Debra J. Vandervoort

Relationships Between The Underlying Constructs Of The Beck Depression Inventory And The Center For Epidemiological Studies Depression Scale

This study examines the relationships between the constructs of depression as measured by the Center for Epidemiological Studies Depression Scale (CES-D) and the revised Beck Depression Inventory (BDI) in a sample of 261 college students. The two scales were found to have a moderately high correlation and a similar pattern of relationships to measures of anxiety, hostility, self-esteem, hypochondriasis, and locus of control. However, the relations between the subscales and the factor structure of the subscales derived from both instruments suggest that the BDI and CES-D measure different aspects of depression despite sharing some symptoms. Therefore, the authors argue that the BDI and CES-D should not be used interchangeably. The results are discussed in terms of the applicability of the two measures of depression for use with nonclinical populations.

Depression, anxiety, hostility, and physical health

This study assessed the relationship of depression, anxiety, and hostility to physical health in a multicultural student population (N=106). When controlling for a variety of demographic and health risk factors (viz., age, sex, body mass, smoking, alcohol, salt, caffeine, and exercise), hostility, depression, and anxiety were related to higher reported incidences of physical symptoms and somatic illness. Depression and hostility had the strongest relationships with physical health, although the most striking single relationship was between depression and illness. Results suggest that it may be premature to focus our attention on hostility in research on the personality-illness relationship. They also suggest that the health behavior model of the relationship between personality and disease does not provide an adequate explanation, since negative affect was significantly associated with illness even when controlling for a variety of health risk factors.

EXPRESSED AND SUPPRESSED ANGER AND HEALTH PROBLEMS AMONG TRANSIT WORKERS

The present study assessed the relationship between anger expression and health outcomes in a sample of 1,407 San Francisco bus drivers. When controlling for a variety of health-risk factors, the results of multiple logistic regression analyses revealed significant positive associations between high levels of suppressed as well as expressed anger and gastrointestinal, respiratory, and musculoskeletal problems, with one exception (viz., the relationship between expressed anger and gastrointestinal problems was only marginally significant [p = .09]). Although both modes of anger expression were related to these health problems for men, none of the associations were significant for women. The results do not support the view that suppressed anger is more detrimental to health than expressed anger but rather suggest that both modes of coping with anger may increase vulnerability to disease in men.

Physical health and social network characteristics as determinants of mental health across cultures

This study examines cross-cultural differences in the etiology of depression and anxiety, two common indicators of mental health problems. Using an ethnically diverse sample of 162 college students, we found that chronic physical symptoms and social network characteristics, particularly network quality, were predictive of both depression and anxiety, yet their effects were mediated by ethnicity. Multiple regression analyses showed that social network quality, compared to physical health, was a much stronger predictor of mental health in Caucasian students, whereas among students of Asian/Pacific descent, physical health was a much stronger predictor of mental health than the social network characteristics. The observed differences were particularly strong for anxiety, which was not significantly associated with physical health in Caucasian students or social network size and quality in the Asian/Pacific group. Theoretical and clinical implications of the results are discussed.

Belief systems and coping styles as mediating variables in the relationship between hostility and illness

The present study investigated the relationship between hostility, belief systems, coping styles, and illness. Hostility is of interest when considering the stress-illness relationship because it has been associated with increased risk for coronary heart disease as well as general mortality. The results suggest that individuals prone toward hostility are more likely to succumb to illness and adhere to irrational beliefs than individuals not so oriented. In addition, hostile individuals were found to employ different, and perhaps less adaptive, coping styles than their low hostility counterparts. It was concluded that the belief systems and coping styles typically employed by individuals prone toward hostility may be important mediating variables in the relationship between hostility and illness. These factors may also be important to take into account in treatment programs designed to reduce illness risks for such individuals. Finally, this study suggests that stress-induced impairment of health for hostility-prone individuals may begin much earlier than the vast majority of the literature currently suggests.

Posttraumatic Relationship Syndrome A Case Illustration

This case study describes the treatment of an individual with Posttraumatic Relationship Syndrome (PTRS), a newly proposed mental health syndrome that occurs subsequent to the experience of trauma in an intimate relationship. It includes the intrusive and arousal symptoms of Posttraumatic Stress Disorder (PTSD) but lacks the avoidance symptoms required for a diagnosis of PTSD due to a very different mode of coping with the traumatized state from that which is characteristic of individuals with PTSD. It also includes a category of relational symptoms that, of course, are not part of PTSD because the trauma it addresses does not have to occur in the context of an emotionally intimate relationship, as in PTRS. The treatment model developed and successfully implemented by the authors is described along with the posttraumatic growth the client achieved.

Posttraumatic Relationship Syndrome: A Treatment Model

Abstract A treatment protocol for a newly proposed diagnosis called Posttraumatic Relationship Syndrome (PTRS) is outlined. As one of the most salient ways in which PTRS differs from Post-Traumatic Stress Disorder (PTSD) is that the former lacks the numbing of affect that the latter includes, treatment accordingly differs. Four stages of treatment are described, namely: (1) Understanding, normalization, and desensitization (which focuses on coping with the initial traumatized state); (2) Reflection and acceptance (which focuses on processing the trauma); (3) Integration of the trauma into the self-concept; and (4) Empowerment and growth. The treatment approach emphasizes that traumatic relationships can not only be survived, but post traumatic growth can, and indeed, often does occur.

Health and a residential care population

This article describes the health status of 234 severely mentally ill (SMI) persons residing in Californias supervised residential care facilities in 1973. Relocated in 1983, 63.2% reported their health as good to excellent. Over the follow-up period 80.8% maintained their SSI benefits, insuring them of health insurance coverage. Surprisingly the follow-up sample, believed to be at high risk of increased physical morbidity, compared quite favorably to low income subsamples of the National Health Interview Survey (NHIS). The SMI reported better health, access to and utilization of health services. Differences were particularly striking in the poor health category with NHIS respondents reporting poor health 3.5 times more frequently than SMI sample numbers. These results offer some support for the contribution of health insurance benefits and supervised residential settings to positive health outcomes of this vulnerable population.