Perfectionism in chronic and state symptoms of depression.

Tested whether perfectionism dimensions uniquely predict chronic unipolar and chronic bipolar symptoms. A sample of 121 patients and former patients (mean age 46.1 yrs) completed the Multidimensional Perfectionism Scale, the General Behavior Inventory, and the Beck Depression Inventory. The results confirm that the perfectionism dimensions are related to chronicity of depression symptoms. Whereas self-oriented perfectionism was uniquely associated only with chronic unipolar symptoms, both socially prescribed and other-oriented perfectionism were uniquely associated with chronic bipolar symptoms. Importantly, these relationships remained significant after controlling for the effects of concurrent state depression. Finally, only socially prescribed perfectionism was uniquely associated with state depression. The results provide support for the position that perfectionism dimensions are important in both chronic. and state depression symptoms, but the perfectionism dimensions may differ in terms of their degree of association with various facets of depressive phenomena. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fantasy and self-esteem of renal dialysis patients and their spouses

The fantasy life and self-esteem of 22 male and 13 female renal dialysis patients and their spouses were examined using a Self-Esteem Evaluation Scale, Empathic Fantasy Scale, and eight portions of the Imaginal Process Inventory reflecting eight types of fantasy use. For the patient group as a whole, a high degree of fantasy behavior was associated with low self-esteem, but the sex of the patient made a difference. Frequency of fantasy was shown to be indicative of poor adjustment for female dialysis patients, but not for male dialysis patients. Results also indicated that patients, without regard to sex, were more prone toward guilt fantasies in which they were punished for some wrongdoing such as feelings of anger toward people involved in their treatment or envy of others who do not suffer their same disability.     

Effects of relationship maintenance on psychological distress and dyadic adjustment among couples coping with lung cancer.

Objective: Relationship maintenance strategies help to ensure the continuation of valued relationships by keeping them at a certain level of intimacy. This study evaluated how lung cancer patients' and spouses' efforts to maintain their relationships affected their psychological and marital adjustment over time. Design: Psychosocial questionnaires were administered within 1 month of lung cancer treatment initiation (baseline) and 3 and 6 months later to 158 lung cancer patients and their spouses. Main Outcome Measures: Study outcomes were global severity index scores on the Brief Symptom Inventory, and total scores on the Dyadic Adjustment Scale. Results: Multilevel modeling analyses using the Actor-Partner Interdependence Model showed that, regardless of gender or social role (i.e., patient or spouse), individuals who engaged in the strategies of positivity, networks, and shared tasks reported less distress at baseline than other participants. Over time, the effects of providing more assurances and experiencing a partner's increased reliance on social networks differed: patient distress was exacerbated, and spouse distress was alleviated. Couples where both partners engaged in more frequent maintenance behaviors reported greater dyadic adjustment at baseline and over time. Conclusion: For couples coping with lung cancer, the initial treatment period may be an important time that sets the tone for future spousal interactions. Engaging in relationship maintenance during this stressful time may help mold more resilient relationships and facilitate adjustment as the disease progresses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of perfectionism in unipolar depression.

We tested the hypothesis that self-oriented perfectionism, other-oriented perfectionism, and socially prescribed perfectionism are related differentially to unipolar depression. The Multidimensional Perfectionism Scale was administered along with measures of depression and anxiety to 22 depressed patients, 22 matched normal control Ss, and 13 anxiety patients. It was found that the depressed patients had higher levels of self-oriented perfectionism than did either the psychiatric or normal control Ss. In addition, depressed patients and anxious patients reported higher levels of socially prescribed perfectionism than did the normal control Ss. The results suggest that various dimensions of perfectionism may play an important role in clinical depression. (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)     

Dyadic coping in metastatic breast cancer.

Objective: Couples facing metastatic breast cancer (MBC) must learn to cope with stressors that can affect both partners’ quality of life as well as the quality of their relationship. Common dyadic coping involves taking a “we” approach, whereby partners work together to maintain their relationship while jointly managing their shared stress. This study prospectively evaluated whether common dyadic coping was associated with less cancer-related distress and greater dyadic adjustment for female MBC patients and their male partners. Design: Couples (N = 191) completed surveys at the start of treatment for MBC (baseline), and 3 and 6 months later. Main Outcome Measures: Cancer-related distress was assessed with the Impact of Events Scale; dyadic adjustment was assessed using the short-form of the Dyadic Adjustment Scale. Results: Multilevel models using the couple as the unit of analysis showed that the effects of common positive dyadic coping on cancer-related distress significantly differed for patients and their partners. Whereas partners experienced slightly lower levels of distress, patients experienced slightly higher levels of distress. Although patients and partners who used more common negative dyadic coping experienced significantly greater distress at all times, the association was stronger for patients. Finally, using more common positive dyadic coping and less common negative dyadic coping was mutually beneficial for patients and partners in terms of greater dyadic adjustment. Conclusion: Our findings underscore the importance of couples working together to manage the stress associated with MBC. Future research may benefit from greater focus on the interactions between patients and their partners to address ways that couples can adaptively cope together. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism, negative social feedback, and interpersonal rumination in depression and social anxiety.

The current study investigated the associations among trait perfectionism, perfectionistic self-presentation, negative social feedback, interpersonal rumination, depressive symptoms, and social anxiety. New measures of negative social feedback and interpersonal rumination were used to evaluate their relevance to the social aspects of perfectionism and their roles in distress. A sample of 155 undergraduate students completed the Multidimensional Perfectionism Scale, the Perfectionistic Self-Presentation Scale, the Social Feedback Questionnaire, Rumination About an Interpersonal Offense, and measures of depressive symptoms and social anxiety. The results confirmed that socially prescribed perfectionism and perfectionistic self-presentation were associated significantly with negative social feedback and rumination following interpersonal events (i.e., being hurt, humiliated, mistreated). Also, depressive symptoms and social anxiety were associated significantly with negative social feedback, interpersonal rumination, trait perfectionism, and perfectionistic self-presentation. Additional analyses indicated that negative social feedback and interpersonal rumination mediated the links between components of the perfectionism construct and distress. Overall, our findings suggest that self-reported receipt of frequent negative feedback from others and engaging in rumination about an interpersonal event play important roles in the distress experienced by certain individuals with high levels of perfectionism. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Implications of agency and communion for patient and spouse adjustment to a first coronary event

The present study examined the effects of agency and communion on psychological adjustment to a 1st coronary event. Patients were interviewed about agency and communion and psychological adjustment in the hospital shortly before discharge (Time 1) and then reinterviewed along with spouses in their homes 3 months after discharge (Time 2). It was hypothesized that the extreme agentic orientation (unmitigated agency) and the extreme communal orientation (unmitigated communion) would be associated with poor adjustment for patients and spouses but that agency would promote self adjustment and communion would promote partner adjustment. In general, results confirmed predictions. It was suggested that the most distressed couples consist of a patient high in unmitigated agency and a spouse high in unmitigated communion. Although patients in such couples did not evidence the most distress, spouses did.     

Psychological and social adjustment to mastectomy: a two-year follow-up study

A consecutive series of 160 women admitted to hospital for breast tumor biopsy was assessed prior to, and at 3, 12, and 24 months following operation for marital, sexual, interpersonal and work adjustment, depression, and personality characteristics by means of rating scales based on structures interviews and standard tests. By 2 years there wery no significant differences in social adjustment between mastectomy patients and benign breast disease controls; 70% of cancer patients were no longer stressed by mastectomy at 1 year. Factors predicting poor adjustment to mastectomy were high preoperative scores on the Hamilton Rating Scale for Depression and the Neuroticism Scale of the Eysenck Personality Inventory; deterioration in sexual adjustment was associated with biological or chronological perimenopausal status. Significantly more cancer than benign disease patients were dissatisfied with the information they received about operation and diagnosis. Implications of these findings for the care of the mastectomy patient are discussed.     

Dyadic perfectionism as a predictor of relationship continuity and distress among college students.

This study examined the nature and impact of dyadic perfectionism over a 3-month interval within a sample of 116 college students who were currently involved in an intimate heterosexual relationship. Dyadic perfectionism scores were stable and correlated as expected with scores on concurrent measures of adult attachment orientations and relationship satisfaction. Logistic regression analyses revealed that, controlling for initial commitment status and adult attachment orientations, Time 1 dyadic perfectionism scores significantly and uniquely predicted relationship continuity 3 months later. Lastly, controlling for social desirability, relationship commitment status, and Time 1 adult attachment orientation scores, Time 1 dyadic perfectionism scores also uniquely predicted Time 2 relationship distress. Findings provide additional evidence that dyadic perfectionism is a risk factor for relationship dysfunction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of psychologic distress in colorectal cancer patients undergoing genetic testing for hereditary colon cancer.

In this article the authors describe the demographic and psychosocial correlates of 2 measures of psychologic distress among 200 colorectal cancer patients undergoing genetic testing for hereditary nonpolyposis colon cancer. The prevalence of symptoms of depression on the Center for Epidemiologic Studies Depression (CES-D) Scale was 24%. In multivariate analysis, female sex, less formal education, fewer sources of social contacts, and less satisfaction with them were associated with high scores on the CES-D Scale. Characteristics associated with high scores on the State-Trait Anxiety Inventory were younger age, less formal education, non-White race, local-regional stage of disease, fewer social contacts, and less satisfaction with them. Information on psychosocial correlates of psychologic distress may prove useful in guiding genetic counseling sessions, in identifying subgroups that need more intensive follow-up, and in developing interventions to facilitate adjustment to genetic test results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and maternal psychosocial adjustment during the transition to parenthood.

Examined whether support from social networks and from husbands would be associated with women's adjustment during pregnancy and postpartum. Levels of perceived stress, attitude toward baby, and social support were assessed for 23 23–38 yr old women at 35 wks gestation and at 3 mo postpartum. Ss also completed the State–Trait Anxiety Inventory, the Dyadic Adjustment Scale, and the Depression Adjective Check Lists. Support from husbands was associated with good adjustment in all areas during pregnancy and with good postpartum marital adjustment. Findings regarding support from network members suggest that women experiencing a difficult adjustment turned to their networks for support. The absence of an inverse relationship between support and adjustment over time suggests that network support was not effective in promoting better postpartum adjustment. Prebirth social support did not predict postpartum adjustment. (French abstract) (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marshalling social support for medical patients and their families.

Discusses the relationship between social support and the outcomes of medical illness and presents tenets of dyadic support (DS) strategies and peer support (PS) groups. DS includes efforts to improve communication between medical caregivers and patients and their family members and the introduction of supportive lay companions (spouses, family, or friends). Partners may be used during childbirth, treatment of juvenile obesity, or during inpatient care. PS groups may be composed of patients with similar afflictions under the sponsorship of a professional and are considered to be most useful when members are matched with respect to disease severity and anxiety. (French abstract) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Perfectionism, stress, and social (dis)connection: A short-term study of hopelessness, depression, and academic adjustment among honors students.

This study tested models of perfectionism predicting psychological distress and academic adjustment and moderators and mediators of those associations in 2 successive cohorts of high-achieving university honors students (N = 499). Participants completed measures early and late in the semester. Adaptive (high standards) and maladaptive (self-critical perceptions of inadequacy in meeting performance expectations) dimensions of perfectionism were found to be significantly associated, in generally expected directions, with concurrent and prospective perceived stress, social connectedness, depression, hopelessness, and perceived academic adjustment. However, some perfectionism effects were reduced when earlier psychological distress and adjustment were controlled in analyses predicting later distress and adjustment. Several effects were moderated and at least partially mediated by perceived stress and social connection. The results suggest several counseling implications for high-achieving, perfectionistic students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pain-related correlates of MMPI profile subgroups among back pain patients.

96 17–80 yr old male and 218 16–83 yr old female outpatients at a back pain clinic were administered the Cornell Medical Index, the Minnesota Multiphasic Personality Inventory (MMPI), the McGill Pain Assessment Questionnaire—Revised, and the Shipley Institute of Living Scale. Analysis showed greater disruption of daily activities and affective disturbance and poorer adjustment to pain among subgroups with elevated neurotic scales. Results are consistent with those of similar studies of chronic pain patients showing that MMPI profile subgroups may be identified that are associated with relatively unique pain-related correlates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Externalizing psychopathology and marital adjustment in long-term marriages: Results from a large combined sample of married couples.

The current study evaluated the associations between externalizing psychopathology and marital adjustment in a combined sample of 1,805 married couples. We further considered the role of personality in these associations, as personality has been found to predict both the development of externalizing psychopathology as well as marital distress and instability. Diagnostic interviews assessed conduct disorder, adult symptoms of antisocial personality disorder, and alcohol dependence. Personality was assessed using the Multidimensional Personality Questionnaire. The Dyadic Adjustment Scale was used to measure marital adjustment. Results indicate that more externalizing psychopathology, greater negative emotionality, and lower communal positive emotionality were associated with reduced marital adjustment in both individuals and their spouses. Low constraint was associated with reduced marital adjustment for individuals but not for their spouses. Multivariate analyses indicated externalizing psychopathology continued to predict marital adjustment even when accounting for overlap with personality. These results highlight the importance of examining the presence of externalizing psychopathology and the personality attributes of both members of a dyad when considering psychological predictors of marital adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Romantic attachment in individuals with physical disabilities.

Objective: To examine the relationship between adult attachment style and physical disability in intimate romantic relationships. Method: Participants were 50 individuals with adult-onset spinal cord injuries (SCI) and 50 individuals with congenital disabilities (CON) living in the community. The main outcome measures were adult attachment style and dyadic relationship adjustment. Results: Participants with SCI and CON did not differ in rates of secure versus insecure attachment, and the rates of neither group differed significantly from rates reported for persons without disability. Dyadic adjustment was clearly predicted by attachment variables and differed between the participants with SCI and those with CON; individuals with SCI reported greater total dyadic adjustment. Avoidance showed a strong negative association with dyadic satisfaction, but no association was found with dyadic cohesion. Social participation variables were associated with dyadic adjustment. For instance, mobility was positively associated with dyadic satisfaction. Conclusions: Dyadic adjustment in people with disabilities, as in other groups, is affected by attachment style, but disability and social participation variables may also affect dyadic adjustment. Clinicians should consider differences in attachment styles among persons with disabilities and their implications for intimate close relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A developmental-contextual model of couples coping with chronic illness across the adult life span.

A developmental-contextual model of couples coping with chronic illness is presented that views chronic illness as affecting the adjustment of both the patient and the spouse such that coping strategies enacted by the patient are examined in relation to those enacted by the spouse, and vice versa. The developmental model emphasizes that dyadic coping may be different at various phases of the life span, changing temporally at different stages of dealing with the illness as well as unfolding daily as spouses interact around dyadic stressors. In addition, couples engaged in dyadic coping are affected by broad sociocultural factors (culture and gender) as well as more proximal contextual factors (quality of the marital relationship and the specific demands of the chronic illness). The model provides a framework for understanding how couples coping with chronic illness may together appraise and cope with illness during adulthood and for determining when spousal involvement is beneficial or harmful to both patient and spousal adjustment. The developmental-contextual model to dyadic appraisal and coping has numerous research implications for the field, and the authors conclude with specific recommendations for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of perfectionism and personality disorder features in response to brief treatment for depression.

Using data from the Treatment of Depression Collaborative Research Program (TDCRP), the authors compared the role of patients' perfectionism and features of personality disorder (PD) in the outcome of brief treatment for depression. Data were extracted as to patients' intake levels of symptoms; perfectionism; and PD features, measured as continuous variables, as well as their symptoms at termination; their contribution to the therapeutic alliance; and their satisfaction with social relations. Poorer therapeutic outcome was demonstrated for patients with elevated levels of perfectionism and odd-eccentric and depressive PD features. Patients' contribution to therapeutic alliance and satisfaction with social relations were predicted by perfectionism but not by PD features. Results highlight the central role played by patients' personality in the course of brief treatment for depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)