Predicting quality of life with a pretransplantation assessment battery: A prospective study of cardiac recipients.

This study provides descriptive data on the prevalence of symptoms and quality of life of cardiac transplantation recipients and tests the predictive validity of a pre-cardiac transplantation psychological assessment battery on posttransplantation quality of life. Following the formation of four cluster groups of pretransplantation MMPI profiles based on previous research, frequency analysis found that the cluster groups were not equally represented among cardiac recipients, such that the "Distressed/Confused" cluster had only one recipient member. Tests of significance among the three remaining cluster groups on the posttransplantation quality of life variables found no significant differences. Regression analyses to test the predictive validity of other pretransplantation medical and psychological variables indicated that trait anxiety was a significant predictor of increased symptom frequency and symptom problems and decreased mental health among recipients. Collectively, modest support was found for the use of pretransplantation psychological variables as predictors of posttransplantation quality of life. Interpretation of psychological test data in the context of other psychosocial variables is discussed.

Psychopathology and anger in interpersonal violence offenders.

The current literature on psychopathology and anger suggests that both contribute to interpersonal violence. The present study examined psychopathology and anger expression with two objectives: to confirm previous distinctions of personality type among abusive individuals and to examine the relation between these types and anger. Cluster analysis was conducted with data gathered from 40 subjects. Results suggested confirmation of four clusters of interpersonal violence offenders. Furthermore, the most pathological cluster type reported the highest level of total anger experience, while the histrionic cluster type reported the lowest anger expression. These results provide tentative support for a positive relationship between psychopathology and anger, as well as for the distinction between overcontrolled and under-controlled anger as subtypes of interpersonal violence offenders.

Current status of psychological research in organ transplantation.

Research addressing the psychological concomitants of organ transplantation is reviewed. Specifically, cognitive, behavioral, and psychosocial correlates of kidney, heart, liver, and bone marrow transplantation in both children and adults are discussed. Despite several conceptual and methodological shortcomings of the psychologically-based research in this area, results seem to indicate that organ transplantation is associated with many psychological issues at pretransplantation, posttransplantation, and follow-up periods. Implications of these general findings for the advancing roles of the health psychologist in organ transplantation are discussed.

Psychometric assessment of cardiac transplantation candidates.

Psychometric assessment protocols were used to chart the course of 287 end-stage cardiac patients' psychological adjustment at pretransplantation and, again, in 34 who were subsequently transplanted. The regression and repeated-measures analyses suggested that psychological distress is typical of the adult transplantation candidate, although impaired cognitive functioning is more typical of the acute postoperative stage. Negative affect, cognitive, personality, and coping measures are interrelated at pretransplantation; depression and mental control show significant decreases at 2 weeks posttransplantation. Whereas the transplantation process is inherently distressing, psychological testing may identify cognitive and personality features that require more specific clinical attention.

Religious coping and the threat of heart transplantation.

The concern of this article is to examine the relationship between religiousness and state-and-trait anxiety in a sample of cardiac transplantation candidates. Religiousness was made operational by integrating measures of religious orientation and religious coping with cluster analysis to form religious coping profiles. Three religious coping profiles were identified:Deferring/Collaborators, Self-Directors, andEclectic. Analyses of variance indicated that coping profiles were significantly different in their report of trait anxiety, such that the Eclectics reported a good deal more trait anxiety than did the Self-Directors. This leads to a discussion of the implications for the clinical presentation of religious coping profiles in cardiac transplantation candidates.

Anger imagery and corrugator electromyography.

Electromyography (EMG) of corrugator muscle activity has been positively related to negative affective states and psychopathology. Research exploring the relationship between corrugator EMG and personality traits is lacking. The relationship between corrugator EMG and state-trait anger was examined using affective imagery in 52 undergraduate females divided into high and low trait anger groups. Results indicated that the high group reported greater difficulty with imagery, but reported more anger during the angry imagery as compared to the low anger group. Covarying imagery ability, no group differences in corrugator EMG were apparent. The greater experience of subjective anger by the high anger group was not associated with greater corrugator EMG or better imagery ability.

Anger and sports participation.

This study investigated differences between 19 varsity and 20 intramural male football players in trait anger, anger expression, and sports orientation. While varsity athletes reported comparable levels of trait anger, they described significantly less internalized (anger in) and externalized anger (anger out) than intramural athletes. Also, the varsity athletes reported significantly less anger control. Significant differences were also found for competitiveness and goal orientation, but not win orientation, such that the varsity athletes were more competitive and goal-oriented than the intramural athletes. The implications of these findings are discussed in terms of several alternative hypotheses.

Negative affect and the experience of chronic pain.

Although it is clear from previous research that pain is associated with negative affect, the relative contribution of specific affective dimensions, e.g. depression, anxiety and anger, to the subjective experience of chronic pain is unclear. The literature is also mixed concerning the relative importance of state versus trait influences in the experience of chronic pain. The present study analyzed the ability of anxiety, anger, and depression (as measured by the State-Trait Personality Inventory, State-Trait Anger Expression Inventory, and the Beck Depression Inventory, respectively) to predict self-report of clinical pain as indicated by the McGill Pain Questionnaire (MPQ) in a sample of 60 chronic pain patients. The results of stepwise regression analyses consistently demonstrated that the state measures were more strongly related to MPQ pain ratings than trait measures. These data suggest support for the hypothesis that chronic pain adversely impacts mood rather than the opposing hypothesis that negative mood is a predisposing factor in the development of chronic pain. Furthermore, different aspects of the state emotional experience were found to be related to different components of pain report. The results of this study also suggest that attributional processes could be an important component of the relationship between negative mood and the experience of pain.

Reliability of lumbar isometric torque in patients with chronic low back pain.

In this study, the test-retest reliability of lumbar isometric strength testing in patients with chronic low back pain (CLBP) was assessed. Isometric torque measurements were obtained from 89 patients with CLBP at seven different angles of lumbar flexion. Because previous studies have demonstrated significant strength differences between male and female subjects, separate data analyses were performed for each gender. Results indicated moderate to high reliability for patients with CLBP when tested at individually determined angles of flexion within their idiosyncratic range of motion (ROM) (female subjects: r = .59-.96, P less than .05, SEE = 12.0-24.2 N.m; male subjects: r = .71-.93, P less than .05, SEE = 25.1-62.1 N.m). For comparison with previously published data on asymptomatic controls, an additional set of analyses was conducted for subjects with full lumbar ROM. Similar reliability was demonstrated for this subsample (female subjects: r = .57-.93, P less than .05, SEE = 12.4-27.9 N.m; male subjects: r = .63-.93, P less than .05, SEE = 34.2-44.2 N.m). The authors concluded that isometric lumbar extension torque could be reliably measured in patients with CLBP at multiple positions within the full ROM, although reliability decreased at the most extended positions. The demonstrated reliability will allow researchers to assess treatment effects and group differences without undue concern for artifact attributable to measurement error.

Physical and psychosocial correlates of test-retest isometric torque variability in patients with chronic low back pain.

Variability in trunk torque production has been suggested as a means of detecting submaximal effort in the assessment of chronic low back pain. Several investigations question the validity of using torque variability to detect submaximal efforts in patients with back injuries. However, few investigations have studied the correlates of text-retest torque variability in clinical populations. The present study investigated psychological distress, disability/flexibility/pain, and symptom magnification correlates of test-retest torque variability in chronic low back pain patients. Contrary to previous studies, psychological distress, tendency to report symptoms, and pain were negatively correlated with measures of torque variability. The findings indicate the potential for psychological variables to influence torque production, but on the whole provide little strong support for the use of test-retest torque variability as a means of detecting submaximal performance.

Effects of age and gender on the relationship between anxiety and coronary artery disease.

This study investigated the relationship between anxiety and coronary artery disease (CAD). State (S-ANX) and trait (T-ANX) anxiety were assessed with the State-Trait Personality Inventory (STPI), which was administered to 373 patients (230 males, 143 females) 12 to 18 hr prior to their undergoing coronary arteriography. Females were significantly higher than males in both T-ANX (p less than 0.05) and S-ANX (p less than 0.01). Younger patients of both sexes were significantly higher in S-ANX (p less than 0.001), but no relationship was found between T-ANX and age. Patients with CAD did not differ in S-ANX from those without CAD. T-ANX scores of female patients were unrelated to MI or CAD. Male patients with chest pain only (CPO) were higher in T-ANX than males with prior myocardial infarction or chest pain plus CAD (p less than 0.01). Although this difference was not significant for older males (p less than 0.31), younger CPO males were significantly higher in T-ANX than the other clinical groups (p less than 0.05). These results were interpreted as indicating that high T-ANX is not associated with CAD, but is a risk factor for angiography, especially for younger males.

Common peroneal nerve palsy following inversion ankle injury: a report of two cases.

Function of the peroneal nerve should be evaluated in all patients with a history of inversion ankle sprain. Two cases were presented that demonstrated significant involvement of the common peroneal nerve following ankle injury. Manual muscle testing and sensory exams identified the involvement of the peroneal nerve, and electrophysiological testing localized the lesion and provided indications of the severity of the trauma. The importance of routinely performing neurological testing on patients with ankle sprains as part of initial and follow-up evaluations has been demonstrated and is supported in the literature.