Rosemary Cogan

Effects of laughter and relaxation on discomfort thresholds.

Two experiments were conducted to test the proposal that laughter is a pain antagonist. In Experiment I, thresholds for pressure-induced discomfort of 20 male and 20 female subjects were measured after each subject listened to a 20-min-long laughter-inducing, relaxation-inducing, or dull-narrative audio tape or no tape. Discomfort thresholds were higher for subjects in the laughter- and the relaxation-inducing conditions. In Experiment II, 40 female subjects were matched for pressure-induced discomfort thresholds. Their discomfort thresholds were measured after they listened to a laughter-inducing, interesting narrative, or uninteresting narrative audio tape, completed a multiplication task, or experienced no intervention. Discomfort thresholds increased for subjects in the laughter-inducing condition. Laughter, and not simply distraction, reduces discomfort sensitivity, suggesting that laughter has potential as an intervention strategy for the reduction of clinical discomfort.

Pain and discomfort thresholds in late pregnancy

&NA; Gintzler [6] found an abrupt increase in pain thresholds in rats during the last days of gestation. While some data suggest a similar increase in pain thresholds for pregnant women, Goolkasian and Rimer [7] have found, using signal detection procedures, that women are increasingly likely to report stimuli as painful during the last 2 weeks of pregnancy. The present studies were carried out to assess pain and discomfort thresholds in the last weeks of womens pregnancies. In the first study, daily measures of the pressure‐induced pain thresholds of 6 women who had spontaneous, vaginal births increased during the last 16 days of pregnancy and exceeded the 300 mm Hg maximum stimulus pressure for the last 9 days of pregnancy. In the second study, the discomfort thresholds of 6 women were measured each day during the last 11 days of pregnancy before spontaneous vaginal births. The discomfort thresholds of the pregnant women were higher than those of 6 non‐pregnant women whose discomfort thresholds were also measured each day. Pregnant womens thresholds increased before the onset of labor, while the discomfort thresholds of the non‐pregnant women were unchanged during the course of the study. These results extend Gintzlers findings of reduced sensitivity to pain shortly before parturition.

The effect of husband participation on reported pain and probability of medication during labor and birth

Abstract The present study investigated the births of women whose husbands attended labor and birth with the births of women whose husbands attended only the first stage of labor. All subjects were enrolled in childbirth education classes and husbands were encouraged to participate as labor coach throughout labor and birth. Those wives whose husbands attended labor and birth reported less pain and had a significantly lower probability of receiving medication during labor and birth. Husbands and wives who attended labor and birth reported more positive feelings about the total birth experience. Developmental implications are discussed.

Social support during premature labor: effects on labor and the newborn

Prematurity is the single most frequent abnormality associated with birth, and is associated with both neonatal deaths and developmental deficits. In uncomplicated labors at term, the presence of a supportive companion has been found to lead to reduced length of labor, reduced need for medication for pain management, and improved neonatal well being. The relationships have not been explored in premature labor. Women in premature labor between 26 and 37 weeks of gestation were randomly assigned to a control group (n = 11) or to a supported group (n = 14), who were accompanied during labor by a supportive companion. Support during labor was associated with fewer abnormally long labors, less frequent use of medication for pain management during labor, and improved neonatal wellbeing.

Alcohol Problems and the Differentiation of Partner, Stranger, and General Violence

To explore the relationship between alcohol problems and physical violence with partners and strangers, 457 college men and 958 college women with low, intermediate, or high scores on the Short Michigan Alcohol Screening Test reported conflict tactics on the Conflict Tactics Scale in the past year to and by partners and strangers. More men than women had high alcohol problems scores. Men with alcohol problems were more likely than other men to commit violence toward strangers or to partners and strangers. However, men with alcohol problems were not more likely than other men to commit violence toward partners only. Among women, alcohol problems had little relationship to committing violence or being the victim of violence.

Clinician reports of personality pathology of patients beginning and patients ending psychoanalysis

OBJECTIVES The purpose of this work was to use a clinician Q-sort procedure to describe the personality pathology and adaptive functioning of patients beginning and ending psychoanalysis. DESIGN With a cross-sectional design, we compared a group of patients beginning and a group of patients ending psychoanalysis. METHODS Twenty-six psychoanalysts described a patient beginning psychoanalysis and 26 described a patient ending psychoanalysis using the Shedler-Westen Assessment Procedure 200 (SWAP-200). Each clinician also completed questions about themselves, the patient, and the treatment. The most characteristic SWAP-200 items describing patients beginning and patients ending psychoanalysis provide a meaningful picture of the two groups. RESULTS Among patients at the end of psychoanalysis, scores were significantly lower on the SWAP-200 Paranoid, Schizotypal, Borderline, Histrionic, and Dependent scales and scores were significantly higher on the SWAP-200 High functioning scale and the DSM-IV GAF scale. Common characteristics of patients beginning psychoanalysis were anxiety, guilt, and shame. Common characteristics of patients ending psychoanalysis were conscientiousness and responsibility, striving to live up to moral and ethical standards, and enjoyment of challenges. CONCLUSIONS The findings demonstrate the usefulness of a clinician report measure for the study of psychoanalytic psychotherapy and psychoanalysis.

Characteristics of men and women completing cognitive/behavioral spouse abuse treatment

Although abuse in relationships is widespread and often escalates without intervention, the scant extant data indicate that people in abusive relationships often fail to complete treatment programs. We compared demographic characteristics, Male-Female Relations Inventory scores (MFRI), and selected MilIon Clinical Multiaxial Inventory I (MCMI-I) scale scores of men and women who did and did not complete an 8-session 4-week cognitive/behavioral group treatment program. The 16 completer men had lower scores on MCMI-I scales related to drug abuse as compared with the 18 noncompleter men. Court-referred men completed more often than other men. The 23 completer women also had lower scores on MCMI-I scales related to drug abuse than the 17 noncompleter women. Fewer of the completer women were employed and fewer had children than the noncompleter women. Scores on the MFRI were not different for completer or noncompleter men or women. Implications for interventions are discussed.

Memories of Labor and Birth: Reliability of Post Partum Questionnaire Reports

The stability of reports of feelings during vaginal births was assessed in three studies. In Study I, post partum reports from 475 primiparous women who participated in a childbirth preparation program were compared to identify differences between reports completed from the day of the birth to more than six weeks after the birth. In Study II, the post partum reports of 46 primiparous and 95 multiparous women completed 1, 3, or 6 mo. after giving birth were compared. In Study III, test-retest reliabilities were calculated for post partum reports completed by 22 primiparous and 16 multiparous women during the 5th and 7th post partum weeks. In these studies, reports of pain during labor were stable.

Defense mechanisms and self-reported violence toward partners and strangers.

We examined the relationship between defense mechanisms and self-reported violence toward partners and toward strangers in a sample of college student men. Fifty men completed the Thematic Apperception Test (TAT; Murray, 1943) and the Conflict Tactics Scale (CTS; Straus, 1979), a self-report measure of strategies (including violence) for resolving conflicts with partners and strangers. The TAT responses were coded for defense mechanisms with the Defense Mechanisms Manual (Cramer, 1991b). The relative use of identification was negatively correlated (r = -.49, p < .001), and the relative use of projection was positively correlated (r = .49, p < .001) with the most extreme CTS report of violence toward partners. The relative use of identification was negatively correlated with the most extreme CTS report of violence toward strangers (r = -.34, p < .05). The relative use of denial was positively correlated with the most extreme CTS report of violence toward strangers (r = .32, p < .05).

Abuse, Outpatient Charges and Utilization, and Psychiatric Symptoms among Urban Women on Medicaid

Background: Adult and childhood sexual and physical abuse are common and intertwined. Our objectives were to assess (1) the relationship between different forms of abuse; (2) outpatient charges and hospital and emergency department use among women with and without childhood and adult abuse; (3) psychiatric symptoms of women with and without childhood and adult abuse; and (4) the relationship between psychiatric symptoms and outpatient charges and hospital and emergency department use among a group of Medicaid-insured women seeking outpatient services in a primary care setting. Methods: We recruited female primary care patients for this cross-sectional study. Women reported childhood and adult sexual and physical abuse and anxiety, depression, and posttraumatic stress symptoms. We assessed outpatient charges through reviews of clinic records. Patients reported hospital and emergency department use. Results: Childhood and adult sexual and physical abuse were highly interrelated. Adult sexual abuse showed a trend toward significantly greater outpatient charges. Women who had experienced physical abuse during childhood had more emergency department visits and women who experienced physical abuse as an adult had more days of hospitalization. Childhood and adult sexual abuse were both related to higher levels of anxiety, depression, and posttraumatic stress symptoms. Anxiety, depression, and posttraumatic stress symptoms were related to higher outpatient charges. Depression and posttraumatic stress symptoms were related to greater emergency department use. Conclusions: Women who experience abuse often have psychiatric symptoms. In our sample it was the severity of psychiatric symptoms rather than reported abuse alone that was related to outpatient charges and emergency department visits.