Mary L. Gick

An investigation of the health beliefs and motivations of complementary medicine clients

The current study was concerned with factors associated with the use of complementary medicine (CM). The reasons for CM use were examined by dividing complementary medicine clients into two groups based on the frequency and length of their use of complementary therapies, and comparing them with conventional medicine clients as well as to each other. New/infrequent CM clients (n = 70), established CM clients (n = 71), and orthodox medicine clients (n = 58) were distinguished on the basis of health beliefs, socio-demographic, medical, and personality variables. Different patterns of predictors of CM use emerged depending on which client groups were compared. In general, health-aware behaviors and dissatisfaction with conventional medicine were the best predictors of overall and initial/ infrequent CM use, and more frequent health-aware behaviors were associated with continued CM use. Medical need also influenced the choice to use CM, and was the best predictor of committed CM use, with the established CM clients reporting more health problems than the new/infrequent CM group. Overall, income was a significant discriminator, but did not predict initial or continued CM use. Openness to new experience was associated with CM use in general, but was most notable in the decision to initially try or explore using CM. The findings support the utility of the three components (predisposing, enabling, and need factors) of the socio-behavioral model for explaining why some people choose CM. Overall, the results of the current study suggest that CM clients need to be looked at in more sophisticated ways, rather than being treated simply as a homogenous group with similar beliefs, motivations and needs.

Task complexity and age differences in working memory

This study investigated age-related differences in working memory using a modified version of the Daneman and Carpenter (1980) working memory task. The subjects were required to verify a series of sentences, and then at the end of each series recall the final word of each sentence. Each series varied in length from one to five sentences. Performance on this task was compared with performance in a word-alone condition, in which the subject had to remember an equivalent list of single words but without sentence verification. When sentences of positive grammatical form were used in the sentence-span condition, age differences were no greater than in the word alone condition; however, the age decrement increased when sentences of negative grammatical form were used. There were no interactions between age and pacing or between age and the number of sentences in each set. These results are discussed in relation to theories of age differences in working memory.

Conceptual transfer insimple insight problems

Three experiments explored the conditions under which information presented in the first part of an experiment facilitates the subsequent solving of simple insight problems. We argue that previous unsuccessful attempts to obtain such facilitation are attributable to the experimenters’ failure to present this information in a form that induces the conceptual operations needed to solve the problem. Substantial facilitation is obtained if the information is presented in a form that induces a few seconds of puzzlement and then a clue is presented that leads to an appropriate reconception; if identical information is presented without such a period of puzzlement and reconception, no facilitation is observed. The results demonstrate that conceptual processing operations, not merely informational content, must be relevant if conceptual transfer is to occur. One possible mechanism involved in such transfer is the indexing of concepts such that they contain pointers to conceptually anomalous episodes

Learning from mistakes : Inducing analogous solution failures to a source problem produces later successes in analogical transfer

In 4 experiments we investigated the use of analogical problem solving to facilitate the solution to a problem that usually results in persistent solution failures without hints. The results of Experiments 1-3 indicate that spontaneous transfer was facilitated by a manipulation of the surface form of the source problem that tends to induce initial solution failures analogous to those produced to the target problem. Surface similarity of content words and diagrams had no effect on transfer in Experiments 1-3. In Experiment 4, facilitation of spontaneous transfer was not obtained when source solution failures were prevented. The importance of failed solutions in problem representation and the relationship between problem representation and surface similarity are discussed

Negative affect and the seeking of medical care in university students with irritable bowel syndrome: A preliminary study

In a preliminary study using only self-report measures, university students completed questionnaires about their bowel symptoms and trait anxiety. Results showed that students with irritable bowel syndrome (IBS) reported higher trait anxiety than asymptomatic controls. Among the students with IBS, there were no significant differences in trait anxiety between those who had sought medical care for IBS mostly from a primary care physician, and those who had not sought care for IBS. Students who had sought medical care for IBS reported being more bothered by the symptoms and were more concerned about their meaning than those students who had not sought care. The results are compared to other research with IBS patients referred to specialist clinics, and a distinction is made between initial vs. continued care seeking for IBS.

Personality dimensions among women with an eating disorder: towards reconceptualizing DSM.

OBJECTIVE To evaluate the incremental validity of a dimensional assessment of personality, after controlling for diagnostic category, in accounting for meaningful variation in eating disorder attitudes and behaviours and in current affective distress among a clinical sample of eating disordered women. METHODS 244 treatment seeking eating disordered women and 116 non-eating disordered women were assessed with the NEO five factor inventory (NEO-FFI), and with measures of eating disorder attitudes and of affective distress using a cross sectional design. RESULTS As predicted, differences were found between eating disordered and non-eating disordered women on several NEO-FFI scales, which provided a context for subsequent analyses. NEO-FFI scales accounted for meaningful variation in eating disordered attitudes and behaviours as well as in levels of current affective distress over and above DSM-IV diagnostic category. CONCLUSION A flexible approach to diagnosis, which includes personality dimensions along with a description of eating disorder symptoms, may result in a more inclusive and useful diagnostic scheme for treating women with eating disorders.

Change in attachment to the therapy group generalizes to change in individual attachment among women with binge eating disorder.

Attachment to groups is analogous to attachment to individuals, and may play an important role in group functioning and in group psychotherapy outcomes. This study examined whether attachment to the therapy group can change during treatment, and whether such change predicts improvements in treatment outcomes, including individual attachment, up to 1 year posttreatment. Eighty-seven women with binge eating disorder (BED) attended Group Psychodynamic Interpersonal Psychotherapy (GPIP). Participants were assigned to one of two conditions in which groups were homogeneously composed of women with either higher or lower individual attachment anxiety. Outcomes were assessed pre, post, 6 months, and 1 year posttreatment. Attachment to the group was assessed at weeks 4, 8, 12, and 16 of GPIP. Group attachment insecurity decreased significantly during treatment. Reductions in group attachment avoidance predicted decreases in individual attachment insecurity at 1 year posttreatment. Study condition did not moderate these associations. These results indicate that women with BED who receive GPIP are able to generalize improvements in group attachment security to their individual attachment relationships outside of therapy up to 1 year post group treatment.

Depressive Symptoms Are Associated with Medication Use and Lower Health-Related Quality of Life in Overweight Women with Binge Eating Disorder

BACKGROUND Depression is a most burdensome illness, with personal and societal costs surpassing those of any other illness. Furthermore, depression affects women at a much higher rate than men. The most prevalent eating disorder among adult women is binge eating disorder (BED). Depression and obesity are common in women with BED, most of whom seek treatment later in life. Depression, obesity, and age are associated with greater health care use and lower health-related quality of life (HRQOL). Hence, for women with BED estimating the effects of depression can be confounded by both age and body mass index (BMI). The current study examined the relationships between depression, HRQOL, and health care utilization among treatment seeking women with BED. METHODS Participants (n = 105) completed the Structured Clinical Interview for DSM-IV, a health care utilization and cost survey, the Personality Assessment Inventory depression scale, and the EQ-5D to measure HRQOL. FINDINGS On average, participants were severely obese with a mean BMI of 38.20 (SD = 6.80); 67.27% had a lifetime history of depression. Participants had higher health care costs and lower HRQOL than published age- and gender-matched norms. After controlling for age and BMI, depressive symptoms were significantly related to greater medication use (excluding antidepressants), and lower HRQOL. CONCLUSION Results suggest that targeting depressive symptoms may reduce the economic and personal burden of BED for women.

Attachment and barriers to cervical screening

The present study explored the role of attachment insecurity in cervical screening behaviors and barriers in a sample of 257 female undergraduates. Information on attachment dimensions as well as attachment style was collected. Attachment anxiety and attachment avoidance were associated with decreased likelihood of having participated in cervical screening and positively associated with screening barriers. Screening barriers were elevated among individuals with insecure attachment styles (preoccupied, fearful, and dismissing), and dismissing participants were less likely to have engaged in screening compared to secure participants. Our findings demonstrate that attachment insecurity may be a risk factor for inadequate cervical screening and screening barriers.

An appraisal-based coping model of attachment and adjustment to arthritis

Guided by pain-related attachment models and coping theory, we used structural equation modeling to test an appraisal-based coping model of how insecure attachment was linked to arthritis adjustment in a sample of 365 people with arthritis. The structural equation modeling analyses revealed indirect and direct associations of anxious and avoidant attachment with greater appraisals of disease-related threat, less perceived social support to deal with this threat, and less coping efficacy. There was evidence of reappraisal processes for avoidant but not anxious attachment. Findings highlight the importance of considering attachment style when assessing how people cope with the daily challenges of arthritis.