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Research provides evidence about the high levels of anxiety and depression in myocardial infarction (MI). This is because patients with MI face both an acute life-threatening illness and the potential for living with a major illness (Roebuck et al. 2001, Thornton 2001, Kim et al. 2000). Consequently, the patients' whole sense of meaning and purpose in life is at stake (Walton 1999, Burnard 1987, Simsen 1985). Research on spiritual coping and spiritual well being (SWB) in MI is still in its infancy. Therefore the aim of the study was to identify possible relationships between spiritual coping strategies (SCS) and anxiety, depression, SWB and personal characteristics of Maltese patients with MI, during hospitalisation and the first three months after discharge.The longitudinal descriptive correlational study recruited a homogenous systematic sample of seventy male (n=46) and female (n=24) patients with first MI, mean age of 61.9 years. The variables under investigation were assessed by the translated versions of the Hospital Anxiety and Depression (HAD) scale (Zigmond and Snaith 1983), JAREL------ SWB scale (Hungelmann et al.1985) and Helpfulness of Spiritual Coping Strategies (HSCS) scale designed for the study. The rationale for the perceived helpfulness of SCS was explored by the semi-structured face to face interview.The theoretical framework which guided the study incorporated the Cognitive Theory of Stress and Coping (Lazarus and Folkman 1984) and the Idea of the Holy (Otto 1950). Analysis of the qualitative data was guided by Burnard (1991) analysis model. Additionally, analysis of the quantitative data utilized both parametric and nonparametric statistical tests in order to identify differences between means of subgroups of the personal characteristics and correlations between SCS and anxiety, depression and SWB across time.The findings revealed a constant decline of anxiety and depression across time which is inconsistent with published research. However, the return of anxiety and depression to normal limits by the third month is congruent with research. In contrast, scores of SWB and SCS increased on discharge and remained stable across time.The qualitative data revealed that SCS, SWB and the Maltese culture, which promotes family support in illness, may have contributed towards the relief of anxiety and depression. The quantitative data exhibited a negative, significant relationship between SCS and anxiety and depression on the sixth week after discharge. Additionally, positive significant relationships were identified between SCS and SWB across time.The findings suggest that SWB may be a precursor to the relief of anxiety and depression. The minimal significant differences in SCS between the subgroups of personal characteristics propose the possible impact of the event of MI on spiritual coping and negative mood states. However these speculations may only be confirmed by further research as recommended in the study. Hopefully, the new knowledge produced by the study will be applied to the clinical practice and nursing education to promote patient care.

Lifestyles, including alcohol consumption and illicit drug use in medical students were assessed using a self-completion questionnaire. Eight cohorts of secondy ear medical students were assessed consecutively between 1993-2000. The proportion of medical students in each cohort drinking excessively increased during this period. Illicit drug use stayed fairly stable with approximately half of each year group reporting having experimented with illicit drugs. Lifestyles in medical students were assessed in the second and final year of studies and one year after graduation. Alcohol consumption and illicit drug use had significantly increased over the 4 year period of the study. Two cohorts of medical and dental students were also compared in a similar study design. Although alcohol consumption in dental students was more than their medical student counterparts during the second year of the studies, it decreased one year after graduation. Illicit drug use was higher in medics than in dentists at all three time points. Nearly half of the fresher medical students reported to have been drinking excessively and using illicit drugs before beginning university life. Personality characteristics of the students were found to be related to their alcohol and illicit drug use. A significant proportion of pre-registration house officers suffered from stress and anxiety with more women than men having anxiety scores within the clinically significant range. Job satisfaction was low, with more pre-registration house officers being dissatisfied with the organisational processes of their jobs. Personality was significantly related to stress, anxiety, depression and job satisfaction. Education on alcohol and illicit drugs for young people may be needed at a much earlier age. Dealing with the problems of drink, drugs and stress among medical students and doctors may require a holistic approach which considers both the culture of medical education and work conditions.

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No description available.

This thesis studied three plants traditionally used for treating a variety of anxiety related conditions. The three species were Roseroot, Rhodiola rosea from Nunavik, Cordonsillo, Piper amalago from Belize and “Sin Susto”, Souroubea sympetala from Costa Rica. The main objective of this research project was to investigate effects on behavior of these traditionally used native plants. It was found that the crude ethanol extracts derived from these plants administered intragastrically had measurable anxiolytic effects in male Sprague Dawley rats. Rats treated with extracts of these plants were then tested in several behavioral paradigms: elevated plus maze (EPM), social interaction (SI), conditioned emotional response (CER) and fear potentiated startle FPS. “Sin susto” produced significant anti-anxiety effects in several paradigms. Its active principle, betulinic acid, was significantly active in the EPM and FPS at a dose of 0.5mg/kg. Cordonsillo had strong activity in the SI paradigm and Roseroot in the CER paradigm. The results suggest that traditional use is based on pharmacological activity of the plants.

The social implications of anxiety have received little empirical attention. Moreover, the continuity of interpersonal processes associated with clinical and non-clinical levels of chronic social anxiety has not been systematically investigated. The relation between interpersonal behavior and anxiety reported during naturally occurring social interactions was examined in two studies; the first examined community volunteers exhibiting a range of chronic social anxiety levels, while the second compared individuals with generalized social anxiety disorder (GSAD) to a matched sample of non-clinical controls. Unique patterns were expected to emerge with respect to state versus chronic levels of social anxiety. State social anxiety was conjectured to predict an alliance-protective response characterized by increased levels of agreeable behavior and decreased levels of quarrelsome behavior. Chronic social anxiety was hypothesized to predict a self-protective interpersonal style characterized by increased levels of submissive behavior and decreased levels of dominant behavior. Event-level appraisals of inferiority were expected to moderate this self-protective orientation; socially anxious individuals were expected to report enhanced levels of submission and reduced levels of dominance during interactions in which subjective inferiority was elevated. As predicted, increased state social anxiety was associated with decreased levels of quarrelsome behavior. Elevated state anxiety was also associated with increased levels of submissive behavior. This pattern was observed across all levels of chronic social anxiety, although participants with GSAD displayed an even greater tendency to increase submissiveness in response to state social anxiety compared to controls. As predicted, elevated levels of chronic social anxiety were associated with increased submissive behavior and decreased dominant behavior across all levels of state social anxiety. Subjective appraisals of inferiority enhanced levels of submission and reduced levels of dominance among socially anxious individuals. The results illustrated separate patterns of behavior for state and chronic social anxiety and were consistent with the proposition that situational elevations in social anxiety are associated with alliance-protective behavior strategies while chronic elevations are associated with a self-protective orientation that is amplified by sensitivity to negative social cues. The findings also supported the contention that social anxiety is a continuous construct associated with similar interpersonal processes across clinical and non-clinical populations.

Despite the fact that the moods, symptoms, and disorders associated with anxiety and depression frequently co-occur in youth, very little is known about the developmental pathways leading to comorbid anxiety and depression. The common aetiology hypothesis proposes that anxiety and depression share common risk, vulnerability, and causal factors which increase the likelihood that they will co-occur. Such common aetiological factors are expected to temporally precede the onset of symptoms and to be uniquely associated with symptoms of each disorder, independent of the strong association between anxiety and depression. Previous research has identified vulnerability factors in the development of both anxious symptoms (e.g., behavioural inhibition) and depressive symptoms (e.g., pessimistic inferential styles) in children. However very little research has examined whether these vulnerability factors are specific to either anxious or depressive symptoms, or whether they are common to both. The purpose of the research presented in this dissertation was to examine the common aetiology hypothesis of anxiety and depression in children by evaluating the specificity of two well-established theories. In addition, the applicability of a diathesis-stress model to the development of anxious and depressive symptoms in children was examined. The research described in Chapter 2 examined behavioural inhibition and found that behaviourally inhibited children who experienced high levels of stress demonstrated increases in anxious, but not depressive symptoms across a six-week period. The research described in Chapter 3 examined the hopelessness theory and found that in the presence of high levels of stress, pessimistic inferential styles about causes, consequences, and the self predicted increases in hopelessness depression symptoms in children with low levels of initial hopelessness depression symptoms. Moreover, children with pessimistic inferential styles about either consequences or the self demonstrated increases in anxious symptoms across the six-week period, even after controlling for changes in hopelessness depression symptoms. These findings have several implications. In line with the common aetiology hypothesis, pessimistic inferential styles about consequences and the self appear to be common vulnerability factors. In contrast, behavioural inhibition and pessimistic inferential style about causes appear to be specific vulnerability factors for anxious symptoms and hopelessness depression symptoms respectively. Finally, vulnerability factors for both anxious and depressive symptoms appear to be amenable to a diathesis-stress framework.

Thesis (Ph. D.)--University of Hawaii at Manoa, 1981. / Bibliography: leaves 441-449. / Microfiche. / viii, 449 leaves, bound 29 cm

Thesis (MSocSc)--University of South Australia, 1997