Bipolar disorder is a serious illness affecting approximately 2-4% of the population and is one of the world’s leading causes of disability. In individuals with bipolar disorder, medical comorbidity associated with cardiovascular, respiratory and endocrine disorders is related to increased rates of mortality. Recent updates to multi-system inflammatory related conceptualizations of bipolar disorder focus on the unique power that medical illness and biological processes may play as factors associated with course and outcome in bipolar disorder. The current study examined medical comorbidity and its associations with various demographic and psychological variables in individuals with bipolar disorder, schizophrenia, and major depressive disorder with psychotic features followed for 10 years from their first hospital admission. When compared to an age, gender and race-matched control sample from the population, those with bipolar disorder had significantly higher medical comorbidity across a range of medical diagnoses both at 6 months and 10 years after first hospital admission. Ten years following initial hospitalization, individuals in all three diagnostic groups reported increased rates of diabetes (OR: 2.0 – 3.7), stroke (OR: 4.6 – 7.0) and asthma (OR: 1.9 - 3.1), and individuals with bipolar disorder reported increased rates of cancer (OR = 2.1). A number of psychological …

The purpose of this manuscript was to present a brief history, the current status, and a prospectus of allergen and allergic reactions. Research on allergic reactions, particularly as viewed from the psychogenic position, was presented. The review strongly suggests that the psychogenic orientation has been frought with contradictions, unnecessarily complex interpretations, and an over-abundance of subjective, dynamic, and analytic redundancies which have done little more than perpetuate the stagnation of a rather important subdomain of the "mental" health professions.

Immunological correlates of anger conditions were investigated. Participants were 33 females and 36 males, ranging from 25 to 55 years old. Percentages of total T-lymphocytes, suppressor-T, helper-T, and ratio of helper-T to suppressor-T cells were measured. Differences were found between males and females for Anger Control and Anger Expression. For females, total T-cell percentages correlated with State Anger, Angry Temperament, Anger Out, and the combination of State Anger/Angry Reaction. Suppressor-T cell percentages correlated with State Anger, Trait Anger, Angry Temperament, Anger Out, Anger Expression, and the combination of Angry Temperament/Anger In. Helper-T cells correlated with State Anger, Angry Temperament, Angry Reaction, Anger Out, and Anger Control. Mindbody appears to function in a unified fashion.

Relationships of negative psychological conditions with general status of cell-mediated and humoral immune systems were investigated. A unique approach was utilized in that indexes representing multiple aspects of each branch of the immune system were employed to better indicate general immunological status. Differences in emotion-immune interactions between males and females were demonstrated. Results indicated a positive relationship between Trait Anger and Cell-Mediated Immunological Index. Particular criticisms of previous psychoneuroimmunological research were met by addressing sex differences and differences in various conditions of anger and depression, as well as through assessment of cumulative effects of negative emotions on immune system status. Directions for future research in eddressing similar issues are suggested. In general, results provide support for validity of mindbody interactionism and imply the need for revision of standard medical and psychological treatment.

COPD is the third leading cause of death in the United States and is the sixth leading cause of death for low-to middle income countries (Downs & Appel, 2006; GOLD, 2011). COPD is a largely preventable disease due to the lifestyle factors that heavily contribute to disease onset and severity. Although traditionally COPD research has focused on health outcomes related to risk factors, compliance, comorbid psychological and physical conditions, and treatment interventions, a growing body of research suggests religious and spiritual factors may play an equally important role in health outcomes for several medical conditions, including pulmonary disease. However, studies of this kind have not specifically examined COPD nor have they examined the role of religious and spiritual beliefs in COPD management among ethnic minority patients. As such, the current study aimed to examine whether spiritual ethnic minority patients with COPD hold religious fatalistic attitudes and less active religious problem solving . A sample of 35 ethnic minority patients from the Louis. B. Stokes Cleveland VA Medical Center (LSCVAMC) Outpatient Pulmonary Clinic in Cleveland, OH. were recruited to participate in the study. Due to the acknowledgeable limitations of the present study, results are preliminary but convey associations between religious health …

The purpose of the present study was to objectively verify psychological and behavioral changes in a group of identifiably susceptible patients who were treated for environmental sensitivities in a highly controlled environment. The subjects were 71 Environmental Control Unit (ECU) patient volunteers and 16 nonpatient volunteers for a total of 87. The patients were divided into a short-treatment (fasting 3-4 days) group (n = 35) and a long-treatment (fasting 5-7 days) group (n = 36). A third group, consisting of the 16 nonpatients, formed a nonpatient/no-treatment control group. All subjects were administered tests for assessment of intellectual/cognitive functioning, neurological/cerebral functioning, perceptual-motor skills, mood states, and general psychopathology.

The primary focus of the current study was to identify health disparities between sexual minority subgroups by examining differences of health indicators in lesbians, gay men, and bisexual individuals, and compare these to their heterosexual counterparts. Data was drawn from the National Health and Nutrition Examination Survey (NHANES), and variables examined in sexual minorities were related to health care access and utilization, risky health behaviors, and overall disease prevalence and outcomes. Findings suggest there are still some current health disparities in terms of insurance coverage, access to medical care, substance use, and prevalence of certain health conditions. However, a trend analysis conducted to examine three NHANES panels, suggests a mild improvement in some of these areas. Further findings, discussion, limitations of the study, current implications, and future directions are addressed.

Spinal cord injury (SCI) is an acute and devastating event that results in significant and permanent life changes for the individuals who are injured, as well as their families and friends. Depression has received more attention from clinicians and researchers than any other psychological issue among persons with SCI. Measurement of depression in this population has a variety of methodological issues, including inconsistent assessments used (self-report versus clinical interviews), varying definitions of depression, inclusion and exclusion of physical symptoms in the assessment process, and use of measures that do not represent DSM-IV criteria for major depressive disorder. The primary goal of this study was to evaluate the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) and provide descriptive analyses of this measure with persons with SCI. Results showed that somatic symptoms were more frequently endorsed than psychological symptoms in this population. Additionally, scores on the QIDS-SR were significantly associated with a depression diagnosis in the patient's medical chart. However, QIDS-SR scores were not found to be correlated inversely with quality of life scores as predicted. The QIDS-SR was shown to have good internal consistency and convergent validity with patients with SCI. However, it failed to demonstrate construct validity. The QIDS-SR …

A psychological intervention involving relaxation training and biofeedback training for the control of peripheral skin temperature was investigated in this study with 27 female rheumatoid arthritics as participants. Based on analysis of the temperature data, it was concluded that the biofeedback response was not learned. From electromyographic data, it was concluded that participants did learn to relax. The hypothesis that the two treatment components would have beneficial effects on the physical, functional, and psychological aspects of rheumatoid arthritis was answered partially. No differential effects as a function of biofeedback training were found as the data for the temperature increase and temperature decrease groups were statistically combined in multiple analyses of variance for repeated measures. Although no differential effects were obtained, numerous positive changes were found. Correlated with the relaxation training were decreases in reported subjective units of discomfort, percentage of time hurting, percentage of body hurting, and general severity of pain. Improved sleep patterns were reported as was increased performance of activities of daily living. Reductions were also found in psychological tension, and in the amount of time mood was influenced by the disease. Shifts were not found in imagery, locus of control, and other psychological dimensions. Constitutional improvements were …

The purpose of this study was to delineate those variables which are indicative of the patient whose health may be adversely affected by sensitivity to chemicals. In stage One analysis, the files of 10 chemically sensitive and 10 non-chemically sensitive patients were used to establish criterion variables as previously defined by legal proceedings prior to the study. Chemically sensitive and non-chemically sensitive patients were compared on all variables included in the study to empirically determine those variables which demonstrated significant differences by chi square analysis.

Dependency is defined as authentic or pathological and is seen as a component important to the treatment of patients with chronic illness. It is hypothesized that a significant portion of ecology patients will meet the criteria for pathological dependence and differ on psychological and physiological parameters from those who do not. This study strongly supports the first two hypotheses but does not find that the two groups differ physiologically. One hundred eleven variables are surveyed. Fifty-two show significant differences between the groups and 29 are significant at greater than the .0001 level. A discriminant analysis was used to determine the least number of orthogonal variables that best discriminate between the groups. These are MMPI Scales 8, 3, subscale Ma2, employment status, and early childhood illness.

This study briefly reviews both historical and recent conceptualizations of dependency. In particular, it focuses on this concept's applicability to patients with chronic illnesses, especially those with allergies. Type and degree of dependency were seen as an important factor in the approach to the medical and psychological treatment of clinical ecology patients. The purpose of the study was to develop an objective measure of dependency which could quickly identify patients whose dependency conflicts interfere with the treatment process. The study was divided into three phases. In the first phase test responses by 84 inpatients to the CAQ, MMPI, and the HAT as well as historical and demographic data were analyzed by a series of stepwise discriminant analysis. The 53 resulting items were examined for those which most concisely discriminated between the two identified groups (pathologically dependent and nonpathologically dependent). These 15 items were used to test 120 additional patients in phase II. Fourteen items were retained and the coefficients obtained classified the patients in phase I and II with a 98.81 percent and 94.17 percent degree of accuracy respectively. These classification coefficients were used to classify another 30 patients in phase III with a 96.67 percent rate of accuracy. These …

The purpose of this study was to analyze the factor structure of items pertaining to health on the Minnesota Multiphasic Personality Inventory (MMPI2) for chronic back pain patients in comparison to a control group. The results may be used as groundwork for developing an MMPI2 subscale to describe this population. The groups differed in the sequence of the resulting factors and the percentage of variance accounted for by each factor. The factors extracted when evaluating the control group were titled in order: Poor Physical Health, Digestive Difficulties, Equilibrium, Depression/Malaise, and Multiple Somatic Complaints. Resulting factors for the pain group were: Depression/Malaise, Digestive Difficulties, Multiple Somatic Complaints, Headaches/Dizziness, and Neurological Reaction/Poor Physical Health.

This study examined the relationship between physical health, social support, and depression in a married, middle-aged/older adult sample in which at least one partner has heart disease. The data was obtained from a national longitudinal study the Health and Retirement Survey (HRS) and is composed of selected respondents and their spouses. The HRS Wave 1 data that was used for these analyses was collected in 1992 and 1993. This study tested a stress buffer model predicting the relationship between physical health, social support, and depression. For study inclusion, participants must have been diagnosed with cardiovascular disease and received treatment in the last year. A heart disease construct was developed by calculating the level of disease by the number of conditions and medical treatments received within the last year. A second health category for other chronic health conditions included diabetes, arthritis, cancer, and chronic pain. These constructs were combined into a total disease construct, which provided a broad measure of health problems typical of an older adult population. Social support was determined by respondents' satisfaction with friends, neighbors, family, their marriage, and enjoyable time spent with their spouse. Social support was subdivided into two constructs separating spousal support from social support …

Grandparent-headed families are diverse in nature and represent a rapidly growing family type. While challenges facing grandparent caregivers are well documented, less is known about the well-being of their grandchildren, with many early studies relying on small samples of convenience. This study used an existing large national database, the National Survey of America's Families (NSAF), to compare differences in well-being of both children and grandparent caregivers across the independent variables of family type, ethnicity, gender, and age. Findings suggested better mental health and less parental aggravation for caregivers in traditional two parent intact families as compared to grandparents co-parenting in a multi-generation home, skipped generation grandparents (raising their grandchild with no parent present) or single parents. Skipped generation grandparents in particular reported most caregiver aggravation. Child physical health was reported to be worse by skipped generation grandparent caregivers. Behavior problems were reported to be worse for children in grandparent headed households than those in traditional families, particularly for teenagers raised in skipped generation households by their grandmothers. Specific results, limitations and future directions for research on grandparent-headed households were discussed.

For the past quarter century, the public has been educated and warned about the dangers of smoking, and both smokers and health researchers have been in search of cost-effective, smoking cessation programs that will lead to long-term cessation. This study used a randomized experimental design to investigate the effectiveness of adding Web-based support materials to a nationally sponsored self-help smoking intervention. There was no significant increase in abstinence rates nor progression through the stages of change by those participants who had access to the Web site. However, there were some overall significant trends that suggested these self-help interventions were successful at decreasing daily rates of smoking and nicotine dependency, as well as tended to encourage repeated quit attempts. Although Web-based supports did not appear to increase the effectiveness of the nationally sponsored self-help intervention, this study demonstrated overall 12 week follow-up abstinence rates of 30-32%--greater than what might be expected, given average success rates of other self-help interventions. This study also supports the notion that women may face additional barriers to smoking cessation. Limitations and implications for future research are discussed.

A total of 60 male and female subjects scoring between 0-5 and 8-12 on the Harvard Group Scale of Hypnotic Susceptibility: Form A underwent hypnosis procedures, hypnosis and age regression procedures to age 10, or were read an article about hypnosis. All subjects then listened to 20 minutes of directed imagery for warming and cooling the hands. Skin temperature was monitored on both index fingers. Dependent measures were the difference between each subject's highest temperature and baseline temperature, the difference between each subject's baseline temperature and lowest temperature, and the latency of change from baseline to highest temperature, and the latency of change from the beginning of cooling imagery to lowest temperature. Results indicated that the age regression group achieved significantly warmer temperatures than the control group and that the age regression group remained significantly warmer than the two other groups during the cooling imagery. Results also indicated that these skin temperature responses generalized to the nondominant hand. The data were interpreted as suggesting that those subjects exposed to the age regression procedures may have been more relaxed than the other groups. Another interpretation suggested the cooling imagery may not have been accessing common or pleasant experiences of the subjects.

Traditional treatment for insomnia has been chemotherapy-- despite short-term value and side effects. Need for an alternative has led to research on behavioral treatment methods for insomnia. Relaxation training has consistently produced effective results, but the limited research on biofeedback and stimulus control suggests that they too may be viable alternate treatment methods. The present research investigated electromyogram (EMG) biofeedback, pseudo-EMG biofeedback, relaxation, training, and stimulus control as methods of treating sleep-onset insomnia. Volunteers consisting of 12 males and 24 females were recruited through newspaper advertisements. Subjects had no known physical cause for insomnia and were either free of sleeping medication or kept their dosage constant during the study. Subjects were matched for age and sex, randomly assigned to one of the four treatment groups, then randomly assigned to one of three therapists. Results indicated that pretreatment EMG scores for the four groups were high but not significantly different-- while post treatment EMG scores were not significantly reduced. Pretreatment sleep-latency measures were high, but not significantly different from each other. Post treatment latency measures were significantly reduced, but not significantly different from each other. Correlation between EMG-change scores and sleep-latency-change measures was non-significant. Pretreatment nightly awakenings for the four groups …

Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) are often reported as experiencing more stress than parents of normal children. The bulk of this research has been conducted primarily on a Caucasian population, however, providing little information regarding multicultural aspects of parenting stress. Research has also been lacking in attention given to the stress related to parenting a child with internalizing disorders. The purpose of this study was 1) to compare parenting stress reported by mothers of children with ADHD to parenting stress reported by mothers of children with depressive disorders, and 2) to compare parenting stress as reported by Caucasian, African American, and Hispanic mothers. Results indicated that mothers of ADHD children experienced more parenting stress related only to their children's hyperactive and distracting behaviors. Contrary to previous research, Caucasian mothers reported significantly more overall and parent-related parenting stress than African American mothers.

Previous research indicates that stressors experienced by a family, the perceived level of burden assigned by the family to the stressor, and the utilization of resources predict family functioning. The current study utilized a nationally representative sample of families of children with autistic disorder to determine if previously proposed models of family functioning accurately conceptualized family functioning within a representative sample. Structural equation modeling was utilized to test the double ABCX and the linear ACBX models of family functioning. With slight modifications, the double ABCX model was supported, thus indicating that pileup of stressors, perception of burden, and utilization of resources each have unique predictive ability for family functioning, with perception of burden demonstrating the highest amount of predictive ability. Results, implications, and limitations of the study are discussed.

Intimate partner violence is endemic in the United States. According to the American Medical Association (1992), one-fifth to one-third of women will sustain violence from a partner or ex-partner in their lifetime. The relevant literature was organized by ICD-9-CM categories. This study examined the health consequences of partner abuse in a sample of community women using a sample consisting of 564 women in three ethnic groups. Because prior research has failed to account for variations by type of abuse on health consequences, this study assessed psychological abuse, violence and sexual aggression by women's partners. To determine whether or not different types of abuse had an effect on women's health, hierarchical regression analyses were conducted. The regression equations were calculated for women within each ethnic group to facilitate identification of similarities and differences and to control for ethnic differences in risk for specific diseases. The results were consistent with past research on health consequences of abuse and extended the prior literature by showing that psychological abuse had a pervasive effect on health conditions, distress and use of health care resources. Additionally, ethnic differences emerged. As expected, ethnicity appeared to function as a moderator. Clinical implications and recommendations are made for future …

The establishment of physiological norms for psychologically hardy vs. non-hardy individuals was attempted by examination of levels of salivary cortisol and urinary norepinephrine before and after a mid-term examination stressor. Normative data was collected on the reported frequency of stressors and their severity one week prior to the examination, and self-reported ratings of stress immediately prior to the examination. Performance on the examination as a function of hardiness was explored. Associations between demographic variables and psychological hardiness were also studied. Results from this study were inconclusive in establishing physiological norms for psychologically hardy individuals. Associations were found between: 1) hardiness and frequency of stressors; 2) hardiness and age; and 3) self-reported ratings of stress and anxiety as measured by the State-Trait Anxiety Inventory (STAI).

Children and adolescent psychiatric inpatients (n = 25) versus staff (n = 35) milieu perceptions were measured with the Ward Atmosphere Scale (WAS) Form K (Kids). The perceptions were compared with previous data collected in 1981, 1982, and 1984 on the same unit. The 1993 staff and patients continued to perceive the unit as a therapeutic environment despite recent restrictions on length of stay due to health care reform. The views of the staff and patients were found to be divergent but less so than in previous years. Additionally, the more seriously ill a patient was determined to be, the more negatively he or she perceived the environment. Differences in perceptions between day shift versus night shift and administrative versus non-administrative staff were also found and discussed. Staff perceptions versus their ideal conceptions were also investigated and compared with those of the 1984 staff. The 1994 staff was found to more closely approximate their ideals than the 1984 staff.

Multiple contributors to neurocognitive impairment in individuals with sickle cell disease have been identified. Research indicates that a history of cerebrovascular accidents, such as silent infarcts and strokes are associated with greater cognitive decline among children with sickle cell disease. Additionally, disease effects such as hemoglobin and hematocrit levels significantly effect cognitive performance among this population and should be taken into consideration when examining neurocognitive impairment. Further, previous studies show a significant relationship between child behavior problems, family functioning, and cognitive performance in children with sickle cell, marking those as important targets for intervention among this population. While cognitive decline with increased age is not typically examined in healthy child populations, some research indicates the presence of age effects in those with SCD. A majority of the literature addresses cognitive impairment from a broad perspective, while a limited number of studies have begun to address effects among specific cognitive domains. Using archival data from the National Institutes of Health's Cooperative Study of Sickle Cell Disease, results revealed that disease severity was negatively correlated with some aspects of cognitive functioning, including visual-spatial domains. Additionally, some measures of cognitive performance were inversely correlated with age. Consistent with hypothesized outcomes, family functioning was …