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Results for “Psychosocial functioning”

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PubMed1989

Psychosocial responses to the threat of HIV exposure among people with bleeding disorders.

The findings of a state-wide needs assessment of people with bleeding disorders at risk of human immunodeficiency virus (HIV) infection are reported. The effects of the threat of HIV exposure on the psychosocial functioning of respondents is assessed. A total of 394 of 796 (49 percent) persons aged 14 years and older responded to a questionnaire. Psychological distress, marital distress, AIDS-related dating problems, and AIDS-related sexual problems were examined. Potential predictors were illness-related indicators, subjective assessments of sources and consequences of vulnerability to HIV, social sources of distress such as AIDS-related isolation and discrimination, and behaviors respondents engaged in to assess or reduce their risk of infection. The implications of these findings for service provision are discussed.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Effectiveness of a care coordination model for stroke survivors: a randomized study.

This study evaluated the effectiveness of systematically integrating biopsychosocial interventions with coordinated delivery of care for outpatients recovering from stroke. Care coordination coordinates resources across the health care system and routinely addresses the psychological and social risks affecting patient outcomes, while monitoring patient progress. A randomized pre-post comparison group design evaluated the model's effectiveness with 28 patients (16 intervention group; 12 control group) over a three-month period. The model's effectiveness was evaluated by monitoring changes in patient quality of life, patient depression, patient psychosocial functioning, and patient adherence to self-care and in meeting patient service needs. Repeated-measures ANOVA showed significant improvement for the intervention group in mental quality of life, depressive symptoms, and adherence to self-care practices. This study provides preliminary data that a standardized, problem-solving care coordination model can improve patient care.

Aged↗

PubMed1999

Nutrition and health outcomes associated with food insecurity and hunger.

This paper explores how food insecurity and hunger relate to health and nutrition outcomes in food-rich countries such as the United States. It focuses on two subgroups of the population for whom data are available: women of childbearing age and school-age children. Special consideration is given to examining how food insecurity relates to these outcomes independently of socioeconomic status and poverty. In a population-based sample of women of childbearing age, the least severe level of food insecurity (household food insecurity) was correlated with higher body mass index (BMI), controlling for other available and known influences on obesity including income level. In low income school-age children from two large urban areas of the U.S., risk of hunger and hunger were associated with compromised psychosocial functioning, controlling for maternal education and estimated household income. The nutrition and health consequences of food insecurity comprise a potentially rich area for future, socially relevant research in the field of nutritional sciences.

Adult↗

PubMed1992

Psychosocial concomitants of children's feeding disorders.

Compared behavior problems, child developmental skills, home environment, and parent emotional distress for 50 families of children aged 11-70 months with differing etiologies of feeding disorders (FD). Results showed that psychosocial functioning differed across FD classifications. Children with nonorganic characteristics to FD had more behavior problems compared to those with only organic FD. Children with primarily or only organic FD displayed lower developmental skills and their parents had higher emotional distress than children with primarily nonorganic FD. High parent distress was associated with older children who had poor feeding skills, less positive disciplinary practices, and higher social status. The findings imply that clinical services to families often are warranted and that service needs vary depending on the nature of FD. Mixed organic and nonorganic FD occurred in the majority of children, which supports the need for more detailed classification than an organic-nonorganic dichotomy used in prior research.

Child Behavior Disorders↗

PubMed1999

Psychosocial changes associated with participation in a pediatric summer camp.

OBJECTIVE: To examine the relationship between a 1-week pediatric summer camping program and children's attitudes toward their physical disabilities and/or medical conditions and levels of trait anxiety. METHOD: The Child Attitude Toward Illness Scale (CATIS; Austin & Huberty, 1993) and the trait scale of the State-Trait Anxiety Inventory for Children (STAIC; Spielberger, 1973) were given to 90 children as pretests to determine baseline attitudes toward their illnesses and their overall levels of trait anxiety. At the end of the 1-week camp sessions, the CATIS and STAIC A-Trait Form were completed once more as posttest measures. RESULTS: Pretest and posttest scores for all camp groups were compared to assess changes in the children's attitudes toward their illnesses and levels of trait anxiety. Overall, participants had better attitudes toward their illnesses and lower levels of trait anxiety at the end of camp. CONCLUSIONS: Participation in a pediatric summer camp was related to changes in psychosocial functioning, with changes evident across diagnostic groups and gender. The consistency of the findings underscores the need for further investigation.

Analysis of Variance↗

PubMed1998

Considerations, conceptualizations, and challenges in the study of concomitant learning disabilities among children and adolescents who are deaf or hard of hearing.

In recent years, there has been increasing concern about the identification of and provision of appropriate services to children and adolescents who are deaf and hard of hearing (D/HH) and who have concomitant learning disabilities (LD). Although it is unclear just how many youths who are D/HH also might have educationally significant learning problems, results from limited survey research and clinical practice provide evidence that such a group exists and that a significant portion of the school-age population of children and adolescents who are D/HH comprise a subgroup of youths who have concomitant LD. The overriding interest of those who advocate the cause of children and adolescents who are D/HH with concomitant LD is in finding effective ways to help these youths acquire future academic competence and attain competent levels of psychosocial functioning and emotional well-being. With creative research efforts and efficacious approaches to psychoeducational practice, we can seize the opportunity to establish high-quality diagnostic and educational services for children and adolescents who are D/HH and who have accompanying LD and set the stage to optimize positive developmental, academic, vocational, social, and economic outcomes for these youths.

Journal Article↗

PubMed2002

Cost-effectiveness of risperidone, olanzapine, and conventional antipsychotic medications.

To assess the cost and effectiveness of risperidone, olanzapine, and conventional antipsychotic medications under "usual practice" conditions in a large, public mental health system, 108 persons diagnosed with schizophrenia or schizoaffective disorder were randomly assigned to one of these three medication groups and followed prospectively over a 12-month period using standard instruments and procedures. Psychiatric medication costs increased more over time in both the olanzapine and risperidone groups than in the conventional medication group. Compliance with the prescribed medication was higher in the olanzapine group than in the conventional group. No differential effects by medication group were evident in this sample on the symptoms of schizophrenia, side effects, psychosocial functioning, time to discharge for index hospitalization, survival to initial rehospitalization, or client satisfaction with services. These results extend findings from previous efficacy and naturalistic studies in several ways but are limited chiefly by the small number of subjects who completed 6 to 12 months of the clinical trial, and the resulting power to detect differences in the statistical analyses.

Adolescent↗

PubMed2000

A prognostic study of clinical dimensions in adolescent-onset psychoses.

Adolescent-onset psychoses often raise diagnostic difficulties because of the mixture of schizophrenic and affective features. This study examined prospectively which clinical dimensions contribute to difficulty in initial diagnosis and which clinical features have predictive value for outcomes of schizophrenia or affective disorders, and for eventual psychosocial functioning. Thirty-six adolescents consecutively admitted for a psychotic episode were followed up for 1 to 4 years. Symptoms were assessed at admission, at discharge, and once a year. DSM-III-R (APA 1989) diagnoses were assessed at admission and once a year. Comparisons were performed across initial and followup diagnostic groups. Positive symptoms did not differentiate the initial clinical pictures, while negative symptoms, manic symptoms, and disorganization differentiated the manic and depressive episodes in the acute phase. When initial positive symptoms (mainly delusions) were severe, they predicted a final diagnosis in the schizophrenia spectrum. Poor outcome was associated with more anhedonia-associality and lower functioning scores at admission. Results suggest (1) a higher vulnerability to positive symptoms in adolescents who will further develop schizophrenia and (2) the low specificity of affective symptoms at this age.

Acute Disease↗

PubMed1985

Overall design and methodology of the Israeli high-risk study.

The unique contribution of the Israeli high-risk study is the comparison of children at risk for schizophrenia with matched controls in two settings: those raised in nuclear families in towns, and those raised in children's houses on kibbutzim. Such a design makes possible direct comparison of genetic and environmental effects on the psychosocial functioning of a group of high-risk children, over time. In this article we describe methods of collecting and examining the sample, provide an overview of the examination procedures, and describe the basic principles of data analysis.

Adolescent↗

PubMed1986

Psychiatric rehabilitation of schizophrenia: editor's introduction.

Well-planned and conceptualized rehabilitation of psychiatric patients who demonstrate persisting impairments, disabilities, and handicaps begins with assessment of symptoms and psychosocial functioning. Rehabilitation interventions--aimed at building skills and providing supportive and prosthetic environments--are linked to initial and ongoing assessment. The refractoriness of large numbers of psychiatric patients to conventional and customary forms of therapy will fuel the development of psychiatric rehabilitation that is efficacious and empirically based.

Adult↗

PubMed1986

Training skills in the psychiatrically disabled: learning coping and competence.

Social skills training methods represent a major strategy for psychiatric rehabilitation. Building skills in patients with schizophrenic and other major mental disorders is based on the assumption that coping and competence can override stress and vulnerability in reducing relapses and improving psychosocial functioning. For maximum efficiency, skills training needs to incorporate procedures and principles of human learning and information processing. Several models for skills training have been designed and evaluated, each of which has proved to be effective in raising the social competence of chronic mental patients. The "basic" model involves role playing by the patient and modeling, prompting, feedback, and reinforcement by the therapist. A "problem-solving" model of training provides general strategies for dealing with a wide variety of social situations. This model uses role playing to enhance behavioral performance but also highlights the patient's abilities to perceive and process incoming social messages and meanings. It is essential that social skills training be imbedded in a comprehensive program of rehabilitation that features continuity of care, supportive community services, therapeutic relationships, and judicious prescription of psychotropic drugs.

Activities of Daily Living↗

PubMed1993

Low-dose depot medication in schizophrenia.

Depot antipsychotic medication is a major component of the maintenance treatment of schizophrenia, but it is still not clear what constitutes an appropriate dose. A number of studies comparing low with standard doses of depot antipsychotic medication on a variety of outcome measures have been published in the last decade. A review of these studies indicates that, compared to standard-dose treatment, low-dose medication tends to improve psychosocial function and reduce the frequency of side effects but may result in an increase in positive symptoms. In such cases, a temporary increase in dose appears to control symptoms and terminate relapse episodes. An explanation of the relative efficacy of low-dose treatment may be derived from recent work in radioreceptor ligand binding.

Antipsychotic Agents↗

PubMed2006

Integrated psychological therapy (IPT) for schizophrenia: is it effective?

Against the background of evidence-based treatments for schizophrenia, nowadays the implementation of specific cognitive and behavioral interventions becomes more important in the standard care of these patients. Over the past 25 years, research groups in 9 countries have carried out 30 independent evaluations of Integrated Psychological Therapy (IPT), a group program that combines neurocognitive and social cognitive interventions with social skills approaches for schizophrenic patients. The aim of the present study was to evaluate the effectiveness of IPT under varying treatment and research conditions in academic and nonacademic sites. In a first step, all 30 published IPT studies with the participation of 1393 schizophrenic patients were included in the meta-analysis. In a second step, only high-quality studies (HQS) (7 studies including 362 patients) were selected and analyzed to check whether they confirmed the results of the first step. Positive mean effect sizes favoring IPT over control groups (placebo-attention conditions, standard care) were found for all dependent variables, including symptoms, psychosocial functioning, and neurocognition. Moreover, the superiority of IPT continued to increase during an average follow-up period of 8.1 months. IPT obtained similarly favorable effects across the different outcome domains, assessment formats (expert ratings, self-reports, and psychological tests), settings (inpatient vs outpatient and academic vs nonacademic), and phases of treatment (acute vs chronic). The HQS confirmed the results of the complete sample. The analysis indicates that IPT is an effective rehabilitation approach for schizophrenia that is robust across a wide range of patients and treatment conditions.

Adult↗

PubMed1997

Psychopathology in male and female HIV-positive and negative injecting drug users: longitudinal course over 3 years.

OBJECTIVE: To evaluate the impact of HIV illness on psychiatric and psychosocial functioning over 3 years in a sample of male and female HIV-positive injecting drug users (IDU), with a comparison group of HIV-negative male and female IDU. DESIGN: As part of a multidisciplinary study, 121 men (69 HIV-positive, 52 HIV-negative) and 66 women (36 HIV-positive, 30 HIV-negative) were evaluated semiannually for seven visits. Attrition, unrelated to sex or serostatus, was 33%. RESULTS: At baseline, rates of major depression and dysthymia ranged from 15% (HIV-negative men) to 33% (HIV-positive men and HIV-negative women). Global impairment was in the range found in psychiatric patients (mean Global Assessment of Functioning scores, 46-51). Higher levels of social support and less social conflict were independently associated with decreased distress and improved global functioning among both men and women. For both HIV-positive groups, degree of improvement over time was related to degree to HIV progression: those who remained healthier in terms of CD4 count and illness stage showed more improvement. HIV-seronegative status was associated with less distress for men but not for women. Overall, women reported higher levels of psychiatric distress than men. CONCLUSIONS: High rates of psychopathology were found in this IDU cohort, independent of HIV status and sex. Although rates of psychopathology, injecting drug use and distress declined slightly during the study, they remained elevated; accordingly, psychiatric services are indicated for this population.

Cohort Studies↗

PubMed1996

Lupus and the central nervous system.

Neuropsychiatric symptoms are recognized to occur in a significant percentage of systemic lupus erythematosus patients and to be a leading cause of morbidity and morality in lupus. Recent findings regarding the clinical presentation, diagnosis, pathogenesis, and treatment of neuropsychiatric lupus erythematosus are reviewed. The study of neurocognitive deficits and psychosocial functioning in systemic lupus erythematosus patients continues to be an area of great research interest worldwide. Severe neuropsychiatric manifestations can be divided into diffuse, focal, and seizure presentations, which can each have a different etiopathogenesis. New techniques for magnetic resonance imaging and single-photon emission CT of the brain may improve the utility and sensitivity of these neuroradiographic tests. Certain combinations of serologic, cerebrospinal fluid, and neuroimaging tests appear to be most useful diagnostically when ordered based on the patient's neurologic presentation. The role of complement, cytokines, and endothelial cell activation in causing the vascular pathology observed in the brains of neuropsychiatric lupus erythematosus patients is an area of promising research. Treatment remains empiric, but intravenous pulse cyclophosphamide and intrathecal administration of immunosuppressive medications are new approaches that have been used successfully to treat patients with severe and refractory symptoms.

Central Nervous System Diseases↗

PubMed1996

Development and validation of a patient needs assessment tool (PNAT) for oncology clinicians.

The Patient Needs Assessment Tool (PNAT) is an interviewer-rated scale that may be completed through a simple structured interview and screens cancer patients for potential problems in physical and psychosocial functioning. The instrument provides separate scores for physical, psychological, and social status, and can potentially clarify the types of interventions needed to address specific areas of dysfunction. Reliability and validity was tested in two studies that used prescreened patient videotapes and other materials to assess the performance of the PNAT in groups of oncology nurses, physicians, and social workers. The data demonstrate that subscale scores for the physical, psychological, and social dimensions have good inter-rater reliability and internal consistency (intraclass correlation coefficients of 0.71-0.97). Criterion and construct validity was suggested through high correlations of each subscale with the evaluation of expert raters (correlation coefficients of 0.85-0.95) and with scores on validated patient-rated instruments appropriate to the functional area. These analyses suggest that the PNAT is a valid scale for the assessment of a range of functional disturbances in the cancer population.

Activities of Daily Living↗

PubMedDate not supplied

A different way of being: adolescents' experiences with cancer.

Adolescents with cancer face many challenges that may impact negatively their psychological well-being. In evaluating the psychosocial functioning of adolescents with cancer, research suggests that an altered self-image may emerge in those who have difficulty adjusting. However, little is known about adolescents' perceptions of how cancer affects their sense of self. Part of a larger study, this article addresses findings specific to understanding the impact that cancer and its symptoms had on adolescents' sense of self. To help discover meaningful interpretations of their experiences, a longitudinal, qualitative study was conducted. Data collection methods included open-ended, individual and focus group interviews and participant observation. The constant comparative method of data analysis yielded theoretical categories that were supported by the adolescents' narratives. Findings revealed that adolescents experienced changes in their lived bodies because of the symptoms and this, in turn, impacted their sense of self and way of being in the world. Six ways of being in the world were identified: life as a klutz; life as a prisoner; life as an invalid; life as an alien; life as a zombie; and life as a kid. In helping adolescents deal with the changes, it was important to family and friends to respond to them like they were the same person, but also to treat them special at times. Although adolescents spoke to the significance that cancer had on their lives, they described themselves as "still being pretty much the same person."

Adaptation, Psychological↗

PubMed1989

Psychometric properties of the K-SADS-P in an Israeli adolescent inpatient population.

Seventy adolescent admissions to a psychiatric unit were evaluated with a Hebrew translation of the Schedule for Affective-Disorders and Schizophrenia for School-Aged Children (K-SADS-P). Interrater and test-retest reliability and mother-child agreement were evaluated for diagnoses, symptom clusters, and 20 affective symptoms. K-SADS diagnoses were also compared with 3-month unit evaluation diagnoses as a measure of consensual validity. The reliability of assessing psychosocial functioning was additionally examined. Reliability and validity of diagnoses were high and reliability of symptoms and syndromes was good to excellent. Mother-child agreement faired less well on all measures. The use of semistructured interviews and DSM-III criteria in an Israeli adolescent psychiatric setting are discussed.

Adolescent↗