Psychosocial adaptation in female partners of men with prostate cancer.

The objective was to explore the psychosocial adaptation of female partners living with men with a diagnosis of either localized or metastatic prostate cancer. Semi-structured qualitative interviews were conducted with 50 women at two time points (baseline and 6 months later). The interviews examined emotions, experiences, attitudes to sexual and continence issues and treatment decision making. As part of a larger prospective observational study, demographic data and scores for depression and anxiety were collected. Initial analysis demonstrated that the group of 11 women assessed as distressed on the anxiety and depression measures described reduced coping skills and poorer adaptation after 6 months. In contrast, the 39 women in the non-distressed group reported emotional adaptation that fitted the Lazarus and Folkman pattern of coping through appraisal of the impact of the diagnosis on their partner and themselves, appraisal of coping strategies and reappraisal of the situation. A surprise finding was the high level of resilience displayed by majority of these women. Results suggest that a psychosocial intervention could strengthen healthy adaptation and provide better coping skills for distressed couples.

The effect of a moderate dose of alcohol on the traffic hazard perception profile of young drink-drivers.

Hazard perception latency has been identified as one source of individual differences in road accidents, but alcohol's effects on hazard perception has not been addressed thoroughly. Furthermore, individuals convicted of driving while impaired (DWI), in comparison with other drink-drivers, have been found to possess a poor driving record, suggesting that they may also respond poorly to hazards. Therefore, this research studied young drivers across the spectrum of drink-driving practices, from non drink-drivers to DWI offenders. It examined alcohol's effects on their hazard perception profile, including aspects of both driving skill (hazard perception latency) and driving style (the perceived level of risk in hazards). Thirty-two subjects aged 18-25 years underwent two experimental conditions in a counterbalanced design: no alcohol and moderate alcohol. Alcohol was found to affect both driving skill and driving style. With a 0.05% BAC subjects took longer to detect hazards and responded to them in a more abrupt manner and these effects were particularly pronounced for DWI offenders. The results also supported a distinction between active hazards (hazards arising from the driver's own actions) and passive hazards (hazards arising from the actions of other road users). Irrespective of their drink-driving practices, subjects perceived active hazards as less dangerous than passive hazards. Furthermore, compared with other drink-drivers, DWI offenders perceived less risk during passive hazards (with a 0.05% BAC) and active hazards (when sober). It is suggested that these effects may underlie, at least in part, the increase in accident risk associated with impaired driving.

The Driving Expectancy Questionnaire: development, psychometric assessment and predictive utility among young drink-drivers.

OBJECTIVE: The primary objective of this research was to develop a Driving Expectancy Questionnaire (DEQ) that reflects a model in which a distinction is made between driving skill and driving style. The second objective was to study young drivers across the spectrum of drink-driving practices, from non-drivers to convicted drink-drivers, and to examine the relationship between their expectancies about driving and their drink-driving practices. METHOD: The data from two separate samples, recruited through availability sampling, were used for the purpose of exploratory (n = 224; 122 men) and confirmatory factor analyses (n = 191; 101 men), respectively. RESULTS: The results revealed two factors of expectancies, driving skill and driving style, supporting the proposed model. The reliability, internal validity and relative independence of the factors were largely confirmed. Furthermore, criterion-related validity was demonstrated: expectancies about driving varied with drink-driving practices. Expectancies also contributed additional predictive power in relation to drink-driving practices beyond that afforded by several well-validated variables. CONCLUSIONS: The results are encouraging in terms of the ability of the DEQ to identify individual differences in expectancies about driving skill and driving style that are closely related to variations in drink-driving practices. The practical implications of these findings, as well as the potential research possibilities, are discussed.

Imagery and craving in alcohol dependent persons.

There is limited evidence supporting the effectiveness of imagery techniques in exposure-based treatments for alcohol dependence. Changes in craving for alcohol following imagery instruction, measured by cognitive and physiological indices, have not been demonstrated. Furthermore, the influence of different imagery script content has not been investigated. This study compared levels of craving elicited, measured by self-report and salivation, under control and imagery conditions, in subjects receiving treatment for alcohol dependence. Imagery script content was varied across three levels. Participants generally reported forming good quality images with strong affective components. Significant effects of imagery treatment were found for changes in self-reported craving levels, but not for the salivation measure. Significant decay in levels of self-reported craving was also observed. No differences in effectiveness between the three script types were discovered. Implications of the results for therapy approaches such as cue exposure are considered.

Depression in chronic low back pain patients: diagnostic efficiency of three self-report questionnaires.

Three self-report questionnaires (the Beck Depression Inventory, the MMPI-D scale, and the depression subscale of the Middlesex Hospital Questionnaire) were examined to see how accurately they could identify chronic low back pain patients who were suffering depression, as defined by DSM-III criteria. According to these criteria, 25% of a sample of 68 patients currently were depressed, a rate comparable to those reported by other studies that have used standardized criteria. On the basis of relative conditional probability ratios, the BDI was shown to be the most efficient instrument for identifying these cases and represents an excellent screening device for depression with this population. The individual items of the BDI then were examined, and the conditional probability ratios revealed that several may be helpful as indicators of possible depression among chronic low back pain patients. The relationship between depression and chronic pain is reconsidered in the light of these results.

Attributional style of depressed chronic low back patients.

This study used the Attributional Style Questionnaire to study the attributional styles of depressed and nondepressed chronic low back pain patients (N = 91) in order to test the Revised Learned Helplessness model's prediction of differences between the two. The results partly supported the hypothesis; an internal, stable, global style for negative events distinguished the depressed group from the nondepressed, but there were no differences in attributional style for positive events. The findings are consistent with recent reviews of the literature that have reported general support for the negative outcome style, but consistent failure to confirm the predictions associated with positive outcome style. In addition, the attributional style was not common to all subjects in the depressed group, which suggested that other factors may be involved in the development of different subtypes of depression. Implications for studying attributional aspects of depression and chronic low back pain are discussed.