Casual dimensions of college students' perceptions of physical symptoms.

According to attribution theory, controllability, locus, and stability are important dimensions underlying causal explanations. The extent to which these theoretical dimensions underlie lay explanations for physical symptoms is unclear. Accordingly, in this study, attributes relevant to the lay public were empirically derived using a multidimensional scaling (MDS) procedure. Undergraduates (N = 194) provided similarity judgments for 18 potential causes of physical discomfort. The MDS analysis yielded a three-dimensional solution. The first dimension captured the distinction between "physical" and "nonphysical" causes. The second dimension distinguished either "variable" versus "stable" causes or those that are "controllable" versus "uncontrollable" by health care professionals. The third dimension differentiated causes under "low" versus "high" personal control. These findings empirically confirm the theoretically proposed dimensions of "personal control" and "stability" and suggest the utility of considering the "physical/nonphysical" and "controllability by health care professional" distinctions in future work on attributions in the health domain.

The effect of litigation status on adjustment to whiplash injury.

STUDY DESIGN: This retrospective study examined the effect of civil litigation on reports of pain and disability in chronic pain patients who sustained whiplash injuries after a motor vehicle accident. OBJECTIVES: To examine the effect of litigation on adjustment to chronic pain. SUMMARY OF BACKGROUND DATA: A common methodologic weakness with many studies in this area is the composition of the nonlitigant group, which often includes individuals who have completed litigation as well as those who opted not to litigate. This introduces a confound in that litigant and nonlitigant groups differ not only with respect to litigation status but with respect to any factors that predispose one to litigate. METHODS: Questionnaire data were obtained from 41 patients (current litigants) in the process of litigation and 21 patients (postlitigants) who had completed litigation. Subjects completed self-report measures assessing demographic characteristics, psychological distress, sleep disturbance, employment status, and various pain indices. RESULTS: There were no significant group differences in demographic characteristics, employment status, or psychological distress. Litigants, however, reported more pain than did postlitigants. Group differences in pain reports remained statistically significant even after controlling for length of time since accident and initial severity of the injuries. CONCLUSIONS: That litigation status did not predict employment status suggests that secondary gain does not figure prominently in influencing the functionality of these patients. The rather robust effect of litigation status on pain reports is discussed with respect to the potential mediational role of the stress of litigation.

The impact of contextual cues on the interpretation of and response to physical symptoms: a vignette approach.

This study examined the impact of two contextual cues--stress and aging--on conceptualizations of, and health care responses to, physical symptoms. Eighty-three undergraduates each read four vignettes describing a woman experiencing physical symptoms indicative of either heart attack, depression, ulcer, or flu. Subjects were randomly assigned to one of six age/stress cue combinations. Consistent with predictions, physical symptoms presented with stress cues were less likely to be attributed to acute illness and were seen as more variable. The effect was most pronounced for heart attack symptoms, which, when presented with stress cues, were also less likely (1) to be identified as a heart attack, (2) to be attributed to chronic illness, (3) to elicit recommendations to seek medical care, (4) and to be regarded as serious. The age manipulation did not exert an effect. Implications of these findings and limitations of the vignette approach are discussed.

The menopausal hot flush: symptom reports and concomitant physiological changes.

Hot flushes are the most frequently reported menopausal symptom. The primary study goal was to develop criteria for the identification of hot flushes that ultimately could be applied independent of symptom report. Twenty-one postmenopausal women each underwent psychophysiological monitoring. Physiological activity accompanying their 93 subjective flush reports was compared with activity during nonflush periods, and a discriminant function analysis was carried out. The Physiological Flush Profile (PFP), developed on the basis of these analyses, consists of peripheral vasodilation plus an increase in skin conductance (sternal and/or palmar), both of a specified magnitude. The PFP was shown to be both a specific and a sensitive measure of hot flushes. Notably, change in sternal skin conductance was highly positively correlated with subjective flush severity ratings. Potential applications of the PFP toward delineating the role of psychological factors in the reporting of menopausal symptomatology are discussed.

Impact of stress on objectively recorded menopausal hot flushes and on flush report bias.

The hot flush (or flash) is the most widely reported menopausal symptom. Anecdotal reports suggest that women experience more hot flushes when stressed. Although stress may actually trigger hot flushes, another possibility is that women under stress may be more aware of the physiological changes associated with flushes and, therefore, more likely to report them. The goal of this study was to test these hypotheses by investigating the association between stress and both objective (i.e., physiologically recorded) and subjective hot flushes. Twenty-one postmenopausal women who reported having frequent hot flushes each underwent psychophysiological monitoring during stressful and nonstressful laboratory sessions. Significantly more objective flushes were recorded during the stress session than during the nonstress session. The stress manipulation, however, did not affect subjects' propensity to report flushes. These results suggest that the observed association between reported hot flushes and stress is not due to changes in report bias. The physiological mechanisms through which stress may stimulate hot flushes are discussed.

Women's attitudes toward the menopause: an update.

A sample of 244 pre-, peri-, post-menopausal and hysterectomized women were administered a 10-item Menopause Attitude Questionnaire which assessed women's agreement with several controversial menopausal issues (i.e., whether the women subscribed to a view of menopause as a normal developmental stage or as a deficiency disease; attitudes toward hormonal replacement; and whether female sexuality was perceived as compromised during and subsequent to menopause). Results revealed that even a fairly homogeneous population of well-educated women held a considerable diversity of beliefs about the menopause. Respondents were clearly divided regarding the issue of hormone replacement therapy and its associated risks, but were united in holding optimistic beliefs about maintaining their femininity and sexuality subsequent to menopause. The implications of this research are discussed in terms of the current zeitgeist regarding menopause.