Showing papers by "David Spiegel published in 1998"
TL;DR: The results are consistent with the ‘buffering hypothesis’ that social support may shield women with metastatic breast cancer from the effects of previous life stress on their emotional adjustment; however, aversive support may be an additional source of life stress associated with emotional distress.
Abstract: The purpose of this study was to examine relationships between emotional adjustment to advanced breast cancer, pain, social support, and life stress. The cross-sectional sample was compromised of 102 women with metastatic and/or recurrent breast cancer who were recruited into a randomized psychosocial intervention study. All women completed baseline questionnaires assessing demographic and medical variables, social support, life stress, pain, and mood disturbance. Three types of social support were assessed: (1) number of persons in support system; (2) positive support; and (3) aversive support. On the Profile of Mood States (POMS) total score, we found significant interactions between life stress and social support; having more people in the patient's support system was associated with less mood disturbance, but only among patients who had undergone greater life stress. Also, aversive social contact was significantly related to total mood disturbance (POMS), and having more aversive social contact was particularly associated with total mood disturbance (POMS) among patients who had undergone greater life stress. Pain intensity was associated with greater total life stress, and was not significantly related to social support. These results are consistent with the 'buffering hypothesis' that social support may shield women with metastatic breast cancer from the effects of previous life stress on their emotional adjustment; however, aversive support may be an additional source of life stress associated with emotional distress. Also, pain is greater among women with greater life stress, regardless of social support.
240 citations
TL;DR: The results suggest not only that being a bystander to violence is highly stressful in the short run, but that acute stress reactions to such an event further predict later posttraumatic stress symptoms.
Abstract: Objective: Using the DSM-IV diagnostic criteria for acute stress disorder, the authors examined whether the acute psychological effects of being a bystander to violence involving mass shootings in an office building predicted later posttraumatic stress symptoms. Method: The participants in this study were 36 employees working in an office building where a gunman shot 14 persons (eight fatally). The acute stress symptoms were assessed within 8 days of the event, and posttraumatic stress symptoms of 32 employees were assessed 7 to 10 months later. Results: According to the Stanford Acute Stress Reaction Questionnaire, 12 (33%) of the employees met criteria for the diagnosis of acute stress disorder. Acute stress symptoms were found to be an excellent predictor of the subjects’ posttraumatic stress symptoms 7‐10 months after the traumatic event. Conclusions: These results suggest not only that being a bystander to violence is highly stressful in the short run, but that acute stress reactions to such an event further predict later posttraumatic stress symptoms. (Am J Psychiatry 1998; 155:620‐624)
230 citations
TL;DR: Evidence is reviewed of one possible mechanism whereby psychosocial factors may influence disease‐resistance capabilities: the neuro‐immune connection, whereby supportive social relationships may buffer the effects of cancer‐related stress on immunity, and thereby facilitate the recovery of immune mechanisms that may be important for cancer resistance.
Abstract: Research has provided growing evidence of links between the social environment and cancer progression. Indeed, social support in the form of marriage, frequent daily contact with others, and the presence of a confidant may all have protective value against cancer progression. Furthermore, retrospective data suggest that major stressful life events are more prevalent in patients with relapse or malignancy, and thus may contribute to cancer morbidity. Initial studies of the effects of psychosocial intervention with cancer patients have provided some promising results. In three randomized prospective trials, protective effects of psychosocial interventions on cancer progression have been confirmed, while one matching and one randomized study showed no survival effect after psychosocial treatment. Though more research is clearly needed in this area, this body of evidence suggests that psychosocial factors have potentially powerful modulating effects on the course of disease. Here we review evidence of one possible mechanism whereby psychosocial factors may influence disease-resistance capabilities: the neuroimmune connection. Suppressive effects of stress on immune function are well documented, and these effects have been shown to be modulated by social support. Thus, it is reasonable to hypothesize that supportive social relationships may buffer the effects of cancer-related stress on immunity, and thereby facilitate the recovery of immune mechanisms that may be important for cancer resistance. Data addressing this hypothesis are reviewed.
109 citations
TL;DR: Overall among cancer patients, those who met symptom criteria for autism reported significantly more impulsive spending, desire to run away to avoid contact with people, giving away personal belongings, thinking about suicide, and forgetting medical information following cancer diagnosis than did cancer patients who did not meet criteria for ASD.
Abstract: We conducted a study to examine prevalence, predictors, and concomitants of acute stress disorder (ASD) following diagnosis of cancer among 89 patients. In addition to other measures, each participant completed the Stanford Acute Stress Reaction Questionnaire (SASRQ). One-third (33%) of the sample met all ASD symptom criteria. Significantly more women than men met criteria for ASD. For women, predictors for ASD symptoms included being of a younger age, having no prior life-threatening illness, perceiving less social support from friends, and reporting less satisfaction with how the diagnosis got communicated to them. A statistical trend was evident between higher religious/spiritual commitment and fewer ASD symptoms. For men, no factors were significantly related to ASD symptoms. Overall among cancer patients, those who met symptom criteria for ASD reported significantly more impulsive spending, desire to run away to avoid contact with people, giving away personal belongings, thinking about suicide, and forgetting medical information following cancer diagnosis than did cancer patients who did not meet criteria for ASD.
34 citations
TL;DR: Although there was no correlation between the VVIQ and hypnotizability, the less hypnotizable subjects made twice as many mistakes in the spatial imagery tasks than did the more hypnotizables, but this difference was not statistically significant.
Abstract: The objective of this study was to correlate computer-generated imagery tasks and a self-report measure of imagery ability with hypnotizability, hypothesizing that computer-generated imagery tasks would be better predictors of hypnotizability than will the self-report measure. Hypnotizability of 43 subjects was assessed using the Hypnotic Induction Profile and the Stanford Hypnotic Susceptibility Scale, Form C. Imagery ability was assessed by the Visual Vividness Imagery Questionnaire (VVIQ) and by computer-generated imagery tasks measuring the ability to generate, maintain, and transform images. Although there was no correlation between the VVIQ and hypnotizability, the less hypnotizable subjects made twice as many mistakes in the spatial imagery tasks than did the more hypnotizables, but this difference was not statistically significant. The relationships among hypnotic performance, hypnotizability, and imagery functions are complex.
30 citations
TL;DR: In this article, the authors examined relationships between acute stress disorder (ASD) symptoms and sexual abuse history, distress, and social support among sexual abuse survivors seeking treatment and found that ASD symptoms were significantly related to seeing the self as the causal locus of the abuse, forgetting the abuse for a period of time, and the number of abusers.
Abstract: This exploratory study examined relationships between acute stress disorder (ASD) symptoms and sexual abuse history, distress, and social support among sexual abuse survivors seeking treatment. Participants were 32 women recruited for a pilot study of group treatment for sexual abuse survivors who completed self-report and interview measures. Many participants (37.5%) met criteria for all ASD symptoms. Also, ASD symptoms were significantly related to seeing the self as the causal locus of the abuse, forgetting the abuse for a period of time, and the number of abusers, the distress of a recent life event, other forms of distress, and poor social support, Acute stress disorder may occur among many sexual abuse survivors seeking treatment, requiring special intervention to help these patients to manage their reactions to ongoing stresses.
26 citations
Book Chapter•
01 Jan 1998
19 citations
TL;DR: This issue is written in memory of Kenneth S. Bowers, who brought a lively intellect and an engaging and lucid writing style reminiscent of Freud's and a set of serious questions to the phenomenon of hypnosis.
Abstract: Kenneth S. Bowers, in whose honor this issue is written, was, in his own words, "seriously curious" (Bowers, 1983 (originally published 1976)) about hypnosis throughout his career. He brought a lively intellect and an engaging and lucid writing style reminiscent of Freud's (forgive me, Ken, I'm referring to style, not content), and a set of serious questions to the phenomenon of hypnosis. We are indebted to him for his many contributions to the field.
16 citations
TL;DR: Cognitive representations of self are an important indicator of adjustment in survivors of childhood sexual abuse and their association with symptomatology is suggested.
15 citations
TL;DR: A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease: The Alzheimer's Disease Cooperative Study.
Abstract: (1998). Getting There Is Half the Fun: Relating Happiness to Health. Psychological Inquiry: Vol. 9, No. 1, pp. 66-68.
14 citations
TL;DR: Clinical administrative staff and others who have direct contact with potentially threatening patients are more likely to experience acute stress reactions, and training to cope with threatening patients should be directed particularly toward them.
Abstract: We examined acute stress reactions following a threatening episode at an outpatient psychiatric clinic. After staff received threats by a patient, 63 of 83 (75.9%) non-faculty psychiatry staff completed a questionnaire on their acute stress and other reactions to this episode and experiences of this and previous threats. Clinic administrative staff reported greater acute stress reactions than did others (i.e., residents, interns or research staff). Greater acute stress symptoms were associated with objective event elements and with identifying the episode as threatening. Acute stress symptoms were strongly and positively related to both functional and dysfunctional behavioral change, including taking protective actions such as calling for help from security staff as well as experiencing interference in social and occupational functioning. Having been threatened or harassed previously was also related to both functional and dysfunctional behavioral change. Because clinic administrative staff and others who have direct contact with potentially threatening patients are more likely to experience acute stress reactions, training to cope with threatening patients should be directed particularly toward them.
TL;DR: Four cases of DID associated with severe self-destructive behavior and comorbid major depression treated with electroconvulsive therapy (ECT) are reported, finding ECT appeared to be helpful in treating theComorbid depression without adversely affecting the DID.
Abstract: Dissociative identity disorder (DID), previously named multiple personality disorder, is a diagnosis often complicated by comorbid major depression. We report on four cases of DID associated with severe self-destructive behavior and comorbid major depression treated with electroconvulsive therapy (ECT). In three of the patients, ECT appeared to be helpful in treating the comorbid depression without adversely affecting the DID. The potential risks of using ECT in patients with DID are reviewed.
TL;DR: The issues of repressed, false, and implanted memories are explored, and advice is given concerning good therapeutic practice and the avoidance of legal liability.
TL;DR: Freyd, Jennifer J. as discussed by the authors, The Logic of Forgetting Childhood Abuse: Betrayal Trauma: The logic of forgetting childhood abuse. Cambridge: Harvard University Press, 232 Pages, $24.95 (Cloth)
Abstract: (1998). Freyd, Jennifer J. (1996). Betrayal Trauma: The Logic of Forgetting Childhood Abuse. Cambridge: Harvard University Press, 232 Pages, $24.95 (Cloth) American Journal of Clinical Hypnosis: Vol. 40, No. 3, pp. 249-251.