Abstract
We examined a sample of 58 individuals with postpolio syndrome (PPS). Subjects completed measures of illness severity, perceived support from the medical community, attributional style, illness uncertainty, and general emotional adaptation. We found elevated levels of emotional distress across several parameters of emotional adaptation. Illness uncertainty and generalized negative outcome expectancies were strongly associated with poorer adaptation; disease severity and perceived support from the medical community did not relate to measures of emotional adaptation. Hierarchical multiple regression analyses revealed that illness uncertainty and both stable and global attributions for negative events contributed significant, unique variance to the prediction of psychological distress beyond the influence of illness severity and demographic parameters. In general, individuals with PPS appear to be at risk for problems in adaptation, and specific cognitive appraisal processes appear to play an influential role in the development of these problems. Our findings have general implications for clinical management of persons with PPS.
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References
Abramson, L., Seligman, M., and Teasdale, J. (1978). Learned helplessness in humans: Critique and reformulation.J. Abnorm. Psychol. 87: 49–74.
Abramson, L., Metalsky, G., and Alloy, L. (1989). Hopelessness depression: A theory-based subtype of depression.Psychol. Rev. 96: 358–372.
Affleck, G., Tennen, H., Pfeifer, C., and Fifield, J. (1987). Appraisals of control and predictability in adapting to a chronic disease.J. Pers. Soc. Psychol. 53: 273–279.
Agre, J., Rodriquez, A., and Sperling, K. (1989). Symptoms and clinical impressions of patients seen in a postpolio clinic.Arch. Phys. Med. Rehabil. 70: 367–370.
Agre, J., Rodriquez, A., and Tafel, J. (1991). Late effects of polio: Critical review of the literature on neuromuscular function.Arch. Phys. Med. Rehabil. 72: 923–931.
Alloy, L. (1982). The role of perceptions and attributions for response-outcome noncontingency in learned helplessness: A commentary and discussion.J. Person. 50: 443–479.
Alloy, L., Peterson, C., Abramson, L., and Seligman, M. (1984). Attributional style and the generality of learned helplessness.J. Pers. Soc. Psychol. 46: 681–687.
Bandura, A. (1986).Social Foundations of Thought and Action: A Social Cognitive Theory. Prentice-Hall, Englewood Cliffs, NJ.
Bruno, R., and Frick, N. (1990a). Five year follow-up to the 1985 post-polio survey.Arch. Phys. Med. Rehabil. 10: 886.
Bruno, R., and Frick, N. (1990a). Psychological profile of polio survivors.Arch. Phys. Med. Rehabil. 10: 889.
Bruno, R., and Frick, N. (1991). The psychology of post-polio as prelude to post-polio sequelae: Behavior modification and psychotherapy.Orthopedics. 14: 1185–1193.
Chaney, J., Mullins, L., Uretsky, D., Doppler, M., Palmer, W., Wees, S., Klein, H., Doud, D., and Reiss, M. (1995). Attributional style and depression in rheumatoid arthritis: The moderating role of perceived illness control.Rehabil. Psychol. (in press).
Cohen, J., and Cohen, P. (1983).Applied Multiple Regression/Correlational Analyses for the Behavioral Sciences (2nd ed.), Lawrence Erlbaum, Hillsdale, NJ.
Conrady, L., Wish, J., Agre, J., Rodriquez, A., and Sperling, K. (1989). Psychological characteristics of polio survivors: A preliminary report.Arch. Phys. Med. Rehabil. 70: 458–463.
Coyne, J., and Gotlib, I. (1983). The role of cognition in depression: A critical review.Psychol. Bull. 94: 472–505.
Derogatis, L. (1983).SCL-90-R: Administration, Scoring and Procedures Manual II, Clinical Psychometric Research, Baltimore.
Derogatis, L., and Spencer, P. (1989).The Brief Symptom Inventory: Administration, Scoring, and Procedures Manual, Clinical Psychometric Research, Baltimore.
Devins, G., Edworthy, S., Guthrie, N., and Martin, L. (1992). Illness intrusiveness in rheumatoid arthritis: Differential impact on depressive symptoms over the adult lifespan.J Rheumatol. 19: 709–715.
Frank, R., Chaney, J., Clay, D., Shutty, M., Beck, N., Kay, D., Elliott, T. and Grambling, S. (1992). Dysphoria: A major symptom factor in persons with disability or chronic illness.Psychiat. Res. 43: 231–241.
Fries, J., Spitz, P., and Young, D. (1982). The dimensions of health outcomes: The Health Assessment Questionnaire Disability and Pain Scales.J. Rheumatol. 9: 789–793.
Lazarus, S., and Folkman, S. (1984).Stress, Appraisal, and Coping, Springer, New York.
Leavitt, F. and Katz, R. (1989). Is the MMPI valid for assessing psychological disturbance in pain related organic conditions?J. Rheumatol. 16: 521–526.
Lorish, C., Abraham, N., Austin, J., Bradley, L., and Alarcon, G. (1991). Disease and psychosocial factors related to physical functioning in rheumatoid arthritis.J. Rheumatol. 18: 1150–1157.
McIntosh, J. (1976). Process of communication, information seeking and control associated with cancer.Soc. Sci. Med. 8: 167–187.
Miller, S., and O'Leary, A. (1993). Cognition, stress, and health. In Dobson, K., and Kendall, P. (eds.),Psychopathology and Cognition. Academic Press, San Diego, CA, pp. 159–189.
Mishel, M. (1981). The measurement of uncertainty in illness.Nurs. Res. 30: 258–263.
Mishel, M., and Braden, C. (1988). Finding meaning: Antecedents of uncertainty in illness.Nurs. Res. 37: 98–127.
Mishel, M., Hostetter, T., King, C., and Graham, V. (1984). Predictors of psychosocial adjustment in patients newly diagnosed with gynecological cancer.Cancer Nurs. 7: 291–299.
Ohman, A., and Bohlin, G. (1989). The role of controllability in cardiovascular activation and cardiovascular disease: Help or hindrance? In Steptoe, A., and Appels, A. (eds.),Stress, Personal Control, and Health, Wiley, New York, pp. 257–276.
Peterson, C., Semmel, A., von Baeyer, C., Abramsom, L., Metalsky, G., and Seligman, M. (1982). The Attributional Style Questionnaire.Cogn. Ther. Res. 6: 287–300.
Peterson, C., Kirsch, N., and Tate, D. (1989). Coping with post-polio III. Optimism and cognitive style.Arch. Phys. Med. Rehabil. 70: A25.
Pincus, T., Leigh, F., Callahan, L., Bradley, L., Vaughan, W., and Wolfe, F. (1986). Elevated MMPI scores for hypochondriasis, depression, and hysteria in patients with rheumatoid arthritis reflect disease rather than psychological status.Arthritis Rheum. 29: 1456–1466.
Pittman, T., and Pittman, N. (1979). Deprivation of control and the attribution process.J. Pers. Soc. Psychol. 39: 377–389.
Schulman, P., Castellon, C., and Seligman, M. (1989). Assessing explanatory style: The content analysis of verbatim explanations and the Attributional Style Questionnaire.Behav. Res. Ther. 27: 505–512.
Smith, T., Peck, J., Milano, R., and Ward, J. (1988). Cognitive distortion in rheumatoid arthritis: Relation to depression and disability.J. Consult. Clin. Psychol. 3: 412–416.
Smith, T., Peck, J., and Ward, J. (1990). Helplessness and depression in rheumatoid arthritis.Health Psychol. 9: 377–389.
Sweeney, P., Anderson, K., and Bailey, S. (1986). Attributional style in depression: A meta-analytic review.J. Pers. Soc. Psychol. 50: 974–991.
Tate, D., Forchheimer, M., Kirsch, N., Maynard, F., and Roller, A. (1993). Prevalence and associated features of depression and psychological distress in polio survivors.Arch. Phys. Med. Rehabil. 74: 1056–1060.
Tate, D., Kirsch, N., Maynard, F., Peterson, C., Forchheimer, M., Roller, A., and Hansen, N. (1994). Coping with the late effects: Differences between depressed and nondepressed polio survivors.Am. J. Phys. Med. Rehab. 73: 27–35.
Thompson, R., Jr. (1985). Coping with the stress of chronic childhood illness. In O'Quinn, A. (ed.),Management of Chronic Disorders of Childhood, G.K. Hall, Boston, MA, pp. 11–41.
Thompson, R., Jr., Gustafson, K., Hamlett, K., and Spock, A. (1992). Psychological adjustment of children with cystic fibrosis: The role of child cognitive processes and maternal adjustment.J. Pediatr. Psychol. 17: 741–755.
Weinberg, J., and Levine, S. (1980). Psychobiology of coping in animals: The effects of predictability. In Levine, S., and Ursin, H. (eds.),Coping and Health, Plenum, New York, pp. 39–60.
Weisz, J., Sweeney, L., Proffitt, V., and Carr, T. (1993). Control related beliefs and self-reported depressive symptoms in late childhood.J. Abnorm. Psychol. 102: 411–418.
Zautra, A., Burleson, M., Matt, K., Roth, S., and Burrows, L. (1984). Interpersonal stress, depression, and disease activity in rheumatoid arthritis and osteoarthritis patients.Health Psychol. 13: 139–148.
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Mullins, L.L., Chaney, J.M., Hartman, V.L. et al. Cognitive and affective features of postpolio syndrome: Illness uncertainty, attributional style, and adaptation. Int J Rehab Health 1, 211–222 (1995). https://doi.org/10.1007/BF02214640
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DOI: https://doi.org/10.1007/BF02214640