The hypothesis that body image and perceived social stigma would be important predictors of psychosocial adjustment to a leg amputation was tested in a sample of 112 clients from five prosthetic offices. Two scales were developed to measure body image disturbance resulting from an amputation and perceived social stigma (the individual’s perception that others hold negative attitudes about him or her due to the amputation). The two scales were internally consistent and only moderately correlated (r =.43). The CES-D depression scale, a quality-of-life scale, and prosthetist ratings were used to measure psychosocial adjustment. Regression analyses indicated that body image was a significant independent predictor of all three adjustment measures after controlling for the effects of age at the time of amputation, time since amputation, site of the amputation, self-rated health, and perceived social support. Perceived social stigma made a significant independent contribution to depression but did not qualify as an independent predictor for the other two measures of adjustment. Based on an established CES-D cutoff score, the overall rate of depression was 28%. Theoretical and clinical implications of these findings are discussed.

To investigate the protective and consolation models of the relationship between religion and health outcomes in medical rehabilitation patients. Design: Longitudinal study, data collected at admission, discharge, and 4 months postadmission. Measures: Religion measures were public and private religiosity, acceptance, positive and negative religious coping, and spiritual injury. Outcomes were self-report of activities of daily living (ADL), mobility, general health, depression, and life satisfaction. Participants: 96 medical rehabilitation inpatients; diagnoses included joint replacement, amputation, stroke, and other conditions. Results: The protective model of the relationship between religion and health was not supported; only limited support was found for the consolation model. In regression analyses, negative religious coping accounted for significant variance in follow-up ADL (5%) over and above that accounted for by admission ADL, depression, social support, and demographic variables. Subsequent item analysis indicated that anger with God explained more variance (9%) than the full negative religious coping scale. Conclusions: Religion did not promote better recovery or adjustment, although it may have been a source of consolation for some patients who had limited recovery. Negative religious coping compromised ADL recovery. Although anger with God was rare, it may be useful in screening for patients who are spiritually at risk for poor recovery.

This study investigated the relation between impaired anticipatory postural adjustments and bradykinesia in Parkinson's disease. Patients with Parkinson's disease and age matched controls stood on a platform. In one series of experiments, they performed fast, discrete shoulder flexion or extension movements. In another series, they were required to press a trigger with the right thumb and thus to release a load that was suspended from a bar which they were holding in front of them in extended arms. One more series included catching a load on the same bar. Anticipatory changes in the activity of postural muscles before fast voluntary movements occurred in patients and controls although the patients showed higher variability of anticipatory patterns. During load dropping and catching, control subjects had reproducible, although smaller, anticipatory changes in postural muscle activity. Such changes were absent in all but one patient. Two sources of these postural perturbations were analysed. The anticipatory postural adjustments in different muscle groups may counteract perturbations of different origin. The distal to proximal sequencing of joint involvement in postural reactions may be related to different reference points and working points associated with these tasks compared with reaching limb movements. The deficit in anticipatory postural adjustments in Parkinson's disease is likely to be unrelated to bradykinesia and is more likely to reflect the deficits in the basic processes of preparation and initiation of a motor act. (J Neurol Neurosurg Psychiatry 1995;58:326-334)

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