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Biofeedback Treatment of Systolic and Diastolic Blood Pressure Under Stress and No-Stress Conditions
This study compares the relative efficacy of systolic and diastolic biofeedback in lowering the systolic and diastolic blood pressures of normotensives. The importance of testing these biofeedback procedures lies in assessment of their potential as blood pressure self-control techniques for the treatment of essential hypertension.
Psychiatric Diagnosis: Rater Reliability and Prediction Using Psychological Rating Scale for Diagnostic Classification
This study was designed to assess the reliability of the "Psychological Rating Scale for Diagnostic classification as an instrument for determining diagnoses consistent with DSM-III criteria and nomenclature. Pairs of raters jointly interviewed a total of 50 hospital patients and then independently completed the 70-item rating scale to arrive at Axis I and Axis II diagnoses which were subsequently correlated with diagnoses obtained by standard psychometric methods, interrater agreement was 88 per cent for Axis I and 62 per cent for Axis II, with correlations of .94 and .79 respectively.
Health Attribution Beliefs and Compliance in Ecological Patients
The relationship between health attribution belief systems and compliance in an ecological treatment regimen was examined in 40 patients with environmental illness. Internal and chance scales on the Health Attribution Test (HAT) were found to be related to reported level of compliance for each subject. Data were subjected to Chi square analysis with highly significant results obtained. Ecology patients appear to take responsibility for their own health and treatment and, although they feel themselves to be victims of fate, they comply with treatment on a high level.
Interrater Reliability of the Psychological Rating Scale for Diagnostic Classification
The poor reliability of the DSM diagnostic system has been a major issue of concern for many researchers and clinicians. Standardized interview techniques and rating scales have been shown to be effective in increasing interrater reliability in diagnosis and classification. This study hypothesized that the utilization of the Psychological Rating Scale for Diagnostic Classification for assessing the problematic behaviors, symptoms, or other characteristics of an individual would increase interrater reliability, subsequently leading to higher diagnostic agreement between raters and with DSM-III classification. This hypothesis was strongly supported by high overall profile reliability and individual profile reliability. Therefore utilization of this rating scale would enhance the accuracy of diagnosis and add to the educational efforts of technical personnel and those professionals in related disciplines.
Emotional Alienation a Consistent Factor in Ecological and Chronic Pain Patients
The purpose of the present study was to determine the extent of emotional alienation consistent with ecological and chronic pain patients and to assess differences on this dimension between these two patient populations. Ecological group included 100 ecological inpatients, chronic pain group, 30 spinal pain clinic patients. Tests administered were the Sixteen Personality Factor (16 PF) and the Minnesota Multiphasic Personality Inventory (MMPI) including Harris and Lingoes subscales. The ecological group was significantly higher on measures of alienation than the pain group or the standardization population. Results also indicated that the ecological group demonstrated more psychopathology. Emotional alienation appeared to be a consistent stressor in ecological and chronic pain patients. Treatment of these patients should include the reduction of this emotional correlate.
Dependency in the Clinical Ecology Patient
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.
Self-Perception of Health: A Proposed Explanatory Model and a Test of its Clinical Significance
A multivariate model of health self-perceptions was postulated based upon a comprehensive set of health related variables suggested by previous bivariate research. Components of the model included measures of health attitudes, health practices, health locus of control, a measure of stress/ coping, and a physical health measure. A stratified random sampling technique was used to select 10 8 subjects based upon the external measure of physical health which included categories ranging from disability-severe to symptom free-high energy level. All subjects completed a health questionnaire comprised of measures of the model components, two measures of health self-perceptions, and the Health Resource Task, an author designed instrument measuring a subject's ability to generate flexible health alternatives/resources. Bivariate correlational analysis revealed that the physical health, stress/coping, health practices, and locus of control measures and certain of the health attitude subscales were significantly correlated to general health self-ratings. A multivariate model including these variables accounted for almost 50 percent of the variance in one of the general health self-ratings measures and approximately 38 percent of the variance in the Health Resource Task. Suggestions for refining the proposed model were made.
Sleep Patterns and Chronic Pain
Sleep, emotions and pain are intimately connected, physiologically, by their location and utilization of the same brain centers and neurotransmitters. Sleep disturbances have been clinically observed in chronic pain populations; yet, no treatment program has formally addressed this aspect of patient care. It is hypothesized that a pain population (PN) will differ significantly from a non-injured workforce (WF) when reviewing quantitative and qualitative sleep data. This study strongly supports that sleep disturbances and socioeconomic decrements exist in chronic pain patients. Forty-seven variables were surveyed and 13 were found to show significant differences between the groups and seven were found to discriminate between the PN and WF groups at less than the .0001 level. A discriminant analysis was performed to determine the smallest model which could efficiently classify cases, according to successive root variables. The major discriminators are pain levels, medication, amount of sleep obtained and number of awakenings.
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