Susan M. Labott

Pain, coping and health care utilization in younger and older adults with sickle cell disease.

Sickle cell disease is characterized by acute pain crises. Pain, chronic medical problems, utilization and coping were compared in younger vs older patients using questionnaires and medical record review. Groups reported similar pain intensity and medical conditions. The pattern of utilization differed such that older patients attended outpatient clinic, and younger patients went to the Emergency Department. Younger patients were more likely to cope by ignoring pain, or by using heat, cold or massage. Older patients were more likely to pray and hope. We conclude that age plays an important role in the utilization and coping of sickle cell patients.

Psychological and Social Risks of Behavioral Research

Risks to human subjects associated with participation in research are an important consideration in the design of studies and in the informed consent process. Yet, there are significant gaps in our knowledge about the psychological and social risks of behavioral research. Our review of federal regulations governing research with humans and empirical work pertaining to behavioral research risks shows that we have little data on the frequency of specific psychological and social risks and on the implications of these risks for research subjects who experience them. We make suggestions for further research in this area to address the current ambiguities.

MALINGERING DISSOCIATIVE IDENTITY DISORDER: OBJECTIVE AND PROJECTIVE ASSESSMENT

Verification of dissociative identity disorder presents challenges given the complex nature of the illness. This study addressed the concern that this disorder can be successfully malingered on objective and projective psychological tests. 50 undergraduate women were assigned to a Malingering or a Control condition, then completed the Rorschach Inkblot Test and the Dissociative Experiences Scale II. The Malingering group were asked to simulate dissociative identity disorder; controls received instructions to answer all materials honestly. Analysis indicated that malingerers were significantly more likely to endorse dissociative experiences on the Dissociative Experiences Scale II in the range common to patients with diagnosed dissociative identity disorder. However, on the Rorschach there were no significant differences between the two groups. Results suggest that the assessment of dissociative identity disorder requires a multifaceted approach with both objective and projective assessment tools. Research is needed to assess these issues in clinical populations.

Emotional Risks to Respondents in Survey Research: Some Empirical Evidence

Some survey research has documented distress in respondents with pre-existing emotional vulnerabilities, suggesting the possibility of harm. In this study, respondents were interviewed about a personally distressing event; mood, stress, and emotional reactions were assessed. Two days later, respondents participated in interventions to either enhance or alleviate the effects of the initial interview. Results indicated that distressing interviews increased stress and negative mood, although no adverse events occurred. Between the interviews, moods returned to baseline. Respondents who again discussed a distressing event reported moods more negative than those who discussed a neutral or a positive event. This study provides evidence that, among nonvulnerable survey respondents, interviews on distressing topics can result in negative moods and stress, but they do not harm respondents.

Psychological Issues in Head and Neck Cancer

Head and neck cancer (HNC) brings a host of issues of importance to patients, families, and treatment providers. Beginning at the time of initial diagnosis, individuals often struggle with fear and guilt due to concerns that they bear some responsibility for the diagnosis. Once treatment is underway, patients frequently must cope with disfiguring consequences, with changes in communication, eating, and body image. Over time, expected adjustment issues can develop into depression and other serious psychological problems. Even several years after treatment is over, patients may need to deal with ongoing pain, communication, and substance use problems, as well as anxieties about disease recurrence. Individuals may report some psychological benefit as a result of the diagnosis and treatment of HNC, even though some ultimately face the end of their lives. Suggestions as to how providers can help patients manage these issues are provided, as well as resources for patients.

Emotional risks to respondents in s

Some survey research has documented distress in respondents with pre-existing emotional vulnerabilities, suggesting the possibility of harm. In this study, respondents were interviewed about a personally distressing event; mood, stress, and emotional reactions were assessed. Two days later, respondents participated in interventions to either enhance or alleviate the effects of the initial interview. Results indicated that distressing interviews increased stress and negative mood, although no adverse events occurred. Between the interviews, moods returned to baseline. Respondents who again discussed a distressing event reported moods more negative than those who discussed a neutral or a positive event. This study provides evidence that, among nonvulnerable survey respondents, interviews on distressing topics can result in negative moods and stress, but they do not harm respondents.

Emotional risks to respondents in survey research.

Some survey research has documented distress in respondents with pre-existing emotional vulnerabilities, suggesting the possibility of harm. In this study, respondents were interviewed about a personally distressing event; mood, stress, and emotional reactions were assessed. Two days later, respondents participated in interventions to either enhance or alleviate the effects of the initial interview. Results indicated that distressing interviews increased stress and negative mood, although no adverse events occurred. Between the interviews, moods returned to baseline. Respondents who again discussed a distressing event reported moods more negative than those who discussed a neutral or a positive event. This study provides evidence that, among nonvulnerable survey respondents, interviews on distressing topics can result in negative moods and stress, but they do not harm respondents.