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Results for “Psychosocial functioning”

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At least 433 records · Page 24Linked to original sources

PubMed2002

Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder.

OBJECTIVE: The purpose of this study was to compare psychosocial functioning in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder and patients with major depressive disorder and no personality disorder. METHOD: Patients (N=668) were recruited by the four clinical sites of the Collaborative Longitudinal Personality Disorders Study. The carefully diagnosed study groups were compared on an array of domains of psychosocial functioning, as measured by the Longitudinal Interval Follow-Up Evaluation--Baseline Version and the Social Adjustment Scale. RESULTS: Patients with schizotypal personality disorder and borderline personality disorder were found to have significantly more impairment at work, in social relationships, and at leisure than patients with obsessive-compulsive personality disorder or major depressive disorder; patients with avoidant personality disorder were intermediate. These differences were found across assessment modalities and remained significant after covarying for demographic differences and comorbid axis I psychopathology. CONCLUSIONS: Personality disorders are a significant source of psychiatric morbidity, accounting for more impairment in functioning than major depressive disorder alone.

Activities of Daily Living↗

PubMed1998

Predictors of child psychological changes during family-based treatment for obesity.

OBJECTIVE: To explore the influence of 1-year changes in child obesity and maternal psychopathology on changes in child psychological problems. DESIGN: Hierarchical regression models were used to predict child psychological change, with demographic variables, maternal psychological change, and child percentage overweight change as predictors. SETTING: Pediatric obesity research clinic. PARTICIPANTS: Clinic sample of 116 obese 8- to 12-year-old children and their mothers. INTERVENTIONS: Family-based behavioral weight-control program. MAIN OUTCOME MEASURES: Child psychopathology was assessed via mother-reported Child Behavior Checklists and maternal psychopathology was determined by standardizing scores on the Cornell Medical Index and the Symptoms Checklist-90-Revised. RESULTS: Significant improvements were observed in child percentage overweight (-20.1% overweight), and child and maternal psychopathology. Improved maternal psychopathology accounted for a significant amount of variance in improvements in the Child Behavior Checklist total Problems Scale and internalizing and externalizing problems subscales. Decreased obesity accounted for a significant amount of variance in improvements in the Total Competence scale and, somatic complaints, social problems and social competence subscales of the Child Behavior Checklist. Significant interactions of child obesity change by sex were found for Total Problems and externalizing scores. The interactions were due to girls with greater obesity reduction showing greater improvement in Total Problems, whereas boys with greater obesity reduction showed less improvement in externalizing problems. CONCLUSIONS: These results highlight the multidimensional nature of psychosocial functioning in obese children and call attention to multiple avenues for intervention to improve their psychosocial functioning.

Adult↗

PubMed2005

Motives for choosing growth-enhancing hormone treatment in adolescents with idiopathic short stature: a questionnaire and structured interview study.

BACKGROUND: Growth-enhancing hormone treatment is considered a possible intervention in short but otherwise healthy adolescents. Although height gain is an obvious measure for evaluating hormone treatment, this may not be the ultimate goal for the person, but rather a means to reach other goals such as the amelioration of current height-related psychosocial problems or the enhancement of future prospects in life and society. The aim of our study was to clarify the motives of adolescents and their parents when choosing to participate in a growth-enhancing trial combining growth hormone and puberty-delaying hormone treatment. METHODS: Participants were early pubertal adolescents (25 girls, 13 boys) aged from 11 to 13 years (mean age 11.5 years) with a height standard deviation score (SDS) ranging from -1.03 to -3.43. All had been classified as idiopathic short stature or persistent short stature born small for the gestational age (intrauterine growth retardation) on the basis of a height SDS below -2, or had a height SDS between -1 and -2 and a predicted adult height SDS below -2. The adolescents and their parents completed questionnaires and a structured interview on the presence of height-related stressors, parental worries about their child's behavior and future prospects, problems in psychosocial functioning, and treatment expectations. Questionnaire scores were compared to norms of the general Dutch population. RESULTS: The adolescents reported normal psychosocial functioning and highly positive expectations of the treatment in terms of height gain, whereas the parents reported that their children encountered some behavioral problems (being anxious/depressed, and social and attention problems) and height-related stressors (being teased and juvenilized). About 40% of the parents were worried about their children's future prospects for finding a spouse or job. The motives of the adolescents and their parents exhibited rather different profiles. The most prevalent parental worries related to the current or future functioning of their children, while a few cases were characterized by no observed motives or by psychosocial problems only reported by the adolescents themselves. CONCLUSION: The motives for participating in a growth-enhancing hormone trial are more obvious in the parents than in the adolescents themselves. Two out of three parents report worries about the future opportunities or observe modest current psychosocial problems in their children. The adolescents want to gain height, but the motivation underlying this remains unclear. Few of the adolescents experience psychosocial problems. Our analyses revealed differences among individuals in terms of motives, which implies that in an evaluation of hormone treatment, the importance of divergent outcome variables will also differ among individuals. Effectiveness evaluations of hormone treatment to increase height and the consequential fulfillment of other goals must be awaited.

Adolescent↗

PubMed1997

The Emotional, Social, and Behavioral Implications of Insulin-Induced Hypoglycemia.

Hypoglycemic episodes occur commonly in patients with insulin-dependent (Type I) diabetes and are associated with several negative sequelae. These include unpleasant symptoms, deterioration in cognitive-motor functions, embarrassment, accidents, unconsciousness, seizures, and even death. Although hypoglycemic disruptions in cognitive and motor function caused by neuroglycopenia are well-documented, the effects of hypoglycemia on other areas of psychosocial function have received less scientific attention. This paper examines the impact of hypoglycemia on emotional status, social behavior, and relationships. The physical symptoms and cognitive impairment that occur with hypoglycemia are caused primarily by hormonal changes and neuroglycopenia. These physiologic responses also seem to cause negative changes in affect and social behavior. These include changes in acute mood state, such as feelings of tension and anger, as well as negative interpersonal behavior, such as argumentiveness. Patients may also develop significant fear of hypoglycemia (FOH) and engage in behaviors aimed at avoiding low blood glucose levels, which may jeopardize metabolic control. Nondiabetic family members, who witness episodes and often must provide emergency treatment, can experience significant distress. Parents of diabetic children who have experienced unconsciousness exhibit high FOH, as do spouses of diabetic adults who have frequent episodes. Taken together, the research clearly shows that hypoglycemia can have a significant negative impact on psychosocial function and quality of life, which has important clinical and empirical implications.

Journal Article↗

PubMed2000

Global assessment of functioning (GAF) ratings: determinants and role as predictors of one-year treatment outcomes.

OBJECTIVE: To assess the adequacy of global ratings of patients' psychosocial functioning, which are an integral part of the current system for obtaining multidimensional psychiatric diagnoses and are embodied by the Global Assessment of Functioning (GAF) Scale as AXIS V of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994). METHOD: We identified a sample of 1,688 patients with substance use disorders, many of whom also had psychiatric disorders; examined the determinants of GAF ratings; and focused on how well these ratings predicted patients' one-year symptom and psychosocial functioning outcomes. RESULTS: Patients' clinical diagnoses and psychiatric symptoms were stronger predictors of GAF ratings than was their social and occupational functioning. Moreover, GAF ratings were only minimally associated with patients' one-year psychological, social, and occupational functioning outcomes. CONCLUSIONS: These findings raise serious questions about the conceptual and clinical value of the current standard method of assessing psychiatric and substance abuse patients' global functioning.

Adult↗

PubMed1993

A functional and psychosocial assessment of patients with post-Sudeck atrophy amputation.

Twelve patients with reflex sympathetic dystrophy were referred to a comprehensive orthopaedic rehabilitation center after failure of conservative management. Ten underwent amputation of the affected limb and, although functional improvement occurred in the patients undergoing lower limb amputation, psychosocial dysfunction persisted. All the patients required psychological support. In cases of post-Sudeck amputation, early orthopaedic diagnosis and referral to a comprehensive treatment center are recommended. In the 12 cases described here, apart from the obvious limb pathology, severe psychological inadequacies were found to be present.

Activities of Daily Living↗

PubMed2005

The effect of hearing aids and frequency modulation technology on results from the communication profile for the hearing impaired.

Hearing impairment has been associated with decline in psychosocial function. Previous investigations have reported that the utilization of hearing aids can ameliorate these reductions in psychosocial function. To date, few investigations have examined the effects of frequency modulation technology on hearing handicap, adjustment to hearing loss, and communicative strategies. The purpose of this investigation was to examine these effects and to compare them to the benefits obtained when using hearing aids alone. Subjects ranged in age from 34 to 81 years and had mean pure-tone thresholds consistent with a bilateral moderate to severe sloping sensorineural hearing loss. All subjects wore hearing aids only and hearing aids plus FM system in a randomized fashion. The Communication Profile for the Hearing Impaired (CPHI) was administered prior to fitting the study devices and once a month for three months in each of the two conditions. A statistically significant difference between device conditions was obtained for the Importance of Communication in Work Situations subscale. Additionally, statistically significant differences over time were noted in several CPHI subscales. Despite statistical significance, none of these results were clinically significant. The implications of these results will be discussed.

Adult↗

PubMedDate not supplied

Psychosocial evaluation of adults with epilepsy in Chile.

The Washington Psychosocial Seizure Inventory (WPSI) was used to assess psychosocial functioning of 116 epileptic outpatients being treated in an epilepsy program at a public health service (PHS). Disturbances in several areas of psychosocial adjustment were noted. Although the distribution was similar to those previously reported using the WPSI, the severity of the observed disturbances was greater. Peak-score scales were Financial Status, Emotional and Interpersonal Adjustment, and Overall Psychosocial Functioning. Rehabilitation measures in epilepsy could play a substantial role in prevention and treatment of psychosocial disorders.

Activities of Daily Living↗

PubMed2001

The roles of beliefs, catastrophizing, and coping in the functioning of patients with temporomandibular disorders.

Pain-related beliefs, catastrophizing, and coping have been shown to be associated with measures of physical and psychosocial functioning among patients with chronic musculoskeletal and rheumatologic pain. However, little is known about the relative importance of these process variables in the functioning of patients with temporomandibular disorders (TMD). To address this gap in the literature, self-report measures of pain, beliefs, catastrophizing, coping, pain-related activity interference, jaw activity limitations, and depression, as well as an objective measure of jaw opening impairment, were obtained from 118 patients at a TMD specialty clinic. Controlling for age, gender, and pain intensity, significant associations were found between (1) pain beliefs and activity interference, depression, and non-masticatory jaw activity limitations, (2) catastrophizing and activity interference, depression, and non-masticatory jaw activity limitations, and (3) coping and activity interference and depression. Controlling for age, gender, pain intensity, and the other process variables, significant associations were found between (1) beliefs and activity interference and depression, and (2) catastrophizing and depression. No process variable was associated significantly with the objective measure of jaw impairment. The results suggest that for patients with moderate or high levels of TMD pain and dysfunction, beliefs about pain play an important role in physical and psychosocial functioning.

Adaptation, Psychological↗

PubMed2006

Psychosocial aspects of aphasia: speech and language therapists' views on professional practice.

BACKGROUND: Although the psychosocial dimensions of aphasia are relatively well understood, there may be variations in how these effects are managed in routine intervention. Speech and language therapists may hold a variety of views about this dimension of the aphasic experience, and these views may play a role in how intervention is managed.Aims. To survey practitioner views on the pertinence of psychosocial dimensions in the management of the aphasia speaker. METHODS AND PROCEDURES: Five hundred and twenty-one speech and language therapists who were members of the British Aphasiology Society were surveyed by questionnaire about their views on the importance and role of psychosocial effects (response rate to questionnaire, 33%). The questionnaire was composed of (i) background details of the participants' work context; (ii) attitude towards preparation for working in this area; (iii) attitude towards the importance of psychosocial effects in the management of aphasia; (iv) perceptions of clinical time devoted to this aspect of management; (v) attitude towards the rated importance of specific dimensions of psychosocial effects; (vi) details of methods used; (vii) an open question asking for further comments. OUTCOME AND RESULTS: Overall, strong agreement was shown about the importance of this aspect of aphasia intervention. Participants who believed that psychosocial aspects were important to overall management of the client also believed that these factors were important to the outcome of the intervention. Quality of life (QOL) was found to be an important dimension in psychosocial function, and premorbid experiences were perceived as affecting the outcome of interventions. A range of methods for working on psychosocial functions were reported. Concerns about managing service delivery in this area were expressed, with variations in reported time spent on this type of intervention. CONCLUSIONS: For this population of participants, the psychosocial dimensions were reported as important to management and outcome from intervention. Although variations in views and reported practice were evident, there were a range of responses, which showed a majority view, and these form the basis of key questions to be examined in further studies.

Anxiety↗

PubMed2003

The functional and psychosocial impact of fecal incontinence on women with urinary incontinence.

OBJECTIVES: The study was undertaken to determine the impact of fecal incontinence (FI) on functional status and quality of life in women with urinary incontinence (UI). STUDY DESIGN: In 24 months 732 women completed a standardized assessment and questionnaire, including the Short Form (SF)-12 and Incontinence Quality of Life (I-QOL) scores. Analysis of variance was used to compare SF-12 scores between groups defined as having UI, FI, or both UI and FI. I-QOL scores in patients with UI or UI and FI were compared by using the Student t test. RESULTS: Of the 732 patients enrolled, 425 patients had either UI (n = 342, 80%), FI (n = 18, 4%), or both (n = 65, 15%). Greater impairment in physical functioning was seen in the group with UI and FI (38.6; P =.027) compared with the group with UI (42.4). Significant decreases in I-QOL scores were seen for the group with UI and FI compared with those with UI (P <.005). CONCLUSION: Fecal incontinence further reduces the functional status and quality of life of women with urinary incontinence.

Adult↗

PubMed2005

Dietary fat intake is associated with psychosocial and cognitive functioning of school-aged children in the United States.

Using cross-sectional data from the Third National Health and Nutrition Survey, 1988-1994, we examined whether dietary fat intake is associated with cognitive and psychosocial functioning in school-aged children. Based upon 24-h diet recall interviews, dietary intakes of total fat, SFA, monounsaturated fatty, PUFAs, and cholesterol were estimated in 3666 participants aged 6 to 16 y. Psychosocial functioning was evaluated in interviews of each child's mother. Cognitive functioning was measured using achievement and intelligence tests. Overall, total fat and saturated fat were unrelated to measures of cognitive and psychosocial functioning. Compared with equivalent energy intake from saturated fat or carbohydrate, each 5% increase in energy intake from PUFAs was associated with lower risks of poor performance on the digit span test (replacing SFA, OR = 0.58, 95% CI = 0.37-0.91; replacing carbohydrate, OR = 0.61, 95% CI = 0.43-0.88). Cholesterol intake was associated with an increased risk of poor performance on the digit span test (OR = 1.25, 95% CI = 1.11-1.42 for each 100-mg increment intake of cholesterol). The associations were independent of socioeconomic status, maternal education and marital status, and children's nutrition status and were consistent across different methods of energy adjustment in regression models. We conclude that high intake of PUFAs may contribute to an improved performance on the digit span test. In contrast, increased intake of cholesterol may be associated with a poorer performance.

Adolescent↗

PubMed2004

Psychosocial adjustment to orthotopic liver transplantation in 266 recipients.

Although the survival rate of patients undergoing orthotopic liver transplantation (OLT) is highly satisfactory, one of the most important objectives for liver transplantation teams at the present time is to achieve the best possible quality of life and psychosocial functioning for these patients after transplantation. We present the preliminary results of a study designed to determine which domains of psychosocial functioning are most affected in liver transplant recipients, and to examine the factors associated with poorer adjustment after OLT, using a utility-based standardized measure. Patients who had undergone liver transplant more than 12 months previously were eligible. They were administered the Psychosocial Adjustment to Illness Scale (PAIS), and they provided the answers themselves. Multivariate regression models showed that attitudes toward health care were poorer in women (beta = 0.916, P <.001), in patients who were employed at the moment of transplantation (beta = 0.530, P =.032), and in patients of lower social class (beta = 0.722, P =.026) than in men, unemployed patients, and patients of higher social class. Sexual functioning was worse in women (beta = 0.907, P =.001) and older patients (beta = 0.999, P <.001) than in men or younger patients. Psychological distress was higher in women (beta = 0.981, P =.001) than in men, and lower in currently employed patients (beta = -0.937, P =.001) than in the unemployed. Only gender remained significantly associated with the total PAIS score (beta = 0.969, P <.001), with women showing a poorer overall psychosocial adjustment to OLT. In conclusion, there seems to be no doubt that liver transplantation improves quality of life, but special attention should be paid to female recipients, who seem to have more difficulty than their male counterparts in adjusting to the psychosocial consequences of the procedure.

Adaptation, Psychological↗

PubMed1992

Diabetes support groups improve health care of older diabetic patients.

OBJECTIVE: To assess whether knowledge or psychosocial and glycemic benefits of a diabetes education program are enhanced by a support group for older patients. DESIGN: A partially randomized controlled trial involving two groups of patients: Group A, subjects who received an education program followed by 18 months of support group sessions; Group B, only the diabetes education program. A third convenience sample, Group C, received neither intervention. Groups A and B were assessed before and immediately after the education program, and all groups were assessed 2 years after the education program. SETTING: Diabetes clinic at a Veterans Affairs Medical Center. PATIENTS: All subjects were male (mean age = 68 +/- 1.3 years, range = 57-82 years; duration of diabetes = 10 +/- 2 years, range 3-16). Sample sizes were 11 in Group A, 13 in Group B, and 8 in Group C. INTERVENTION: The education program consisted of six weekly sessions covering aspects of diabetes self-care. The support group consisted of 18 monthly sessions for continuing education, discussion, and structured social activities. OUTCOME MEASURES: Diabetes knowledge, psychosocial factors (self-care-related quality of life, stress, family involvement in care, and social involvement), depression, and glycemic control. RESULTS: Group A scored better (at least P less than 0.05) on knowledge, quality of life, and depression than the other groups. Groups A and B showed less stress, greater family involvement, better glycemic control, but less involvement in social activities than Group C. CONCLUSION: Diabetes education programs can have long term benefits on knowledge, psychosocial functioning, and glycemic control for older diabetic patients. The addition of support groups enhances diabetes knowledge and psychosocial functioning.

Age Factors↗

PubMed1998

Retrospective review of treatment outcome for 63 patients with trichotillomania.

OBJECTIVE: The authors' goal was to assess naturalistic treatment outcome in trichotillomania. METHOD: Sixty-three patients who had been treated in a specialty clinic for trichotillomania over a period of 6 years were contacted. The patients were given paper-and-pencil instruments that assessed current severity of hairpulling, depression, anxiety, self-esteem, and psychosocial functioning. RESULTS: Significant mean improvement was found on measures of hairpulling, depression, anxiety, self-esteem, and psychosocial functioning. Improvement in hairpulling was associated with greater depression at the time of their index clinic evaluation as well as more improvement in depression after treatment. CONCLUSIONS: State-of-the-art behavioral and pharmacological treatments offer substantial clinical benefit to patients with trichotillomania, both in hairpulling symptoms and ancillary measures of functioning.

Adolescent↗

PubMed2026

Does Timing Matter? Age of First Mobile Phone Acquisition and Psychological Outcomes in Middle and Late Adolescence.

The age at which adolescents acquire their first smartphone has decreased markedly in recent years; however, evidence on its long-term effects on psychosocial adjustment remains limited. This study investigated whether age at first mobile phone acquisition is associated with psychosocial functioning in middle and late adolescence, including social integration and competence, emotion regulation difficulties, disordered eating behaviors and problematic social media use (PSMU). The sample comprised 1179 adolescents aged 15-17 years (53.8% female). Linear regression and generalized additive mixed models were used to examine both linear and nonlinear associations, adjusting for age, gender and school clustering. Earlier smartphone acquisition was linearly but weakly associated with greater emotion regulation difficulties, disordered eating and PSMU, even after adjustment for covariates. In contrast, associations with social integration and competence were nonlinear: acquiring a first smartphone between ages 6 and 10 or after age 13 was associated with lower social integration in adolescence, whereas acquisition between ages 11 and 13 was linked to higher social functioning. These findings suggest that the developmental timing of first smartphone access shows a modest association with subsequent psychosocial functioning during middle and late adolescence. Focusing on the timing of access, alongside other demographic and contextual factors, may contribute to a better understanding of digital influences on adolescent well-being.

Humans↗

PubMedDate not supplied

Motor preference, major depression and psychosocial dysfunction among children with attention deficit hyperactivity disorder.

Since left motor preference has been hypothesized to lead to increased risk for psychopathology and cognitive deficits, it is possible that it may confer greater vulnerability for these problems to attention deficit hyperactivity disorder (ADHD) children. Subjects were 6-17 year-old boys with DSM-III-R ADHD (N = 140) and normal controls (N = 120) and their first-degree relatives. Information on motor preference was obtained in a standardized manner blind to the proband's clinical status. Although no excess of non-right motor preference was identified in ADHD probands compared with normal controls, the non-right motor preference observed in ADHD probands was partly familial and was associated with significantly increased risk for major depressive disorder and impaired psychosocial functioning. Non-right motor preference in ADHD probands significantly increases the risk for major depression and impaired psychosocial functioning. These findings raise the possibility of alterations in cerebral dominance which may be implicated in the expression of specific problems in some patients with ADHD. Further research is needed to replicate these findings and to directly assess cerebral functioning in ADHD.

Adolescent↗

PubMed2004

Reducing cardiovascular risk factors in postmenopausal women through a lifestyle change intervention.

BACKGROUND: The impact of a 6-month lifestyle change intervention on cardiovascular risk factors in obese, sedentary, postmenopausal women was examined. A secondary aim of this investigation was to determine whether the addition of self-control skills training to an empirically supported lifestyle change intervention would result in greater cardiovascular risk reduction. METHODS: Forty-four women were randomly assigned to receive either a lifestyle change or a lifestyle change with self-control skills intervention. Pretreatment and posttreatment weight loss, body composition, physical activity, cardiorespiratory fitness, diet, blood pressure (BP), blood lipids, and psychosocial functioning were assessed. Also, at 1-year posttreatment, weight loss, body composition, self-reported physical activity, and psychosocial functioning were assessed. RESULTS: The women significantly increased their physical activity (+39.6%) and cardiorespiratory fitness (+13.5%) and reduced their body weight (-6.5%), fat mass (-7.4%), body fat (-2.4%), BP (SBP -6.2%, DBP -9.2%), total cholesterol (-7.4%), triglycerides (-16.5%), and low-density lipoprotein (LDL) cholesterol (9.1%) and improved their diet (p < 0.05). At the 1-year follow-up, women had regained approximately 63% of their posttreatment weight loss (p < 0.05), but had maintained their previous increases in physical activity. Additionally, there were no significant changes in fat free mass, body fat, anxiety, or depression between the end of treatment and 1-year posttreatment. The addition of self-control skills training did not significantly improve cardiovascular risk reduction. CONCLUSIONS: Lifestyle change interventions may be an effective means for reducing cardiovascular risk in obese, sedentary, postmenopausal women. However, greater attention should be devoted to the maintenance of these positive lifestyle changes.

Aged↗