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Results for “Psychosocial functioning”

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PubMed2005

Self-efficacy and psychosocial functioning in schizophrenia: a mediational analysis.

The construct of self-efficacy has been hypothesized to mediate the relationship between efforts at coping with psychiatric illness and functional outcome. This study examined whether self-efficacy mediated the relationships between psychosocial functioning and important predictors of functioning: premorbid functioning, negative symptoms, and cognitive functioning. Although self-efficacy was positively associated with psychosocial functioning, it did not mediate the relationships between functioning and the other established predictors. Rather, negative symptoms were the strongest predictor of functioning and mediated the relationship between self-efficacy and functioning. The findings suggest that negative symptoms, and not self-efficacy, are the most critical determinants of psychosocial functioning in schizophrenia, and that psychosocial treatment should focus on the amelioration of these symptoms.

Adult↗

PubMed2006

Substance use and psychosocial functioning in schizophrenia among new enrollees in the NIMH CATIE study.

OBJECTIVE: This study examined the relationship between substance use and psychosocial functioning in schizophrenia. METHODS: Participants were enrolled in the Clinical Antipsychotic Trials of Intervention Effectiveness. This study used baseline assessments and examined psychosocial functioning assessed by the Quality of Life Scale. Participants were classified as being abstinent, using substances, or having a substance use disorder. RESULTS: Of the 1,460 participants, 23 percent used substances and 37 percent had a substance use disorder. Of the 544 with a substance use disorder, 87 percent used alcohol, 44 percent used marijuana, and 36 percent used cocaine. Compared with participants who used substances, those with a substance use disorder had higher rates of polysubstance use. Compared with those who were abstinent, those who used substances had higher overall psychosocial functioning, and those with a substance use disorder had similar overall functioning but lower scores on the common objects and activities subscales. Among participants with a substance use disorder, those who used cocaine had lower overall functioning. CONCLUSIONS: Compared with abstinence, substance use and substance use disorder, unless they involved cocaine use, were generally associated with higher or equivalent overall psychosocial functioning. Patterns of substance use were similar to those in the community, suggesting that treatment of substance use disorders in schizophrenia should focus on reconnecting substance users to nonusing peer groups.

Adult↗

PubMed1995

Psychosocial functioning among adult drug users: the role of parental absence, support, and conflict.

The relationship between perceptions of parental absence, support, and conflict during childhood and psychosocial functioning in adulthood was examined for 411 drug user clients in methadone treatment. History of parental support was related to adult psychosocial functioning and parent-child conflict was related to psychosocial functioning only when parental support was low. Findings indicate parental absence is related to the quality of parental support, which in turn predicts psychosocial functioning in adulthood. Implications for treatment intervention are discussed.

Adolescent↗

PubMed2004

Psychosocial functioning in patients with treatment resistant depression.

BACKGROUND: Depression is a disorder that causes disability, with a profound adverse impact on all areas of psychosocial functioning. This is particularly true for those with treatment resistant depression (TRD). However, to date, no systematic assessments of psychosocial functioning for patients with TRD have been conducted. METHODS: In the present study, we used the Longitudinal Interval Follow-up Evaluation (LIFE) scale to measure psychosocial functioning in 92 patients with TRD. These patients met formal criteria for TRD and were part of a clinical trial examining the efficacy of lithium augmentation of nortriptyline. RESULTS: Clinicians rated this sample of patients as experiencing mild to moderate impairment in work-related activities, good to fair interpersonal relations, poor level of involvement in recreational activities, and mild impairment of ability to enjoy sexual activity. Patients and clinicians rated global social adjustment as poor. CONCLUSIONS: Patients with formally defined TRD experience significant impairment in psychosocial functioning. In this sample a tendency existed for both clinicians and patients to assign more severely impaired global ratings when compared with ratings for specific functional areas.

Adolescent↗

PubMed1999

Differential effects of treatment modality on psychosocial functioning of cocaine-dependent men.

Changes in psychosocial functioning, including depression, anxiety, somatization, obsessive-compulsiveness, interpersonal sensitivity, confidence in the ability to resist taking drugs in different situations, and social adjustment are examined for male veterans entering treatment for cocaine dependence. The sample was comprised of African Americans (66%), Hispanics (8%), and Whites (26%) with a mean age of 35 years at intake. Participants were assessed at the end of 1 year and 2 years; during the follow-up period, participants utilized different combinations of treatment modalities. Paired t-tests showed significant improvement between intake and follow-up, both at the end of 1 year and 2 years, on the Beck Depression Inventory, on the depression, anxiety, obsessive-compulsiveness, and interpersonal sensitivity scores of the Symptom Check List (SCL-58), and in four role areas of social adjustment on the Social Adjustment Inventory. There were no significant differences between intake and follow-up on the somatization subscale of the SCL-58 and on the Drug Taking Confidence Questionnaire (DTCQ). Measures taken at Year 2 were not significantly different from Year 1. Repeated measures analysis of variance revealed that treatment modality did not differentially affect psychosocial functioning on nearly all measures, except on somatization, confidence in the ability to resist taking drugs in different situations, and social adjustment involving leisure time. However, a combination of inpatient, high-intensity outpatient, and self-help group participation and a combination of outpatient and self-help group participation were better than a combination of inpatient, low-intensity outpatient, and self-help participation in increasing the confidence in the ability to resist cocaine use in different situations and to reduce symptoms of somatization.

Adult↗

PubMedDate not supplied

Effects of cardiac rehabilitation on psychosocial functioning and life satisfaction of coronary artery disease clients.

This article details a quantitative, descriptive study that explored the effects of participation in two types of cardiac rehabilitation programs on psychosocial functioning and life satisfaction. Forty-seven clients with coronary artery disease (CAD) were included in the study sample. Data were collected during a home visit made 6 to 8 weeks after the coronary event. All subjects completed two data collection tools: the Sickness Impact Profile (SIP), which measured clients' psychosocial functioning, and the Quality of Life Index (QLI), which measured clients' life satisfaction. No significant differences were found between the two treatment groups in psychosocial functioning or life satisfaction. Psychosocial functioning and life satisfaction were found to be related strongly. Further research efforts are needed to document empirically the influence of cardiac rehabilitation participation on the client's quality of life.

Adaptation, Psychological↗

PubMed1991

The nature of elder impairment and its impact on family caregivers' health and psychosocial functioning.

This study assessed the nature of elder impairment and its impact on the health and psychosocial functioning of family caregivers. All caregivers were daughters or daughters-in-law living with an elderly parent. Contrary to expectations and previous research, no differences were revealed among caregivers of cognitively impaired, functionally impaired, and nonimpaired elderly relatives in terms of self-reported health or psychosocial functioning. Thus, other aspects of the caregiving context, such as familial generation, gender, and living arrangement, may affect caregiver health and psychosocial functioning more than the nature of the elder's impairment.

Adult↗

PubMedDate not supplied

The relationship between oral health status and biological and psychosocial function in the bedridden elderly.

The present study was conducted in order to determine what item of biological and psychosocial function is related to oral health status in the bedridden elderly. The subjects were 94 elderly individuals (30 males, 64 females) who had been admitted to a nursing home in Chiba city, Japan. We assessed the number of remaining teeth and the number of functional teeth as oral health status variables. Biological and psychosocial function levels were determined using the functional independence measure method developed by the State University of New York at Buffalo. More than 70% of subjects had less than ten remaining teeth. Almost all subjects needed prosthesis treatment. More than 50% of subjects had 27 or less functional teeth. Mann-Whitney U-test and logistic regression models showed that 'expression' was concerned with the number of remaining teeth and 'bladder management', 'locomotion', 'transfers' were related to the number of functional teeth. These data suggest close relation between oral health status and biological and psychosocial function levels in the bedridden elderly.

Journal Article↗

PubMed1993

Recovery after allogeneic marrow transplantation: prospective study of predictors of long-term physical and psychosocial functioning.

No prospective data have documented the physical and psychosocial functioning of patients before and after BMT. In this study 67 allogeneic transplant patients completed standardized self-report measures pre-transplant. Survivors were re-assessed at 90 days (n = 34) and 1 year (n = 31) post-transplant. Telephone interviews established 4-year work history and performance status. Physical function was most impaired at 90 days post-transplant, with a return to pre-transplant levels of functioning by 1 year in most areas. By 2 years post-transplant, 68% of patients had returned to full-time work. Only 9% of 4-year survivors failed to return to full-time occupations. Mean levels of anxiety and depression did not change over the first year. Pre-transplant, 27% of patients reported depression and 41% reported elevated anxiety. Greater emotional distress at 1 year was predicted by pre-transplant family conflict, non-married status and development of less severe chronic GVHD. Impaired physical recovery at 1 year was predicted by more severe chronic GVHD, pre-transplant physical impairment and family conflict. The large majority of long-term survivors returned to full-time employment with normal physical and psychosocial functioning, although recovery took longer than 1 year for approximately 40%. Family relationships were important determinants of physical and emotional recovery.

Adult↗

PubMed2005

Psychosocial functioning after discontinuation of long-term growth hormone treatment in girls with Turner syndrome.

It is common practice in the case of Turner syndrome (TS) to treat short stature with GH treatment and to induce puberty with estrogens at an age as close to normal puberty as possible. This approach in most cases leads to a height in the normal range in childhood, adolescence, and adulthood in TS. Little data is available, however, on its effect on psychosocial functioning. In the present study, we evaluated psychosocial functioning in a group of 50 women with TS, after reaching final height in two multicenter GH trials. Thirty-six girls participated in a randomized dose-response study from mean (SEM) age 6.8 (0.4) years, and 14 girls participated in a frequency-response study from age 13.2 (0.4) years. After discontinuation of long-term GH treatment, these 50 girls were evaluated for psychosocial functioning at a mean age of 18.8 (0.3) years. GH was given in a dosage of 4 IU/m2/day (approximately 0.045 mg/kg/day), 6 IU/m2/day, or 8 IU/m2/day. After a mean GH treatment duration of 7.1 (0.4) years, mean final height (ref. normal girls) was FH1.2 (0.2) SD score. Behavioral problem scores (Achenbach) of the TS women were comparable to normal Dutch peers. Although self-perception (Harter total scale: p < 0.01), and bodily attitude (Baardman: p < 0.05) was significantly less positive than for their normal Dutch peers, we found no evidence of depression. TS women rated their family functioning higher than their Dutch peers (p < 0.0001), and had a slightly different coping pattern. These results show that even after reaching a height in most cases within the normal range and puberty induction at a pubertal age, some women with TS still experience psychosocial problems. It is likely, however, that GH and estrogen treatment improved psychosocial functioning. Long-term follow-up of these GH-treated patients will allow an evaluation of their life achievements.

Adaptation, Psychological↗

PubMed2000

A brief assessment of psychosocial functioning of subjects with bipolar I disorder: the LIFE-RIFT. Longitudinal Interval Follow-up Evaluation-Range Impaired Functioning Tool.

Those afflicted with bipolar disorder often suffer from substantial functional impairment both when in episode and when in remission. This study examined the psychometric properties of a brief assessment of psychosocial functioning, the Range of Impaired Functioning Tool (LIFE-RIFT), among subjects with bipolar I disorder. The study sample consisted of 163 subjects who presented with bipolar I disorder at intake into the NIMH Collaborative Depression Study (CDS). All LIFE-RIFT items come from the Longitudinal Interval Follow-up Evaluation (LIFE). Follow-up data that were used to examine the reliability and validity of the scale come from assessments of psychosocial functioning that were conducted 6, 12, 18, and 24 months after intake into the CDS. The results of factor analyses indicate that the scale items are measures of one construct, psychosocial functioning. The interrater agreement on the scale score was very good with an intraclass correlation coefficient was 0.94. The internal consistency reliability among the scale items was uniformly satisfactory over the four assessment periods, with coefficient alpha ranging from 0.78 to 0.84. Mixed-effect regression analyses showed that during mood episodes subjects were significantly more impaired than those in recovery. In conclusion, the psychometric properties of the LIFE-RIFT were examined in subjects with bipolar I disorder. The analyses from this longitudinal, observational study provide empirical support for the reliability and validity of the scale. The LIFE-RIFT provides a brief, inexpensive alternative to scales currently used to assess psychosocial functioning and can be easily added to semistructured assessments that are used in clinical and treatment outcome studies.

Adaptation, Psychological↗

PubMed2001

Diverse aspects of dating: associations with psychosocial functioning from early to middle adolescence.

Theories imply that some aspects of adolescent dating behavior will be associated with individuals' positive psychosocial functioning, while other aspects will be associated with problems. This study addressed associations between diverse aspects of dating at age 16 and: (1) individual and social functioning at age 12 and at age 16; and (2) change in psychosocial functioning from age 12 to age 16. Controlling for physical maturity, overinvolvement in dating at age 16 was associated with poorer psychosocial functioning in early and middle adolescence and also predicted declines in functioning between the two ages. Level of dating experience and quality of romantic relationships were associated with social adaptation at age 16, especially in the friendship and dating domains.

Adolescent↗

PubMed2006

Predicting family caregiver psychosocial functioning in palliative care.

BACKGROUND: Health professionals are expected to support family caregivers of patients requiring palliative care. However, there is a dearth of empirical evidence to help clinicians identify caregivers who might be at risk of poor psychosocial functioning. PURPOSE: This secondary analysis of baseline data from a larger study sought to determine if it was possible to predict the psychosocial functioning of family caregivers who were supporting a relative with advanced incurable cancer. METHOD: Data from 35 primary family caregivers obtained at the start of home-based palliative care services and five weeks later was used in the analysis. Instruments to measure caregiver preparedness, competence, mastery, social support, anxiety, and self-efficacy were used. RESULTS: Cluster and logistic analyses revealed that self-reported "anxiety" and "competence" subscale total scores at time of commencement of home-based palliative care services were associated with caregivers at risk of lower levels of psychosocial functioning five weeks later. CONCLUSIONS: This study suggests that it may be possible to identify family caregivers who are at risk for poorer psychosocial functioning. However, replication in a larger sample is required before this screening approach can be recommended for clinical use.

Adaptation, Psychological↗

PubMed1999

Depressive cognitions and psychosocial functioning: a test of Beck's cognitive theory.

Depression, the most common mental disorder, is frequently treated with cognitive therapy based on Beck's theory, which suggests that depressive cognitions (negative views of self, world, and future) affect psychosocial functioning. This study tested Beck's theory in depressed inpatients, previously hospitalized and nonhospitalized outpatients, and undiagnosed adults. Multiple regression indicated that negative views of self, world, and future explained a substantial part of psychosocial functioning in all 4 groups. In the 3 depressed groups, views of self and world had a greater impact on psychosocial functioning than did the view of the future, suggesting that interventions to build self-esteem and enhance self-control may be most effective in improving psychosocial functioning of depressed adults.

Adult↗

PubMed2006

Psychosocial functioning following bariatric surgery.

Morbid obesity is associated with an increased risk of morbidity and mortality as well as psychosocial problems and poor quality of life. The ultimate goal of bariatric surgery is not only reduced weight and reduction of co-morbidities, but also improved psychosocial functioning and quality of life. However, not all patients are successful. A systematic literature search of recent articles identified relevant variables reflecting postoperative psychosocial functioning. Most studies showed that bariatric surgery does not only lead to substantial weight reduction, but also to improvement or cure of physical as well as psychological co-morbidities. Although most studies are optimistic and report broad psychosocial improvement, a significant minority of patients do not benefit psychologically from surgery. Although there are mixed results, the overall improvements in psychosocial functioning provide additional justification for surgical treatment of morbid obesity.

Bariatric Surgery↗

PubMed2003

Psychosocial functioning in a group of Swedish adults with Asperger syndrome or high-functioning autism.

This study reports on psychosocial functioning in Swedish adults with Asperger syndrome (AS) or high-functioning autism (HFA). A systematically selected sample of patients and relatives was interviewed concerning their psychosocial situation. The majority was living independently. All persons but one were unemployed. None was married and none had children. Only a few had some kind of partner. Most persons needed a high level of public and/or private support. The overall adjustment was rated good in 12 percent, fair in 75 percent and poor in 12 percent. Adult persons with AS/HFA have extensive need for support from their families and/or society. This information is important in order to provide adequate interventions that are in accordance with the expressed needs of the individuals themselves.

Activities of Daily Living↗

PubMedDate not supplied

Physicians' attention to parents' concerns about the psychosocial functioning of their children.

BACKGROUND: Epidemiological data indicate that approximately 20% of children have psychosocial problems, yet less than 2% of children are seen by mental health specialists each year. Primary care physicians tend to identify children with psychosocial problems when parents discuss concerns with them. OBJECTIVE: To examine factors related to physicians' attention to parental disclosures. DESIGN: Parents reported the psychosocial functioning of themselves and their children. Physicians reported the psychosocial functioning of 75 children and whether the parent disclosed psychosocial concerns to them. SETTING: Ambulatory care clinic of a community-based, university-affiliated, residency training program. PARTICIPANTS: Seventy-five parents of children aged 2 to 16 years who presented for routine primary care, and 26 physicians. MAIN OUTCOME MEASURES: Beck Depression Inventory (parental distress), Eyberg Child Behavior Inventory (child behavior problems), physician and parent report. RESULTS: Physicians identified 50.0% of children with clinically significant behavior problems. Logistic regression indicated that parental disclosure was the only significant predictor of physician identification (P < .002). When children had clinically significant behavior problems, physicians were more likely to report disclosures by parents (45.0% vs 5.7% for parents of children with and without behavior problems, respectively). Physicians were more likely to report parental disclosure when parents reported personal psychosocial distress (38.9% for distressed vs 5.7% nondistressed parents). CONCLUSIONS: Parental disclosure of concerns was a better predictor of physician identification of child psychosocial problems than was the presence of child behavior problems. Physicians responded more frequently to the disclosures of potential problems by parents of children with clinically significant psychosocial problems. They also attended more frequently to disclosures about behavior problems when the parent was also experiencing psychosocial distress.

Adaptation, Psychological↗

PubMed2001

Randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer.

PURPOSE: To determine whether making patient-reported cancer needs, quality-of-life (QOL), and psychosocial information available to the health care team, allowing coordinated specifically targeted psychosocial interventions, resulted in reduced cancer needs, improved QOL, and increased satisfaction with care received. METHODS: Self-reported cancer needs, QOL, and psychosocial information was collected from 450 people with cancer, using standardized questionnaires via a touch-screen computer. For a randomly chosen two thirds, this information was made available to the health care team who coordinated targeted psychosocial interventions. Information from the remaining one third was not seen. Patients were assessed 2 and 6 months after randomization for changes in their cancer needs, QOL, and psychosocial functioning and satisfaction with overall care received. RESULTS: There were no significant differences between the two arms with respect to changes in cancer needs, QOL, or psychosocial functioning between the baseline and follow-up assessments, nor with respect to satisfaction with care. However, for the subgroup of patients who were moderately or severely depressed at baseline, there was a significant reduction in depression for the intervention arm relative to the control arm at the 6-month assessment (P =.001). CONCLUSION: Making patient-reported cancer needs, QOL, and psychosocial data available to the health care team at a single consultation together with coordinated psychosocial interventions does not seem to reduce cancer needs nor improve QOL, psychosocial functioning, or satisfaction with the care received. However, identification of patients with moderate or severe levels of depression may be valuable in reducing subsequent levels of depression.

Adaptation, Psychological↗