Psychosomatic medicine
-
Psychosomatic medicine · Jul 2002
Attachment theory: a model for health care utilization and somatization.
Attachment theory proposes that cognitive schemas based on earlier repeated experiences with caregivers influence how individuals perceive and act within interpersonal relationships. We hypothesized that medical patients with two types of insecure attachment-preoccupied and fearful attachment-would have higher physical symptom reporting compared with those with other attachment styles, but that preoccupied attachment would be associated with higher and fearful attachment with lower primary care utilization and costs. ⋯ These results suggest that attachment style is an important factor in assessing symptom perception and health care utilization. Despite being on opposite ends of the utilization spectrum, patients with preoccupied and fearful attachment have the highest symptom reporting. These data challenge the observation that increased symptom reporting is uniformly associated with increased utilization in medical patients.
-
Psychosomatic medicine · Jul 2002
Are veterans seeking Veterans Affairs' primary care as healthy as those seeking Department of Defense primary care? A look at Gulf War veterans' symptoms and functional status.
This study compared Gulf War veterans seeking VA primary care with Gulf War veterans seeking treatment from a Department of Defense primary care clinic on measures of physical symptoms, psychiatric complaints, and functional status. Additionally, the association between employment status and health was examined. ⋯ Our findings reveal important differences in health status between veterans seeking primary care at a VA and a Department of Defense facility, differences that are in part related to employment status. Both groups report symptoms of psychiatric distress and decreased functional status, though VA patients are more impaired. Research findings based on clinical samples of veterans at VA sites may not generalize to Gulf War veterans still on active duty (and vice versa).
-
Psychosomatic medicine · Jul 2002
Changes in nociceptive flexion reflex threshold across the menstrual cycle in healthy women.
We assessed the influence of changes in steroid hormones across the menstrual cycle on the spinal nociceptive reflex. ⋯ A higher sensitivity to pain stimuli was observed during the luteal phase of the menstrual cycle, which probably results from a reduction in the inhibitory descending control on spinal nociceptive flexion reflex. Complex neuromodulatory interactions of ovarian steroids with other systems of neurotransmission (especially serotonergic) may account for these observations.