Individual Psychological Factors Research Articles

Genetics of nicotine and tobacco dependency

The prevalence of smoking in our society is subject to many social influences. Heavy and regular smoking and the development of nicotine dependence, however, are determined not only by social factors but also by individual psychological and biological factors. Recent epidemiological and molecular genetic studies have provided evidence that nicotine dependence is, at least partially, genetically determined. Regular smoking and more particularly heavy smoking have been attributed with a high probability to genetic factors. The development of nicotine dependence results from the direct effect of nicotine on nicotinergic acetylcholine receptors, and perhaps more importantly, the dopaminergic transmitter system. The nucleus accumbens, an important part of the dopaminergic reward system, appears to play a particularly important role in nicotine dependence. A possibly relevant genetic variability in the dopaminergic system was found in the D2 dopamine receptor gene (DRD2) of alcoholics and heavy smokers. Animal studies have shown that variations in the structure of the nicotinergic acetylcholine receptor might interfere with the development of nicotine dependence. Other possible candidate genes for receptors in the serotonergic, adrenergic and dopaminergic system are being examined as potential contributors to the development of nicotine or tobacco dependence. Furthermore, reduced metabolism of nicotine into cotinine may also reduce risk for nicotine dependence. Although current research findings cannot fully explain how nicotine or tobacco dependence develops, it has advanced understanding of dependence disorders.

Do psychological factors increase the risk for back pain in the general population in both a cross-sectional and prospective analysis?

This study aimed to conduct a comprehensive evaluation of background, individual and workplace psychological risk factors to investigated their relationship with spinal pain. Because there is some doubt as to whether the results of cross-sectional findings hold in longitudinal studies, a prospective study was superimposed upon a cross-sectional design of the effects of psychological variables on back pain and function to determine, whether similar results are obtained. Participants were workers randomly selected from the general population, where 372 had not experienced pain during the past year, and 209 had experienced considerable pain problems. A cross-sectional comparison of these groups using multivariate statistics indicated that the most potent risk factors were psychological distress (odds ratio = 13.2) and poor function (odds ratio = 6.4). Much smaller levels of risk were found for perceived workload, gender and foreign birth. Those participants with no pain were followed for one year to determine development of a spinal pain problem. Although few participants developed a significant pain problem, the prospective analyses showed that psychological distress (odds ratio = 2.2), catastrophizing (odds ratio = 3.0), and workload (odds ratio = 2.3) produced the highest odds ratios. Taken together these results underscore the need for a multidimensional view of the development of pain disability. Moreover, individual psychological factors such as distress and catastrophizing as well as work place factors like work load were found to be highly related to the development of back pain in a sample of workers from the general population. The cross-sectional and prospective results were similar in character and demonstrate that cross-sectional studies may provide valuable information. Because psychological variables were relevant very early on, these factors may be important targets for pain prevention programs.

Insights into causal pathways for ischemic heart disease: adverse childhood experiences study.

The purpose of this study was to assess the relation of adverse childhood experiences (ACEs), including abuse, neglect, and household dysfunction, to the risk of ischemic heart disease (IHD) and to examine the mediating impact on this relation of both traditional IHD risk factors and psychological factors that are associated with ACEs. Retrospective cohort survey data were collected from 17,337 adult health plan members from 1995 to 1997. Logistic regression adjusted for age, sex, race, and education was used to estimate the strength of the ACE-IHD relation and the mediating impact of IHD risk factors in this relation. Nine of 10 categories of ACEs significantly increased the risk of IHD by 1.3- to 1.7-fold versus persons with no ACEs. The adjusted odds ratios for IHD among persons with > or =7 ACEs was 3.6 (95% CI, 2.4 to 5.3). The ACE-IHD relation was mediated more strongly by individual psychological risk factors commonly associated with ACEs than by traditional IHD risk factors. We observed significant association between increased likelihood of reported IHD (adjusted ORs) and depressed affect (2.1, 1.9 to 2.4) and anger (2.5, 2.1 to 3.0) as well as traditional risk factors (smoking, physical inactivity, obesity, diabetes and hypertension), with ORs ranging from 1.2 to 2.7. We found a dose-response relation of ACEs to IHD and a relation between almost all individual ACEs and IHD. Psychological factors appear to be more important than traditional risk factors in mediating the relation of ACEs to the risk of IHD. These findings provide further insights into the potential pathways by which stressful childhood experiences may increase the risk of IHD in adulthood.

Promoting mental health in students: is there a role for sleep?

Independently both the role of being a student and reporting insufficient or unsatisfactory sleep have been shown to have deleterious consequences on mental health. However, few studies have examined the combined relationship between students' sleep patterns specifically with mental health in mind, and how individual psychological characteristics and situational factors can influence this relationship. The purpose of this research was to examine the relationship between sleep functioning and students' levels of perceived stress over the course of an exam period. Additionally, the influence of perfectionism (as an individual characteristic) and daytime sleep-related intrusive thoughts (sleep catastrophising) on sleep functioning and stress were also examined. Two assumptions were tested. Firstly, that stress would increase between baseline and the morning of the exam and secondly, that this relationship would be moderated by poor sleep functioning, sleep catastrophising and levels of perfectionism. Levels of stress, sleep functioning and sleep catastrophising were examined over a seven-day period in 48 Access to Higher Education students about to take an exam and 44 non-exam taking controls. For the exam group, levels of stress and sleep catastrophising increased between time-points. At baseline higher reported perfectionism predicted stress scores. Conversely, low perfectionism predicted high stress on the morning of the exam. Additionally, going to bed later and high levels of sleep catastrophising were also related to stress levels the morning of the exam. The results suggest an association between perfectionism and pre-exam stress, and are discussed in terms of mental health promotion for higher education students.

A conceptual model of the fashion process – part 1

The purpose of this paper is to present a new framework to conceptualise the fashion process called “the fashion transformation process model”. This model integrates much previous research about the fashion process, fills important gaps that the symbolic interactionist (SI) theory of fashion omits, and makes a number of new predictions about the translation of social trends into specific lifestyles and individual differences. Those new emerging lifestyles are interpreted by fashion designers into fashion concepts and then translated into fashion commodities. The model proposes two important fashion forces: the “differentiating force” and the “socialising force”. These operate at different levels (macro and micro) and through different fashion practitioners. Two empirical studies investigate the framework: a case study at the macro level and a survey interview study at the micro level. The studies provide excellent support for the reconceptualisation and, in particular, suggest that individual psychological factors might be given a new prominence in the overall fashion process and the way in which new fashions emerge.

The Influence of Socioeconomic and Psychological Factors on Patient Adherence to Self-Management Strategies

Patient adherence to self-management strategies is a major issue in asthma, as in other chronic diseases. Adherence should not be defined exclusively in terms of medication use, but the more behavioral aspects of self-management such as avoidance of aggravating factors and risk behaviors, disease monitoring, alterations in therapy according to level of disease control and initiating emergency action when required, need to be considered. There are different forms of non-adherence and many patients undertake some form of cost-benefit analysis with respect to treatment. Furthermore, adherence is not an ‘all or none’ phenomenon and the level of adherence may vary between different aspects of management of a condition and over time. While asthma self-management strategies are undoubtedly effective, many patients make serious self-management errors during an attack and do not put into practice the self-management knowledge they possess. In asthma, adverse social, economic and psychological factors are common and these may have detrimental effects on self-management at different levels; health seeking behavior, in terms of the ability to benefit from self-management education, adherence to self-management strategies and in the ability to self-manage exacerbations of asthma. These adverse factors vary between patients and their influence may be subtle and insidious. Although a seemingly fundamental requirement for self-management, not all patients want an active role in disease management. The patient’s willingness to participate needs to be assessed and strategies adapted accordingly. Because of the variety of adverse influences, all strategies to improve adherence need to be individualized. Provision of appropriate pharmaceuticals and good quality ongoing medical care are necessary prerequisites to any self-management strategies. It is important for the healthcare professionals involved to recognize and taken into account, but not necessarily solve, the individual adverse social, economic and psychological factors when providing advice. An ongoing therapeutic alliance needs to be established between the patient and the healthcare professional; ‘the clinician as a good listener and teacher’. This involves ascertaining the patients concerns about their illness and its management, and addressing these issues. Self-management education (and self-management generally) needs to ascribe to the five R’s: Relevant to the individual, Realistic goals, Readily available, Reinforced and Refined over time. Optimal use needs to be made of the ‘teachable moment’ and involvement of a wide range of persons in management (including peers) needs to be considered. While the self-management strategies need to be individualized, they can be augmented by generic material.

Resistance to organisational change: the role of defence mechanisms

Observes that the published literature on resistance to organisational change has focused more on organisational issues rather than individual psychological factors. The present study investigated the role of both adaptive and maladaptive defence mechanisms in individual resistance. Surveys were conducted in nine organisations undergoing major change and responses were obtained from 615 employees. The results indicate that five maladaptive defence mechanisms are positively correlated with behavioural intention to resist change, namely, projection, acting out, isolation of affect, dissociation and denial. The adaptive defence mechanism of humour was found to be negatively correlated with resistance intention. Identifies two intervention strategies which can be used by management to address the effects of defence mechanisms on resistance during periods of change in organisations.

Factors related to quality of life in breast cancer patients receiving chemotherapy.

This descriptive correlation study investigated the relationship among individual characteristics, disease characteristics, psychological factors (anxiety, depression, self-esteem), social support, and quality of life in patients with breast cancer receiving chemotherapy. One hundred and fifty women from nine Taipei area hospitals were surveyed with a structured questionnaire. The total quality of life index for breast cancer patients was about average (M = 19.88). The family factor scored highest for importance and satisfaction with quality of life. Patients showed the most dissatisfaction with the health factor. Of the individual characteristics affecting patient quality of life, number of children and social status were statistically significant (p < .05). Of the disease characteristics, the stage of the disease, the commencement of chemotherapy, and the number of chemotherapy treatments were statistically significant (p < .05). The psychological factors were significantly related to patients' quality of life (p < .05). Social support of both relatives and health professionals was significantly related to patients' quality of life (p < .01). Of the four independent variables (individual characteristics, disease characteristics, psychological factors and social support), the most influential factor affecting breast cancer patients' total quality of life was the psychological factor of self-esteem (p < .001). The findings can assist nurses to plan and improve the quality of breast cancer care in terms of understanding the factors affecting patients' quality of life.

Socioeconomic status and health: what we know and what we don't.

In the past 15 years, we have seen a marked increase in research on socioeconomic status (SES) and health. Research in the first part of this era examined the nature of the relationship of SES and health, revealing a graded association; SES is important to health not only for those in poverty, but at all levels of SES. On average, the more advantaged individuals are, the better their health. In this paper we examine the data regarding the SES-health gradient, addressing causal direction, generalizability across populations and diseases, and associations with health for different indicators of SES. In the most recent era, researchers are increasingly exploring the mechanisms by which SES exerts an influence on health. There are multiple pathways by which SES determines health; a comprehensive analysis must include macroeconomic contexts and social factors as well as more immediate social environments, individual psychological and behavioral factors, and biological predispositions and processes.

IS IT MILK ALLERGY OR LACTOSE INTOLERANCE?

The terms allergy and intolerance are often used interchangeably in referring to adverse reactions to foods. Strictly speaking, allergy denotes a hypersensitivity reaction, i.e., a reaction that is immunologically mediated. Intolerance on the other hand is a general, nonspecific term meaning inability to withstand. In the case of cow's milk (CM), intolerance is mostly due to inadequate digestion often of the milk sugar lactose and occasionally of its fat. It also can be caused by defective metabolism of specific milk constituents in certain inborn errors of metabolism, such as phenylketonuria and galactosemia. Other forms of intolerance, with varying symptoms, can be related to individual psychological factors or to aversion. Numerous health hazards of milk have been addressed elsewhere. 17 This article limits discussion to the most common two adverse reactions to milk that are frequently and interchangeably misdiagnosed, namely cow milk allergy (CMA) and lactose intolerance (LI).

Understanding adverse events: human factors.

(1) Human rather than technical failures now represent the greatest threat to complex and potentially hazardous systems. This includes healthcare systems. (2) Managing the human risks will never be 100% effective. Human fallibility can be moderated, but it cannot be eliminated. (3) Different error types have different underlying mechanisms, occur in different parts of the organisation, and require different methods of risk management. The basic distinctions are between: Slips, lapses, trips, and fumbles (execution failures) and mistakes (planning or problem solving failures). Mistakes are divided into rule based mistakes and knowledge based mistakes. Errors (information-handling problems) and violations (motivational problems) Active versus latent failures. Active failures are committed by those in direct contact with the patient, latent failures arise in organisational and managerial spheres and their adverse effects may take a long time to become evident. (4) Safety significant errors occur at all levels of the system, not just at the sharp end. Decisions made in the upper echelons of the organisation create the conditions in the workplace that subsequently promote individual errors and violations. Latent failures are present long before an accident and are hence prime candidates for principled risk management. (5) Measures that involve sanctions and exhortations (that is, moralistic measures directed to those at the sharp end) have only very limited effectiveness, especially so in the case of highly trained professionals. (6) Human factors problems are a product of a chain of causes in which the individual psychological factors (that is, momentary inattention, forgetting, etc) are the last and least manageable links. Attentional "capture" (preoccupation or distraction) is a necessary condition for the commission of slips and lapses. Yet, its occurrence is almost impossible to predict or control effectively. The same is true of the factors associated with forgetting. States of mind contributing to error are thus extremely difficult to manage; they can happen to the best of people at any time. (7) People do not act in isolation. Their behaviour is shaped by circumstances. The same is true for errors and violations. The likelihood of an unsafe act being committed is heavily influenced by the nature of the task and by the local workplace conditions. These, in turn, are the product of "upstream" organisational factors. Great gains in safety can ve achieved through relatively small modifications of equipment and workplaces. (8) Automation and increasing advanced equipment do not cure human factors problems, they merely relocate them. In contrast, training people to work effectively in teams costs little, but has achieved significant enhancements of human performance in aviation. (9) Effective risk management depends critically on a confidential and preferable anonymous incident monitoring system that records the individual, task, situational, and organisational factors associated with incidents and near misses. (10) Effective risk management means the simultaneous and targeted deployment of limited remedial resources at different levels of the system: the individual or team, the task, the situation, and the organisation as a whole.

Patient-controlled analgesia for sickle-cell-related pain

To delineate dose ranges, utilization patterns, and the frequency and types of problems encountered, we retrospectively reviewed the medical records of 46 patients with sickle hemoglobinopathies who used patient-controlled analgesia (PCA) a total of 92 times for the management of vasoocclusive pain. Patients varied widely in the drug administered, use of basal infusion, individual dose, and total amount of drug received. On the day of heaviest use, the average maximum hourly dose was equivalent to 0.09 mg/kg of morphine. In this study, 11 patients and two families disliked PCA, one patient had respiratory compromise, and one patient tampered with the machine. Patient satisfaction with PCA probably reflects interactions among the psychosocial impact of chronic illness and chronic pain, individual psychological and temperamental factors, environmental contingencies, and the expectations and beliefs of the family and the health-care professionals. Based on this experience, recommendations can be proposed for the use of PCA in this condition.

Disability Exaggeration as a Predictor of Functional Restoration Outcomes for Patients with Chronic Low-Back Pain

Many of the individual biological, psychological, and social factors attributed to low-back disability have been tested previously for their ability to predict treatment outcomes. To test the assumption that disability exaggeration affects treatment outcomes, models were developed to quantify this complex characteristic and to test its predictive value. Two hundred fifty-eight patients with chronic back disability entering a program of functional restoration were initially evaluated with a battery of tests, including measurements of trunk flexibility, lifting capacity, cycling endurance, self-assessments of pain and disability, and psychological attributes. On the basis of these measurements, patients were characterized as disability exaggerators if by peer comparison their self-assessments of pain and disability were in the most severe range despite high levels of physical capacity. Program completion and work status 1 and 2 years after treatment were compared between disability exaggerators and their peers. Individual initial attributes associated with program completion included pain intensity and Million Visual Analogue scores, lifting capacity, trunk flexibility, some Minnesota Multiphasic Personality Inventory and Million Behavioral Health Inventory scales, and cigarette smoking. One-year re-employment was associated with Minnesota Multiphasic Personality Inventory Scale 8, Wechsler Adult Intelligence Score-Revised, and cycling endurance. There were no significant associations between any individual factor and 2-year work status. Only two of the 12 disability exaggeration models distinguished between program graduates and dropouts, and none of the models accurately predicted return to work following treatment. Prescription of intensive multidisciplinary treatment should not be denied on the basis of any individual patient attribute or of disability exaggeration, as measured in this study.(ABSTRACT TRUNCATED AT 250 WORDS)

Fasting girls: the emergence of anorexia nervosa as a modern disease

Anorexia nervosa may affect as many as five to ten percent of adolescent in the United States, and on some college campuses, the estimate is as high as twenty percent. Despite its recent popularity, however, the disease remains puzzling in its causes and stubbornly resistant to a cure. For, as Fasting Girls demonstrates, anorexia nervosa existed long before our current preoccupation with lean bodies. This landmark, award-winning work offers a solution to the mystery of anorexia nervosa, exploring its historical roots from the saints of the Middle Ages and the curious fasting girls of the Victorian era to the weight-obsessed celebrities of our own time. By linking broad cultural forces to individual biomedical and psychological factors, Fasting Girls shows how a society that believes a woman can never be too rich or too actually recruits certain adolescents to anorexia -- those who regard a thin body as a state of perfection. Combined with other social stresses, such an attitude puts an increasing number of contemporary young women at risk. Highly readable and authoritative, Fasting Girls takes the reader into the private world of sufferers in the past, and also shows today's health professionals and parents why America's young women are so vulnerable to anorexia, and what treatments have proven effective in combating this frequently misunderstood, often deadly, disorder.

A study of homicide: the validity of predictive test factors.

This study is a retrospective comparison of the psychological test findings within four groups, including 61 murderers, 42 assaulters, 71 perpetrators of theft, and 24 unemployed non-criminal controls. Psychological test findings did not discriminate very well among these groups. Some purported hostility scales, such as the Elizur Hostility Scale, the DeVos Hostility Scale, and Megargee's Overcontrolled-Hostility Scale, did not discriminate at all. The 16 Personality-Factor Questionnaire was particularly unhelpful, rating all four groups as having above-average emotional stability, One must conclude that individual psychological test factors are of little value in predicting violent behaviour. Further research is being undertaken to separate the murder group into motivational sub-categories.

Jaw muscle fatigue and pains induced by experimental tooth clenching: a review.

Maximal voluntary isometric contractions of the elevator jaw muscles, with the mandible in the position of maximal intercuspation of the natural teeth, can induce fatigue and weak as well as severe pains in the jaw muscles of children and adults. A subjective sensation of muscle fatigue appears after about 0.5 min of clenching, and it seems as if the psychological parameter of fatigue onset to a large, but unknown, extent is determined by the physiological parameter of the amount of isometric contractile activity, and perhaps also the original strength of the muscle; however, also individual psychological factors seem to play a role. Pains in the elevator jaw muscles appear after about 1 min of clenching. Although isometric contractions are necessary to cause onset of jaw muscle pains, it is conceivable that perception of the moment of onset of pains to a large, but unknown, extent depends on psychological factors, perhaps the intensity of pains; however, also physiological factors may play a role. The severe muscle pains and gradually increasing subjective exhaustion of the elevator jaw muscles can be endured for about 2 min of maximal voluntary tooth clenching. It is suggested that the psychological parameter of muscle endurance to a large, but unknown, extent depends on the physiological parameter of isometric contractile activity but also individual psychological factors seem to play a role.

Taux de croissance démographique et développement économique en Afrique noire

Mortality rates have sharply decreased in Africa during the past 2 decades. Such phenomenon has been accompanied by an increase in birth rates due not only to decreased mortality, but to the disappearance of infertility causes, to urbanization, which eliminates many sexual taboos, and to increased monogamy, which produces more chidlren than poligamy. The ideal family size desired has also decreased since, in a modern society, children are no longer seen as income producing but as income consuming agents. The use of contraception in Africa is secondary to 2 conditions, i.e. information and motivation. If information is easily obtained through the mass media, motivation depends not only on individual psychological factors, but on global social factors, the most important of which is economic development; without increased incomes there will be no widespread acceptance of contraception, since increased income involves almost automatically a change in values, from traditional ones, to modern ones. Improvement in the educational level of the population would hasten the process.

Clinical assessment of intrafamilial violence.

A common problem in clinical practice with cases of intrafamilial violence is incomplete assessments and, therefore, treatment interventions based on incomplete data. The problem is not surprising since the literature in the field is complex, multidisciplinary, unintegrated, and rarely comprehensive. In this article the author integrates theory and research on violence in families into five areas that need to be evaluated for a complete clinical assessment. Those five areas include physiological-medical factors, individual psychological factors, current interpersonal-familial factors, cultural and family-background factors, and level of life stress and available resources. Those factors must also be considered when a method of intervention is selected. In the article following this one, the author outlines stages of intervention in cases of intrafamilial violence.

The Mental Illness of Hung Hsiu-Ch'uan, Leader of the Taiping Rebellion

The evolution of China into a modern nation-state has seen few episodes more meaningful than the Taiping Rebellion occurring in the latter half of the last century. In the leader of this rebellion, Hung Hsiu-ch'uan, there is much that is of special interest to the sociologist and the psychiatrist. In the origin of this vast movement can be seen the great importance of individualpsychological factors which elevate a leader and help to precipitate a revolutionary social transformation—for Hung is known to have suffered an acute mental disturbance which undoubtedly moulded his destiny. The rebellion has been interpreted variously as a peasant uprising against official corruption, a protest against intolerable economic distress, or simply a nationalistic revolt against the Manchu dynasty. Be that as it may, there is general agreement that it was a movement unique in Chinese history because it instituted a radical change in the political system which existed for more than two thousand years, and brought about economic, social, cultural, and religious reforms over the greater part of Central and South China between 1851 and 1864.