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Results for “Psychosocial functioning”

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PubMed1995

Family-environment risk factors for attention-deficit hyperactivity disorder. A test of Rutter's indicators of adversity.

BACKGROUND: This study investigated whether family-environment risk factors are associated with attention-deficit hyperactivity disorder (ADHD). Compelling work by Rutter and coworkers revealed that it was the aggregate of adversity factors (severe marital discord, low social class, large family size, paternal criminality, maternal mental disorder, and foster care placement) rather than the presence of any single factor that led to impaired development. Based on the work of Rutter, we hypothesized a positive association between indicators of adversity and the diagnosis of ADHD and ADHD-associated impairments. METHODS: We studied 140 ADHD and 120 normal control probands. Subjects were non-Hispanic white boys between the ages of 6 and 17 years. Rutter's indicators of adversity were used to predict ADHD-related psychopathology as well as impaired cognitive and psychosocial functioning. RESULTS: The odds ratio for the diagnosis of ADHD increased as the number of Rutter's adversity index predicted ADHD-related psychopathology (depression, anxiety, and conduct disorder), learning disabilities, cognitive impairment, and psychosocial dysfunction. CONCLUSIONS: A positive association appears to exist between adversity indicators and the risk for ADHD as well as for its associated psychiatric, cognitive, and psychosocial impairments. These findings support the work of Rutter and stress the importance of adverse family-environment variables as risk factors for children with ADHD.

Adolescent↗

PubMed2006

Understanding predictors of functional recovery and outcome 30 months following early childhood head injury.

Much is known about outcome following traumatic brain injury (TBI) in school-age children; however, recovery in early childhood is less well understood. Some argue that such injuries should lead to good outcome, because of the plasticity of the developing brain. Other purport that the young brain is vulnerable, with injury likely to result in a substantial impairment (H. G. Taylor & J. Alden, 1997). The aim of this study was to examine outcomes following TBI during early childhood, to plot recovery over the 30 months postinjury, and to identify predictors of outcome. The study compared 3 groups of children sustaining mild, moderate, and severe TBI, ages 2.0 to 6.11 years at injury, with healthy controls. Groups were comparable for preinjury adaptive and behavioral function, psychosocial characteristics, age, and gender. Results suggested a strong association between injury severity and outcomes across all domains. Further, 30-month outcome was predicted by injury severity, family factors, and preinjury levels of child function. In conclusion, children with more severe injuries and lower preinjury adaptive abilities, and whose families are coping poorly, are at greatest risk of long-term impairment in day-to-day skills, even several years postinjury.

Activities of Daily Living↗

PubMed1999

Social resources and social function in comorbid eating and substance disorder: a matched-pairs study.

OBJECTIVE: To assess social resources and function among patients with comorbid Eating Disorder (ED) and substance abuse/dependence, referred to here as Substance Related Disorder (SRD). DESIGN: Descriptive, cross-sectional, comparative. SETTINGS: A university medical center with an Alcohol-Drug Program located within a Department of Psychiatry. SUBJECTS: 70 patients with Substance Related Disorder and Eating Disorder (SRD-ED), matched for gender, age, and race-ethnicity with 70 SRD-only patients. METHODS: A research associate assessed current social resources and social function based on data obtained from patients and collateral sources while blind to the ED status of the patient. Addiction psychiatrists made the diagnoses of SRD and ED and conducted assessments for axis 4 psychosocial stressors and axis 5 psychosocial function. RESULTS: SRD-ED patients had more advantageous social resources than SRD-only patients, including residence with family or friends, more education, higher socioeconomic status, and larger social networks. However, SRD-ED patients manifested martial status, employment, stressors, and coping levels similar to SRD-only patients. CONCLUSIONS: Several alternative explanations exist for these expected though unusual findings. Further analyses will be required to understand this lack of articulation between social resources and social function across two diagnostic groups.

Adolescent↗

PubMed2005

Is alexithymia related to negative symptoms of schizophrenia? A preliminary longitudinal study.

BACKGROUND: Alexithymic features are close to anhedonia, blunted affect, and alogia that are also characteristics of the negative symptoms of schizophrenia. This study aimed to evaluate whether alexithymia is associated with negative symptoms and is related to the change of schizophrenic symptoms over time. SAMPLING AND METHODS: A consecutive sample of 29 schizophrenic outpatients was evaluated at baseline and at 3, 6, and 12 months during appropriate treatment. They completed the Positive and Negative Syndrome Scale, the Montgomery and Asberg Depression Rating Scale, the Global Assessment of Functioning Scale, and the 20-item Toronto Alexithymia Scale at any time points. RESULTS: The psychiatric scale scores showed significant symptom improvement over time but were unrelated to the alexithymia score that was instead stable over time. Hierarchical regression showed that the 20-item Toronto Alexithymia Scale at baseline was the sole predictor of alexithymia at 12 months, after controlling for psychopathology and psychological functioning. CONCLUSIONS: Alexithymia was unrelated to negative symptoms, suggesting it is an independent and separate construct from schizophrenia. As expected, the negative symptoms were associated instead with illness-related aspects of depression and psychosocial functioning. Caution should be expressed in generalization mainly because this study is limited by the small sample size.

Adult↗

PubMed1999

Prolonged adjustment difficulties among those with acute posttrauma distress following burn injury.

This study examined the impact of mild to moderate symptoms of in-hospital posttrauma distress (PTD) following severe burn injury on quality of life (QOL) at 2-month follow-up after controlling for preburn QOL, injury severity, and state Negative Affectivity (depression, body image dissatisfaction) and dispositional optimism-pessimism. Participants' (n = 86) self-report established PTD and non-PTD groups (median split on Davidson Trauma Scale). After covarying preburn level of psychosocial QOL, PTD groups differed on psychosocial functioning at follow-up. This effect remained after covarying injury severity, state NA, dispositional optimism-pessimism, and preburn Mental domain QOL. PTD groups also differed significantly on physical functioning at follow-up after covarying preburn physical functional status. This effect was removed by controlling preburn Physical domain QOL and either injury severity or state NA and dispositional optimism-pessimism. Therefore, PTD is related to significant impairments in the physical and psychosocial adjustment of survivors of severe burns regardless of pretrauma level of adjustment. Injury severity and state NA and dispositional optimism-pessimism moderate the impact of PTD on physical but not psychosocial adjustment.

Activities of Daily Living↗

PubMedDate not supplied

Hypertension affects neurobehavioral functioning.

This study compared the neurobehavioral performance of hypertensive and normotensive men and women using neuropsychological, information-processing, and psychometric assessments. One hundred subjects, including 68 hypertensive and 32 normotensive individuals, completed a test battery that yielded scores on measures of speed of information processing, verbal and figural memory, psychosocial functioning, Type A behavior, and locus of control. Results showed that, compared with the normotensive individuals, the hypertensives performed more poorly on a set of tasks that measure speed of information processing and short-term memory (Digit Symbol, Digit Span (Backwards), and Reaction Time (slope)). The hypertensives also reported higher levels of state anxiety relative to their normotensive counterparts. The effects of hypertension on neurobehavioral functioning could not be accounted for on the basis of age or education.

Adult↗

PubMed2003

Psychosocial status after pediatric traumatic brain injury: a subtype analysis using the Child Behavior Checklist.

This study identified subtypes of psychosocial functioning in children who had sustained traumatic brain injury (TBI). Child Behavior Checklist (CBCL) profiles for 92 participants, aged 12 to 18 years, who had sustained a mild, moderate, or severe TBI were subjected to Q-Factor analysis. Sixty-four of the participants (75%) were classified into a four-category psychosocial typology labelled Normal (n = 32), Attention (n = 14), Delinquent (n = 10), and Withdrawn-Somatic (n = 8). This typology was found to overlap in part with previous TBI psychosocial typology (Butler et al., 1997), and with three of the clinical profile types derived by Achenbach (1993) for the CBCL. The majority of participants, including those who sustained severe TBI, were assigned to the Normal subtype and the overall level of psychosocial deviance was relatively mild in the other three subtypes. The results of this study support previous typology efforts and confirm the heterogeneous presentation of social and emotional functioning following TBI.

Adaptation, Psychological↗

PubMed2006

Course and outcome of bipolar spectrum disorder in children and adolescents: a review of the existing literature.

The longitudinal course of children and adolescents with bipolar disorder (BP) is manifested by frequent changes in symptom polarity with a fluctuating course showing a dimensional continuum of bipolar symptom severity from subsyndromal to mood syndromes meeting full Diagnostic and Statistical Manual of Mental Disorders criteria. These rapid fluctuations in mood appear to be more accentuated than in adults with BP, and combined with the high rate of comorbid disorders and the child's cognitive and emotional developmental stage, may explain the difficulties encountered diagnosing and treating BP youth. Children and adolescents with early-onset, low socioeconomic status, subsyndromal mood symptoms, long duration of illness, rapid mood fluctuation, mixed presentations, psychosis, comorbid disorders, and family psychopathology appear to have worse longitudinal outcome. BP in children and adolescents is associated with high rates of hospitalizations, psychosis, suicidal behaviors, substance abuse, family and legal problems, as well as poor psychosocial functioning. These factors, in addition to the enduring and rapid changeability of symptoms of this illness from very early in life, and at crucial stages in their lives, deprive BP children of the opportunity for normal psychosocial development. Thus, early recognition and treatment of BP in children and adolescents is of utmost importance.

Adolescent↗

PubMed2001

Child sexual abuse, peer sexual abuse, and sexual assault in adulthood: a multi-risk model of revictimization.

This study explored the predictors and consequences of sexual assault occurring after the age of 16 years in a nonclinical sample of women. Child sexual abuse occurring before the age of 16 years was the only predictor of later sexual assault among comorbid risk factors. Peer sexual abuse, number of perpetrators, age at time of sexual abuse, and severity of sexual abuse did not increase the risk for later sexual assault. Adult sexual assault victims showed lower levels of mental health functioning than did survivors of child or peer sexual abuse. We discuss a specificity model of revictimization and the differential effects of child, peer, and adult sexual trauma on the developmental trajectory of sexual violence and psychosocial functioning.

Adolescent↗

PubMed1990

Ethnicity and psychosocial factors in alcohol and tobacco use in adolescence.

Research on ethnic group differences has suggested that (a) adolescents from various groups differ on a number of dimensions that have been related to risk for substance use initiation, and (b) adolescents of different groups choose different substances. However, there is little consensus regarding the reasons for such differences. There is an especially high rate of alcohol use among Hispanic adolescents, and Hispanics are at high risk for alcohol abuse. In light of ethnic group differences in both substance use and the precursors of substance use in adolescence, this study examined differences among black, Anglo, Puerto Rican, and Dominican adolescents in the relation between cigarette and alcohol use and psychosocial functioning. Comparisons between the Puerto Rican and Dominican subjects were of special interest due to preexisting differences between these groups that may be attributed to acculturation. Results provided evidence of the importance of acculturation in modifying psychosocial vulnerability, especially for alcohol use, with the Dominican group at highest risk.

Acculturation↗

PubMed2005

Family education for people with schizophrenia in Beijing, China: randomised controlled trial.

BACKGROUND: Much of China lacks well-developed services for people with schizophrenia and their families, and most of the existing services focus on hospitals. There is a need for culturally sensitive family treatments offered by nurses. AIMS: To conduct a longitudinal experimental study examining the effect of patient and family education in a sample of Chinese people with schizophrenia. METHOD: A randomised controlled trial was conducted in a large hospital with a was conducted in a large hospital with a sample of 101 patients with schizophrenia and their families. Data were collected at admission and at discharge, and then at 3 and 9 months after discharge. The intervention group received family education, and data on their knowledge about schizophrenia, symptoms, functioning, psychosocial behaviour, relapse and medication adherence were collected and compared with the control group. RESULTS: There was a significant improvement in knowledge about schizophrenia in the experimental group and a significant difference in symptom scores and functioning at 9 months after discharge. Patients who were nonadherent to medication regimens were more likely to relapse. CONCLUSIONS: Family education on schizophrenia by nurses in China was effective in improving knowledge and promoting improvement in patients' symptoms.

Adolescent↗

PubMed1996

The impact of coping styles and family communication on the social skills of children of alcoholics.

OBJECTIVE: This study examined the relationship between parents alcoholism and their young adult children's social skills. Although parental alcoholism was hypothesized to be negatively related to children's social skills, this relationship was hypothesized to be moderated by family communication styles and young adults' coping styles. METHOD: Prior to the actual study, potential subjects were screened on a measure of parental alcoholism. To compensate for the positively skewed distribution of this variable, a greater percentage of those in the upper extreme of the scale were invited to participate in the study. For the study, 143 students (77 female) completed self-report measures of parental alcoholism, social skills, family communication and coping styles. Subjects also had a sibling complete measures of parental alcoholism and family communication. RESULTS: Results indicated no significant differences in adult children's social skills as a function of parental alcoholism. Furthermore, family communication and young adults' coping styles did not appear to moderate this relationship. CONCLUSIONS: This is one of a growing number of studies that show that children may exhibit undisturbed psychosocial functioning despite having an alcoholic parent.

Adaptation, Psychological↗

PubMed2006

Randomized clinical trial examining psychosocial and quality of life benefits of bilateral breast reduction surgery.

BACKGROUND: The aim was to determine the effects of bilateral reduction mammaplasty on quality of life and psychosocial functioning in women with mammary hypertrophy. METHODS: Seventy-three women who were referred to either the Hull Breast Unit or Hull Plastic and Reconstructive Surgery Unit were randomized to early or delayed surgery. Both groups had quality of life and psychosocial assessment. Each group underwent two sets of tests. Women who had early bilateral breast reduction were tested before and at 4 months after surgery, whereas those in the control group were tested at the time of randomization and 4 months later, before undergoing surgery. RESULTS: All 73 women completed the study. Mean age was 39 years, and the two groups were well matched for age, body mass index and breast dimension. There were highly significant differences between groups in scores measured on the Functional Assessment of Non-Life Threatening Conditions version 4, EuroQoL, and both mental and physical scales of Short Form 36 (P < 0.001). The Eysenck Personality Questionnaire-Revised demonstrated a statistically significant increase in extroversion and emotional stability in the early treatment group. CONCLUSION: Reduction mammaplasty significantly improved quality of life, and increased extroversion and emotional stability.

Adolescent↗

PubMed1998

Outcomes in the first 5 years after traumatic brain injury.

OBJECTIVE: To examine the extent to which outcomes from traumatic brain injury differ as a function of time and can be predicted at discharge from inpatient rehabilitation. DESIGN: Survey method employing cross-sectional analyses. SETTING: An inpatient brain injury rehabilitation unit in a large midwestern academic medical center. SUBJECTS: Ninety-five adults with traumatic brain injuries, 6 months to 5 years after inpatient rehabilitation, stratified by time postdischarge. MAIN OUTCOME MEASURES: Functional Independence Measure (FIM), Sickness Impact Profile (SIP), Medical Outcomes Survey SF-36, Community Integration Questionnaire (CIQ), Craig Handicap Assessment and Reporting Technique (CHART), Brief Symptom Inventory (BSI), Satisfaction With Life Scale (SWLS), and indices of current psychosocial functioning. RESULTS: Substance abuse, need for supervision, life satisfaction, and selected subscales of the CIQ and CHART differed over the period 6 months to 5 years after discharge. Approximately 75% of the variance in current FIM scores, and 40% to 50% of CHART, CIQ, and SIP total scores, could be predicted at time of discharge. CONCLUSIONS: Outcomes over the first 5 years after discharge were dynamic, with most change being improvement, at least after the first 2 years. Important aspects of outcome could not be predicted based on premorbid characteristics, injury severity, and initial functional abilities.

Activities of Daily Living↗

PubMed2003

A multimethod, multi-informant, and multidimensional perspective on psychosocial adjustment in preadolescents with spina bifida.

This study examined the psychosocial adjustment of preadolescents with spina bifida in relation to a comparison sample of able-bodied preadolescents (8- and 9-year-olds; n = 68 in each sample). The study also examined the potential clinical utility of a narrowband multimethod, multi-informant, and multidimensional perspective on the assessment of psychosocial functioning in children and adolescents with pediatric conditions. Findings revealed that children with spina bifida tended to be socially immature and passive, less likely to have social contacts outside of school, more dependent on adults for guidance, less competent scholastically, less physically active, less likely to make independent decisions, and more likely to exhibit attention and concentration difficulties. No group differences were found for externalizing symptoms, affective functioning, or global self-worth, suggesting resilience in these domains for the spina bifida sample. Findings also suggest that low socioeconomic status and the presence of a physical disability may be additive risk factors for certain psychosocial adjustment difficulties.

Adaptation, Psychological↗

PubMed2000

Pretreatment quality of life of inoperable non-small cell lung cancer patients referred for primary radiotherapy.

This study examined the association between the most important prognostic factors in non-small cell lung carcinoma (NSCLC) and self-reported pretreatment quality of life (QoL) and the impact of the presence, severity and changes in respiratory symptoms on general symptoms and QoL. The study included 262 patients. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and EORTC QLQ-LC13 were used to assess symptoms and QoL before radiotherapy. Patients with inoperable NSCLC showed major differences in self-reported QoL as a function of clinical prognostic factors. A significant association was found between World Health Organization (WHO) performance status and QoL but not other prognostic factors. Dyspnoea was the only respiratory symptom associated significantly with general symptoms, physical and psychosocial functioning and QoL. Furthermore, changes in dyspnoea were associated significantly with changes in physical and role functioning, global QoL and fatigue as assessed 6 weeks after radiotherapy. These results indicate that palliation of dyspnoea may have a significant beneficial effect on QoL and that palliation of other respiratory symptoms is not necessarily associated with improvement of general symptoms, physical and psychological functioning or global QoL.

Adult↗

PubMed2001

Psychological adjustment of adolescent girls with chronic fatigue syndrome.

OBJECTIVE: To examine psychosocial problems and adaptation of adolescent girls with chronic fatigue syndrome (CFS). METHODOLOGY: Thirty-six adolescent girls with CFS (mean age: 15.2 years; mean syndrome duration: 19.7 months) who fulfilled the criteria of the Centers for Disease Control and Prevention were examined by interviews regarding premorbid problems and by questionnaires regarding psychosocial functioning and distress, psychological attitudes, and coping resources. Data were compared with normative data. RESULTS: Of the adolescents, 86.1% reported 1 or more premorbid problems (58.3% physical, 38.9% psychological, and 52.8% familial). Normal adjustment was reported for psychosocial self-esteem, social abilities, and attentional abilities. High adjustment to adult social standards of behavior was found, but low perceived competence in specific adolescent domains, such as athletic ability, romance, and participation in recreational activities. The girls reported predominantly internalizing problems. Normal achievement motivation, no debilitating fear of failure, and high internal locus of control were observed. Palliative reaction patterns and optimism were predominantly used as coping strategies. CONCLUSIONS: The large number of premorbid problems suggests a possible contributing factor to the onset of the syndrome, although there were no reference data of healthy adolescents. In distinct domains of psychosocial adjustment, the adolescent girls with CFS showed strengths such as adequate self-esteem and scholastic and social abilities, and weaknesses such as low competence in adolescent-specific tasks and internalizing distress, which may partly be explained by syndrome-specific somatic complaints. The use of optimistic and palliative reaction patterns as coping strategies in this patient group indicates that the patients with CFS seem to retain an active and positive outlook on life, which may result in a rather adequate psychological adaptation to the syndrome, but also in maintenance of the syndrome by exceeding the physical limits brought about by the CFS. Our results on adjustment and coping strategies may be helpful to implement (individual) rehabilitation programs.

Adaptation, Psychological↗

PubMed2001

Sensitizing clinicians and patients to the social and functional aspects of remission.

Axis I disorders are defined by specific symptom constellations that are frequently accompanied by notable impairments in social functioning. Social role impairments diminish personal fulfillment, satisfaction, and quality of life. It is now clear that these findings suggest a broader definition of remission that involves not only the absence of symptoms but also improvement in psychosocial functioning. Clinicians and patients need to become sensitized to the role of social functioning and quality of life in the assessment of treatment outcomes. Although there has been a recent emphasis on the inclusion of social function and quality of life measures in the definition of and requirements for remission, numerous standardized scales for measuring these factors already exist. In addition, selection of efficacious therapeutic agents proven to promote both elimination of symptoms and return to full social functioning is important. Finally, significant improvement in both symptoms and function may be necessary to prevent not only relapse but also ensure full remission of anxiety and depressive disorders.

Anti-Anxiety Agents↗