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Effects of some psychosocial variables on different disease manifestations in 112 Cadets: A longitudinal study
Abstract
One-hundred and twelve cadets attending the 141st training course for reserve officers of the 'Scuola Transmission' of the Italian Army were administered, 10 days after incorporation, a battery of personality tests and measures of stressful events in the preceding year. Test scores were considered both individually and grouped into factors. During the 6 months of the course all disease episodes for each cadet were recorded. Total episodes infections and traumas were considered. A significantly higher number of total episodes and, specifically, of infections was present in subjects reporting a higher number of stressful events, in interaction with attitudes towards parent figures, hardiness, loneliness, and an alienation factor. A younger age of subjects also appeared predictive of a higher number of total episodes and infections, as a main effect and in interaction with attitudes to mother, hardiness, and alienation. Very few effects were obtained for traumas, suggesting that the effects of variables are mediated through a biological route rather than through behaviour, as would be the case if traumas were involved. No effect was shown by measures of stressful events alone. Results are discussed in the light of a reconsideration of the notion of stressful events.
... However, recent literature, as well as the observation that Funk and Houston (1987) based their conclusion on a relatively small number of cases, seems to indicate hardiness is capable of moderating the relationship between stress and certain outcomes. Researchers have found significant hardiness X 36 stress interaction in stress-illness (Solano, Battisti, Coda, & Stanisci, 1993;Hills & Norvell, 1991;Banks & Gannon, 1988;Kobasa & Pucetti, 1983;Kobasa, 1982;Kobasa et al., 1982), stress-performance (Westman, 1990;Herlich, 1985), and stress-absenteeism (Tang & Hammontree, 1992) relationships. So, it appears that hardiness can moderate stress. ...
... The possibility that cardiovascular parameters may mediate the hardiness/control-illness relationship appears 38 to not have been aggressively pursued by Lawler and Schmied (1992). Solano et al. (1993) (Sarason, Johnson, & Siegel, 1978)) increased, those who were high in hardiness manifested decreased incidence of illness episodes while those who were low in hardiness displayed increased episodes of illness. It is worth noting the high and low hardiness groups did not differ when life change units were low. ...
... Perhaps hardiness does not act as a stress resiliency resource beyond some given level of Stressor intensity, severity, or duration. While the hardy trainees in the Solano et al. (1993) study appeared to be more resilient in high stress situations than their low hardy counterparts, it may be important to consider their environment (training versus actual). Tang and Hammontree's finding is not entirely unique. ...
... Tako je npr. čvrstoća povezana s nižim krvnim tlakom (Maddi, 1999), s manjim brojem ozljeda kod sportaša (Wadey, Evans, Hanton i Neil, 2013), s kraćim vremenom oporavka nakon ozljeda kod atletičara (Ford i sur., 2000), s brojnim pokazateljima oporavka kod kroničnih bolesnika (Brooks, 2003), dok je kod polaznika vojne akademije interakcija niske čvrstoće i stresa prospektivno povezana s češćim oboljevanjem, pogotovo od infekcijskih bolesti (Solano, Battisti, Coda i Stanisci, 1993). Hystad, Eid i Brevik (2011) su pokazali da je čvrstoća prospektivno povezana s medicinski potvrđenim bolestima kao razlozima za izostajanje s posla, čak i nakon kontrole dobi, spola i prethodnih izostajanja. ...
The aim of this article was to review the research literature on the relationship of hardiness with health outcomes and describe potential mechanisms through which hardiness exerts its effects. In the first part we described the concept of hardiness and its components, operationalizations and some basic problems of its measurement, especially those coming from the overlap of hardiness and neuroticism. Furthermore, we reviewed the most important findings on the effects of hardiness on various health outcomes, focusing on its protective role from the deleterious effects of stress. Several potential mechanisms through which hardiness may influence health outcomes are emphasized: its effects through immune functioning, cognitive appraisal, coping, physiological arousal and health behaviors. These mechanisms, as well as the most important findings that show the role of hardiness in each of them are described. At the end we presented the most prominent methodological problems that arise in the studies exploring the relationship of hardiness and health outcomes, whose solutions may be a prerequisite for a step forward in understanding this relationship. © 2016 Faculty of Arts and Sciences in Rijeka. All rights reserved.
... Several reports describe a significant relation between life events and health, often using self-reported or subjective health as an outcome measure [29 ±34]. Some studies used more objective health-related data obtained from a physician's registration or examination, and did not report any significant relations [35,36]. Only one study described a significant relationship between life events and mortality during a 7-year follow-up [37]. ...
The aim of this study was to get a profile of patients who are vulnerable to get multiple chronic, recurrent or high-impact diseases in a limited time period. We studied the incidence rates of morbidity and multimorbidity, and the influence of psychosocial characteristics on their occurrences.
Cohort study with 3551 subjects. Baseline measurement of psychosocial characteristics and a 2-year follow-up period for morbidity. The relations were evaluated using multiple logistic regression analysis.
After adjustment for basic socio-demographic variables, a high internal locus of control belief was found to be protective [odds ratio (OR)=0.82] for the occurrence of morbidity, negative life events increased the risk (OR=1.22). Characteristics specifically protective for the occurrence of multimorbidity as compared to monomorbidity were: a high internal locus of control belief (OR=0.73), living as a couple or in a family as compared to living alone (OR=0.68) and a large social network (OR=0.41).
It appears that certain patient characteristics are specifically related to the occurrence of multimorbidity. This provides opportunities for the future development of preventive interventions.
تهدف الدراسة إلى الكشف عن طبيعة العلاقة بين الولاء التنظيمي والاغتراب والمعاناة النفسية. تكونت عينة الدراسة من (418) مشاركاً من العاملين في القطاع الحكومي، بواقع (215 ) من الذكور و(203) من الإناث . وكشفت نتائج الدراسة عن وجود علاقة سلبية بين الولاء التنظيمي وكل من الاغتراب والمعاناة النفسية، كما أنه لا يوجد علاقة بين الولاء التنظيمي والعمر ومدة الخدمة والمستوى التعليمي، بينما توجد فروق دالة إحصائياً بين الذكور والإناث في الولاء التنظيمي، حيث نجد أن الذكور أكثر ولاء لمنظماتهم من نظرائهم الإناث، كما لا توجد فروق دالة إحصائياً بين الذكور والإناث من الاغتراب والمعاناة النفسية.
The aim of this paper was to analyse the psychometric properties of the Military Adaptation Questionnaire (CAM). The CAM was designed to measure adaptation of professional soldiers to their military enviroment. A sample of 379 soldiers (ranging in age from 19 to 28 years) completed the CAM together with other emotional, psychosocial stress and health tests. The factorial structure of the test suggests three elements related to the following aspects of adaptation to military life: 1) Adaptation to tasks and duties, 2) Adaptation to relationships with equals/superiors and to professional prospects and 3) Adaptation to a tactical position. Reliability of the CAM was analysed on both total scale and subscale dimensions. The CAM is shown to have sound psychmetric properties for both reliability and validity.
The study aims to examine the relationship between loyalty and commitment to one's own organization and feelings of alienation and psychological suffering amongst government employees. The study chose (418) samples 215 of which were males and 203 females. The study revealed the following results: A significant negative relation between organization commitment and loyalty was noticed in relation to both alienation and psychological suffering, whereas no significant relation was noted between organization commitment and loyalty, age, experience, and educational level. On the other hand, significant differences were evident between males and females with regard to their organization commitment where males scored higher in their loyalty. Also no significant differences were detected between males and females in feelings of alienation and psychological suffering. Furthermore, there were no significant differences between organization loyalty and commitment and alienation that differentiate the more highly educated and the less educated. However, there were significant differences in psychological suffering in relation to level of education where it was found that the higher educated displayed greater psychological suffering.
An expanding literature reveals that personality traits and psychological resources (PRs) are important in human well-being. In this article, the author reviews the literature regarding four PRs (positive thoughts, hardiness, generalized self-efficacy, and optimism), discusses the relationships among PRs and between PRs and personality characteristics, and proposes a theory that helps to account for current findings. Specific hypotheses are proposed, and implications for the practice of counseling psychology are discussed.
To assess the influence of life event stress and hassles, and the moderating effects of psychological coping style, social support, and family environment, on susceptibility to upper respiratory tract infectious illness.
One hundred seven adults aged 18 to 65 years took part in a 15-week study. Measures of life event stress were obtained for the 12 months preceding the study and for the study period itself, and social support, information seeking and avoidant coping styles, and family environment were assessed. Hassles and perceived stress were measured weekly, whereas dysphoric mood and changes in personal health practices (smoking, alcohol consumption, exercise, and sleep patterns) were assessed at three weekly intervals. Episodes of upper respiratory tract infectious illness were verified by clinical examination.
During the study period, 29 individuals experienced at least one clinically verified episode of upper respiratory tract illness. There were no differences in cigarette smoking, sleep habits, or exercise between those who did and did not become ill but alcohol consumption was lower among those who experienced verified episodes. Risk of infectious illness was greater in those who experienced high life event stress both before and during the study period, but the impact of life events was buffered by an avoidant coping style. Strict family organization was associated with illness risk. The three weeks preceding illness onset were characterised by high levels of perceived stress, but also by a decrease in the number of hassles reported.
Results suggest that under naturalistic conditions, the influence of stressful experience on risk of infectious illness is moderated by psychosocial resources. Variations in personal health practices do not seem to be responsible.
The aim of this study was to assess the effects of the writing technique on postoperative course in interaction with different levels of risk. Participants were 40 urologic inpatients waiting to undergo transurethral resection of the prostate, with different levels of surgical risk as assessed with the Goldman Preoperative Risk Index (L. Goldman et al., 1978). Only 20 participants wrote for 3 days about the experience of being in the hospital. Measures were days of stay in the hospital after the operation, the Symptom Check List (SCL-90; L. R. Derogatis, 1977; Italian version: G. Magni, C. Messina, D. De Leo, A. Mosconi, & M. Carli, 1983) scores, and a medical evaluation of postoperative course. A significant positive effect of writing on all three dependent variables emerged only in low-risk participants. High-risk writing participants showed a nonsignificantly worse postoperative course on all parameters than did high-risk nonwriting participants. In highly stressful conditions, writing therefore should be employed only with caution.
Studied personality as a conditioner of the effects of stressful life events on illness onset. Two groups of middle- and upper-level 40-49 yr old executives had comparably high degrees of stressful life events in the previous 3 yrs, as measured by the Schedule of Recent Events. One group of 86 Ss suffered high stress without falling ill, whereas the other group of 75 Ss reported becoming sick after their encounter with stressful life events. Illness was measured by the Seriousness of Illness Survey (A. R. Wyler et al 1970). Discriminant function analysis, run on half of the Ss in each group and cross-validated on the remaining cases, supported the prediction that high stress/low illness executives show, by comparison with high stress/high illness executives, more hardiness, that is, have a stronger commitment to self, an attitude of vigorousness toward the environment, a sense of meaningfulness, and an internal locus of control. (43 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).
Hypothesized that hardiness—commitment, control, and challenge—functions to decrease the effect of stressful life events to producing illness symptoms. 259 upper- and middle-level male managers (mean age 48 yrs) were administered a battery of tests (including Rotter's Internal–External Locus of Control Scale, the Schedule of Life Events, and the Seriousness of Illness Survey) covering a 5-yr period. Results support the hypothesis by showing main effects on illness for both stressful life events and hardiness and an interaction effect for these independent variables. (37 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Describes the development of a new instrument, the Life Experiences Survey (LES), for the measurement of life changes. The LES is a 57-item self-report measure that is divided into 2 sections: Section 1 consists of 47 items that refer to life changes in a wide variety of situations; Section 2 consists of 10 items that are designed primarily for use with students. It was designed to eliminate certain shortcomings of previous life stress measures and allows for separate assessment of positive and negative life experiences as well as individualized ratings of the impact of events. The reliability and possible sex differences of the LES are discussed, and the LES is compared with the State-Trait Anxiety Inventory, the Marlowe-Crowne Social Desirability Scale, the Psychological Screening Inventory, the Beck Depression Inventory, Rotter's Internal–External Locus of Control Scale, and the Schedule of Recent Experiences using undergraduate samples. Several studies bearing on the usefulness of the Life Experiences Survey are presented and the implications of the findings are discussed.
Several psychogenic theories have been developed to explain the onset of cancer. Much of the research used to support them suffers from methodological weaknesses, particularly the absence of control groups and/or the use of criterion samples already suffering from malignancies. In the present study, the psychiatric diagnoses and MMPI performances of psychiatric patients who later developed malignant and benign neoplasms were compared to controls. No differences (beyond a chance level) appeared in the diagnostic composition, the MMPI clinical scale scores, or the individual MMPI-item performances of the groups. Results do not offer support for the major psychogenic-origin theories of the development of neoplasms. (15 ref)
This article reviews research on the role of stress in infectious disease as measured either by illness behaviors (symptoms and use of health services) or by verified pathology. Substantial evidence was found for an association between stress and increased illness behavior, and less convincing but provocative evidence was found for a similar association between stress and infectious pathology. Introverts, isolates, and persons lacking social skills may also be at increased risk for both illness behaviors and pathology. Psychobiological models of how stress could influence the onset and progression of infectious disease and a psychological model of how stress could influence illness behaviors are proposed.
The purpose of this article is to determine whether the positive association between social support and well-being is attributable more to an overall beneficial effect of support (main- or direct-effect model) or to a process of support protecting persons from potentially adverse effects of stressful events (buffering model). The review of studies is organized according to (a) whether a measure assesses support structure or function, and (b) the degree of specificity (vs. globality) of the scale. By structure we mean simply the existence of relationships, and by function we mean the extent to which one’s interpersonal relationships provide particular resources. Special attention is paid to methodological characteristics that are requisite for a fair comparison of the models. The review concludes that there is evidence consistent with both models. Evidence for a buffering model is found when the social support measure assesses the perceived availability of interpersonal resources that are responsive to the needs elicited by stressful events. Evidence for a main effect model is found when the support measure assesses a person’s degree of integration in a large social network. Both conceptualizations of social support are correct in some respects, but each represents a different process through which social support may affect well-being. Implications of these conclusions for theories of social support processes and for the design of preventive interventions are discussed.
Thirty-five women with metastatic breast cancer received a battery of baseline psychological tests; results were correlated with length of survival. Patients who died in less than one year from baseline were categorized as short-term survivors, while patients who lived for one year or longer were assigned to the long-term survivor group. The long-term survivors were more symptomatic overall, with particular elevations on measures of anxiety and alienation, and substantially higher levels of dysphoric mood (eg, depression, guilt) than the short-term survivors. Short-term survivors revealed significantly lower levels of hostility, with higher levels of positive mood. Treating oncologists perceived the long-term survivors to show significantly poorer adjustment to their illnesses than the short-term survivors, and an interviewer's ratings indicated that long-term survivors had significantly poorer attitudes toward their physicians. Measures of clinical status and demographic data revealed few differences between the two groups.
(JAMA 242:1504-1508, 1979)
Varied subjects were asked to judge, on a 0 to 20 scale, the degree to which 61 life events were upsetting. Mean event scores covered almost the entire scale range and ranked in a meaningful way. At the top end of the scale were catastrophic and highly distressing events such as deaths of child or spouse. At the bottom of the scale were events which were either trivial, or important but desirable and not distressing. Consistency of the scaling indicated acceptable interrater reliability. Individual variability reflected in standard deviations was moderate. Agreement across groups was high, although there were small differences due to sociodemographic group, item order, and recent experience of the event. Consensus scaling of events may facilitate use of a quantified methodology in empirical studies of life stress.
A review of the literature on the relation of life events, stress, and illness shows the clear recognition that illness onset is the outcome of multiple characteristics of the individual interacting with interdependent factors in the individual's social context, in the presence of a disease agent. The conceptual model is comprehensive, multicausal, and interactive; empirical designs should consider this complexity. Crucial in the process of measuring relationships between change in life events and illness onset are the psychometric properties of the measures used and the method of data collection that is employed. The importance of (a) thorough conceptualization and sampling, (b) multidimensional scaling of item samples to identify common dimensions of life events, (c) determination of the true variance and stability of the measures over a variety of populations is stressed. In retrospective studies, important sources of error in measuring life events are selective memory, denial of events, and overreporting to justify an illness. In prospective studies, the subjective evaluation of the significance of a life event to a respondent has been neglected. It is concluded that improvement in data analytic procedures remains a major challenge for life events investigators. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In a longitudinal study started in 1965 in Crvenka (Yugoslavia), a number of psychosocial and organic variables were measured in 1353 Ss and related to the incidence of cancer, circulatory and other diseases in the subsequent 10-yr period by multivariate statistical methods. The present article reports on an attempt at differential prediction of lung cancer and cardiac infarct or apoplexy, which were selected because smoking is usually held to be a common risk factor for them. In a discriminant analysis (minimizing the overall classification error), 86–87% of the lung cancer and infarct/apoplexy cases could be predicted correctly, as well as 97% of the cases showing neither of the diseases. Some psychosocial variables like rationality and anti-emotionality or long-lasting hopelessness were about as relevant as the strongest organic predictors like level and variability of blood cholesterol.
A prospective, multidisciplinary, 5-year study of 69 consecutive female patients with early (T0,1N0,1M0) breast cancer was conducted. Patients' psychological responses to the diagnosis of cancer were assessed 3 months postoperatively. These responses were related to outcome 5 years after operation. Recurrence-free survival was significantly common among patients who had initially reacted to cancer by denial or who had a fighting spirit than among patients who had responded with stoic acceptance or feelings of helplessness and hopelessness.
A selected review of life changes and illness studies is presented which illustrates both the diversity of samples that have been tests in these studies and the generally positive results which have been obtained. Although early (retrospective) work in this field led to simplistic explanations, later (prospective) studies have begun to document the several intervening variables which occur between subjects' recent life change experiences and their subsequent symptomatology and disease. A life change and illness model is presented to illustrate key intervening variables. The authors believe that future research in the field of life change and illness should concentrate on further delineations of these intervening variables--an effort necessitating active collaboration between social and medical scientists.
As part of an interdisciplinary study of breast cancer, psychological investigation of a consecutive series 160 women admitted to hospital for breast tumour biopsy was carried out by means of detailed structured interviews and standard tests. Interviews and testing were conducted on the day before operation, without knowledge of the provisional diagnosis. Information obtained from patients was verified in almost all cases by separate interviews with husbands or close relatives. Present results are based on statistical comparisons between 69 patients found at operation to have breast cancer and a control group comprising the remaining 91 patients with benign breast disease. Our principal finding was a significant association between the diagnosis of breast cancer and a behaviour pattern, persisting throughout adult life, of abnormal release of emotions. This abnormality was, in most cases, extreme suppression of anger and, in patients over 40, extreme suppression of other feelings. Extreme expression of emotions, though much less common, also occurred in a higher proportion of cancer patients than controls. Previous reports of correlations between breast cancer and extraversion, previous stress and depression were not confirmed.
Ninety-two newly diagnosed patients with hematologic malignancies treated with chemotherapy, and 47 patients with rectal cancer treated with abdominal-perineal resection were prospectively studied to assess the relationship between mood and survival. Hematology patients were measured within one week of diagnosis and were remeasured at six months. Rectal cancer patients were measured within three months of surgery and remeasured six months later. Medical records were abstracted to obtain data on treatment given, disease characteristics and outcome of treatment. On univariate analyses using Cox regression, we examined the effect of depression, coping style and locus of control on survival. None of these variables were found to be significantly related to survival whether assessed at intake or six months later. Furthermore there were no statistically significant correlations between these factors and subsequent survival at two years or with long-term survival. Biological prognostic variables including extent of disease for rectal cancer patients and severity of specific type of hematologic cancer were significantly related to survival. Although psychosocial adjustment is important for the quality of life experienced by cancer patients it was not related to length of survival in this study. Further exploration of this issue should be conducted using patients with a single site and preferrably an early stage of disease.
This prospective study tested the self-complexity buffering hypothesis that greater self-complexity moderates the adverse impact of stress on depression and illness. This hypothesis follows from a model that assumes self-knowledge is represented in terms of multiple self-aspects. As defined in this model, greater self-complexity involves representing the self in terms of a greater number of cognitive self-aspects and maintaining greater distinctions among self-aspects. Subjects completed measures of stressful events, self-complexity, depression, and illness in two sessions separated by 2 weeks. A multiple regression analysis used depression and illness at Time 2 as outcomes, stressful life events and self-complexity at Time 1 as predictors, and depression and illness at Time 1 as control variables. The Stress X Self-Complexity interaction provided strong support for the buffering hypothesis. Subjects higher in self-complexity were less prone to depression, perceived stress, physical symptoms, and occurrence of the flu and other illnesses following high levels of stressful events. These results suggest that vulnerability to stress-related depression and illness is due, in part, to differences in cognitive representations of the self.
This study investigated the relationship between prognosis (estimated by histopathologic indicators) in cutaneous malignant melanoma and a comprehensive set of physical risk, demographic, psychosocial, and situational variables. These variables were derived from the medical examination, the pathology report, psychosocial self-report measures, and an hour-long videotaped interview with 59 patients from two melanoma clinics in San Francisco. Variables significantly correlated with tumor thickness were: darker skin/hair/eye coloring, longer patient delay in seeking medical attention, two correlated dimensions within an operationally defined 'Type C' constellation of characteristics, two character style measures, and less previous knowledge of melanoma and understanding of its treatment. Of these variables, delay was the most significant in a hierarchical multiple regression analysis in which tumor thickness was the dependent variable. Associations between tumor thickness and psychosocial measures of Type C were considerably stronger and more significant for subjects less than age 55, suggesting that the role of behavioral and psychosocial factors in the course of malignant melanoma is more potent for younger than for older subjects.
: World War II Army inductees medically discharged for psychoneurosis in 1944 experienced a 20-percent excess mortality over the period 1946-1969, highest in the earlier years and diminishing thereafter. Some of the differential mortality, e.g., from inflammatory diseases of the CNS, may represent diagnostic error in 1944. Behavioral maladjustments, or pathological personality types coexisting with psychoneurosis, may explain the increased risk of death from alcoholism, suicide, and homicide. Although they usually existed prior to service, and most probably continued thereafter, the anxiety and emotional conflicts leading to discharge in 1944 seem not to have been associated with chronic disturbances of physiologic function sufficient to cause severe organic disease in later life. A possible exception is cerebrovascular disease, for which the discrepancy is neither large nor reinforced by similar differences in mortality from hypertension or hypertensive heart disease. Copyright (C) 1974 by American Psychosomatic Society
Twenty male medical students who later developed malignant tumor reported significantly less closeness to parents in early life than their classmate controls. This finding supports one previously reported on a smaller group. Those students who later committed suicide or experienced episodes of mental illness showed a similar trend, but the differences were not statistically significant. The distribution of the 17 subjects in the mental illness group was bimodal. Students later developing hypertension or coronary occlusion, on the other hand, were no different from their controls in respect to closeness to parents. In an earlier study, medical students who later committed suicide, were psychologically disturbed or developed malignant tumor, were found to have significantly more pathological content in their responses to the Rorschach test than their classmate controls. Considering the data from that study and the present one together, it is concluded that the suicide, mental illness and malignant tumor groups showed psychological differences from their unaffected classmates one to 23 yr before the onset of disease or death. This is a particularly challenging finding in view of the fact that it is based upon prospective rather than retrospective data. In this population, neither the occurrence of parental death or separation of parents early in the subject's life, nor other aspects of the family constellation which were examined, distinguished suicides or other disorder groups from their controls. In general, the various family relationships of the small group of women with the disorders under study resembled those of the men.
The facilities of the Oxford Record Linkage Study were used in an attempt to replicate the finding of Kerr, Schapira and Roth (1969) that a characteristic form of depressive illness may be a precursor of cancer. 823 patients (309 men, 514 women) admitted to psychiatric or general hospitals in the Oxford area during 1963-64 with a principal diagnosis of depression were identified. Any subsequent hospital admissions or deaths of these patients were recorded for a standardized 4 yr followup period. As would be predicted from earlier studies, rates for deaths from all natural causes and from suicide were significantly above those expected for the background population. However, rates for morbidity and mortality from malignant diseases diagnosed after the key depressive illness were not above expected values. There was thus no evidence to support an association between depressive illness and subsequent deaths from cancer in psychiatric inpatients. It is concluded that, although the hypothesis is not disproved by this study, the Newcastle findings cannot be replicated using the I.C.D. categories of affective disorder. There is a need for studies based on all psychiatric patients, or better on community surveys.
IN PREVIOUS studies [l] it has been established that a cluster of social events requiring change in ongoing life adjustment is significantly associated with the time of illness onset. Similarly, the relationship of what has been called ‘life stress,’ ‘emotional stress,’ ‘object loss,’ etc. and illness onset has been demonstrated by other investigations [2-131. It has been adduced from these studies that this clustering of social or life events achieves etiologic significance as a necessary but not sufficient cause of illness and accounts in part for the time of onset of disease. Methodologically, the interview or questionnaire technique used in these studies has yielded only the number and types of events making up the cluster. Some estimate of the magnitude of these events is now required to bring greater precision to this area of research and to provide a quantitative basis for new epidemiological studies of diseases. This report defines a method which achieves this requisite. METHOD
This study addressed the effects of a naturally occurring stressor on components of the immune response. Blood was drawn twice from 75 first-year medical students, with a baseline sample taken one month before their final examinations and a stress sample drawn on the first day of final examinations. Median splits on scores from the Holmes--Rahe Social Readjustment Rating Scale and the UCLA Loneliness Scale produced a 2 X 2 X 2 repeated measures ANOVA when combined with the trials variable. Natural killer (NK) cell activity declined significantly from the first to the second sample. High scorers on stressful life events and loneliness had significantly lower levels of NK activity. Total plasma IgA increased significantly from the first to second sample, while plasma IgG and IgM, C-reactive protein, and salivary IgA did not change significantly.
Previous work from the Faith Courtauld Unit described an association between the diagnosis of breast cancer and an apparent tendency to suppression of anger, particularly in younger patients. A detailed study of this phenomenon has been carried out in 71 patients prior to breast biopsy, using structured interviews, the Eysenck Personality Questionnaire (EPQ) and the Spielberger State—Trait Anxiety Inventory (STAI). Taped transcripts of interviews, independently rated, using a revised anger rating scale, again demonstrated a significant difference between patients with benign breast disease and those with breast cancer in expression of anger. Mean EPQ ‘N’ score was significantly lower for cancer patients. STAI A-State and A-Trait anxiety scores were significantly higher than standard scores for all patients other than young cancer patients. The pattern of correlation between variables differed for the two diagnostic groups suggesting (a) that cancer patients are more stressed by impending biopsy and (b) that young cancer patients are more likely than other patients to use denial in the face of stress.
A consecutive unselected series of 60 in-patients suffering from dermatologic disorders (psoriasis, chronic urticaria and fungal infections of the skin) was examined. Twenty patients with each illness were included. Stressful life events immediately before illness onset, levels of psychological distress, and alexithymic traits were investigated. Patients with psoriasis and chronic urticaria were exposed to stressful life situations before disease onset and suffered from psychological distress (anxiety, depression, inadequacy) significantly more than those with fungal infections. Implications for psychosomatic research and treatment are discussed.
The aim of the study was to assess the relationship between the initial psychosocial situation and the probability of later symptom development in HIV-1 infection. One hundred HIV-1 seropositive subjects, 79 in Stage III (LAS) and 21 in Stage II (asymptomatic), were examined both immunologically (CD4+, Skin Test) and psychologically (test battery). Follow-up at 6 and 12 months involved clinical and immunological reassessment of subjects, who were then classified as fully symptomatic (S, Stage IV) or unchanged (U). The two groups were compared through ANOVA on initial psychosocial measures, while stepwise logistic multiple regression was employed to assess the predictive value of psychosocial measures on clinical and immunological evolution. Psychosocial measures most clearly showing an association with clinical evolution were Denial/Repression attitudes (negatively) and Fighting Spirit (positively), whereas aspects of Hardiness and Social Support showed an effect in interaction with initial CD4+ levels. No stable results were obtained on immunologic evolution. The two groups (U and S) did not show significant differences on other independent variables, with the exception of age.
A preliminary account is given of a controlled personality investigation of 116 male lung cancer patients and 123 male non-cancer controls, in respect of extraversion and neuroticism, using the short form of the Maudsley Personality Inventory.The study was undertaken as one test of a hypothesis that lung cancer patients had a significantly diminished outlet for emotional discharge as compared with non-cancer patients.Account was taken of the presence or absence of a history of psychosomatic disorders in both lung cancer patients and non-cancer controls.The main findings, which are tentative, are that lung cancer patients are somewhat extraverted and markedly lower in neuroticism compared with non-cancer controls, and that there may be interaction effects with psychosomatic disorders.The available evidence suggests that lung cancer patients have personality features distinct from (1) the general cigarette smoking population, (2) non-cancer patients with a history of commonly accepted psychosomatic disorders, and possibly (3) patients with cancer in other sites.
Life events and psychological distress in dermatologic disorders
- Fava
Psychosocial factors, immunological mediation, and human susceptibility to infectious diseases
- Jemmot
Angina pectoris among 10,000 men: 5 years incidence and univariate analysis
- Medalie