Journal of consulting and clinical psychology
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J Consult Clin Psychol · Jun 2008
Morbidity of DSM-IV Axis I disorders in patients with noncardiac chest pain: Psychiatric morbidity linked with increased pain and health care utilization.
The present study examined current and lifetime psychiatric morbidity, chest pain, and health care utilization in 229 patients with noncardiac chest pain (NCCP), angina-like pain in the absence of cardiac etiology. Diagnostic interview findings based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) revealed a psychiatrically heterogeneous sample of whom 44% had a current Axis I psychiatric disorder. A total of 41% were diagnosed with a current anxiety disorder, and 13% were diagnosed with a mood disorder. ⋯ Presence of an Axis I disorder was associated with increased life interference and health care utilization. Findings reveal that varied DSM-IV Axis I psychiatric disorders are prevalent among patients with NCCP, and this psychiatric morbidity is associated with a less favorable NCCP presentation. Implications for early identification of psychiatric disorders are discussed.
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J Consult Clin Psychol · Jun 2008
Acceptance and values-based action in chronic pain: a study of treatment effectiveness and process.
Developing approaches within cognitive behavioral therapy are increasingly process-oriented and based on a functional and contextual framework that differs from the focus of earlier work. The present study investigated the effectiveness of acceptance and commitment therapy (S. C. ⋯ Effect size statistics were uniformly medium or larger. According to reliable change analyses, 75.4% of patients demonstrated improvement in at least one key domain. Both acceptance of pain and values-based action improved, and increases in these processes were associated with improvements in the primary outcome domains.
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J Consult Clin Psychol · Apr 2006
Exposure to terrorism, stress-related mental health symptoms, and defensive coping among Jews and Arabs in Israel.
The authors conducted a large-scale study of terrorism in Israel via telephone surveys in September 2003 with 905 adult Jewish and Palestinian citizens of Israel (PCIs). Structural equation path modeling indicated that exposure to terrorism was significantly related to greater loss and gain of psychosocial resources and to greater posttraumatic stress disorder (PTSD) and depressive symptoms. ⋯ PCIs had significantly higher levels of PTSD and depressive symptoms than Jews. Further, PTSD symptoms in particular were related to greater authoritarian beliefs and ethnocentrism, suggesting how PTSD may lead to a self-protective style of defensive coping.
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J Consult Clin Psychol · Oct 2005
Randomized Controlled Trial Comparative StudyCan group interventions facilitate forgiveness of an ex-spouse? A randomized clinical trial.
This study evaluated the effectiveness of 2 versions of an 8-session forgiveness group intervention for divorced individuals. Participants (randomized, n=192; analyzed, n=149) were randomly assigned to a secular forgiveness condition, a religious forgiveness condition, or a no-intervention comparison condition. ⋯ Participants in the secular condition showed a greater decrease in depressive symptoms than comparison participants. Intrinsic religiousness did not moderate intervention effects.
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J Consult Clin Psychol · Apr 2005
Positive affect as a source of resilience for women in chronic pain.
A sample of 124 women with osteoarthritis or fibromyalgia, or both, completed initial assessments for demographic data, health status, and personality traits and 10-12 weekly interviews regarding pain, stress, negative affect, and positive affect. Multilevel modeling analyses indicated that weekly elevations of pain and stress predicted increases in negative affect. ⋯ Finally, increases in weekly negative affect and higher average negative affect related to greater levels of pain in subsequent weeks. In contrast, higher levels of overall positive affect predicted lower levels of pain in subsequent weeks.