Measuring intermediate outcomes of violence prevention programs targeting African-American male youth: an exploratory assessment of the psychometric properties of six psychosocial measures.
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This study examined the psychometric properties of six psychosocial measures that may be useful indicators of intermediate outcomes of violence prevention programs targeting African-American male youth. Baseline and 6 month follow-up survey data are used from 223 African-American male 12-16 year olds participating in a violence prevention program evaluation study. The constructs of interest are beliefs supporting aggression, aggressive conflict-resolution style, hostility, ethnic identity, self-esteem and hopelessness. Each construct is measured as a multi-item scale. Exploratory factor analysis results provided limited support for the unidimensionality of these scales, thus suggesting that further scale development is warranted. Reliability coefficients for the scales ranged from 0.55 to 0.80. Bivariate analyses with baseline data indicate that all six measures have construct and criterion-related validity, as they are associated with each other and with four behavioral criteria in the expected directions. Predictive validity was also demonstrated for beliefs supporting aggression, aggressive conflict-resolution style, hostility and hopelessness which were associated with weapon-carrying behaviors measured in the 6 month follow-up survey both before and after controlling for corresponding behaviors measured in the baseline survey. (+info)
Psychosocial stress and treatment outcome following assisted reproductive technology.
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This study investigated the association between psychosocial stress and outcome of in-vitro fertilization and gamete intra-Fallopian transfer treatment. Ninety women, enrolled for treatment at a private infertility clinic, completed two self-administered psychometric tests (Bi-polar Profile of Mood States, POMS; and State-Trait Anxiety Inventory, STAI) and a questionnaire to ascertain demographic and lifestyle characteristics before the start of treatment. Approximately 12 months later an outcome measure was determined for each participant in terms of whether she was pregnant or not pregnant and the number of treatment cycles undertaken to achieve clinical pregnancy. The women's scores on the psychological tests were similar to published normative scores. On univariate analysis, history of a previous pregnancy was positively related to the probability of pregnancy and full-time employment, a more 'hostile' mood state and higher trait anxiety were associated with a lower cumulative pregnancy rate. A Cox multiple regression model found previous pregnancy history, trait anxiety, and the POMS agreeable-hostile and elated-depressed scales to be the most important lifestyle and stress variables predictive of pregnancy. The results emphasize the importance of psychosocial stress in treatment outcome but indicate that the relationships are complex. Further studies are required to validate whether these findings can be generalized to other populations. (+info)
Importance of the psychosocial environment in epidemiologic studies.
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It has been common for the starting point of occupational health studies to be the disease risks associated with particular occupations. The research effort then focuses on features of the work environment that might be exposures for the particular disease. The starting point of this paper has been different; it is the inverse social gradient in morbidity and mortality observed in all industrialized (and nonindustrialized) countries. In Great Britain, it has been usual for the socioeconomic classification to be based on occupation. This usage raises the question of how much of the social gradient in disease is related to the circumstances under which people work, and how much to living circumstances, acting through the life course. This paper illustrates how attention to psychosocial factors in the workplace and outside have the potential to reduce the burden of ill health for working people and to diminish the social gradient in morbidity and mortality. (+info)
Tryptophan enhancement/depletion and reactions to failure on a cooperative computer game.
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Twenty-eight high trait hostility male volunteers played a "cooperative" computer game 4.5 hours after an amino acid drink enhanced with, or depleted of, tryptophan. Each trial involved steering a tank through minefields following directions from an unknown "partner." Failure was experienced when the tank hit a mine or when time ran out. Subjects' moods, verbal aggression, attributions of blame, vocal acoustics, and blood pressure were assessed. Differences between tryptophan groups were not significant for primary measures of anger and verbal aggression. However, depleted subjects reported greater increases in feelings of restlessness and incompetence, were less successful in avoiding mines and showed greater increases in blood pressure during the game. Subjects in both groups sent more negative ratings when they lost the game by virtue of hitting a mine rather than losing by running out of time. However, ratings of the depleted group were less influenced by the reason for losing the game. Also, vocal acoustics showed a group X reason-for-losing interaction in the high-frequency band. Tryptophan-depleted subjects with high scores on Behavioral-Activation-System-Drive were most likely to send negative ratings and those scoring high on Buss-Durkee Hostility Inventory Assault and Guilt to report increased anger after the game. (+info)
Medical and lay views of irritable bowel syndrome.
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OBJECTIVES: The purpose of this study was to investigate doctors' and patients' views of irritable bowel syndrome (IBS) in order to assess why problems in the doctor-IBS patient relationship seem to occur. METHODS: A qualitative study was undertaken involving in-depth, semi-structured interviews that were tape-recorded, transcribed verbatim and analysed using the constant comparative method. The subjects comprised 12 doctors, including six GPs and six gastroenterologists, and 14 patients with IBS. RESULTS: Doctors hold two definitions of IBS, one 'public' and akin to a textbook definition, the other 'private' and including experiential knowledge and absorbed prejudices about IBS patients. Doctors are not universally hostile towards IBS patients, although the views of gastroenterologists may tend to be more pejorative than those of GPs. Most doctors experience frustration with IBS, and this is due as much to medical uncertainty and shortage of effective interventions as to intolerance of the personal characteristics of IBS patients. Doctors distinguish between 'good' and 'bad' IBS patients and manage them accordingly. Many patients tend to find their IBS symptoms very troublesome. Patients are more satisfied if they are taken seriously and helped to manage their symptoms, but many feel that they are labelled as neurotic by the medical profession. They tend to feel stigmatized and let down by doctors. CONCLUSIONS: Better partnerships could be created with patients, and better outcomes for IBS might be achieved, if doctors recognized the impact of medical beliefs about IBS on patients. Doctors should offer IBS patients empowering explanations for their disorder. (+info)
Lack of correlation between psychological factors and subclinical coronary artery disease.
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BACKGROUND: The relation between psychological variables and clinically evident coronary artery disease has been studied extensively, although the potential mechanisms of such a relation remain speculative. We studied the relation between multiple psychological variables and subclinical coronary artery disease to assess the possible role of such variables in atherogenesis. METHODS: We conducted a prospective study of 630 consecutive consenting, active-duty U.S. Army personnel, 39 to 45 years of age, without known coronary artery disease. Each participant was assessed for depression, anxiety, somatization, hostility, and stress. Subclinical coronary artery disease was identified by electron-beam computed tomography. RESULTS: The mean (+/-SD) age of the subjects was 42+/-2 years; 82 percent were male, and 72 percent were white. The prevalence of coronary-artery calcification was 17.6 percent (mean calcification score, 10+/-49). The prevalence of prior or current psychiatric disorders was 12.7 percent. There was no correlation between the coronary-calcification score and the scores measuring depression (r= -0.07, P=0.08), anxiety (r=-0.07, P=0.10), hostility (r=-0.07, P=0.10), or stress (r=-0.002, P=0.96). Somatization (the number and severity of durable physical symptoms) was inversely correlated with calcification scores (r=-0.12, P=0.003), even after we controlled for age and sex. In multivariate logistic-regression models, a somatization score greater than 4 (out of a possible 26) was independently associated with the absence of any coronary-artery calcification (odds ratio, 0.49; 95 percent confidence interval, 0.25 to 0.96). CONCLUSIONS: Our data suggest that depression, anxiety, hostility, and stress are not related to coronary-artery calcification and that somatization is associated with the absence of calcification. (+info)
Impact of social support, cynical hostility and anger expression on progression of coronary atherosclerosis.
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OBJECTIVES: This prospective cohort study of patients with coronary artery disease (CAD) sought to determine the impact of social support, anger expression and cynical hostility on progression of coronary atherosclerosis as shown by angiography. BACKGROUND: Low social support, high levels of expressed anger and cynical hostility are correlated to increased CAD morbidity and mortality. However, the impact of these factors, alone or together, on progression of human coronary atherosclerosis is unknown. METHODS: Of 223 patients with CAD documented by standardized angiography at baseline, 162 had a second angiogram after two years. An expert panel who had no knowledge of the patients' characteristics evaluated the films pairwise to determine disease progression. At baseline, all patients were asked to answer three self-report questionnaires: questions concerning emotional social support, the State-Trait-Anger-Expression Inventory (STAXI) and the Cook-Medley cynical hostility scale. Each patient's clinical and laboratory status was followed. RESULTS: Questionnaires and angiographic follow-up data were available for 150 patients. Bivariate analysis of the psychological variables showed a higher risk of progression only for patients who scored high on STAXI anger-out or low on social support. In the multivariate analysis, when adjusting for confounding variables and examining the interaction between psychological variables, only patients with both high anger-out and low social support were at highly increased risk for progression (odds ratio 30, confidence interval [CI] 5.5 to 165.1; RR 3.19). CONCLUSIONS: Patients with CAD and low emotional social support who express anger outwardly are at a highly increased risk of disease progression, independent of medication or other risk factors. (+info)
A comparison of psychological functioning in women at different stages of in vitro fertilization treatment using the mean affect adjective check list.
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PURPOSE: The objectives were to identify the stage/s of IVF treatment where a woman is most vulnerable to psychological stress, and to assess the Mean Affect Adjective Check List (MAACL) as a measure of psychological functioning during IVF treatment, which has hitherto not been reported. METHODS: Thirty-seven women undergoing IVF treatment according to the long protocol of controlled ovarian stimulation completed the MAACL questionnaire at the following stages: (a) before treatment (visit 1), (b) before embryo transfer (visit 2), and (c) before pregnancy test (visit 3). RESULTS: Apart from anxiety scores for visit 2, the hostility, depression, and state anxiety scores for visit 3 were higher than the corresponding scores for visits 1 and 2 (P < 0.001). Anxiety scores for visits 2 and 3 were similar. CONCLUSIONS: Psychological counseling should be targeted at women after embryo transfer and leading up to the pregnancy test. The MAACL is a useful method for measuring psychological stress in women during IVF treatment. (+info)