摘要:

Alexithymia's link with health care utilization is unclear.Alexithymia may be overrepresented among clinical samples because of a proclivity to seek care, or alexithymia may prompt delay or avoidance of care, perhaps exacerbating illness. In 911 young adults, this study examined relationships between alexithymia (Toronto Alexithymia Scale-20: total and three factor scores) and the use of six health services during the past year: outpatient medical treatment, emergency room, hospitalization, psychotherapy, routine dental care, and nonprescription analgesics. Three potential mediators (insurance status, depression, and somatic complaints) were controlled to determine alexithymia's unique relation to utilization. The alexithymic difficulty in identifying feelings was linked to increased use of outpatient treatment, after controlling for potential mediators. Difficulty identifying feelings also was related to the use of psychotherapy and analgesics, but these relationships were accounted for by increased depression and somatic complaints, respectively. The alexithymic preference for externally oriented thinking was independently linked with the decreased use of outpatient treatment, to not having psychotherapy, and to being more likely to obtain preventive dental care. Our results may explain contradictions in the literature; separate alexithymic characteristics have different relationships with different types of health care utilization.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Although clinical observations suggest that alexithymic individuals have a deficit in their ability to recognize emotional stimuli and that this deficit is not simply due to a problem in verbal labeling, these two hypotheses have not been empirically confirmed.Three hundred eighty participants in a community survey without current or past histories of psychiatric disorder completed two independent measures of alexithymia [the Levels of Emotional Awareness Scale (LEAS) and the Toronto Alexithymia Scale (TAS-20)] and the Perception of Affect Task (PAT), a 140-item measure of the ability to match emotion stimuli. The PAT includes four subtasks that require the subject to match verbal or nonverbal emotion stimuli with verbal or nonverbal emotion responses. The subtasks include matching sentences and words (verbal-verbal), faces and words (nonverbal-verbal), sentences and faces (verbal-nonverbal), and faces and photographs of scenes (nonverbal-nonverbal). Across the entire sample, higher (alexithymic) TAS-20 and lower LEAS scores were both correlated with lower accuracy rates on each of the subtasks of the PAT (p <.001), accounting for 10.5% and 18.4% of the variance, respectively. Fifty-one subjects met TAS-20 criteria for alexithymia. Alexithymic individuals scored lower than other subjects on purely nonverbal matching, purely verbal matching, and mixed verbal-nonverbal matching (all p <.001). These results suggest that alexithymia is associated with impaired verbal and nonverbal recognition of emotion stimuli and that the hallmark of alexithymia, a difficulty in putting emotion into words, may be a marker of a more general impairment in the capacity for emotion information processing.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

There is little empirical research on the familial and parental correlates of alexithymia.A two-part study explored how the affective and cognitive characteristics of alexithymia are related to family dysfunction and maternal alexithymia. In Part I, 127 young adults were evaluated for alexithymia with the Toronto Alexithymia Scale-20 (TAS-20), for impaired imagination with the Scored Archetypal Test with Nine Elements, and for family dysfunction with the McMaster Family Assessment Device. In Part II, 80 of their mothers completed the TAS-20 about themselves, and maternal alexithymia characteristics were correlated with those of their offspring. In Part I, general family pathology was associated with alexithymia. In particular, difficulty identifying feelings was related to dysfunctional family affective involvement, externally oriented thinking was related to deficient family behavior control, and impaired imagination was related to inadequate family problem solving; these relationships were independent of general family pathology and subjects' positive and negative affect. In Part II, maternal alexithymia characteristics were correlated significantly with the offsprings', controlling for both respondents' positive and negative affect. These findings implicate disturbed family functioning and maternal alexithymia in the development of alexithymia characteristics in children.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Research linking psychological inhibition to physical illness led us to examine whether human immunodeficiency virus (HIV) infection might progress more rapidly among gay men who conceal their homosexual identity than among those who do not.We also sought to determine whether any accelerated course of HIV infection among "closeted" gay men might be attributable to differences in health-relevant behavior (e.g., health practices, sexual behavior) or psychosocial characteristics (e.g., depression, anxiety, social support, repressive comping style). Data came from a longitudinal psychosocial study associated with the Los Angeles site of the Multicenter AIDS Cohort Study. Eighty gay men, HIV-seropositive but otherwise healthy at study entry (CD4 T lymphocytes = 30-60% of total lymphocytes), were examined at 6-month intervals for 9 years. Indicators of HIV progression included time to a critically low CD4 T lymphocyte level (15% of total peripheral blood lymphocytes), time to AIDS diagnosis, and time to AIDS mortality. On all measures, HIV infection advanced more rapidly in a dose-response relationship to the degree participants concealed their homosexual identity. Sample characteristics and statistical controls ruled out explanations based on demographic characteristics, health practices, sexual behavior, and antiretroviral therapy. Mediational analyses indicated that observed effects were not attributable to differences in depression, anxiety, social support, or repressive coping style. HIV infection appears to progress more rapidly in gay men who conceal their homosexual identity. These results are consistent with hypotheses about the health effects of psychological inhibition, but further research is required to definitively identify the psychosocial, behavioral, and physiological mechanisms underlying these findings.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Psychosexual dysfunction is often suggested the cause of the disturbed eating habits associated with hypothalamic secondary amenorrhea.In contrast, we explored the possibility that impaired sexual function may result from reduced levels of testosterone in amenorrheic subjects as a consequence of particular lifestyles. We studied the effects of erotic stimuli in two experiments, one comparing amenorrheic women to normal controls, the other comparing testosterone substitution to a placebo treatment. The amenorrheic women had a higher incidence of lifestyle and bodily conditions identified as risk factors for amenorrhea (i.e., weight loss before the onset of amenorrhea, low body weight, strenuous exercise, and vegetarianism), lower levels of testosterone, and impaired sexual function compared with normally menstruating women. In an experimental session in which amenorrheic women were asked to produce erotic fantasies, they demonstrated a reduced capacity for sexual fantasizing, less subjective sexual excitement, and less vaginal vasocongestion (vaginal pulse amplitude). However, when exposed to the stronger of two erotic film excerpts, the degree of vaginal response of the amenorrheic women was comparable to that of normally menstruating women. Subsequently, we showed that treatment with testosterone increased vaginal vasocongestion in the same amenorrheic women during exposure to the most potent visual stimulus but had no effect on subjective sexual experience. Testosterone substitution influenced physiological aspects of sexual function, but the psychological level remained unaffected.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study sought to test whether a cognitive-hypnotic intervention could be used to decrease skin reactivity to histamine and whether hypnotizability, physiological variables, attitudes, and mood would influence the size of the skin weals. Thirty eight subjects undertook three individual laboratory sessions: a pretest session to determine sensitivity to histamine, a control session, and an intervention session during which the subject experienced a cognitive-hypnotic procedure involving imagination and visualization. Compared with the control session, most subjects (32 of 38) decreased the size of their weals measured during the intervention session, and the differences between the weal sizes produced in the two sessions were highly significant (N = 38; t = 4.90; p <.0001). Mood and physiological variables but not hypnotizability scores proved to be effective in explaining the skin test variance and in predicting weal size change. Feelings of irritability and tension and higher blood pressure readings were associated with less change in weal size (i.e., a continuation of reactivity similar to that found in the control session without the cognitive-hypnotic intervention), and peacefulness and a lower blood pressure were associated with less skin reactivity during the intervention. This study has shown highly significant results in reducing skin sensitivity to histamine using a cognitive-hypnotic technique, which indicates some promise for extending this work into the clinical area.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study was a 19-week prospective conducted to determine the effectiveness of a self-hypnosis/relaxation intervention to relieve symptoms of psychological distress and moderate immune system reactivity to examination stress in 35 first-year medical students. Twenty-one subjects were randomly selected for training in the use of self-hypnosis as a coping skill and were encouraged to practice regularly and to maintain daily diary records related to mood, sleep, physical symptoms, and frequency of relaxation practice. An additional 14 subjects received no explicit training in stress-reduction strategies, but completed similar daily diaries. Self-report psychosocial and symptom measures, as well as blood draws, were obtained at four time points: orientation, late semester, examination period, and postsemester recovery. It was found that significant increases in stress and fatigue occurred during the examination period, paralleled by increases in counts of B lymphocytes and activated T lymphocytes, PHA-induced and PWM-induced blastogenesis, and natural killer cell (NK) cytotoxicity. No immune decreases were observed. Subjects in the self-hypnosis condition reported significantly less distress and anxiety than their nonintervention counterparts, but the two groups did not differ with respect to immune function. Nevertheless, within the self-hypnosis group, the quality of the exercises (ie, relaxation ratings) predicted both the number of NK cells and NK activity. It was concluded that stress associated with academic demands affects immune function, but immune suppression is not inevitable. Practice of self-hypnosis reduces distress, without differential immune effects. However, individual responses to the self-hypnosis intervention appear to predict immune outcomes.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The objective of this study was to address the cellular and psychological mechanisms underlying previously observed changes in natural killer (NK) cell cytotoxicity associated with chronic stress.We compared 28 current and former spousal caregivers of patients with Alzheimer's disease (AD) and 29 control subjects. NK cells were enriched (E-NK) using a 4- step procedure that resulted in a cell preparation consisting of 88.2% NK cells. These cells were then incubated with either recombinant interferon-gamma (rIFN-gamma) or recombinant interleukin-2 (rIL-2) for 65 hours. Although an average of over 3 years had elapsed since the death of the patient with AD for the former caregivers, current and former caregivers did not differ in the E-NK cell responses to rIFN-gamma and rIL-2. However, the E-NK cell response for the combined caregiver group was significantly suppressed compared with controls, which is consistent with a previous report from our laboratory. Higher E-NK cell responses to each cytokine were associated with heightened levels of positive emotional and tangible social support, independent of levels of depression. Preliminary data suggest that defects of NK cell function in response to rIFN-gamma and rIL-2 as a consequence of caregiver stress may be independent of non-NK cells. Finally, our data are consistent with other studies regarding the role of social support in immune modulation.

ISSN:0033-3174    

出版商:OVID    

年代:1996

数据来源: OVID