Showing papers on "Somatization published in 1985"
TL;DR: In this article, the authors tested whether self-concept discrepancy theory (Higgins, 1983) provides a psychological model for distinguishing among different aspects of depression and anxiety, and the Selves Questionnaire was created to measure selfconcept discrepancy.
Abstract: This study tested whether self-concept discrepancy theory (Higgins, 1983) provides a psychological model for distinguishing among different aspects of depression and anxiety. Nondepressed, slightly depressed, and moderately depressed undergraduates filled out a variety of standard questionnaires—the Beck Depression Inventory, Blatt Depressive Experiences Questionnaire, Emotions Questionnaire (measuring chronic rather than momentary affect), and Hopkins Symptom Checklist (Depression, Anxiety, Hostility, and Somatization subscales)—as well as the Selves Questionnaire, which was created to measure self-concept discrepancy. The Selves Questionnaire asked subjects to list up to 10 attributes associated with each of six different self-concepts. Each self-concept involved a particular domain of the self (i.e., the “actual” self, the “ideal” self, or the “ought” self) combined with a particular standpoint on that self (i.e., the subject's “own” standpoint or the standpoint of a significant “other”). To calculate ...
677 citations
TL;DR: Unemployed men made significantly more visits to their physicians, took more medications, and spent more days in bed sick than did employed individuals even though the number of diagnoses in the two groups were similar.
Abstract: From a prospective study of the impact of stress on health in 300 men assessed every six months, men who became unemployed after entering the study were compared with an equal number, matched for age and race, who continued to work. Psychological and health data after unemployment were compared between the two groups by multivariate analysis of variance and covariance. After unemployment, symptoms of somatization, depression, and anxiety were significantly greater in the unemployed than employed. Large standard deviations on self-esteem scores in the unemployed group suggested that some men coped better than others with job-loss stress. Further analysis showed those with higher esteem had more support from family and friends than did those with low self-esteem. Furthermore, unemployed men made significantly more visits to their physicians, took more medications, and spent more days in bed sick than did employed individuals even though the number of diagnoses in the two groups were similar.
429 citations
Journal Article•
TL;DR: It is concluded that, despite considerable overlap with subaffective disorders, the current adjectival use of this rubric does not identify a specific psychopathologic syndrome.
Abstract: Outpatients diagnosed as borderline (N = 100) were prospectively followed for 6-36 months and examined from phenomenologic developmental, and family history perspectives. At index evaluation, 66 met criteria for recurrent depressive, dysthymic, cyclothymic, or bipolar II disorders, and 16 for those of schizotypal personality. Other subgroups included sociopathic, somatization, panic-agoraphobic, attention deficit, epileptic, and identify disorders. Compared with nonborderline personality controls, borderlines had a significantly elevated risk for major affective but not for schizophrenic breakdowns during follow-up. Prominent substance abuse history, tempestuous biographies, and unstable early home environment were common to all diagnostic subgroups. In family history, borderlines were most like bipolar controls, and differed significantly from schizophrenic, unipolar, and personality controls. It is concluded that, despite considerable overlap with subaffective disorders, the current adjectival use of this rubric does not identify a specific psychopathologic syndrome.
294 citations
31 Dec 1985
210 citations
TL;DR: Data on the incidence and magnitude of sexual functioning morbidity following the diagnosis and treatment of cancer at major organ sites, including breast, genital, colon, rectum, and bladder, are reviewed and strategies for continuing descriptive study of the sexual problems of cancer patients are suggested.
Abstract: The current article reviews available data and considers methodologic issues for future research in which sexual functioning among adult cancer patients is an endpoint variable. Circumstances that may cause sexual disruption for any cancer patient are suggested, including mood disturbance, changed health status, somatization, and reprioritization of life concerns. Data on the incidence and magnitude of sexual functioning morbidity following the diagnosis and treatment of cancer at major organ sites, including breast, genital, colon, rectum, and bladder, are reviewed. Finally, strategies for continuing descriptive study of the sexual problems of cancer patients are suggested. Such data are necessary to eventually target preventive or therapeutic resources to patients in greatest need.
139 citations
TL;DR: The authors conclude that contemporary operational criteria for borderline disorder identify a wide net of temperamental disorders with strong affective coloring rather than a unitary nosologic entity.
Abstract: The REM latencies of 24 nonschizotypal borderline outpatients--who were not in the midst of a major depressive episode--were in the range of those of 30 patients with primary major depression but were significantly shorter than those of 16 patients with nonborderline personality disorders and 14 nonpsychiatric controls. Also, more of the borderline subjects had lifetime diagnoses of affective disorder, such as dysthymic, cyclothymic, and bipolar II disorder, and of a spectrum of anxiety and somatization disorders. The authors conclude that contemporary operational criteria for borderline disorder identify a wide net of temperamental disorders with strong affective coloring rather than a unitary nosologic entity.
136 citations
TL;DR: Although sociodemographic characteristics did not strongly differentiate patients with somatization from others, ethnicity and indicators of decreased resources such as large households with low income, households headed by single women, or a limited English proficiency were associated with Somatization in certain ethnic groups.
Abstract: The clinical records of Chinese, Filipino, Vietnamese, Laotian, and Mien patients in primary care were reviewed to determine the prevalence of somatization, its associated patient characteristics, and the manifested illness behavior. Patients in this study were generally poor, unemployed, and spoke little English. Somatization accounted for 35 per cent of illness visits. These visits were also more costly. Refugees had a higher rate of somatization (42.7 per cent) than immigrants (27.1 per cent). Although sociodemographic characteristics did not strongly differentiate patients with somatization from others, ethnicity and indicators of decreased resources such as large households with low income, households headed by single women, or a limited English proficiency were associated with somatization in certain ethnic groups. Somatization is thus an important health problem among Asian refugees and immigrants.
131 citations
TL;DR: More productive treatment strategies are presented, emphasizing the need for a long-term relationship with a primary care provider who will treat the patient and his symptoms seriously and respectfully but who is not compelled to invasively evaluate all symptoms.
Abstract: Patients with somatization disorders are frequently unrecognized and misdiagnosed. The diagnosis depends on recognizing a long-standing pattern of seeking medical intervention for vague, multisystemic symptoms, often without clear physical cause. These patients use symptoms as a way to communicate, express emotion, and be taken care of. Instead of recognizing the disorder and exploring psychosocial contributors to illness, nonpsychiatric physicians tend to repeatedly pursue organic possibilities through multiple tests, procedures, medications, and operations. In patients with somatization disorders, the dollar costs of this strategy are only exceeded by its potential for iatrogenic harm. More productive treatment strategies are presented, emphasizing the need for a long-term relationship with a primary care provider who will treat the patient and his symptoms seriously and respectfully but who is not compelled to invasively evaluate all symptoms. ( JAMA 1985;254:3075-3079)
112 citations
TL;DR: B Bereaved parents with higher concurrent life stresses and parents from a lower socioeconomic background were at higher risk for emotional symptomatology and nonbereaved parents, however, more frequently reported appetite and sleep problems.
Abstract: The purpose of this study was to compare the emotional symptoms and physical health of parents whose children had died suddenly in an accident, parents whose children had died following a chronic disease, and nonbereaved parents. Data for this retrospective survey were collected by mailed questionnaires: the Hopkins Symptom Checklist (HSCL), Bereavement Health Assessment Scale, Review of Life Experiences Scale, and a personal-situation questionnaire. Subjects were 30 bereaved parents who had experienced the death of a child following a chronic disease; 31 bereaved parents whose children died in an accident; and 81 nonbereaved parents. Findings indicated significant differences between the bereaved groups and the control group on the total scale score of the HSCL and on the subscales measuring Depression, Anxiety, Somatization, Obsession-Compulsion, and Interpersonal Sensitivity. However, there were no differences on these variables between the two bereaved groups. Bereaved parents with higher concurrent life stresses and parents from a lower socioeconomic background were at higher risk for emotional symptomatology. There were no significant differences among the three groups on the number of physician/nurse visits, number of hospital admissions, number of new or recurrent illnesses, or drug usage. Bereaved parents, however, more frequently reported appetite and sleep problems.
76 citations
TL;DR: Conurrent negative life stress was the most important single predictor in all three health outcomes in both groups of subjects.
Abstract: Investigators have focused primarily on the bereavement experiences of widows and parents of deceased infants. In this study, subjects were 69 bereaved close family members and friends of deceased disaster victims and 50 control subjects. Six variables, not examined before, were entered in a series of hierarchical step-wise regression equations to determine their ability to predict health outcomes. The six variables were gender, age, concurrent life stress, perception of the prior relationship between the bereaved and deceased as central or peripheral, perception of catastrophic death as preventable or unpreventable, and perception of social support. The three health outcomes were depression, somatization, and physical health status. Results indicated that the six selected variables accounted for 48% of the variance in predicting depression, 39% in predicting somatization, and 35% in predicting physical health status in the bereaved group. Concurrent negative life stress was the most important single predictor in all three health outcomes in both groups of subjects.
Journal Article•
TL;DR: The primary physician can manage the majority of the common somatizing patients by observing the following principles: develop a good physician-patient relationship, apply techniques of behavior modification, engage the patient at the somatic level but extend it to include associated life stresses, strategically use symptomatic measures, treat depression with full doses of antidepressants, and accept the importance of ongoing contact with the patient irrespective of symptoms.
Abstract: Patients with chronic, unexplained physical complaints are evaluated diagnostically in two steps in primary care: (1) brief consideration of three specific, but rare, disorders (somatic delusion, conversion, and malingering); and (2) extensive consideration of the remaining three common but overlapping disorders (somatization disorder, hypochondriasis, and psychogenic pain). Because of frequent confusion in differentiating among the common somatizing disorders and because the treatment is similar for all, the family physician can be content with the general designation of "common somatization syndrome" when unable to distinguish among them. This diagnosis can be easily established by a good history and physical examination. Psychiatric referral is required for the rare somatizing disorders. The primary physician can manage the majority of the common somatizing patients by observing the following principles: develop a good physician-patient relationship, apply techniques of behavior modification, engage the patient at the somatic level but extend it to include associated life stresses, strategically use symptomatic measures, treat depression with full doses of antidepressants, and accept the importance of ongoing contact with the patient irrespective of symptoms. When these therapeutic principles are employed, decreased morbidity, medical utilization, and cost can be expected to follow.
TL;DR: The authors administered self-rating scales of anger-hostility, somatic symptoms, and hypochondriacal fears and beliefs to patients and nonpatients, and the findings do not support the view that anger or hostility are main or specific etiological factors either in somatization or in hypochondrian fears or beliefs.
Abstract: The authors administered self-rating scales of anger-hostility, somatic symptoms, and hypochondriacal fears and beliefs to seven groups of patients and nonpatients. Somatic symptoms were positively correlated with anger-hostility and were negatively correlated with feelings of friendliness; the correlation coefficients ranged from low to moderately high and were significant in most groups. Somatic symptoms tended to be associated more strongly with symptoms of anxiety and depression than with those of hostility. The associations of hypochondriacal fears and beliefs with hostility were inconsistent, varied between groups and with the concern measured. The findings do not support the view that anger or hostility are main or specific etiological factors either in somatization or in hypochondriacal fears or beliefs.
TL;DR: Patients who were depressed solely due to cancer were not significantly different from those with 'normal' symptoms and the use of anti-depressant treatment with a subset of depressed cancer patients is suggested.
01 Jan 1985
TL;DR: This chapter reviews psychopathology observed in Hong Kong and focuses on the issue of somatic presentation among Chinese patients, showing that emotional problems were among the most frequently cited problems brought in for counseling.
Abstract: Publisher Summary This chapter reviews psychopathology observed in Hong Kong and focuses on the issue of somatic presentation among Chinese patients. Somatization refers to the presentation, complaint, or manifestation of somatic symptoms that relate to psychological or emotional problems. Cultural differences in the baseline of normal and pathological behavior may be found in studies of psychological testing. Cross-cultural test comparisons show that Hong Kong subjects differ from their Western counterparts in their scale scores and item endorsement patterns. Psychiatric patients tend to associate somatic complaints with their illnesses throughout their experiences with medical consultation. An examination of the consultation history of patients attending a psychiatric outpatient clinic for the first time showed that over half of the patients had symptoms for more than a year prior to their psychiatric consultation. The expression of emotions is dependent upon the situational context. Expressions of emotional difficulties are found more frequently in nonmedical settings. Reports on counseling resources in Hong Kong show that emotional problems were among the most frequently cited problems brought in for counseling.
Journal Article•
TL;DR: This paper addresses the problem of the differential presentation of illness by women and men in two Spiritualist temples and a physician's office situated in rural Mexico to highlight the socio-cultural and psychosocial variables that promote illness in women from the same sociocultural strata of rural Mexico.
Abstract: This paper addresses the problem of the differential presentation of illness by women and men in two Spiritualist temples and a physician's office situated in rural Mexico. Women's morbidity raises the broader anthropological questions of the interplay between symptomatic expression and women's unequal status in the social structure, their cognitive evaluation of specific life experiences, cultural etiological explanations and Western models of dysphoria. Symptoms presented by patients in different health care delivery sites are compared and case vignettes of patients' illnesses and attributions are presented to demonstrate the ways in which culturally constructed illness attributions and illness expressions comprise a somatic grammar for the articulation of experiential distress. The sick population is compared with a control group of healthy women to highlight the socio-cultural and psychosocial variables that promote illness in women from the same sociocultural strata of rural Mexico. Collective understandings of the role of life events and emotional expression in illness attributions legitimize somatization as a coping style under adverse existential conditions.
TL;DR: The findings of cross-sectional and change analyses over the three waves of data point to a stable relationship between rat infestation and a single dimension of psychological well-being, somatization.
Abstract: Interview data from a three-wave panel study of the impact of the residential environment upon the psychological well-being of 337 minority women were used to examine the effects of household infestation upon self-reported depression, phobic anxiety, somatization, hostility, and anomia. The findings of cross-sectional and change analyses over the three waves of data point to a stable relationship between rat infestation and a single dimension of psychological well-being, somatization.
Journal Article•
TL;DR: Future studies on the behavioral treatment of irritable bowel syndrome patients may well include a personality inventory as a consideration of how irritable bowel syndrome patients have different personality styles.
TL;DR: It has often been suggested that Americans tend to seek psychiatric help for depression, whereas Chinese patients are more likely to have somatic symptoms of emotional disturbance, but when studying 99 Taiwanese and 97 American psychiatric outpatients given computerized diagnoses based on information obtained in a standard psychiatric interview schedule, it was found that the Chinese patients scored higher on the measures of somatization.
Abstract: It has often been suggested that Americans tend to seek psychiatric help for depression, whereas Chinese patients are more likely to have somatic symptoms of emotional disturbance. When the authors tested this assumption by studying 99 Taiwanese and 97 American psychiatric outpatients given computerized diagnoses based on information obtained in a standard psychiatric interview schedule, they found that the Chinese patients scored higher on the measures of somatization but also on the measures of depression.
01 Jan 1985
TL;DR: Patients with a cardiac anxiety syndrome were only distinguished by a greater intensity of somatization and phobic avoidance from patients with no cardiacxiety syndrome, confirming the hypothesis that the cardiac anxiety Syndrome is a subtype of panic attacks and does not represent a separate disorder.
Abstract: Cardiac anxiety syndrome and the diagnosis of cardiac neurosis respectively are characterized by panic attacks. Panic attacks are the core syndrome of a validated anxiety disorder (panic disorder). The purpose of this study was to investigate if the cardiac anxiety syndrome represents a separate disorder or if it is only a subtype of panic attacks. In a sample of 122 patients with panic attacks, all patients with a cardiac anxiety syndrome were selected (n = 31). Furthermore, parallel to this group—matched in the variables age and sex—a second group of patients with no cardiac anxiety syndrome was selected. There were no significant differences in course; in clinical phenomenology, patients with a cardiac anxiety syndrome were only distinguished by a greater intensity of somatization and phobic avoidance from patients with no cardiac anxiety syndrome. These results confirm the hypothesis that the cardiac anxiety syndrome is a subtype of panic attacks and does not represent a separate disorder.
TL;DR: Gender differences in psychological response appear to modify endocrine responses to the experience of low back pain, and most of the data support the earlier assumption that male and female pain patients have different coping mechanisms.
Abstract: Demographic, clinical and psychological characteristics of 92 patients with low back pain were correlated with prolactin and cortisol levels in cerebrospinal fluid (CSF). Somatization and depression scores correlated statistically significantly with the CSF serum ratio of prolactin both in men and in the total group. An increased CSF/serum ratio of cortisol was slightly associated with somatization scores in the total group. Multiple stepwise regression, furthermore, revealed that somatization, anxiety and one of the pain indices contributed to the variance in the CSF prolactin level, which was mostly dependent on the respective serum level. Sex and electromyographic findings (EMG) accounted for 12 and 7%, respectively, of the variance in the afternoon cortisol levels. Women reported more somatization and depression feelings than did men. Most of the data support our earlier assumption that male and female pain patients have different coping mechanisms. In spite of the common underlying endocrine responses to distress in men and women, gender differences in psychological response appear to modify endocrine responses to the experience of low back pain.
01 Jan 1985
TL;DR: In this paper, a study was undertaken to improve prediction of physical and psychological complaints subsequent to life event stress by more comprehensive measurement of life event characteristics and by assessment of locus of control, social supports, and somatization as moderating variables in the life stress-illness process.
Abstract: Although there is considerable evidence to support the contributions of life event stress to subsequent psychological and physical symptoms, the correlations reported between obtained stress scores and illness measurements have been low. This study was undertaken to improve prediction of physical and psychological complaints subsequent to life event stress by more comprehensive measurement of life event characteristics and by assessment of locus of control, social supports, and somatization as moderating variables in the life stress-illness process. An overview of psychosomatic medicine was given and the relevant life event research was reviewed. Fifty undergraduate students completed the experimental version of the Life Experiences Survey (LES), Rotter's Internal-External Control of Reinforcement Scale (I-E Scale), the Minnesota Multiphasic Personality Inventory (MMPI), and the Interview Schedule for Social Interaction (ISSI). Subjects then completed psychological and somatic complaint checklists (modified SCL-90-R, modified Wahler Physical Symptoms Inventory) every four weeks for a three month period. Pearson product-moment correlations were calculated, providing an intercorrelation matrix for all
TL;DR: It is maintained that the Primary Care Air Force physician may be able to deal with many of the psychological problems, provided that they are given adequate consultation and supervision by the Mental Health Officer to enable them to detect the problems early in their develop ment.
Abstract: This study examined the impact of a brief psychological intervention on a number of criteria, these being psychological variables, the use of medical services, and the nature of medical problems. Twenty-five soldiers treated in the Clinic were compared to 28 non-treated soldiers, randomly chosen from the general population on the .base. Psychological factors were measured on Global Assessment Scale: I-E Scale (4), A-State and A-Trait Anxiery Scale (5), and the Sensitivity of Symptom- and Nonsymptom-focused Criteria (2). Use of medical care was the number of outpatient visits made by the soldiers. Nature of medical complaints involved dividing medical problems into three categories: medical complaints with possible psychological components, clear psychological complaints, and clear medical complaints. The psychological treatment was a brief active technique focusing and defining immediate problems and working out practical ways of dealing with them. Essential results indicated that (1) at intake, the treated group showed greater emotional instability than the controls as reflected by the significantly higher scores on state and trait anxiety, general neurotic feelings, somatization, cognitive performance difficulties, depression and fear, and anxiety. (2) In the treated group over 4 mo., significant decreases on the above psychological measures were found. Except for state anxiety, the treated group after 4 mo. was similar to controls on all psychological measures. (3) Comparison of pre- and the 3-mo. poscrreaunent periods showed significant reductlon in psychological visits by the treated group, but controls showed no such change. Clearly the brief psychological intervention was effective. In general, the effect of psychological intervention appeared clearly positive. It improved the emotional state of the treated sample which confirms previous findings ( 1). It also led to adequate use of medical services which, particularly in the military context, has many broad ramifications. We maintain that the Primary Care Air Force physician (as well as, in some cases, the soldiers' officers-in-charge) may be able to deal with many of the psychological problems, provided that they are given adequate consultation and supervision by the Mental Health Officer (3) to enable them to detect the problems early in their develop ment. Effective cooperation and coordination among the Mental Health Officer, the military physician, and officer-in-charge is crucial for soldiers' improved mental health and effective use of medical services. REFERENCES 1. JACOBS, M..H. The assessment of change in distress levels and style of adaption as a
01 Jan 1985
TL;DR: In this paper, interview data from a panel study of337 minority women were used to examine the effects of household infestation upon self-reported depression, phobic anxiety, somatization, hostility, and anomia.
Abstract: Interview datafromathree-wave panel study ofthe impact oftheresidential environment uponthepsychological well- being of337minority womenwereusedtoexamine theeffects of household infestation uponself-reported depression, phobic anxiety, somatization, hostility, andanomia. Thefindings ofcross-sectional