International journal of psychosomatics : official publication of the International Psychosomatics Institute最新文献

Bandler's theatre technique for the treatment of phobias is described and its application to post-traumatic stress disorder is illustrated by means of a case study. Attention is drawn to the manner in which the technique makes use of double dissociation and a sense of the ridiculous to help patients modify their thinking.

The effects of a brain wave synchronizer (BWS) on endodontic (root canal) anxiety was evaluated in the clinical practices of the senior author. The experimental groups were: (1) a verbal method (routine calming words by dentist) plus BWS (N = 10) and (2) verbal method plus BWS and alpha relaxation tape (N = 10). The control group was verbal method alone (N = 10). All three groups were evaluated during a complete endodontic treatment by the use of galvanic skin resistance (GSR), pulse rate (PR), physical responses, and pre- and post-treatment questionnaires. Recordings were made during the following periods: (1) start; (2) local anesthetic injection; (3) rubber dam application; (4) drilling; (5) x-ray taking; (6) instrumentation; (7) obturation; and (8) conclusion. Results showed that the experimental groups were significantly better than the control group in the reduction of endodontic anxiety. The findings reinforced the belief that local anesthetic injection is the most anxiety producing aspect of endodontic treatment.

The present study is concerned with (1) the question whether patients with ankylosing spondylitis (AS) are different from patients with rheumatoid arthritis (RA) reported previously, with respect to the personality trait of irrational attitudes and to disease impacts, and (2) how the socio-psychological variables of life stress and irrational attitudes relate to disease impacts. Subjects were 197 patients with definite AS from a rheumatic treatment center. AS-patients scored lower in irrationality, pain-intensity, sensory pain, pain avoidance and disability than RA-patients but were not different in affective pain and in general health condition. Relations between negative events and avoidance behavior were stronger in AS-patients. The associations between irrationality versus pain intensity, affective pain and disability were lower (but significant) in AS-patients compared to RA. Of equal strength were correlations between irrationality and avoidance as well as general symptoms. Hierarchical regression analyses with disease activity as control variables revealed 2.2% to 7.1% common variance between life stress and disease impacts (affective pain, avoidance behavior, general symptoms). Irrational attitudes explained 8.9% to 18.3% of disease impact variation. The results suggest influences of social and personality variables on suffering of AS-patients and expect these patients to be good treatment candidates-though they seem stable and non-neurotic in their personality.

Because of both psychoneuroendocrine and psychobehavioral mechanisms, the chronicity of negative emotional arousal is probably the final common pathway mediating the relationship of psychosocial factors (cognitions, environments and behaviors) on one side of the mind-brain chasm, and ischemic heart disease (IHD) on the other. But the problem of "denial" remains a potential source of measurement error in studies of the association of such factors and IHD endpoints. The present study examined the association of patient-reported and spouse/friend-reported AIAI (aggravation, irritation, anger and impatience) with four measures of Type A Behavior or hostility (the Framingham Type A Scale, Cook-Medley Hostility Scale, Type A Structured Interview and a Hostility rating from the Structured Interview) in two samples: 175 men undergoing coronary angiography; and 56 age and SES-matched males with no manifest history of occlusive atherosclerotic disease. Chronic AIAI was underreported by the sample as a whole relative to spouse/friend perception, while the opposite was true of Depression and Anxiety/Worry (p < .001). All four measures were significantly associated with both patient and spouse/friend reported chronicity of AIAI, but the FTAS was the most reliable correlate according to both sources. The FTAS was also negatively associated with denial of AIAI, while the other three measures were not.

The psychological construct of control is increasingly thought to be an important variable in psychosomatic medicine, but there are limitations with how it has been measured by previous instruments. The current study details four limitations of previous instruments as a rationale for developing a new multi-faceted, multi-dimensional instrument to measure control, the Shapiro Control Inventory (SCI). Discriminant, divergent, and incremental validity of the SCI is compared with the Rotter's Internal/External Locus of Control Scale and Wallstons' Multidimensional Health Locus of Control Scales on five groups, one normal and four clinical groups (depression, generalized anxiety disorder, borderline personality, and panic disorder). Analysis of variance showed significant differences among populations on each of the nine SCI scales. The majority of these results were highly significant, whereas for Rotter's scale the results were barely significant, and for Wallstons' three scales, not at all significant. Correlations of the SCI scales with Rotter's and Wallstons' scales were small to moderate, but in no case explained more than 15% of the variance. The SCI also provided incremental validity over Rotter's and Wallstons' scales both for sensitivity (clinical versus normal) and specificity (between clinical groups). The discussion section provides suggestions for future research.

The author describes his experience with the use of yoga in the prevention and treatment of alcohol and drug related problems, in psychosomatics, neuroses, geriatric psychiatry, and in some other areas. He deals with problems of the use of yoga in psychiatry like compliance, systems aspect, competitiveness and respecting specific indications in regard to health status and contraindications with personal differences. The usefulness of yoga in the prevention of stress and burn-out in health care professionals is emphasized.

Adverse effects of meditation were assessed in twenty-seven long term meditators (average 4.27 years) both retrospectively (time one) and prospectively at one month (time two) and six months (time three) following a meditation retreat. At both time one and time three subjects reported significantly more positive effects than negative from meditation. However, of the twenty-seven subjects, seventeen (62.9%) reported at least one adverse effect, and two (7.4%) suffered profound adverse effects. When subjects at time one were divided into three groups based on length of practice (16.7 months; 47.1 months; 105 months) there were no significant differences in adverse effects. How the data should be interpreted, and their implications both for the clinical and psychotherapeutic use of meditation as a relaxation/self-control strategy, and as a technique for facilitating personal and spiritual growth, are discussed. Limitations of the study and suggestions for future research are also offered.

This experimental work was designed to investigate the relationships between pH and conditioned fear. The levels of pH were measured in skin and saliva, and were studied in connection with conditioned electrodermal and heart rate (HR) responses (extinction versus resistance to extinction or enhancement). The results of this investigation show that the changes in skin and salivary pH have a tendency to occur in an inverse pattern to the changes in skin conductance and HR. The data are interpreted in terms of skin and salivary pH as new psychophysiological variables and as new tools for psychopathological and psychosomatic research.

The present article reports on a controlled intervention study concerning the effects of non-directed use of pictures of works of art as a way of stimulating institutionalized elderly women. After the stimulation period differences in ratings between the groups indicated improved well-being in the intervention group. Such improvement was not seen in the C-group. The quantitative analyses of the results reveal a significant change of the parameters happiness, peacefulness, creativeness, social activities and systolic blood pressure. The qualitative analysis shows that the conversations about pictures of works of art in the intervention group give the person free rein to her own imagination and are merely characterized by happiness. In the control group the conversations are to a great extent characterized by downheartedness, despair and complaining.

The present pilot study is part of an ongoing effort to further the investigation of the relationship between spinal patterns and personality. The present pilot study seeks to identify likely spinal patterns of certain personality profiles and asks whether changing posture can affect personality, and/or can emotional states alter posture? Forty patients of a private chiropractic practice participated in the study. Four radiographs (x-rays) of each subject were taken and each subject completed the Minnesota Multiphasic Personality Inventory (MMPI). Measurements obtained from the radiographs and the MMPI data were used to derive general linear models of the predictability of the MMPI in terms of the spinal/postural measures. Several models were highly significant and preliminary support for the authors' hypothesis that spinal patterns are likely to be predictive of personality profiles is suggested. Support for previous research is offered and directions for future research are discussed.