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Results for “SOCIAL ISOLATION”

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PubMed2001

Effects of central noradrenaline depletion by the selective neurotoxin DSP-4 on the behaviour of the isolated rat in the elevated plus maze and water maze.

RATIONALE: Social isolation of the rat from weaning influences behaviour following central noradrenaline (NA) depletion by the selective neurotoxin N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4). OBJECTIVES: The study characterised the effects of DSP-4 on the behaviour of isolates in the elevated plus maze and water maze. METHODS: Male Lister hooded rats were reared singly or in groups after weaning. Two weeks postweaning, the rats were injected with DSP-4 (25 mg/kg, i.p.) or saline. From week 4, rats were tested in the plus maze and in the water maze. RESULTS: DSP-4 significantly reduced cortical and hippocampal NA but had no effect on hypothalamic NA. Isolation rearing alone had no significant effects on behaviour in the elevated plus maze but enhanced retention of platform placement in the water maze as measured by increased entries to the platform annulus during the probe test. DSP-4 in group-reared rats increased activity in the open arms and increased general activity in the elevated plus maze with no effect on water maze performance. DSP-4-treated isolates spent less time in the open arms and were hypoactive in the plus maze compared to group-reared DSP-4-treated rats, and had impaired retention of spatial memory in the water maze compared to isolate controls. CONCLUSIONS: DSP-4 treatment had an 'anxiolytic' effect in group-reared rats in the elevated plus maze. In the water maze, isolation rearing enhanced retention of spatial information, an effect normalised by NA depletion. The results demonstrate the importance of noradrenergic function in the regulation of responsiveness to environmental cues.

Animals↗

PubMed2006

Caring for children with learning disabilities who present problem behaviours: a maternal perspective.

The theoretical cognitive model of stress and coping provides a structure to obtain and analyse maternal perceptions of caring for children with learning disabilities who present severe problem behaviours. The Family Fund database identified 18 families who met the sample criteria of children aged five years to 15 years with severe to moderate learning disability presenting severe problem behaviour. Physical aggression was reported to be the primary behavioural problem for 13 of the children. Interviews undertaken with the main carer of the child at their home were taped and transcribed. The data were analysed using grounded theory techniques which identified 'secondary stressors' for the parent. These were social isolation, conflict, limitation of lifestyle and self-blame. It is proposed that the amalgamated impact of these can weaken parents' coping resources and, therefore, may prove to be as significant to the negative association with maternal wellbeing as the problem behaviour.

Adaptation, Psychological↗

PubMed2002

Mothers with learning difficulties and their support networks.

Mothers with learning difficulties are thought to be among the most socially isolated parents in the community. A great deal of attention has been directed to assessing their parenting abilities and teaching parenting skills, but less has been given to the support that mothers may (or may not) receive from family, friends and the service system. The present paper investigates mothers' views about the types of support which they receive and from whom they receive it. Data were derived from 70 mothers who participated in interviews using a support interview guide designed to accommodate the mothers' cognitive difficulties. The primary purpose of the interview was to explore the quantity and composition of the mothers' support networks, the frequency of contact and geographical proximity of support people, and the type of support provided. Key findings include: the central place that family members have in these mothers' lives; the importance of service providers as sources of information and advice; and the relative absence of friends and neighbours. Briefly, mothers living alone have service-centred networks, mothers living with a partner have family-centred networks with relatively dispersed family ties, and mothers living in a parent/parent-figure household have local, family-centred networks. The overall conclusion to be drawn from the present results is that these mothers do not live in a social vacuum, but many are socially isolated. The finding that so few mothers could identify supportive ties with friends and neighbours suggests that these mothers are isolated from their local communities and are potentially vulnerable if a breakdown occurs in the support provided by their families. The need for service providers to be more actively involved in linking mothers to their communities is discussed.

Adult↗

PubMed1998

Major Depression and Heart Disease: Treatment Trials.

Cardiac disease and depression affect a significant number of individuals every year, and developing effective treatment for depression in cardiac disease could have a substantial impact on public health. Several studies have shown that depression increases cardiac morbidity and mortality and total costs of care and is associated with a poor psychosocial outcome. Psychopharmacological treatment trials have shown that tricyclic antidepressants have antiarrhythmic effects, prolong cardiac conduction, and cause orthostatic hypotension, but do not impair left ventricular function, even in patients with underlying left ventricular impairment. Tricyclic antidepressants are efficacious in treating depression but have a higher rate of cardiovascular complications than other antidepressants, with orthostatic hypotension being the most common complication. Recent small clinical trials with bupropion and selective serotonin reuptake inhibitors (SSRIs) indicate that they are efficacious and have a more benign cardiovascular side-effect profile, although large studies need to be performed to establish their safety and efficacy. Most psychosocial studies have focused on cardiac patients in general and not specifically on depressed cardiac patients. Studies of cardiac patients have shown that stress, social isolation, and lower income and educational levels are associated with a poorer cardiac outcome. A large meta-analysis of randomized, controlled trials of psychosocial interventions in nondepressed cardiac patients found that a diverse array of psychosocial interventions decreased morbidity and mortality. However, one recent psychosocial treatment trial of post-myocardial infarction (MI) patients has shown increased mortality in women in the intervention arm of the trial. There have been several recent studies showing that mental stress induces cardiac ischemia, that mental stress-induced cardiac ischemia is associated with a higher rate of adverse cardiac events than exercise-induced ischemia, and that with stress management training, patients show significant reductions in ischemic responses to mental stress. Currently, there are two large studies underway examining pharmacological and psychotherapeutic treatment of post-MI depressed and/or socially isolated patients. These large clinical trials are needed to determine if effective treatment of depression can modify the increased risk for mortality and morbidity associated with depression in cardiac disease. Hopefully, the development of effective treatment for depressed cardiac patients will decrease their morbidity and mortality and enhance their overall quality and enjoyment of life.

Journal Article↗

PubMed1985

Census tract predictors of physical, psychological, and social functioning for needs assessment.

The advantages of census data-based needs assessment cannot be fully realized in the absence of demonstrated relationships between area characteristics and aggregate individual service need. This study sought to ascertain these relationships by using tract characteristics from the 1980 census to predict tract aggregate levels of individually measured social, physical, and psychological functioning. A census tract stratified sample of 3,465 permanent households in eastern Long Island, New York was used for the study. In each household, a randomly selected adult was surveyed regarding physical functioning, depressed mood, and social isolation. Stepwise multiple regression was used to determine which census variables best predicted the tract distributions of each of the functioning measures. Census variables explained from 23 to 30 percent of the variance in tract need level. Study findings have immediate utility for efficient needs assessment and suggest avenues for future improvement of needs assessment methods.

Adolescent↗

PubMed2003

Octogenarians reaching end-stage renal disease: cohort study of decision-making and clinical outcomes.

The fate of octogenarians reaching end-stage renal disease (ESRD) is poorly defined, and implicit dialysis rationing may be practiced in this age group. The main objectives of this study were to analyze the characteristics of pre-ESRD octogenarians offered dialysis or not and to identify factors influencing mortality while on dialysis, to improve prognosis assessment and decision-making. In this single-center cohort, 146 consecutive pre-ESRD octogenarians were referred to a nephrology unit over a 12-yr period (1989 to 2000). Main outcome measures were baseline characteristics of patients offered dialysis and conservative therapy and overall and 1-yr survival according to effective treatment. A therapeutic decision was made for 144 patients. Octogenarians who were not proposed dialysis (n = 37) differed from those who were proposed dialysis (n = 107) mainly in terms of social isolation (43.3% versus 14.7%; P = 0.03), late nephrologic referral (51.4% versus 28.9%; P = 0.01), Karnofsky score (55 +/- 18 versus 63 +/- 20; P = 0.03), and diabetic status (22.2% versus 6.5%, P = 0.008). Six patients refused the dialysis proposal. During the 12-yr observation period, 99 patients died (68.7%). Median survival was 28.9 mo (95% CI, 24 to 38) in patients undergoing dialysis, compared with 8.9 mo (95% CI, 4 to 10) in patients treated conservatively (P < 0.0001). In multivariable piecewise Cox analysis, independent predictors of death within 1 yr on dialysis were poor nutritional status, late referral, and functional dependence. Included in a survivor function, these covariates predict groups with low and high 1-yr mortality risk. Beyond 1 yr on dialysis, the only independent predictor of death was the presence of peripheral vascular disease. It is concluded that beside a patient's individual refusal, late referral, social isolation, low functional capacity, and diabetes may have oriented medical decision toward withholding dialysis in a significant proportion of pre-ESRD octogenarians. Although most patients on dialysis experienced a substantial prolongation of life, identification of mortality predictors in this age group should improve the process of decision-making regarding the expected benefit of renal replacement therapy.

Aged↗

PubMed1991

Conjugal violence: changing attitudes in two northern native communities.

In recent years, North American society has begun to recognize the tragic extent of conjugal violence in our homes. Family violence knows no social boundaries and tragically our native peoples have suffered its full impact on their homes and communities. This article reports the findings of case studies of two Arctic communities and compares their responses to family violence before oil and gas development and after. The communities are situated in the centre of the recent exploration for hydrocarbon resources in the Beaufort Sea and have experienced the direct social impacts of this industrial activity. Thus, they provided an excellent opportunity to analyze the relationship between industrial development and violence within the home. The research applied a model developed by Blishen et al (1979), developed specifically for northern communities. The model analyzed the community's social processes and functioning on a continuum from "communitarianism" (social integration) to "privatization" (social isolation). This research collected data comparing conjugal violence before and after development and explored how individuals would respond to family violence and where they would go for help in addressing this problem. The analysis revealed that the communities held different levels of communitarianism and privatization before hydrocarbon development accelerated. After development, both communities experienced increased responses to family violence which were both communitarian and privatized in nature. Previous to development, the respondents tended to avoid situations of family violence and when confronted with it they often did not know how to respond. The findings indicated that conjugal violence has been present in native communities for a long time and it was incorrect to suggest that it was a new phenomenon blamed on increased development. The data indicated that native communities can and have successfully taken a community-based action on this problem. The data demonstrated that social work intervention focused on the community at large can have a positive impact on changing attitudes and stimulate community-based action. And there exists a danger that the social/human service worker may "professionalize" the problem, thereby removing the sense of responsibility from the community and "privatizing" the solution. The article's contribution lies in its critical assessment of traditional human service intervention with individuals and the structures of northern society. And, the paper challenges the professional helpers to broaden their strategies to include innovative community-based approaches.

Arctic Regions↗

PubMed1982

Effects of early social experience on activity and object investigation in the ferret.

Earlier experiments have shown that many of the effects of early social isolation in the rat may be due to deprivation of social play. The isolated ferret, like the isolated rat, is hyperactive; furthermore, its hyperactivity appears to be related to deprivation of social play. However, the relationship between object investigation and social rearing is more complex in the ferret than it is in the rat.

Animals↗

PubMed2003

Virtuality in human supervisory control: assessing the effects of psychological and social remoteness.

Virtuality would seem to offer certain advantages for human supervisory control. First, it could provide a physical analogue of the 'real world' environment. Second, it does not require control room engineers to be in the same place as each other. In order to investigate these issues, a low-fidelity simulation of an energy distribution network was developed. The main aims of the research were to assess some of the psychological concerns associated with virtual environments. First, it may result in the social isolation of the people, and it may have dramatic effects upon the nature of the work. Second, a direct physical correspondence with the 'real world' may not best support human supervisory control activities. Experimental teams were asked to control an energy distribution network. Measures of team performance, group identity and core job characteristics were taken. In general terms, the results showed that teams working in the same location performed better than teams who were remote from one another.

Adult↗

PubMed2006

Before and after the 1999 Chi-Chi earthquake: traumatic events and depressive symptoms in an older population.

Natural disasters, such as earthquakes, can have deleterious consequences for physical and psychological health. In this study, we investigate variability in resilience to depressive symptoms in the aftermath of a massive earthquake that struck Taiwan in 1999. We analyze data on 1160 older individuals from a national, longitudinal survey with interviews before and after the earthquake. This survey contains extensive information on physical and cognitive function, depressive symptoms, socio-demographic characteristics and earthquake-related exposure and experiences. We estimate regression models to identify risk factors associated with the presence of depressive symptoms after the disaster, controlling for health status and the presence of depressive symptoms beforehand. We pay special attention to how socio-demographic factors moderate the psychological impact of the earthquake. Results indicate that persons of low socioeconomic status (SES), socially isolated individuals, and women reported higher levels of depressive symptoms than their respective counterparts, as did persons who experienced damage to their homes. The psychological effects of damage were strongest among those aged 54-70. The findings suggest that people who experience damage to their home during a disaster are at risk of experiencing depressive symptoms, with the elderly being more resilient than the near-elderly.

Activities of Daily Living↗

PubMed2000

Health related quality of life in Parkinson's disease: a prospective longitudinal study.

OBJECTIVES: To examine the change over time in health related quality of life (HRQL) in a community based cohort of patients with Parkinson's disease. METHODS: One hundred and eleven patients were evaluated for HRQL in 1993 and then again in a follow up study 4 years later. The patients included in the study in 1993 were derived from a prevalence study of patients with Parkinson's disease in the county of Rogaland, Norway. The HRQL was measured by the Nottingham health profile (NHP). At both evaluations clinical and demographic variables were determined during semistructured interviews and by clinical examinations by a neurologist. RESULTS: During the 4 year follow up period there was a significant increase in NHP scores, reflecting a decreased HRQL, in the dimensions of physical mobility, emotional reactions, pain, and social isolation. In the same time period mean total NHP score increased from 120.0 (SD 102.6) to 176.0 (SD 119.4) (p<0.01). There were no clinical or demographic factors found in 1993 that identified patients at higher risk for developing decreased HRQL. Increased UPDRS score (unified Parkinson's disease rating scale) and Hoehn and Yahr stage during the 4 year study period correlated with increased NHP scores. Even though there was no increase in depressive symptoms or self reported insomnia, these symptoms, together with lower Schwab and England score, were the most important factors for a poor HRQL in 1997. CONCLUSIONS: Parkinson's disease has a substantial impact on HRQL. Despite modern care, we found a significantly increased distress during the 4 year follow up period. Increased parkinsonism, measured by UPDRS and Hoehn and Yahr stage, correlated with increased stress, not only in the dimension of physical mobility, but also in the areas of pain, social isolation, and emotional reactions. In addition to the clinical examination, HRQL scoring provides valuable information on the total health burden of Parkinson's disease in both cross sectional and longitudinal evaluations, and contributes to a more comprehensive picture of the total disease impact.

Aged↗

PubMed2006

Coping with Dravet syndrome: parental experiences with a catastrophic epilepsy.

The aim of this study was to investigate how parents cope with and care for a child with Dravet syndrome, a severe myoclonic epilepsy with three distinct stages. Twenty-four parents of children with Dravet syndrome participated in a semi-structured interview and 17 completed the Impact of Childhood Neurologic Disability Scale (ICND) questionnaire. Children included 11 males and 13 females aged 2 to 24 years (mean age 10y 2mo [SD 5y 8mo]). Stage 1 of the syndrome was generally very difficult. Uncertainty about the diagnosis was the primary cause of stress. Seizure control was worst during this time. The primary concern in Stage 2 remained seizure control but developmental, behavioral, and sleep issues also emerged. Negative effects were noted in parents' relationships with others. Stage 3 brought better seizure control but decreased cognitive level, increased behavioral problems, and increasing social isolation for parents. Respite and relief care were hard to obtain at each stage. ICND scores mirrored the findings of the interviews. The three stages of Dravet syndrome present serious challenges for parents. Seizures are persistent and severe but developmental, behavioral, and sleep issues add to the stress. In the absence of successful medical treatment for Dravet syndrome, further attention needs to be paid to helping families cope with the disorder.

Adaptation, Psychological↗

PubMed1987

The daily life of ambulatory chronic mental patients.

The purpose of this research is to describe in greater detail than is typically done the daily life experiences of 11 ambulatory chronic mental patients and 11 nonpsychiatric controls. The subjects, although diagnostically heterogeneous, were representative of Dutch chronic mental patients. The Experience-Sampling Method was used to signal subjects randomly 10 times a day for 6 consecutive days to fill out self-rating forms assessing mental state and contextual information at the moment of the signal. Compliance was good. In time-allocation comparisons with nonpsychiatric subjects the patients were found to live relatively "normal" lives. As expected, their psychopathology was influenced by social environments such as being alone, at home, or in society at large. Contrary to other studies that stress the social isolation of such individuals, the chronic subjects reported feeling better away from home and among people than normal subjects. When alone, chronic patients reported daydreaming more and noted a tendency to drift away from thoughts about current activities. Mental state fluctuations and daily interactions, characteristic of this group, are examined in relation to theories of vulnerability and coping style of chronic mental patients, with an eye to individualized treatment applications.

Activities of Daily Living↗

PubMed2002

Adapting to psychiatric disability and needs for home- and community-based care.

The objective of the study was to describe adaptation strategies and use of formal and informal support by individuals with psychiatric disabilities, to delineate remaining needs, and to determine how home- and community-based services might address those needs. Using in-depth interviews and structured questionnaires, we examined functional status, adaptation, and needs for home- and community-based care among 33 severely mentally ill members of a large health maintenance organization. Despite success in community living, participants had significant functional deficits (physical and emotional), relied heavily on only one or two key informal caregivers, and often needed significant support from mental health professionals. Limited numbers of caregivers and social isolation placed participants at risk of negative outcomes if informal support resources were to be lost. Home- and community-based care interventions that attempt to increase informal support networks and provide instrumental help (cooking, cleaning, transport) on short notice during flare-ups could augment existing (but limited) informal caregiving, help severely mentally ill individuals remain independent, and reduce the likelihood that loss of an informal caregiver would result in unwanted outcomes.

Activities of Daily Living↗

PubMed1991

[Psychological and social aspects of juvenile chronic arthritis].

Juvenile rheumatoid arthritis (JRA) affects the physical, psychological and social development of children and adolescents. Illness characteristics such as visibility, pain and uncertainty may influence the development of independence and social adjustment. Children can suffer from growth deficiencies, school problems, social isolation, sometimes psychopathology. International research does not yield consensus on the incidence of psychopathology in chronically ill children. The psychosocial effects of the illness are partly determined by the ways the child and the family react to the illness and its physical consequences. The functioning of child and family ultimately depends upon the balance between burdens and strengths. Reciprocal influences between illness and daily living can be understood through modern psycho-neuroimmunologic theories. These concepts ask for a multidisciplinary team-approach for suitable, individualized care.

Activities of Daily Living↗

PubMed2004

Cultural concepts of tuberculosis and gender among the general population without tuberculosis in rural Maharashtra, India.

Gender-specific patterns of experience, meaning, and behaviour for tuberculosis (TB) require consideration to guide control programmes. To clarify concepts of gender, culture, and TB in a rural endemic population of Maharashtra, India, this study of 80 men and 80 women employed qualitative and quantitative methods of cultural epidemiology, using a locally adapted semi-structured Explanatory Model Interview Catalogue (EMIC) interviews are instruments for cultural epidemiological study of the distribution of illness-related experiences, meanings, and behaviours. This interview queried respondents without active disease about vignettes depicting a man and woman with typical features of TB. Emotional and social symptoms were frequently reported for both vignettes, but more often considered most distressing for the female vignette; specified problems included arranging marriages, social isolation, and inability to care for children and family. Job loss and reduced income were regarded most troubling for the male vignette. Men and women typically identified sexual experience as the cause of TB for opposite-sex vignettes. With wider access to information about TB, male respondents more frequently recommended allopathic doctors and specialty services. Discussion considers the practical significance of gender-specific cultural concepts of TB.

Adult↗

PubMed2005

Melatonin enhances NADPH-diaphorase activities in the hypothalamus of maternally-separated rats.

Maternal separation or social isolation is a risk factor in the development of mammalian species affecting both physical and mental growth, and food intake regulation. Melatonin has been known to regulate body weight on various species including rodents. We investigated the effect of melatonin treatment on the expression of nitric oxide synthase, which may involved in food intake regulation, in the brain of maternally separated-rats using nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) histochemistry. Melatonin (10 mg/kg i.p.) was injected to 14-day-old maternally-separated rats for 7 days. Maternally-separated rats with melatonin administration showed significantly higher staining intensities of NADPH-d-positive neurons in the paraventricular nucleus (PVN) and in lateral hypothalamic area (LHA) than maternally-separated without melatonin administration (P < 0.05). Body weight of melatonin treated rats significantly increased at the 6th and 7th day compared to that of rats without melatonin treatment (P < 0.05). These results indicate that melatonin may be associated with increase body weight via NOS in the hypothalamic areas in maternally-separated or socially isolated rats.

Animals↗

PubMedDate not supplied

Impact of external fixation on adolescents: an integrative research review.

PURPOSE: To define the state of nursing knowledge about the psychological impact of treating adolescents with external fixation devices (EFDs). METHOD: An integrated research review was conducted on literature available from CINAHL, MEDLINE, and PsycINFO. Keywords used were external fixation, fracture fixation, orthopaedic or orthopaedic, limb lengthening, Ilizarov, halo traction, Orthofix, EBI fixator, pelvic fixator, ring fixator, body image, self-concept, self-esteem, self-perception, adaptation, emotional, behavior, and outcome. Inclusion criteria for studies were (a) publication from 1990 to 2003, (b) focus on psychosocial and functional outcomes of treating adolescents with EFDs, and (c) publication in English. Studies were categorized by author, year, discipline(s), design, focus, sample, measurement, findings, and research recommendations. Findings and recommendations were compared across publications. RESULTS: All studies reported psychological and behavioral changes after EFD treatment. Pain and pin-site infections were the most problematic physical findings. Depression was universally evident to varying degrees, with some suicidal ideation and self-destructive behaviors, although mostly reported as transient. This predominantly retrospective cohort of studies reported social isolation as well as eating and sleep disturbances. Family and nursing support, a multiple disciplinary approach, and better preoperative preparation were crucial to adolescents psychological health after EFD treatment. CONCLUSION: Adolescents treated with EFDs require significant psychosocial support. The findings reveal major gaps in the knowledge on adolescents treated with external fixation for traumatic injury and none focused on EFD treatment in the acute period.

Adaptation, Psychological↗