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Results for “Psychosocial functioning”

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PubMedDate not supplied

Profile of a large sample of patients with social phobia: comparison between generalized and specific social phobia.

This study examines a large cohort of subjects with social phobia, as part of a larger naturalistic and longitudinal study of 711 subjects with anxiety disorders. We focused on 176 subjects who were in an episode of social phobia at intake. We were particularly interested in evaluating the diagnostic distinction between generalized and specific social phobia. We compared these two groups along demographic characteristics, comorbidities, psychosocial functioning (health, role functioning, social functioning, and emotional functioning) and global assessment scores. We found that generalized social phobics tended to have an earlier age of onset as compared to the specific group; however, this is not a statistically significant difference at this level of analysis. The two groups did not differ for the current comorbidities examined. We observed no differences in the treatment received by the two types of social phobia subjects, and the two groups functioned equally well in terms of health and fulfilling social roles. In addition, we examined adverse childhood events (i.e., death of a parent, childhood abuse) and found no evidence for any differential impact these events might have on the type of social phobia. Although we did observe significantly greater fear of public speaking among the specific compared to the generalized group, which may indicate a qualitative difference between the subtypes, our results suggest that for most parameters, generalized and specific social phobia represent a continuum of similar and overlapping entities.

Adult↗

PubMed1997

Panic disorder versus panic disorder with major depression; defining and understanding differences in psychiatric morbidity.

The present study examined the impact of comorbid major depressive disorder (MDD) on psychiatric morbidity, panic symptomatology and frequency of other comorbid psychiatric conditions in subjects with panic disorder (PD). Four hundred thirty-seven patients with PD were evaluated at intake as part of a multicenter longitudinal study of anxiety disorders; 113 of these patients were also in an episode of MDD. Patients were diagnosed by DSM-III-R criteria utilizing structured clinical interviews. The 113 PD/MDD patients were compared with the 324 remaining PD subjects regarding panic symptoms at intake, sociodemographic, quality of life and psychiatric morbidity variables. Differences in frequency of other comorbid Axis I psychiatric disorders were assessed at intake; personality disorders were evaluated twelve months after intake. The results revealed the PD/MDD patients exhibit increased morbidity and decreased psychosocial functioning as compared to PD patients. Personality disorders were more prevalent in the PD/MDD group at six month follow-up assessment; the PD/MDD group also had an increased frequency of posttraumatic stress disorder (PTSD) and more comorbid Axis I anxiety disorders as compared to the PD group. The total number and frequency of panic symptoms was highly consistent between the two patient groups.

Adolescent↗

PubMed1996

Six month follow-up of early-onset chronic depression.

BACKGROUND: This study sought to characterize the morbidity and treatment behavior of 49 patients with early-onset chronic depression, 6 months after terminating treatment at a university-based psychopharmacology research clinic. METHOD: Patients with and without early-onset chronic depression were selected to participate in a naturalistic follow-up study. Assessments were conducted blind to patients' histories. Patients' depressive symptoms, psychosocial functioning, and post-discharge treatment histories were assessed. RESULTS: After termination, the mean length of recovery for the sample was 3.6 months. When they left the clinic, 78% (38/49) were euthymic. At follow-up, 37% (14/38) of these had relapsed; while 45% (17/38) remained in remission for 6 months. During the follow-up period, 47% of the patients were on antidepressants. Sixty-three percent of the patients who relapsed, or were depressed when they left the clinic, did not enter treatment, 50% of whom cited insufficient resources as the primary reason for not receiving care. CONCLUSIONS: After leaving a depression research clinic, a substantial portion of patients with early-onset chronic depression remained recovered during a 6-month period, but financial impediments prevented a majority of those who did poorly from entering treatment.

1-Naphthylamine↗

PubMed1987

Psychological response to mastectomy. A prospective comparison study. Psychological aspects of Breast Cancer Study Group.

This study reports data from 412 women prospectively studied over a 1-year period from five collaborating centers: one group had modified radical mastectomy for Stages I and II breast cancer, 145; cholecystectomy for gallbladder disease, 90; biopsy for benign breast disease, 87; and healthy women, 90. All were between the ages of 30 and 70 years, without pre-existing psychiatric illness and absence of current physical illness. All women were seen initially within 3 months of surgery. Data were analyzed from structured interviews, speech samples, and questionnaire responses which measured presence and degree of psychopathological symptoms, mood, physical complaints, self-esteem, and quality of interpersonal relationships. Principal components analysis was used to generate seven identifiable factors which were analyzed by MANOVA (multiple analysis of variance). Women with breast cancer showed greater psychological distress related to social and interpersonal relationships. More distress was seen in women with Stage II disease, and they also had more negative attitudes toward self and the future, concern with physical symptoms, anxiety, strain, and interpersonal difficulties. They did not, however, show any greater signs of psychopathological symptoms severe enough to warrant psychiatric intervention than the other groups over the year following surgery. The findings suggest that healthy women without prior psychiatric disorder or concurrent physical illness experienced some post-surgical distress, primarily in psychosocial functioning which was more than that in women after cholecystectomy or biopsy, but severe psychopathological symptoms over the year following surgery were conspicuously absent. These data do not support the belief that severe psychiatric sequelae follow a mastectomy in psychologically healthy women.

Adult↗

PubMed1988

Emotions and cancer. New perspectives on an old question.

This article outlines current issues in the study of psychological factors and cancer: (1) the role of psychological factors in disease promotion and progression, (2) the impact of neoplastic disease and its treatment on psychosocial functioning, and (3) the long-term impact of cancer and cancer treatment on the survivor and issues of family bereavement following the death of a cancer patient. The discussion ends with a consideration of future directions for research.

Emotions↗

PubMed1976

Relationship between psychopathology, experienced control and perceived locus of control: in search of alcoholic subtypes.

Alcoholic Ss were categorized into four subtypes based upon differential levels of perceived locus of control and experienced control. The relationship between generalized psychopathology, as measured by the MMPI, and subtype classification was investigated. Alcoholics with an internal locus of control and high levels of experienced control exhibited the least psychopathology. The greatest degree of psychopathology was found among Ss with an external locus of control and minimal levels of experienced control. The implications of these results with respect to psychosocial functioning and drinking behavior among alcoholic subgroups were discussed.

Adult↗

PubMed1987

Five psychosocial variables related to the existence of post-traumatic stress disorder symptoms.

Sixty Vietnam veterans from a midwestern VA Medical Center were surveyed to determine the relationship between symptoms of Post-Traumatic Stress Disorder (PTSD) and five psychosocial variables: Intensity of combat experienced in Vietnam, current subjective impact of the previously experienced stress of Vietnam experiences, current level of life stress, extent and nature of social support available to the veteran during the first year of return from Vietnam, and pre-service psychosocial functioning. A stepwise discriminant function analysis revealed that combat intensity, current impact of the previously experienced events in Vietnam, and current level of life stress correctly classified 75% of the total cases. These findings were supported by other lines of analyses, including tests of correlation and stepwise regression analysis. Current levels of life stress, especially disruption in interpersonal relationships, also were associated significantly with PTSD symptoms. These findings are consistent with previous reports on the etiology and correlates of PTSD symptoms and suggest the existence of a quantifiable constellation of symptoms associated with psychological sequelae of severely stressful trauma.

Adult↗

PubMedDate not supplied

A supportive-expressive group intervention for women with a family history of breast cancer: results of a phase II study.

BACKGROUND: Evidence suggests that there are significant psychological and behavioural sequelae associated with having a family history of breast cancer (BC) which can interfere with comprehension of risk estimates. PURPOSE: The purpose of this study was to develop, standardize and do preliminary testing of a group intervention designed to address the emotional impact of having a family history of BC. METHODS: This study is a single-arm pilot design with pre- and post-measures of perceived risk, psychosocial distress, knowledge and screening practices. RESULTS: The primary study outcome measure of risk comprehension was significantly improved by 70%, according to our predetermined criteria for success. In addition, the most important secondary measures of psychosocial functioning, such as cancer-related distress (p=0.025), depression (p=0.05), anxiety (p=0.005) and unresolved grief (p=0.034) were significantly improved. CONCLUSION: The results of this initial pilot study are encouraging; however, further research is required, using a randomized controlled study design to evaluate the relative contribution of this intervention to the successful modification of risk comprehension, enhanced psychological functioning, and to promote optimal screening adherence.

Adaptation, Psychological↗

PubMed2003

Studies of offspring of parents with bipolar disorder.

Children and adolescents who are the biological offspring of individuals with bipolar disorder (BD) (bipolar offspring) represent a population rich in potential for revealing important aspects in the development of BD. Multiple cross-sectional assessments of psychopathology in bipolar offspring have confirmed high incidences of BD, as well as mood and behavioral disorders, and other psychopathology in this population. Longitudinal studies of offspring have begun to shed light on precursors of BD development. Other assessments of bipolar offspring have included dimensional reports of psychiatric and psychosocial functioning, temperament assessments, and descriptions of family environments and parenting styles. Neurobiological studies in bipolar offspring are just beginning to yield findings that may be related to the underlying neuropathophysiology of BD. The future holds promise for longitudinal studies of bipolar offspring incorporating all of these facets, including genetic analyses, to further elucidate the factors involved in the evolution of BD.

Adolescent↗

PubMed1989

Summer camps for juveniles with rheumatic disease: do they make a difference?

Summer camps for juveniles with rheumatic disease are being offered increasingly as components of comprehensive treatment approaches, but the therapeutic value of these sessions is largely undetermined. This study attempted to judge the impact of a summer camping experience on two aspects of participants' psychosocial functioning, self-concept, and locus of control. Both of these constructs have been related to effective disease management. On both measures, the mean scores of 36 campers improved significantly following a week-long camp session, and these positive effects were maintained over a 6-month follow-up period. Campers who had attended previous camping sessions appeared to obtain maximal benefit, and male campers with rheumatic disease were identified as needing special attention. The study's limitations are discussed, and future research directions are outlined.

Adolescent↗

PubMed2001

Open trial of nefazodone among Hispanics with major depression: efficacy, tolerability, and adherence issues.

The efficacy and tolerability of nefazodone in the treatment of major depression among Spanish-monolingual Hispanics was examined and compared to historical controls among English-speaking, predominantly non-Hispanic subjects. Fifty monolingual Hispanic outpatients with major depression and a HAM-D17 score > or = 18 were treated with nefazodone in a flexible-dose 8-week open-label protocol. Sixty-three percent of the intent-to-treat (ITT) sample with > or = 1 efficacy visit were considered responders according to CGI-I criteria, falling within the range of response rates (58-69%) reported in six prior nefazodone trials with non-Hispanic subjects. Significant improvement was found for the ITT and completer samples in HAM-D17, HAM-D28, and SCL-90 scores and in two measures of psychosocial functioning. Endpoint mean dose in the ITT sample was 379 mg/day (SD = 170), also within the range of previous trials (321-472 mg/day). Adverse effects were not elevated, with only dry mouth (8%) reported by > 6% of subjects. However, 42% of the sample dropped out of treatment before study termination, usually because of side effects or due to family or work difficulties, a higher rate than previously reported for nefazodone (21-33%). This open trial finds nefazodone to be an efficacious treatment for major depression among monolingual Hispanics, with comparable efficacy to previous controlled trials among non-Hispanic subjects. Double-blind studies are required to confirm this comparable efficacy. Mean endpoint doses and adverse effect rates similar to previous trials do not support the need for reduced doses of nefazodone among Hispanics. However, an elevated rate of treatment discontinuation threatens treatment efficacy among this population. Causes for this elevated rate require explanation, given the apparently unremarkable pattern of adverse effect reports.

Adult↗

PubMed2002

Long-term impact of treatment in women diagnosed with bulimia nervosa.

OBJECTIVE: Both cognitive-behavioral therapy (CBT) and antidepressant medication have demonstrated efficacy in the treatment of bulimia nervosa. However, data concerning the long-term impact of such treatments have been limited. This study sought to determine if treatment with CBT and antidepressant medication was associated with better long-term outcome among women diagnosed with bulimia nervosa. METHOD: Women (N = 101) who completed a controlled treatment study of bulimia nervosa participated in follow-up assessments approximately 10 years later. RESULTS: Women who received treatment with CBT or antidepressant medication or both reported improved social adjustment at long-term follow-up compared with women randomized to the placebo condition. DISCUSSION: Treatments with demonstrated efficacy for short-term outcome appear to improve psychosocial function at long-term follow-up among women initially diagnosed with bulimia nervosa.

Adult↗

PubMed2002

The impact of body image experiences: development of the body image quality of life inventory.

OBJECTIVE: Substantial research confirms that body image affects multiple aspects of psychosocial functioning, yet there is no direct assessment to quantify its impact on an individual's quality of life. METHOD: In the present study, the Body Image Quality of Life Inventory was developed and empirically evaluated with 116 college women. RESULTS AND DISCUSSION: This 19-item assessment was internally consistent and stable over a 2- to 3 week period. It converged significantly with multiple measures of body image evaluation and investment and with body mass. The results further revealed that women in the sample reported more positive than negative consequences of their body image for various domains of life. The implications of these findings and directions for continued validation of this unique measure are considered.

Adult↗

PubMed2004

The assessment of body image investment: an extensive revision of the appearance schemas inventory.

OBJECTIVE: The Appearance Schemas Inventory (ASI) is a 14-item instrument that assesses body image investment in relation to certain beliefs or assumptions about the importance, meaning, and influence of appearance in one's life. Despite empirical support of the ASI, critical examination evinces several limitations of this assessment. These problems entail the inclusion of explicitly self-evaluative items and social stereotypes, few behavioral items, and a repeated failure to find expected gender differences on the ASI. METHOD: We initially constructed a 45-item measure (40 new items plus 5 original items) and administered it, along with the original ASI and other validational assessments, to 603 college students (468 women and 135 men). RESULTS: The end result was a 20-item revision of the inventory (ASI-R), which included two factors: Self-Evaluative Salience and Motivational Salience. For both genders, the composite ASI-R and its two factors had high internal consistency and were significantly convergent with other pertinent measures of body image and psychosocial functioning. The ASI-R and its two subscales showed significant gender differences, whereas the original ASI did not. We also examined racial differences on the ASI-R, its correlations with body mass, and its unique contribution to the prediction of disturbed eating attitudes. DISCUSSION: We offer this measure as an improved, psychometrically sound replacement for the ASI.

Adolescent↗

PubMed2004

Dissonance thin-ideal and didactic healthy behavior eating disorder prevention programs: results from a controlled trial.

OBJECTIVE: Negative body image, a common problem among college-age women in the United States, strongly correlates with low self-esteem, disturbed eating behavior, and eating disorders. Psychoeducational programs have inconsistently shown improvement in body image, thin-ideal internalization, eating behaviors, psychosocial functioning, and self-esteem. METHOD: In the current study, college women with body image concerns (N = 84) were randomly assigned to a cognitive dissonance-based, thin-ideal internalization, single-session workshop (DTI; n = 26); a psychoeducational, healthy behavior, single-session workshop (HB; n = 24); or a wait-list control (WL; n = 34). RESULTS: Comparing baseline data with 4-week follow-up data, results indicated that both DTI and HB participants reported improvement in body image, thin-ideal internalization, and eating behaviors. DISCUSSION: Results provide evidence that both interventions effectively reduce risk factors for eating pathology.

Adolescent↗

PubMed2005

How do eating disorders and alcohol use disorder influence each other?

OBJECTIVE: Although eating disorders and alcohol use disorder (AUD) are known to co-occur, the influence of one on the other has not been studied. METHOD: In a prospective study, women diagnosed with either anorexia nervosa (AN; n = 136) or bulimia nervosa (BN; n = 110) were interviewed and assessed for Research Diagnostic Criteria (RDC) AUD every 6-12 months over 8.6 years. RESULTS: Over one fourth of the sample (n = 66 [27%]) reported a lifetime history of AUD. Ten percent of the study subjects (n = 24) developed AUD over the course of the study. AUD did not influence recovery from either eating disorder. Poor psychosocial functioning and history of substance use predicted prospective onset of an episode of AUD for both diagnostic groups. Unique predictors for AUD for women with AN were depression, overconcern with body image, and vomiting. Recovery from AUD was predicted by group therapy and hospitalization (women with AN) and individual therapy and exercise (women with BN). CONCLUSION: The influence of eating disorders on AUD appears to be greater than the reverse. A substantial number of patients who initially present with an eating disorder develop alcohol problems over the course of time, suggesting that the risk is an ongoing one that should be monitored by clinicians.

Adult↗

PubMed2006

An update on the definition of "excessive exercise" in eating disorders research.

OBJECTIVE: The current study informed the definition of "excessive exercise" by examining relations between exercise behavior, eating-disordered behavior, and quality of life (QOL) in a community sample of women. METHOD: Self-report measures of frequency of exercise, obligatory exercise and motivation for exercise, and of eating disorder psychopathology and QOL, were completed by 3,472 women aged 18-42 years who engaged in regular exercise. RESULTS: The extent to which exercise is intended to influence weight or shape and the degree to which guilt is experienced when exercise is postponed were the exercise variables most strongly associated with elevated levels of eating disorder psychopathology and reduced QOL. Subgroups of participants who reported exercising solely for weight and shape reasons (n = 322 [9.3%]), intense guilt after postponement of exercise (n = 136 [3.9%]), or both (n = 116 [3.3%]), had markedly elevated levels of eating disorder psychopathology. There was no association between excessive exercise and reduced QOL after the effects of eating disorder psychopathology were statistically controlled. CONCLUSION: The findings suggest that exercise is excessive when its postponement is accompanied by intense guilt or when it is undertaken solely to influence weight or shape. Operational definitions of excessive exercise might usefully include reference to these terms. The findings may also be of benefit in informing the content of prevention programs, which address dysfunctional exercise behavior. Excessive exercise is unlikely to be associated with impairment in psychosocial functioning in the absence of eating disorder psychopathology. It may, however, be a useful indicator of such psychopathology.

Activities of Daily Living↗

PubMed2006

Comorbidity of body dysmorphic disorder and eating disorders: severity of psychopathology and body image disturbance.

OBJECTIVE: The current study examined comorbidity and clinical correlates of eating disorders in a large sample of individuals with body dysmorphic disorder (BDD). METHOD: Two hundred individuals with DSM-IV (4th ed. of the Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 1994) BDD completed reliable interviewer-administered and self-report measures, including diagnostic assessments and measures of body image, symptom severity, delusionality, psychosocial functioning, quality of life (QOL), and history of psychiatric treatment. RESULTS: A total of 32.5% of BDD subjects had a comorbid lifetime eating disorder: 9.0% had anorexia nervosa, 6.5% had bulimia nervosa, and 17.5% had an eating disorder not otherwise specified. Comparisons of subjects with a comorbid lifetime eating disorder (n = 65) and subjects without an eating disorder (n = 135) indicated that the comorbid group was more likely to be female, less likely to be African American, had more comorbidity, and had significantly greater body image disturbance and dissatisfaction. There were no significant group differences in BDD symptom severity, degree of delusionality, or suicidal ideation or attempts. Functioning and QOL were notably poor in both groups, with no significant between-group differences. However, a higher proportion of the comorbid eating disorder group had been hospitalized for psychiatric problems. This group had also received a greater number of psychotherapy sessions and psychotropic medications. CONCLUSION: Eating disorders appear relatively common in individuals with BDD. BDD subjects with a comorbid eating disorder differed on several demographic variables, had greater comorbidity and body image disturbance, and had received more mental health treatment than subjects without a comorbid eating disorder. These findings have important implications for the assessment and treatment of these comorbid body image disorders.

Adolescent↗