Anxiety during the stressful medical procedure of endoscopy was studied as a function of the number of prior viewings of an explicit preparation videotape and of repression-sensitization coping style. Sixty naive patients veiwed a videotaped endoscopy either zero, one, or three times. Dependent measures included heart rate, behavioral ratings, tranquilizer required, and self-report. On each dependent measure, three viewings generally resulted in the least distress; one, more distress; and zero, the most distress. Most comparisons reached statistical significance. These results are interpreted as resulting from extinction and/or habituation of anxiety. The repression-sensitization factor interacted with heart rate change. Sensitizers showed a monotonic decrease in heart rate as a function of number of tape exposures. Repressers showed an inverted-U-shaped function, with one viewing producing the highest heart rate; this is interpreted as resulting from a disruption of repressing defenses by one tape exposure followed by extinction of fear by three exposures.Preparation-for-stress messages have generally proved effective in reducing the emotional trauma of stressful real-life experiences (e.g.,
Visible changes associated with dysplasia or carcinoma have been assessed in 62 colectomy specimens from patients with ulcerative colitis. In 34 colectomy specimens with one or more carcinomas, there were 51 visible carcinomas and 65 macroscopic dysplastic lesions; only one carcinoma was found in flat mucosa. Among 28 specimens with microscopic dysplasia but no carcinoma, eight contained no visible dysplastic lesion, and the remaining 20 contained a total of 40 polypoid or elevated dysplastic areas. In 32 operative specimens removed for long-standing chronic colitis without dysplasia or carcinoma, nine contained visible inflammatory polypoid lesions. On radiological or endoscopic examination of the colon in long-standing colitis close attention should be given to the identification and biopsy of polyps, elevated nodular areas or plaques, strictures, and isolated ulcers. It is likely that colectomy specimens with visible polypoid or elevated dysplastic lesions will contain a carcinoma more often than those removed for dysplasia in flat mucosa.
Thirty-six patients, experienced in the stressful endoscopy examination, were prepared to reexperience that examination by viewing an explicit videotaped endoscopy either zero, one, or three times. Patients were also classified as having either a repressing or sensitizing coping style. On dependent anxiety measures including heart-rate change, behavioral ratings, and self-report, tape viewing generally resulted in decreased anxiety in sensitizers, and had no effect or produced increased anxiety in repressers. When the data were analyzed ignoring repression-scnsitization coping style, tape viewing produced little effect. Results are discussed in terms of the accurate information and extinction theories of preparation effects. Requests for reprints should be sent to Robert
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