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At least 343 records · Page 19Linked to original sources
PubMed2000

The social context of insight in schizophrenia.

BACKGROUND: Psychiatrists place great weight on impaired insight in schizophrenia, generally attributing it to pathological mental processes. However, denial of illness may be based on attitudes common in patients' social and cultural groups. Moreover, even where denial of illness has a pathological element, it may be affected by the social context. In this paper, we predicted that denial of illness would be associated with social distance between clinician and patient, and reduced by access to 'normalizing' social interaction. METHOD: One hundred and fifty patients with schizophrenia in the London arm of the European Schizophrenia cohort were assessed using the 'Awareness of Illness' (AI) subscale of David's Assessment of Insight. Clinical and social attributes were related to AI. RESULTS: There was little evidence for our social distance hypotheses: there was little variation in AI by social class, ethnicity, membership of a drug taking culture or the presence of strongly held religious beliefs. However, there were strong relations between AI and the size of primary group, consistent with our normalizing hypothesis. CONCLUSIONS: The normalizing function of social support is in line with modern psychological models of delusion formation. Longitudinal data will eventually be available from the current study that will assist in establishing the causal direction of this association.

Adult↗
PubMed1999

Thought disorder in schizophrenia. Testing models through confirmatory factor analysis.

Theoretical and empirical models of thought disorder (ThD) were tested through Confirmatory factor analysis (CFA). A sample of 253 DSM-III-R acute schizophrenic patients consecutively admitted was studied. A semistructured interview for schizophrenia was used for diagnosis, and ThD was assessed by means of the Thought, Language, and Communication scale (TLC). Nine ThD models comprising the 18 symptoms of the TLC were tested (ranging from a null model to a six-factor model). The six-dimension model achieved the best fit to the data, although no perfect fit was found. ThD dimensions included in this model were Disorganization, Negative, Idiosyncratic, Semantic, Attentional, and Referential dimensions. The TLC was close to capture adequately these underlying constructs. The Disorganization and the Negative dimensions received more validity on conceptual and psychometric grounds than the remaining dimensions. Thought Disorder multidimensional models fitted the data better than one-dimension models. Thought Disorder dimensions would be potential markers for biological, neurophysiological, and neuropsychological studies of schizophrenic disorder.

Adolescent↗
PubMed1993

Development of a predictive model for role strain in registered nurses returning to school.

This study identified the individual characteristics that are expected to predict and explain role strain in registered nurses (RNs) returning to school. A model was developed and tested to predict and explain role strain. The characteristics expected to predict role strain were personality, stage of career development, and marital status. Personality was assessed by the Comrey Personality Scales, stage of career development was assessed by the Career Concerns Inventory, and the criterion variable role strain was assessed by the Lengacher Role Strain Inventory. A convenience sample of 123 RN students were asked to participate in the study and 86 RNs volunteered. The data were analyzed using multiple stepwise regression analysis. Results of the stepwise regression analysis identified 13 variables as significant predictors of role strain. A double cross-validation regression procedure was completed to validate the results of the multiple regression analysis. In subsample A of the cross-validation analysis, six variables were found to be significant predictors of role strain, while in subsample B, 12 variables were significant predictors.

Adult↗
PubMed1991

The middle schooling process: influences on science and mathematics achievement from the longitudinal study of American youth.

The purpose of this longitudinal study was to develop and test a model of middle school science and mathematics achievement with a national probability sample of 3,116 seventh-grade public school students. Eighth-grade achievement was viewed as a function of readiness attributes on entry into seventh grade and intervening parent, peer, self, and classroom affective and behavioral measures. Data were collected from students and parents over three time periods in seventh and eighth grade. Results of a revised structural model showed that prior achievement in science and math was a strong mediator of effects in the process of schooling. Grades in sixth grade, parental expectations, parent educational attainment, and motivation had moderately strong indirect effects on eighth-grade achievements. Also notable was the positive direct influence of perceptions of classroom context on science and math achievement growth and the negative direct influence of sex (in favor of girls) on science achievement growth. Cross-validation on a split-half sample did not disconfirm the model. It was concluded that while prior achievement had a dominant influence in the schooling process, other variables including parental expectations, motivation, and classroom context do contribute to the schooling process and can be a focal point for improving school success. These and other factors, though helpful, may be most effective well before the middle school years.

Achievement↗
PubMed2001

Organizational context and provider perception as determinants of mental health service use.

This study refines and tests an individual client model of service use and contrasts it with a model of service provision based on gateway provider perspectives. Structural equation models demonstrate that provider variables account for more service use variation than client variables. The client model accounts for 24% of the variance in service use, while the provider model accounts for 55% of the variance. Youth self-reported mental health was not positively associated with increased services or with provider perception of youth mental health. The provider model demonstrates the critical role played by provider perceptions, which are influenced more by work environment than by client problems.

Adolescent↗
PubMed1990

Intersubjective processes in psychotherapy.

An intersubjective field is created by the interplay between the subjective inner worlds of the patient and therapist. The study of intersubjective processes has been based loosely on the paradigm of infant and caregiver interactions with subsequent empathic appreciation of each others' subjective realities. This approach is not necessarily dependent on an acceptance of a self-psychology model. Dyadic interactional dynamics can be explored and understood using different theoretical models. It may be therapeutic to be able to communicate and clarify significant moments of shared mutuality and affects, which when put into words often uncover previously repetitive and frustrating misunderstandings and expectations.

Adult↗
PubMed2005

Matrix model of clinical psychology: applause or the sound of one hand clapping?

The matrix model as proposed by C.R. Snyder and T.R. Elliott (this issue, pp.1033-1054) is a welcome refocusing of clinical psychology for the 21st century. Yet, limitations to the model are that (a) it shifts attention to the target of interventions (i.e., "clients") and virtually ignores the function of the interventionist; (b) it might not be the best way to characterize "clients"; and (c) training might take longer than 5 years. Overall, it is a heuristic model; will it be accepted?

Curriculum↗
PubMed2006

Modeling and simulation of sexual activity daily diary data of patients with female sexual arousal disorder treated with sildenafil citrate (Viagra).

PURPOSE: To develop a model to explore the dose-response of sildenafil citrate in patients with female sexual arousal disorder (FSAD) based on telephone sexual activity daily diary (TSADD) data obtained in double-blind, placebo controlled clinical studies. MATERIALS: Data were available on 614 patients with FSAD. A parametric model (Weibull distribution) was developed to describe the probability density function of the time between sexual events. Orgasm satisfaction scores and overall sexual satisfaction scores were simultaneously modeled as ordered categorical variables. Simulations were performed to evaluate the expected clinical response in patients with FSAD. RESULTS: The expected time between sexual events was approximately 3.5 days. Satisfaction scores increased with time to achieve a plateau after 3 to 4 weeks on treatment. The expected probability of satisfying orgasm (score of 3 and higher) ranged from 34.7% for placebo to 41.6% for 100 mg sildenafil citrate. Treatment effect (difference from placebo) was 6.9% for 100 mg sildenafil citrate, ranging from 0.6 to 24.7% for testosterone levels of 0.1 to 4.0 pg/ml. The treatment effect in postmenopausal women was larger than in premenopausal women. CONCLUSION: A modeling and simulation framework to support drug development in FSAD was developed. Sildenafil citrate demonstrated a dose-dependent effect in patients with FSAD.

Adult↗
PubMed1990

Composite holographic associative recall model (CHARM) and blended memories in eyewitness testimony.

The idea that compositing or blending occurs in human episodic memory stems from two sources: (a) distributed memory models and (b) studies on the errors that occur in eyewitness testimony. These two traditions of research--theoretical and empirical--have been independent and distinct. Here, data from the eyewitness testimony paradigm are simulated by the distributed model CHARM (Composite Holographic Associative Recall Model). Of focal concern are Loftus's studies, which have been interpreted in favor of the blending hypothesis, and McCloskey and Zaragoza's studies, which have been interpreted as refuting Loftus's position. Both of these seemingly contradictory results, as well as recent findings with yes/no recognition, fall out of the model. Finally, the model predicts empirically found color shifts and provides specifications for when blends and memory impairments will and will not be expected.

Association Learning↗
PubMed1996

Positive illusions and coping with adversity.

We review the literature showing that positive illusions (i.e., self-aggrandizement, unrealistic optimism, and exaggerated perceptions of control) are common and associated with successful adjustment to stressful events, including conditions of extreme adversity. Using theory and recent data, we offer a basis for integrating positive illusions with the constraints of reality. We explicitly contrast the social psychological model of positive illusions with a personality viewpoint that addresses the question "Do higher levels of positive illusions predict higher levels of adjustment?" These issues are explored in the context of people coping with an array of normal stressful events, as well as those coping with more extreme stressful events, including cancer, heart disease, and HIV infection.

Adaptation, Psychological↗
PubMedDate not supplied

Understanding and caring for the distressed patient with multiple medically unexplained symptoms.

BACKGROUND: Although physicians commonly encounter patients with complicated medical problems, some have a mix of unexplained medical symptoms and distress that can seem overwhelming to patient and physician alike. METHODS: We describe a model for thinking about and helping these complex patients. The model was developed from our personal clinical experience as primary care psychiatric consultants, as well as from a review of the literature using such key words as "difficult," "frustrating," and "somatization." RESULTS: The model involves understanding predisposing factors that render the patient vulnerable to the development of a disabling condition, precipitating factors that initiate an episode of illness, and perpetuating factors that maintain maladaptive illness behaviors with time. CONCLUSIONS: Awareness of these factors allows the clinician not only to tolerate and gradually unravel the complicated interactions that create and sustain distress in patients with multiple medically unexplained symptoms, but also devise practical and effective management strategies for these complex patients.

Adult↗
PubMed2000

The traveling salesman problem: a hierarchical model.

Our review of prior literature on spatial information processing in perception, attention, and memory indicates that these cognitive functions involve similar mechanisms based on a hierarchical architecture. The present study extends the application of hierarchical models to the area of problem solving. First, we report results of an experiment in which human subjects were tested on a Euclidean traveling salesman problem (TSP) with 6 to 30 cities. The subject's solutions were either optimal or near-optimal in length and were produced in a time that was, on average, a linear function of the number of cities. Next, the performance of the subjects is compared with that of five representative artificial intelligence and operations research algorithms, that produce approximate solutions for Euclidean problems. None of these algorithms was found to be an adequate psychological model. Finally, we present a new algorithm for solving the TSP, which is based on a hierarchical pyramid architecture. The performance of this new algorithm is quite similar to the performance of the subjects.

Algorithms↗
PubMed2006

Influence of the ice-hockey environment on taking up snuff: an interview study among young males.

In Sweden, snuff-use is an established and accepted phenomenon in society, especially in connection with certain sports. The aim of this qualitative study was to analyze and describe the psychosocial environment influencing young male ice-hockey players into starting to use snuff. The study sample comprised 16 male participants between 15 and 32 years of age strategically selected for being active or having been active as ice-hockey players--snuff-users and non-users alike. A grounded theory design, including in-depth interviews, was used to generate a theory from data and thereby create theoretical concepts explaining social phenomena, human behavior, and process. An interview guide containing different themes was used to cover the study area. Five higher-order categories were developed and labeled: having a role model, residing in a consenting environment, experiencing performance demands, experiencing a sense of community and creating an image. Socialization in and through psychosocial norms of the ice-hockey environment was identified as a core category describing the central meaning of the informants' experiences of snuff in the ice-hockey environment. In the present study, the identified categories that integrate within the environment in which the young people reside and pursue their sports activities have been interpreted as factors enhancing the commencement of snuff-use. We suggest health promotion activities within the ice-hockey environment based on a health psychology model of planned behavior.

Adolescent↗
PubMed1998

Factor structure and clinical validity of competing models of positive symptoms in schizophrenia.

BACKGROUND: The factor structure of four competing models of positive symptoms and their clinical validity was studied in a sample of 253 schizophrenia inpatients. METHODS: The following models were tested using confirmatory factor analysis: a one-dimension severity model, a two-dimension model comprising a psychosis factor and a disorganization factor, a four-dimension model based on the Scale for the Assessment of Positive Symptoms (SAPS) structure in subscales, and a five-dimension model derived from the previous one by further differentiating Schneiderian delusions from non-Schneiderian ones. RESULTS: More complex multifactorial models fit the data better than simpler models. The five-dimension model was the best adjusted (goodness of fit index = .844, nonnormed fit index = .812, normed fit index = .728). Whereas the one-dimension model did not display significant association with the clinical variables, multidimensional models were related to age at onset and illness severity. The two-dimension model captured well the clinical correlates of the more complex models. CONCLUSION: None of the tested models showed good fit to the data. The one-dimension model displayed both poor factor validity and poor external validity; therefore, research relying on the SAPS total score may reach misleading conclusions.

Adult↗
PubMed2004

Isumagijaksaq: mindful of the state: social constructions of Inuit suicide.

Inuit suicide is the most significant mental health issue in the newly created Nunavut Territory of Canada's eastern Arctic. Suicide rates in Nunavut are 6 times those of Canada's southern provinces. Consistent with other Canadian populations, males aged 15-29 years of age are most at risk. Various social constructions have been used to make sense of Inuit suicide, a phenomenon of historical interest to anthropologists, who popularized the idea of elderly Inuit voluntarily abandoning their lives to the elements so as not to burden their surviving relatives. An examination of the literature and research dealing with Inuit suicide suggests that three typologies have typically been used to explain the problem: organic or quasi-organic explanations, social explanations involving concepts of social change and social disruption, and socio-psychological models of two types; a risk assessment approach focusing on the circumstances surrounding the deceased or the person with suicidal thoughts and another dealing with norms, values, thought processes and relationships within Inuit culture. We argue that these approaches offer incomplete explanations of the current problem. Attempts to complete the picture by identifying risk factors have produced contradictory and unsatisfactory results. We conclude that the impact of colonial relations of ruling has much to do with the current problem and advocate an approach that combines narrative research and intergenerational communication with community action to address the problem. Low Inuit inuusittiaqarniq (self-esteem) is an important factor in Inuit suicide, but rather than a psychological problem, has its roots in a history of colonialism, paternalism and historical events.

Adolescent↗
PubMed1995

Empirical validation for a family-centered model of care.

OBJECTIVE: To examine whether family relations and family-life stress predict adherence behaviors and metabolic control in youths by testing a theoretically- and empirically-based model. RESEARCH DESIGN AND METHODS: HbA1c levels of 157 youths 12-20 years of age with insulin-dependent diabetes mellitus (IDDM) were evaluated, along with treatment adherence and psychosocial family data based on interviews and self-reports. A family-centered model for IDDM care was analyzed with the EQS structural modeling statistical program. An additional exploratory model including HbA1c levels 6 months earlier was also tested. RESULTS: Positive family relations (high family cohesion and low family conflict), especially during the first years of illness, indirectly related to good metabolic control through positive adherence behaviors. High levels of family-life stress related to worse metabolic control directly, and also indirectly via poor family relations, which in turn related to poor adherence to treatment. Longer illness duration related indirectly to metabolic control via adherence to treatment. Longer illness duration also related to maternal perceptions of higher family-life stress. Older youths perceived more family-life stress as well. The older age of the youths related indirectly to poor metabolic control through its association with poor adherence behaviors and less cohesive and more conflictual family relations. Results were consistent when earlier levels of metabolic control were included in the model, except that the direct relationship between family-life stress and metabolic control became nonsignificant. CONCLUSIONS: The findings suggest that a family-centered approach to diabetes care that facilitates positive family functioning and leads to lower levels of family-life stress may be useful in promoting optimal health outcomes.

Adolescent↗