Chronic physical illness and sexual behavior: Psychological issues.

States that the impact of chronic physical illness on sexual behavior is often overlooked in clinical care and research and that psychological adaptations of patients and their partners are often ignored as contributing to sexual difficulties. A model of sexual behavior and chronic illness must take into account the mutual feedback mechanisms between biological and psychological disease-related processes. Chronic physical illness threatens basic personal resources—sexual identity and self-esteem, personal control over body functions, intimacy, and generativity—that affect sexual behavior after diagnosis. Psychological processes of cognitive appraisal, emotional expression, and coping strategies that are triggered by chronic disease play a vital role in sexual adaptations. Psychologists have a critical role to play in assessments and interventions as well as in providing guidance for other professionals in more effectively and sensitively meeting the sexual needs of seriously ill persons. (53 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's reactions to hospitalization and illness

The paper describes children's reactions to illness and hospitalizations from a developmental point of view. Taking the latter into account, it becomes easier to understand not only the child's reaction at different ages and the reasons for it, but the nature of the potential damage, that is, where and why it takes place, as well as the resources available to the child that may help, if wisely used, to minimize the potential traumas.     

Psychological reactions of nonsmokers to secondhand smoke.

Comments on the article by Gibson (see record 1995-13278-001), which examined the psychological aspects of smoker-nonsmoker interaction. The current author adds two comments that he hopes will strengthen the positive impact of Gibson's papers. First, it is unlikely that laws and policies that provide for "nonsmoking" sections in public places will solve the problem by themselves. Second, the literature on the psychological reactions of nonsmokers to secondhand smoke reviewed by Gibson understates the psychological effects, including anger felt toward nearby smokers that is equal to the anger that anyone would feel against a person who assaults them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological reactions to films by chronic schizophrenics.

40 chronic schizophrenic patients had their psychophysiological responses to 1 of 2 tension-arousing movies recorded. Following assignment to drug (thiordizane) or placebo status for 1 wk, they were retested on a similar film. The results were that the drug Ss showed a decrease in skin resistance and heart rate but not finger-pulse volume over their responses to the 1st showing while the placebo group showed opposite trends. Interview data collected after the films indicated no correlation between the autonomic changes and plot comprehension. Pilot work on word-association test responses indicates that the drug group showed a decrease while the placebo group showed an increase in idiosyncratic responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological factors in illness and recovery

To review evidence that psychological factors affect the course of physical illness three areas are examined: epidemiological evidence showing the levels of psychiatric disturbance co-morbid with physical illness; health services research showing the burden of disease and care associated with this co-morbidity; randomised, controlled trials of psychological interventions in cancer, myocardial infarction and irritable bowel syndrome. There is substantial psychiatric co-morbidity with physical illness which is associated with increased disability, mortality and utilisation of health-care resources (primary care visits, hospitalization, length of hospital stay, cost). A small number of controlled intervention studies have shown the efficacy of psychological interventions to prolong survival in cancer and myocardial infarction, and to improve symptomatology in irritable bowel syndrome and other chronic somatizing conditions. Psychological factors do significantly affect outcomes of physical illness. The role of psychological treatments, alongside somatic therapies, needs further study.     

Anniversary reactions masquerading as manic-depressive illness

The authors suggest that many patients diagnosed as having manic-depressive illness, depressed type, may in fact be experiencing anniversary reactions--time-specific psychological and physiological reactions to a past trauma. They report three cases of cyclic depressive disorder, two of which were first diagnosed as manic-depressive illness, depressed type. Careful, complete interviewing and attention to temporal sequence led to the correct diagnosis of anniversary reaction.     

Patient variables in emotional response to hospitalization for physical illness.

Emotional response to hospitalization was related to a variety of patient variables for 517 relatively long-term male medical patients from 10 VA hospitals across the country. Feelings of comfort with the hospitalization experience were greater for: (1) older patients, (2) patients who prefer an authoritarian approach by the staff, and (3) patients with lower characteristic trait anxiety. These 3 variables were essentially independent predictors. Neither current nor expected future medical status was significantly related to comfort when age was held constant. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Describing the crime victim: Psychological reactions to victimization.

There is now a growing research literature on the types of reactions that are experienced by crime victims of all types. We review research on systematic differences in such reactions over time. Such reactions often seem more severe than might be expected on the basis of the material loss or physical injury caused by the victimization. Theories developed to explain the stress resulting from being a crime victim are outlined. They include a loss of a sense of self, a loss of safety or invulnerability, and feelings of inequity or injustice. Also reviewed are the cognitive and behavioral coping responses of victims. Redefining the victimization experience as less severe than it originally seemed or as occurring for some other purpose is one common coping mechanism. Another is to blame oneself as a means of reestablishing control over the situation. Behavioral coping through withdrawal or through assertive action and help seeking is also discussed. Some of the special issues associated with family violence and with children who are victimized, as well as another special type of victim, the friend or relative of someone else who has been killed or seriously injured, are discussed. Needs for future research are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship of childhood physical and sexual abuse to adult illness behavior

A sample of 275 undergraduate subjects reported (i) their history of sexual and physical abuse in childhood and (ii) their health care utilization, somatization, and hypochondriasis as an adult. Physical and sexual abuse were recalled by largely separate groups, physical abuse predominating in males and sexual abuse in females. Both types of abuse were followed by a greater number of hospital admissions and surgical procedures in adulthood. Although sexual, and especially physical, abuse were associated with recall of emotionally disturbed parenting, this could not explain their influence on health care utilization because this was unrelated to parenting. Similarly, although abuse was followed by greater somatization and hypochondriasis, these also were unrelated to health care utilization. Physical and sexual abuse in childhood are risk factors, independent of their association with poor parenting, in the development of separate aspects of adult illness behavior.     

Previous personal experience and reactions to depression and physical disability.

Conducted 2 experiments with 121 undergraduates to examine the effects of prior experience with people with disability on interpersonal reactions to depression expressed by a person with a disability. In the 1st study, Ss rejected further involvement with the depressed person and perceived this person to be socially impaired. In the 2nd study, Ss ascribed significantly more negative personal characteristics to the depressed person and evidenced more stereotypic attitudes toward persons with disability than Ss who viewed the nondepressed person. Results provide evidence that prior personal experience with people with disability does not moderate negative reactions to social displays of depressive behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fatigue in HIV illness: relationship to depression, physical limitations, and disability

Several filters specific for respiratory function tests have been on the market for several years. Recommended by the manufacturers to avoid contaminating the equipment and thus improve patient safety, these filters require a considerable financial investment. We studied the passage of diluted blood into artificial saliva in a patient model simulating inspiration tests and rapid forced expiration to assess the retention capacity of three filters used for respiratory function tests: Multi SPIRO MI-90016 (MultiSPIRO), PF 30S (Pall Biomedical) and Spirobac (Dar. S.p.A). The mean percentage of passage was 1.48% through the MI-90016 filter, 57.15% through the PF 30 S filter and 70.45% through the Spirobac filter. These findings provide further elements for choosing filters for respiratory function tests. Indeed, despite the manufacturers' commercial arguments, the technical documents provided do not give necessary information on the filtering capacity of the filters on the market. We have observed that two out of the three filters tested do no meet the standards expected by clinicians.     

Psychological reactions to radiation therapy: Reconsideration of the adaptive aspects of anxiety.

Individual differences in the psychological reactions of 45 16–75 yr old patients undergoing external radiation treatment were examined in the context of the I. L. Janis's (1958) model and the linear decline model by C. D. Spielberger et al (see record 1973-21109-001) of medical stressor anxiety. The State-Trait Anxiety Inventory, Profile of Mood States, and self-reports of symptomatology were completed by Ss pre- and posttreatment. Technologists administering the daily treatments assessed behavioral indicants of affective distress. Data analyses revealed that increases in complaints and side effects were reported by all Ss at treatment conclusion. Significant changes in state anxiety were obtained from pre- to posttreatment: (a) Ss with an initial high level of anxiety reported a significant reduction, although they remained the most anxious subgroup; (b) Ss with a moderate level of pretreatment anxiety reported no change; and (c) Ss with low levels of anxiety reported significant increases in state anxiety. No change in trait anxiety was found for any group, suggesting that the foregoing changes in state anxiety were not simply attributable to regression. Findings are consistent with the Janis model, which posits that in threatening situations the level of fear can potentially determine the adequacy of adaptation. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The factor structure of self-reported physical stress reactions

A self-report questionnaire tapping 98 frequently reported physical stress reactions was subjected to factor analysis. The instrument was given to 1,210 subjects (593 males, 520 females, and 97 who failed to indicate their gender). The final factor solution identified 18 interpretable factors for the combined sample. Some of the more notable findings are: (a) Gastric Distress (Factor 1) is by far the most prominent factor and accounts for .491 of the total variance; (b) the factor solutions for males and females are highly similar, although Cardiorespiratory Activity (Factor 2) is defined by a greater diversity of noncardiac reactions for females than for males; and (c) six independent striated muscle tension factors can be identified for the entire sample. Results are discussed in terms of a behavioral conceptualization of psychosomatic symptoms. Clinical implications are noted.     

Reply to the ministries' reactions to the Canadian Psychological Association's position paper on beginning reading instruction.

Reactions to the position paper (M. L. Simner; see record 1994-03519-001) approved by the Canadian Psychological Association on beginning reading instruction were received from 8 ministries (departments) of education. Despite widespread media and public support for the Association's claim that the level of phonics instruction in whole language is insufficient to meet the needs of many beginning readers, the majority of the ministries took issue with this claim. The present article clarifies the Association's stand by drawing attention to the differences between the phonics exercises that research shows should be employed in beginning reading instruction and the phonics exercises that teachers are being encouraged to employ as a result of the ministries' endorsement of whole language. Four additional measures are provided that the Association now asks the ministries to adopt to avoid having more children suffer the consequences of improper beginning reading instruction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological aggression predicts physical aggression in early marriage.

Psychological aggression by self and partner, physical aggression by the partner, and marital dissatisfaction were examined as longitudinal predictors of first instances of physical aggression during marriage. Subjects who were not physically aggressive at a premarital assessment were selected from a sample of 393 engaged couples. Couples participated in three subsequent assessments over the first 30 months of marriage. As hypothesized, individuals' own psychological aggression predicted their initial incidents of physical aggression in marriage. Psychological aggression by their partners also predicted initial incidents of physical aggression. Prior physical aggression by their partners was inconsistently associated with first instances of physical aggression. Contrary to our hypothesis, previous levels of marital dissatisfaction did not predict initial incidents of physical aggression. These findings were consistent across sexes. The results underscore the progression from psychological to physical abuse and have clear implications for understanding the development and prevention of interspousal aggression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acting up and physical illness: temporal patterns and emerging structure

Many psychoanalytic writers have viewed acting out and somatization as alternate routes for the discharge of uncontained aggressive impulses in borderline patients. In order to investigate this empirically, we tracked the occurrence of two related behaviors--acting up and physical illness--over the course of one patient's long-term hospitalization. Daily scores on these variables were analyzed using a time series procedure. Results indicated that as treatment progressed, acting up and physical illness became more synchronized, and this occurred just prior to symptom remission. Material from psychotherapy suggested that these behavioral changes were associated with the patient's increased ability to verbalize aggressive impulses in the context of fantasy and memory.     

Predicting receipt of social support: A longitudinal study of parents' reactions to their child's illness.

101 Israeli women whose children required medical attention were interviewed at the time of initial hospital contact and again 1 yr later. On the 2nd occasion, their spouses were also interviewed for their assessment of their wives' personal and social characteristics. Greater personal resources, more intimate relations, and lower discomfort in seeking support were related to greater receipt of social support 1 yr later. Chronic stress conditions were found, however, to diminish the effect of individuals' social characteristics on receipt of support. Spouses' assessments showed moderate agreement with that of their wives, lending support to the findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)