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Results for “Psychosocial functioning”

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PubMed1989

School adjustment, school performance and peer relations among first-graders in a Swedish suburban area.

A study of 95 first-graders in one school management area used teacher ratings of problems and sociometric ratings to assess school adjustment and peer relations; 14% of the children had difficulties in reading/writing, motor skill, concentration and psychosocial function. Behavioural problems did not generally coincide with poor scholastic performance, but a small group (6.3%) exhibited problems in both reading/writing, concentration, gross and fine motor skill and psychosocial functions. Sociometric results showed only moderate agreement with teacher ratings. Extremely popular boys had no teacher-rated problems, but children with teacher-rated problems did not to any high degree tend to be isolated. Poor gross motor skill did distinguish isolated boys from others, a relationship that was not evident among the girls. The need to study the validity of teacher ratings as well as the prognostic value of school adjustment in first grade was stressed.

Achievement↗

PubMed2001

Classification rules for basic phonological processing disabilities and nonverbal learning disabilities: formulation and external validity.

Rules for the classification of two subtypes of learning disabilities (LD), namely, Basic Phonological Processing Disabilities (BPPD) and Nonverbal Learning Disabilities (NLD), are reported. These rules (refined as a result of application to two separate samples of children with LD) were used to select children from an entirely new sample who could be classified as having "definite" or "probable" BPPD or NLD. As a first step in the external validation of these rules, the patterns of psychosocial functioning exhibited by these two subtypes of LD were determined. As predicted, the vast majority of the BPPD subtype exhibited a pattern most consistent with normal or relatively normal psychosocial adjustment, and no appreciable increase in the incidence of significant psychosocial disturbance with advancing years. Also, as predicted, an increasing incidence of internalized psychosocial dysfunction (a form of significant psychosocial disturbance) was evident in the NLD subtype with advancing years. It is clear that children classified as having BPPD or NLD using these rules exhibit quite different, and predicted, relative patterns of psychosocial functioning. Thus, in this sense, the rules have concurrent validity. Finally, sets of rules/criteria for classification are presented that reflect their actual incidence in the two subtypes of LD generated for use in the validation phase of this investigation. These rules would appear to be useful for clinical purposes. It is also clear that they should be subjected to further validation studies in a broader age range for clinical and research purposes.

Adolescent↗

PubMed1994

Do patients' health status reports predict future hospital stays for patients with an acute myocardial infarction?

OBJECTIVE: Although patients' reports of health status and functioning have been shown to be reliable and valid measures for use in health care research, there is limited information on their practical utility in clinical settings. The purpose of this study was to determine if patients' reports of physical and psychosocial health status have prognostic value by predicting future hospital stays in acute myocardial infarction (AMI) patients. METHODS: Research design was an observational, longitudinal follow-up study involving a sample of 132 AMI patients recently discharged from nine community hospitals. One hundred twelve patients (85%) completed the study. Patient reports of general health status, diagnosis-specific measures of health status, medical history, and demographic characteristics were collected one to two months post AMI; follow-up data were gathered six months later to identify occurrence of new cardiac-related stays. RESULTS: Poor psychosocial functioning and cardiac symptoms were significantly associated with the likelihood of being rehospitalized (odds ratios of 4.62 and 4.00). Multivariate results, however, show that poor psychosocial function and younger age--but not cardiac symptoms--are significant independent predictors of new hospital stays, after controlling for medical history and demographic variables. CONCLUSION: Simple patient reports of health status, which physicians can obtain easily from AMI patients shortly after an infarction, are predictive of rehospitalization.

Acute Disease↗

PubMed1998

Psychosocial aspects of adolescent cancer survival.

OBJECTIVE: The purpose of this research was to examine the psychosocial status of adolescent cancer survivors and compare them with healthy peers. It has been suggested in previous research that the majority of survivors display equivalent levels of psychosocial functioning post-treatment as compared with healthy controls. However, despite successful treatment, survivors may have to adjust to living with a chronic illness and its associated late effects interspersed across the lifespan (e.g. infertility, cognitive deficits, heart complications). Whilst young people appear to have similar levels of psychosocial functioning, avoidance strategies such as denial may result in previous research findings being confounded and in underestimating the true psychosocial status of survivors. It is important to understand the psychosocial status of survivors in order to optimise their quality of life. METHODOLOGY: Coping mechanisms, anxiety levels and self-concepts of 32 adolescent cancer survivors, predominantly Acute Lymphoblastic Leukaemia (ALL) were compared with 34 healthy adolescents (age range 12-17 years), via a mailout. RESULTS: Survivors' self-reports suggest no overt psychological dysfunctioning. Whilst the two groups shared similar coping strategies, survivors were found to be less anxious than peers, with a tendency to employ avoidance strategies to deal with problems faced in adolescence. Age, gender and specific illness variables, such as age at diagnosis and time since treatment, were strong predictors of psychological outcome. CONCLUSIONS: Results can be interpreted as suggesting that whilst cancer survivors have a similar psychosocial profile to healthy peers, they are more likely to utilise avoidance strategies to manage problems.

Adaptation, Psychological↗

PubMed2003

Exposure to "low-level" aggression in school: associations with aggressive behavior, future expectations, and perceived safety.

Examined associations with witnessing and being victimized by "low-level" aggressive acts (e.g., pushing, gossip) and three indicators of psychosocial functioning in a sample of 771 elementary school students from one urban and one suburban school district. Results indicated that exposure to low-level aggression appears to relate to psychosocial functioning in ways similar to more severe forms of aggression. Students who were exposed to higher levels of both witnessing and victimization by low-level aggression reported the highest levels of engagement in aggression, the lowest levels of positive expectations for the future, and the lowest levels of perceived safety. Findings are discussed in the context of research on exposure to aggression in general, with suggestions offered for future studies. Implications of the findings for school-based intervention programs are raised.

Aggression↗

PubMed1996

Predictors of enhanced well-being after coronary artery bypass surgery.

OBJECTIVES: To assess patients' perception of the therapeutic outcome after coronary artery bypass surgery, and to find predictors for increased well-being. DESIGN: Self-administered questionnaires (Family APGAR and GHQ-30) were completed on admission and at the follow-up after 12 months, together with functional classification according to the NYHA index. SETTING: Ullevål University Hospital, Oslo, Norway, 1990-1992. SUBJECTS: Two hundred and thirteen patients with stable angina admitted for elective coronary artery bypass surgery. INTERVENTION: Elective coronary artery bypass surgery. MAIN OUTCOME MEASURES: Improved physical and psychosocial functioning after one year. RESULTS: One hundred and ninety-seven (92%) patients improved their NYHA class, while it remained stable or declined in 16 (8%) patients. Significantly fewer patients with mental distress were found at the follow-up than at the baseline examination (49 patients [23%] versus 80 patients [38%], respectively, P < 0.0001). One hundred and forty-six patients (69%) reported enhanced psychosocial well-being, while it was reduced (n = 60) or unchanged (n = 7) in 67 patients (31%). Predictors for improved psychosocial well-being following coronary artery bypass surgery were mental distress before surgery (odds ratio 2.8) and being a male patient (odds ratio 2.8). CONCLUSIONS: The majority of the patients reported significant improvement in their physical and psychosocial functioning one year after coronary artery bypass surgery. Mental distress and male sex were significant predictors of enhanced well-being. Questionnaires on psychosocial well-being such as the GHQ-30 may, in addition to health status measurements, offer additional useful information when coronary artery bypass surgery is considered.

Coronary Artery Bypass↗

PubMed2002

The effects of second-generation antipsychotics on cognitive functioning and psychosocial outcome in schizophrenia.

Neuropsychological deficits seem to be a major predictor of psychosocial outcome in patients with schizophrenia. Second-generation antipsychotics have shown greater promise in treating neuropsychological deficits than conventional antipsychotic drugs. This article summarizes the effect of newer antipsychotics on cognitive functioning and the implications for functional outcome. In this context it also addresses several methodological and conceptional issues that limited the comparison of these studies.

Antipsychotic Agents↗

PubMed2002

Childhood adversity, parental vulnerability and disorder: examining inter-generational transmission of risk.

BACKGROUND: An investigation of intergenerational factors associated with psychiatric disorder in late adolescence/early adulthood was undertaken to differentiate influences from maternal disorder, maternal poor psychosocial functioning and poor parenting, on offspring. METHOD: The sample comprised an intensively studied series of 276 mother-offspring pairs in a relatively deprived inner-city London area with high rates of lone parenthood and socio-economic disadvantage. The paired sample was collected over two time periods: first a consecutively screened series of mothers and offspring in 1985-90 (n = 172 pairs) and second a 'vulnerable' series of mothers and offspring in 1995-99 (n = 104 pairs). The vulnerable mothers were selected for poor interpersonal functioning and/or low self-esteem and the consecutive series were used for comparison. Rates of childhood adversity and disorder in the offspring were examined in the two groups. Maternal characteristics including psychosocial vulnerability and depression were then examined in relation to risk transmission. RESULTS: Offspring of vulnerable mothers had a fourfold higher rate of yearly disorder than those in the comparison series (43% vs. 11%, p < .001). They were twice as likely as those in the comparison series to have experienced childhood adversity comprising either severe neglect, physical or sexual abuse before age 17. Physical abuse, in particular, perpetrated either by mother or father/surrogate father was significantly raised in the vulnerable group. Analysis of the combined series showed that maternal vulnerability and neglect/abuse of offspring provided the best model for offspring disorder. Maternal history of depression had no direct effect on offspring disorder; its effects were entirely mediated by offspring neglect/abuse. Maternal childhood adversity also had no direct effect. CONCLUSIONS: Results are discussed in relation to psychosocial models of risk transmission for disorder. Maternal poor psychosocial functioning needs to be identified as a factor requiring intervention in order to stem escalation of risk across generations.

Adolescent↗

PubMed1996

Efficacy of audiologic rehabilitation for older adults.

Two intervention procedures for the rehabilitation of elderly adults with hearing impairment were evaluated: analytic auditory training and active listening training. Seventy-eight older adults with hearing loss served as subjects. Twenty-six subjects received no training, 26 received analytic training, and 26 received active listening training. The effectiveness of the audiologic rehabilitation programs was determined via measures of speech recognition, hearing handicap perception, and psychosocial function. Active listening was found to be an effective treatment for helping individuals with hearing impairment improve their auditory-visual recognition of speech in noise and improve certain aspects of their psychosocial functioning. Support for analytic speech recognition drills alone was not demonstrated.

Aged↗

PubMed1993

Psychosocial outcomes of children of unipolar depressed, bipolar, medically ill, and normal women: a longitudinal study.

The psychosocial functioning of children of unipolar depressed, bipolar, medically ill, and psychiatrically normal women was studied over a 2-year period. Ninety-six children aged 8-16 years were assessed at 6-month intervals on Child Behavior Checklist behavior problems, social competence, internalizing and externalizing behaviors, academic performance, and school behavior. The children of unipolar mothers showed significantly poorer functioning on all measures as compared with the other 3 groups of children, including bipolar offspring. A greater proportion of children in the unipolar group also had relatively chronic, clinically significant problems in psychosocial functioning. Children of bipolar women did not differ from children of psychiatrically normal women. Results are discussed in terms of the consequences of children's continuing exposure to maternal depression and attendant stressors, as well as the contribution of social and academic difficulties to a vicious cycle of maladjustment.

Adolescent↗

PubMed1998

Minor depressive disorder and subsyndromal depressive symptoms: functional impairment and response to treatment.

BACKGROUND: This study quantifies functional impairment and depressive symptomatology in patients with minor depressive disorder (MinD) and subsyndromal depressive symptomatology (SSD) before and after 8 weeks of treatment with fluvoxamine. Study patients were compared and contrasted with archival data from a sample of the general population measured by the Medical Outcome Survey Short Form 36. METHOD: Fifteen patients with MinD and 15 patients with SSD were identified from primary care clinics, referrals and newspaper advertisements. Patients signed informed consent and were offered open label treatment with fluvoxamine 25-100 mg/day. Patients were seen biweekly and measures of functional impairment and depressive symptomatology were gathered systematically. RESULTS: MinD and SSD were associated with dysfunction and disability when compared to archival normative data from the general population. Eight week treatment with fluvoxamine was associated with a substantial decrease in depressive symptomatology and a normalization of psychosocial functioning. CONCLUSION: This is the first study to quantify functional impairment and the severity of depressive symptomatology in a clinical sample of patients with MinD and SSD, and to demonstrate that treatment with a selective serotonin reuptake inhibitor decreases depressive symptomatology and improves psychosocial functioning. Placebo-controlled double-blind confirmation of these preliminary observations seems warranted.

Antidepressive Agents, Second-Generation↗

PubMed1984

Influence of a cardiac rehabilitation program on the cardiovascular, psychological, and social functioning of cardiac patients.

Twenty-eight male cardiac patients who had either experienced myocardial infarction or undergone coronary bypass surgery were assigned to a treatment condition and participated in a 3-month, exercise-based Cardiac Rehabilitation Program, whereas 20 other cardiac patients were assigned to a routine-care condition and did not participate in the rehabilitation program. Cardiovascular, psychological, and psychosocial functioning were assessed before treatment or routine care was begun, after 3 months of treatment or routine care, and 4 months later. Results indicated that patients in the treatment condition evidenced reliably more efficient cardiovascular functioning (resting heart rate, resting diastolic blood pressure, treadmill exercise performance, exercise heart rate, exercise systolic blood pressure), better understanding of heart disease, better understanding of and reported compliance with treatment recommendations, more positive self-perceptions (health, body concept, self-concept, progress toward goals), and better psychosocial functioning (e.g., decreased employment-related stress, more active use and enjoyment of leisure time, more physical and sexual activity). Chronic patients benefited as much from the treatment as did acute patients, and the beneficial effects for all treated patients were evident not only just after rehabilitation, but also 4 months later. This investigation appears to be the first such test of effects of this type of treatment, and the results have wide generalizability and applicability.

Adult↗

PubMed2005

Psychosocial factors associated with indices of cortisol production in women with breast cancer and controls.

The present study was designed to (i) explore which psychosocial factors were associated with indices representing the early morning peak, diurnal cortisol rhythm and area under the curve (AUC); (ii) examine whether the relationships between psychosocial functioning and these cortisol indices were consistent and (iii) explore whether these relationships were influenced by the clinical status of the participant. Newly diagnosed breast cancer patients (n = 85) and healthy control women (n = 59) were recruited. State and trait measures of psychosocial functioning (i.e. anxiety, depression, distress, neuroticism, extraversion, marital satisfaction and mastery) were undertaken. In addition, all participants provided four saliva samples (on waking, 30 min later, between 11 and 1 p.m., before lunch and between 8 and 10 p.m., at least 2h after evening meal) over two consecutive days to assess cortisol levels. The results highlighted the divergent nature of the four cortisol indices; revealed the presence of some significant relationships between the psychosocial measures and the cortisol indices; but highlighted inconsistencies in the relationships evident for patients and those observed for control women.

Adaptation, Psychological↗

PubMed2003

Longitudinal correlates of depressive symptoms among urban African American children: II. Extension of findings across 3 years.

We examined the association between childhood self-reported depressive symptoms and 2 areas of child psychosocial functioning: social and cognitive competence. Urban African American children, ages 6 to 11 and their mothers (N = 177) were interviewed at 2 assessments separated by 3 years. As a test of the relations among depressive symptoms and subsequent psychosocial functioning, independent hierarchical regression analyses were performed, with mother-reported social and cognitive competence and grades at the latter assessment as dependent variables. The analyses indicated that Children's Depression Inventory (CDI) scores at the initial assessment predicted changes in mother-reported social competence from the initial assessment to the latter assessment. This study also examined the impact of an additional stressor, maternal HIV infection, on this same relation. The analyses indicated that maternal HIV infection did not moderate the relation between childhood self-reported depressive symptoms and later competence.

Black or African American↗

PubMed2004

Evaluation of changes in occupational performance among patients in a pain management program.

OBJECTIVES: The aims of this study were to evaluate changes in occupational performance among chronic pain patients after a pain management program and to explore relationships between these changes and demographic and clinical factors, psychosocial functioning and psychological well-being. SUBJECTS: 188 consecutive patients were included. METHODS: Changes were registered by using Canadian Occupational Performance Measure, Multidimensional Pain Inventory and Psychological General Well-Being Index. RESULTS: There were statistically significant positive changes in occupational performance. Patients with sickness compensation had significantly higher changes in occupational performance than those without sickness compensation. The patients with a profile group as interpersonally distressed had statistically significant higher change scores on occupational performance than the adaptive coper group. Furthermore, increases in changes on general activity level, general health, and vitality and decreases in pain severity were associated with positive changes on perceived occupational performance and performance satisfaction. CONCLUSION: Changes in occupational performance, psychological well-being and psychosocial functioning seem all to be of relevance in the evaluation of pain management programs. Psychosocial profiles and sickness compensation has relevance for directions on changes in occupational performance, whereas other demographic and clinical factors do not.

Adaptation, Psychological↗

PubMed1994

The Psychosis Project: outcome and cost-effectiveness of a psychoeducational treatment programme for schizophrenic adolescents.

The outcome of a psychoeducational treatment programme for very early-onset schizophrenics was compared with a standard reference treatment. The study sample consisted of 12 patients in each group. Clinical outcome was assessed by relapses during the 2-year treatment period and changes in psychosocial functioning as measured by the Global Assessment Scale. A cost-effectiveness analysis was also carried out. The results indicated that the most effective programme measured by relapse was also the cheapest: the psychoeducational programme. Patients with poor premorbid psychosocial functioning benefit most from this treatment. Decisive with respect to how effective the programme can be is the cooperativeness of patients' parents and their ability to change their emotional attitudes toward the patient.

Adolescent↗

PubMed1999

Remediation of attention deficits in head injury.

Head injury is associated with psychological sequelae which impair the patient's psychosocial functioning. Information processing, attention and memory deficits are seen in head injuries of all severity. We attempted to improve deficits of focused, sustained and divided attention. The principle of overlapping sources of attention resource pools was utilised in devising the remediation programme. Tasks used simple inexpensive materials. Four head injured young adult males with post concussion syndrome underwent the retraining program for one month. The patients had deficits of focused, sustained and divided attention parallel processing, serial processing, visual scanning, verbal learning and memory and working memory. After the retraining programme the deficits of attention improved in the four patients. Serial processing improved in two patients. Parallel processing and neuropsychological deficits did not improve in any patient. The symptom intensity reduced markedly and behavioural functioning improved in three of the four patients. The results supported an association between improving attention and reduction of symptom intensity. Attention remediation shows promise as a cost effective, time efficient and simple technique to improve the psychological and psychosocial functioning of the head injured patient.

Adult↗

PubMed2005

Outcome predictors for severe obsessive-compulsive patients in intensive residential treatment.

Intensive residential treatment (IRT) is an effective management approach for those with severe obsessive-compulsive disorder (OCD). This study aimed to identify IRT response predictors for clinical and research use. Consecutive subjects admitted to the Massachusetts General Hospital/McLean OCD Institute (OCDI) between February 1997 and June 2003 were included (N=476). IRT responder and non-responder group characteristics were compared using t-tests and chi(2) analyses. Multiple regression analysis modeled relationships between final OCD severity (Yale-Brown Obsessive-Compulsive scale scores) and predictor variables, while accounting for multicollinearity and potential outliers. Treatment responders comprised 59.3% of the treatment sample. Responders had significantly fewer males (p=0.02), lower depression severity (p=0.03), poorer psychosocial functioning (p=0.03) and fewer tic disorders (0.04), but were not different with respect to admission length, age, marital or employment status, OCD onset, family OCD history, treatment or admission history. In the final regression model, decreased initial OCD severity (p<0.001), female gender (p=0.003) and better initial psychosocial functioning (Work and Social Adjustment scale scores) (p=0.003) were predictors of less severe OCD at discharge (adjusted R-square=0.28). Depression severity (Beck Depression Inventory scores) and insight were not predictive of treatment outcome. Future research is necessary to elucidate putative relationships between gender and OCD psychopathology, and to understand the interplay of psychosocial factors, OCD severity and treatment outcome.

Adolescent↗