Date of Award

1994

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

Phillip J. Brantley

Abstract

One hundred thirty-three low socioeconomic status adult subjects from Earl K. Long Medical Center were interviewed using the Structured Clinical Interview for DSM-III-R - Nonpatient Edition. Subjects also completed the Schedule of Recent Experiences, Interpersonal Support Evaluation List, and Structured Clinical Interview for DSM-III-R Personality Disorders Questionnaire. This study attempted to predict medical utilization over the past year. The independent variables included in the predictive portion of the study were active medical problems, manic symptoms, depressive symptoms, psychotic symptoms, alcohol abuse symptoms, non-alcohol substance abuse symptoms, anxiety symptoms, somatic symptoms, somatization symptoms, personality disorder symptoms, life events, and social support. It was hypothesized that, by including the personality disorder variables, by assessing the roles of sub-clinical levels of psychopathology, and by including established predictors, the proposed regression equation would account for a larger portion of the variance in utilization than that found in previous studies. The study also attempted to verify a hypothesized model that explains the method of interaction for the various factors in utilization. Regression analyses attempting to demonstrate an association between psychopathology, stress, and social support with primary care utilization were all negative. Also, the hypothesized model explaining the role of the various factors in utilization was not supported. When subjects were grouped based on presence or absence of a chronic medical diagnosis, psychiatric variables (alcohol symptoms and cluster B symptoms) did become significant predictors of medical utilization for the group without chronic medical diagnoses. A high prevalence of psychiatric disorders was found to exist in the subject sample. It was concluded that the high prevalence of psychiatric disorders, as well as an improper control of chronic medical diagnoses led to the negative findings. Implications of the findings for future research are discussed.

Pages

91

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