Anthony F. Greene

Negative affect and the experience of chronic pain

Although it is clear from previous research that pain is associated with negative affect, the relative contribution of specific affective dimensions, e.g. depression, anxiety and anger, to the subjective experience of chronic pain is unclear. The literature is also mixed concerning the relative importance of state versus trait influences in the experience of chronic pain. The present study analyzed the ability of anxiety, anger, and depression (as measured by the State-Trait Personality Inventory, State-Trait Anger Expression Inventory, and the Beck Depression Inventory, respectively) to predict self-report of clinical pain as indicated by the McGill Pain Questionnaire (MPQ) in a sample of 60 chronic pain patients. The results of stepwise regression analyses consistently demonstrated that the state measures were more strongly related to MPQ pain ratings than trait measures. These data suggest support for the hypothesis that chronic pain adversely impacts mood rather than the opposing hypothesis that negative mood is a predisposing factor in the development of chronic pain. Furthermore, different aspects of the state emotional experience were found to be related to different components of pain report. The results of this study also suggest that attributional processes could be an important component of the relationship between negative mood and the experience of pain.

Psychopathology and anger in interpersonal violence offenders

The current literature on psychopathology and anger suggests that both contribute to interpersonal violence. The present study examined psychopathology and anger expression with two objectives: to confirm previous distinctions of personality type among abusive individuals and to examine the relation between these types and anger. Cluster analysis was conducted with data gathered from 40 subjects. Results suggested confirmation of four clusters of interpersonal violence offenders. Furthermore, the most pathological cluster type reported the highest level of total anger experience, while the histrionic cluster type reported the lowest anger expression. These results provide tentative support for a positive relationship between psychopathology and anger, as well as for the distinction between overcontrolled and under-controlled anger as subtypes of interpersonal violence offenders.

Effects of age and gender on the relationship between anxiety and coronary artery disease.

&NA; This study investigated the relationship between anxiety and coronary artery disease (CAD). State (S‐ANX) and trait (T‐ANX) anxiety were assessed with the State‐Trait Personality Inventory (STPI), which was administered to 373 patients (230 males, 143 females) 12 to 18 hr prior to their undergoing coronary arteriography. Females were significantly higher than males in both T‐ANX (p less than 0.05) and S‐ANX (p less than 0.01). Younger patients of both sexes were significantly higher in S‐ANX (p less than 0.001), but no relationship was found between T‐ANX and age. Patients with CAD did not differ in S‐ANX from those without CAD. T‐ANX scores of female patients were unrelated to MI or CAD. Male patients with chest pain only (CPO) were higher in T‐ANX than males with prior myocardial infarction or chest pain plus CAD (p less than 0.01). Although this difference was not significant for older males (p less than 0.31), younger CPO males were significantly higher in T‐ANX than the other clinical groups (p less than 0.05). These results were interpreted as indicating that high T‐ANX is not associated with CAD, but is a risk factor for angiography, especially for younger males.

Predicting quality of life with a pretransplantation assessment battery: A prospective study of cardiac recipients

This study provides descriptive data on the prevalence of symptoms and quality of life of cardiac transplantation recipients and tests the predictive validity of a pre-cardiac transplantation psychological assessment battery on posttransplantation quality of life. Following the formation of four cluster groups of pretransplantation MMPI profiles based on previous research, frequency analysis found that the cluster groups were not equally represented among cardiac recipients, such that the “Distressed/Confused” cluster had only one recipient member. Tests of significance among the three remaining cluster groups on the posttransplantation quality of life variables found no significant differences. Regression analyses to test the predictive validity of other pretransplantation medical and psychological variables indicated that trait anxiety was a significant predictor of increased symptom frequency and symptom problems and decreased mental health among recipients. Collectively, modest support was found for the use of pretransplantation psychological variables as predictors of posttransplantation quality of life. Interpretation of psychological test data in the context of other psychosocial variables is discussed.

A psychobiological theoretical characterization of interpersonal violence offenders

The current literature suggests that anger and violent behavior have multiple psychobiological and sociocultural determinants. However, due to methodological or ethical constraints, our ability to accurately predict or influence the manifestations of interpersonal violence is very limited. Recent reports in the domestic violence literature suggest that there may be specific subtypes of offenders, and the clarification of these subtypes may improve our ability to predict and intervene. Following a brief review of the major psychobiological theories of violence, four putative psychopathological types of offenders are described, and hypotheses are generated as to the relative contributions of underlying determinants. These speculative characterizations may provide a clearer heuristic for further investigations.

Psychopathology and History of Sexual Abuse

Minnesota Multiphasic Personality Inventories (MMPI-1) were used to compare the personality characteristics of a sexually abused ( n = 105) and a matched nonabused sample of clinic patients ( n = 105). Sexual abuse survivors were more frequently characterized by higher scores on the Psychopathic Deviate (4) and Schizophrenia (8) scales, likely representing high levels of interpersonal discord and social alienation. Within the sexually abused sample, more psychopathology was associated with male-to-male abuse, and more social discomfort was evident with abuse onset between ages 6-11 years. The results are discussed in terms of attributional processes associated with the abuse experience and implications for future research.

Current status of psychological research in organ transplantation

Research addressing the psychological concomitants of organ transplantation is reviewed. Specifically, cognitive, behavioral, and psychosocial correlates of kidney, heart, liver, and bone marrow transplantation in both children and adults are discussed. Despite several conceptual and methodological shortcomings of the psychologically-based research in this area, results seem to indicate that organ transplantation is associated with many psychological issues at pretransplantation, posttransplantation, and follow-up periods. Implications of these general findings for the advancing roles of the health psychologist in organ transplantation are discussed.

Construct Validity of the Robson Self-Esteem Questionnaire in a College Sample:

This study examined the construct validity of the multidimensional Robson Self-Esteem Questionnaire (RSEQ). The RSEQ and seven other scales measuring affect and self-esteem-related constructs were completed by 307 undergraduate students. Factor analysis suggested that the RSEQ has three factors, which were labeled Self-Deprecation, Attractiveness, and Self-Respect. Correlations between the RSEQ and related constructs provided strong convergent and discriminant validation that the scale measures self-esteem. Correlations between the factors and the constructs provided moderate support for the independent validity of each of the dimensions.

Preparing Physicians for the 21st Century: Targeting Communication Skills and the Promotion of Health Behavior Change

The prevalence of behavior-related diseases is a predominant concern in the health care profession. Further complicating matters, the biomedical disease model has demonstrated limited effectiveness in treating the consequential array of chronic health conditions. Medical educators have been tasked with developing curricula to better prepare physicians to address the complex health issues of the 21(st) century. A review of empirically supported educational endeavors is essential in planning for future interventions. Prior efforts specific to physician-patient communication and the promotion of health behavior change will be reviewed. Opportunities to enhance medical education by targeting patient-centered care, attitudinal measures, individualized training, and an empirically supported, theoretically based model of change will be presented.

Religious Coping and Heart Transplantation: From Threat to Health

Previous research has established the existence of homogeneous religious coping profiles in cardiac-transplantation candidates labeled as the deferring/collaborators, self-directors, and the eclectic religious copers. However, their prospective impact on outcome has not yet been established. This paper examines potential differences between pre-cardiac transplantation religious coping cluster groups on post-cardiac transplantation quality of life (physical functioning, mental health, and general health). Results indicated that the religious coping profiles of deferring/collaborators and self-directors had significantly better scores on mental health and general health than did the eclectics. Implications for religious-coping research and clinical practice are discussed.