A preliminary study of negative appraisals and dysfunctional coping associated with post-traumatic stress disorder symptoms following myocardial infarction.

OBJECTIVES: To investigate associations between post-traumatic stress disorder (PTSD) symptoms following myocardial infarction (MI) and subjective experience of MI, negative perception of consequences, negative appraisals of symptoms, and use of dysfunctional coping strategies, as described by Ehlers and Clark's (2000) model of PTSD. DESIGN: Cross-sectional questionnaire study of people who experienced a MI within the previous 12 weeks (N=74; 51% response rate). METHODS: Participants completed questionnaires assessing PTSD symptoms, subjective experience of MI, perception of consequences, appraisal of symptoms, and dysfunctional coping strategies. RESULTS: Of the participants, 16% met DSM-IV criteria for PTSD and a further 18% reported moderate to severe PTSD symptoms. People with PTSD symptoms also had more somatic symptoms, anxiety, depression, and social dysfunction. PTSD symptoms were associated with perceived severity and danger of MI, a history of psychological problems, previous trauma, negative appraisal of symptoms, perceived severe consequences, and dysfunctional coping strategies. These variables were entered into a regression with MI and past history variables on Step 1, and appraisal and coping variables on Step 2. This showed that perceived consequences and dysfunctional coping were strongly associated with PTSD symptoms after controlling for MI and past history variables. CONCLUSION: The results of this preliminary study suggest perception of consequences and dysfunctional coping may be important in PTSD symptoms following MI.

Attributional style and symptoms of depression in persons with multiple sclerosis.

This study was designed to assess hypotheses derived from the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989), specifically that negative attributional style would be associated with depressive symptoms and that negative life events would interact with negative attributional style to explain depressive symptoms in a sample of persons with multiple sclerosis (MS). The research was cross sectional in design. Data was collected via survey from 495 persons with MS. Attributional style was positively associated with depressive symptoms across the whole sample. The proposition that negative life events would interact with negative attributional style to explain depressive symptoms was also supported, although only for global attributional style. Longitudinal studies would assist in determining the causal direction proposed by the hopelessness theory of depression in this population. It is also appropriate that clinicians consider attributional style in persons with MS whom they are treating for depression.

Treating an opiate-dependent inpatient population: a one-year follow-up study of treatment completers and noncompleters.

INTRODUCTION: The aim of this study was to compare the characteristics of patients who completed (completers) inpatient treatment of drug dependence with those who failed to complete this programme (noncompleters). METHOD: Participants were assessed at admission using the Substance Abuse Assessment Questionnaire (SAAQ) to obtain information about the sociodemographic background, history of drug and alcohol use, physical health, mental health, offending behaviour, and interpersonal relationships. Follow-up interviews were carried out 3, 6, 9, and 12 months after discharge using the SAAQ-Follow-up. To form the three comparison groups, participants were divided on the basis of completion of detoxification and receipt of aftercare. RESULTS AND CONCLUSIONS: Significantly better treatment outcome was observed amongst those who completed detoxification and went on to spend at least 6 weeks in a recovery and/or residential rehabilitation unit. In contrast, there were no significant differences between noncompleters and completers who had no aftercare on the majority of measures of drug use during follow-up.