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Biomedical subjects

H Schut

Publications and source records attributed to H Schut.

8 recordsLinked to original sources
PubMed2001

DSM-IV internal construct validity: when a taxonomy meets data.

The use of DSM-IV based questionnaires in child psychopathology is on the increase. The internal construct validity of a DSM-IV based model of ADHD, CD, ODD, Generalised Anxiety, and Depression was investigated in 11 samples by confirmatory factor analysis. The factorial structure of these syndrome dimensions was supported by the data. However, the model did not meet absolute standards of good model fit. Two sources of error are discussed in detail: multidimensionality of syndrome scales, and the presence of many symptoms that are diagnostically ambiguous with regard to the targeted syndrome dimension. It is argued that measurement precision may be increased by more careful operationalisation of the symptoms in the questionnaire. Additional approaches towards improved conceptualisation of DSM-IV are briefly discussed. A sharper DSM-IV model may improve the accuracy of inferences based on scale scores and provide more precise research findings with regard to relations with variables external to the taxonomy.

Adolescent↗
PubMed2001

The traumatization of grief? A conceptual framework for understanding the trauma-bereavement interface.

Scientific opinion differs on whether pathological (or complicated, traumatic) grief is an entity distinct from post-traumatic stress disorder. Some argue that it is different, and for the creation of a new category of pathological grief for the DSM system, while others consider bereavement and associated grief reactions to fall within the category of traumatic life events, for which the existing system would offer adequate classification. Although investigators have begun to explore similarities and differences in the trauma and bereavement domains, there is still confusion and lack of consensus about definitions and basic concepts. A conceptual framework, suggested here, may help bring clarity to the area. Our analysis shows that the lack of consensus about the nature of reactions and disorders of bereavement is due to concentration on different parts of the framework. Furthermore, the lack of differentiation between traumatic and non-traumatic bereavement has caused neglect of the unique features of non-traumatic grief reactions. These components need further exploration, especially since extension of DSM classification is currently under consideration.

Adaptation, Psychological↗
PubMed2000

On the classification and diagnosis of pathological grief.

It has been suggested that pathological grief should become either a separate category of mental disorder or be integrated within existing, extended classifications in systems such as the Diagnostic and Statistical Manual of Mental Disorders. Despite strong arguments for inclusion, and advancements by scientists toward development of diagnostic classification, there has been a lack of critical evaluation. Several issues need further scrutiny and clarification. These concern the definition of pathological grief, the distinction of pathological from normal grief, its relationship with other disorders, and the lack of agreement among scientists about criteria for pathological grief. Further research needs to focus on delineation of syndromes that comprise "pathological grief," and on derivation of acceptable, valid, diagnostic criteria. Evaluation of the ramifications--both positive and potentially negative--associated with the revision of the diagnostic status of pathological grief needs also to be undertaken.

Grief↗
PubMed1996

The role of loneliness and social support in adjustment to loss: a test of attachment versus stress theory.

A longitudinal study of a matched sample of 60 recently widowed and 60 married men and women tested predictions from stress and attachment theory regarding the role of social support in adjustment to bereavement. Stress theory predicts a buffering effect, attributing the impact of bereavement on well-being to stressful deficits caused by the loss and assuming that these deficits can be compensated through social support. In contrast, attachment theory denies that supportive friends can compensate the loss of an attachment figure and predicts main effects of marital status and social support. Attachment theory further suggests that marital status and social support influence well-being by different pathways, with the impact of marital status mediated by emotional loneliness and the impact of social support mediated by social loneliness. Results clearly supported attachment theory.

Adaptation, Psychological↗
PubMed1994

[Communication and dental practice. Practica in social dentistry and information].

An overview is presented of several undergraduate courses given by the Department of Social Dentistry and Dental Health Education (ACTA). A short description of the contents of courses in communication skills, treatment of anxious patients and practice management is given together with the results of a student-evaluation. Students consider these courses useful and relevant for future dental practice. This is especially true in case the direct relevance for clinical practice is clear.

Communication↗
PubMed1989

Elevated maternal serum alpha-fetoprotein values. How low is high?

Most maternal serum alpha-fetoprotein (MSAFP) screening programs are set up with the goal of prenatal detection of fetal neural tube defects. It is also commonly accepted that MSAFP testing yields many false-positive results. Screening programs commonly utilize schemata that identify abnormal levels of MSAFP as greater than 2.5 multiples of the median (MOM) and also recommend two abnormal values before initiating ultrasound evaluation. Our pilot program evaluating obstetric outcomes found that 21 of the 29 women with elevated MSAFP values (greater than 2.0 MOM) eventually developed significant pregnancy management changes or complications of pregnancy. Thus, we believe that the use of MSAFP screening solely for the purpose of detecting fetal neural tube defects is inconsequential relative to its usefulness in detecting other pregnancy abnormalities. We also believe that ultrasound evaluation should be accomplished after the first abnormal value and that the cutoff of 2.5 MOM should be lowered to at least 2.0.

Adult↗
PubMedDate not supplied

The dual process model of coping with bereavement: rationale and description.

There are shortcomings in traditional theorizing about effective ways of coping with bereavement, most notably, with respect to the so-called "grief work hypothesis." Criticisms include imprecise definition, failure to represent dynamic processing that is characteristic of grieving, lack of empirical evidence and validation across cultures and historical periods, and a limited focus on intrapersonal processes and on health outcomes. Therefore, a revised model of coping with bereavement, the dual process model, is proposed. This model identifies two types of stressors, loss- and restoration-oriented, and a dynamic, regulatory coping process of oscillation, whereby the grieving individual at times confronts, at other times avoids, the different tasks of grieving. This model proposes that adaptive coping is composed of confrontation--avoidance of loss and restoration stressors. It also argues the need for dosage of grieving, that is, the need to take respite from dealing with either of these stressors, as an integral part of adaptive coping. Empirical research to support this conceptualization is discussed, and the model's relevance to the examination of complicated grief, analysis of subgroup phenomena, as well as interpersonal coping processes, is described.

Adaptation, Psychological↗