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PubMed2006

The cognitive, emotional, and social sequelae of stroke: psychological and ethical concerns in post-stroke adaptation.

In the clinical domain, ethical analyses involve examination of complex individual responses, psychological processes, and social context. Psychological aspects of stroke adaptation include the risk for depression and anxiety, changes in identity and personality processes, and potential for social isolation. Depression and anxiety are heterogeneous constructs and can affect individuals' emotional functioning and cognitive abilities. Executive function, self-agency, and volition may be affected. Alterations in identity and personality may also result from the interaction of fluctuating emotional, cognitive, and physical abilities as well as from changes in social context and family dynamics. Social isolation, or lack of access to social contact or resources, can be a consequence of difficulties in cognitive and emotional function that influence interpersonal relationships, changes in social roles, communication difficulties, and challenges in transportation and employment. Social stigma and marginalization also contribute to isolation. The authors describe these psychological phenomena in the context of brain damage and recovery and raise ethical concerns including impact on decision-making capacity, pre- and postinjury selves and interests, and the social milieu in which strokes are experienced.

Ethics, Clinical↗

PubMed1990

Psychosocial effects on carers of living with persons with dementia.

A survey of members of the Alzheimer's Disease and Related Disorders Society confirmed high rates of psychological morbidity, though not of depression, and social isolation in family carers of persons with dementia. Psychological morbidity in carers was associated with having an affected person at home, the carer being a spouse, demanding problem behaviours, poor physical health in the carer, social isolation, dissatisfaction with social supports, greater use of psychotropic medication, and a deteriorated marital relationship. Carers and patients had high rates of consultations with doctors and other health professionals. There was a vulnerable group of carers who were impaired psychologically, socially and physically. The identification of risk factors to carer morbidity may lead to useful interventions.

Adaptation, Psychological↗

PubMed1993

The round table in a community-based outpatient service.

The community-based outpatient service of Berne has used the round table for 8 years. It has become a strong element of the care of long-term outpatients. The aim of the present study is to examine how the round table is used and estimated by the patients: whether it only fulfils the function of a psychosocial contact facility to reduce social isolation or whether it has other helpful functions of social relationship. Further, we were interested to find out which of the therapeutic factors in group therapy are of importance. Four major factors could be elaborated by factor analysis: the functions and the importance of the caretakers at the round table, the acceptance and social integration of the patients and psychotherapeutic factors such as self-disclosure and vicarious learning. The round table is not only a social contact facility but also a new form of an informal, open, socio-therapeutic group.

Adult↗

PubMed1975

Alcoholism and alienation.

Dean's alienation scale was administered to comparable samples of alcoholic and normal males and females in groups of 10 to 12. Alcoholics not only evidenced significantly greater overall alienation than normals, but also demonstrated greater specific alienation, namely social isolation, powerlessness and normlessness. Furthermore, the degree of specific alienation reported by alcoholics, but not by normals, differed significantly. Social isolation reflected the greatest amount of alienation, then powerlessness, and normlessness revealed the least. Sex differences were found for the alcoholic sample, but not for the normals in terms of the specific forms of alienation, although not for overall alienation. In each of these instances, males expressed more alienation than females. The meaning of the results was discussed in view of both the etiology and treatment of alcoholism.

Adult↗

PubMed1977

Psychogeriatric hospital admissions from the community and institutions.

In a sample of 100 psychogeriatric admissions to three Toronto hospitals, the elderly in other institutions, including old age and nursing homes, and those living alone in the community were over-represented. Patients who had lived with relatives, on the other hand, were found to be at low risk for psychogeriatric hospitalization. These three groups of patients were compared using information obtained from psychiatric and social interviews with patients and informants, usually close relatives. Identification of specific needs for the various groups and the implication of these differences for the improvement of psychogeriatric care and prevention of unnecessary hospitalization are discussed. Institutional residents suffered more major physical illness, were less able to maintain functional independence, were referred more often for harmful behavior, were more socially isolated, and had a poorer outcome than community patients. Patients living along lacked familial support, but were not otherwise more socially isolated that those living with relatives, and showed no other deficits. The subjective and objective burdens on the patients' families before admission were considerable. The results are consistent with previous literature on the elderly.

Activities of Daily Living↗

PubMed2025

A Systematic Review of Quantitative Studies of Depression and Loneliness in Black Women with Hypertension in the United States.

INTRODUCTION: Hypertension disproportionately affects Black women with subsequent complications that can extend beyond physical health. Notably, there is a significant relationship between hypertension, depression, and loneliness, with hypertensive Black women more likely to exhibit symptoms of depression. Since loneliness and social isolation are predictors of depression, recognizing and addressing these interconnected health concerns could improve patient outcomes and quality of life. This systematic review presents a synthesis of findings on depression screening practices, depression symptoms, and loneliness in quantitative studies of Black women with hypertension in the United States. METHODS: Using the EbscoHost platform, a comprehensive literature search for studies measuring depression and loneliness in Black women with hypertension was conducted. The following databases were selected: Medline Complete, CINAHL Complete, APA PsychArticles, and PsychINFO. RESULTS: Twenty-three articles were included; 16 focused on depression, and these studies highlighted a significant burden of depression in this demographic compared to their counterparts. Five studies reported loneliness and its relation to depression and hypertension. Loneliness and social isolation, as independent risk factors, exacerbated symptoms of depression and contributed to the onset and progression of hypertension. Two prior reviews corroborated these findings. Studies have emphasized the role of trust in clinical interactions and the importance of appropriate therapeutic interventions. DISCUSSION: Black women with hypertension are at a heightened risk for symptoms of depression, compounded by feelings of loneliness. Loneliness and depression are linked to physiological stress, contributing to hypertension. These problems are underrecognized and undertreated across populations, and this lack of recognition and treatment contributes to health inequity.

Humans↗

PubMed1993

Biologic factors as predictors of social outcome of epilepsy in intellectually normal children: a population-based study.

We studied social outcome for all the normally intelligent children in our province with onset of epilepsy between 1977 and 1985 (excluding absence and "minor motor" seizures). After follow-up averaging 7 1/2 years, the 337 patients were 7 to 28 years of age. Outcome measures were age dependent. Of those old enough to be at risk, the percentage with each unfavorable outcome was as follows: school failure 34%, use of special educational resources 34%, mental health consultation 22%, psychotropic medication 5%, unemployment 20%, social isolation 27%, inadvertent pregnancy 12%, and criminal conviction 2%. In social isolation 27%, inadvertent pregnancy 12%, and criminal conviction 2%. In a multivariate model correcting for number of potential unfavorable outcomes (based on age at end of follow-up), many variables related to epilepsy, seizure control, and electroencephalographic findings were not associated with social outcome. Only two variables were associated with at least one unfavorable outcome--learning disorder (p < 0.001) and more than 21 seizures before treatment was begun (p < 0.03). The only variable with no unfavorable outcome was simple partial seizures (p < 0.003). Sensitivity and specificity of this model were 54% and 68%, respectively, indicating that social outcome for these children was often not related to biologic factors reflected by the medical details and clinical course of their disorder.

Adolescent↗

PubMed2003

The atypical antipsychotic ziprasidone, but not haloperidol, improves phencyclidine-induced cognitive deficits in a reversal learning task in the rat.

The glutamate/N-methyl-D-aspartate receptor antagonist phencyclidine (PCP) has been shown to induce both positive and negative symptoms of schizophrenia, as well as cognitive deficits, thus providing a relatively valid model of psychosis. Isolation rearing from weaning in the rat has been proposed as a non-pharmacological model of psychosis. The aim of the present study was to explore the validity of a combination of these techniques to model cognitive dysfunction associated with schizophrenia. The present study evaluates the effects of the novel antipsychotic ziprasidone and the typical antipsychotic haloperidol in their ability to reverse the cognitive deficit induced by PCP in isolation reared rats and social controls. Rats housed in social isolation (n = 25) or in groups of five (n = 25) from weaning were food deprived and trained to respond for food in an operant reversal learning paradigm. PCP at 1.0 and 1.5 mg/kg (intraperitoneally, i.p.) significantly and selectively impaired reversal task performance in both groups of rats. This impairment was not significantly improved following the coadministration of haloperidol (0.05 mg/kg, i.p.). Higher haloperidol doses (0.1 and 0.25 mg/kg, i.p.) were found to impair task performance, with the social animals being more sensitive than isolation-reared animals. In contrast, ziprasidone (2.5 mg/kg, i.p.) reversed the impairment caused by PCP. This was significant in social animals, while in isolates there was a non-significant enhancement in performance of the reversal task with ziprasidone compared to PCP alone. Thus, PCP produced a selective reversal learning deficit in rats, which was ameliorated following treatment with ziprasidone but not haloperidol. Rearing conditions did not influence performance of the test or the deficit produced by PCP.

Animals↗

PubMed1984

The male nursing student as a token.

The purpose of this research was to test the applicability of Kanter's theory of tokenism to male nursing students. Kanter's theory states that numerical underrepresentation, not cultural factors, causes tokens to experience greater performance pressure, social isolation, and role entrapment. Subjects were 322 male and female nursing students from two similar midwestern nursing schools. Subjects completed instruments measuring social isolation, upward communication distortion, performance pressure, and communication apprehension. This research did not find support for Kanter's claims. Possible explanations for the findings include sex status differences and the nurturing character of the nursing profession.

Achievement↗

PubMed2001

[Epidemiological studies on the relationship between psychosocial factors and cardiovascular disease].

Psychosocial factors contribute significantly to the pathogenesis and expressions of cardiovascular disease(CVD). Recent studies have demonstrated that 5 specific psychosocial entities are most relevant: (1) depression, (2) anxiety; (3) personality factors and character traits; (4) social isolation, and (5) chronic life stress. Epidemiological studies consistently demonstrate a significant prospective relationship between the occurrence of major depression and the cardiac events. Increasing evidence now links anxiety disorders to the development of CVD events in general populations. Although type A behavior is continuously found to be positively related with increased risk of CVD, a series of studies have reported no correlation between type A behavior and CVD risk. However, hostility, a major attribute of the type A behavior pattern, is considered to be more pathogenic. Social isolation characterized mainly by a relatively small social network has been shown to be associated with increase in the incidence of CVD over time. Finally, chronic life stress, particularly the work-related stress, proved to be closely related to CVD risk. The pathophysiological mechanisms of psychosocial factors on the pathogenesis of CVD are: (1) excessive sympathetic nervous system activation, (2) triggering of myocardial ischemia; (3) promotion of arrhythmogenesis, (4) stimulation of platelet function, and (5) deterioration of endothelial function.

Adult↗

PubMed1990

Social adjustment and symptomatology in two types of homeless adolescents: runaways and throwaways.

Previous research on homeless adolescents has largely ignored the distinction between those who have left home on their own volition (runaways), and those who have been forced to leave (throwaways). Fifty-two homeless adolescents in Brisbane, Australia, were assessed to compare male and female runaways and throwaways for social adjustment and symptomatology. Differences for social adjustment (antisocial tendencies and aggression) and symptomatology (social isolation and depression) were predicted. Results indicated that male runaways were significantly more hostile than male throwaways (p less than .001), and significantly more socially isolated than female runaways (p less than .025). Female throwaways, however, were significantly more hostile than male throwaways (p less than .025) and female runaways (p less than .025). Yet homeless males overall had a significantly stronger urge to act out hostility than homeless females (p less than .025). In addition, female throwaways were significantly more antisocial than male throwaways (p less than .001). There were no significant differences for depression. A theory of inner social control (Hirschi, 1969), postulating absence of bonding in earlier socialization, was supported.

Adaptation, Psychological↗

PubMed2003

Hyperresponsiveness to phencyclidine in animals lesioned in the amygdala on day 7 of life. Implications for an animal model of schizophrenia.

Phencyclidine (PCP) has been described to exacerbate psychotic symptoms in patients suffering from schizophrenia. In rats, PCP, dose-dependently, induces hyperactivity, stereotyped behaviour and social isolation, postulated to represent the positive (hyperactivity, stereotypy) and negative (social isolation) symptoms of schizophrenia. Based on previous studies, ibotenic acid lesions in the amygdala on day 7 of life have been proposed as an animal model of psychiatric neurodevelopmental disorders like schizophrenia. The purpose of the present study was to determine whether the responsiveness to PCP on locomotor activity in animals lesioned in the amygdala on day 7 of life is different from the response to this drug in sham-operated animals. The effect of graded doses of PCP on behaviour was assessed in a small open field. Animals lesioned in the amygdala on day 7 of life appeared to be hyperresponsive to PCP compared to sham-operated animals. The hyperresponsiveness to PCP in rats lesioned in the amygdala on day 7 of life further contributes to the validation of this putative animal model of schizophrenia.

Amygdala↗

PubMed1982

A quantitative Golgi study in the occipital cortex of the pyramidal dendritic topology of old adult rats from social or isolated environments.

It has been previously established that the housing condition influences the appearance of the dendritic tree in young animals. The purpose of this investigation was to determine the extent of the influence that the housing condition exerts on morphometric studies involving old animals. Specifically, we found superficial pyramidal cells from the visual cortex of socially aged 20-month-old rats had more extensive oblique dendritic trees than neurons from isolated rats of the same age. The basal dendritic tree of neurons from socially reared rats was denser nearest layer IV while the basal dendritic tree of neurons from isolated rats appeared to shift away from layer IV. Our results indicate that the external environment is an independent variable and cortical dendritic morphology is a dependent variable in studies on old adult rats. Thus, the external environment should be considered in reporting results of aging studies on dendritic topology.

Aging↗

PubMed1994

Locomotor and rewarding effects of amphetamine in enriched, social, and isolate reared rats.

This study examined the influence of environmental enrichment on the behavioral response to amphetamine. Beginning at 21 days of age, rats were raised in one of three different environmental conditions: a) an enriched condition (EC), in which animals were caged in groups and provided with novel objects daily; b) a social condition (SC), in which animals were caged in groups without any novel objects; and c) an isolated condition (IC), in which animals were caged individually without any novel objects. At 53 days of age, animals from each environmental condition were assessed for amphetamine-induced changes in locomotor activity and reward using the conditioned place preference (CPP) paradigm. Results from saline-injected control animals indicated that EC animals exhibited less vertical activity than IC animals when exposed to the CPP apparatus. When challenged with amphetamine (0.5 or 2.0 mg/kg), there were no significant differences between SC and IC animals in either locomotor behavior or CPP. However, EC animals exhibited more horizontal and vertical activity following amphetamine than both the SC and IC animals. Similarly, EC animals exhibited a greater magnitude of amphetamine-induced CPP than both the SC and IC animals.

Amphetamine↗

PubMed1987

Chronic imipramine effects on exploratory behavior in rats.

Approximately 100 days old hooded rats, socially isolated or group-housed since weaning, received 15 daily IP injections of isotonic saline, 10 mg/kg or 20 mg/kg of imipramine HCl. Following their last injection, the rats' active choices of a novel environment, frequencies of rearing and grooming, and cells entered in an exploration box were recorded. The drug treatment reduced rearing, ambulation and (for isolated rats only) grooming, but had no effect on novelty choices. There was a significant weight loss with the higher dose and (for males only) with social isolation during the drug treatment period. While imipramine reduced grooming in isolated but not group-housed rats, there were no other interactions between the two forms of treatment. It was concluded that, in spite of its sedative action on motor activity, chronic imipramine did not alter curiosity about a novel environment.

Animals↗

PubMed1999

Social behavior and social motivation in adolescent rats: role of housing conditions and partner's activity.

The present study investigated 1) the effects of individual and grouped housing on social investigation, social contact behavior, and play behavior in adolescent rats tested with low socially active (grouped) and high socially active (isolated) play partners; and 2) the effects of long-term (8 days) and short-term (24 h) isolation on social behavioral manifestations and social motivation in terms of preference or avoidance of play partners. Social isolation of adolescent rats activated play behavior and social behaviors different from play, but play was predominantly affected under the conditions of this study. Long-term isolation was more effective than short-term, and resulted in greater manifestation of play and social preference. Adolescent rats were able to modify their social behaviors in response to social activity of the play partner: in isolated animals exposed to low socially active group-housed partners, play behavior was transformed into social activities unrelated to play; exposure of group-housed adolescents to high socially active previously isolated partners resulted in an increase of play behavior. Testing that allowed avoidance of social contacts revealed a dissociation between manifestations of play behavior and social motivation: group-housed play partners of isolated animals showed elevated levels of play behavior but a tendency to avoid their isolated pairmates.

Aging↗

PubMed2005

The importance of housing conditions on behavioral sensitization and tolerance to ethanol.

The differential outcomes of social isolation and crowding environment on the effects of single or repeated administration of ethanol on open-field behavior were examined in female mice. Whereas housing conditions did not alter the increase in locomotor activity induced by ethanol single administration, behavioral sensitization (a progressive increase of a drug effect following repeated drug administration) to the locomotor activating effect of ethanol was significantly greater in crowded mice as compared to isolated and control groups. Single administration of ethanol significantly decreased rearing frequency and increased immobility duration, there being tolerance to these ethanol behavior effects after repeated treatment. Social isolation attenuated the increase in immobility behavior induced by single administration of ethanol and potentiated the tolerance of ethanol-induced rearing decrease, verified after repeated treatment. These results point out that both sensitization and tolerance to the behavioral effects of ethanol can be critically influenced by housing conditions.

Animals↗

PubMed2001

Performance of a perceived health measure in different groups of the population: a comprehensive study in Spain.

The metric properties of health-related quality of life measures are typically evaluated on selected samples and assumed to hold across different population groups. We assessed the extent to which the measurement properties of the Spanish version of the Nottingham Health Profile (NHP) were stable across sociodemographic, clinical and geographical characteristics. We collected information from all available studies using the NHP in Spain (1986-1995), and obtained data from 9419 individuals. We examined data completeness and distribution, as well as reliability and construct validity. The percentage of missing dimensions was lower than 5%, but increased with age and poor health status. Large ceiling effects in scores were observed for social isolation and energy dimensions, being largest for younger ages and individuals reporting "very good/good" health. Reliability was higher than 0.7 in all population groups considered, except for social isolation and energy dimensions in some subgroups. Mean NHP scores correlated with self-rated overall health (r = 0.48), but they varied substantially by age among those rating their health as "very good/good." We conclude that NHP is adequate for all Spanish populations. Nevertheless, some caution is needed because the reliability of dimension scores is not sufficient for individual purposes. And also, because a non-negligible high ceiling effect renders the instrument inefficient to measure changes over time among healthy populations.

Adult↗