Goal instability and adjustment to physical disability.

Few studies have examined psychoanalytic constructs in the adjustment of individuals who incur physical disability. According to H. Kohut (1977), optimal adjustment during life transitions is contingent on the individual's capacity for maintaining and pursuing meaningful goals, which reflects a stable sense of self. A series of studies was conducted to determine if goal instability would predict adjustment and health following disability. Goal instability was predictive at depressive behavior and acceptance of disability among individuals with recent-onset disability. Goal instability predicted subjective well-being 1 year later. Among community residents with a disability, goal instability was associated with life satisfaction; this relationship was not mediated by perceived stigma or community mobility. These findings indicate that a flexible yet durable goal orientation is associated with optimal psychological adjustment among individuals with a physical disability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging, limitation in physical strength and effects of exercise

HLA typing was performed on 384 individuals of an isolated population of 1,500 people with a familial aggregate of lymphoma and immunodeficiency cases. Eighty-five % of the total population were descendants of the founding couple. First cousin marriages were common. There was a three-fold or higher increase of the following haplotypes as compared to the frequencies in Sheffield: HLA-A28,Bw35, HLA-A28, B18, HLA-A10, B18, HLA-A2, B18,HLA-A11, Bw40 and HLA-A11, B7. The frequency of HLA-A1, B8 was low (5.4%). The most common genotype was HLA-A2, B12/A2, B12 followed by HLA-A2, B12/A28, Bw35. We found 20 HLA homozygous individuals, of these 15 were HLA-A2, b12/a2, b12. There were two possible HLA cross-overs which may be confirmed and three postulated cross-overs which can never be confirmed as one or both parents of the individuals in question are deceased. Some of the haplotypes could be traced back to the first, second and third generations, i.e. to the first half of the nineteenth century. No single haplotype or antigen was shared by the patients.     

Effects of age, sex, and physical attractiveness on child-peer relations, academic performance, and elementary school adjustment.

Assessed the effects of age, sex, and physical attractiveness for 56 4th- and 48 6th-grade male children's actual and perceived social, personal, and academic development. Ss' physical attractiveness was rated by 97 adults who viewed standardly posed photographs of them. Teachers rated Ss for academic ability and adjustment. Actual academic performance was indexed by GPAs. Actual adjustment was measured through subsections of the California Test of Personality. Positive and negative peer relations scores were derived from peer nominations. Physical attractiveness was positively related to positive peer relations and teachers' appraisals of academic ability and adjustment, and was negatively related to negative peer relations. Evidence was found for relations among physical attractiveness, GPA, and actual adjustment. No sex or grade effects were found. Organismic developmental notions, specifying how a child's physical attributes provide a basis of his own development, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term adjustment to physical disability: The role of social support, perceived control, and self-blame.

100 40–73 yr olds with spinal cord injuries were interviewed an average of 20 yrs after the disability occurred. Ss answered questions concerning perceived control, attributions of blame, and the nature of the social comparisons they made. Adjustment was measured by an index of psychological well-being, a life satisfaction index, and a depression scale. For all 3 outcome measures, Ss reported levels of well-being only slightly lower than population means of nondisabled persons of similar age. Controlling for health status and current income, it was found that persons who had high levels of social support, who were satisfied with their social contacts, and who felt they had high levels of perceived control reported high levels of well-being. Self-blame and the perceived avoidability of the cause of the disability correlated only moderately with the measures of adjustment, suggesting that there are important differences between coping successfully immediately after a traumatic event has occurred and coping successfully many years later. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging changes of the optic nerve head in relation to open angle glaucoma

AIMS: To determine the age related changes in optic nerve head structure in a group of normal subjects and assess the significance of any changes in relation to those found in open angle glaucoma. METHODS: A group of 88 white volunteers and friends and spouses of patients with a normal visual field and normal intraocular pressure was studied. Two different imaging and measurement devices were used (computer assisted planimetry and scanning laser ophthalmoscopy), and the results from each were compared. Measurements were made of the optic disc, optic cup, and neuroretinal rim areas, and the vertical optic disc diameter and cup/disc diameter ratio. RESULTS: Neuroretinal rim area declined at the rate of between 0.28% and 0.39% per year. Vertical optic cup diameter and optic cup area increased with age. The mean cup/disc diameter ratio increased by about 0.1 between the ages of 30 and 70 years. CONCLUSIONS: Age related changes are significant and measurable, and should be taken into account when assessing the glaucoma suspect, and when estimating the rate of progression of glaucomatous optic neuropathy in patients with established disease.     

Emotionally expressive coping predicts psychological and physical adjustment to breast cancer.

This study tested the hypothesis that coping through emotional approach, which involves actively processing and expressing emotions, enhances adjustment and health status for breast cancer patients. Patients (n ?=?92) completed measures within 20 weeks following medical treatment and 3 months later. Women who, at study entry, coped through expressing emotions surrounding cancer had fewer medical appointments for cancer-related morbidities, enhanced physical health and vigor, and decreased distress during the next 3 months compared with those low in emotional expression, with age, other coping strategy scores, and initial levels on dependent variables (except medical visits) controlled statistically. Expressive coping also was related to improved quality of life for those who perceived their social contexts as highly receptive. Coping through emotional processing was related to one index of greater distress over time. Analyses including dispositional hope suggested that expressive coping may serve as a successful vehicle for goal pursuit. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived social support, psychological adjustment, and functional ability in youths with physical disabilities.

Objective: To examine the relationship between perceived social support and psychological adjustment and functional ability in youths with physical disabilities. Participants: Thirty-seven youths with neuromuscular disease and 33 with spina bifida. Measures: Demographic and disability-related questions, Child Health Questionnaire, Functional Disability Inventory, and Multidimensional Scale of Perceived Social Support. Results: Social support from family, but not from friends, was significantly associated with better psychological adjustment. Significant interactions emerged between family support and age, as well as between friend support and gross motor functioning, in the prediction of functional ability. Conclusions: Social support appears to play an important role in psychological adjustment and functional ability in this population, and the nature of this role may be moderated, to some extent, by age and gross motor functioning. Future research and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's adjustment in joint and sole physical custody families.

Examined patterns of custody and their relationship to the behavioral-emotional and social adjustment of 93 children, ages 3–14, in divorcing families. Assessed children and their parents within 1 year after parents filed for divorce, and again 1 and 2 years later. Children in joint physical custody (38%) had more access to both parents and made slightly more transitions between parental homes. However, custody arrangements were not significantly related to child adjustment. Factors associated with child adjustment included number of children in the family, child age and gender, parental depression/anxiety at baseline, and parental conflict at 1-year follow-up. Thus, no evidence was found that joint physical custody arrangements are different from sole physical custody arrangements with regard to child adjustment postdivorce. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Caregiver social problem-solving abilities and family member adjustment to recent-onset physical disability.

Objective: The authors examined the relation of caregiver problem-solving abilities to patient adjustment. Design: Correlational methods were used to test the hypothesis. Participants: Data from 11 male and 55 female caregivers were matched with data from 38 men and 18 women with recent spinal cord injuries. Main Outcome Measures: The Acceptance of Disability Scale score and pressure sore diagnosis were the outcome measures. Results: Caregiver tendencies to impulsively and carelessly solve problems were associated with lower acceptance of disability and were significantly predictive of pressure sore diagnosis among those returning for a medical evaluation 1 year later. Conclusions: Caregiver characteristics are associated with the adjustment of persons with SCI and warrant consideration in terms of psychological interventions and health policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consequences of self-handicapping: Effects on coping, academic performance, and adjustment.

Self-handicappers erect impediments to performance to protect their self-esteem. The impediments may interfere with the ability to do well and, as such, may result in poor adjustment. Using a longitudinal design, the present studies examined prospective effects of self-handicapping on coping, academic performance, and several adjustment-related variables (e.g., self-esteem). It was found that, compared to low self-handicappers, high self-handicappers reported higher usage of coping strategies implying withdrawal and negative focus. High self-handicappers performed less well academically, an effect that was mediated in part by poor study habits. Finally, high self-handicapping resulted in poorer adjustment over time, and poorer adjustment resulted in higher self-handicapping over time. These relations are consistent with the idea of a vicious cycle in which self-handicapping and poor adjustment reinforce one another. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Five-year outcomes in TMD: relationship of changes in pain to changes in physical and psychological variables

Factors influencing natural history and clinical course of pain in temporomandibular disorders (TMD) are largely unknown. Physical, psychological and behavioral data from a population-based epidemiologic study of TMD were examined in 234 cases of persons reporting TMD pain. The cases were assigned to one of five pain pattern groups based on changes in average TMD pain from baseline to 5-year follow-up: (i) remitted (49% of the sample), (ii) high-improvement (14%), (iii) low-improvement (9%), (iv) same (13%), and (v) worse (16%). For each pain change group, an ANOVA-derived pattern analysis was performed to assess whether the pattern of change in each of seven physical and three psychological variables was congruent or dissimilar to the pattern of change in average pain intensity. For none of the physical or psychological variables was the change over time completely congruent with the changes in pain. Changes in ambient average TMD pain were most closely related to those clinical variables whose assessment is influenced by pain or other self-reported symptoms (e.g., number of muscle sites painful to examiner palpation), while the amount of pain change was less closely related to changes in clinical variables, such as joint sounds, where assessment is not dependent on subjective report. The three psychological variables, anxiety, depression, and somatization, displayed similar change patterns, but these patterns were distinctly different from those of the physical variables in that the remitted pain group was at the population mean at baseline for these psychological variables and remained there; significant improvement in psychological status was observed only in the pain group showing high improvement. The other three pain change groups exhibited elevated psychological distress scores at both baseline and 5 years. These results indicate that although the relationships among the course of pain, of physical variables, and of psychological variables are complicated, the 5-year outcome in pain is largely independent of readily discernible changes in clinical signs.     

Aging and ischemia in gerbils impair spatial memory performance

Conventional gravimetric (weight loss) calibration of jet nebulizers overestimates their aerosol output by up to 80% due to unaccounted evaporative loss. We examined two methods of measuring true aerosol output from jet nebulizers. A new adaptation of a widely available clinical assay for lithium (determined by flame photometry, LiCl method) was compared to an existing electrochemical method based on fluoride detection (NaF method). The agreement between the two methods and the repeatability of each method were examined. Ten Mefar jet nebulizers were studied using a Mefar MK3 inhalation dosimeter. There was no significant difference between the two methods (p=0.76) with mean aerosol output of the 10 nebulizers being 7.40 mg x s(-1) (SD 1.06; range 5.86-9.36 mg x s(-1)) for the NaF method and 7.27 mg x s(-1) (SD 0.82; range 5.52-8.26 mg x s(-1)) for the LiCl method. The LiCl method had a coefficient of repeatability of 13 mg x s(-1) compared with 3.7 mg x s(-1) for the NaF method. The LiCl method accurately measured true aerosol output and was considerably easier to use. It was also more repeatable, and hence more precise, than the NaF method. Because the LiCl method uses an assay that is routinely available from hospital biochemistry laboratories, it is easy to use and, thus, can readily be adopted by busy respiratory function departments.     

Influence of adjustment and physical attractiveness on the employability of schizophrenic women.

Compared manifest adjustment and physical attractiveness for their effects on hirability. Employment interviewers assessed 21 18–54 yr old female psychiatric patients who had been videotaped taking part in a simulated job interview. Results indicate that (a) 43% of the interviewees were considered employable by at least 3 of 4 interviewers, although all interviewees were hospitalized with diagnoses of psychosis at the time. (b) Manifest adjustment (i.e., during the interview) related strongly to Ss' hirability. (c) Variables that had nonsignificant correlations with hirability included physical attractiveness (whether judged from videotapes or still photos) and demographic indexes such as number of previous hospitalizations and age at 1st hospitalization. The significant correlation between manifest adjustment and employability corroborates results of earlier studies that used "normal" confederates (stooges) rather than actual mental patients. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-blame, self-efficacy, and adjustment to abortion.

The causal impact of attributions and coping self-efficacy on adjustment to abortion was examined. 283 women were randomly assigned prior to their abortion to 1 of 3 counseling interventions: 1 designed to alter attributions for unwanted pregnancy (ATT-INT), 1 designed to raise coping expectations (EXP-INT), or a control (standard counseling) group. Depression, mood, anticipated consequences, and physical complaints were assessed postabortion. Ss in the ATT-INT or EXP-INT group were better adjusted immediately postabortion than women in the control group. The EXP-INT group was also less depressed than the ATT-INT group. Three individual difference factors were also related to better adjustment: high coping self-efficacy, low self-character blame, and low other-blame. Self-efficacy also predicted adjustment 3 wks postabortion. Implications for theories of adjustment to major life events, therapeutic interventions to assist coping with such events, and public policy on abortion are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family caregivers: Gender differences in adjustment to stroke survivors' mental changes.

Objectives: This prospective longitudinal study investigated gender differences in caregiving spouses' adjustment to the challenges of a poststroke life situation based on the caregiving stress model of Yee and Schulz (2000), which we modified. Method: The sample consisted of 97 stroke-survivor and spouse dyads who were questioned 3 months after stroke and again 1 year later. The Beck Anxiety Inventory (Beck & Steer, 1997), the Beck Depression Inventory (Beck, Steer, & Garbin, 1988), and the Giessen Complaints List (Br?hler & Scheer, 1995) were used to capture mental health and physical complaints in stroke survivors' spouses. Covariance analytical methods (analysis of covariance; ANCOVA) were conducted on data from both measuring times to test gender-related interaction effects. Results: Generally, women caregivers reported more anxiety and depressive symptoms than did their men counterparts. However, 15 months after stroke onset, in cases where individuals with stroke had substantial cognitive and mental impairments, the opposite appeared to be true. The results supported the modified caregiving stress model. Women spousal caregivers seem to adjust better to cognitive and emotional changes in their partners than did caregiving husbands. Conclusions: The rehabilitation of stroke survivors may be more successful if gender differences in caregivers' adaptation to their partners' mental changes are taken into consideration in intervention programs for families of stroke survivors. Men spousal caregivers may need counseling aimed at supporting their adjustment to stroke-related cognitive and emotional changes in their wives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychophysiological, somatic, and affective changes across the menstrual cycle in women with panic disorder.

This study explored menstrual symptoms, somatic focus, negative affect, and psychophysiological responding across the menstrual cycle in women with panic disorder and controls. Women with and without panic disorder completed a psychophysiological task and self-report measures of menstrual symptoms, somatic focus, and negative affect on 4 occasions across 2 menstrual cycles (twice during intermenstrual and premenstrual phases). Women in the panic disorder group exhibited greater skin conductance magnitude and more frequent skin conductance responses to anxiety-provoking stimuli during the premenstrual phase than did controls. Compared to controls, women with panic disorder endorsed more severe menstrual symptoms relating to bodily sensations, anxiety sensitivity, state and trait anxiety, fear of body sensations, and illness-related concerns. The applicability of anxiety sensitivity to understanding the relation of menstrual reactivity and panic disorder is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptual adjustment to highly compressed speech: Effects of talker and rate changes.

This study investigated the perceptual adjustments that occur when listeners recognize highly compressed speech. In Experiment 1, adjustment was examined as a function of the amount of exposure to compressed speech by use of 2 different speakers and compression rates. The results demonstrated that adjustment takes place over a number of sentences, depending on the compression rate. Lower compression rates required less experience before full adjustment occurred. In Experiment 2, the impact of an abrupt change in talker characteristics was investigated; in Experiment 3, the impact of an abrupt change in compression rate was studied. The results of these 2 experiments indicated that sudden changes in talker characteristics or compression rate had little impact on the adjustment process. The findings are discussed with respect to the level of speech processing at which such adjustment might occur. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in physical fitness and changes in mortality

BACKGROUND: Point estimates of physical fitness give important information on the risk of death in healthy people, but there is little information available on effects of sequential changes in physical fitness on mortality. We studied this latter aspect in healthy middle-aged men over a total follow-up period of 22 years. METHODS: 2014 healthy men aged 40-60 years had a bicycle exercise test and clinical examination, and completed a questionnaire in 1972-75 (survey 1). This was repeated for 1756 (91%) of 1932 men still alive by Dec 31, 1982 (survey 2). The exercise scores were adjusted for age. The change in exercise scores between surveys was divided into quartiles (Q1=least fit, Q4=fittest). An adjusted Cox's proportional hazards model was used to study the association between changes in physical fitness and mortality, with the Q1 men used as controls. FINDINGS: By Dec 31, 1994, 238 (17%) of the 1428 men had died, 120 from cardiovascular causes. There were 37 deaths in the Q4 group (19 cardiovascular); their relative risks of death were 0.45 (95% CI 0.29-0.69) for any cause and 0.47 (0.26-0.86) for cardiovascular causes. There was a graded, inverse relation between changes in physical fitness and mortality irrespective of physical fitness status at survey 1. INTERPRETATION: Change in physical fitness in healthy middle-aged men is a strong predictor of mortality. Even small improvements in physical fitness are associated with a significantly lowered risk of death. If confirmed, these findings should be used to influence public health policy.     

Aging and individual differences in the development of skilled memory search performance.

We examined individual differences in measures of multiple intellectual abilities and performance on a pure memory search task over 5 experimental sessions. Old (n?=?104) and young (n?=?97) participants showed expected patterns of substantial improvement in memory search intercepts and slopes in consistently mapped (CM) conditions, relative to varied mapping (VM) conditions. Initial (unskilled) CM and VM memory search was highly correlated with a Semantic Memory Access Speed factor and moderately correlated with General Intelligence. Structural equation models showed that measures of Semantic Memory Access remained a strong predictor of skilled CM search performance in both age groups despite individual differences in CM memory search performance changes. These results indicate qualitative differences in the nature of automaticity between memory search and visual search and suggest age invariance in the mechanisms determining automaticity in memory search. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging and dual-task performance: A meta-analysis.

The relations between dual-task effects and aging were examined through a meta-analysis of 33 studies (with 48 independent participant groups) using latency as the dependent measure and 30 studies (with 40 independent participant groups) focusing on accuracy. Brinley plots and state traces were derived, and a model to explicate different types of complexity (additive and multiplicative) was developed. The effects of dual-task processing on latency were additive, and this additive cost was larger in older adults than in younger adults and larger than predicted from general slowing. This cost was small and independent of task complexity. The effects of dual-task processing on logit-transformed accuracy were likewise additive, but no specific age deficit was associated with this dual-task cost. (PsycINFO Database Record (c) 2010 APA, all rights reserved)