PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Behavioral problems”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,585 records · Page 88Linked to original sources

[Is pain therapy just an ethical-behavioral problem?].

Pain is a subjective sensation caused not only by pathological events which trigger signals perceived as algogenic (sensory component), but also by emotional mechanisms and critical assessments which modify its perception, both quantitatively and qualitatively. Therefore pain is an unique and unrepeatable experience resulting from the interaction of these three components. When faced with a patient suffering pain, it is fundamental to establish the respective quantitative incidences of these three components, in order to define the correct therapy of the pain in its totality. Whereas there are numerous therapies for dealing with the sensory component, the same cannot be said of the emotional and critical elements. We therefore suggest a number of guidelines for tackling the problem and for developing therapeutic strategies. In the literature there are few perspective and randomized studies that may evaluate the real effectiveness of the different treatments; it follows that the tested and accepted by scientific community therapeutical protocols are very few. Only recently some studies that intend to evaluate the different therapeutical strategies in connection with the different algesic syndromes are being published in the most important scientific journals.

Acute Disease↗

[Being raised by lesbian parents or in a single-parent family is no risk factor for problem behavior, however being raised as an adopted child is].

Modern reproductive techniques and alternative family structures (with single or homosexual parents and adoption situations) raise questions about the consequences for the growing children involved. Genetic links appear to be less important for the functioning of a family than a strong wish for parenthood; parents who have become parents only through great efforts display a better quality of parenthood than average natural parents. Characteristics of the parent/parents, such as paedagogic qualities, and the quality of the parent-child relationship appear more important than the type of family. Published results of research reveal no reason why lesbian families should be judged differently from heterosexual ones as family types for the raising of children. The main negative factor for the functioning of the child growing up in a single-parent family is the marriage conflicts that have led to the single-parent situation; being raised by a single parent in itself has no adverse effect. Raising adopted children from other countries makes far greater demands on the adoptive parents than parents of biological children have to meet. The raising of a foreign adopted child by a single parent entails additional risks for the child's development. Data on the development of children in alternative family structures frequently concern exceptionally competent parents, which may have biased the findings.

Adoption↗

[Incidence of emotional problems and behavioral difficulties in school and correlation with reading and writing disorders: results of a longitudinal study].

As a part of a longitudinal study on reading development from the 2th to the 8th grade teachers ratings about behavior problems of school children and their emotional situation were assessed. Problems in motivation and concentration were reported most frequent. Comparing children with poor reading and spelling ability to children without deficits in reading and spelling, differences could be found. Poor readers and spellers showed more dissocial and disturbing classroom behavior. Nevertheless, those problems were as persistent as the problems reported for children, who did not show any reading and spelling difficulties, or increasing in nearly the same ratio over time. This results does not support the hypothesis, that behavior problems may occur as a consequence of learning difficulties.

Adolescent↗

Modeling family dynamics in children with fragile x syndrome.

Few studies have examined the impact of children with genetic disorders and their unaffected siblings on family functioning. In this study, the reciprocal causal links between problem behaviors and maternal distress were investigated in 150 families containing a child with fragile X syndrome (FXS) and an unaffected sibling. Both children's behavior problems appeared to have strong, direct effects on maternal distress, but maternal distress did not appear to have any reciprocal causal effects on either child's behavior problems. Surprisingly, there were no significant differences in the effects of the two children's behavior problems on maternal distress. These data suggest that the problem behaviors of children with FXS, as well as their unaffected siblings, can have a substantial and additive impact on maternal depression and anxiety. Future research efforts should employ longitudinal research designs to confirm these findings.

Adult↗

Schedule thinning following communication training: using competing stimuli to enhance tolerance to decrements in reinforcer density.

Functional communication training (FCT) is a widely used treatment for individuals with developmental disabilities who exhibit severe behavior problems. One inherent challenge of employing FCT as a treatment in the community is that reinforcement for appropriate communication cannot always be immediate or even possible in some circumstances. Of the few studies that have incorporated some form of schedule thinning for communication, most have reported disruption of communication or increases in problem behavior when the schedule of reinforcement is thinned. In the current study, we compared FCT with extinction to FCT with extinction and access to competing stimuli. After conducting a functional analysis, a competing stimulus assessment was performed to identify stimuli that produce reinforcement that ostensibly competes with reinforcement that maintains problem behavior. It was hypothesized that FCT with competing stimuli would result in more stable reductions in problem behavior during schedule thinning, which would ultimately result in quicker achievement of the treatment goal (low levels of problem behavior under the terminal reinforcement schedule for communication) than FCT without competing stimuli. Results confirmed this hypothesis.

Adolescent↗

Videotaped assessment of parenting practices: a preliminary report.

Assessment of parenting skills was based upon a standardized videotape of vignettes of parents reading a magazine while their children were playing, playing with their children, or trying to get them to clean up. Parents who viewed this videotape came from 40, 2-parent families referred to an outpatient clinic for behavior problems (Behavior Problem group) or 20 nonreferred 2-parent families (Nonclinic group). They were compared on the degree to which they selected: (1) positive responses to children's prosocial behavior (praise), (2) ignoring children's inappropriate behavior (ignore), and (3) punishing children's aversive behavior (punish). The Nonclinic group was more accurate than the Behavior Problem Group and mothers were more accurate than fathers in their selection of praise to children's prosocial behavior. Nonclinic mothers were more accurate than all other combinations of Group and Parent Sex in their selection of ignore for children's inappropriate behavior. Sensitivity calculations suggested that this instrument could potentially be useful as a screening tool in clinical pediatric practice and early intervention. Implications for nursing research and practice were discussed.

Adult↗

Disruptive behaviors in Veterans Affairs nursing home residents: how different are residents with serious mental illness?

OBJECTIVES: To determine the prevalence and correlates of behavior problems of residents of Veterans Affairs (VA) nursing homes and to compare residents with serious mental illness (SMI) with other resident groups. DESIGN: This study combined cross-sectional resident assessments with administrative data for all residents in VA nursing homes. Multivariate ordinal logistic regression was used to evaluate associations between resident characteristics and problem behaviors. SETTING: Nursing home care units in the VA healthcare system. PARTICIPANTS: A total of 9,618 nursing home residents assessed as part of the VA's April 2001 national resident census. MEASUREMENTS: The Patient Assessment Instrument assessed each resident's verbally disruptive, physically aggressive, and socially inappropriate behaviors in the prior 4 weeks. Functional limitations in eating, mobility, toileting, and transfer were assessed. Diagnoses were evaluated for the stay and up to 6 months before assessment. RESULTS: Almost one-fifth (17.9%) of residents received a diagnosis of SMI. Residents with SMI or dementia had greater behavior problems than residents with neither condition. Residents with SMI (and without dementia) exhibited more verbal disruption than residents with dementia (and without SMI), but the two subgroups did not differ in physically aggressive or socially inappropriate behavior. CONCLUSION: Many VA nursing home residents have SMI. Their level of behavior problems is comparable with that of residents with dementia. Clinical practice and nursing home staff training must encompass geriatric mental health and behavior management to meet the needs of residents with SMI.

Aged↗

Strain experienced by caregivers of dementia patients receiving palliative care: findings from the Palliative Excellence in Alzheimer Care Efforts (PEACE) Program.

BACKGROUND: Programs that provide palliative care to individuals with dementia, which is a progressive terminal illness, are likely to encounter different issues (e.g., management of problem behaviors, caregiver strain extending over years) from those typically addressed by hospice programs. Little research is available on palliative care for individuals with dementia who live in the community. OBJECTIVE: This study examines predictors of types of strain experienced by caregivers of community-dwelling patients with dementia enrolled in a unique demonstration program titled Palliative Excellence in Alzheimer Care Efforts (PEACE), which moved palliative care "upstream," integrating palliative care into the primary care of patients with dementia. DESIGN: Data were collected through structured, face-to-face interviews with 150 community-dwelling, predominantly African American patient-caregiver dyads who were enrolled in the PEACE program. MEASUREMENTS: Established measures, including the Caregiver Strain Index, the Revised Memory and Behavior Problems Checklist, and the Katz Index of Activities of Daily Living, were used in addition to other measures assessing caregiver, patient, and situational characteristics. RESULTS: Factor analysis of the Caregiver Strain Index revealed three dimensions of strain (role, personal, and emotional) related to caregiving. Using a stress process model, regression analyses examined stressors and resources related to patient, caregiver, and support system characteristics in predicting these three dimensions of strain among caregivers. Patient problem behaviors predicted all types of caregiver strain. Perceived lack of support from the health care team predicted personal and emotional strain, whereas higher income, surprisingly, predicted role strain. Patient functional limitations predicted personal and role strain. CONCLUSIONS: Findings suggest that effective palliative care programs for patients with dementia need to understand and address the various sources and types of caregiver strain; provide adequate support to caregivers for the management of problem behaviors; provide counseling to help cope with the emotional reactions to the cognitive and behavioral changes associated with dementia progression; facilitate communication with the health care team; and broker access to community and other resources for assistance with functional limitations. Further research examining changes in strain over time will provide useful insights on the delivery of care and services for patients with dementia and their families in a palliative care framework.

Black or African American↗

Successful behavioral intervention to treat children who are reluctant to ambulate.

The authors report two patients with marginal ambulation skills whose severe behavioral problems prevented participation in physical therapy. The problem behavior also limited the patients' participation in activities of daily living and social interaction. Because of the risks of loss of ambulation to overall health, an aggressive behavioral intervention was implemented to decrease problem behavior and to increase participation in physical therapy. With the use of the behavioral interventions, the authors demonstrated concomitant increases in compliance to requests to ambulate, distances ambulated, and decreases in the rates of self-injury and aggression.

Adolescent↗

Quality of the caregiver--care recipient relationship: does it offset negative consequences of caregiving for family caregivers?

This study examined whether relationship quality mediates, moderates, or both mediates and moderates the associations between caregiving stressors (e.g., disability and behavioral problems) and negative consequences associated with caregiver well-being (overload, role captivity, and depression). Data on family (spouses and children) caregivers (n = 118) came from a longitudinal study of a representative sample of disabled older people and their primary caregivers. Relationship quality mediated the linkages between the presence of problem behaviors and the outcomes of role captivity and depression. That is, when problem behaviors were present, they related to higher levels of captivity and depression because quality of the relationship suffered. Relationship quality moderated the linkage between disability and overload. Specifically, for those with a higher quality of relationship, increased disability was related to higher levels of perceived overload.

Adult↗

Judicial involvement and conduct problems of fathers of infants born to adolescent mothers.

Data were obtained from retrospective review of 191 patient records to determine the extent and types of conduct problems among fathers of infants born to adolescent mothers. Ninety-eight fathers (51%) reported having committed a legal offense prior to the pregnancy. This rate appears substantially greater than rates of arrests of adolescents in the general population. When paired data for couples were analyzed, there was great similarity for severity of offense. Fathers, however, had committed more severe crimes than their partners. Male offenders came from families of lower socioeconomic status backgrounds and more single-parent families and were less frequently employed or in school (or graduated) than nonoffenders. They also had been more involved with various other problem behaviors, such as a previous pregnancy, drinking behavior, and behavior problems at school. There was a clustering of problem behaviors among offenders suggesting psychosocial maladjustment prior to the pregnancy. Our results suggest an association between fatherhood and delinquency among partners of adolescent mothers. It appears that these fathers form a heterogeneous group. Although some young fathers may be well adjusted, others have significant psychologic problems.

Adolescent↗

The effects of duration of caregiving on institutionalization.

PURPOSE: Our objective in this analysis was to determine how the duration of caregiving interacts with key care demands (i.e., severity of problem behaviors) to influence the institutionalization of individuals suffering from dementia. METHODS: We utilized multiregional data from 4,761 caregivers of individuals with dementia over a 3-year period. We conducted multinomial logistic and Cox proportional hazards analyses to determine the moderating effects of duration on behavior problems when institutionalization was predicted. Baseline covariates included the context of care, primary objective stressors, primary subjective stressors, resources, and global outcomes. RESULTS: The Duration of care x Behavior problems interaction term was not significant in the multinomial regression or Cox hazards models. However, main effects models demonstrated that more recent caregivers were more likely to institutionalize individuals with dementia than respondents in different stages of the caregiving career. IMPLICATIONS: The results emphasize the need to (a) broaden scientific conceptualizations to consider duration of care as integral; (b) refine targeting when interventions are administered early in the dementia caregiving process; and (c) understand patterns of attrition when caregiver adaptation is modeled over time.

Dementia↗

Is short stature a handicap? A comparison of the psychosocial functioning of referred and nonreferred children with normal short stature and children with normal stature.

OBJECTIVES: Normal short stature (NSS), defined as height below the 5th percentile for age and sex norms that is not due to illness, hormonal deficiency, or part of a dysmorphic syndrome, has been thought to have a deleterious effect on psychosocial functioning based on observations of referred populations. Recent studies of nonreferred children with NSS, however, have demonstrated normal function. This study directly compared the psychosocial functioning of referred children with NSS, nonreferred children with NSS, and children with normal stature. STUDY DESIGN: Participants, 90 children (46 boys, 44 girls) between 6 and 12 years of age (mean, 9. 6 years), were administered intelligence and achievement tests. Parents and teachers assessed adaptive and problem behaviors. Family adaptability and cohesiveness were measured. RESULTS: Intelligence and achievement for referred and nonreferred children with NSS were average. Referred children with NSS were reported to have more externalizing behavior problems and poorer social skills than nonreferred children with NSS and children in the control group. Family adaptability and cohesiveness were comparable across groups. CONCLUSIONS: Children with NSS have normal psychosocial function, and results suggest that externalizing behavior problems, attention problems, and poor social skills in children referred to clinics for NSS are inappropriately attributed to short stature.

Achievement↗

Longitudinal relations between parenting and child adjustment in young children.

We studied the predictive relations between reports of parenting behavior on the one hand and academic achievement and reported behavior problems of young children on the other hand. Data were gathered for 352 children and their parents from kindergarten to 2nd grade. The results indicated that in the academic domain, low supportive and high controlling parenting practices were modestly related to poor subsequent math achievement. Children's externalizing and attention problem behavior was clearly predictive of high levels of control in mothers and low levels of support in fathers. The combination of high parental support and control was especially associated with high levels of problem behavior. However, when previous parenting and child adjustment were taken into account, the magnitude of the predictive power of parenting for child adjustment, and of child adjustment for parenting, remained limited.

Adult↗

An evaluation of the effects of INSIGHTS on the behavior of inner city primary school children.

A prevention trial was conducted to evaluate a temperament-based intervention (INSIGHTS into Children's Temperament) as compared to a Read Aloud attention control condition in reducing behavior problems among inner city children. The participants were 148 inner-city first and second grade children, their parents, and their 46 teachers who were from six schools in a Northeastern city. Parents were interviewed on the Parent Daily Report at baseline and every two weeks until the completion of the intervention phase to assess the extent of child problem behaviors in the home. The parents also were interviewed at baseline with the Disruptive Module of the Diagnostic Interview for Children and completed the Brief Symptom Index to assess parental depression.A repeated measures multivariate analysis of covariance with parental depression as a covariate was conducted to examine the children's behavior over the course of the intervention. In order to test the impact of INSIGHTS for the overall sample and to determine whether the intervention was differentially effective for children diagnosed with a disruptive disorder versus those who did not receive a diagnosis, two and three-way interactions were examined and found to be significant. The INSIGHTS intervention was more effective than Read Aloud in reducing children's problem behaviors at home across both the diagnosed and non-diagnosed groups, but demonstrated a significantly greater efficacy among children who were at diagnostic levels compared to those who were within normal levels. Editors' Strategic Implications: The authors describe the promising practice of instructing parents and teachers on how to adapt their behavior management strategies to fit each child's temperament. Replication with a longitudinal follow-up will be necessary to determine whether program effects persist.

Child↗