The effects of neuroticism and extraversion on cardiovascular reactivity during a mental and an emotional stress task.

UNLABELLED: Evidence suggests that physiological reactivity to mental and emotional stress may be influenced by personality traits. OBJECTIVES: This study aimed to examine the relationship between, emotionally based personality traits, Neuroticism (N) and Extraversion (E), and cardiovascular reactivity (CVR) during mental arithmetic (MA) and anger recall (AR). METHODS: Heart rate, blood pressure, cardiac output and total peripheral resistance were measured in 114 Singaporean male patrol officers from the Singapore Police Force while they performed MA and AR tasks. N and E were assessed using the NEO PI-R. RESULTS: Higher N was associated with lower DBP and TPRI reactivity during MA as compared to lower N, but higher TPRI reactivity during AR. Lower E scores were associated with heightened CVR while higher E scores were associated with lower CVR. For SBP and HR, E was associated with a reduction in reactivity across tasks; whereas, for DBP and TPRI this reduction was found only during AR. CONCLUSION: In this population, N had differential effects on CVR depending upon the nature of the stress task, cognitive or emotional. However, higher E was consistently linked to lower CVR during stress tasks and appeared to influence how individuals express and cope with anger.

Attitudes and beliefs of Singapore health care professionals concerning HIV/AIDS.

AIM OF STUDY: This study examines the beliefs and attitudes of Singapore doctors, dentists, and nurses concerning HIV/AIDS and persons living with HIV/AIDS (PWAs). METHOD: A mail survey was done of all doctors and dentists in Singapore as well as a random sample of 1,500 nurses from the Singapore Nursing Board Register. RESULTS: The results showed that respondents held accurate beliefs concerning transmission of HIV via sex and needle sharing but a significant proportion also expressed belief in transmission via everyday social contact. Respondents were aware of universal precautions when treating persons with HIV/AIDS but tended to be overly cautious in low/no risk situations. A substantial proportion of respondents indicated little or no knowledge or experience with AIDS-related conditions and the majority believed that most health care professionals are unprepared to care for PWAs. Further, there was evidence of substantial stigmatisation and fear of treating PWAs, both of which were significantly and negatively correlated with accuracy of beliefs about HIV transmission and universal precautions. CONCLUSION: These results point to important misconceptions about HIV/AIDS held by Singapore health care professionals as well as stigma towards and fear of treating PWAs. These are areas that need to be addressed through better professional education concerning HIV/ AIDS. This education needs to address both the factual misconceptions about HIV/AIDS as well as the stigma associated with this disease and the fears that health care professionals have of treating PWAs.

Anger, harassment, and cardiovascular reactivity among Chinese and Indian men in Singapore.

OBJECTIVE: This experiment examined psychological and cardiovascular responses to experimental harassment among Chinese and Indian men in Singapore who differed in levels of dispositional anger. METHODS: Eighty-four Chinese and Indian men participated in a laboratory experiment on cardiovascular reactivity in which mood was rated and heart rate and blood pressure were measured during computer tasks in which they were either harassed or allowed to complete the tasks without interruption. RESULTS: Comparison of systolic reactivity to harassment and nonharassment indicated, as expected, that reactivity was greater after harassment. Furthermore, a significant race by dispositional anger by harassment effect was obtained for systolic reactivity that indicated different patterns of reactivity for Chinese and Indian participants. In the absence of harassment, Chinese participants showed low systolic reactivity regardless of their level of dispositional anger, whereas systolic reactivity increased as a function of dispositional anger when they were harassed. For Indians, however, systolic reactivity was a positive function of dispositional anger both when they were harassed and not harassed. CONCLUSIONS: These results suggest stronger cardiovascular reactivity to stress among Indian than among Chinese men. This seems to be particularly true for Indians high in dispositional anger.

The role of attitudes and beliefs in differential health care utilisation among Chinese in Singapore.

Abstract One hundred and twenty-eight Chinese patients at two Western medical practices and two Chinese medical practices in Singapore completed a questionnaire regarding perceptions of illnesses. Health beliefs and attitudes towards different medical practitioners. Results indicate significant differences between those who consult only allopathic physicians (Western doctors) and those who consult both practitioners of traditional Chinese medicine (sinsehs) and Western doctors. Individuals consulting both Western doctors and sinsehs perceived a smaller proportion of "general" illness attributes (those found in both Western and Chinese medicine) to be relevant to specific diseases and showed greater endorsement of Chinese health beliefs than did individuals seeking help only from Western doctors. Also individuals consulting both types of practitioners expressed less satisfaction with the doctor's treatment than did those consulting only Western doctors and also rated sinsehs as more concerned with patient well-being and as listening more to their patients.

Anger Expression, Coping Styles, and Well-being.

This study examined the role of anger expression in the experience of stress, coping with stress and psychological and physical well-being. Based on a sample of 268 Singaporeans, the results, using structural equation modelling, indicated that anger expression was significantly related to reported stress, mechanisms for coping with stress and psychological wellbeing. Higher levels of anger expression were associated with higher levels of stress as well as lower use of active coping. Active coping was in turn positively related to psychological well-being. In addition, higher levels of anger expression showed a direct negative relationship with psychological well-being as did higher levels of stress. In contrast, the only significant predictor of physical well-being was reported stress, with higher levels of stress related to lower levels of physical well-being. The implications of these results for understanding the role of anger expression in psychological and physical wellbeing are discussed.

Sexual practices among men attending an anonymous HIV testing site in Singapore.

This study was undertaken to provide an empirical basis for planning safer sex interventions in Singapore by examining the sexual practices of men attending an anonymous HIV testing site. All male clients attending the testing site from January, 1996 to January 1997 were asked to complete an anonymous questionnaire concerning oral and anal sex with men as well as vaginal, oral and anal sex with women within the past year. Questionnaires were obtained from 251 male clients, ranging in age from 17 to 70 years (mean = 30.3). Of these 50.6% reported sex with women only, 39% with men only, 7.2% with both men and women and 3.2% with no one. Condom use was moderately high for anal and vaginal sex but low for oral sex. A risk index based on the riskiness of specific activities showed that bisexuals were the most likely to engage in high risk behaviour whereas homosexuals were the least likely. One factor in the greater riskiness of bisexuals' behaviour appeared to be a higher frequency of unprotected sex with women. These findings provide a preliminary portrait of sexual risk-taking among men in Singapore and suggest the need for continued emphasis on consistent condom use for penetrative sex as well as appropriate precautions for oral sex. The results also suggest the need to develop targeted interventions for bisexuals, particularly with respect to unprotected sex with women.

PIP: All male clients attending the Action for AIDS Anonymous HIV Testing Site from January 1996 to January 1997 were asked to complete an anonymous questionnaire on oral and anal sex with men and vaginal, oral, and anal sex with women during the past year. Completed questionnaires were obtained from 251 men aged 17-70 years, of mean age 30.3, 71.3% of the men who attended the site during the period of study. 50.6% reported having sex with women only, 39% with men only, 7.2% with both men and women, and 3.2% with no one. 51.7% and 47.9% of men who reported having receptive and insertive anal sex, respectively, with men reported always using condoms. However, only 2% and 2.8% of respondents who reported having receptive and insertive oral sex, respectively, with men always used condoms. The overwhelming majority of men never used condoms during oral sex. Overall, among men who reported having sex with men, 25.0% reported unprotected receptive anal sex, 32.8% unprotected insertive anal sex, 82.8% unprotected receptive oral sex, and 87.9% unprotected insertive oral sex. With women, the men most often engaged in vaginal sex, insertive oral sex less frequently, and rarely anal sex. Prostitutes and strangers were the most frequently cited female sex partners. 39.4% of men who reported having vaginal sex and 14.9% who reported oral sex with women stated that they always used a condom. Bisexual men were the most likely to engage in high-risk behavior, while homosexuals were the least likely. A factor in the greater riskiness of bisexuals' behavior was their higher frequency of unprotected sex with women.

Singaporean beliefs about HIV and AIDS.

As part of an in-home survey, 429 Singaporeans responded to questions concerning beliefs about AIDS as a disease and the ways in which one can contract HIV. The results indicated that, although many held realistic beliefs, identifiable biases and misconceptions were present. Virtually all respondents were aware that HIV is contracted through sexual contact as well as the sharing of needles during IV drug use. However, many respondents believed that it is either somewhat or very likely for HIV to be transmitted through casual contact, by giving blood, or from mosquitoes and other insects. Also, many expressed the belief that persons with AIDS are identifiable through visible symptoms or membership in high risk groups and a significant percentage indicated a lack of concern about the disease. Implications for understanding AIDS beliefs and for health education are discussed.

PIP: The Government of Singapore has conducted national AIDS awareness campaigns since 1985. To assess the effectiveness of these campaigns, 429 randomly selected Singaporeans (Chinese, Malay, and Indian) were interviewed. The first set of questions examined misperceptions about HIV/AIDS. Substantial proportions of respondents believed HIV is more likely to be contracted from foreigners (56.4%), persons with AIDS usually have visible symptoms (41.5%), AIDS is God's punishment for immoral behavior, and AIDS cannot be transmitted through heterosexual relationships (22.2%). Although respondents had good awareness of the risks of HIV transmission associated with sex with an infected person, sharing drug-injecting equipment, and blood transfusion, high percentages thought transmission was likely through kissing (64.0%), donating blood (52.0%), mosquito bites (44.9%), sharing eating utensils (40.8%), being coughed or sneezed on by someone with AIDS (39.7%), eating in a restaurant where the cook has AIDS (35.3%), and working near (25.9%) or attending school with a child who has AIDS (17.9%). 47.2% agreed with the statement, "I am not worried about the spread of AIDS, as it has little to do with me." These findings indicate the national AIDS campaign has been successful in educating Singaporeans about the major risk factors for HIV. However, many misconceptions about casual contact remain and are fueling the stigmatization of people with AIDS. Health education campaigns should indicate that AIDS, while communicable, is not a typical contagious disease and is not spread through casual contact. Also needed are messages aimed at dispelling the belief that the risk of AIDS is confined to homosexuals, prostitutes, drug users, and foreigners.

Seeking help for illness: the roles of cultural orientation and illness cognition.

A group of 112 Chinese Singaporean undergraduates and 109 of their parents completed a questionnaire on disease perceptions, help-seeking behaviour, Chinese cultural values and personal background. Analysis of these data using structural equation modelling indicated that individuals high in Chinese cultural orientation were more likely to describe diseases using Chinese health concepts and less likely to describe diseases in terms of physical causality or chronicity. Illness concepts, in turn, related to illness behaviour in that participants making greater use of Chinese health concepts were significantly more likely to state that they would seek treatment from a sinseh (practitioner of Chinese medicine) and less likely to go to an allopathic physician whereas participants tending to describe diseases as physically caused indicated greater likelihood of seeking help from an allopathic physician. Also, cultural orientation was positively related to seeking help from a sinseh, independent of its relationship to illness concepts.

Psychological stress and the fibrositis/fibromyalgia syndrome.

The relationship of stress and social support to the fibrositis/fibromyalgia syndrome (FS) was investigated by administration of 4 questionnaire instruments to 28 patients with FS, 20 patients with rheumatoid arthritis (RA) and 28 pain-free normal controls. FS showed higher levels of stress as measured by daily "hassles" than did RA or controls. However, on a measure of major life stress, they reported lower levels. No differences were found between groups with regard to daily "uplifts" or social support. Correlations between those measures of stress and social support with their scores on the Arthritis Impact Measurement Scale showed that the Hassles Scale was significantly related to the AIMS Psychological component.

An approach to developing a valid Spanish language translation of a health-status questionnaire.

This article discusses methodological issues confronting health professionals using questionnaires to study health care variables among populations with limited literacy in English, and suggests techniques for minimizing problems that plague questionnaire-based research among these populations. A recent effort to validate a questionnaire for Rheumatoid Arthritis patients in South Texas is used to illustrate pitfalls and potential solutions.

Development and initial validation of a dual-language English-Spanish format for the Arthritis Impact Measurement Scales.

Language, cultural, and educational barriers complicate efforts to validate health status questionnaires that have been translated into Spanish. To overcome these problems, a prototype dual-language format was developed for the Arthritis Impact Measurement Scales. Validity testing with 72 patients diagnosed as having rheumatoid arthritis indicated high levels of test-retest reliability, item-to-scale internal consistency, and construct validity for both Anglo and Hispanic subjects. A technique for developing and pilot-testing a questionnaire written in a regional Spanish dialect is described. Linguistic considerations, questionnaire design, and other applications are discussed in light of the results obtained.

Illness representations: a prototype approach.

Two experiments tested the hypothesis that laypeople cognitively organize and recall information about physical symptoms according to prototyped conceptions they have of physical diseases. Based on pilot studies that identified the extent to which subjects associated specified symptoms with specific diseases, symptom sets were assembled to vary in the extent to which the symptoms were perceived to be associated with (to be prototypical of) a given disease. Experiment 1 asked subjects to indicate whether a given set of symptoms indicated a disease and, if so, which one. Experiment 2 tested subjects' recall for symptom sets varying in prototypicality for given diseases and also tested the effects on recall of giving subjects a diagnosis. Results of both experiments support the prototype hypothesis that information about physical symptoms is organized and processed according to people's preexisting beliefs about the association between particular symptoms and diseases. Implications for illness behavior and help seeking are discussed.

Gender, role, and illness behavior in a military population.

This research investigated the effects of gender and role stress on reporting and response to symptoms in a military population. Forty-six female and 44 male enlisted soldiers, who were members of administrative or combat support units, were interviewed and asked to keep a health diary for 30 days. The results showed that although females reported twice as many health problems in the initial interview there were no significant gender differences observed in symptom reporting on the health diary. Significant differences were obtained, however, between members of administrative and support units with members of combat support units reporting twice as many symptoms on the diary. Overall, the results are interpreted as emphasizing the impact of occupational stress and group cohesion rather than gender as influences on illness behavior.

Discussion effects on racial attitudes.

We predicted that discussion would enhance dominant group values, leading to increased polarization between homogeneously composed groups of high-, medium-, and low-prejudice high school subjects. In an experimental condition, group members made individual attitude judgments, discussed them, and remade judgments. Control groups discussed irrelevant materials before responding again to the attitude items. As predicted, discussion of the racial attitude items with others having similar attitudes significantly increased the gap between high- and low-prejudice groups.