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[Assessment of psychosocial functioning in multiple sclerosis: psychometric characteristics of four self-report measures].

Major and subsyndromic depression are highly prevalent in multiple sclerosis(MS). Assessment of psychosocial functioning in MS requires sound psychometric instruments. Self-report measures offer several advantages, but a valid and reliable depression self-report diagnostic measure is lacking. Beck Depression Inventory (BDI) and General Health Questionnaire (GHQ) have been validated and widely used in Brazilian neuropsychological context. BDI use in MS may confound depressive symptoms with somatic disease manifestations. We examined the psychometric properties of the BDI, QSG and two additional self-report measures of fatigue (CPF-MS) and self-efficacy (MSSE). All scales presented excellent reliability coefficients. BDI and GHG discriminated MS from control participants. Intercorrelations were observed between depression, general mental health, fatigue and self-efficacy scores, but not between these and traditional indices of neurological impairment such as AI and EDSS. Depressive symptoms and fatigue may represent a different dimension of neurological impairment, unrelated to sensory and motor deficits. Self-report scales are useful in diagnosing subsyndromic distress symptoms in a MS sample.

Adaptation, Psychological↗

Thought disorder and psychosocial functioning in schizophrenia: the concurrent and predictive relationships.

Recent findings have linked impairments in social performance among individuals with schizophrenia to deficits in cognition. However, one component of cognition, thought disorder (TD), has received little attention in its association with social functioning. The current investigation examined the cross-sectional and predictive relationships between bizarre-idiosyncratic thought and psychosocial functioning throughout the early course of schizophrenia and compared these relationships to those observed among individuals with affective disorders (i.e., bipolar disorder, manic type, and major depression without psychotic features). Participants were assessed on TD, work, and social functioning using standardized procedures across three follow-ups over an 8-year period. The cross-sectional relationships between TD and impairment in work performance were generally significant. TD also significantly predicted subsequent work functioning years later. Less support was found for the relationship between TD and social functioning. Finally, the relationship between TD and work performance appeared to be more consistent over time for the subjects with schizophrenia compared to those with affective disorders. The results suggest that techniques which minimize TD may have implications for occupational functioning among persons with chronic psychiatric disorders.

Adaptation, Psychological↗

Religiousness, spirituality, and psychosocial functioning in late adulthood: findings from a longitudinal study.

This study used longitudinal data to examine the relations among religiousness, spirituality, and 3 key domains of psychosocial functioning in late adulthood: (a) sources of well-being, (b) involvement in tasks of everyday life, and (c) generativity and wisdom. Religiousness and spirituality were operationalized as distinct but overlapping dimensions of individual difference. In late adulthood, religiousness was positively related to well-being from positive relations with others, involvement in social and community life tasks, and generativity. Spirituality was positively related to well-being from personal growth, involvement in creative and knowledge-building life tasks, and wisdom. Neither religiousness nor spirituality was associated with narcissism. The relations between religiousness, spirituality, and outcomes in late adulthood were also observed using religiousness scored in early and spirituality scored in late middle adulthood. All analyses were controlled for gender, cohort, social class, and the overlap between religiousness and spirituality.

Activities of Daily Living↗

The relation between pain beliefs, negative thoughts, and psychosocial functioning in chronic pain patients.

Cognitions and beliefs appear important in predicting adjustment to chronic pain. The current study examines how cognitions and beliefs are related to psychosocial functioning. One hundred and sixty-three chronic pain out-patients were assessed. Regression analyses were performed using scores on the Pain Beliefs and Perceptions Inventory and the Inventory of Negative Thoughts in Response to Pain as predictor variables and responses to the West Haven Yale Multidimensional Pain Inventory as criterion variables. Pain cognitions and pain beliefs were correlated. After controlling for demographics, employment status and pain severity, pain beliefs and cognitions accounted for a significant amount of the variance in general activity, pain interference, and affective distress. Negative cognitions, particularly negative self-statements, were more predictive of outcome than pain beliefs. Although these data are correlational, they provide additional support for a biopsychosocial model of adjustment to chronic pain.

Adaptation, Psychological↗

Attachment, Friendship, and Psychosocial Functioning in Early Adolescence.

Fifth-graders' (N = 162; 93 girls) relationships with parents and friends were examined with respect to their main and interactive effects on psychosocial functioning. Participants reported on parental support, the quality of their best friendships, self-worth, and perceptions of social competence. Peers reported on aggression, shyness and withdrawal, and rejection and victimization. Mothers reported on psychological adjustment. Perceived parental support and friendship quality predicted higher global self-worth and social competence and less internalizing problems. Perceived parental support predicted fewer externalizing problems, and paternal (not maternal) support predicted lower rejection and victimization. Friendship quality predicted lower rejection and victimization for only girls. Having a supportive mother protected boys from the effects of low-quality friendships on their perceived social competence. High friendship quality buffered the effects of low maternal support on girls' internalizing difficulties.

Journal Article↗

Variations in internet-related problems and psychosocial functioning in online sexual activities: implications for social and sexual development of young adults.

This survey of 760 university students examined differences in Internet-related problems and psychosocial functioning between four patterns of participation in online sexual information and entertainment activities. Students who did not participate in either online sexual activity were more satisfied with their offline life and more connected to friends and family. Those who engaged in both online sexual activities were more dependent on the Internet and reported lower offline functioning. Students who only sought sexual information maintained strong offline affiliations. Those who only sought entertainment did not report lower offline functioning. Respondents most deficient in offline social support did not report compensatory online support. Despite students' common participation in online sexual activities (OSA) as a venue for social and sexual development, those relying on the Internet and the affiliations it provides appear at risk of decreased social integration. The authors discussed the finding's implications for social and sexual development.

Adult↗

Postmastectomy reconstruction: comparative analysis of the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous flap versus breast implant reconstruction.

Over 40,000 postmastectomy breast reconstructions are performed annually. In this study, we investigated the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous (TRAM) flap versus breast implant reconstruction. Thirty-three women who had undergone postmastectomy breast reconstruction were contacted by telephone and agreed to participate in the study. Twenty-two women completed the self-assessment questionnaires regarding their quality of life, psychological symptoms, functional status, body image, and global satisfaction. The TRAM and implant groups contained 8 and 14 patients, respectively. The groups were well matched for age, employment status, marital status, race, religion, and severity of medical and surgical illnesses. The average follow-up was 36 months. Statistical analysis of the responses revealed that women who had undergone TRAM flap reconstruction were more satisfied with how their reconstructed breast felt to the touch (p = .01), and there was a trend toward greater satisfaction with the appearance of their reconstructed breast (p = .08). However, these same patients identified more difficulties as far as functioning at work or school, performing vigorous physical activities, participating in community or religious activities, visiting with relatives, and interacting with male friends (p < .04). There were no statistically significant differences in body image or overall satisfaction. In this small cohort study, both the TRAM flap group and the implant group were satisfied with the results of their breast reconstruction, but the TRAM flap group was more satisfied with how their breast felt and tended to be more satisfied with the cosmetic result. The TRAM flap group reported greater psychological, social, and physical impairments as a result of their reconstruction.

Adult↗

Emotional responsivity during daily life: relationship to psychosocial functioning and ambulatory blood pressure.

Emotional responsivity refers to acute changes in affective states. This study examined the relationship of emotional responsivity during daily life with ambulatory blood pressure (ABP) and psychosocial functioning. Subjects were 162 employed men and women, aged 25-45 years. Subjects underwent 24-h ABP monitoring in which they completed a behavioral diary with each cuff inflation. On a separate day, subjects completed a psychometric test battery including measures of depression, trait anxiety, and social support. Emotional Responsivity, an index of negative emotional variability during waking hours, was operationalized as the standard deviation of each individual's negative emotions scores throughout the day. Individuals with high levels of emotional responsivity showed greater increases in ABP and heart rate (HR) associated with negative emotions. Emotionally responsive individuals also reported less satisfaction with social support and higher levels of perceived daily stress, trait anxiety, and depressive symptoms. These findings suggest that psychosocial traits that have been linked to cardiovascular disease may be associated with more marked cardiovascular activation occurring in response to negative emotions experienced throughout the day.

Activities of Daily Living↗

Psychosocial functioning in children and young adults with juvenile arthritis.

A questionnaire survey of 363 children and young adults with juvenile arthritis was conducted to assess the relations among disease severity, psychosocial functioning, and adjustment in three age groups--primary school, high school, and young adult. Parents were surveyed separately to determine which characteristics of the ill child at different ages most significantly impact the well-being of the family. Indices of psychologic functioning and disease severity were associated with adjustment in the primary school and high school groups, whereas measures of social relationships were strongly associated with adjustment only in the high school group. Relations among measures of psychologic functioning, social relationships, disease severity, and adjustment in young adults were minimal. Level of disease severity was associated with the presence of financial concerns, emotional problems, and physical strain in parents of high school children and young adults. The results emphasize the importance of using a developmental model for understanding the adjustment of individuals with chronic juvenile arthritis and their families.

Adaptation, Psychological↗

Psychosocial functioning, self-perception and body image and their auxologic correlates in growth hormone and oestrogen-treated young adult women with Turner syndrome.

BACKGROUND: Few data are available on the psychosocial status of growth hormone (GH) and oestrogen treated women with Turner syndrome (TS). In this study, we evaluated psychosocial functioning, self-concept and body image in GH and oestrogen treated young adult women with TS and we studied the relationship with auxological parameters. PATIENTS AND METHODS: Thirty women with TS (mean +/- SD age: 22.1 +/- 2.4 years), all treated with GH and oestrogens if indicated, and an age-matched reference group of 44 non-Turner female students (age: 20.5 +/- 2.1 years) completed 3 questionnaires evaluating, respectively, behavioural and emotional problems (Young Adult Self Report), self-concept (Self Perception Profile for College Students) and body-image (Body Attitude Scale). RESULTS: TS patients did not report more behavioural and emotional problems compared to the non-TS females except for attention problems; they even reported fewer problems on some subscales (somatic complaints, thought problems, delinquent behaviour). TS patients did not differ from the non-TS female group in their bodily satisfaction. TS patients, particularly patients with a 45,X karyotype, perceived themselves as less socially competent. BMI was significantly related to the appraisal score of the Body Attitude Scale, whereas height was not related to any of the evaluated psychosocial parameters. CONCLUSION: The psychosocial adaptation of young adult women with TS, diagnosed at an early age and treated during childhood with GH and oestrogens if indicated, appears to be quite satisfactory. Follow-up of adult TS patients should not neglect the problem of overweight and associated psychosocial consequences.

Adolescent↗

Psychosocial functioning on the Independent Living Skills Survey in older outpatients with schizophrenia.

Improving real-life community functioning in patients with severe mental illness has been an important recent focus of treatment outcome research. Few studies, however, have examined psychosocial functioning in older psychotic patients. The Independent Living Skills Survey (ILSS) is a measure of the basic functional living skills of individuals with severe and persistent mental illness. The self-report version of the ILSS was administered to 57 middle-aged and older community dwelling outpatients with schizophrenia and 40 age-comparable nonpsychiatric participants. Regardless of whether patients resided in assisted living or independent settings, they showed significantly impaired functioning on a majority of the functional areas assessed by the ILSS. No consistent relationship was found between symptom severity and functioning. With certain modifications, the ILSS appears to be a sensitive indicator of functional impairment in this older sample of community-dwelling outpatients with schizophrenia. Information provided by the instrument might be useful to guide rehabilitation efforts and measure functioning changes in response to treatment in this population.

Activities of Daily Living↗

Psychosocial functioning of adolescents with and without paediatric bipolar disorder.

BACKGROUND: While there has been a growing interest in the presentation of Bipolar Disorder (BD) in children and adolescents, few studies have investigated the psychosocial functioning of these individuals and its relationship to trauma and suicidal ideation. METHODS: 63 adolescents aged 13-17 participated: 39 controls and 24 with Bipolar Disorder (BD). Group allocation and histories of trauma and suicidal ideation were obtained using the K-SADS-PL and WASH-U-KSADS. Adolescents completed questionnaires covering negative life events, self-esteem, hopelessness, regulation of anger, locus of control and coping. RESULTS: More traumatic events and negative life experiences were reported by the BD group with over 50% of the BD sample indicating a history of trauma compared with 10% of the controls. The BD group reported lower self-esteem, more hopelessness, more negative life events, a more external locus of control and greater difficulties regulating emotion in anger-provoking situations. They were also found to have poorer coping strategies than the controls. Histories of trauma did not differentiate those with and without psychosocial problems. Further, hopelessness was found to be the best predictor of those BD adolescents reporting suicidal ideation. Comorbidity could not account for the differences found. LIMITATIONS: The sample was small and therefore disallowed comparisons among subtypes of BD. Cross-sectional design limited the ability to investigate causal relationships. CONCLUSIONS: This is the first study to document the widespread psychosocial difficulties facing youth with BD, highlighting these issues as important ones to explore during assessment and treatment, particularly in management of affective storms and suicidal risk.

Adaptation, Psychological↗

Mild mental retardation: psychosocial functioning in adulthood.

BACKGROUND: Evidence on the adult adaptation of individuals with mild mental retardation (MMR) is sparse, and knowledge of the factors associated with more and less successful functioning in MMR samples yet more limited. METHOD: Prospective data from the National Child Development Study were used to examine social circumstances and psychosocial functioning in adulthood in individuals with MMR and in a non-retarded comparison group. RESULTS: For many individuals with MMR, living circumstances and social conditions in adulthood were poor and potential stressors high. Self-reports of psychological distress in adulthood were markedly elevated, but relative rates of psychiatric service use fell between childhood and adulthood, as reflected in attributable risks. Childhood family and social disadvantage accounted for some 20-30% of variations between MMR and non-retarded samples on a range of adult outcomes. Early social adversity also played a significant role in contributing to variations in functioning within the MMR sample. CONCLUSIONS: MMR appears to be associated with substantial continuing impairment for many individuals.

Adaptation, Psychological↗

Changes in physical and psychosocial functioning among adolescents with chronic kidney disease.

Little research has been published assessing changes in the functional health status of children and adolescents with chronic kidney disease (CKD). We know little about which clinical parameters influence functional status or health-related quality of life in these young people. In a prospective study using data from semi-annual visits over a 4-year period from 78 adolescents with CKD aged 11 years to 18 years, we detail the impact of several clinical measures (i.e., kidney function, albumin, hematocrit, height) on short-term changes in health-related quality of life. The 50-item Child Health Questionnaire Parent Form, a validated health-related quality of life measure in children, was used to obtain physical and psychosocial functioning summary scores at each visit. After adjustment for the variables mentioned above, the physical summary score on the Child Health Questionnaire (CHQ) declined as glomerular filtration rate declined. Increasing height was associated with a positive change in physical and psychosocial summary scores. We conclude that decline in kidney function is associated with a subsequent decline in health-related quality of life, particularly in terms of physical activity.

Activities of Daily Living↗

Adolescent body image and psychosocial functioning.

Researchers have highlighted the significance of a poor body image in the development of dysfunctional eating but have systematically investigated few other outcomes. The authors examined the relationships between different aspects of body image and psychosocial functioning. Participants were 245 boys and 173 girls from Grades 8 and 9 (M age = 13.92 years, SD = 0.69 years). Respondents completed measures of physical attractiveness, body satisfaction, body image importance, body image behaviors, appearance comparison, social physique anxiety, self-esteem, depression, anxiety, and same-sex and opposite-sex relations. Whereas girls tended to report a more negative body image than did boys, the relevance of body image to self-esteem was similar for boys and girls. Concern about others' evaluation of their bodies was especially important in understanding low female self-esteem, whereas for boys, ratings of general attractiveness most strongly predicted self-esteem. The authors found a negative body image to be unrelated to symptoms of negative affect but to be strongly associated with poor opposite-sex peer relationships, especially among boys. A negative body image also affected same-sex relations among girls.

Adaptation, Psychological↗

Coping and psychosocial function after brain injury.

A total of 74 brain-injured patients and 46 non-neurological matched controls consecutively admitted to a specialist medical rehabilitation unit were administered the 'Ways of Coping' checklist and the 'Headley Court psychosocial rating scale'. The relatives of all participants were sent the psychosocial rating scale. An analysis of the 'Ways of Coping' checklist showed the brain-injured patients used four strategies for coping, namely problem-focused, emotion-focused, avoidance, and wishful thinking. Correlations between these four factors and the responses on the 'Headley Court psychosocial rating scale' showed that less use of emotion-focused, avoidance, and wishful thinking coping strategies predicts better psychosocial functioning in the brain-injured group, a result similar to those reported for a wide variety of other health problems. The implications for treatment and management are discussed.

Activities of Daily Living↗

Body-image attitudes and psychosocial functioning in Euro-American and Asian-American college women.

Euro-American (n = 94) and Asian-American (n = 72) college women were compared on multiple dimensions of body image, including global body satisfaction, preoccupation with appearance, satisfaction with individual body parts or features, and weight concern, and psychosocial functioning, including self-esteem, public self-consciousness, social anxiety, and public body consciousness. Both groups reported similar scores on these variables and showed similar patterns of correlations between body-image and psychosocial variables. Despite similar global body satisfaction, there were group differences in satisfaction with individual body parts or features, with Asian-American women reporting lower satisfaction with six parts or features and higher satisfaction with one feature. Stepwise multiple regression analyses predicting global body satisfaction from individual body parts or features suggested that both the specific body parts or features most salient to global body satisfaction and the relative influence of these parts or features varied as a function of ethnicity. Implications of these findings for research and practice are discussed.

Adult↗

Consequences of worksite hypertension screening. Differential changes in psychosocial function.

To evaluate reports of psychosocial dysfunction after worksite screening, a three-stage blood pressure screening was performed using standardized screening and labeling procedures. Of a heterogeneous group of 5,888 workers, 296 with sustained hypertension were identified and randomly assigned to traditional arousal or reassurance debriefings, matching each hypertensive subject with one to three normotensive control subjects on eight sociodemographic and occupational variables. Subjects exhibiting absenteeism increases or persistent hypertension six months after screening were randomly assigned to worksite health education programs or no intervention. After adjustment for values among matched control subjects, previously unaware hypertensive subjects had significant post-screening decreases in anxiety that were significantly associated with specific worksites and with reassurance rather than traditional debriefing (p less than 0.05). The health education program did not significantly affect anxiety, blood pressure, or absenteeism. Increased absenteeism was associated with higher baseline anxiety levels (p less than 0.05). It is concluded that worksite hypertension screening produces minimal adverse psychosocial changes, reassurance debriefing may be beneficial, and unspecified worksite characteristics may determine consequences of similar preventive medicine efforts.

Absenteeism↗