摘要:

This paper considers the findings from psychological studies of adults with sickle cell disease (SCD), an inherited haematological disorder which causes recurrent episodes of acute pain. Studies are reviewed that deal with aspects of the condition's clinical presentation in adulthood, the risk of maladjustment and psychopathology among affected groups, the role played by cognitive factors in mediating psychological distress and facilitating more effective coping, and the implications of the condition for family life and employment. Adults with SCD experience high levels of maladjustment by comparison with other illness groups, and differences in adjustment are predicted better by measures of social support and life stress than by illness variables. The use of coping strategies plays an important role in pain management and the mediation of psychosocial adjustment, with passive and negative responses to painful episodes associated with less favourable outcomes. Existing findings in this rapidly expanding area of research have implications for the management of SCD and the organization of support services, and point to a need for interventions to enhance patients' coping skills. Future research could evaluate specific cognitive and behavioural interventions to promote more effective coping, and look at the effects of SCD on reproductive behaviour, family life, performance in the workplace, and development and adjustment over the life‐spa

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1996.tb00495.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This study aims to evaluate the feasibility and effectiveness of a four‐session cognitive–behavioural treatment (CBT) for hot flushes—a symptom commonly experienced by menopausal women for whom hormone replacement therapy (HRT) has been the main treatment option. A patient preference design was used to compare CBT (N= 24), HRT (N= 12) and no‐treatment (NT) (N= 16) groups, with a randomized comparison of CBT participants into treatment vs. waiting (followed by treatment) conditions. A monitoring control condition was also included.Hot flush measures did not change after monitoring, or after the wait condition, nor for the NT group. CBT and HRT significantly reduced hot flush frequency, but CBT also significantly reduced anxiety and hot flush problem ratings. Changes were maintained at three‐month follow‐up. The development of psychological treatments appears feasible and warranted in view of treatment effects and patient

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1996.tb00496.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Twenty pregnant women and 20 controls matched for age and IQ were tested on a range of cognitive functions at three time points: in the last month of pregnancy, 48 hours after delivery, and four weeks after delivery. Pregnant women obtained significantly lower scores on digit symbol and paced auditory serial addition tests 48 hours after delivery. There were no significant differences between the groups on logical memory, trail making or letter cancellation tasks. The degree of cognitive impairment was correlated with the severity of depression, and the differences between the pregnant and control groups in cognitive function became nonsignificant when the effect of depression was controlled. Cognitive functions related to fluid cognitive ability are impaired in the immediate post‐partum period and the severity of impairment is correlated with self‐reported depress

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1996.tb00497.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Despite its high prevalence and implications for health care resources, health anxiety is still a relatively neglected area of research. This paper describes the development of the Health Anxiety Questionnaire (HAQ), a measure based on a cognitive–behavioural analysis of health anxiety. The measure was developed to identify individuals with high levels of concern about their health. Psychiatric and medical samples were used in the reported studies. The HAQ was found to have good internal consistency (coefficient alpha and split‐half reliability) and short‐term temporal stability (test–retest reliability). Long‐term stability (one year) was modest but predictably responsive to external events. Analysis of the structure of the HAQ (cluster and factor analyses) revealed four factors: worry and health preoccupation, fear of illness and death, reassurance‐seeking behaviour and the extent to which symptoms interfere with a person's life. Studies of the HAQ's validity indicate that it has appropriate discriminate validity. It is concluded that the HAQ appears to reflect relatively enduring features consistent with the cognitive–behavioural model of health anxiety. It is anticipated that the HAQ should be able to predict response to reassurance following medica

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1996.tb00498.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This study evaluated the effectiveness of a cognitive–behavioural treatment programme, delivered in either clinic‐based group format, or home‐based minimal‐therapist‐contact format, in the treatment of chronic headache (migraine, tension or combined), for 10–12‐year‐old children. Subjects were assigned randomly to three conditions: clinic‐based treatment (eight sessions); home‐based treatment (three sessions supplemented by working at home from treatment manuals); and waiting‐list control. Both treatment conditions were associated with significant reductions in headaches, but no changes occurred for the control condition. The two treatment formats were equally efficacious; however, the home‐based format was over twice as cost effective as

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1996.tb00499.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Long‐term distress was assessed in 29 patients who had suffered an injury during surgery, a failure of diagnosis or other incorrect treatment, and who had taken legal action as a result. Psychological distress reported over four years after the incident was severe: 38 per cent of those interviewed were identified as ‘cases’ for anxiety, 41 per cent for depression and 55 per cent for both on the Hospital Anxiety and Depression Scale, using the conservative cut‐off criteria of 11 for caseness. Scores on the Impact of Events Scale indicated higher levels of intrusive memories and posttraumatic distress than have been previously reported for serious life‐events and other accidents. Early and ongoing psychosocial interventions would benefit many victims of medical accidents. Clinical psychologists have an important role to play in providing psychological treatment where appropriate and in re‐establishing a relationship of trust and confidence in health care pr

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1996.tb00500.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Women referred for colposcopy following abnormal cervical smears are extremely anxious. The purpose of the current study is to compare the effectiveness of two booklets in reducing this anxiety. One booklet was brief, simply written to provide procedural information, behavioural instructions and outcome information. The other booklet was longer and more complex focusing largely upon procedural and outcome information. Women referred for colposcopy for the first time following abnormal cervical smears were randomly allocated to one of four groups: Group 1 received the appointment letter, Group 2 received the appointment letter and the simple booklet, Group 3 received the appointment letter and the more complex booklet, Group 4 received the appointment letter and both booklets. While receipt of either booklet increased women's knowledge about cervical abnormalities and colposcopy, women who received the simpler booklet were less anxious shortly after receipt of their appointments than women receiving no information or the complex booklet, and were also less anxious than those not receiving this booklet when they attended the hospital for colposcopy. There was also some evidence that these women were more reassured from this consultation than those who had not received this booklet. Receiving the more complex booklet increased knowledge but did not reduce anxiety. The aspects of the simple booklet that led to reduced anxiety, and how, remain to be determined.

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1996.tb00501.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY