SEARCH · PubMed Health

Results for “Psychosocial functioning”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources

PubMed2003

Juvenile sex offenders: toward the development of a typology.

Adolescent males who sexually offended against prepubescent children were contrasted with those who targeted pubescent and postpubescent females. As hypothesized, path analyses revealed that the former group had greater deficits in psychosocial functioning, used less aggression in their sexual offending, and were more likely to offend against relatives. Theorized relationships between developmental risk factors, personality mediators, and sexual and nonsexual offense characteristics were assessed in both groups of juvenile sex offenders. Deficits in psychosocial functioning were found to mediate the influence of childhood exposure to violence against females on adolescent perpetration of sexual and nonsexual offenses. Additional univariate analyses were conducted to further explore some associations among early risk factors, personality mediators, and outcomes. Childhood physical abuse by a father or stepfather and exposure to violence against females were found to be associated with higher levels of comorbid anxiety and depression. Noncoercive childhood sexual victimization by a male nonrelative was found to be associated with sexual offending against a male child. Clinical and theoretical implications of the findings are discussed.

Adolescent↗

PubMed1996

Randomised trial of biofeedback training for encopresis.

AIMS: To evaluate biofeedback training in children with encopresis and the effect on psychosocial function. DESIGN: Prospective controlled randomised study. PATIENT INTERVENTIONS: A multimodal treatment of six weeks. Children were randomised into two groups. Each group received dietary and toilet advice, enemas, oral laxatives, and anorectal manometry. One group also received five biofeedback training sessions. MAIN OUTCOME MEASURES: Successful treatment was defined as less than two episodes of encopresis, regular bowel movements, and no laxatives. Psychosocial function after treatment was assessed using the Child Behaviour Checklist. RESULTS: Children given laxatives and biofeedback training had higher success rates than those who received laxatives alone (39% v 19%) at the end of the intervention period. At 12 and 18 months, however, approximately 50% of children in each group were successfully treated. Abnormal behaviour scores were initially observed in 35% of children. Most children had improved behaviour scores six months after treatment. Children with an initial abnormal behaviour score who were successfully treated had a significant improvement in their behavioural profiles. CONCLUSIONS: Biofeedback training had no additional effect on the success rate or behaviour scores. Psychosocial problems are present in a subgroup of children with encopresis. The relation between successful treatment and improvement in behavioural function supports the idea that encopresis has an aetiological role in the occurrence and maintenance of behavioural problems in children with encopresis.

Adolescent↗

PubMed2000

Relationship between depression and substance use disorders in adolescent women during the transition to adulthood.

OBJECTIVES: To examine the continuity of substance use disorder (SUD) in adolescent women during the transition to adulthood and to assess psychosocial functioning associated with SUD. Furthermore, to examine concurrent and longitudinal relationships' between major depressive disorder (MDD) and SUD during this developmental transition. METHOD: One hundred fifty-five women, aged 17 to 19 years, were recruited from 3 high schools and were followed annually for 5 years. Comprehensive diagnostic and psychosocial assessments were performed with standardized instruments. The primary outcome measures included MDD and SUD during follow-up in those with and without a prior history of MDD or SUD, and psychosocial functioning associated with SUD. RESULTS: The 5-year incidence of SUD was 9.6% and, by the end of follow-up, 18.7% had a lifetime episode. Prior SUD significantly increased the risk for SUD diagnosis during the study. Co-occurrence of MDD and SUD was high during adolescent and early adult years, with episodes of both disorders occurring in close temporal proximity. SUD also predicted MDD over time, but the reverse was not true. After controlling for the effects of MDD on social adjustment, SUD was associated with significant impairment in school functioning. CONCLUSIONS: These results suggest that the risk for new onset and recurrence of SUD is high during the developmental transition to adulthood. SUD during this developmental period is associated with significant school-related problems. The findings also suggest that SUD and MDD frequently co-occur during the post-high school transition in women. Given the significant psychosocial dysfunction associated with these illnesses, early detection of these problems and effective intervention are crucial.

Adolescent↗

PubMed2006

Are drug experimenters better adjusted than abstainers and users?: a longitudinal study of adolescent marijuana use.

PURPOSE: Experimentation with substance use is normative during adolescence and prior research suggests that adolescents who refrain from experimentation may be psychologically maladjusted. This longitudinal study compared lifetime marijuana abstainers (n = 1177), experimenters (n = 873), and frequent users (n = 205) at grade 12 on psychosocial functioning during late adolescence and young adulthood. METHODS: Participants were recruited from middle schools in 1985 (grade 7) and assessed repeatedly, including in 1990 (grade 12) and 1995 (age 23). Self-report surveys assessed lifetime substance use at grade 12, and psychosocial functioning at grade 12 and age 23. Group differences after controlling for key demographics were estimated using multivariate logistic regression and analysis of covariance. RESULTS: Adolescent abstainers from marijuana often fared better (and in no case worse) than experimenters and frequent users both concurrently and later in life on school engagement, family and peer relations, mental health, and deviant behavior. Similar results were found in ancillary analyses using a definition of adolescent "abstainer" that also accounted for cigarette and alcohol use. CONCLUSIONS: Results refute the idea that adolescents who abstain from substance use are maladjusted, and suggest instead that they function better than experimenters later in life, during the transition to young adulthood.

Adolescent↗

PubMed1996

The utility of dual diagnosis services for consumers from nonwhite ethnic groups.

Differences in psychosocial functioning, symptoms, service use, and costs for 40 nonwhite consumers of mental health services and 92 white consumers were compared at baseline and six months in a controlled clinical trial of three dual diagnosis interventions. At six months nonwhite consumers had lower psychosocial functioning than white consumers as measured by self-report and clinicians' ratings. Nonwhite consumers received significantly less supportive treatment than white consumers. Qualitative data from staff interviews indicated that nonwhite consumers had inadequate community and family supports due to a variety of problems. Although the nonwhite consumers had outcomes similar to those of white consumers, the complex needs of the nonwhite consumers warrant additional staff resources and culturally sensitive services in dual diagnosis treatment programs.

Adolescent↗

PubMed2004

Maternal distress, child behaviour, and disclosure of psychosocial concerns to a paediatrician.

BACKGROUND: Despite the availability of effective screening measures, primary care providers continue to fail to identify and manage many children with psychosocial problems. One of the best predictors of identification by a primary care physician is whether mothers disclose concerns about their child's psychosocial functioning to their child's physician. This study examined if maternal distress and child behaviour predicted whether mothers had and discussed concerns about their child's behaviour and emotions with paediatricians. METHODS: Participants were 138 mothers who accompanied their 4-12-year-old children to a health supervision visit at an urban teaching hospital. Mothers completed a demographic questionnaire, the Pediatric Symptom Checklist, the Beck Depression Inventory, and an exit questionnaire. Results Logistic regression correctly classified 97.3% of mothers who did not disclose child problems. Only 34.5% of mothers who did disclose were correctly classified. CONCLUSIONS: The results supported the hypothesis that mothers' psychosocial functioning is significantly related to concern about child behaviour and disclosure of concerns to the paediatrician. The inability of child behaviour and maternal functioning to predict which mothers were concerned and disclosed concerns supports the hypothesis that disclosure and identification of psychosocial problems in primary care is complex and requires a multifactor model.

Adult↗

PubMed1997

Executive function and psychosocial adjustment in children with early treated phenylketonuria: correlation with historical and concurrent phenylalanine levels.

The issue of what level of phenylalanine (phe) constitutes a safe upper limit for the therapeutic range in dietary treatment of phenylketonuria (PKU) remains unsettled. It has been proposed that the previous guideline figure of 600 mumol l-1 may result in specific impairment of executive functions such as attention, planning and set maintenance. The executive dysfunction theory was investigated by correlation historical and concurrent phe with executive, non-executive and personality tests in a group of early and continuously treated children, aged 10-13 years, with classical PKU, whose average phe levels of 355 mumol l-1 (SD = +/-144) for the pre-school period and 480 mumol l-1 (SD +/-193) for the primary school period corresponded to the upper limits presently recommended in the UK of 360 and 480 mumol l-1 for these age ranges. No clear associations were found between historical or concurrent phe levels and any of the neuropsychological or personality measures, thereby weakening the case for the emergence of executive deficits, at least when average phe levels remain close to the upper limits now considered safe. Furthermore no significant differences were found on psychological variables where comparison with population norms was possible.

Adjustment Disorders↗

PubMed1994

Substance abuse among patients with treatment-resistant schizophrenia: characteristics and implications for clozapine therapy.

OBJECTIVE: The goals of this study were 1) to determine the extent of substance abuse in patients with treatment-resistant schizophrenia and 2) to assess the relevance of such abuse to subsequent response to treatment with clozapine. METHOD: The subjects were 118 treatment-resistant patients with DSM-III-R diagnoses of schizophrenia or schizoaffective disorder who underwent detailed demographic, clinical, and psychopathological evaluations before commencing treatment with clozapine. Lifetime and current histories of substance abuse were also systematically evaluated and characterized according to the Research Diagnostic Criteria and DSM-III-R. Response to clozapine treatment at 6 months was determined with measures of psychopathology and psychosocial function. RESULTS: An antecedent or current history of substance abuse was determined for 29 patients. Although predominantly male, the abusers did not differ from the nonabusers on other demographic features. The substance abusers actually showed less psychopathology (negative and disorganization symptoms) and better psychosocial functioning at baseline; however, both groups attained similar improvements on these measures after 6 months of clozapine therapy. CONCLUSIONS: A modest extent of previous or current substance abuse was observed among neuroleptic-resistant schizophrenic patients who subsequently received treatment with clozapine. This antecedent history of substance abuse did not appear to negatively influence subsequent response to clozapine treatment.

Adult↗

PubMed1996

Short stature--the role of intelligence in psychosocial adjustment.

Short children are often described as having psychosocial problems. These reports may be inaccurate as former studies have relied largely on parental report. Psychosocial functioning of short children was assessed with the aim of using them and their peers as informants. Twenty two short (mean (SD) height -2.53 (0.28) SD score) prepubertal children aged between 6 and 11 years were recruited from growth clinics. Comparison children were recruited from each case child's class at school. Cognitive and psychosocial functioning was assessed. Peer relationships were measured using sociometry. There were no significant group differences in terms of peer acceptance, self perception, and social competence. Although cases described themselves as receiving less social support from teachers, no differences were evident in other areas of social support. Little evidence was found to suggest clinic referred prepubertal short children are psychosocially maladjusted. Further analysis revealed cognitive ability was a better predictor than height for most aspects of behavioural and emotional adjustment.

Anthropometry↗

PubMed1993

FACES III and the Kvebaek Family Sculpture Technique as measures of cohesion and closeness.

In a longitudinal study of psychosocial factors in children with recent onset of rheumatic disease (N = 72), it was hypothesized that FACES III cohesion sum scores would be correlated with family closeness as measured by the Kvebaek Family Sculpture Technique (KFST). A second aim was to examine how these instruments were associated with semi-structured interview assessments of child and family psychosocial function, and whether these associations were linear or curvilinear. FACES III cohesion sum scores and KFST family mean interpersonal distance were not correlated, whereas the cohesion sum scores were related to the mother-father distance on the KFST. Where associations with child and family psychosocial function were found, they were linear. The results support the usefulness of a distinction between cohesion as a family or group characteristic and dyadic closeness, especially between the parent figures. The need for further conceptual clarification and more thorough empirical validation procedures in this area is emphasized.

Adaptation, Psychological↗

PubMed2002

Aging and spinal cord injury: medical, functional, and psychosocial changes.

Fifty years ago, people who had a spinal cord injury had very limited life expectancies. Today, these individuals can expect to live into their 60s, 70s, and beyond. Advances in rehabilitation, technology, surgery, and medicines have been chiefly responsible for this change. Recent research in both Europe and the United States now indicates that as these people age, they often develop medical and functional problems that are not as common in their nondisabled peers until much later in life. The importance of these "premature" age-related problems has led the National Institute on Disability and Rehabilitation Research to fund the Rehabilitation Research and Training Center (RRTC) on Aging With a Spinal Cord Injury at Rancho Los Amigos National Rehabilitation Center in Downey, California. This article summarizes some of the important findings from this RRTC and from other sources.

Activities of Daily Living↗

PubMed2005

Cross-sectional and longitudinal relations among children's trust beliefs, psychological maladjustment and social relationships: are very high as well as very low trusting children at risk?

Four hundred and thirty-four children enrolled in school years 5 and 6 in the United Kingdom were administered measures of trust beliefs in peers/best friends and psychosocial functioning (internalized maladjustment, self-perceived social acceptance, social preference, and social exclusion) across an 8-month period (mean age = 9 years-9 months at Time 1). The relation between children's trust beliefs in peers or trust beliefs within best friend dyads and measures of psychosocial functioning conformed to a quadratic pattern. Compared to children in the middle range of trust beliefs, children with very low trust beliefs and those with very high trust beliefs in peers and/or within best friend dyads displayed higher internalized maladjustment, lower self-perceived social acceptance, higher social exclusion, and lower social preference. The relation between the trust beliefs and internalized maladjustment was asymmetrical, with children who held very low trust beliefs being comparatively more disadvantaged.

Adaptation, Psychological↗

PubMed1985

Clinical-subjective evaluation of high-risk children: integration and discussion.

Clinical evaluations of index and control children from the point of view of the clinical interview, observations of the subjects during testing, the subjects' parents, and their teachers were compared. There was general agreement that index children showed more psychopathological symptoms, poorer ego development, poorer interpersonal relations, and poorer use of leisure time than their controls. By contrast, behaviors related to aggression, phobias, shame, sleep pathology, eating disorders, frustration tolerance, sexual behavior, and verbal communication skills failed to show consistent group differences. Index boys showed greater anxiety than their controls, while there were no such differences among the girls. Rearing environment exerted no apparent effect on the psychosocial functioning of the children. Factor analysis disclosed that a general factor, accounting for 32.6 percent of the variance, discriminated between index and control children, while several special factors, which represented rarely seen traits, did not discriminate. Group differences, therefore, appeared to stem from global impairment of psychosocial functioning rather than from several distinct patterns of deficit. The present results are in general agreement with previously reported evaluations of children at risk for schizophrenia.

Adaptation, Psychological↗

PubMed2004

Helping alliance and ward atmosphere in psychiatric in-patient care.

OBJECTIVE: The study investigated how patients in a psychiatric in-patient ward perceived the therapeutic relationship and the ward atmosphere, the interrelationships between these phenomena, and whether demographic and clinical factors had an influence on the helping alliance. DESIGN: This was an explorative study in a natural setting. A correlational and multiple regression design were adopted. METHOD: All discharged patients (N = 61) during a limited period completed questionnaires regarding the ward atmosphere and the helping alliance, were rated on psychosocial functioning, and diagnosed according to the ICD-10. RESULTS: Several ward-atmosphere factors correlated with the helping alliance. A multivariate analysis suggested that support, programme clarity, and spontaneity were important ingredients and that support was the most important contributor. Patients with a high level of psychosocial functioning established a better helping alliance and patients with personality disorders tended to develop a weaker helping alliance. CONCLUSION: The findings emphasize that a holding environment is important in establishing a good helping alliance, which is consistent with results from the psychotherapy area. Since helping alliance is known to have a most important influence on therapy outcome, one conclusion must be that the staff, in their endeavour to strengthen the supportive element of the ward atmosphere, may improve the therapeutic outcome as well.

Adult↗

PubMed1995

Comparative effectiveness of three approaches to serving people with severe mental illness and substance abuse disorders.

This study examines the rationale for and relative effectiveness of three intervention models for treating people with severe mental illness and substance abuse disorders: Twelve Step recovery, behavioral skills training, and intensive case management. Using clinical trial methods, 132 dually diagnosed clients were assigned to three service approaches. Changes in client psychosocial outcomes, and psychiatric and substance abuse symptomatology were tracked over a 24-month period. Differential effectiveness was evident, with clients in the behavioral skills group demonstrating the most positive and significant differences in psychosocial functioning and symptomatology, compared with the Twelve Step recovery approach. However, the case management intervention also resulted in several positive and important differences compared with the Twelve Step recovery approach. We also found significant changes over time, not only at 6 months but increasingly positive changes in psychosocial functioning at 12 and 18 months as well. These results underscore the need for clinical trials to further examine the relative cost effectiveness of treatment approaches for dually disordered clients and to incorporate means of assessing subgroup differences so that the interventions being tested can be further refined and targeted to a broad set of needs among the dually diagnosed.

Adolescent↗

PubMed1995

Psychosocial predictors of acute complications of diabetes in youth.

In this paper we determine whether individual and family psychosocial functioning predicts the risk for recurrent acute diabetic complications. An onset-cohort of 61 children and adolescents with Type 1 diabetes received conventional diabetes care. Episodes of ketoacidosis and of severe hypoglycemia were recorded for 8 years, and glycaemic control was measured by glycohaemoglobin. Measures of psychosocial functioning of the patient and parents were obtained during the first year. Over 8 years, 28% of subjects had at least one episode of ketoacidosis, and 21% had at least one episode of hypoglycaemia. The odds of observing recurrent hypoglycaemia versus recurrent ketoacidosis was 14 times greater in boys than in girls (Fisher's exact test p < 0.05). Girls with recurrent ketoacidosis had more behaviour problems and lower social competence, they reported higher levels of family conflict, and their parents reported lower levels of family cohesion, expressiveness and organization in year one. These relationships were independent of any association with poor glycaemic control. Recurrent hypoglycaemia in boys was generally unrelated to individual and family functioning or glycohaemoglobin. Despite our small sample size, our findings are suggestive of relationships that may lead to early identification of patients who are prone to recurrent ketoacidosis, and to the development of early intervention strategies.

Adolescent↗

PubMed2004

Prospective psychosocial monitoring of living kidney donors using the Short Form-36 health survey: results at 12 months.

BACKGROUND: Lack of prospective psychosocial outcome studies on living kidney donors impedes identification of risk factors for poor outcome. METHODS: Psychiatric assessment of living kidney donors was performed preoperatively and at 4 and 12 months postoperatively using a semistructured interview, the Short Form (SF)-36 Health Survey, and Patient Health Questionnaire psychiatric assessment. A total of 48 of 51 consecutive donors (94%) over a 5-year period were available for follow-up and completed all assessments. RESULTS: At preoperative assessment, only 1 of the 48 donors (2%) had a Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Axis I psychiatric disorder, but 15 (31%) developed a disorder during the 12 months, a 29% incidence. Disorders were depressive (12%), anxiety (6%), and adjustment (13%). Seven donors (15%) demonstrated a disorder at 12 months (depressive 10%, anxiety 2%, adjustment 2%). There was a corresponding decline in psychosocial function as measured by the SF-36 Mental Component Summary score; it decreased at both 4 and 12 months (P<0.01, P<0.05); for 19% of donors, this was a larger decrease than would be expected for the cohort (>2 standard error of measurement units). Scores for SF-36 scales of General Health and Vitality decreased significantly (P<0.05), as did those of Bodily Pain, indicating greater impairment from pain. Psychiatric disorder at 12 months was associated with donor psychosocial function (Mental Component Summary) and psychiatric disorder at 4 months (P<0.01), physical function (SF-36 Physical Component Summary score) at 4 and 12 months (P<0.01), and recipient psychiatric disorder at 12 months (P<0.05). CONCLUSIONS: Donors should be alerted to possible psychosocial impairment, assessed for risk factors, and monitored for at least 12 months. Treatment should be available.

Adaptation, Psychological↗

PubMedDate not supplied

Ethnic differences in the treatment of dual mental and substance disorders. A preliminary analysis.

Differences between white and ethnic client psychosocial functioning, psychiatric and substance abuse symptomatology, and service utilization costs from a longitudinal clinical trial examining the relative cost effectiveness of three specialized interventions for dual disorders are compared within the study sample and to the existing literature. Ethnic clients comprised 30% of the treated sample, had lower psychosocial functioning scores (rated and self-reported), and received less supportive treatment services during the first 6 months of the intervention program; however, their overall outcomes were equivalent to those of white clients at 6 months. There were no functioning or symptom outcome differences across the three treatment groups, but the 12-step group had the highest intensive and supportive service costs over time, and also the greatest reductions in intensive service costs after 6 months. Clinical issues are described and the clinical implications for more effectively serving dually diagnosed ethnic clients are outlined.

Adolescent↗