Psychology of chronic pelvic pain.

Women with CPP are psychologically distressed group. Many come from severely disturbed families; a history of physical and sexual abuse is common. Emotional problems and depression are often expressed in terms of somatic complaints. Evaluation of the patient must, from the beginning, include attention to psychosocial factors. Close collaboration with mental health professionals is highly recommended.

Comparing high school and college students' leisure interests and stress ratings.

We compared a large high school area sample with normative data from prior research with college students on the Leisure Interests Checklist (LIC) factor scales, and on the BAROMAS. Whether combined or separated by sex, the college sample displayed far more interest in the LIC activities than the high school students (all P << 0.001). On the BAROMAS, differences were more complex. The teenagers expressed more confidence about dismissing time pressures, sleeping soundly and finding time to do sports, but college students were more confident about falling asleep and sticking to set priorities. The high school data replicated the previous pattern of LIC x BAROMAS relationships, with most scales significantly inter-correlated within inventories, but mainly the sports scales covarying across the two inventories. Numerous differences between the sexes emerged from the high school student sample.

Hospital violence: site, severity, and nurses' preventive training.

A sample of 663 nurses was surveyed about exposure to violence at the work site; 243 (37%) had faced violence. Hospitals with low response rates to the questionnaire reported less assault, yet the violence admitted to was described as more deadly. More nurses at public than private hospitals had obtained some training to handle potentially violent situations. Serious assault was negatively related to amount of training. At the public psychiatric hospital, violent acts were most frequent, but the rate of deadly violence (e.g., rape, use of knives or guns, etc.) was lowest. The need to train staffs at general as well as psychiatric hospitals was discussed.

Similarities and differences on five inventories among mood and anxiety disorder patients.

The Eysenck Personality Questionnaire (EPQ), BAROMAS, Leisure Interests Checklist (LIC), Mental Health Inventory (MHI) and a one-page checklist of Body Problems were given to 128 outpatients with serious mood or anxiety disorders. Compared to normative data published on the first four devices, the combined patients were far 'sicker' in nearly all comparisons (P less than or equal to 0.01). However, anxiety and mood patients did not differ on the EPQ, BAROMAS, or LIC. On Body Problems, strong contrasts emerged (P less than 0.04), especially when 'fringe' cases were excluded (e.g. dysthymics from mood, and obsessives from anxiety disorder diagnoses). Small anxiety subtype groups also differed (P less than 0.05). On the MHI, both global and core groups of mood--especially unipolar (depressed)--patients differed from the anxiety disorders (P less than 0.04).

Assessing emotional distress at the internist's office.

At their first visits to a clinic, 102 outpatients rated the severity of their presenting complaint, of 12 possible body problems including 6 nonspecific symptoms, of a set of adjustment difficulties, and answered the Welsh A and the Beck Depression inventories. Then, an internist 'blind' to the foregoing answers performed a routine history and physical exam, afterward rating the patient for degree of organic and of psychosomatic involvement. Significant correlations were found between clinician judgments of psychosomatic involvement and patients' self-reported complaints on all assessment measures (smallest r = 0.25, P less than 0.01). Substantial intercorrelations were found among the assessment measures, especially between Welsh A (Anxiety) and Beck Depression scores (r = 0.73).

Students' self-ratings of stress in medical school: a replication across 20 months.

We replicated the essential results of a prior study on the capacity of the BAROMAS scales to reflect stress in medical school as perceived by students. As before, subjective stress was high at the start of medical school, and when facing the exams prerequisite to entry into clinical clerkships. On most measures, stress was lowest when the second year began (i.e. after having passed the first). Once again, most test-retest reliabilities (significant rs ranged from 0.24 to 0.66 for confidence ratings at 12- and 20-months after entry) were moderate.

Substance abuse patterns reveal contrasting personal traits.

The Eysenck Personality Questionnaire (EPQ) responses of 202 male and 95 female substance users taken during 21 months at a public-sector hospital facility were studied. Collectively, inpatients were more impulsive (high P), introverted (low E), and anxious (high N) than same-sexed normals on the main EPQ scales (p less than .001). The alcohol, cocaine, opioid, and polysubstance users and a residual mixed group differed on all EPQ scales (ps less than .05). Cocaine users were the most impulsive, with alcohol and opioid users least so. The polysubstance and residual mixed groups were the most extroverted, with opioid users least. The alcohol and residual mixed groups were the most anxious, and cocaine users least so. Alcohol users earned the highest "lie" (L) scores, with opioid users lowest. When the residual mixed group was excluded from analyses the results were little changed.

Psychogenic vomiting: a review.

Psychogenic vomiting appears to be an exacerbation of a longstanding pattern of episodic stress-related vomiting. A small fraction of these patients has serious psychiatric problems and are in need of specialized treatment. Generally, psychogenic vomiters are very resentful of the suggestion that they should seek psychiatric help and more often than not refuse to be referred. Indeed, the majority of these patients is not seriously psychiatrically disturbed. They respond very well to an opportunity to ventilate their stresses to the treating physician and to supportive contacts to help them over their crisis.

Familial and developmental factors in characterological depressions.

Patients with chronic low-grade depressions (screened to exclude primary affective illness and those secondary to rigorously defined nonaffective disorders) were divided into subaffective dysthymic versus character-spectrum groups and compared to 40 primary unipolar controls. A prior report found the 30 character-spectrums different from the 20 dysthymics (and usually from the unipolars) on pharmacological, phenomenological, REM sleep, social and outcome criteria. The present study parsed family history and developmental differences: The character-spectrum group had significantly lower incidence of familial depressions, but higher frequencies of loss of a parent in childhood, familial alcoholism, and parental assortative mating than both other groups--which did not differ. Just 10% of our 90 patients had bipolar family histories; 7 were dysthymics and 6 of these had earlier shown brief, tricyclic-induced hypomania. The results support, at the subsyndromal level, Winokur's separation of disorders with +FH for alcoholism from those with +FH for affective illness. Furthermore, data suggest the DSM-III concept of 'dysthymia' is too broad and needs further distinctions among several subaffective and nonaffective chronic depressions.

Selective attention and self-control in delinquent adolescents.

Research studies are briefly reviewed to examine the hypothesis that delinquent adolescents may process information in a different manner than non-delinquents. Studies suggest that delinquents may have less control over which information they attend to, may expose themselves to more stimulation, may process information more slowly, and may selectively attend to different information than matched controls. Findings from a recent study are presented in support of the latter hypothesis. A clinical example illustrates how these attention differences may appear in the course of treatment.

Characterological depressions. Clinical and sleep EEG findings separating 'subaffective dysthymias' from 'character spectrum disorders'.

Early-onset characterological depressions are distinguished from late-onset chronic depressions that complicate the long-term course of unipolar and nonaffective illnesses. In turn, characterological depressions are divisible into at least two subtypes: (1) "Subaffective dysthymias" have even sex distribution, are often complicated by superimposed depressive episodes, rapid eye movement latency is shortened, and they tend to respond to tricyclics of lithium carbonate. In brief, they share many features of primary affective illness. (2) "Character spectrum disorders," by contrast, represent a heterogeneous mixture of personality disorders with inconstant depressive features, are more common in women, are often complicated by alcohol and drug abuse, and outcome tends to be unfavorable.

Intratask distractibility in hyperkinetic and nonhyperkinetic children.

Previous laboratory studies that have either introduced extraneous enviromental stimulation or tested children in cubicles have failed to provide support for the common clinical notion that hyperkinetic children are highly distractible. Based on the Rosenthal and Allen (1978) proposal, distractibility was investigated by introducing irrelevant information within the task context. Intratask distractibility was examined by comparing the performance of hyperkinetic and nonhyperkinetic children on a speeded classification task. Errors measured for responses to slides containing either zero, constant, one varying, or two varying irrelevant stimulus dimensions. Dimensional salience of the three dimensions used in the study was measured for each child. The data indicate that hyperkinetics made more errors than nonhyperkinetics when constant irrelevant or two varying irrelevant dimensions were presented, but the two groups made equal errors when there was no irrelevant information presented within the stimulus array. No group differences in distractibility were found when the irrelevant dimension was low salience. It was concluded that salience of distractors presented within the task context may be useful in specifying the particular task conditions in which hyperkinetic children exhibit high distractibility.

First time major motor seizures in an emergency department.

A five-year retrospective study was conducted to review 91 emergency patients with first time major motor seizures who were hospitalized. Patients were reviewed with regard to etiology of seizures, evaluation, and hospital course. Our objectives were to compare admission and discharge diagnoses, to establish a screening survey which might determine the need for immediate admission, and to evaluate the sensitivity of tests used in diagnostic evaluation. The emergency department diagnosis was in agreement with the discharge diagnosis in 89% of cases. A screening system included a history, physical examination, urinalysis, complete blood cell count, electrolytes, blood urea nitrogen, glucose, electrocardiogram, and arterial blood gases more than one hour post-seizure. When applied to the cases, it distinguished need for admission in 90 of 91 patients. Skull radiographs, electroencephalograms, CAT scans, brain scans, and lumbar punctures were helpful in making a specific diagnosis, but not in determining the need for immediate admission.