Goal-relevant dimensions of hypochondriacal tendencies and their relation to symptom manifestation and psychological distress.

A national sample of 60 male and 61 female adults completed a telephone interview that included measures of hypochondriacal tendencies, psychological distress, and symptom manifestation. They also provided cognitive evaluations for their most important health goal on scales measuring self-efficacy, value, planning, self-reward, self-criticism, self-monitoring, social comparison, and positive and negative goal-based arousal. Health goal cognition significantly predicted hypochondriacal tendencies measured 15 to 30 days after the goal assessment, even after controlling for chronic illness diagnosis. Correlations between goal cognition and hypochondriacal tendencies differed from those observed for psychological distress, and no significant correlations emerged with symptom manifestation. Results support a motivational account of hypochondriacal tendencies and extend previous goals research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The medical context of hypochondriacal traits

OBJECTIVE: This study examines the effects of two medical contexts on the relationship of hypochondriacal traits and their potential correlates. METHOD: Correlates of hypochondriacal traits were compared from a matched sample of fifty-five general medical inpatients with a sample of fifty-five medical inpatients referred for psychiatric evaluation. Patients completed questionnaires assessing emotional distress and health attitudes, beliefs, and behaviors, and their attending physician completed ratings of the patient's illness and illness behavior. RESULTS: Patients referred for psychiatric consultation exhibited significantly higher levels of hypochondriacal illness presentation than the matched nonreferred sample. Moderated regression analyses revealed three trends regarding the interactive effects of group status on the relationship of hypochondriacal traits to their potential correlates: 1) presence of angry feelings and interpersonal friction was positively associated with hypochondriacal concerns for the psychiatric referred patients only, 2) the tendency to deny life stresses and attribute all problems to the effects of illness was positively associated with a misinterpretation of the severity of their illness and hypochondriacal illness presentation for the psychiatric referred patients, whereas this association was negative for the nonreferred medical patients, and 3) the association of reports of emotional distress symptoms with hypochondriacal illness preparation was negative for the psychiatric referred patients and positive for the nonreferred medical patients. CONCLUSIONS: Study results suggest that hypochondriasis may not represent a uniform nosological disorder and that the context of its study can significantly influence etiologic findings.     

The self-serving function of hypochondriacal complaints: Physical symptoms as self-handicapping strategies.

Tested the hypothesis that hypochondriacal individuals commonly use reports of physical illness and symptoms as a strategy to control attributions made about their performances in evaluative settings (i.e., self-handicapping strategies). It was predicted that hypochondriacal Ss would report more recent physical illness and complaints and more current physical symptoms in an evaluative setting in which poor health could serve as an alternative explanation for poor performance than would either Ss in an evaluative setting in which poor health was precluded as an excuse or Ss in a nonevaluative setting. 109 undergraduates selected on the basis of their high or low score on the Hypochondriasis scale of the MMPI were administered a short form of the State-Trait Anxiety Inventory and then received either the evaluative or nonevaluative instructions as a rationale for the experiment. It was found that as predicted, results support the self-protective pattern of complaints in hypochondriacal Ss but not in nonhypochondriacal Ss. The self-protective role of hypochondriacal behavior is discussed in relation to theory and research on the nature and treatment of hypochondriasis. (57 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do age of onset and course of illness define biologically distinct groups within atypical depression?

Illness course separates patients with atypical depression into tricyclic responders and nonresponders as does perceptual asymmetry. The authors therefore investigated whether the course-of-illness parameters would define groups within atypical depression differing in brain laterality. Patients with atypical depression were assessed for illness course and brain laterality. Two patient groups were defined, 1 with onset prior to age 20 plus a very chronic course, and a 2nd group having later onset or less chronic illness. Patients reporting early onset of very chronic dysphoria showed significantly less right-ear (left-hemisphere) accuracy and also differed in characteristic perceptual asymmetry when compared to patients with later onset or less chronicity. Course of illness may usefully define more homogeneous depressive subgroups within atypical depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

State and trait negative affect as predictors of objective and subjective symptoms of respiratory viral infections.

State and trait negative affect (NA) were measured in healthy people immediately before an illness was induced through exposure to a respiratory virus. State NA, disease-specific health complaints (e.g., runny nose, congestion, sneezing), and an associated objective marker of disease severity (mucus secretion weights) were assessed daily during the illness. Baseline trait and state NA were both associated with increased numbers of subsequent complaints. Although greater numbers of complaints among people high in state NA were explicable in terms of greater disease severity, the association of trait NA and symptoms was independent of objective disease. The trait NA complaint association was also independent of state NA and hence not attributable to trait-elicited state affect. Greater trait NA was associated with biases in complaining during but not before illness. This suggested failure to discriminate between symptoms rather than increased sensitivity or hypochondriacal response. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dependence on external influence: Correlates in perception, attitudes, and judgment.

The hypothesis that people have a generalized tendency to accept or reject external influence is tested in perceptual and conformity situations, using 53 college males as S's. The results show that S's who are highly influenced by the field in one perceptual test perform similarly in other perceptual tests, conformity measures are not significantly interrelated, and field dependent perceptual behavior is associated with high conformity in other tests, particularly autokinetic and attitude change measures. It is suggested that while perceptual performance reflects central tendencies of the person, his performance in specific conformity situations is subject to greater fluctuation as a result of more peripheral factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clonal origin of trisomy for chromosome 7 in the epithelial compartment of colon neoplasia

To examine primary care physician recognition of hypochondriacal patients, we identified a series of such patients in a general medicine clinic using the Whiteley Index. Clinic physicians made blind global ratings of severity of physical disease and unreasonable fear of illness (hypochondriasis) and completed a checklist of somatizing characteristics. Patient records were audited for diagnoses, laboratory tests, consultations, and medications prescribed. Twenty-nine (14%) of 210 patients scored above an established cutoff on the Whiteley Index. These hypochondriacal patients were rated by clinic physicians as more hypochondriacal and were more often given psychiatric diagnoses. Also, clinic physicians identified more somatizing features among hypochondriacal patients including their own reaction to them. This recognition of hypochondriac characteristics may have contributed to better management but may need to be raised to the diagnostic level for maximum benefit.     

A prospective 4- to 5-year study of DSM-III-R hypochondriasis

BACKGROUND: Although hypochondriasis is generally thought to be a chronic and stable condition with a relatively low remission rate, this disorder remains understudied. METHODS: This is a 4- to 5-year prospective case-control study of DSM-III-R hypochondriasis. Medical outpatients meeting DSM diagnostic criteria for hypochondriasis completed an extensive research battery assessing hypochondriacal symptoms, medical and psychiatric comorbidity, functional status and role impairment, and medical care. A comparison group of nonhypochondriacal patients from the same setting underwent the same battery. Four to 5 years later, both cohorts were re-interviewed. RESULTS: One hundred twenty hypochondriacal and 133 nonhypochondriacal comparison patients were originally studied. Follow-up was obtained on 73.5% (n = 186) of all patients. At follow-up, the hypochondriacal sample was significantly (P<.001) less hypochondriacal and had less somatization (P<.001) and disability than at inception, but 63.5% (n = 54) still met DSM-III-R diagnostic criteria. When compared with the comparison group using repeated measures multivariate analysis of variance, these changes remained statistically significant (P<.0001). Changes in medical and psychiatric comorbidity did not differ between the 2 groups. When hypochondriacal patients who did and did not meet diagnostic criteria at follow-up were compared, the latter had significantly less disease conviction (P<.05) and somatization (P<.01) at inception, and their incidence of major medical illness during the follow-up period was significantly (P<.05) greater. CONCLUSIONS: Hypochondriacal patients show a considerable decline in symptoms and improvement in role functioning over 4 to 5 years but two thirds of them still meet diagnostic criteria. Hypochondriasis, therefore, carries a very substantial, long-term burden of morbidity, functional impairment, and personal distress.     

On the Automatic Evaluation of Social Exemplars.

The present article focuses on the automatic evaluation of exemplars whose category membership has been learned in the past. Studies 1 and 2 confirmed the hypothesis that once an exemplar has been encoded as a member of a given group, at a later encounter the evaluation associated with the group will be unintentionally retrieved from memory, even when no perceptual cue indicates the exemplar's category membership. Study 3 extended the results to the domain of in-group/out-group differentiation. In addition. Studies 4 and 5 confirmed the hypothesis that stored evaluations can be retrieved and affect responses even when the semantic information on which the evaluations were originally based is no longer available for retrieval. Finally, Study 6 investigated spontaneous approach-avoidance behavior tendencies. Overall, results demonstrate the pervasive effects of person-based representations, and they are discussed in terms of recent models of person perception and out-group discrimination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quantitative cytomegalovirus (CMV) antigenaemia during antiviral treatment of AIDS-related CMV disease

Self-inflicted dermatoses are associated with personality disorders and psychoses, including monosymptomatic hypochondriacal psychosis (MHP), which is characterized by a delusion involving a particular hypochondriacal concern. We report an unusual case of MHP with severe mutilation of the skin complicated by a skull defect and brain abscess. The patient was a 66-year-old uneducated man who damaged his forehead repeatedly because he believed that a 'toxic root' in the forehead was the source of his general ailment. He admitted that the lesions were self-inflicted. There was no other evidence of psychosis or primary skin disease and MHP was diagnosed. Despite initial favourable response to pimozide, the patient was lost to follow-up for 4 years, during which he continued to damage his forehead and applied corrosive agents. He was then referred with a personality change and a 6 x 4 cm bony defect in the skull, complicated by herniation and abscess of the left frontal lobe. This case represents one of the most severe examples of self-mutilation ever reported. The differential diagnosis of dermatitis artefacta and the principles of treating MHP are discussed.     

The status of the minimum principle in the theoretical analysis of visual perception.

Examines recent empirical investigations into minimum tendencies (MTs) in the visual perception of form, depth, and motion for purposes of comparison and evaluation, explores the theoretical status of MTs and proposed minimum principles (MPs) using systematic analysis, and considers the chief types of process models proposed to account for minimization. An MT is a psychophysical finding that perception tends toward simplicity, as measured in accordance with a specified metric. An MP is a theoretical construct imputed to the visual system to explain MTs. The notion that simple perceptual representations must be defined within the "geometric constraints" provided by proximal stimulation is examined, as are the metrics of simplicity. It is contended that any study of perceptual economy must use a metric of simplicity; the choice of metric may be seen as a matter of convention or it may have deep theoretical and empirical implications. Several answers to the question of why the visual system might favor economical representations are evaluated. Several accounts of the process for achieving perceptual economy are examined, and it is concluded that those that favor massively parallel processing are the most plausible. (99 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychodynamics of intrinsic and extrinsic job orientation.

Studied personality correlates of intrinsic and extrinsic job orientation using 136 employees in an social service organization. Results are presented for general intrinsic orientation as well as for specific factors included in the 2 broad categories. Results indicate that concern with intrinsic factors signifies approach tendencies, while concern with extrinsic factors points to avoidance tendencies. (19 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prodromal signs and symptoms of schizophrenic relapse.

Six-week periods prior to 17 psychotic relapses and to 10 relapses characterized by depression and/or hostility were examined for 23 recent-onset schizophrenic outpatients. These prodromal periods were compared with periods that did not precede relapse for the same patients and for 27 schizophrenic patients who did not relapse. The Brief Psychiatric Rating Scale (BPRS) was used to assess symptomatology. Psychotic relapse was defined as an elevation to severe or extremely severe from nonpathological levels on one or more of BPRS items: Hallucinations, Unusual Thought Content, and Conceptual Disorganization. Nonpsychotic relapses were similarly defined using the Depression and Hostility items of the BPRS. Even small elevations in odd thought content, unusual perceptual experiences, depression, somatic concern, and guilt above the levels usually present for a given patient may presage psychotic relapse during the 6 to 8 weeks prior to its occurrence. When compared with nonprodromal periods of other patients, periods before relapse were found to show significantly higher levels of hostility and grandiosity in addition to higher levels of unusual thought content and perceptual abnormalities. For relapses characterized by depression and hostility, an elevation of activation was found in the prodromal period. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Resistance of high-anxious subjects under ego threat to perception of figural distortion.

40 college students were selected as high and 40 as low in anxiety (IPAT Anxiety Scale). Ss judged the horizontal plane while viewing a specially designed room (Leaf Room) through aniseikonic lenses. Groups of Ss were subdivided and provided either task or threat orientation to the perceptual procedure. High-anxious in comparison with low-anxious Ss required more time to recognize the perceptual distortion produced by aniseikonic lenses, and they estimated a smaller degree of distortion. Thus high anxiety appeared to retard ability to shift from familiar to unfamiliar but veridical percepts. The effects of ego threat were less clear but seemed to relate to certain inverse reaction tendencies present among high anxious Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning as accumulation: A reexamination of the learning curve.

Theories of learning that predict a negative exponential growth curve are based on the assumption that learning is a process of replacement—incorrect response tendencies are replaced with correct ones. In the present article, an alternate model is presented that describes learning as a process of accumulation where incorrect response tendencies remain constant and correct response tendencies increase with practice. These 2 approaches were compared in their ability to describe the shapes of the learning curves for several experiments in free recall and perceptual and motor learning. In nearly every case, the predictions of the accumulation model were superior, and the predictions of the best fitting replacement equations failed in systematic ways. The relationship between the accumulation model and a reinforcement theory of steady-state responding is discussed. It is argued that the accumulation model should be given greater consideration as a viable model of the learning process. (68 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of mental abilities: An investigation of the "differentiation hypothesis."

Attempted to determine the extent to which verbal, numerical, spatial, and perceptual speed abilities will be differentiated as a function of differing amounts of classroom learning. The hypothesis was tested that verbal and numerical abilities will be differentiated earlier than perceptual speed and spatial scanning, because learning requiring the former types of abilities is emphasized quite early in the school program. 3 groups (111 7th graders, 95 9th graders, and 75 11th graders) were given the tests measuring verbal, numerical, perceptual, and spatial-scanning abilities from the Kit of Reference Tests. The factor analyses of the correlation matrices yielded 4 factors for each sample associated with eigenvalues greater than 1. The verbal and number factors were identifiable at the Grade-7 level but neither of the other 2 was easily interpretable. The spatial-scanning factor emerged at the Grade-9 level and all 4 factors were distinctly defined at the Grade-11 level. Results support the hypothesis that mental abilities become differentiated as a function of increased learning experiences. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arousal and perceptual sensitivity in hypochondriacs.

Absolute auditory sensitivity and visual 2-flash fusion sensitivity were examined in 22 high- and 21 low-hypochondriasis (MMPI Hs scale and Whiteley Index, an attitude toward illness measure) scorers selected from a normal undergraduate population. Signal detection analysis was used for both the visual and auditory measures to separate the effects of criterion and actual sensitivity. Hypochondriacal Ss were significantly more sensitive on the 2-flash fusion task than nonhypochondriacal Ss. For the auditory experiment, the difference in sensitivity between hypochondriacal and nonhypochondriacal Ss was in the predicted direction but was not significant. Cluster analysis of the hypochondriasis items showed a cluster of items consistent with the concept of an arousal-based hypochondriasis. Analysis of the visual data showed this cluster to be a better predictor of visual 2-flash fusion sensitivity than the total hypochondriasis scale. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repetition deficit in rapid-serial-visual-presentation displays: Encoding failure or retrieval failure?

The repetition deficit associated with rapid serial visual presentation (RSVP) has been explained as a repetition-induced blindness, that is, as a perceptual or encoding failure. The repetition deficit was replicated in a standard free-recall RSVP task, and it was shown that participants were able to report the lost item when they were prompted with a retrieval probe. The authors argue that both copies of the repeated items were available in memory but that they were not accessible for report. Hence, they conclude that the repetition deficit in the RSVP task reflects a retrieval failure, not a perceptual failure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do you see what we see? The complex effects of perceptual distance between leaders and teams.

Previous distance-related theories and concepts (e.g., social distance) have failed to address the sometimes wide disparity in perceptions between leaders and the teams they lead. Drawing from the extensive literature on teams, leadership, and cognitive models of social information processing, the authors develop the concept of leader-team perceptual distance, defined as differences between a leader and a team in perceptions of the same social stimulus. The authors investigate the effects of perceptual distance on team performance, operationalizing the construct with 3 distinct foci: goal accomplishment, constructive conflict, and decision-making autonomy. Analyzing leader, member, and customer survey responses for a large sample of teams, the authors demonstrate that perceptual distance between a leader and a team regarding goal accomplishment and constructive conflict have a nonlinear relationship with team performance. Greater perceptual differences are associated with decreases in team performance. Moreover, this effect is strongest when a team's perceptions are more positive than the leader's are (as opposed to the reverse). This pattern illustrates the pervasive effects that perceptions can have on team performance, highlighting the importance of developing awareness of perceptions in order to increase effectiveness. Implications for theory and practice are delineated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Geriatric depression and hypochondriasis: Incidence, interaction, assessment and treatment.

Reviews the incidence and interaction of depression and hypochondriasis in late life. It is argued that when psychometric instruments are used to assess these disorders, it is imperative to use tests that have been developed for and standardized with the aged. Psychotherapy for depression must preserve the therapist's authority role and focus on problem solving in the present and active mastery of the environment rather than attempt to develop insight. The treatment of hypochondriasis must focus on treating the underlying depression, not on removing the hypochondriacal defense. The therapist of choice for hypochondriacal patients is a primary-care physician. (45 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)