural information on coping with stressful medical procedures and pain: A meta-analysis.

A meta-analysis of studies on preparation for medical procedures and pain evaluated the relative effects of sensory, procedural, and combined sensory-procedural preoperational information on coping outcomes. Results indicated that, in contrast to sensory information, procedural information provided no significant benefits over control group instruction. Combined sensory-procedural preparation, however, yielded the strongest and most consistent benefits in terms of reducing negative affect, pain reports, and other-rated distress. The meta-analytic results are consistent with the dual process preparation hypothesis, which proposes that the information combination is optimal because procedural details provide a map of specific events while sensory information facilitates their interpretation as nonthreatening. It is concluded that a combined preparation is the preferred clinical option. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations among discipline style, child behaviour problems, and perceived ineffectiveness as a caregiver among parents with conduct problem children.

Examined relations among discipline style, parents' self-attributions in the caregiver role, and child behavior problems in a clinical sample of 253 parents (91% female) of 274 6–12 yr old, clinic-referred, children (219 boys, 55 girls) with conduct problems. Principal components factor analysis of parents' responses to 9 discipline techniques reveals 2 general styles labeled severe and mild aversive. Hierarchical regression analyses support the mediating role of parents' self-efficacy as a caregiver for the severe aversive, but not the mild aversive, discipline style after controlling for demographic variables. Also, parents who felt ineffective in using a particular discipline technique rated their child as having more behavior problems than did parents who did not use that technique or who used the technique effectively. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)