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PubMed2001

Body image, psychosocial functioning, and personality: how different are adolescents and young adults applying for plastic surgery?

This study addressed three questions: (1) Do adolescents undergoing plastic surgery have a realistic view of their body? (2) How urgent is the psychosocial need of adolescents to undergo plastic surgery? (3) Which relations exist between bodily attitudes and psychosocial functioning and personality? From 1995 to 1997, 184 plastic surgical patients aged 12 to 22, and a comparison group of 684 adolescents and young adults from the general population aged 12 to 22 years, and their parents, were interviewed and completed questionnaires and standardised rating scales. Adolescents accepted for plastic surgery had realistic appearance attitudes and were psychologically healthy overall. Patients were equally satisfied with their overall appearance as the comparison group, but more dissatisfied with the specific body parts concerned for operation, especially when undergoing corrective operations. Patients had measurable appearance-related psychosocial problems. Patient boys reported less self-confidence on social areas than all other groups. There were very few patient-comparison group differences in correlations between bodily and psychosocial variables, indicating that bodily attitudes and satisfaction are not differentially related to psychosocial functioning and self-perception in patients than in peers. We concluded that adolescents accepted for plastic surgery have considerable appearance-related psychosocial problems, patients in the corrective group reporting more so than in the reconstructive group. Plastic surgeons may assume that these adolescents in general have a realistic attitude towards their appearance. are psychologically healthy, and are mainly dissatisfied about the body parts concerned for operation. corrective patients more so than reconstructive patients. Introverted patients may need more attention from plastic surgeons during the psychosocial assessment.

Adaptation, Psychological↗

PubMed2005

Psychosocial functioning of adolescents with idiopathic short stature or persistent short stature born small for gestational age during three years of combined growth hormone and gonadotropin-releasing hormone agonist treatment.

AIM: To examine psychosocial functioning of medically referred adolescents with idiopathic short stature (ISS) or persistent short stature born small for gestational age (SGA) during 3 years of combined growth hormone (GH) and gonadotropin-releasing hormone agonist (GnRHa) treatment. METHODS: Thirty-eight adolescents participated in a controlled trial with GH/GnRHa treatment or no intervention. Each year the adolescents and their parents completed questionnaires and structured interviews. Multilevel analysis was used to analyze data. RESULTS: The adolescents of the treatment group showed a worse outcome than the adolescents of the control group on 3 of 16 variables: perceived competence of scholastic (p < 0.01) and athletic ability (p < 0.05) and trait anxiety (p < 0.05). Adolescents in both the treatment and control groups perceived improved current height (p < 0.001) and self-appraisal of physical appearance (p < 0.05). The parents did not report changes in their children during treatment. CONCLUSION: The observation of some adverse psychological consequences as experienced by the adolescents indicates that it is useful to monitor psychosocial functioning during a combined GH/GnRHa treatment in adolescents with ISS or SGA. It is uncertain whether the hypothesized positive effects of the expected gain in final height by adulthood can sufficiently counterbalance possible short-term negative effects.

Adolescent↗

PubMed2003

Psychosocial functioning and stress-processing of children with asthma in the school context: differences and similarities with children without asthma.

OBJECTIVE: To characterize children with asthma by their stress processing at school and their psychosocial functioning. To establish similarities and differences between children with and without asthma. METHODS: Participants were 79 children with asthma and 359 children without asthma (ages 8-12). Children completed questionnaires on stress processing and their well-being at school. Parents filled in a questionnaire on behavior problems, and teachers provided data on school performance and absence rate. RESULTS: Children with asthma had higher scores on absence rates, teacher-rated well-being, internalizing behavior problems, occurrence of "rejection by peers," and use of aggression when coping with "problems with school work." However, using discriminant analyses, the groups could not reliably be distinguished from one another by these variables. CONCLUSIONS: Children with asthma are similar to other children with regard to their stress processing at school and their psychosocial functioning. The value of conducting multivariate analysis over several univariate tests is underscored.

Adaptation, Psychological↗

PubMedDate not supplied

Change in psychosocial functioning and quality of life of patients with body dysmorphic disorder treated with fluoxetine: a placebo-controlled study.

In a 12-week placebo-controlled study of fluoxetine in the treatment of body dysmorphic disorder, the authors investigated change in psychosocial functioning and mental health-related quality of life in 60 subjects. The subjects were assessed with the LIFE-RIFT (a measure of impaired functioning), Social and Occupational Functioning Scale (SOFAS), and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) before and after receiving fluoxetine or placebo. At baseline, the patients had impaired psychosocial functioning and markedly poor mental health-related quality of life. Compared to placebo, fluoxetine was associated with significantly greater improvement in LIFE-RIFT and SOFAS scores and with improvement on the mental health subscale of the SF-36 that approached significance. Decrease in the severity of body dysmorphic disorder, as measured by the Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder, was significantly correlated with improvement in functioning and quality of life.

Adult↗

PubMed2006

Effects of a physical exercise intervention on subjective physical well-being, psychosocial functioning and general well-being among office workers: a cluster randomized-controlled cross-over design.

The purpose of the study was to examine the effects of a workplace physical exercise intervention on subjective physical well-being, psychosocial functioning and general well-being. The study was a cluster randomized-controlled trial with the department (n=4) as the unit of randomization. The subjects (n=90) were office workers [mean age 45.7 (SD 8.5) years]. Psychosocial functioning and well-being variables were measured by descriptive visual rating scales. The cross-over design consisted of one 15-week intervention period of light resistance training and guidance and another 15-week period of no training and no guidance. The statistical analysis was based on linear mixed models. The active component of the intervention, light resistance training, resulted in a slight, but statistically significant, increase in subjective physical well-being (P=0.015). At the average training time of 5 min/working day (25 min/week) the average increase during the 15-week period was 4 units (95% confidence interval (CI) 1-7) and 5% (95% CI 1-9). The physical exercise intervention had no effect on somatic symptoms, anxiety, self-confidence, mood, mental stress at work, working atmosphere, life satisfaction or meaning of life. Daily light resistance training, conducted during the working day, had a positive direction on subjective physical well-being among office workers.

Cross-Over Studies↗

PubMed2006

Child and caregiver psychosocial functioning in pediatric immunodeficiency disorders.

BACKGROUND: Children with chronic illness have been found to be at an increased risk of behavioral and emotional difficulties. To date, children with pediatric immunodeficiency disorders (PIDDs) and their families have not been the focus of extensive published psychosocial research. OBJECTIVE: To determine if children with PIDDs and their caregivers have altered psychosocial function and whether the severity of the PIDD was associated with such difficulties. METHODS: Twenty children with PIDDs and 20 children with asthma were recruited for this study. Children and their caregivers completed various psychosocial questionnaire forms. Responses were compared with normative data for the appropriate measure and with other variables. RESULTS: Higher frequencies of children with PIDDs were found to have a number of elevated psychosocial concerns when contrasted with normative data, particularly from parent report. These concerns included depression, anxiety, somatization, social withdrawal, and social skills. The severity of the PIDDs was significantly associated with a number of behavioral adjustment issues, including receiving psychiatric diagnoses and special education services. Although children with PIDDs had significantly more psychiatric diagnoses than did asthmatic children, these groups did not differ significantly on questionnaire scores regarding child or caregiver psychosocial adjustment. CONCLUSIONS: Children with PIDDs have significant behavioral problems. Children receiving intravenous immunoglobulin or immunomodulatory treatments were reported to have more problems than children not receiving them. This study highlights the need for further research in psychosocial functioning of children with PIDDs in an effort to develop interventions to promote their overall adjustment.

Adolescent↗

PubMed2001

A pessimistic attitude towards the future and low psychosocial functioning predict psychiatric diagnosis among treatment-seeking adolescents.

OBJECTIVE: The objective was to study factors associated with psychiatric diagnosis among adolescents (n = 164) seeking psychiatric care for mental symptoms. METHOD: Psychiatric diagnosis was confirmed by a structured diagnostic interview. Psychosocial functioning was assessed with the Global Assessment of Functioning Scale, and the Beck Depression Inventory and Offer Self-Image Questionnaire were also used. Background data were gathered. RESULTS: A majority (76%) of the adolescents met DSM-III-R criteria for psychiatric diagnosis. The self-image was more negative and the Beck score was higher among these adolescents than the others. All who had attempted suicide had a psychiatric disorder. Those diagnosed as having a psychiatric disorder consumed alcohol in order to get drunk more often than others. Continual conflicts with parents and smoking were not associated with the existence of a psychiatric disorder. In logistic regression analysis, low psychosocial functioning (OR = 3.9) and an uncertain or pessimistic attitude towards the future (OR = 9.1) proved to be independent risk factors for psychiatric disorders. CONCLUSIONS: Health service staff should be aware of factors associated with psychiatric disorders in adolescents so that they can identify those at high risk.

Adolescent↗

PubMed2001

Psychosocial functioning and psychiatric comorbidity among substance-abusing Icelandic adolescents.

Our objectives were to compare behaviour problem scores (BPS) for Icelandic adolescents admitted for detoxification treatment for alcohol and narcotic abuse as compared with the general population, in accordance with the Youth Self Report (YSR), and to describe psychosocial functioning and psychiatric comorbidity for the treated adolescents. The case series consisted of 103 adolescents, ages 12-18 years, who completed the YSR at the end of a 10-day stay at the National Hospital of Addiction Medicine. The total BPS tallied from the YSR items was compared with scores for the general population. The psychiatric comorbidity and psychosocial functioning of the case series were assessed through diagnostic interviews in accordance with DSM-IV and ICD-10 criteria. The BPS for the 36 treated girls was significantly higher than for the general population (104 versus 36) and higher than for the 56 treated boys (82 versus 56) with 2 standard deviations above the norm for the population. Three-quarters of the adolescents had psychiatric comorbidity: conduct disorder (44%), depression (28%), or posttraumatic stress disorder (11%). The findings support the discriminative validity of the YSR as part of a structured global assessment of substance-abusing adolescents, in particular to identify the frequently present psychiatric comorbidities.

Adolescent↗

PubMed2003

Psychosocial functioning following surgical treatment for intractable epilepsy in childhood.

METHODS: Psychosocial functioning was examined in 13 children who had undergone surgical treatment for intractable epilepsy. The ratings of each child's social, emotional and behavioural problems were obtained via parent and teacher reports made an average of 2 years post-operatively. RESULTS: Parents viewed their children as having greater social difficulties than reported in standardisation samples. Although the overall level of difficulty fell below clinically significant cut-offs, the proportion of children who were rated as having clinically significant levels of difficulties approached significance. Teachers rated these children as displaying more symptoms of anxiety and depression, although the levels remained subclinical. DISCUSSION: These results are discussed in view of the complex interaction between neurological and environmental variables involved in social-emotional functioning following surgical treatment for epilepsy.

Adolescent↗

PubMed2006

Young adults with learning disabilities: a study of psychosocial functioning at transition to adult services.

A study of the psychosocial functioning of young adults with a history of learning disability (LD) in childhood is reported. The design was a non-clinic community follow-up investigation of a cohort of children who had received special education, the sample frame for which was a birth-period cohort survey. Participants were 149 young adults (89 males and 60 females derived from a survey of the 33,800 children born in the Cambridge Health District between 1967 and 1973) at the stage of transition to adult services (age 18-22y), whose measured IQ scores in childhood were <80, and who had received special education during school years. Most of the young adults were living at home (n=108) and many were in full-time employment (independent employment n=41, sheltered employment n=20), this survey having been carried out in an area of high employment. A strong correlation was found between the child IQ score and subsequent adult Vineland Scale Score. Greater efforts should be made to detect and assess LD and its attendant problems in children in order to plan future care and transition to adulthood, especially for those with more severe disabilities.

Adolescent↗

PubMed2001

Psychosocial functioning during the year following severe traumatic brain injury.

The psychosocial functioning of a group of 65 adults with severe traumatic brain injury was assessed at 6 months and 1 year post-injury. Aspects of emotional, behavioural, and social functioning were investigated. The prevalence of depression remained constant (24%) over time, although there was some individual variation in the reporting of symptoms. Impatience was the most frequently reported behavioural problem at both assessments. Whilst there was a slight increase in the number of behavioural problems and level of distress reported over time, the most obvious change was in the type of behavioural problems that caused distress. At 1 year post-injury, problems with emotional control were found to be most distressing for the patients. A comparison with pre-morbid social functioning showed the loss of employment to be 70%, 30% returned to live with their parents, and relationship breakdown occurred for 38%. There was also a significant and ongoing decrease in all five aspects of social and leisure activities.

Activities of Daily Living↗

PubMed2001

Controlled, prospective trial of psychosocial function before and after continuous positive airway pressure therapy.

The aim of the study was to investigate psychosocial function before and after continuous positive airway pressure (CPAP) therapy, and establish the determinants and consequences of objective CPAP use. In a prospective, parallel-group study, changes in psychosocial scores were compared with conservative management or CPAP therapy for the sleep apnoea/hypopnoea syndrome (SAHS). Patient/partner couples from the top (CPAP treated, n=44) or bottom (conservatively treated, n=25) of a CPAP waiting list rated marital satisfaction (evaluation and nurturing relationship issues, communication and happiness (ENRICH), behavioural questionnaire), health/functional status (Short-Form-36 Health Survey, functional outcomes of sleep questionnaire) and sleepiness (Epworth sleepiness scale). Both groups' ratings at baseline were completed while on conservative therapy. Baseline variables did not differ between groups. At follow-up, all seven summary psychosocial scores were statistically better in CPAP-treated patients, effect sizes (ES) ranging from moderate (0.5 SD: marital satisfaction) to very large (>1.0 SD: patients health, functional status and sleepiness scores). Scores in conservatively-treated patients deteriorated to a small or moderate degree (ES -0.2- -0.7 SD), while those in the CPAP-treated group improved to a larger degree (0.3-1.3 SD). Baseline polysomnographical and psychosocial scores, including marital satisfaction, did not predict objective CPAP use (r<0.3). CPAP use was modestly correlated (r=0.3-0.6) with improvement in all psychosocial areas. Continuous positive airway pressure produced statistically and clinically significant psychosocial improvements, some of large magnitude, in psychosocial function. Determinants of usage were not identified, but benefits and usage were positively correlated.

Health Status↗

PubMed2004

Relationships among psychosocial functioning, diagnostic comorbidity, and the recurrence of generalized anxiety disorder, panic disorder, and major depression.

The present study examined the relationships among impaired psychosocial functioning, comorbidity, and the cumulative probability of future recurrence of anxiety disorders and major depression in recovered patients. Participants were part of the Harvard/Brown Anxiety Disorders Research Program (HARP), a naturalistic, prospective, longitudinal study of anxiety disorders in psychiatric outpatients. Using proportional hazards regressions, worsening psychosocial impairment in general and in specific areas was significantly associated with an increased risk of panic disorder, generalized anxiety disorder, and major depression recurring, even after controlling for diagnostic comorbidity. These results are consistent with and extend similar findings for patients with major depression [Leon, A., Solomon, D. A., Mueller, T. I., Endicott, J., Posternak, M., Judd, L. L., et al. (1999). The range of Impaired Functioning Tool (LIFE-RIFT): a brief measure of functional impairment. Psychological Medicine, 29, 869-878; Leon, A., Solomon, D. A., Mueller, T. I., Endicott, J., Posternak, M., Judd, L. L., et al. (2000). A brief assessment of psychosocial functioning of subjects with bipolar I disorder: The LIFE-RIFT. The Journal of Nervous and Mental Disease, 188, 805-812], and suggest that increased psychosocial impairment may be a risk factor for relapse.

Adult↗

PubMed2000

Prevalence, quality of life and psychosocial function in obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in northern Germany.

BACKGROUND: Despite the worldwide relevance of obsessive-compulsive disorder (OCD) there are considerable differences in prevalence rates and gender ratios between the studies and a substantial lack of prevalence data on subclinical OCD. Moreover, data on quality of life and on psychosocial function of subjects with OCD and subclinical OCD in the general population are missing to date. METHODS: German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18-64 years living in a northern German region. Specific DSM-IV based criteria for subclinical OCD were used. RESULTS: The life-time prevalence rates for OCD and subclinical OCD were 0.5% and 2%, respectively. Twelve month prevalence rates were 0.39% and 1.6%, respectively. The gender female:male ratio was 5.7 in OCD and 1.2 in subclinical OCD. In various measures of psychosocial function and quality of life, OCD and subclinical OCD were significantly impaired. However, subclinical OCD subjects did not visit mental health professionals more often than controls. CONCLUSION: Due to different epidemiological characteristics subclinical OCD might represent a syndrome distinct from OCD which is also associated with significant impairments in personal and interpersonal functions and in quality of life.

Adolescent↗

PubMed1998

Relationship between hunger and psychosocial functioning in low-income American children.

OBJECTIVE: Using large-scale surveys from nine states, the Community Childhood Hunger Identification Project (CCHIP) estimates that 8% of American children under the age of 12 years experience hunger each year. CCHIP operationalizes child hunger as multiple experiences of parent-reported food insufficiency due to constrained resources. The current study examined the relationship between food insufficiency and school-age, low-income children's psychosocial functioning. The study also assessed the interinformant (parent versus child) reliability and time-to-time reliability of the CCHIP measure. METHOD: Two hundred four school-age children and their parents from four inner-city public schools were interviewed using parent, teacher, and clinician report measures of psychosocial functioning. Ninety-six children and their parents were reinterviewed 4 months later. RESULTS: Hungry and at-risk for hunger children were twice as likely as not-hungry children to be classified as having impaired functioning by parent and child report. Teachers reported higher levels of hyperactivity, absenteeism, and tardiness among hungry/at-risk children than not-hungry children. Parent and child reports of hunger were significantly related to each other, and time-to-time reliability of the CCHIP measure was acceptable. CONCLUSIONS: Results of this study suggest that intermittent experiences of food insufficiency and hunger as measured by CCHIP are associated with poor behavioral and academic functioning in low-income children. The current study also supports the validity and reliability of the CCHIP measure for assessing hunger in children.

Adolescent↗

PubMed1992

[Incidence of psychiatric syndromes and the psychosocial functional level of patients with HIV-1 infection].

There are not yet unselected studies on psychopathological syndromes in the course of HIV-infection in German-speaking countries. In a group of 55 patients in different stages of the infection two psychiatric explorations were done within an interval of about one year. The findings were analysed by the Brief Psychiatric Rating Scale (BPRS). The degree of psychosocial functioning was estimated using the GAF-scale (axis 5 of DSM-III-R). The diagnosis of dementia was based on DSM-III-R-criteria. Most of the patients (72%) showed normal or only slightly remarkable psychopathologic findings at both times. A significant increase in psychopathologic conspicuousness in the course of the disease was only found for the subscore BPRS 2 ("anergia"). Dementia was seen in five patients (9%) and only in the stage of manifest immune deficiency syndrome (WR 6). All-together there was only a slight decrease of psychosocial functioning detectable (median on the GAF-scale 75), which only in dementia showed a significant reduction.

AIDS Dementia Complex↗

PubMed1997

Intrainstitutional relocation. Effects on residents' behavior and psychosocial functioning.

INTRODUCTION: Relocation effects in the elderly have been a topic of gerontologic research for many years. Prior research, however, has focused on individuals who could make a cognitive appraisal of the relocation process. With a greater prevalence of cognitive impairments and/or psychiatric illnesses in long-term care residents, research is needed to clarify the impact of relocation on these individuals. OBJECTIVE: The purpose of this study was to determine how intrainstitutional relocation affects behavior and psychosocial functioning in residents with and without cognitive, mood, and/or psychotic disorders. METHOD: This prospective study followed 78 residents being relocated intrainstitutionally in a health-related facility that was undergoing major renovations. Medical and nursing information was collected at 1 month pre-move and at 1 and 3 months post-move. Five areas of behavioral and psychosocial functioning (self-care, disoriented behavior, depressed/anxious mood, irritable behavior, and withdrawn behavior) were assessed using the Multidimensional Observation Scale for Elderly Subjects (MOSES). RESULTS: A significant increase was seen in the number of medical visits (p = .04) from time of relocation to 1 month post-move. The groups diagnosed with mood disorder and psychotic disorder had a statistically significant weight loss (p = .04) between 1 month pre-move and 1 month post-move. The study revealed an increase in the number of residents who fell immediately after relocation, but the increase did not reach statistical significance (p = 12). Residents who fell after relocation had resided at the facility for a longer time than the remainder of the sample (p = .08). Residents with a diagnosis of cognitive impairment showed a statistically significant difference in self-care (p = 0.01) and withdrawn behavior (p = 0.01) at 3 months post-move. Extensive relocation preparation and support may have been the main contribution to diminishing the stress of relocation over time and across diagnostic categories.

Adaptation, Psychological↗

PubMed2006

Associations of symptoms, psychosocial function and hope with qualities of self-experience in schizophrenia: comparisons of objective and subjective indicators of health.

While changes in self-experience have been suggested to be an important element of recovery from severe mental illness, little is known about how qualities of self-experience are linked with other indicators of health including objective measures such as symptoms profiles and subjective measures such as hope. To examine these issues the narratives of self and illness of 65 persons with schizophrenia spectrum disorder were obtained prior to entry into rehabilitation and rated using the Scale to Assess Narrative Development (STAND). STAND scores were then compared with concurrent assessments of hope assessed with the Beck Hopelessness Scale (BHS), psychosocial function using the Quality of Life Scale (QOLS) and symptom profile defined categorically using the Positive and Negative Syndrome Scale (PANSS). Results suggest that higher ratings of the STAND were associated with greater expectations of perseverance on the BHS and higher levels of psychosocial function on the QOL. Lower symptom profiles were similarly linked with higher STAND scores. Results suggest qualities of self-experience expressed within personal narratives are linked to symptom profiles and subjective assessments of health. Theoretical and clinical implications are discussed.

Adult↗