Crown-Crisp Experiential Index Research Articles

Temporomandibular pain and dysfunction syndrome: the relationship of clinical and psychological data to outcome.

A prospective study of 60 patients with the temporomandibular pain and dysfunction syndrome (TMPDS) was done using the General Health Questionnaire, the Crown-Crisp Experiential Index, and the Parental Bonding Instrument. Three months after an initial visit 59 patients were reassessed: 18 patients were completely better or improved a lot, 27 were improved a little, and 14 were the same or worse. Patients' outcomes were not related to the severity or duration of symptoms at the initial presentation. Thirty-five percent of the patients had not received any therapy in the 3-month interval. The outcomes of these patients were not different from the outcomes of patients who had received treatment. A significant relationship was found between initial psychological test scores and outcome (multivariate F = 3.80, P less than 0.05). This relationship was curvilinear: the group with the worst outcomes scored highest, that with the best outcomes scored in the middle, and that with intermediate outcomes scored lowest. These results imply that mild psychological distress may facilitate a successful outcome, whereas either excessive psychological disturbance or minimal psychological complaint is associated with poor results.

Psychological normality and abnormality in persistent headache patients

One hundred and three patients referred to a neurological outpatient clinic were examined to assess the relationship between persistent headache, not due to significant physical illness, and emotional disturbance. Overall, the patients showed slightly more evidence of emotional disturbance than a general practice population but less than psychiatric outpatients. Thus, with cut-off points of 4 5 and 9 10 on the General Health Questionnaire (GHQ 28) the whole group had 52% or 20% of psychiatric ‘cases’ respectively. On the Crown-Crisp Experiential Index the 70 females had mean total scores of 37.19 ± 11.11 and the 33 males had scores of 31.79 ± 11.36. In addition the childhood experiences measured by the Parental Bonding Instrument appeared to be normal. Seven patients had significant depressive illness, according to the Levine-Pilowsky Depression Questionnaire. Statistically significant differences in psychological state did not emerge between the diagnoses of cluster headache, classical migraine, common migraine, tension headache or combined headache. However, negative correlations were found between the duration of illness and measures of anxiety. It is concluded that although the emotional state contributes to the development of pain and headache in some patients, there are others in whom comparable headaches are unlikely to be due to emotional factors. Selection effects are held to be important and some of the emotional changes will vary at different phases of a chronic disorder. A new symptom may initially cause anxiety but when a condition persists some patients will be increasingly concerned or depressed whilst others develop tolerance for the situation.

The Crown-Crisp Experiential Index in patients complaining of tinnitus.

The Crown-Crisp Experiential Index (CCEI) was administered to 472 patients complaining of tinnitus who took part in a multi-centre study on tinnitus masking (Hazell et al., 1985). This inventory includes scales of anxiety, phobic anxiety, obsessionality, somatic anxiety, depression and hysteria. The scores on the CCEI scales for patients with and without 'dizziness' as an additional symptom were compared. In the non-dizzy patients, scores on the anxiety and depression scales were consistently elevated compared with the published normative values. In the dizzy patients scores on all scales except Hysteria were elevated. The most pronounced and consistent difference between the dizzy and non-dizzy patients was in the Somatic Anxiety scale. The presence of dizziness also obscured the relationship between the CCEI scales and measures of tinnitus. In contrast, however, hearing disability did not appear to influence the results.

Do patients like psychometric testing by computer?

Programmed a micro-computer to administer and score the Crown-Crisp Experiential Index (CCEI) (Crown & Crisp, 1979) for a study of the psychological state of 59 newly delivered mothers. This publication reports the findings of a separate paper-and-pencil questionnaire assessment of the patients' attitudes to the computer itself. The 59 patients were almost unanimous in finding the computer acceptable and easy to use; only 1 S minded using it. None found the instructions difficult to understand, and only 1 had difficulty in reading them. Only 2 would object to using the computer again.

MYOCARDIAL INFARCTION AND THE EMOTIONAL CLIMATE

Within the general population people destined for myocardial infarction are found to be more obsessional and greater worriers than others. Moreover, in the year before their infarction they display high levels of sadness, anxiety-related symptoms, loss of libido, and fatigue, unrelated to angina and other physical discomforts. They also claim, more so than others, to have no fear of having an incurable illness. Derived optimum weightings to responses to items in the Crown-Crisp Experiential Index permit the development of a simple scoring system which in the present study allows a two-thirds correct identification of those due for imminent infarction and an overall 81·5% correct classification of infarct/non-infarct cases. This apparent capacity of the instrument now needs to be tested in a prospective study. In the year after infarction survivors in the present study show very high levels of dysphoria and social withdrawal.

Classification of depressive illness: Clinico-psychological correlates

347 patients with primary depressive illness were studied. Patients were classified on the Newcastle Diagnostic Scale and their depression was rated on the Hamilton Rating Scale for Depression (HRS) and self-rated on the Beck Depression Inventory (BDI). Clinical and personality factors were studied in relation to classification. Personality was measured by the Eysenck Personality Questionnaire, Fould's Personality Deviance Scale, the Marke-Nyman Temperament Scale and the Crown-Crisp Experiential Index. The frequency distribution of the Newcastle scores of all 347 patients was unequivocally unimodal. Significant positive correlations were obtained between patients' Newcastle scores, age, and HRS scores but not with BDI scores. Patients with non-endogenous depression showed clinical and personality differences compared with those with endogenous depression, and with a group of bipolar depressives.

Factor analysis and reliability studies of the Crown-Crisp Experiential Index (CCEI).

Factor analysis of the Crown-Crisp Experiential Index (CCEI) is described. Two groups took part in the study; one from a working population (n = 8292) and one from clients attending three Employment Rehabilitation Centres (n = 281). Comparison of the factors obtained from these two groups, and between these and the original CCEI subscales, are reported, together with estimates of reliability. Overall, the results point to the retention of the CCEI as a reliable instrument for measuring psychoneurotic illness.

Is the temporo-mandibular pain and dysfunction syndrome a disorder of the mind?

It was assumed that patients with temporo-mandibular pain and dysfunction syndrome (TMPDS) would represent a population whose pain resulted from their emotional state. It was anticipated in the light of existing reports in the literature that they would score like patients with anxiety neurosis or other psychiatric illness on the General Health Questionnaire (GHQ) and the Crown-Crisp Experiential Index (CCEI: a measure of anxiety and other emotional characteristics). It was also anticipated that patients with facial pain associated with lesions would show evidence of similar emotional disturbance secondary to their pain. It was postulated, however, that the TMPDS patients would be separated from the others by a scale which measured their attitudes to parents and childhood experience, namely, the Parental Bonding Instrument (PBI). The actual comparison of TMPDS patients and patients with facial pain and lesions or pathophysiological disorders showed little evidence of neuroticism in either group; nor were the parental bonding attitudes found to be abnormal. It is questioned whether TMPDS is primarily psychological in origin.

What does the MMPI dependency scale really measure?

Examined the mean DY score of various clinical and nonclinical groups (N = 855). It was significantly higher for females, whether patients or nonpatients; nonpatients with a high total score and high scores on several subscales of the Crown Crisp Experiential Index of neurotic symptomatology; psychiatric patients in general; patients and nonpatients with a high modified Zung depression score; neurotic as opposed to endogenous depressives; suicide attemptors, especially non-serious ones; Ss with early bereavement or separation particularly if followed by poor replacement care; Ss with poor quality marriages and husband dominant marriages as measured by the Ryle Marital Patterns Test. The DY Scale relates directly with the PT and D Scales and inversely with the Do Scale. Separation of the test items into those that were and were not predominantly depressive revealed that most, though not all, significant associations were due to the depressive component, which it was suggested should be markedly diminished.

Anorexia nervosa: some observations on "dieters" and "vomiters", cholesterol and carotene.

Twenty consecutive cases of anorexia nervosa admitted to a general medical ward were found to consist of ten who reduced weight by means of dieting and ten who in addition employed self-induced vomiting. Clinical and biochemical differences between "dieters' and "vomiters' were less pronounced than those reported elsewhere. However, the "vomiters' had higher scores on the anxiety, somatic and depression subscales of the Crown-Crisp Experiential Index and lower serum carotene concentrations. The implications of these findings are discussed.

The Crown-Crisp Experiential Index (CCEI) profile in Anorexia Nervosa.

Patients with anorexia nervosa show a decrease in psychoneurotic symptomatology as measured by the Crown-Crisp Experiential Index (CCEI) as their clinical status improves. Those who remain ill continue to display a moderate degree of varied psychopathology 4 to 8 years after their presentation. Vomiters and those with anxiety on eating with others can be distinguished on the CCEI from those without such features. Lower anxiety, phobia, obsessional and somatic scores at presentation are predictive of good outcome in terms of weight and menstrual function 4 to 8 years later.