Couples coping with congestive heart failure: Role and gender differences in psychological distress.

Psychological distress and marital quality were assessed with male (n=128) and female (n=49) congestive-heart-failure (CHF) patients and their spouses. Hopkins Symptom Check List-25 scores were in the distressed range for 57% of patients and 40% of spouses. This role difference was greater for men than for women, and a gender difference (more distress in women than men) was greater for spouses than for patients. The patient's distress, but not the spouse's, reflected the severity of the patient's illness, and distress for both partners correlated negatively with ratings of marital quality. Female-patient couples reported better relationship quality than male-patient couples, however, and a mediation analysis indicated that the gender difference in spouse distress could be explained by marital quality. Results highlight the contextual nature of CHF distress and suggest that role differences in distress vary by gender. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of physical touch in the "talking cure": A journey to the outskirts of psychotherapy.

The present literature review examines how physical touch has been used by therapists with their clients in traditional verbal psychotherapy. Attitudes and practices of therapists are presented in a historical context, starting with physicians' treatment of female hysteria in the 19th century, and concluding with current issues of debate. The use of touch in therapy has been highly controversial ever since Freud stated his principle of abstinence. This paper intends to give an overview of the various positions of influential therapists on the use of touch and their rationale for touching or not touching their clients, including the contextual factors that have shaped the use of touch over time. Furthermore, research findings pertinent to the use of touch in psychotherapy are included. The review concludes with practical recommendations concerning the use of touch in the contemporary therapeutic setting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The stress connection. Women and coronary heart disease

Assessment and treatment of the stressors associated with major medical illness such as CHD without regard to gender overlooks women's issues in some extremely fundamental ways. To ensure that rehabilitation formats are relevant for women, more qualitative studies are needed so that women can give voice to the story of an MI recovery from a feminine perspective. It is vital to understand the psychologic contribution to the development and treatment of CHD both as described by women in their own words and as evaluated by distinctly feminine constructs. Assessment of psychosocial factors should be an essential component of a CHD diagnostic evaluation. Although little can be done about a genetic predisposition to CHD, education and personal support can help women make needed lifestyle changes to forestall further cardiac damage and to improve a woman's level of functioning. The capacity to take charge of one's life and social support are strong counterpoints to negative psychosocial symptoms of CHD. There is a strong need to make rehabilitation programs for women with CHD contextually congruent. Strategies to involve women in cardiac rehabilitation must take into account a woman's needs, providing both age-appropriate physical exercise and psychologic social support for women at times convenient to their schedules. Women must be given permission to let go of normally performed duties after a major cardiac event and to seek out what is meaningful. Group formats that offer women essential social support, an opportunity to verbally process the meaning of a life-threatening diagnosis, an opportunity to share their experiences with other women, and the ability to reconstruct a new sense of self based on feminine constructs may be as important for women as other lifestyle structural components in effective rehabilitation programs. Society must reclassify the CHD disease process as one that equally affects women. Research studies with women as primary subjects and key informants can provide needed direction in the identification of psychosocial risk factors and appropriate treatments to reduce alarming morbidity and mortality of CHD in women. More data are needed about the psychosocial mechanisms that aggravate and mediate physiologic responses in CHD in women.     

"Personality disorder is disease": Comment.

Comments on the article by David Ausubel (see record 1962-03334-001) which argued that mental disorders are a disease. The point made by the current author that the facts that all behavior is mediated through neural structures and physiological processes and that impairment in these may result in disturbed behavior in no way support the proposition that the use of medical measures in treating behavior disorders is justified. Medical interventions for psychological disturbances seem to be warranted only when it can be demonstrated that, first, such procedures are directed toward the alleviation of certain underlying physical anomalies, and second, that the disturbances can be best treated by means of such interventions. Moreover, the fact that physical or psychological interventions can affect behavior in no way bears on the question of whether the condition represents a disease process or not. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of It's Not All In Your Head: How Worrying about Your Health Could Be Making You Sick--and What You Can Do about It.

Reviews the book, It's Not All In Your Head: How Worrying about Your Health Could Be Making You Sick--and What You Can Do about It by Gordon J. G. Asmundson and Steven Taylor (see record 2005-07983-000). In this book, Drs. Gordon Asmundson and Steven Taylor provide a 14-week, self-help program designed for people who suffer from health anxiety. The book is organized in a manner consistent with standard cognitive-behavioural therapeutic (CBT) practice, with three sections: Understanding Health Anxiety (Chapters 1-4), Breaking the Health Anxiety Cycle (Chapters 5-7), and Maintaining Your Gains (Chapters 8-10), emulating the treatment process of psychoeducation, skills training, and relapse prevention. Most impressive is the tone adopted by the authors whereby they strive to validate the experience of health anxious individuals by acknowledging the reality of their symptoms and the frustration they must feel when unsatisfactorily served by traditional medical treatments. This approach lends itself to facilitating, rather than demanding, change in behaviour. Readers are encouraged to "take control" of their health, an important message for a population that relies so heavily on the expertise and reassurance of healthcare practitioners. This book is well written and user-friendly although it may be most helpful as a tool to be employed within the therapeutic context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

You never think about my feelings: Interpersonal dominance as a predictor of emotion decoding accuracy.

Dominance and submission constitute fundamentally different social interaction strategies that may be enacted most effectively to the extent that the emotions of others are relatively ignored (dominance) versus noticed (submission). On the basis of such considerations, we hypothesized a systematic relationship between chronic tendencies toward high versus low levels of interpersonal dominance and emotion decoding accuracy in objective tasks. In two studies (total N = 232), interpersonally dominant individuals exhibited poorer levels of emotion recognition in response to audio and video clips (Study 1) and facial expressions of emotion (Study 2). The results provide a novel perspective on interpersonal dominance, suggest its strategic nature (Study 2), and are discussed in relation to Fiske's (1993) social–cognitive theory of power. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

What is so bad about a little name-calling? Negative consequences of gender harassment for overperformance demands and distress.

Few studies have investigated why harassment has negative effects on women's well-being. The authors proposed that, for women working in traditionally male occupations, gender harassment (GH) causes overperformance demands (OPD), which lead to psychological distress. This mediated model was strongly supported for 262 female police officers but, as proposed, was not supported for male officers (N=315). For men, levels of GH and OPD were lower than for women, and GH was not a significant predictor of OPD. Harassing behaviors thus had different consequences for women and men. A lack of perceived support for equal deployment of women police was associated with OPD for women, and family → work conflict was a significant predictor of OPD for both men and women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The costs and benefits of writing, talking, and thinking about life's triumphs and defeats.

Three studies considered the consequences of writing, talking, and thinking about significant events. In Studies 1 and 2, students wrote, talked into a tape recorder, or thought privately about their worst (N = 96) or happiest experience (N = 111) for 15 min each during 3 consecutive days. In Study 3 (N = 112), students wrote or thought about their happiest day; half systematically analyzed, and half repetitively replayed this day. Well-being and health measures were administered before each study's manipulation and 4 weeks after. As predicted, in Study 1, participants who processed a negative experience through writing or talking reported improved life satisfaction and enhanced mental and physical health relative to those who thought about it. The reverse effect for life satisfaction was observed in Study 2, which focused on positive experiences. Study 3 examined possible mechanisms underlying these effects. Students who wrote about their happiest moments--especially when analyzing them--experienced reduced well-being and physical health relative to those who replayed these moments. Results are discussed in light of current understanding of the effects of processing life events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive–behavioral stress management increases free testosterone and decreases psychological distress in HIV-seropositive men.

The effects of a 10-week group-based cognitive–behavioral stress management (CBSM) intervention on psychological distress and plasma free testosterone in symptomatic, HIV-seropositive men were examined. Participants were randomized to either CBSM (n?=?42) or a wait-list control group (n?=?23). Men in the CBSM intervention showed significant increases in testosterone, whereas control participants showed significant decreases. Those participating in CBSM had significant distress reductions, whereas controls showed no such change. Alterations in free testosterone were inversely related to changes in distress states over time, independent of any changes in cortisol. These findings demonstrate that a short-term CBSM intervention increases free testosterone levels among symptomatic, HIV-seropositive men, and alterations in free testosterone are associated with changes in psychological distress observed during CBSM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic results and their clinical interpretation--or: what you never wanted to know about diagnosis

OBJECTIVE: To analyze HLA-DR4 alleles in New Zealand Polynesians with rheumatoid arthritis (RA). METHODS: Thirty Polynesians and 30 Caucasians with RA, as well as 65 Polynesian and 60 Caucasian healthy blood donors, were DR4 subtyped using the polymerase chain reaction and sequence-specific oligonucleotide probes. RESULTS: The frequency of DR4 (DRB1*04) was increased in both Polynesian (P < 0.001) and Caucasian (P < 0.005) RA patients compared with race-matched controls. Dw4 (DRB1*0401) was detected in 15 of 30 Caucasian patients but only 2 of 30 Polynesian patients (P < 0.001). In Polynesians, RA was associated with Dw15 (DRB1*0405), which was present in 11 of 30 patients and 3 of 65 controls (P < 0.001). Dw13 (DRB1*0403) was the most frequent DR4 allele in healthy Polynesians, but was not significantly associated with RA. CONCLUSION: The predominance of the Dw13 subtype in Polynesians may explain in part the low prevalence of RA in this population. The association of Dw15 with RA in Polynesians supports the hypothesis that the third hypervariable region of DR beta determines susceptibility to RA.     

Women and heart attack: a study of women's experiences

Cardiovascular disease in general, and myocardial infarction (MI) in particular, is the major health problem of females after 50 years of age. To date, heart disease research has focused primarily on males. The limited evidence suggests that the physical, psychological, and social ramifications of MI for women are significant, and different from those of men. Since the specific rehabilitation needs of women are not yet clear, this study was designed to explore the unique experiences and needs of women following a first MI. A phenomenological study using focus groups was used to explore the experiences, questions, concerns, and preferred interventions of women after a MI. Participants were female volunteers (n = 14) who had been hospitalized for a MI within the previous 6 months. Focus groups were audio taped and analysed by the investigators. Four major themes emerged: validation; perceived gender differences; role expectations/role tensions; and helps and hindrances to recovery.     

Hypoplastic left heart syndrome: "Which is the best operative strategy?"

It has been recognized for some time that psychiatric symptoms, such as depression, anxiety, and behavioral alterations, may occur in patients who have pituitary disease. From other research focused on endocrine abnormalities seen in patients with psychiatric illness, it is understood that there is a significant interrelationship between the endocrine system and mental health. More recent research focusing on neural circuits in the brain and the impact of alterations in neurotransmission and neurohormonal modulation has shown that the prefrontal cortex can be affected by perturbations in functioning occurring in distant sites. Such is the situation with the hypothalamic-pituitary axis. Through its rich connections with other limbic structures, the hypothalamic-pituitary axis may affect the behavioral control exerted by the prefrontal cortex, causing mood and personality alterations. In the more severe cases, an apathy syndrome may develop which must be carefully differentiated from depression and other cognitive disorders. This report will review: (1) the neuroanatomical components that cause the behavioral changes observed in many patients with pituitary disease; (2) the current concept of apathy syndrome; (3) the differentiation of apathy syndrome from major depression; (4) the underlying neurobiology of apathy, and (5) potential treatments.     

Pain and dissociation in the cold pressor test: A study of hypnotic analgesia with "hidden reports" through automatic key pressing and automatic talking.

To test whether pain blocked by hypnotic analgesia may still be perceived at some level, 20 highly hypnotizable undergraduates participated in an experiment involving cold pressor pain in the normal condition and in hypnotically suggested analgesia. 3 reports were obtained reflecting felt pain within the hypnotic analgesia condition: the usual verbal report on a numerical scale, a manual report by "automatic key pressing," and a retrospective verbal report through "automatic talking." 9 Ss who were amnesic for both keypressing and automatic talking reported more pain in the automatic (hidden) reports than in their usual verbal reports. 8 of these 9, following release of amnesia, had a clear perception of 2 levels of awareness of the pain: the usual hypnotic experience of pain attenuated by analgesia suggestions, and a knowledge at another level of a more severe pain. In no case, however, did an S give a retrospective report of normal suffering at this "hidden" level. The hypnotically analgesic S may have reported no pain verbally because he was amnesic for it; when amnesia was removed he recalled the sensory pain, but without a suffering component, because suffering apparently did not occur. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Language and the body: The talking cure in the new century.

This panel was the second plenary meeting entitled "History and Psychoanalysis." The 3 invited speakers were Robert Wallerstein, Charles Spezzano, and Hanna Decker. Dr. Wallerstein discussed his current views of psychoanalysis, pointing out that there are areas of common ground within contemporary psychoanalytic theories. Dr. Spezzano suggested that there are 3 sites in the analytic situation: free association, reveries, and enactments in which the analyst gathers information that structures his or her understanding of technique. Professor Decker spoke about hysteria from a historical perspective and discussed its manifestation in somatic patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment is about safety and protection, intersubjectivity is about sharing and social understanding: The relationships between attachment and intersubjectivity.

The relationships between intersubjectivity and attachment are beginning to be explored within the psychoanalytic and developmental literature. We contribute to this comparative effort by exploring the different evolutionary origins of attachment and intersubjectivity. Five interlocking themes are central to this article. First, from an evolutionary perspective, attachment and intersubjectivity serve different functions. The main function of attachment is to seek protection, whereas the main function of intersubjectivity is to communicate, at intuitive and automatic levels, with members of the same species and to facilitate social understanding. Second, to survive in changing and highly competitive environments, an evolutionary strategy emerged among our human ancestors based on developing high levels of cooperation within small bands of hunters and gatherers. In turn, high levels of cooperation and social complexity put selective pressures toward developing effective modes of communication and more complex forms of social understanding (mindreading/mentalizing/intersubjective abilities). These abilities far surpass mindreading abilities among our closest Great Ape relatives. Third, we provide further evidence for this hypothesis showing that in comparison with other Great Apes, young children show qualitatively different levels of collaboration and altruism. Fourth, we provide an overview of the development of attachment and intersubjective abilities during the first 2 years of life that support the hypothesis of a cooperative origin of intersubjectivity. Fifth, we return to the main theme of this article showing three ways in which attachment and intersubjective abilities can be distinguished. We conclude by exploring some clinical implications of this cooperative–intersubjective model of human development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repetition as a possible source of "isolation" in free recall.

Ss listened to lists in which 1 or more items were repeated in immediate succession to determine whether an item is better retained when it is embedded in a series of unique items, or of items repeated at longer lags, than when it occurs within a series of items that are also presented twice in a row. Data indicate that it is not. It is concluded that repetition does not normally function as a significant source of "isolation" in tests of free recall. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Walking and talking: Dual-task effects on street crossing behavior in older adults.

The ability to perform multiple tasks simultaneously has become increasingly important as technologies such as cell phones and portable music players have become more common. In the current study, we examined dual-task costs in older and younger adults using a simulated street crossing task constructed in an immersive virtual environment with an integrated treadmill so that participants could walk as they would in the real world. Participants were asked to cross simulated streets of varying difficulty while either undistracted, listening to music, or conversing on a cell phone. Older adults were more vulnerable to dual-task impairments than younger adults when the crossing task was difficult; dual-task costs were largely absent in the younger adult group. Performance costs in older adults were primarily reflected in timeout rates. When conversing on a cell phone, older adults were less likely to complete their crossing compared with when listening to music or undistracted. Analysis of time spent next to the street prior to each crossing, where participants were presumably analyzing traffic patterns and making decisions regarding when to cross, revealed that older adults took longer than younger adults to initiate their crossing, and that this difference was exacerbated during cell phone conversation, suggesting impairments in cognitive planning processes. Our data suggest that multitasking costs may be particularly dangerous for older adults even during everyday activities such as crossing the street. (PsycINFO Database Record (c) 2011 APA, all rights reserved)