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Effects of surgical menopause on psychological characteristics and lipid levels: the Healthy Women Study.

The authors examined the effects of surgical menopause, with or without hormone replacement therapy (HRT), on psychosocial functioning and lipid levels in a population-based study of initially premenopausal women. Within 5 years of study entry, 28 women underwent hysterectomy, with 9 retaining their ovaries and 19 having bilateral salpingo oophorectomy (BSO), and with 173 premenopausal women as a comparison group. Women undergoing hysterectomy reported fewer stress symptoms and a more optimistic attitude at follow-up, whereas BSO cases without HRT had lower mean total high-density lipoprotein (HDL) and HDL2, relative to premenopausal women. Subject to limited power, the authors' findings suggest that surgical menopause among middle-aged women does not lead to negative psychological outcomes but that BSO in the absence of hormone use has significant adverse effects on the HDL and HDL2.

Adaptation, Psychological↗

Fathers' participation in family research: is there a self-selection bias?

The representativeness of fathers who participate in family research was examined among 661 families. Approximately two thirds of eligible fathers participated. Mothers' and observers' reports on families of participating and non-participating fathers were compared. Participating fathers underrepresented fathers with less education, later-born children, more ambivalent marriages, partners with more traditional child-rearing beliefs, families with less optimal parenting environments, and infants who were unplanned, had more difficult temperaments, and were less healthy. Also underrepresented were ethnic minority families and working-class fathers. However, no differences were found in regard to child gender, family income, mothers' psychosocial functioning, either parent's employment experiences, or child-care arrangements. Implications for the generalizability of findings and the recruitment of fathers are discussed.

Adult↗

Nonproblem drinking outcomes in adolescents treated for alcohol use disorders.

Change to nonproblem drinking was studied in 159 adolescents (70% male) presenting for alcohol use disorders (AUDs) treatment. A community sample (n = 148,47% male) also was assessed. Clinical participants had a current AUD at baseline; 1 year later, 17% remained abstinent, 60% had at least 1 AUD symptom (problem drinkers), and 23% were drinking but had no AUD symptoms (nonproblem drinkers). Drinking among the nonproblem drinkers decreased and was lower than in the problem drinkers. Nonproblem drinkers increased in psychosocial functioning and decreased in the number of illicit drugs used relative to problem drinkers and generally did not differ from the abstainers. The results suggest alternative views of treatment goals, relapse, and treatment outcome in adolescents.

Adolescent↗

Subsyndromal depressive symptoms and major depression in postpartum women.

This study documents differences in the psychosocial functioning of women three months postpartum with subclinical depression, major depression prior to the birth of the baby, major depression both pre- and post-birth, and no depression. An understanding of these differences may have implications for intervention insofar as maternal depression places at risk not only the mother's functioning but her infant's development, as well.

Adult↗

Rehabilitative residential treatment in patients with severe mental disorders: personality features associated with short-term outcome.

The aims of this study were to evaluate the outcome of inpatients with severe psychiatric disorders after 6 months of multimodal residential treatment. Ninety-one subjects admitted to residential prolonged treatment at an Italian rehabilitative complex were included in the study. Within 6 months, the program of treatment was effective in reducing symptoms and improving the patients' psychosocial functioning. The study of personality can be useful to "dose" symptomatic (pharmacological and psychotherapeutic) and rehabilitative treatments in the therapy program.

Adult↗

A qualitative investigation of adolescents' experiences with parental HIV/AIDS.

The present qualitative study investigated the implications of parental HIV/AIDS for affected adolescents. The purpose of the study was (a) to understand adolescents' perceptions of and experiences with parental HIV/AIDS and (b) to explore how parental HIV/AIDS affects adolescents' psychosocial functioning, particularly in the home and school environments. Semistructured interviews were conducted with 9 adolescents between the ages of 11 and 17. Major themes included loss, transitions, disclosure, school implications, paradoxical situations, support networks, and coping. Findings validated and expanded on previous research and yielded hypotheses for future research.

Acquired Immunodeficiency Syndrome↗

Mental health in adolescence: is America's youth flourishing?

A continuous assessment and a categorical diagnosis of the presence of mental health, described as flourishing, and the absence of mental health, characterized as languishing, are proposed and applied to data from the second wave of the Child Development Supplement (CDS-II) of the Panel Study of Income Dynamics (PSID), in which a comprehensive set of subjective well-being items were administered to a sample of 1,234 youth ages 12-18. Flourishing was the most prevalent diagnosis among youth ages 12-14; moderate mental health was the most prevalent diagnosis among youth ages 15-18. Depressive symptoms decreased as mental health increased. Prevalence of conduct problems (arrested, skipped school, alcohol use, cigarette smoking, and marijuana use) also decreased and measures of psychosocial functioning (global self-concept, self-determination, closeness to others, and school integration) increased as mental health increased. Findings suggest the importance of positive mental health in future research on adolescent development.

Adolescent↗

Predictors of paternal involvement for resident and nonresident low-income fathers.

In a sample of low-income families (N = 239), structural equation models assessed predictors of fathers' involvement with preschool-aged children in instrumental, behavioral, and emotional realms. Results suggest that parental conflict has a strong negative relation with father involvement. Fathers' human capital characteristics, healthy psychosocial functioning, and past stability in family relationships all predicted greater father involvement directly and/or indirectly through parental conflict. Numerous differences emerged in the predictive models between resident and nonresident fathers, although few differences were statistically significant. Results suggest that policy efforts aimed at enhancing fathers' responsible parenting should focus both on increasing fathers' human and social capital and on supporting positive family processes.

Adolescent↗

Association of parental depression with psychiatric course from adolescence to young adulthood among formerly depressed individuals.

The authors examined whether parental major depressive disorder (MDD) is associated with course of depression and other psychopathology among formerly depressed adolescents as they enter adulthood. The sample consisted of 244 individuals (age 24) in a longitudinal study who had experienced MDD by 19. Maternal MDD was associated with MDD recurrence, chronicity and severity, anxiety disorders, and (among sons only) lower psychosocial functioning in offspring between the ages of 19 and 24. Paternal MDD was associated with lower functioning. Sons of depressed fathers had elevated suicidal ideation and attempt rates in young adulthood. Recurrent paternal MDD was associated with depression recurrence in daughters but not sons. The impact of parental MDD on offspring could not be attributed to characteristics of the offspring's depression prior to age 19.

Adolescent↗

Structural ecosystems therapy for HIV-seropositive African American women: effects on psychological distress, family hassles, and family support.

This study tests the efficacy of Structural Ecosystems Therapy (SET), a family-ecological intervention, in improving psychosocial functioning when compared with an attention-comparison person-centered condition and a community control condition. A sample of 209 HIV-seropositive, urban, low-income, African American women was randomized into 1 of the 3 conditions. Results of growth curve analyses over 5 time points revealed that SET was more efficacious than either of the control conditions in reducing psychological distress and family-related hassles. However, contrary to hypotheses, SET was not more efficacious in increasing family support. Latent growth mixture modeling analyses indicated that SET was most efficacious for women who, on average, were at or near the clinical threshold for psychological distress and for women with high levels of family hassles. Implications for further intervention development are discussed.

Adult↗

How has body image changed? A cross-sectional investigation of college women and men from 1983 to 2001.

Body-image dissatisfaction is not uncommon and can adversely affect individuals' psychosocial functioning and quality of life. Various oft-cited surveys and a meta-analysis implicate a worsening of body image over the past several decades, especially among women and possibly among men. The present cross-sectional study examined changes in multiple facets of body image among 3,127 college students from 1983 through 2001; the same standardized assessment was used in 22 studies conducted within the same university. Results confirmed non-Black women's increasing body-image dissatisfaction until the early or mid-1990s, after which significant improvements occurred in terms of overall body-image evaluation and overweight preoccupation among both non-Black and Black women, despite heavier body weights. A reduction over time in women's investment in their appearance was also evident. Men's body image was relatively stable during the 19-year period. Explanations, limitations, and implications of the findings are discussed.

Adult↗

Validity of sudden gains in acute phase treatment of depression.

The authors examined the validity of sudden gains identified with T. Z. Tang and R. J. DeRubeis's (1999) method in 2 clinical data sets that involved treatment of major depressive disorder (N=227). Sudden gains replicated among self- and clinician reports of depressive symptoms and predicted better psychosocial functioning at the acute phase treatment end point, in support of their validity. However, sudden gains occurred with roughly the same moderate frequency in pill placebo and pharmacotherapy with clinical management as in cognitive therapy. Furthermore, sudden gains predicted more depressive symptoms and negative failure attributions in longitudinal follow-up of responders to acute phase cognitive therapy. On the basis of these findings, the authors conceptualize sudden gains as one of several possible patterns of acute phase treatment response.

Acute Disease↗

Mental illness and/or mental health? Investigating axioms of the complete state model of health.

A continuous assessment and a categorical diagnosis of the presence (i.e., flourishing) and the absence (i.e., languishing) of mental health were proposed and applied to the Midlife in the United States study data, a nationally representative sample of adults between the ages of 25 and 74 years (N = 3,032). Confirmatory factor analyses supported the hypothesis that measures of mental health (i.e., emotional, psychological, and social well-being) and mental illness (i.e., major depressive episode, generalized anxiety, panic disorder, and alcohol dependence) constitute separate correlated unipolar dimensions. The categorical diagnosis yielded an estimate of 18.0% flourishing and, when cross-tabulated with the mental disorders, an estimate of 16.6% with complete mental health. Completely mentally healthy adults reported the fewest health limitations of activities of daily living, the fewest missed days of work, the fewest half-day work cutbacks, and the healthiest psychosocial functioning (low helplessness, clear life goals, high resilience, and high intimacy).

Adult↗

Caregiver-therapist ethnic similarity predicts youth outcomes from an empirically based treatment.

The effects of caregiver-therapist ethnic similarity on youth outcomes from multisystemic therapy (MST), as implemented in dissemination sites, were examined. Consistent with hypotheses, findings confirmed that youths whose caregivers were ethnically matched with their therapists demonstrated greater decreases in symptoms, longer times in treatment, and increased likelihood of discharge for meeting treatment goals relative to youths whose caregivers and therapists were not ethnically matched. In addition, for youths whose caregivers were of mixed ethnic heritage, caregiver-therapist ethnic match was associated with greater improvements in psychosocial functioning. Ethnic match effects on both treatment length and discharge success were partially mediated by therapist adherence to MST. This study shows the importance of examining the effects of both client and therapist ethnicity on outcomes from empirically based treatments.

Adolescent↗

Childhood experiences and psychosocial influences on HIV risk among adolescent Latinas in southern California.

This study determined how adverse childhood experiences influenced risky sexual behavior in a community sample of Latina adolescents in Los Angeles (N = 904) within a modified ecodevelopmental perspective. Psychosocial, sociocultural, and environmental mediators of the relations between childhood experiences and risky sexual behavior were tested. Many direct and mediated paths were revealed using structural equation modeling. Childhood maltreatment was associated with risk sexual practices, including more partners, less condom use, more frequent intercourse, and less HIV testing. Drug use and general self-efficacy mediated several relationships. Reducing childhood maltreatment reduced HIV risk and improved psychosocial functioning. Many factors tested did not influence HIV risk. Much of what is known about HIV risk among other populations may not apply to young Latina women.

Adolescent↗

Temperament and adjustment in young adulthood: a 15-year longitudinal analysis.

The relationship between easy/difficult temperament and adjustment from middle adolescence to young adulthood was examined. Cluster analysis revealed four groups of individuals via composite temperament scores over three points of measurement. Multivariate analyses indicated that extremely difficult temperament was associated with poorer psychosocial functioning in childhood and young adulthood.

Adaptation, Psychological↗

Subjective experience in schizophrenia: factors influencing self-esteem, satisfaction with life, and subjective distress.

The relative and combined effects of individual characteristics, severity of illness, psychosocial functioning, treatment intensity, and milieu variables on self-esteem, distress and satisfaction with life were examined in a study of 103 subjects diagnosed with schizophrenia or schizoaffective disorder, all of whom had been in either high-intensity or low-intensity community-based interventions for at least six months. Implications of the findings for treatment and for research on subjective experience in schizophrenia are discussed.

Adult↗

Psychosocial adaptation of patients and families following bone marrow transplantation: a prospective, longitudinal study.

Using a prospective, repeated measures design, this study investigated the psychosocial functioning of patients and a close relative pre- and post-allogeneic and autologous bone marrow transplantation (BMT). All patients (n = 28) undergoing BMT in a 1 year period, and their relatives, were interviewed 1 week pre-transplant and at 3, 6 and 12 months post-BMT, using quantitative and qualitative measures. Pre-transplant data revealed a high level of anxiety (61% with moderate to severe anxiety), and a low level of depression (14% with moderate to severe depression). Twelve patients died in the study period. For the surviving patients there was a statistically significant improvement in physical, psychological and social functioning. Most relatives (88%) reported considerable psychological distress pre-transplant and at 3 months post-transplant, but this was largely resolved by 12 months post-transplant. Significant correlations between the relative's distress and patient's physical and psychological wellbeing were observed at 3 months post-transplant, but not at the other assessment points. The findings from this study will help in counselling patients and their relatives as to what to expect in the year following BMT.

Adaptation, Psychological↗