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Results for “Psychosocial functioning”

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PubMed2005

A behavioral group treatment program for menopausal hot flashes: results of a pilot study.

In the present study, we tested the effectiveness of a cognitive-behavioral group treatment (CBGT) for hot flashes in menopausal women. Treatment was administered over 8, 90 min weekly sessions and consisted of education, relaxation training and cognitive restructuring. Nineteen women meeting STRAW staging criteria for the menopause transition (stages -1 to +1) were randomly assigned to immediate or delayed treatment (wait list) and were asked to monitor their hot flashes and night sweats prospectively. They also completed questionnaires, including the Women's Health Questionnaire and the Menopause Specific Quality of Life Questionnaire to determine psychosocial benefits of treatment. Results suggested that the CBGT was moderately successful in reducing the frequency of total vasomotor symptoms [F (1, 17) = 6.16, p < .01], as measured by daily symptom diaries. While there were arithmetic improvements in psychosocial functioning in this sample, these results were not significant. Despite the limitations of small sample size and possible placebo effect, this pilot study supports the notion that cognitive-behavioral interventions aimed at reducing vasomotor symptoms may be of value for menopausal hot flashes when administered in a small-group format.

Cognitive Behavioral Therapy↗

PubMed2006

Assessing defense structure in school-age children using the Response Evaluation Measure-71-Youth version (REM-Y-71).

This study used the Response Evaluation Measure-Youth (REM-Y-71), a self-report measure of 21 defense reactions, among school-age children. Participants were elementary and middle school students (n = 290; grades 3-8; age range: 8-15; mean = 11.73). Factor analysis revealed a 2-factor defense structure consistent with structure among high school and adult samples. The composite REM-Y defense scores for each factor were significant predictors of social desirability, using the Children's Defensiveness Scale (CDS); anxiety, using the State-Trait Anxiety Inventory for Children (STAIC); and psychosocial functioning. This study represents the first cross-sectional empirical analysis of overall defense structure and use among children and early adolescents.

Adolescent↗

PubMed2000

Opioids in chronic pain management: is there a significant risk of addiction?

In the last decade there has been significant controversy about the appropriateness, efficacy, safety, and wisdom of treating chronic pain patients (CPPs) with opioids. Arguments against their use have included concerns about tolerance, dependence, addiction, persistent side effects, and interference with physical or psychosocial functioning. However, considerable experience and research with long-term cancer pain treatment suggests that in appropriately selected patients, opioids have a low morbidity, and a low addiction potential, and in addition to the primary analgesic action, can facilitate reduction in suffering, enhance functional activity level, and improve quality of life without significant risk of addictive behaviors. Some patients, however, are at risk. Risk factors for addiction are discussed in this article.

Automobile Driving↗

PubMed2002

Recent research of relationships among eating disorders and personality disorders.

This review focuses on recent research examining the relationships among eating disorders (ED) and personality disorders (PD). Studies that have examined rates of PD in patients with ED and rates of ED in patients with PD have generally reported high rates of diagnostic co-occurrence, although the marked inconsistency and variability in rates across studies is striking. Methodologic limitations and conceptual problems make interpretation of the existing literature ambiguous. Overall, circumspect review suggests that anorexia nervosa may be associated with obsessional and perfectionistic forms of personality disturbances, bulimia nervosa with impulsive and unstable personality disturbances, and binge eating disorder with avoidant and anxious forms of personality disturbances. In terms of longitudinal associations, PD may be more closely associated with the course of general psychiatric or psychosocial functioning than with fluctuations in the course of ED. The significance (and more precise nature) of these associations, however, is unclear and will require sophisticated longitudinal studies to arrive at more definitive answers.

Comorbidity↗

PubMed2002

Central Nervous System Germ Cell Tumors.

Germ cells tumors most commonly affect children and adolescents, and occasionally arise in the central nervous system. Except for mature teratomas, they are all malignant. Pure germinomas are exquisitely sensitive to treatment and are highly curable with craniospinal radiation therapy. Surgery plays no role other than to establish the histologic diagnosis. Diagnostic confirmation includes normal levels of serum and cerebrospinal fluid alpha-fetoprotein and at most only minor elevations in beta human chorionic gonadotrophin (beta-hCG). Although it has become quite common to use chemotherapy to reduce the dose and field of radiation in the treatment of germinomas, longer follow-up in these patients is revealing a significant number of subarachnoid and ventricular recurrences. A recent follow-up study in patients treated for intracranial germinomas showed no significant difference in the psychosocial functioning of those treated with chemotherapy and radiation compared with those treated with chemotherapy alone, which raises further questions about the rationale for modifying a proven successful treatment. Malignant non-germinomatous germ cell tumors are much more resistant to treatment and difficult to cure. Surgical resection appears to have prognostic significance, although the predilection for midline structures makes complete resection difficult if not impossible at times. The best results have been obtained with platinum-based chemotherapy and full-dose craniospinal radiation therapy. Pure teratomas are not typically responsive to chemotherapy or radiation therapy and surgery is the only proven treatment modality.

Journal Article↗

PubMed1989

Psychologic characteristics of polio survivors: a preliminary report.

Ninety-three men and women with histories of polio were administered the Symptom Check List-90 Revised (SCL-90R), Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), and a questionnaire about their polio histories. The SCL-90R and PAIS-SR are measures of emotional and psychosocial functioning. Two samples were used: a clinic sample (n = 71) and a postpolio support group sample (n = 22). Initial results for both on the SCL-90R and PAIS-SR indicated elevated scores on a number of subscales. SCL-90R subscale elevated scores for men included those for somatization, depression, anxiety, hostility, and phobia, whereas for women there were elevations on measures of somatization, depression, anxiety, and psychoticism. Elevations were found in the following subscales on the PAIS-SR (pooling men and women): health care orientation, social environment, and extended family relationships. Men scored slightly, but not significantly, higher than women in the SCL-90R except for the hostility subscale, in which the difference was significant (p less than 0.05). Symptom profiles indicated psychologic distress. Comparisons with variables associated with polio and its late effects (such as severity of initial polio, use of an iron lung during initial illness, number of involved limbs, etc) were not statistically significant.

Attitude to Health↗

PubMed1996

Who develops PTSD from motor vehicle accidents?

Within 1 to 4 months of their motor vehicle accident (MVA), we assessed 158 MVA victims who sought medical attention as a result of the MVA. Using the Clinician-Administered PTSD Scale (CAPS: Blake, Weathers, Nagy, Kaloupek, Klauminzer, Charney & Keane, 1990. National Center for Post-Traumatic Stress Disorder, Boston, MA)., we found that 62 (39%) met DSM-III-R (American Psychiatric Association, 1987. Washington, DC: American Psychiatric Press) criteria for Post-Traumatic Stress Disorder. Using variables from the victim's account of the accident and its sequelae, pre-MVA psychosocial functioning, demographic variables, pre-MVA psychopathology and degree of physical injury, we found that 70% of the subjects could be classified as PTSD or not with 4 variables: prior major depression, fear of dying in the MVA, extent of physical injury and whether litigation had been initiated. Using multiple regression to predict the continuous variable of total CAPS score, as a measure of post-traumatic stress symptoms, we found that 8 variables combined to predict 38.1% of variance (Multiple R = 0.617).

Accidents, Traffic↗

PubMedDate not supplied

Follow-up study on borderline versus nonborderline personality disorders.

Using a semi-structured interview, 18 DSM-III borderline personality disorder (BPD) patients and 17 other (nonborderline) personality disorder (OPD) patients were compared blind 4 1/2 years after their index discharge. Although significantly younger and mostly single, BPD patients did not differ from OPD patients in the degree of overall psychopathology or in the level of psychosocial functioning and adjustment. They do not seem to represent a particularly severe personality disorder group. Those characteristics differentiating BPD patients from affective disorders and schizophrenia may be nonspecific regarding other personality disorder types. As such, more attention should be paid to cases of OPD in the future.

Adult↗

PubMedDate not supplied

Reliability and validity of the longitudinal interval follow-up evaluation for assessing outcome of anxiety disorders.

The LIFE-UP, an instrument for prospectively following course for psychiatric disorders, has been extended to include Psychiatric Status Ratings (PSRs) for the DSM-III-R anxiety disorders panic (with and without agoraphobia), agoraphobia without panic, generalized anxiety disorder, social phobia, and simple phobia. This paper reports data on the reliability and validity of the LIFE-UP as used in the Harvard/Brown Anxiety Disorders Research Program. We found generally good reliability for the PSRs, both inter-rater and long-term test-retest. The reliability coefficients for the rater-administered instruments were very similar to those for the self-reports, suggesting that a large proportion of the variance was due to subject variability rather than rater variability. Reliability for the beginning of the year of follow-up was very similar to that for the time just before the interview. In addition, correlations with other measures of psychosocial function or anxiety symptomatology provided evidence for the external validity of the PSRs as measures of psychiatric morbidity.

Adolescent↗

PubMed1982

The relationship between psychological distress and knowledge of disease among hemophilia patients and their families: a pilot study.

As part of a large scale, comprehensive study of the psychosocial functioning of hemophilic patients and their families, 12 pilot families were assessed using objective measures of psychiatric symptomatology and general knowledge of hemophilia. Although the small number of subjects in this pilot study precludes any detailed statistical analyses, some preliminary findings are presented concerning the level of psychological distress reported by patients and their family members and the subjects' level of general knowledge about hemophilia. Of most interest was the presence of significant negative correlations between knowledge of hemophilia and extent of self-reported psychological distress for mothers and patients under 15 yr of age. Maintenance of this relationship with a larger sample would have important implications for patient and family education.

Adolescent↗

PubMed1994

Psychosocial adjustment to infertility and its treatment: male and female responses at different stages of IVF/ET treatment.

Gender differences in psychosocial adjustment to infertility and its treatment were evaluated amongst a cross-sectional sample of 330 couples, of whom 113 were first time participants and 217 were repeat cycle couples. Whilst 30% of both husbands and wives experienced clinically elevated anxiety regardless of stage of treatment; repeat cycle women (25%) faced the further risk of developing clinically severe depressive symptoms. Significant differences in the amount of care and control received from their spouse and in the degree they suppressed their emotions were reported amongst repeat cycle couples. Any clinical implications of differences in male-female caring styles are discussed within the IVF context. Our results suggest that interventions intended not only to reduce anxiety and depressive symptoms, but also to facilitate ongoing psychosocial functioning, should be implemented for couples at different stages of IVF/ET treatment.

Adaptation, Psychological↗

PubMed1990

Selective electroencephalograph-guided microsurgical callosotomy for refractory generalized epilepsy.

Between 1978 and 1985, 35 patients with medically refractory multiform seizures were submitted for sections of variable portions of the corpus callosum. Guided by intraoperative electroencephalographic and electrocorticographic monitoring, the section was carried out only in the portion of callosum that was involved in the maintenance of the bilaterally synchronous slow spike and wave discharge (as documented by intraoperative electrocorticography). In our patients, only part of the frontal corpus callosum needed to be sectioned to interrupt the bilateral synchrony of epileptic discharge. Of the 35 patients, operated on, 28 have had an adequate long-term follow up and are presented herein. All had significant improvement in seizure frequency and psychosocial functioning.

Adolescent↗

PubMed1992

The psychological, social, and sexual consequences of gestational trophoblastic disease.

Seventy-six women diagnosed with gestational trophoblastic disease (GTD) from 1985 to 1989 completed questionnaires evaluating their status on mood disturbance, marital satisfaction, sexual functioning, psychosocial response to illness, and report of the most stressful event occurring within the past year. Multivariate analyses of variance (MANOVA) were conducted on dependent measures to examine differences between diagnostic groups (partial mole, complete mole, persistent disease), time from diagnosis (less than 1 year, 1-2 years, or 3-5 years from diagnosis), and follow-up status (active disease or remission). MANOVAs revealed no significant differences in the dependent measures based on time from diagnosis, type of medical treatment received, or type of molar disease. The metastatic disease group displayed significantly greater mood disturbance (F(1, 66) = 17.63, P less than 0.0001) and reported suffering clinically significant levels of distress and significantly greater levels of distress in response to the illness (F(33, 39) = 2.32, P less than 0.006). Women with active disease also reported significantly greater levels of distress in response to the illness (F(33, 39) = 2.76, P less than 0.001). Across disease types, GTD patients experience clinically significant levels of anxiety, anger, fatigue, confusion, and sexual problems and are significantly impacted by pregnancy concerns for protracted periods of time.

Adaptation, Psychological↗

PubMed1990

Health promotion for adolescents: preventive and corrective strategies against problem behavior.

This paper, in its first part, gives an overview of research on "problem behavior" in adolescence. Adolescence is considered to be a stage in life characterized by more experimentation, exploration, risk-taking, and rebellion than any other stages. Many health-damaging behaviors (drug consumption, precocious sexual activity, riskful driving, aggressive behavior, etc.) have important psychosocial functions in adolescents' developments. Some of these behaviors can be signals of "stress", defined as a bio-psycho-social state of tension resulting from a variety of stressors which confront adolescents daily in modern industrial societies. In the second part of the paper, the implications of this research for strategies of intervention are discussed. The systematic analysis distinguishes between different stages in the process by which problem behavior emerges and separates "preventive" from "corrective" forms of intervention. Additionally, the analysis differentiates between the dimensions targeted by the measures: interventions addressed toward individual behavior ("personal resources") on the one hand, and living conditions ("social resources") on the other hand. The resulting types of intervention approaches are illustrated with examples and discussed in view of how appropriate they are for health promotion in adolescence. Implications for "social policy for adolescents" are discussed.

Adolescent↗

PubMed1996

The long-term sequelae of child and adolescent abuse: a longitudinal community study.

The purpose of the present study was to examine the relationship between childhood and adolescent physical and sexual abuse before the age of 18 and psychosocial functioning in mid-adolescence (age 15) and early adulthood (age 21) in a representative community sample of young adults. Subjects were 375 participants in an ongoing 17-years longitudinal study. At age 21, nearly 11% reported physical or sexual abuse before age 18. Psychiatric disorders based on DSM-III-R criteria were assessed utilizing the NIMH Diagnostic Interview Schedule, Revised Version (DIS-III-R). Approximately 80% of the abused young adults met DSM-III-R criteria for at least one psychiatric disorder at age 21. Compared to their nonabused counterparts, abused subjects demonstrated significant impairments in functioning both at ages 15 and at 21, including more depressive symptomatology, anxiety, psychiatric disorders, emotional-behavioral problems, suicidal ideation, and suicide attempts. While abused individuals were functioning significantly more poorly overall at ages 15 and 21 than their nonabused peers, gender differences and distinct patterns of impaired functioning emerged. These deficits underscore the need for early intervention and prevention strategies to forestall or minimize the serious consequences of child abuse.

Adolescent↗

PubMed1985

Integrated services for chronic mental patients: theoretical perspective and experimental results.

The theoretical basis of an integrated service approach to the care of chronic mental patients is discussed. An experiment testing the Treatment Network Team (TNT) program, based on that approach, is described and results are reported. Although TNT and control patients exhibited minimal differences in symptomatology and psychopathology, those in the experimental group showed substantive improvement in psychosocial functioning. The authors conclude that flexible service systems that deemphasize locus of care and offer a range of treatment modalities have the potential for enriching the social lives of chronic mental patients.

Arizona↗

PubMed1995

The effect of managed care on the treatment outcome of substance use disorders.

This study examined the effect of managed care and other reimbursement mechanisms on the outcome of substance abuse treatment at a single treatment facility. A retrospective review of 1594 patient records yielded treatment utilization, diagnostic, and demographic data. Recidivism rates for intensive managed care, traditional managed care, private pay, and state-funded groups of patients were compared. Results showed that, contrary to expectations, recidivism rates were not different for managed vs nonmanaged care patients. In addition, recidivist patients had significantly more ICD-9 diagnoses than nonrecidivist patients. A discussion of future research suggests that other outcome measures need to be examined in addition to recidivism rate, such as psychosocial functioning following treatment and indicator(s) of severity of illness, to better determine the effect of managed care and other reimbursement mechanisms on treatment outcome.

Adult↗

PubMedDate not supplied

The influence of alcoholism on the course of depression.

The clinical course of 289 patients with primary non-bipolar major depression without concurrent alcoholism was compared with that of 79 patients with non-bipolar major depression with concurrent alcoholism. Neither patient group suffered from dysthymia or current drug abuse. Contrary to expectations, the two groups did not differ on time to recovery from the major depression, time to relapse into a subsequent major depression, or various cross-sectional clinical ratings at 2 years. The two groups did differ on psychosocial status. Although they were equally impaired at index, the alcoholism group maintained significantly lower levels of psychosocial functioning throughout the 2-year follow-up period. Interpersonal relation with spouse was particularly worse among the alcoholic group.

Adult↗