This article describes the validation of an Inventory of Positive Psychological Attitudes that ha... more This article describes the validation of an Inventory of Positive Psychological Attitudes that has potential relevance to health outcomes and its preliminary testing with chronic pain patients. The inventory taps two attitudinal domains: (1) life purpose and satisfaction and (2) self-confidence during potentially stressful situations. It also provides a total score. The inventory scales, developed using factor analysis, were found to have a strong degree of internal reliability and concurrent validity. Preliminary testing suggested that positive change on these scales correlates with positive changes in the health status of chronic pain patients. Multiple regression analyses suggested that the interactions of these positive psychological attitudes with health status are not fully accounted for by the interactions of negative psychological attitudes with health status.
Despite the abundant literature showing a relationship of sexual and/or physical abuse history wi... more Despite the abundant literature showing a relationship of sexual and/or physical abuse history with poor health status, few studies provide evidence about which dimensions of abuse may have a worse impact on health. In female patients with gastrointestinal (GI) disorders, the present study aims to identify which dimensions of abuse history (eg, number of perpetrators, injury) might predict poor current health status, in order to develop an empirically based severity of abuse measure. Of a sample of 239 female patients from a referral gastroenterology clinic, this paper primarily focuses on 121 women with a past history of contact sexual abuse (N = 99), and/or life threatening physical abuse (N = 68). Among those with a sexual abuse history, 24% of current health status was explained by serious injury during abuse (p = .0006), victimization by multiple perpetrators (p = .03), and being raped (p = .09). Among the physically abused, rape (in addition to life threat) (p = .0001), and multiple life-threatening incidents (p = .002) explained 39% of the variance in overall health. Among the women with a sexual and/or physical abuse history, the experience of rape, serious injury during sexual abuse, and multiple life-threatening incidents explained one fourth of the variance in current health status. Based on these three dimensions of abuse, we created an abuse severity measure which explained about one fourth of the variance in health status among the subgroup with abuse history, and among the entire clinic sample. Given the high prevalence of abuse in referral practice, and the potential health impact of previous abuse, it is important that history taking include details concerning the abuse experience. The severity of abuse measure developed in this paper should prove useful for both research and clinical practice.
Human immunodeficiency virus (HIV) is now commonly viewed as a chronic disease, which often consi... more Human immunodeficiency virus (HIV) is now commonly viewed as a chronic disease, which often consists of a wide array of recurrent and sometimes severe psychosocial stressors. An individual's response to these multiple challenges over time may impact their health. In this article, we review research examining the relationship of psychologic factors (eg, depression, stressful life events, coping, social support) with immune system function and disease course. We also explore some of the potential physiologic pathways that may underlie these types of psychosocial-immune relationships, as well as the effects of psychologic interventions, particularly cognitive-behavioral stress management (CBSM), on the psychosocial, neuroendocrine, and immune functioning of people living with HIV. We conclude by suggesting some areas for future research, particularly the study of HIV-positive women.
To examine the biological correlates associated with histories of sexual or physical abuse in wom... more To examine the biological correlates associated with histories of sexual or physical abuse in women meeting DSM criteria for premenstrual dysphoric disorder (PMDD) and in healthy, non-PMDD controls. Twenty-eight women with prospectively confirmed PMDD were compared with 28 non-PMDD women for cardiovascular and neuroendocrine measures at rest and in response to mental stressors, and for beta-adrenergic receptor responsivity, during both the follicular and luteal phase of the menstrual cycle. Structured interview was used to assess psychiatric history and prior sexual and physical abuse experiences. All subjects were free of current psychiatric comorbidity and medication use. More PMDD women had prior sexual and physical abuse experiences than controls (20 vs. 10, respectively). Relative to nonabused PMDD women, PMDD women with prior abuse (sexual or physical) exhibited significantly lower resting norepinephrine (NE) levels and significantly greater beta1- and beta2-adrenoceptor responsivity and greater luteal phase NE reactivity to mental stress. For non-PMDD control women, abuse was associated with blunted cortisol, cardiac output, and heart rate reactivity to mental stress relative to nonabused controls. The results of this initial study suggest that a history of prior abuse is associated with alterations in physiological reactivity to subsequent mental stress in women, but that the biological correlates of abuse may be different for PMDD vs. non-PMDD women.
This article describes the validation of an Inventory of Positive Psychological Attitudes that ha... more This article describes the validation of an Inventory of Positive Psychological Attitudes that has potential relevance to health outcomes and its preliminary testing with chronic pain patients. The inventory taps two attitudinal domains: (1) life purpose and satisfaction and (2) self-confidence during potentially stressful situations. It also provides a total score. The inventory scales, developed using factor analysis, were found to have a strong degree of internal reliability and concurrent validity. Preliminary testing suggested that positive change on these scales correlates with positive changes in the health status of chronic pain patients. Multiple regression analyses suggested that the interactions of these positive psychological attitudes with health status are not fully accounted for by the interactions of negative psychological attitudes with health status.
Despite the abundant literature showing a relationship of sexual and/or physical abuse history wi... more Despite the abundant literature showing a relationship of sexual and/or physical abuse history with poor health status, few studies provide evidence about which dimensions of abuse may have a worse impact on health. In female patients with gastrointestinal (GI) disorders, the present study aims to identify which dimensions of abuse history (eg, number of perpetrators, injury) might predict poor current health status, in order to develop an empirically based severity of abuse measure. Of a sample of 239 female patients from a referral gastroenterology clinic, this paper primarily focuses on 121 women with a past history of contact sexual abuse (N = 99), and/or life threatening physical abuse (N = 68). Among those with a sexual abuse history, 24% of current health status was explained by serious injury during abuse (p = .0006), victimization by multiple perpetrators (p = .03), and being raped (p = .09). Among the physically abused, rape (in addition to life threat) (p = .0001), and multiple life-threatening incidents (p = .002) explained 39% of the variance in overall health. Among the women with a sexual and/or physical abuse history, the experience of rape, serious injury during sexual abuse, and multiple life-threatening incidents explained one fourth of the variance in current health status. Based on these three dimensions of abuse, we created an abuse severity measure which explained about one fourth of the variance in health status among the subgroup with abuse history, and among the entire clinic sample. Given the high prevalence of abuse in referral practice, and the potential health impact of previous abuse, it is important that history taking include details concerning the abuse experience. The severity of abuse measure developed in this paper should prove useful for both research and clinical practice.
Human immunodeficiency virus (HIV) is now commonly viewed as a chronic disease, which often consi... more Human immunodeficiency virus (HIV) is now commonly viewed as a chronic disease, which often consists of a wide array of recurrent and sometimes severe psychosocial stressors. An individual's response to these multiple challenges over time may impact their health. In this article, we review research examining the relationship of psychologic factors (eg, depression, stressful life events, coping, social support) with immune system function and disease course. We also explore some of the potential physiologic pathways that may underlie these types of psychosocial-immune relationships, as well as the effects of psychologic interventions, particularly cognitive-behavioral stress management (CBSM), on the psychosocial, neuroendocrine, and immune functioning of people living with HIV. We conclude by suggesting some areas for future research, particularly the study of HIV-positive women.
To examine the biological correlates associated with histories of sexual or physical abuse in wom... more To examine the biological correlates associated with histories of sexual or physical abuse in women meeting DSM criteria for premenstrual dysphoric disorder (PMDD) and in healthy, non-PMDD controls. Twenty-eight women with prospectively confirmed PMDD were compared with 28 non-PMDD women for cardiovascular and neuroendocrine measures at rest and in response to mental stressors, and for beta-adrenergic receptor responsivity, during both the follicular and luteal phase of the menstrual cycle. Structured interview was used to assess psychiatric history and prior sexual and physical abuse experiences. All subjects were free of current psychiatric comorbidity and medication use. More PMDD women had prior sexual and physical abuse experiences than controls (20 vs. 10, respectively). Relative to nonabused PMDD women, PMDD women with prior abuse (sexual or physical) exhibited significantly lower resting norepinephrine (NE) levels and significantly greater beta1- and beta2-adrenoceptor responsivity and greater luteal phase NE reactivity to mental stress. For non-PMDD control women, abuse was associated with blunted cortisol, cardiac output, and heart rate reactivity to mental stress relative to nonabused controls. The results of this initial study suggest that a history of prior abuse is associated with alterations in physiological reactivity to subsequent mental stress in women, but that the biological correlates of abuse may be different for PMDD vs. non-PMDD women.
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