Sample records for improving psychosocial functioning

  1. The Prospective Relationships Among Intrinsic Motivation, Neurocognition, and Psychosocial Functioning in Schizophrenia

    PubMed Central

    Nakagami, Eri; Hoe, Maanse; Brekke, John S.

    2010-01-01

    To address significant gaps in our understanding about how neurocognition, intrinsic motivation (IM), and psychosocial functioning are interrelated in schizophrenia, this study investigated the following questions: Is IM stable or dynamic over time? Does neurocognition predict change in IM over time? What is the association between change in neurocognition, change in IM, and change in psychosocial functioning? Finally, what is the causal structure of the relationships among neurocognition, IM, and psychosocial functioning over time? One hundred and thirty individuals diagnosed with schizophrenia or schizoaffective disorder were recruited from 4 community-based psychosocial rehabilitation programs in urban Los Angeles. Measures of neurocognition were taken at baseline and 12 months. Measures of IM, psychosocial functioning, and symptoms were taken at baseline, 6, and 12 months. Results of latent growth curve modeling analyses demonstrated that IM is dynamic over time. Baseline neurocognition was associated with the initial level of IM but did not predict the rate of change in motivation. However, baseline levels of IM predicted rates of subsequent improvement in neurocognition. Change in IM was strongly associated with change in psychosocial functioning, and change in neurocognition was associated with change in psychosocial functioning, but change in IM was not associated with change in neurocognition. Latent difference score analyses revealed that neurocognition caused changes in psychosocial functioning, and psychosocial functioning caused changes in IM. These findings improve our fundamental understanding of the relationships among these variables and contribute to intervention development for improving outcomes in schizophrenia. PMID:20462998

  2. Improvement in cognitive and psychosocial functioning and self image among adolescent inpatient suicide attempters.

    PubMed

    Hintikka, Ulla; Marttunen, Mauri; Pelkonen, Mirjami; Laukkanen, Eila; Viinamäki, Heimo; Lehtonen, Johannes

    2006-12-29

    Psychiatric treatment of suicidal youths is often difficult and non-compliance in treatment is a significant problem. This prospective study compared characteristics and changes in cognitive functioning, self image and psychosocial functioning among 13 to 18 year-old adolescent psychiatric inpatients with suicide attempts (n = 16) and with no suicidality (n = 39) The two-group pre-post test prospective study design included assessments by a psychiatrist, a psychologist and medical staff members as well as self-rated measures. DSM-III-R diagnoses were assigned using the SCID and thereafter transformed to DSM-IV diagnoses. Staff members assessed psychosocial functioning using the Global Assessment Scale (GAS). Cognitive performance was assessed using the Wechsler Adult Intelligence Scale, while the Offer Self-Image Questionnaire (OSIQ) was used to assess the subjects' self-image. ANCOVA with repeated measures was used to test changes from entry to discharge among the suicide attempters and non suicidal patients. Logistic regression modeling was used to assess variables associated with an improvement of 10 points or more in the GAS score. Among suicide attempter patients, psychosocial functioning, cognitive performance and both the psychological self and body-image improved during treatment and their treatment compliance and outcome were as good as that of the non-suicidal patients. Suicidal ideation and hopelessness declined, and psychosocial functioning improved. Changes in verbal cognitive performance were more pronounced among the suicide attempters. Having an improved body-image associated with a higher probability of improvement in psychosocial functioning while higher GAS score at entry was associated with lower probability of functional improvement in both patient groups. These findings illustrate that a multimodal treatment program seems to improve psychosocial functioning and self-image among severely disordered suicidal adolescent inpatients. There were no changes in familial relationships, possibly indicating a need for more intensive family interventions when treating suicidal youths. Multimodal inpatient treatment including an individual therapeutic relationship seems recommendable for severely impaired psychiatric inpatients tailored to the suicidal adolescent's needs.

  3. Do psychosocial interventions improve rehabilitation outcomes after anterior cruciate ligament reconstruction? A systematic review.

    PubMed

    Coronado, Rogelio A; Bird, Mackenzie L; Van Hoy, Erin E; Huston, Laura J; Spindler, Kurt P; Archer, Kristin R

    2018-03-01

    To examine the role of psychosocial interventions in improving patient-reported clinical outcomes, including return to sport/activity, and intermediary psychosocial factors after anterior cruciate ligament reconstruction. MEDLINE/PubMed, CINAHL, PsycINFO, and Web of Science were searched from each database's inception to March 2017 for published studies in patients after anterior cruciate ligament reconstruction. Studies were included if they reported on the effects of a postoperative psychosocial intervention on a patient-reported clinical measure of disability, function, pain, quality of life, return to sport/activity, or intermediary psychosocial factor. Data were extracted using a standardized form and summary effects from each article were compiled. The methodological quality of randomized trials was assessed using the Physiotherapy Evidence Database Scale and scores greater than 5/10 were considered high quality. A total of 893 articles were identified from the literature search. Of these, four randomized trials ( N = 210) met inclusion criteria. The four articles examined guided imagery and relaxation, coping modeling, and visual imagery as postoperative psychosocial interventions. Methodological quality scores of the studies ranged from 5 to 9. There were inconsistent findings for the additive benefit of psychosocial interventions for improving postoperative function, pain, or self-efficacy and limited evidence for improving postoperative quality of life, anxiety, or fear of reinjury. No study examined the effects of psychosocial interventions on return to sport/activity. Overall, there is limited evidence on the efficacy of postoperative psychosocial interventions for improving functional recovery after anterior cruciate ligament reconstruction.

  4. The Effects of "VelaMente?!" Project on Social Functioning of People With Severe Psychosocial Disabilities.

    PubMed

    Sancassiani, Federica; Lorrai, Stefano; Cossu, Giulia; Cocco, Alessio; Trincas, Giuseppina; Floris, Francesca; Mellino, Gisa; Machado, Sergio; Nardi, Antonio Egidio; Fabrici, Elisabetta Pascolo; Preti, Antonio; Carta, Mauro Giovanni

    2017-01-01

    Physical activity helps to improve several clinical outcomes of people with severe psychosocial disabilities. The aims of this study were; 1) to assess the efficacy of a psychosocial rehabilitative intervention focused on sailing in a crew on: a) social functioning; b) severity of the psychosocial disability; c) general functioning; d) dysregulation of biorhythms of people with severe psychosocial disabilities, and 2) to evaluate the attenders' satisfaction about the project. A randomized waitlist controlled trial with parallel groups was carried out involving 51 people with severe psychosocial disabilities. The intervention was a 3 months-lasting course to learn sailing in a crew. Just after the randomization, a group began the sailing course and the other group (wait list) attended the sailing course after 3 months of treatments as usual. Before and after the sailing course, as well as the waiting list period, all attenders were assessed by HoNOS, GAF, CGI-S and BRIAN. At the end of the sailing course, they completed also a self-report satisfaction questionnaire. Social functioning significantly improved after the sailing course (HoNOS total score "time X group": p=0.011), mainly because of the improvement of psychopathological symptoms (HoNOS symptoms score "time X group": p=0.003). Furthermore, participants greatly appreciated the rehabilitative program based on sailing in a crew. When compared to more traditional rehabilitative activities that are usually carried out in mental health services, a psychosocial rehabilitative intervention based on sailing in a crew significantly improve the social functioning of people with severe psychosocial disabilities.

  5. Cognitive Rehabilitation for Bipolar Disorder: An Open Trial for Employed Patients with Residual Depressive Symptoms

    PubMed Central

    Deckersbach, Thilo; Nierenberg, Andrew A.; Kessler, Ronald; Lund, Hannah G.; Ametrano, Rebecca M.; Sachs, Gary; Rauch, Scott L.; Dougherty, Darin

    2009-01-01

    Introduction Bipolar Disorder is characterized by recurrent episodes of depression and/or mania along with interepisodic mood symptoms that interfere with psychosocial functioning. Despite periods of symptomatic recovery, individuals with bipolar disorder often continue to experience impairments in psychosocial functioning, particularly occupational functioning. Two determinants of psychosocial functioning of euthymic (neither fully depressed nor manic) individuals with bipolar disorder are residual depressive symptoms and cognitive impairment (i.e. difficulties with executive functioning, attention and memory). Aims The present study explored whether a new cognitive remediation (CR) treatment designed to treat residual depressive symptoms and, for the first time to the best of our knowledge, address cognitive impairment would be associated with improvement in psychosocial functioning in individuals with bipolar disorder. Following a neuropsychological and clinical assessment 18 individuals with DSM-IV bipolar disorder were treated with 14 individual sessions of CR. Results Results indicated that at the end of treatment, as well as at the 3-months follow-up, patients showed lower residual depressive symptoms, and increased occupational, as well as overall psychosocial functioning. Pre-treatment neuropsychological impairment predicted treatment response. Improvements in executive functioning were associated with improvements in occupational functioning. Conclusions These findings suggest that treating residual depressive symptoms and cognitive impairment may be an avenue to improving occupational and overall functioning in individuals with bipolar disorder. PMID:19895584

  6. Psychosocial impairment in DSM-5 intermittent explosive disorder.

    PubMed

    Rynar, Lauren; Coccaro, Emil F

    2018-03-30

    The purpose of this study was to document the functional severity of DSM-5 IED in a clinical research sample. IED and control groups were compared on psychosocial functioning, life satisfaction, and on a variety of cognitive and behavioral issues. IED study participants reported significantly worse psychosocial function, quality of life, and higher job dysfunction than both psychiatric and healthy control study participants. The presence of DSM-5 IED is associated with significant psychosocial and functional impairment. Early intervention may aid in minimizing the consequences of impulsive aggressive behavior, and improving psychosocial functioning and quality of life. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Contours of a causal feedback mechanism between adaptive personality and psychosocial function in patients with personality disorders: a secondary analysis from a randomized clinical trial.

    PubMed

    Klungsøyr, Ole; Antonsen, Bjørnar; Wilberg, Theresa

    2017-06-05

    Patients with personality disorders commonly exhibit impairment in psychosocial function that persists over time even with diagnostic remission. Further causal knowledge may help to identify and assess factors with a potential to alleviate this impairment. Psychosocial function is associated with personality functioning which describes personality disorder severity in DSM-5 (section III) and which can reportedly be improved by therapy. The reciprocal association between personality functioning and psychosocial function was assessed, in 113 patients with different personality disorders, in a secondary longitudinal analysis of data from a randomized clinical trial, over six years. Personality functioning was represented by three domains of the Severity Indices of Personality Problems: Relational Capacity, Identity Integration, and Self-control. Psychosocial function was measured by Global Assessment of Functioning. The marginal structural model was used for estimation of causal effects of the three personality functioning domains on psychosocial function, and vice versa. The attractiveness of this model lies in the ability to assess an effect of a time - varying exposure on an outcome, while adjusting for time - varying confounding. Strong causal effects were found. A hypothetical intervention to increase Relational Capacity by one standard deviation, both at one and two time-points prior to assessment of psychosocial function, would increase psychosocial function by 3.5 standard deviations (95% CI: 2.0, 4.96). Significant effects of Identity Integration and Self-control on psychosocial function, and from psychosocial function on all three domains of personality functioning, although weaker, were also found. This study indicates that persistent impairment in psychosocial function can be addressed through a causal pathway of personality functioning, with interventions of at least 18 months duration.

  8. Impact of psychosocial factors on functional improvement in Latino older adults after Tai Chi exercise.

    PubMed

    Siu, Ka-Chun; Rajaram, Shireen S; Padilla, Carolina

    2015-01-01

    Increasing evidence underscores the health benefits of Tai Chi (TC), although there is limited evidence of benefits among racial and ethnic minorities. This study investigated the impact of psychosocial status on balance among 23 Latino seniors after a twice-a-week, 12-week TC exercise program. Functional status was measured at baseline, immediately after, and three months following the TC exercise program, using the Timed Up and Go Test and Tinetti Falls Efficacy Scale. Psychosocial status was measured at baseline by the Center for Epidemiologic Studies Depression Scale and Norbeck Social Support Questionnaire. Both measures of functional status improved and were sustained after three months of TC. Greater improvement was significantly related to a higher level of baseline social support. More depressed seniors reported less fear of falling after TC. Depression and social support are important moderators of functional improvement after TC among Latino seniors.

  9. Psychosocial functioning in pediatric heart transplant recipients and their families.

    PubMed

    Cousino, Melissa K; Schumacher, Kurt R; Rea, Kelly E; Eder, Sally; Zamberlan, Mary; Jordan, Jessica; Fredericks, Emily M

    2018-03-01

    Across pediatric organ transplant populations, patient and family psychosocial functioning is associated with important health-related outcomes. Research has suggested that pediatric heart transplant recipients and their families are at increased risk for adverse psychosocial outcomes; however, recent investigation of psychosocial functioning in this population is lacking. This study aimed to provide a contemporary characterization of psychosocial functioning in pediatric heart transplant recipients and their families. Associations between psychosocial function, demographic variables, and transplant-related variables were investigated. Fifty-six parents/guardians of pediatric heart transplant recipients completed a comprehensive psychosocial screening measure during transplant follow-up clinic visits. Descriptive statistics, correlational analyses, and independent samples t tests were performed. Forty percent of pediatric heart transplant recipients and their families endorsed clinically meaningful levels of total psychosocial risk. One-third of patients presented with clinically significant psychological problems per parent report. Psychosocial risk was unassociated with demographic or transplant-related factors. Despite notable improvements in the survival of pediatric heart transplant recipients over the past decade, patients and families present with sustained psychosocial risks well beyond the immediate post-transplant period, necessitating mental health intervention to mitigate adverse impact on health-related outcomes. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. [Psychosocial interventions in dementia].

    PubMed

    Kurz, A

    2013-01-01

    Psychosocial interventions improve cognitive abilities (cognitive stimulation, cognitive training), enhance emotional well-being (activity planning, reminiscence), reduce behavioral symptoms (aromatherapy, music therapy) and promote everyday functioning (occupational therapy). Through these effects they reinforce and augment pharmacological treatments for dementia. In addition, psychosocial interventions complement the treatment of patients by supporting family caregivers (educational groups, support programs). The potential of psychosocial interventions in dementia needs to be explored further in studies using improved methodology to determine effective components, clinical relevance and duration of effects, predictors of individual treatment response and health-economic implications.

  11. Behavior Therapy for Tics in Children: Acute and Long-Term Effects on Psychiatric and Psychosocial Functioning

    PubMed Central

    Woods, Douglas W.; Piacentini, John C.; Scahill, Lawrence; Peterson, Alan L.; Wilhelm, Sabine; Chang, Susanna; Deckersbach, Thilo; McGuire, Joseph; Specht, Matt; Conelea, Christine A.; Rozenman, Michelle; Dzuria, James; Liu, Haibei; Levi-Pearl, Sue; Walkup, John T.

    2014-01-01

    Children (n = 126) ages 9 to 17 years with chronic tic or Tourette disorder were randomly assigned to receive either behavior therapy or a control treatment over 10 weeks. This study examined acute effects of behavior therapy on secondary psychiatric symptoms and psychosocial functioning and long-term effects on these measures for behavior therapy responders only. Baseline and end point assessments conducted by a masked independent evaluator assessed several secondary psychiatric symptoms and measures of psychosocial functioning. Responders to behavior therapy at the end of the acute phase were reassessed at 3-month and 6-month follow-up. Children in the behavior therapy and control conditions did not differentially improve on secondary psychiatric or psychosocial outcome measures at the end of the acute phase. At 6-month posttreatment, positive response to behavior therapy was associated with decreased anxiety, disruptive behavior, and family strain and improved social functioning. Behavior therapy is a tic-specific treatment for children with tic disorders. PMID:21555779

  12. IMPROVEMENTS IN PSYCHOSOCIAL FUNCTIONING AND HEALTH-RELATED QUALITY OF LIFE FOLLOWING EXERCISE AUGMENTATION IN PATIENTS WITH TREATMENT RESPONSE BUT NONREMITTED MAJOR DEPRESSIVE DISORDER: RESULTS FROM THE TREAD STUDY.

    PubMed

    Greer, Tracy L; Trombello, Joseph M; Rethorst, Chad D; Carmody, Thomas J; Jha, Manish K; Liao, Allen; Grannemann, Bruce D; Chambliss, Heather O; Church, Timothy S; Trivedi, Madhukar H

    2016-09-01

    Functional impairments often remain despite symptomatic improvement with antidepressant treatment, supporting the need for novel treatment approaches. The present study examined the extent to which exercise augmentation improved several domains of psychosocial functioning and quality of life (QoL) among depressed participants. Data were collected from 122 partial responders to antidepressant medication. Participants were randomized to either high- (16 kcal/kg of weight/week [KKW]) or low-dose (4-KKW) exercise. Participants completed a combination of supervised and home-based exercise for 12 weeks. The Short-Form Health Survey, Work and Social Adjustment Scale, Social Adjustment Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, and Satisfaction with Life Scale were collected at 6 and 12 weeks. Participants with data for at least one of the two follow-up time points (n = 106) were analyzed using a linear mixed model to assess change from baseline within groups and the difference between groups for each psychosocial outcome measure. All analyses controlled for covariates, including baseline depressive symptomatology. Participants experienced significant improvements in functioning across tested domains, and generally fell within a healthy range of functioning on all measures at Weeks 6 and 12. Although no differences were found between exercise groups, improvements were observed across a variety of psychosocial and QoL domains, even in the low-dose exercise group. These findings support exercise augmentation of antidepressant treatment as a viable intervention for treatment-resistant depression to improve function in addition to symptoms. © 2016 Wiley Periodicals, Inc.

  13. Improvements in psychosocial functioning and health-related quality of life following exercise augmentation in patients with treatment response but non-remitted major depressive disorder: Results from the TREAD study

    PubMed Central

    Greer, Tracy L.; Trombello, Joseph M.; Rethorst, Chad D.; Carmody, Thomas J.; Jha, Manish K.; Liao, Allen; Grannemann, Bruce D.; Chambliss, Heather O.; Church, Timothy S.; Trivedi, Madhukar H.

    2016-01-01

    BACKGROUND Functional impairments often remain despite symptomatic improvement with antidepressant treatment, supporting the need for novel treatment approaches. The present study examined the extent to which exercise augmentation improved several domains of psychosocial functioning and quality of life among depressed participants. METHODS Data were collected from 122 partial responders to antidepressant medication. Participants were randomized to either high (16 kilocalories per kilogram of weight per week [KKW]) or low dose (4KKW) exercise. Participants completed a combination of supervised and home-based exercise for 12 weeks. The Short-Form Health Survey, Work and Social Adjustment Scale, Social Adjustment Scale, the Quality of Life Enjoyment and Satisfaction Questionnaire, and the Satisfaction with Life Scale were collected at 6 and 12 weeks. Participants with data for at least one of the two follow-up time points (n=106) were analyzed using a linear mixed model to assess change from baseline within groups and the difference between groups for each psychosocial outcome measure. All analyses controlled for covariates, including baseline depressive symptomatology. RESULTS Participants experienced significant improvements in functioning across tested domains, and generally fell within a healthy range of functioning on all measures at Weeks 6 and 12. While no differences were found between exercise groups, improvements were observed across a variety of psychosocial and quality-of-life domains, even in the low exercise dose group. CONCLUSIONS These findings support exercise augmentation of antidepressant treatment as a viable intervention for treatment-resistant depression to improve function in addition to symptoms. PMID:27164293

  14. The effect of bupropion XL and escitalopram on memory and functional outcomes in adults with major depressive disorder: results from a randomized controlled trial.

    PubMed

    Soczynska, Joanna K; Ravindran, Lakshmi N; Styra, Rima; McIntyre, Roger S; Cyriac, Anna; Manierka, Marena S; Kennedy, Sidney H

    2014-12-15

    Decrements in cognitive function are a common feature of Major Depressive Disorder (MDD), and whether distinct classes of antidepressants differentially affect memory in these individuals has not been sufficiently evaluated. In this study we sought to determine the effect of escitalopram and bupropion XL on memory and psychosocial function. Forty-one individuals (18-50 years) with MDD were enrolled in an 8-week, double-blind, double-dummy, randomized controlled comparative trial of bupropion XL and escitalopram. Thirty-six participants completed pre and post memory assessments. Verbal, non-verbal and working memory were evaluated with a comprehensive neuropsychological battery. Psychosocial function was assessed with the Sheehan Disability Scale and Endicott Work Productivity Scale. Escitalopram and bupropion XL significantly improved immediate as well as delayed verbal and nonverbal memory, global function (all p≤0.001), and work productivity (p=0.045), with no significant between-group differences. Improvement in immediate verbal memory exerted a direct influence on improvement in global function (p=0.006). Treatment with either escitalopram or bupropion XL was associated with improvement in memory and psychosocial function in adults with MDD. Copyright © 2014. Published by Elsevier Ireland Ltd.

  15. The effects of aerobic exercise on psychosocial functioning of adolescents who are overweight or obese.

    PubMed

    Goldfield, Gary S; Adamo, Kristi B; Rutherford, Jane; Murray, Marisa

    2012-01-01

    To evaluate effects of stationary cycling to music versus interactive video game cycling on psychosocial functioning in obese adolescents. 30 obese adolescents aged 12-17 years were randomized to twice weekly laboratory-based sessions of stationary cycling to music or interactive video game cycling for a 10-week trial. Participant's self-reported measures of scholastic competence, social competence, athletic competence, body image, and self-esteem were obtained. Aerobic fitness and body composition were directly measured. Although no differences emerged between exercise groups over time, when collapsed across exercise modality, significant pre-post improvements were found for body image, perceived scholastic competence and social competence. Changes in aerobic fitness, but not body composition, were positively associated with psychosocial functioning. Aerobic exercise was associated with improvements in body image, perceived academic performance, and social competence in obese adolescents, and these psychological benefits were related to improved aerobic fitness but not changes in body composition.

  16. Depression, worry, and psychosocial functioning predict eating disorder treatment outcomes in a residential and partial hospitalization setting.

    PubMed

    Fewell, Laura K; Levinson, Cheri A; Stark, Lynn

    2017-06-01

    This retrospective study explores depression, worry, psychosocial functioning, and change in body mass index (BMI) as predictors of eating disorder (ED) symptomatology and BMI at discharge and 1-year follow-up from a residential and partial hospitalization ED treatment center. Participants were 423 male and female patients receiving treatment at an ED treatment center. Results indicate significant improvement in ED symptomatology, psychological impairment, and change in BMI (in patients with anorexia nervosa) at treatment discharge and follow-up compared to treatment admission (ps < 0.001). Depression and worry predicted ED symptomatology and psychological impairment at discharge (ps < 0.05). Depression, worry, and psychosocial functioning predicted ED symptomatology and psychological impairment at 1-year follow-up (ps < 0.001). Change in BMI was not a significant predictor of outcome. Depression, worry, and psychosocial functioning each play a role in treatment outcomes and may help clarify who might benefit from treatment. Clinicians in ED treatment centers should consider these as areas of focus for improved outcomes.

  17. Psychosocial functioning in offspring of parents with bipolar disorder.

    PubMed

    Bella, Tolulope; Goldstein, Tina; Axelson, David; Obreja, Mihaela; Monk, Kelly; Hickey, Mary Beth; Goldstein, Benjamin; Brent, David; Diler, Rasim Somer; Kupfer, David; Sakolsky, Dara; Birmaher, Boris

    2011-09-01

    Offspring of parents with bipolar disorder are at increased risk for a range of psychopathology, including bipolar disorder. It is not clear if they also have impairments in their psychosocial functioning. We compared the psychosocial functioning of three groups of children enrolled in the Pittsburgh Bipolar Offspring Study (BIOS): offspring of probands with bipolar disorder (n=388), offspring of probands with other types of psychopathology (n=132), and offspring of healthy probands (n=118). Psychosocial functioning was assessed at study intake using the schedule of the Adolescent Longitudinal Interval Follow-Up Evaluation (A-LIFE), the Child Behavior Check List (CBCL) and the Children's Global Assessment Scale (CGAS). Offspring of probands with bipolar disorder exhibited impairments in various aspects of psychosocial functioning. On all measures, they had worse functioning in comparison with offspring of healthy probands. Offspring of probands with bipolar disorder generally exhibited more impairment than offspring of probands with nonbipolar psychopathology. After adjusting for proband parent functioning and the child's Axis I psychopathology, functioning of offspring of probands with bipolar disorder was similar to that of offspring of healthy probands. Data are cross-sectional and therefore do not allow for causal conclusions about the association between parental psychopathology, child psychopathology and offspring psychosocial functioning. Offspring of parents with bipolar disorder exhibit impairments in psychosocial functioning which appear largely attributable to proband parent functional impairment and the child's own psychopathology. As such, interventions to improve parental functioning, as well as early interventions to treat the child's psychopathology may help reduce the risk for long-term functional impairment in offspring. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria.

    PubMed

    Costa, Rosalia; Dunsford, Michael; Skagerberg, Elin; Holt, Victoria; Carmichael, Polly; Colizzi, Marco

    2015-11-01

    Puberty suppression by gonadotropin-releasing hormone analogs (GnRHa) is prescribed to relieve the distress associated with pubertal development in adolescents with gender dysphoria (GD) and thereby to provide space for further exploration. However, there are limited longitudinal studies on puberty suppression outcome in GD. Also, studies on the effects of psychological support on its own on GD adolescents' well-being have not been reported. This study aimed to assess GD adolescents' global functioning after psychological support and puberty suppression. Two hundred one GD adolescents were included in this study. In a longitudinal design we evaluated adolescents' global functioning every 6 months from the first visit. All adolescents completed the Utrecht Gender Dysphoria Scale (UGDS), a self-report measure of GD-related discomfort. We used the Children's Global Assessment Scale (CGAS) to assess the psychosocial functioning of adolescents. At baseline, GD adolescents showed poor functioning with a CGAS mean score of 57.7 ± 12.3. GD adolescents' global functioning improved significantly after 6 months of psychological support (CGAS mean score: 60.7 ± 12.5; P < 0.001). Moreover, GD adolescents receiving also puberty suppression had significantly better psychosocial functioning after 12 months of GnRHa (67.4 ± 13.9) compared with when they had received only psychological support (60.9 ± 12.2, P = 0.001). Psychological support and puberty suppression were both associated with an improved global psychosocial functioning in GD adolescents. Both these interventions may be considered effective in the clinical management of psychosocial functioning difficulties in GD adolescents. © 2015 International Society for Sexual Medicine.

  19. The Vienna psychosocial assessment procedure for bionic reconstruction in patients with global brachial plexus injuries

    PubMed Central

    Sturma, Agnes

    2018-01-01

    Background Global brachial plexopathies cause major sensory and motor deficits in the affected arm and hand. Many patients report of psychosocial consequences including chronic pain, decreased self-sufficiency, and poor body image. Bionic reconstruction, which includes the amputation and prosthetic replacement of the functionless limb, has been shown to restore hand function in patients where classic reconstructions have failed. Patient selection and psychological evaluation before such a life-changing procedure are crucial for optimal functional outcomes. In this paper we describe a psychosocial assessment procedure for bionic reconstruction in patients with complete brachial plexopathies and present psychosocial outcome variables associated with bionic reconstruction. Methods Between 2013 and 2017 psychosocial assessments were performed in eight patients with global brachial plexopathies. We conducted semi-structured interviews exploring the psychosocial adjustment related to the accident, the overall psychosocial status, as well as motivational aspects related to an anticipated amputation and expectations of functional prosthetic outcome. During the interview patients were asked to respond freely. Their answers were transcribed verbatim by the interviewer and analyzed afterwards on the basis of a pre-defined item scoring system. The interview was augmented by quantitative evaluation of self-reported mental health and social functioning (SF-36 Health Survey), body image (FKB-20) and deafferentation pain (VAS). Additionally, psychosocial outcome variables were presented for seven patients before and after bionic reconstruction. Results Qualitative data revealed several psychological stressors with long-term negative effects on patients with complete brachial plexopathies. 88% of patients felt functionally limited to a great extent due to their disability, and all of them reported constant, debilitating pain in the deafferented hand. After bionic reconstruction the physical component summary scale increased from 30.80 ± 5.31 to 37.37 ± 8.41 (p-value = 0.028), the mental component summary scale improved from 43.19 ± 8.32 to 54.76 ± 6.78 (p-value = 0.018). VAS scores indicative of deafferentation pain improved from 7.8 to 5.6 after prosthetic hand replacement (p-value = 0.018). Negative body evaluation improved from 60.71 ± 12.12 to 53.29 ± 11.03 (p-value = 0.075). Vital body dynamics increased from 38.57 ± 13.44 to 44.43 ± 16.15 (p-value = 0.109). Conclusions Bionic reconstruction provides hope for patients with complete brachial plexopathies who have lived without hand function for years or even decades. Critical patient selection is crucial and the psychosocial assessment procedure including a semi-structured interview helps identify unresolved psychological issues, which could preclude or delay bionic reconstruction. Bionic reconstruction improves overall quality of life, restores an intact self-image and reduces deafferentation pain. PMID:29298304

  20. The Vienna psychosocial assessment procedure for bionic reconstruction in patients with global brachial plexus injuries.

    PubMed

    Hruby, Laura Antonia; Pittermann, Anna; Sturma, Agnes; Aszmann, Oskar Christian

    2018-01-01

    Global brachial plexopathies cause major sensory and motor deficits in the affected arm and hand. Many patients report of psychosocial consequences including chronic pain, decreased self-sufficiency, and poor body image. Bionic reconstruction, which includes the amputation and prosthetic replacement of the functionless limb, has been shown to restore hand function in patients where classic reconstructions have failed. Patient selection and psychological evaluation before such a life-changing procedure are crucial for optimal functional outcomes. In this paper we describe a psychosocial assessment procedure for bionic reconstruction in patients with complete brachial plexopathies and present psychosocial outcome variables associated with bionic reconstruction. Between 2013 and 2017 psychosocial assessments were performed in eight patients with global brachial plexopathies. We conducted semi-structured interviews exploring the psychosocial adjustment related to the accident, the overall psychosocial status, as well as motivational aspects related to an anticipated amputation and expectations of functional prosthetic outcome. During the interview patients were asked to respond freely. Their answers were transcribed verbatim by the interviewer and analyzed afterwards on the basis of a pre-defined item scoring system. The interview was augmented by quantitative evaluation of self-reported mental health and social functioning (SF-36 Health Survey), body image (FKB-20) and deafferentation pain (VAS). Additionally, psychosocial outcome variables were presented for seven patients before and after bionic reconstruction. Qualitative data revealed several psychological stressors with long-term negative effects on patients with complete brachial plexopathies. 88% of patients felt functionally limited to a great extent due to their disability, and all of them reported constant, debilitating pain in the deafferented hand. After bionic reconstruction the physical component summary scale increased from 30.80 ± 5.31 to 37.37 ± 8.41 (p-value = 0.028), the mental component summary scale improved from 43.19 ± 8.32 to 54.76 ± 6.78 (p-value = 0.018). VAS scores indicative of deafferentation pain improved from 7.8 to 5.6 after prosthetic hand replacement (p-value = 0.018). Negative body evaluation improved from 60.71 ± 12.12 to 53.29 ± 11.03 (p-value = 0.075). Vital body dynamics increased from 38.57 ± 13.44 to 44.43 ± 16.15 (p-value = 0.109). Bionic reconstruction provides hope for patients with complete brachial plexopathies who have lived without hand function for years or even decades. Critical patient selection is crucial and the psychosocial assessment procedure including a semi-structured interview helps identify unresolved psychological issues, which could preclude or delay bionic reconstruction. Bionic reconstruction improves overall quality of life, restores an intact self-image and reduces deafferentation pain.

  1. Optimizing psychosocial interventions in first-episode psychosis: current perspectives and future directions.

    PubMed

    Breitborde, Nicholas Jk; Moe, Aubrey M; Ered, Arielle; Ellman, Lauren M; Bell, Emily K

    2017-01-01

    Psychotic-spectrum disorders such as schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features are devastating illnesses accompanied by high levels of morbidity and mortality. Growing evidence suggests that outcomes for individuals with psychotic-spectrum disorders can be meaningfully improved by increasing the quality of mental health care provided to these individuals and reducing the delay between the first onset of psychotic symptoms and the receipt of adequate psychiatric care. More specifically, multicomponent treatment packages that 1) simultaneously target multiple symptomatic and functional needs and 2) are provided as soon as possible following the initial onset of psychotic symptoms appear to have disproportionately positive effects on the course of psychotic-spectrum disorders. Yet, despite the benefit of multicomponent care for first-episode psychosis, clinical and functional outcomes among individuals with first-episode psychosis participating in such services are still suboptimal. Thus, the goal of this review is to highlight putative strategies to improve care for individuals with first-episode psychosis with specific attention to optimizing psychosocial interventions. To address this goal, we highlight four burgeoning areas of research with regard to optimization of psychosocial interventions for first-episode psychosis: 1) reducing the delay in receipt of evidence-based psychosocial treatments; 2) synergistic pairing of psychosocial interventions; 3) personalized delivery of psychosocial interventions; and 4) technological enhancement of psychosocial interventions. Future research on these topics has the potential to optimize the treatment response to evidence-based psychosocial interventions and to enhance the improved (but still suboptimal) treatment outcomes commonly experienced by individuals with first-episode psychosis.

  2. Psychosocial Functioning of Children with and without Dyslexia: A Follow-up Study from Ages Four to Nine.

    PubMed

    Parhiala, P; Torppa, M; Eklund, K; Aro, T; Poikkeus, A-M; Heikkilä, R; Ahonen, T

    2015-08-01

    This longitudinal study compares developmental changes in psychosocial functioning during the transition into school of children with and without dyslexia. In addition, it examines the effects of gender and family risk for dyslexia in terms of the associations between dyslexia and psychosocial functioning. Children's psychosocial functioning (social skills, inattention and externalizing and internalizing problems) was evaluated by their parents at ages 4, 6 and 9, and diagnosis for dyslexia was made at age 8 (in grade 2). The findings indicated that children with dyslexia were already rated as having poorer social skills and being more inattentive than were typical readers before their entry into school. Significant interactions of gender and diagnosis of dyslexia emerged for social skills and inattention. The social skills of boys with dyslexia improved after school entry as compared to the level of girls without dyslexia, whereas the social skills of girls with dyslexia did not improve. Boys with dyslexia were rated as showing a high level of inattention both prior to and after school entry, whereas, for girls with dyslexia, inattention ratings increased after school entry, eventually matching the boys' levels. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Systematic review of psychosocial outcomes for patients with advanced melanoma.

    PubMed

    Dunn, Jeff; Watson, Maggie; Aitken, Joanne F; Hyde, Melissa K

    2017-11-01

    New advanced melanoma therapies are associated with improved survival; however, quality of survivorship, particularly psychosocial outcomes, for patients overall and those treated with newer therapies is unclear. Synthesize qualitative and quantitative evidence about psychosocial outcomes for advanced (stage III/IV) melanoma patients. Five databases were searched (01/01/1980 to 31/01/2016). Inclusion criteria were as follows: advanced melanoma patients or sub-group analysis; assessed psychosocial outcomes; and English language. Fifty-two studies met review criteria (4 qualitative, 48 quantitative). Trials comprise mostly medical not psychosocial interventions, with psychosocial outcomes assessed within broader quality of life measures. Patients receiving chemotherapy or IFN-alpha showed decreased emotional and social function and increased distress. Five trials of newer therapies appeared to show improvements in emotional and social function. Descriptive studies suggest that patients with advanced, versus localized disease, had decreased emotional and social function and increased distress. Contributors to distress were largely unexplored, and no clear framework described coping/adjustment trajectories. Patients with advanced versus localized disease had more supportive care needs, particularly amount, quality, and timing of melanoma-related information, communication with and emotional support from clinicians. Limitations included: lack of theoretical underpinnings guiding study design; inconsistent measurement approaches; small sample sizes; non-representative sampling; and cross-sectional design. Quality trial evidence is needed to clarify the impact of treatment innovations for advanced melanoma on patients' psychosocial well-being. Survivorship research and subsequent translation of that knowledge into programs and services currently lags behind gains in the medical treatment of advanced melanoma, a troubling circumstance that requires immediate and focused attention. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Quality of life assessments in major depressive disorder: a review of the literature.

    PubMed

    Papakostas, George I; Petersen, Timothy; Mahal, Yasmin; Mischoulon, David; Nierenberg, Andrew A; Fava, Maurizio

    2004-01-01

    According to the DSM-IV classification, a diagnosis of Major Depressive Disorder (MDD) is possible only when there is evidence of significant inference with functioning. However, despite the high prevalence of MDD in the general population, it is uncommon for clinicians to assess overall functioning in a systematic way before making such diagnosis. An important correlate of functioning is quality of life, which is typically defined as "patients' own assessments of how they feel about what they have, how they are functioning, and their ability to derive pleasure from their life activities". In the present article, we review studies focusing on the relationship between depression and quality of life, particularly focusing on the impact of the treatment of depression on quality of life. Studies focusing on the quality of life in MDD are reviewed. Candidate studies published between 1970 and recently were initially identified by Pubmed and Ovid search cross-referencing the terms "quality of life," "psychosocial functioning" with "major depression" and "treatment." A number of studies report poorer quality of life in MDD patients compared to controls. Several studies also report an improvement in quality of life measures during various phases of treatment with antidepressants and/or psychotherapy. However, trials comparing the role of newer psychopharmacologic agents in the acute phase of treatment, and the role of newer psychotherapies in the continuation and maintenance phases of treatment in restoring psychosocial functioning and improving the quality of life in MDD are lacking. Exploring the impact of these modalities on psychosocial function and quality of life in MDD are necessary to help translate clinical response into restoration of psychosocial function and to thus further improve the standard of care.

  5. Epilepsy characteristics and psychosocial factors associated with ketogenic diet success.

    PubMed

    McNamara, Nancy A; Carbone, Loretta A; Shellhaas, Renée A

    2013-10-01

    The ketogenic diet is an effective therapy for childhood epilepsy, but its important impacts on families could affect successful treatment. We assessed medical and psychosocial factors associated with successful ketogenic diet treatment. A total of 23 families of patients treated with ketogenic diet completed questionnaires (30% response), including inquiries about challenges to successful dietary treatments and validated family functioning scales. Of these, 14 were considered successful (diet discontinued once the child was seizure-free or continued as clinically indicated). Family-identified challenges were food preparation time (n = 11) and that the diet was too restrictive (n = 9). Neither Medicaid insurance nor family functioning scale scores were significantly associated with successful treatment. Lower seizure frequency prior to ketogenic diet initiation (P = .02) and postdiet seizure improvement (P = .01) were associated with increased odds of success. Effective ketogenic diet treatment is dictated both by psychosocial and epilepsy-related influences. A focus on understanding the psychosocial issues may help to improve families' experiences and success with the ketogenic diet.

  6. Effects of group prenatal care on psychosocial risk in pregnancy: Results from a randomised controlled trial

    PubMed Central

    Ickovics, Jeannette R.; Reed, Elizabeth; Magriples, Urania; Westdahl, Claire; Rising, Sharon Schindler; Kershaw, Trace S.

    2012-01-01

    Few interventions have succeeded in reducing psychosocial risk among pregnant women. The objective of this study was to determine whether an integrated group prenatal care intervention already shown to improve perinatal and sexual risk outcomes can also improve psychosocial outcomes compared to standard individual care. This randomised controlled trial included pregnant women ages 14–25 from two public hospitals (N = 1047) who were randomly assigned to standard individual care, group prenatal care or integrated group prenatal care intervention (CenteringPregnancy Plus, CP+). Timing and content of visits followed obstetrical guidelines, from 18-week gestation through birth. Each 2-h group prenatal care session included physical assessment, education/skills building and support via facilitated discussion. Using intention-to-treat models, there were no significant differences in psychosocial function; yet, women in the top tertile of psychosocial stress at study entry did benefit from integrated group care. High-stress women randomly assigned to CP+ reported significantly increased self-esteem, decreased stress and social conflict in the third trimester of pregnancy; social conflict and depression were significantly lower 1-year postpartum (all p-values <0.02). CP+ improved psychosocial outcomes for high-stress women. This ‘bundled’ intervention has promise for improving psychosocial outcomes, especially for young pregnant women who are traditionally more vulnerable and underserved. PMID:21318932

  7. Parenting Interventions for Indigenous Child Psychosocial Functioning: A Scoping Review

    ERIC Educational Resources Information Center

    Macvean, Michelle; Shlonsky, Aron; Mildon, Robyn; Devine, Ben

    2017-01-01

    Objectives: To scope evaluations of Indigenous parenting programs designed to improve child psychosocial outcomes. Methods: Electronic databases, gray literature, Indigenous websites and journals, and reference lists were searched. The search was restricted to high-income countries with a history of colonialism. Results: Sixteen studies describing…

  8. Changes in functional health status of older women with heart disease: evaluation of a program based on self-regulation.

    PubMed

    Clark, N M; Janz, N K; Dodge, J A; Schork, M A; Fingerlin, T E; Wheeler, J R; Liang, J; Keteyian, S J; Santinga, J T

    2000-03-01

    This study involving 570 women aged 60 years or older with heart disease, assessed the effects of a disease management program on physical functioning, symptom experience, and psychosocial status. Women were randomly assigned to control or program groups. Six to eight women met weekly with a health educator and peer leader over 4 weeks to learn self-regulation skills with physical activity as the focus. Evaluative data were collected through telephone interviews, physical assessments, and medical records at baseline and 4 and 12 months post baseline. At 12 months, compared with controls, program women were less symptomatic (p < .01), scored better on the physical dimension of the Sickness Impact Profile (SIP; p < 0.05), had improved ambulation as measured by the 6-minute walk (p < 0.01), and lost more body weight (p < .001). No differences related to psychosocial factors as measured by the SIP were noted. A self-regulation-based program that was provided to older women with heart disease and that focused on physical activity and disease management problems salient to them, improved their physical functioning and symptom experience. Psychosocial benefit was not evident and may be a result of measurement error or due to insufficient program time spent on psychosocial aspects of functioning.

  9. Cognitive Remediation: A New Generation of Psychosocial Interventions for People with Schizophrenia

    PubMed Central

    Eack, Shaun M.

    2013-01-01

    Schizophrenia is a mental health condition characterized by broad impairments in cognition, which place profound limitations on functional recovery. Social work has an enduring legacy in pioneering the development of novel psychosocial interventions for people with schizophrenia, and this article introduces cognitive remediation, the latest advance in psychosocial treatments for the disorder designed to improve cognition. First, an overview of the nature of cognitive impairments and their functional consequences in schizophrenia is presented, followed by a description of the theoretical basis and key practice principles of cognitive remediation. Next, the latest biopsychosocial evidence for the efficacy of cognitive remediation in schizophrenia is critically reviewed. Finally, a model cognitive remediation program, Cognitive Enhancement Therapy, which was developed and evaluated by a social work-led multidisciplinary team is presented. Cognitive Enhancement Therapy represents a significant advance in cognitive remediation for schizophrenia, and uses a unique holistic approach that extends beyond traditional neurocognitive training to facilitate the achievement of adult social-cognitive milestones and broader functional recovery. It is concluded that cognitive remediation represents an effective next generation of psychosocial interventions that social workers can use to help improve the lives of many people who live with schizophrenia. PMID:23252315

  10. Influence of surgical and minimally invasive facial cosmetic procedures on psychosocial outcomes: a systematic review.

    PubMed

    Imadojemu, Sotonye; Sarwer, David B; Percec, Ivona; Sonnad, Seema S; Goldsack, Jennifer E; Berman, Morgan; Sobanko, Joseph F

    2013-11-01

    Millions of surgical and minimally invasive cosmetic procedures of the face are performed each year, but objective clinical measures that evaluate surgical procedures, such as complication rates, have limited utility when applied to cosmetic procedures. While there may be subjective improvements in appearance, it is important to determine if these interventions have an impact on patients in other realms such as psychosocial functioning. This is particularly important in light of the Patient Protection and Affordable Care Act and its emphasis on patient-centered outcomes and effectiveness. To review the literature investigating the impact of facial cosmetic surgery and minimally invasive procedures on relevant psychological variables to guide clinical practice and set norms for clinical performance. English-language randomized clinical trials and prospective cohort studies that preoperatively and postoperatively assessed psychological variables in at least 10 patients seeking surgical or minimally invasive cosmetic procedures of the face. Only 1 study investigating minimally invasive procedures was identified. Most studies reported modest improvement in psychosocial functioning, which included quality of life, self-esteem, and body image. Unfortunately, the overall quality of evidence is limited owing to an absence of control groups, short follow-up periods, or loss to follow-up. The current literature suggests that a number of psychosocial domains may improve following facial cosmetic surgery, although the quality of this evidence is limited (grade of recommendation 2A). Despite the dramatic rise in nonsurgical cosmetic procedures, there is a paucity of information regarding the impact of chemodenervation and soft-tissue augmentation on psychosocial functioning.

  11. A comparison of paroxetine versus paroxetine plus amisulpride in the treatment of dysthymic disorder: efficacy and psychosocial outcomes.

    PubMed

    Rocca, Paola; Marchiaro, Livio; Rasetti, Roberta; Rivoira, Elisa; Bogetto, Filippo

    2002-10-10

    Dysthymic disorder is a chronic depressive condition with considerable psychosocial impairment. Even if DD patients respond to various antidepressant medications, there has been little systematic study on antidepressant-refractory DD. Only a few trials have evaluated the effects of treatment on psychosocial functioning of dysthymic patients. In this 3-month, open-label study, 60 outpatients with DSM-IV criteria for dysthymic disorder who failed to respond to 3-month treatment with paroxetine 20 mg/day were randomly assigned to treatment with paroxetine 40 mg/day or paroxetine 20 mg/day plus amisulpride 50 mg/day. The effects of the two treatments were assessed for both mood symptoms (21-item Hamilton Rating Scale for Depression, Montgomery-Asberg Depression Rating Scale, Clinical Global Impression, severity and improvement) and psychosocial outcomes (DSM-IV Global Assessment of Functioning, Social Adaptation Self-evaluation Scale). Analysis of variance on all rating scales showed that both treatments were effective over this observation period. Response and remission rates did not differ in the treatment groups. A significantly greater psychosocial improvement was observed in the group receiving combined treatment compared with patients receiving paroxetine alone. Both treatments appeared to be effective in our sample of dysthymic subjects. Combined treatment with paroxetine and amisulpride resulted in a better outcome in terms of social functioning.

  12. Memory, Executive Skills, and Psychosocial Phenotype in Children with Pharmacoresponsive Epilepsy: Reactivity to Intervention.

    PubMed

    Schaffer, Yael; Ben Zeev, Bruria; Cohen, Roni; Shufer, Avinoam; Geva, Ronny

    2017-01-01

    Recent studies on pharmacoresponsive epilepsies demonstrate specific memory, executive functions (EF), and psychosocial deficits in this group. These deficits are often undertreated, and little is known about the neuropsychological factors that may support moderation of the deficits through intervention. The aim of this study was to explore the effects of a structured cognitive behavioral group intervention on both memory and emotional domains and to evaluate the factors influencing its efficacy. The feasibility study implemented a newly designed intervention for children with pharmacoresponsive epilepsies ( N  = 33, aged 9-14 years, 51% girls), hypothesizing that memory and psychosocial symptoms in children with pharmacoresponsive epilepsies are sensitive to intervention using structured memory and psychosocial modules in a weekly group session setting. Comparable memory and psychosocial assessments were used to evaluate performance at baseline and post-intervention. Results were compared to age- and education-matched healthy controls ( N  = 27, aged 9-14 years). Pre-post-intervention comparisons show improvements in STM ( p  < 0.01, η 2 = 0.358), optimism ( p  < 0.05, η 2 = 0.245), and self-efficacy ( p  < 0.05, η 2 = 0.164). Unique negative relations between memory deficits and psychosocial phenotype were seen in epilepsy patients and not in controls in response to the intervention. EF moderated this intervention effect ( p  < 0.05, η 2 = 0.252), whereas psychosocial status and pharmacological profile did not. Cognitive behavioral therapy focusing on memory and psychosocial perceptions for children with pharmacoresponsive epilepsies seems promising, with greater improvement in memory and psychosocial functioning in children with more affected EF.

  13. An evaluation of cognitive behavioral therapy as a treatment for dissociative seizures: a pilot study.

    PubMed

    Goldstein, Laura H; Deale, Alicia C; Mitchell-O'Malley, Sara J; Toone, Brian K; Mellers, John D C

    2004-03-01

    To evaluate in an open trial the effectiveness of cognitive behavioral therapy as a treatment of adults with dissociative seizures (i.e., "pseudoseizures"). Although suggestions have been made concerning the management of patients with dissociative seizures, no studies have previously evaluated the systematic use of cognitive behavioral therapy in the treatment of this disorder. Twenty patients diagnosed with dissociative seizures were offered treatment comprising 12 sessions of cognitive behavioral therapy. Principal outcome measures were dissociative seizure frequency and psychosocial functioning, including improvement in employment status and mood. Measures were administered before treatment, at the end of treatment, and at a 6-month follow-up. Treatment was completed by 16 patients (questionnaire measures were not available for 4 patients who discontinued treatment). Following treatment, there was a highly significant reduction in seizure frequency and an improvement in self-rated psychosocial functioning. These improvements were maintained at the 6-month follow-up. There was also a tendency for patients to have improved their employment status between the start of treatment and the 6-month follow-up period. In this open prospective trial, cognitive behavioral therapy was associated with a reduction in dissociative seizure frequency and an improvement in psychosocial functioning in adults with dissociative seizures.

  14. How neurocognition and social cognition influence functional change during community-based psychosocial rehabilitation for individuals with schizophrenia.

    PubMed

    Brekke, John S; Hoe, Maanse; Long, Jeffrey; Green, Michael F

    2007-09-01

    The purpose of this study was to assess how neurocognition and social cognition were associated with initial functional level and with rates of functional change in intensive community-based psychosocial rehabilitation interventions that have been shown to yield significant functional change for individuals diagnosed with schizophrenia. We also examined how service intensity was associated with rates of change and whether it served as a moderator of the relationship between functional change and both neurocognition and social cognition. The sample consisted of 125 individuals diagnosed with schizophrenia or schizoaffective disorder who were recruited upon admission to 1 of 4 community-based psychosocial rehabilitation facilities and were followed prospectively for 12 months. One hundred and two subjects completed the 12-month protocol. The findings suggested that (i) the initial level of psychosocial functioning was related to both social cognition and neurocognition at baseline, (ii) when significant rehabilitative change occurs, higher neurocognition and social cognition scores at baseline predicted higher rates of functional change over the subsequent 12 months, (iii) greater service intensity was related to higher rates of improvement in functional outcome over time, and (iv) service intensity moderated the relationship between neurocognition and initial functional level and moderated the relationship between social cognition and the rates of functional change at a trend level. These findings have relevance to our understanding of the heterogeneity in functional rehabilitative outcomes, to our understanding of the conditions of rehabilitative change and for the design of psychosocial interventions in the community.

  15. Step-down versus outpatient psychotherapeutic treatment for personality disorders: 6-year follow-up of the Ullevål personality project

    PubMed Central

    2014-01-01

    Background Although psychotherapy is considered the treatment of choice for patients with personality disorders (PDs), there is no consensus about the optimal level of care for this group of patients. This study reports the results from the 6-year follow-up of the Ullevål Personality Project (UPP), a randomized clinical trial comparing outpatient individual psychotherapy with a long-term step-down treatment program that included a short-term day hospital treatment followed by combined group and individual psychotherapy. Methods The UPP included 113 patients with PDs. Outcome was evaluated after 8 months, 18 months, 3 years and 6 years and was based on a wide range of clinical measures, such as psychosocial functioning, interpersonal problems, symptom severity, and axis I and II diagnoses. Results At the 6-year follow-up, there were no statistically significant differences in outcome between the treatment groups. Effect sizes ranged from medium to large for all outcome variables in both treatment arms. However, patients in the outpatient group had a marked decline in psychosocial functioning during the period between the 3- and 6-year follow-ups; while psychosocial functioning continued to improve in the step-down group during the same period. This difference between groups was statistically significant. Conclusions The findings suggest that both hospital-based long-term step-down treatment and long-term outpatient individual psychotherapy may improve symptoms and psychosocial functioning in poorly functioning PD patients. Social and interpersonal functioning continued to improve in the step-down group during the post-treatment phase, indicating that longer-term changes were stimulated during treatment. Trial registration NCT00378248. PMID:24758722

  16. The Effects of Mitral Valve Repair on Memory Performance, Executive Function, and Psychological Measures in Patients With Heart Failure.

    PubMed

    Nikendei, Christoph; Schäfer, Hannah; Weisbrod, Matthias; Huber, Julia; Geis, Nicolas; Katus, Hugo A; Bekeredjian, Raffi; Herzog, Wolfgang; Pleger, Sven T; Schultz, Jobst-Hendrik

    2016-05-01

    Heart failure (HF) is a prevalent disease that remains costly and associated with a high mortality rate. HF is also associated with poor neurocognitive functioning. For the treatment for HF patients with severe mitral regurgitation, the MitraClip device has emerged as a promising interventional tool that reduces the mitral valve leakage and thus increases cardiac output. Currently, there is only limited knowledge on changes in cognitive and psychosocial functioning before and after the MitraClip intervention. Cognitive function (memory and executive function) and psychosocial measures (depression, anxiety, and quality of life) were assessed before and after the MitraClip intervention in 24 HF patients and 23 healthy participants (comparison group). MitraClip intervention in HF patients was followed by improvements in figural long-term memory (p = .003) and executive function (planning ability, p < .001) relative to the comparison group. In addition, the intervention resulted in a significant improvement in depression (p = .002), anxiety (p = .003) and quality of life scores (physical p = .017, mental p = .013) as well as improved 6-minute walk test results over time (p = .002). The presented data provide evidence of a significant improvement in memory and executive function as well as in depression, anxiety, and quality of life scores in patients with chronic HF after MitraClip intervention. Further research is needed to shed light on the long-term development of cognitive function, psychosocial well-being, and clinical parameters after MitraClip intervention and how these factors depend on one another.

  17. The psychosocial benefits of secondary hydroxyapatite orbital implant insertion and prosthesis wearing for patients with anophthalmia.

    PubMed

    Wang, Junming; Zhang, Hong; Chen, Wei; Li, Guigang

    2012-01-01

    Anophthalmia is associated with a range of psychosocial difficulties and hydroxyapatite orbital implant insertion and prosthesis wearing is the predominant rehabilitation therapy for anophthalmia. However, few articles have compared preoperative and postoperative psychosocial outcomes using standardized questionnaires. This study aimed to investigate the psychosocial benefits of hydroxyapatite orbital implant insertion and prosthesis wearing in this patient population. In all, 36 participants were tested preoperatively and 6-months postoperatively using standardized measures of anxiety and depression (Hospital Anxiety and Depression Scale), social anxiety and social avoidance (Derriford Appearance Scale-Short Form), and quality of life (World Health Organization Quality of Life Scale-Short Form). Before treatment, levels of depression were comparable with population norms; however, levels of general anxiety were slightly raised, levels of social anxiety, social avoidance, and quality of life were significantly poorer than population norms. Treatment resulted in significant improvement in psychosocial adjustment with improvements in all study variables for the participant group as a whole. Hydroxyapatite orbital implant insertion and prosthesis wearing offers significant improvements in psychological and physical functioning for patients with anophthalmia.

  18. Which method of posttraumatic stress disorder classification best predicts psychosocial function in children with traumatic brain injury?

    PubMed

    Iselin, Greg; Le Brocque, Robyne; Kenardy, Justin; Anderson, Vicki; McKinlay, Lynne

    2010-10-01

    Controversy surrounds the classification of posttraumatic stress disorder (PTSD), particularly in children and adolescents with traumatic brain injury (TBI). In these populations, it is difficult to differentiate TBI-related organic memory loss from dissociative amnesia. Several alternative PTSD classification algorithms have been proposed for use with children. This paper investigates DSM-IV-TR and alternative PTSD classification algorithms, including and excluding the dissociative amnesia item, in terms of their ability to predict psychosocial function following pediatric TBI. A sample of 184 children aged 6-14 years were recruited following emergency department presentation and/or hospital admission for TBI. PTSD was assessed via semi-structured clinical interview (CAPS-CA) with the child at 3 months post-injury. Psychosocial function was assessed using the parent report CHQ-PF50. Two alternative classification algorithms, the PTSD-AA and 2 of 3 algorithms, reached statistical significance. While the inclusion of the dissociative amnesia item increased prevalence rates across algorithms, it generally resulted in weaker associations with psychosocial function. The PTSD-AA algorithm appears to have the strongest association with psychosocial function following TBI in children and adolescents. Removing the dissociative amnesia item from the diagnostic algorithm generally results in improved validity. Copyright 2010 Elsevier Ltd. All rights reserved.

  19. Psychosocial functioning in prepubertal major depressive disorders. II. Interpersonal relationships after sustained recovery from affective episode.

    PubMed

    Puig-Antich, J; Lukens, E; Davies, M; Goetz, D; Brennan-Quattrock, J; Todak, G

    1985-05-01

    Psychosocial relationships with parents, peers, and siblings, as well as school functioning, were measured at two points in time by parental interview in 21 prepubertal children: during an episode of major depression and after they had sustained an affective recovery from the index episode for at least four months. School functioning was completely normalized, but deficits in the child's intrafamilial and extra-familial relationships had improved only partially. The pattern of improvement was merely quantitative. Moderate deficits during the depressive episode reached, after affective recovery, the level of the normal control group. In contrast, severe deficits only improved to a moderate level of severity. It is suggested that treating the affective disorder is not sufficient in many children with major depression and that efficacy studies of psychotherapeutic interventions in affectively recovered children are needed.

  20. Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years

    PubMed Central

    SKODOL, ANDREW E.; PAGANO, MARIA E.; BENDER, DONNA S.; SHEA, M. TRACIE; GUNDERSON, JOHN G.; YEN, SHIRLEY; STOUT, ROBERT L.; MOREY, LESLIE C.; SANISLOW, CHARLES A.; GRILO, CARLOS M.; ZANARINI, MARY C.; McGLASHAN, THOMAS H.

    2012-01-01

    Background A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable ? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period. Method Six hundred treatment-seeking or treated patients were recruited primarily from clinical services in four metropolitan areas of the Northeastern USA. Patients were assigned to one of five diagnostic groups: schizotypal (STPD) (n=81), borderline (BPD) (n=155), avoidant (AVPD) (n=137), or obsessive–compulsive (OCPD) (n=142) personality disorders or MDD and no PD (n=85), based on the results of semi-structured interview assessments and self-report measures. Impairment in psychosocial functioning was measured using the Longitudinal Interval Follow-up Evaluation (LIFE) at baseline and at three follow-up assessments. Results Significant improvement in psychosocial functioning occurred in only three of seven domains of functioning and was largely the result of improvements in the MDD and no PD group. Patients with BPD or OCPD showed no improvement in functioning overall, but patients with BPD who experienced change in personality psychopathology showed some improvement in functioning. Impairment in social relationships appeared most stable in patients with PDs. Conclusion Impairment in functioning, especially social functioning, may be an enduring component of personality disorder. PMID:15841879

  1. A psychosocial resilience curriculum provides the "missing piece" to boost adolescent physical health: A randomized controlled trial of Girls First in India.

    PubMed

    Leventhal, Katherine Sachs; DeMaria, Lisa M; Gillham, Jane E; Andrew, Gracy; Peabody, John; Leventhal, Steve M

    2016-07-01

    Despite a recent proliferation of interventions to improve health, education, and livelihoods for girls in low and middle income countries, psychosocial wellbeing has been neglected. This oversight is particularly problematic as attending to psychosocial development may be important not only for psychosocial but also physical wellbeing. This study examines the physical health effects of Girls First, a combined psychosocial (Girls First Resilience Curriculum [RC]) and adolescent physical health (Girls First Health Curriculum [HC]) intervention (RC + HC) versus its individual components (i.e., RC, HC) and a control group. We expected Girls First to improve physical health versus HC and controls. Over 3000 girls in 76 government middle schools in rural Bihar, India participated. Interventions were delivered through in-school peer-support groups, facilitated by pairs of local women. Girls were assessed before and after program participation on two primary outcomes (health knowledge and gender equality attitudes) and nine secondary outcomes (clean water behaviors, hand washing, menstrual hygiene, health communication, ability to get to a doctor when needed, substance use, nutrition, safety, vitality and functioning). Analyses included Difference-in-Difference Ordinary Least-Squares Regressions and F-tests for equality among conditions. Girls First significantly improved both primary and eight secondary outcomes (all except nutrition) versus controls. Additionally, Girls First demonstrated significantly greater effects, improving both primary and six secondary outcomes (clean water behaviors, hand washing, health communication, ability to get to a doctor, nutrition, safety) versus HC. This study is among the first to assess the impact of a combined psychosocial and adolescent health program on physical health. We found that combining these curricula amplified effects achieved by either curriculum alone. These findings suggest that psychosocial wellbeing should receive much broader attention, not only from those interested in improving psychosocial outcomes but also from those interested in improving physical health outcomes. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Influence of personality and neuropsychological ability on social functioning and self-management in bipolar disorder.

    PubMed

    Vierck, Esther; Joyce, Peter R

    2015-10-30

    A majority of bipolar patients (BD) show functional difficulties even in remission. In recent years cognitive functions and personality characteristics have been associated with occupational and psychosocial outcomes, but findings are not consistent. We assessed personality and cognitive functioning through a range of tests in BD and control participants. Three cognitive domains-verbal memory, facial-executive, and spatial memory-were extracted by principal component analysis. These factors and selected personality dimensions were included in hierarchical regression analysis to predict psychosocial functioning and the use of self-management strategies while controlling for mood status. The best determinants of good psychosocial functioning were good verbal memory and high self-directedness. The use of self-management techniques was associated with a low level of harm-avoidance. Our findings indicate that strategies to improve memory and self-directedness may be useful for increasing functioning in individuals with bipolar disorder. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Acceptance and Commitment Therapy for adults who stutter: psychosocial adjustment and speech fluency.

    PubMed

    Beilby, Janet M; Byrnes, Michelle L; Yaruss, J Scott

    2012-12-01

    The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N=20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b) readiness for therapy and change, (c) utilisation of mindfulness skills and psychological flexibility, and (d) frequency of stuttering. The findings provide innovative evidence for Acceptance and Commitment Therapy as an effective intervention with statistically significant improvements in psychosocial functioning, preparation for change and therapy, utilisation of mindfulness skills, and overall speech fluency. Follow-up data collected at three months post-treatment revealed that therapeutic gains were successfully maintained over time. These findings enhance the understanding of the impact of stuttering on psychological wellbeing and offer a new perspective on what might constitute successful stuttering treatment. Further, clinical research support is provided for Acceptance and Commitment Therapy delivered in a group format as a promising and novel intervention for adults who stutter. The reader will be able to: (a) appreciate the potential for Acceptance and Commitment Therapy for adults who stutter; (b) identify the improvements participants experienced in psychosocial functioning and frequency of stuttered speech; (c) appreciate the six core processes of Acceptance and Commitment Therapy; and (d) appreciate the differences between an ACT model of intervention for adults who stutter compared to a CBT approach. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Acceptance and Commitment Therapy for Adults Who Stutter: Psychosocial Adjustment and Speech Fluency

    ERIC Educational Resources Information Center

    Beilby, Janet M.; Byrnes, Michelle L.; Yaruss, J. Scott

    2012-01-01

    The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N = 20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b)…

  5. Effectiveness of a Psychosocial Intervention Model for Persons with Chronic Psychiatric Disorders in Long-Term Hospitalization

    ERIC Educational Resources Information Center

    Elbaz-Haddad, Merav; Savaya, Riki

    2011-01-01

    The article describes a psychosocial model of intervention with psychiatric patients in long-term hospitalization in a psychiatric ward in Israel and reports the findings of the evaluation conducted of its effectiveness. The model was aimed at maintaining or improving the patients' functioning in four main areas: personal hygiene, environmental…

  6. Self-Esteem, Confidence, and Relationships in Men Treated with Sildenafil Citrate for Erectile Dysfunction

    PubMed Central

    Althof, Stanley E; O' Leary, Michael P; Cappelleri, Joseph C; Glina, Sidney; King, Rosie; Tseng, Li-Jung; Bowler, Jessica L

    2006-01-01

    BACKGROUND Men with erectile dysfunction (ED) often have low self-esteem, confidence, and sexual relationship satisfaction. OBJECTIVE We evaluated the impact of sildenafil citrate and its generalizability across cultures on self-esteem, confidence, and sexual relationship satisfaction in men with ED using the Self-Esteem And Relationship (SEAR) questionnaire. DESIGN Pooled analysis of 2 double-blind, placebo-controlled, flexible-dose trials of sildenafil with identical protocols: 1 was conducted in the United States and the other in Mexico, Brazil, Australia, and Japan. PATIENTS Men ≥18 years old with ED. MEASUREMENTS The impact of treatment on psychosocial factors associated with ED was determined by patient responses to the SEAR questionnaire. Erectile function was determined using the International Index of Erectile Function (IIEF) and a global efficacy question. Successful sexual intercourse attempts were derived from event logs of sexual activity. Treatment effect sizes were calculated for all study outcomes. RESULTS Compared with patients who received placebo (n = 274), patients who received sildenafil (n = 279) reported significantly greater improvements (P<.0001) in self-esteem, confidence, sexual relationship satisfaction, and in all sexual function domains of the IIEF. Treatment effect sizes were large (range, 0.7 to 1.2) for all SEAR components, and improvement in psychosocial measures showed moderate to high correlations (range, 0.50 to 0.83, P<.0001) with improvement in erectile function, percentage of successful intercourse attempts, and global efficacy. CONCLUSIONS In men with ED from 5 different nations, sildenafil produced substantial improvements in self-esteem, confidence, and sexual relationship satisfaction. Improvements in these psychosocial factors were observed crossculturally and correlated significantly and tangibly with improvements in erectile function. PMID:16836626

  7. Psychosocial impact of implantable cardioverter defibrillators (ICD) in young adults with Tetralogy of Fallot.

    PubMed

    Opić, Petra; Utens, Elisabeth M W J; Moons, Philip; Theuns, Dominic A M J; van Dijk, Arie P J; Hoendermis, Elke S; Vliegen, Hubert W; de Groot, Natasja M S; Witsenburg, Maarten; Schalij, Martin; Roos-Hesselink, Jolien W

    2012-07-01

    To investigate the psychosocial impact of having an implantable cardioverter defibrillator (ICD) in adults with Tetralogy of Fallot (ToF). Included were 26 ToF-patients with an ICD (age 44 ± 12 years), and two control groups consisting of 28 ToF-patients without an ICD (age 40 ± 10 years) and a group of 35 ICD-patients of older age without ToF (age 72.0 ± 8 years). This last control group was chosen to represent the "older general ICD population" with acquired heart disease seen at the out-patient clinic. Psychosocial functioning encompassed daily functioning, subjective health status, quality of life, anxiety, depression, coping and social support. ToF-patients with ICD showed diminished psychosocial functioning in comparison to ToF-patients without ICD. This was reflected by diminished subjectively perceived physical functioning (p = 0.01), general health perception (p < 0.01) and a lower satisfaction with life (p = 0.02). In comparison to older ICD-patients, ToF-patients with ICD showed less satisfaction with life (p = 0.03), experienced more anxiety (p = 0.01) and showed less favourable coping styles, although physical functioning was better for ToF-patients with ICD than for older ICD-patients (p = 0.01). More inappropriate shocks were found in ToF-patients with ICD compared to the older ICD-patients. In patients with ToF, ICD implantation had a major impact on psychosocial functioning which should be taken into account when considering ICD implantation in these young patients. To help improve psychosocial functioning, psychological counselling attuned to the specific needs of these patients may be useful.

  8. The Relationship between Symptom Relief and Psychosocial Functional Improvement during Acute Electroconvulsive Therapy for Patients with Major Depressive Disorder.

    PubMed

    Lin, Ching-Hua; Yang, Wei-Cheng

    2017-07-01

    We aimed to compare the degree of symptom relief to psychosocial functional (abbreviated as "functional") improvement and explore the relationships between symptom relief and functional improvement during acute electroconvulsive therapy for patients with major depressive disorder. Major depressive disorder inpatients (n=130) requiring electroconvulsive therapy were recruited. Electroconvulsive therapy was generally performed for a maximum of 12 treatments. Symptom severity, using the 17-item Hamilton Depression Rating Scale, and psychosocial functioning (abbreviated as "functioning"), using the Modified Work and Social Adjustment Scale, were assessed before electroconvulsive therapy, after every 3 electroconvulsive therapy treatments, and after the final electroconvulsive therapy. Both 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale scores were converted to T-score units to compare the degrees of changes between depressive symptoms and functioning after electroconvulsive therapy. Structural equation modeling was used to test the relationships between 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale during acute electroconvulsive therapy. One hundred sixteen patients who completed at least the first 3 electroconvulsive therapy treatments entered the analysis. Reduction of 17-item Hamilton Depression Rating Scale T-scores was significantly greater than that of Modified Work and Social Adjustment Scale T-scores at assessments 2, 3, 4, and 5. The model analyzed by structural equation modeling satisfied all indices of goodness-of-fit (chi-square = 32.882, P =.107, TLI = 0.92, CFI = 0.984, RMSEA = 0.057). The 17-item Hamilton Depression Rating Scale change did not predict subsequent Modified Work and Social Adjustment Scale change. Functioning improved less than depressive symptoms during acute electroconvulsive therapy. Symptom reduction did not predict subsequent functional improvement. Depressive symptoms and functional impairment are distinct domains and should be assessed independently to accurately reflect the effectiveness of electroconvulsive therapy. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  9. Quality of life of patients who have undergone the minimally invasive repair of pectus carinatum.

    PubMed

    Bostanci, Korkut; Ozalper, Mehmet Hakan; Eldem, Barkin; Ozyurtkan, Mehmet Oguzhan; Issaka, Adamu; Ermerak, Nezih Onur; Yuksel, Mustafa

    2013-01-01

    Several studies previously demonstrated an improvement in the quality of life (QoL) of the patients undergoing a minimally invasive repair of pectus excavatum, but there are no data about such improvement following the minimally invasive repair of pectus carinatum (PC) deformity. The purpose of this study was to investigate the effects of the minimally invasive repair of PC deformity on the psychosocial and physical functioning of the patients. Among 40 patients who underwent minimally invasive repair for PC deformity from July 2008 to March 2011, 35 patients accepted to answer the QoL questionnaires, and 30 of them who had completed the postoperative 6th month were evaluated in this study. The modified two-step Nuss questionnaire was used for the QoL assessment. All patients and their parents completed the appropriate questionnaires regarding the patients' preoperative psychosocial and physical functioning, and they were asked to answer the same questions on the postoperative 6th month. The results from these questionnaires were analysed using Wilcoxon signed rank test to investigate the effects of the minimally invasive repair of PC deformity on psychosocial and physical functioning of the patients. The questionnaires used in the study confirmed the positive impact of the surgical correction on psychosocial and physical well-being in the patients and their parents. Spearman's ρ correlation coefficient determined how well the answers to the same question at two different times correlated with each other, and Cronbach's alpha demonstrated the internal consistency of these answers. These two parameters showed that the statistical results of the study were reliable enough. Statistical analysis of the scoring of the individual questions and the total scoring of individual patients revealed a statistically significant improvement (P < 0.05) following surgery. Similar significant improvements were observed in the total scoring of individual parents and in most scoring of the individual questions (10 of 13, 77%) in the parental questionnaire (P < 0.05). The results of this study confirm for the first time that minimally invasive repair of PC deformity has a positive impact on both psychosocial and physical functioning of the patient, which is supported by parental assessment.

  10. Psychosocial rehabilitation after war trauma with adaptive disclosure: Design and rationale of a comparative efficacy trial.

    PubMed

    Yeterian, Julie D; Berke, Danielle S; Litz, Brett T

    2017-10-01

    Posttraumatic stress disorder (PTSD) from warzone exposure is associated with chronic and disabling social and occupational problems. However, functional impairment is rarely assessed or targeted directly in PTSD treatments, which instead focus on symptom reduction. Trauma-related contributors to diminished functioning, including guilt, shame, and anger resulting from morally compromising or loss-based war experiences, are also underemphasized. The goal of this clinical trial is to fill a substantial gap in the treatment of military-related PTSD by testing a modified Adaptive Disclosure (AD) therapy for war-related PTSD stemming from moral injury and traumatic loss focused on improving psychosocial functioning AD. This paper describes the rationale and design of a multi-site randomized controlled trial comparing AD to Present-Centered Therapy (PCT). We will recruit 186 veterans with PTSD, who will be assessed at baseline, post-treatment, and 3- and 6-months post-treatment. Primary outcomes are functional changes (i.e., functioning/disability and quality of life). Secondary outcomes are mental health variables (i.e., PTSD, depression, guilt, shame). We hypothesize that veterans treated with AD will experience greater improvements in all outcomes compared to those treated with PCT. This trial will advance knowledge in rehabilitation research by testing the first therapy specifically designed to address psychosocial functioning among veterans with war-related PTSD. The results may improve the quality of mental health care for veterans by offering an ecologically sound treatment for experiences that are uniquely impactful for war veterans. Published by Elsevier Inc.

  11. Effects of using Nintendo Wii™ exergames in older adults: a review of the literature.

    PubMed

    Chao, Ying-Yu; Scherer, Yvonne K; Montgomery, Carolyn A

    2015-04-01

    The purpose of this review is to summarize and synthesize the impact of using the Nintendo Wii™ exergames in older adults. A database search was conducted to identify relevant studies. The search was limited to empirical studies, with particular attention paid to the effects of Wii exergames intervention on cognition, physical function, and psychosocial outcomes in older adults. A total of 22 empirical studies met inclusion criteria and were included in this review. Positive effects included improving physical function, decreasing depression, and increasing cognition and quality of life in older adults. Improved socialization and motivation to exercise were also reported. Using Wii exergames does show promise as an intervention to improve physical function, cognition, and psychosocial outcomes in older adults. Evidence supports that Wii exergames is a safe and feasible tool to encourage older adults to engage in exercise. © The Author(s) 2014.

  12. Expressive Writing for Gay-Related Stress: Psychosocial Benefits and Mechanisms Underlying Improvement

    ERIC Educational Resources Information Center

    Pachankis, John E.; Goldfried, Marvin R.

    2010-01-01

    Objective: This study tested the effectiveness of an expressive writing intervention for gay men on outcomes related to psychosocial functioning. Method: Seventy-seven gay male college students (mean age = 20.19 years, SD = 1.99) were randomly assigned to write for 20 min a day for 3 consecutive days about either (a) the most stressful or…

  13. Family Relationships and Psychosocial Dysfunction Among Family Caregivers of Patients With Advanced Cancer.

    PubMed

    Nissen, Kathrine G; Trevino, Kelly; Lange, Theis; Prigerson, Holly G

    2016-12-01

    Caring for a family member with advanced cancer strains family caregivers. Classification of family types has been shown to identify patients at risk of poor psychosocial function. However, little is known about how family relationships affect caregiver psychosocial function. To investigate family types identified by a cluster analysis and to examine the reproducibility of cluster analyses. We also sought to examine the relationship between family types and caregivers' psychosocial function. Data from 622 caregivers of advanced cancer patients (part of the Coping with Cancer Study) were analyzed using Gaussian Mixture Modeling as the primary method to identify family types based on the Family Relationship Index questionnaire. We then examined the relationship between family type and caregiver quality of life (Medical Outcome Survey Short Form), social support (Interpersonal Support Evaluation List), and perceived caregiver burden (Caregiving Burden Scale). Three family types emerged: low-expressive, detached, and supportive. Analyses of variance with post hoc comparisons showed that caregivers of detached and low-expressive family types experienced lower levels of quality of life and perceived social support in comparison to supportive family types. The study identified supportive, low-expressive, and detached family types among caregivers of advanced cancer patients. The supportive family type was associated with the best outcomes and detached with the worst. These findings indicate that family function is related to psychosocial function of caregivers of advanced cancer patients. Therefore, paying attention to family support and family members' ability to share feelings and manage conflicts may serve as an important tool to improve psychosocial function in families affected by cancer. Copyright © 2016 American Academy of Hospice and Palliative Medicine. All rights reserved.

  14. Cognitive training plus a comprehensive psychosocial programme (OPUS) versus the comprehensive psychosocial programme alone for patients with first-episode schizophrenia (the NEUROCOM trial): a study protocol for a centrally randomised, observer-blinded multi-centre clinical trial.

    PubMed

    Vesterager, Lone; Christensen, Torben Ø; Olsen, Birthe B; Krarup, Gertrud; Forchhammer, Hysse B; Melau, Marianne; Gluud, Christian; Nordentoft, Merete

    2011-02-09

    Up to 85% of patients with schizophrenia demonstrate cognitive dysfunction in at least one domain. Cognitive dysfunction plays a major role in functional outcome. It is hypothesized that addition of cognitive training to a comprehensive psychosocial programme (OPUS) enhances both cognitive and everyday functional capacity of patients more than the comprehensive psychosocial programme alone. The NEUROCOM trial examines the effect on cognitive functioning and everyday functional capacity of patients with schizophrenia of a 16-week manualised programme of individual cognitive training integrated in a comprehensive psychosocial programme versus the comprehensive psychosocial programme alone. The cognitive training consists of four modules focusing on attention, executive functioning, learning, and memory. Cognitive training involves computer-assisted training tasks as well as practical everyday tasks and calendar training. It takes place twice a week, and every other week the patient and trainer engage in a dialogue on the patient's cognitive difficulties, motivational goals, and progress in competence level. Cognitive training relies on errorless learning principles, scaffolding, and verbalisation in its effort to improve cognitive abilities and teach patients how to apply compensation strategies as well as structured problem solving techniques. At 16-week post-training and at ten-months follow-up, assessments are conducted to investigate immediate outcome and possible long-term effects of cognitive training. We conduct blinded assessments of cognition, everyday functional capacity and associations with the labour market, symptom severity, and self-esteem. Results from four-month and ten-month follow-ups have the potential of reliably providing documentation of the long-term effect of CT for patients with schizophrenia. Clinicaltrials.gov NCT00472862.

  15. Finding Success in Failure: Using Latent Profile Analysis to Examine Heterogeneity in Psychosocial Functioning among Heavy Drinkers Following Treatment

    PubMed Central

    Wilson, Adam D.; Bravo, Adrian J.; Witkiewitz, Katie

    2016-01-01

    Aims To estimate differences in post-treatment psychosocial functioning among treatment “failures” (i.e., heavy drinkers, defined as 4+/5+ drinks for women/men) from two large multi-site clinical trials, and to compare these levels of functioning to those of the purported treatment “successes” (i.e., non-heavy drinkers). Design Separate latent profile analyses of data from COMBINE and Project MATCH, comparing psychosocial outcomes across derived classes of heterogeneous treatment responders. Setting Eleven U.S. academic sites in COMBINE, 27 U.S. treatment sites local to nine research sites in Project MATCH. Participants 962 individuals in COMBINE (69% male, 77% white, mean age: 44 years) treated January 2001 to January 2004 and 1,528 individuals in Project MATCH (75% male, 80% white, mean age: 40 years) treated April 1991 to September 1994. Measurements In COMBINE, we analyzed health, quality of life, mental health symptoms, and alcohol consequences 12-months post-baseline. In Project MATCH, we examined social functioning, mental health symptoms, and alcohol consequences 15-months post-baseline. Findings Latent profile analysis of measures of functioning in both samples supported a three-profile solution for the group of treatment “failures,” characterized by high-functioning, average-functioning, and low-functioning individuals. The high-functioning treatment “failures” were generally performing better across measures of psychosocial functioning at follow-up than participants designated treatment “successes” by virtue of being abstainers or light drinkers. Conclusions Current Food and Drug Administration guidance to use heavy drinking as indicative of treatment “failure” fails to take into account substantial psychosocial improvements made by individuals who continue to occasionally drink heavily post-treatment. PMID:27367263

  16. Diagnosis and management of Duchenne muscular dystrophy, part 3: primary care, emergency management, psychosocial care, and transitions of care across the lifespan

    PubMed Central

    Birnkrant, David J; Bushby, Katharine; Bann, Carla M; Apkon, Susan D; Blackwell, Angela; Colvin, Mary K; Cripe, Linda; Herron, Adrienne R; Kennedy, Annie; Kinnett, Kathi; Naprawa, James; Noritz, Garey; Poysky, James; Street, Natalie; Trout, Christina J; Weber, David R; Ward, Leanne M

    2018-01-01

    Improvements in the function, quality of life, and longevity of patients with Duchenne muscular dystrophy (DMD) have been achieved through a multidisciplinary approach to management across a range of health-care specialties. In part 3 of this update of the DMD care considerations, we focus on primary care, emergency management, psychosocial care, and transitions of care across the lifespan. Many primary care and emergency medicine clinicians are inexperienced at managing the complications of DMD. We provide a guide to the acute and chronic medical conditions that these first-line providers are likely to encounter. With prolonged survival, individuals with DMD face a unique set of challenges related to psychosocial issues and transitions of care. We discuss assessments and interventions that are designed to improve mental health and independence, functionality, and quality of life in critical domains of living, including health care, education, employment, interpersonal relationships, and intimacy. PMID:29398641

  17. Relationship of psychological symptoms, antipsychotics and social data with psychosocial function in schizophrenia patients in Malaysia.

    PubMed

    Norlelawati, A Talib; Kartini, Abdullah; Norsidah, Kuzaifah; Ramli, Musa; Wan Azizi, Wan Sulaiman; Tariq, Abdul Razak

    2015-03-01

    The present study investigated the relationship between psychological symptoms and psychosocial function and the role of relevant sociodemographic data and antipsychotic use in the prediction of psychosocial function among multiracial schizophrenia outpatients in Malaysia. A total of 223 participants were recruited in this cross-sectional study conducted from December 2010 to April 2011. Psychological symptoms were assessed using the Positive and Negative Syndrome Scale whilst the psychosocial function was assessed using the Personal and Social Performance scale. Sociodemographic and treatment variables were gathered through interview or review of the medical records. All dimensions of psychosocial functions were inversely correlated with Positive and Negative Syndrome Scale sub-domains. Only the disorganization sub-domain significantly predicts all dimensions of psychosocial function. For social data, body mass index and employment status were significant predictors of all dimensions of psychosocial functions. Typical antipsychotics significantly predict social function negatively as compared to sulpiride (β = -0.152, P = 0.028). We found that the relationship between psychological symptoms and psychosocial functions were relatively consistent with the findings from the Caucasian population. Additionally, disorganization was the only significant predictor of all dimensions of psychosocial functions. This further emphasized the importance of cognition in psychosocial function. The roles of sulpiride, body mass index and employment status as predictors of psychosocial function were also discussed. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  18. Intrinsic motivation, neurocognition and psychosocial functioning in schizophrenia: testing mediator and moderator effects.

    PubMed

    Nakagami, Eri; Xie, Bin; Hoe, Maanse; Brekke, John S

    2008-10-01

    This study examined the nature of the relationships among neurocognition, intrinsic motivation, and psychosocial functioning for persons with schizophrenia. Hypotheses concerning both mediator and moderator mechanisms were tested. 120 individuals diagnosed with schizophrenia were recruited as they entered outpatient psychosocial rehabilitation programs. Measures of psychosocial functioning and intrinsic motivation were administered at baseline. Measures of neurocognition were administered at baseline by testers blind to scores on other study variables. Data were analyzed using latent construct modeling to test for mediator and moderator effects. There were strong bivariate relationships between neurocognition, intrinsic motivation, and psychosocial functioning. The results demonstrated that intrinsic motivation strongly mediated the relationship between neurocognition and psychosocial functioning. This mediation was evidenced by: (i) the direct path from neurocognition to functional outcome no longer being statistically significant after the introduction of motivation into the model, (ii) the statistical significance of the indirect path from neurocognition through motivation to functional outcome. There was no support for the two moderation hypotheses: the level of neurocognition did not influence the relationship between intrinsic motivation and psychosocial functioning, nor did the level of intrinsic motivation influence the relationship between neurocognition and psychosocial functioning. Neurocognition influences psychosocial functioning through its relationship with intrinsic motivation. Intrinsic motivation is a critical mechanism for explaining the relationship between neurocognition and psychosocial functioning. Implications for the theoretical understanding and psychosocial treatment of intrinsic motivation in schizophrenia are discussed.

  19. Local food supplementation and psychosocial stimulation improve linear growth and cognitive development among Indonesian infants aged 6 to 9 months.

    PubMed

    Helmizar, Helmizar; Jalal, Fasli; Lipoeto, Nur Indrawati; Achadi, Endang L

    2017-01-01

    To evaluate the effect of culturally-relevant food supplementation and psychosocial stimulation on infant growth and development. A community-based randomized controlled trial was conducted in 40 clusters from 5 selected villages in Tanah Datar District of West Sumatera, Indonesia. We assessed 355 infants aged 6 to 9 months at the beginning of the study. The infants were divided into 4 groups: 1) Food Supplementation (FS); 2) Psychosocial Stimulation (PS); 3) Food Supplementation and Psychosocial Stimulation (FS+PS); and 4) Control Group (CG). The formula food supplement was comprised of a variety of local food sources (local MP-ASI) and adjusted for the local habits. The quality of psychosocial stimulation was assessed with the Infant HOME inventory method. Progress at 6 months was assessed by anthropometry and the Bayley scores of cognition, language and motor function. There were improvements in linear growth, cognitive and motor development of children in the FS (p<0.05) and the FS+PS (p<0.01) groups compared to the CG. After six months of intervention, mean length increased to 6.86±2.08 cm and 6.66±2.41 cm for FS and FS+PS respectively (p<0.05). With the combination of food supplementation and psychosocial stimulation (FS+PS), cognitive development increased to 21.4±12.2 points (effect size 0.56) (p<0.01) and motor development increased to 20.7±18.4 points (effect size 0.50) (p<0.001). Combined intervention with local food supplementation and psychosocial stimulation improved infant growth, cognitive and motor development.

  20. Malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement.

    PubMed

    Suzana, S; Boon, P C; Chan, P P; Normah, C D

    2013-04-01

    Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor. A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p < 0.05 for both parameters). Multiple linear regression showed that 19.8% of malnutrition risk was predicted by poor appetite, decreased functional status (IADL) and depression. Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.

  1. The mediating effects of family functioning on psychosocial outcomes in healthy siblings of children with sickle cell disease.

    PubMed

    Gold, Jeffrey I; Treadwell, Marsha; Weissman, Lina; Vichinsky, Elliott

    2011-12-01

    Children with siblings coping with chronic illness experience stresses and disruptions in daily life as families work together to care for the affected child. Research suggests that children and adolescents with sickle cell disease (SCD) may be at risk for adjustment problems, impaired psychosocial functioning, and reduced quality of life. These potential stressors affect the child with SCD as well as their caregivers and other family members. This study examined the role of family functioning on the psychosocial functioning of healthy siblings of children with SCD. Participants were 65 healthy African-American siblings of children with SCD with a mean age of 11.19 years (range: 7-16) and their primary caregiver. Caregivers completed questionnaires assessing family functioning and child adjustment including demographic surveys, the Family Relations Scale (FRS), and the Child Behavior Checklist (CBCL). Increased number of emergency room visits (β = -0.28, P < 0.05) predicted poor psychosocial adjustment in siblings. Family functioning mediated this effect (β = 0.27; P < 0.05). High levels of family expressiveness (total score, r = -0.34; P < 0.01), support (total score, r = -0.54; P = 0.001), and low levels of family conflict (total score, r = 0.41; P < 0.001) were associated with improved adjustment among healthy siblings of children with SCD. Awareness of the possible negative psychosocial outcomes of living with a sister or a brother with SCD is important for clinicians. In particular, interventions that focus on family expressiveness, support, and conflict are indicated for this population. Copyright © 2011 Wiley-Liss, Inc.

  2. Self-investigation in adolescent chronic fatigue syndrome: narrative changes and health improvement.

    PubMed

    van Geelen, Stefan M; Fuchs, Coralie E; Sinnema, Gerben; van de Putte, Elise M; van Geel, Rolf; Hermans, Hubert J M; Kuis, Wietse

    2011-05-01

    A small-scale intervention study into narrative self-investigation in adolescent chronic fatigue syndrome (CFS). The self-confrontation method (SCM) is an instrument to assess and change personal life stories. Forty-two adolescents diagnosed with CFS were included and randomly assigned to either 6 or 12 sessions with the SCM. Twenty-five healthy adolescents were assigned to 6 sessions. Outcome was measured directly after the self-investigation procedure at 4 months. Follow-up measurements were made 10 months later. The Checklist Individual Strength and the Child Health Questionnaire were used to measure changes in fatigue, physical and psychosocial functioning. Self-investigation resulted in significant changes in participants' narratives. Moreover, after self-investigation there was a significant improvement in fatigue, physical and psychosocial functioning for the adolescents with CFS. The patients who completed 12 sessions improved most. At follow-up, the positive effects were maintained. Self-investigation enables a move beyond the symptoms of CFS in an individualized, patient centered way. Narrative transformation seems to contribute to improved physical and psychosocial outcome in adolescent CFS. The SCM allows adolescents to discover (for themselves) factors that might cause or perpetuate their fatigue. The results suggest that self-investigation is a useful instrument in the management of adolescent CFS. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Psychosocial outcomes in a cohort of perinatally HIV-infected adolescents in Western Jamaica.

    PubMed

    Evans-Gilbert, Tracy; Kasimbie, Kazie; Reid, Gail; Williams, Shelly Ann

    2018-02-05

    Background Psychosocial factors interact with adolescent development and affect the ability of HIV-infected adolescents to cope with and adhere to treatment. Aim To evaluate psychosocial outcomes in perinatally HIV-infected adolescents (PHIVAs) in Western Jamaica after psychosocial intervention. Methods The Bright Futures Paediatric Symptom Checklist (BF-PSC) was used for psychological screening of PHIVAs in Western Jamaica. Referred patients were evaluated using the Youth version of the Columbia Impairment Scale (CIS). Demographic, laboratory and clinical data obtained between July 2014 and June 2016 were evaluated retrospectively and outcomes were reviewed before and after psychosocial intervention. Results Sixty PHIVAs were enrolled and 36 (60%) had a positive BF-PSC score that necessitated referral. The BF-PSC correctly identified 89% of patients with impaired psychosocial assessment by CIS scores. Referred patients were less likely to adhere to treatment, to be virologically suppressed or to have a CD4+ count of >500 cells/μl, and were more likely to be in the late teenage group or to be of orphan status. After intervention, the prevalence of viral suppression increased and median viral load decreased. A difference in mean CD4+ cell count was detected before but not after intervention in teenage and orphan groups. Conclusions The BF-PSC identified at-risk PHIVAs with impaired psychosocial functioning. Increased vulnerability was noted in orphans and older teenagers. Psychosocial interventions (including family therapy) reduced psychosocial impairment and improved virological suppression. Mental health intervention should be instituted to facilitate improved clinical outcomes, autonomy of care and transition to adult care.

  4. Implementation of the thinking skills for work program in a psychosocial clubhouse.

    PubMed

    McGurk, Susan R; Schiano, Diane; Mueser, Kim T; Wolfe, Rosemarie

    2010-01-01

    Cognitive remediation programs aimed at improving role functioning have been implemented in a variety of different mental health treatment settings, but not in psychosocial clubhouses. This study sought to determine the feasibility and preliminary outcomes of providing a cognitive remediation program (the Thinking Skills for Work program), developed and previously implemented in supported employment programs at mental health agencies, in a psychosocial club-house. Twenty-three members with a history of difficulties getting or keeping jobs, who were participating in a supported employment program at a psychosocial clubhouse, were enrolled in the Thinking Skills for Work program. A neurocognitive battery was administered at baseline and 3 months later after completion of the computer cognitive training component of the program. Hours of competitive work were tracked for the 2 years before enrollment and 2 years following enrollment. Other work-related activities (school, volunteer) were also tracked for 2 years following enrollment. Twenty-one members (91%) completed 6 or more computer cognitive training sessions. Participants demonstrated significant improvements on neurocognitive measures of processing speed, verbal learning and memory, and executive functions. Sixty percent of the members obtained a competitive job during the 2-year follow-up, and 74% were involved in some type of work-related activity. Participants worked significantly more competitive hours over the 2 years after joining the Thinking Skills for Work program than before. The findings support the feasibility and promise of implementing the Thinking Skills for Work program in the context of supported employment provided at psychosocial clubhouses.

  5. Parent-child communication patterns during the first year after a parent's cancer diagnosis: the effect on parents' functioning.

    PubMed

    Gazendam-Donofrio, Stacey; Hoekstra, Harald; van der Graaf, Winette; van de Wiel, Harry; Visser, Annemieke; Huizinga, Gea; Hoekstra-Weebers, Josette

    2009-09-15

    Good parent-child communication is thought to help families adjust more easily during stressful events such as parental cancer. Families dealing with cancer who communicate openly have reported less psychological distress. The first year after diagnosis may be particularly stressful. The authors investigated parents' quality of life (QOL) and stress-response symptoms and parent-child communication during the first year after diagnosis and examined possible relationships between communication and parents' functioning. Recently-diagnosed cancer patients (N=70) and spouses (N=55) participated within 4 months of diagnosis (T1) and 6 months (T2) and 12 months later (T3). Parents reported on communication with the children (PACS) and on their own physical and psychosocial functioning (RAND-36) and stress-response symptoms (IES). Parent-child communication remained stable throughout the first year after diagnosis and was similar to communication in families 1 year to 5 years after diagnosis. Patients' functioning improved and cancer-related distress decreased significantly. Spouses' cancer-related distress decreased; their functioning fluctuated through the year. In concurrent analyses, patients' open communication with the children related only to T1 intrusion. Spouses' open communication related to T3 psychosocial functioning; problem communication related to T1 and T2 psychosocial functioning and T2 avoidance. In prospective analyses, no significant relationships were found between parent-child communication and change in parents' functioning. Communication between parents and children remained stable over time; patients' and spouses' functioning improved. Parent-child communication seems to have a limited affect on parents' functioning. Copyright (c) 2009 American Cancer Society.

  6. The effectiveness of wellness coaching for improving quality of life.

    PubMed

    Clark, Matthew M; Bradley, Karleah L; Jenkins, Sarah M; Mettler, Emily A; Larson, Brent G; Preston, Heather R; Liesinger, Juliette T; Werneburg, Brooke L; Hagen, Philip T; Harris, Ann M; Riley, Beth A; Olsen, Kerry D; Vickers Douglas, Kristin S

    2014-11-01

    To learn more about the potential psychosocial benefits of wellness coaching. Although wellness coaching is increasing in popularity, there are few published outcome studies. In a single-cohort study design, 100 employees who completed the 12-week wellness coaching program were of a mean age of 42 years, 90% were women, and most were overweight or obese. Three areas of psychosocial functioning were assessed: quality of life (QOL; 5 domains and overall), depressive symptoms (Patient Health Questionnaire-9), and perceived stress level (Perceived Stress Scale-10). Participants were recruited from January 1, 2011, through December 31, 2011; data were collected up to July 31, 2012, and were analyzed from August 1, 2012, through October 31, 2013. These 100 wellness coaching completers exhibited significant improvements in all 5 domains of QOL and overall QOL (P<.0001), reduced their level of depressive symptoms (P<.0001), and reduced their perceived stress level (P<.001) after 12 weeks of in-person wellness coaching, and they maintained these improvements at the 24-week follow-up. In this single-arm cohort study (level 2b evidence), participating in wellness coaching was associated with improvement in 3 key areas of psychosocial functioning: QOL, mood, and perceived stress level. The results from this single prospective cohort study suggest that these areas of functioning improve after participating in wellness coaching; however, randomized clinical trials involving large samples of diverse individuals are needed to establish level 1 evidence for wellness coaching. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  7. Randomised trial of biofeedback training for encopresis.

    PubMed Central

    van der Plas, R N; Benninga, M A; Redekop, W K; Taminiau, J A; Büller, H A

    1996-01-01

    AIMS: To evaluate biofeedback training in children with encopresis and the effect on psychosocial function. DESIGN: Prospective controlled randomised study. PATIENT INTERVENTIONS: A multimodal treatment of six weeks. Children were randomised into two groups. Each group received dietary and toilet advice, enemas, oral laxatives, and anorectal manometry. One group also received five biofeedback training sessions. MAIN OUTCOME MEASURES: Successful treatment was defined as less than two episodes of encopresis, regular bowel movements, and no laxatives. Psychosocial function after treatment was assessed using the Child Behaviour Checklist. RESULTS: Children given laxatives and biofeedback training had higher success rates than those who received laxatives alone (39% v 19%) at the end of the intervention period. At 12 and 18 months, however, approximately 50% of children in each group were successfully treated. Abnormal behaviour scores were initially observed in 35% of children. Most children had improved behaviour scores six months after treatment. Children with an initial abnormal behaviour score who were successfully treated had a significant improvement in their behavioural profiles. CONCLUSIONS: Biofeedback training had no additional effect on the success rate or behaviour scores. Psychosocial problems are present in a subgroup of children with encopresis. The relation between successful treatment and improvement in behavioural function supports the idea that encopresis has an aetiological role in the occurrence and maintenance of behavioural problems in children with encopresis. PMID:8957948

  8. Neurocognition and psychosocial functioning in adolescents with bipolar disorder.

    PubMed

    Best, Michael W; Bowie, Christopher R; Naiberg, Melanie R; Newton, Dwight F; Goldstein, Benjamin I

    2017-01-01

    Adults with bipolar disorder demonstrate significantly poorer psychosocial functioning and neurocognition compared to controls. In adult bipolar disorder neurocognition predicts a substantial portion of variance in functioning. Adolescents with bipolar disorder have reducedpsychosocial functioning, but less is known about neurocognitive impairments, and no studies have examined the relationship between neurocognition and functioning in an adolescent sample. 38 adolescents with bipolar disorder and 49 healthy controls under 20 years of age completed assessments of psychosocial functioning, neurocognitive ability, and psychiatric symptoms. Adolescents with bipolar disorder had significantly poorer psychosocial functioning in domains of daily activities, social functioning, and satisfaction with functioning, ps<.006, compared to healthy controls. They also had poorer general neurocognitive functioning than controls, p=.004, with the greatest impairment on a test of sustained attention. Neurocognition was not a significant predictor of psychosocial functioning in this sample, but depressive symptoms significantly predicted functioning in all domains, p<.033. Limited sample size did not allow for complex statistical analyses. Differences in demographic characteristics of the clinical and control groups may limit generalization of these results. This adolescent sample with bipolar disorder experiences significantly poorer neurocognitive and psychosocial functioning compared to controls; however, psychosocial functioning appears to be more strongly related to mood symptoms than to neurocognition. Future work is needed to delineate the time course of neurocognitive functioning and its relation to psychosocial functioning across the course of illness. Adolescence may provide an ideal time for cognitive enhancement and intensive psychosocial intervention. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Prospective Cohort Study Investigating Changes in Body Image, Quality of Life, and Self-Esteem Following Minimally Invasive Cosmetic Procedures.

    PubMed

    Sobanko, Joseph F; Dai, Julia; Gelfand, Joel M; Sarwer, David B; Percec, Ivona

    2018-04-13

    Minimally invasive cosmetic injectable procedures are increasingly common. However, a few studies have investigated changes in psychosocial functioning following these treatments. To assess changes in body image, quality of life, and self-esteem following cosmetic injectable treatment with soft tissue fillers and neuromodulators. Open, prospective study of 75 patients undergoing cosmetic injectable procedures for facial aging to evaluate changes in psychosocial functioning within 6 weeks of treatment. Outcome measures included the Derriford appearance scale (DAS-24), body image quality of life inventory (BIQLI), and the Rosenberg self-esteem scale. Body image dissatisfaction, as assessed by the DAS-24, improved significantly 6 weeks after the treatment. Body image quality of life, as assessed by the BIQLI, improved, but the change did not reach statistical significance. Self-esteem was unchanged after the treatment. Minimally invasive cosmetic injectable procedures were associated with reductions in body image dissatisfaction. Future research, using recently developed cosmetic surgery-specific instruments, may provide further insight into the psychosocial benefits of minimally invasive procedures.

  10. Clinical and cognitive factors affecting psychosocial functioning in remitted patients with bipolar disorder.

    PubMed

    Konstantakopoulos, G; Ioannidi, N; Typaldou, M; Sakkas, D; Oulis, P

    2016-01-01

    Impaired interpersonal, social, and occupational functioning is very often observed in patients with bipolar disorder, not only at the acute stages of the illness but in remission as well. This finding raises the question of multiple factors that might affect psychosocial functioning in bipolar patients, such as residual subsyndromal symptoms and neuropsychological deficits. Social cognition impairment, especially impaired Theory of Mind (ToM), might also play an important role in bipolar patients' every-day functioning, similarly to what was found in patients with schizophrenia. The present study aimed to investigate the potential effect of clinical and cognitive factors on the psychosocial functioning of patients with bipolar disorder during remission, assessing ToM along with a broad range of basic cognitive functions. Forty-nine patients with bipolar disorder type I in remission and 53 healthy participants were assessed in general intelligence, working memory, attention, speed processing, verbal learning and memory, and executive functions using a comprehensive battery of neuropsychological tests. The Faux Pas Recognition Test was used to assess ToM. The two groups were matched for gender, age and education level. The Hamilton Rating Scale for Depression (HDRS), the Young Mania Rating Scale (YMRS), and the Brief Psychiatric Rating Scale (BPRS) were also administered to the patients. Every-day functioning was assessed with the Global Assessment of Functioning (GAF). In order to examine the contribution of many factors in psychosocial functioning, we used hierarchical multiple regression analysis. Bipolar patients presented significant impairment compared to healthy participants in all the basic cognitive functions tested with the exception of verbal memory. Moreover, patients had significant poorer performance than healthy controls in overall psyand cognitive ToM but not in affective ToM as measured by Faux Pas. Psychosocial functioning in patient group was significantly correlated to symptom severity-especially depressive (p<0.001) and psychotic symptoms (p=0.001), history of psychotic episodes (p=0.031) and ToM, overall (p=0.001) as well as its cognitive (p=0.023) and affective (p=0.004) components. Only the contribution of ToM in psychosocial functioning remained significant in the final multiple regression model. The findings of the current study indicate that residual symptoms and cognitive dysfunctions, especially deficits in social cognition, negatively affect psychosocial functioning of remitted patients with bipolar disorder. Moreover, our results suggest that ToM may play a central role in these patients' functioning. ToM is a mediator of the relationship between other clinical or cognitive variables and functioning, while it has also significant effect on social skills independently of other factors. Therefore, specific therapeutic interventions targeting social cognitive dysfunction might improve functional outcome in bipolar disorder. Putative contribution of other clinical characteristics (comorbid personality disorders, substance abuse, anxiety) and psychosocial factors (stigma, self-stigma, lack of social network) in bipolar patients' functioning should be examined in future studies.

  11. Psychosocial functioning in first-episode psychosis and associations with neurocognition, social cognition, psychotic and affective symptoms.

    PubMed

    Stouten, Luyken H; Veling, Wim; Laan, Winfried; van der Helm, Mischa; van der Gaag, Mark

    2017-02-01

    Most studies on the determinants of psychosocial functioning in first-episode psychosis used few predictors. This study examines the effects of multiple cognitive domains and multiple symptoms on psychosocial functioning. A total of 162 patients with a first-episode psychosis were assessed within 3 months after referral to an early psychosis treatment department. Four psychopathological subdomains (positive and negative symptoms, depression and anxiety) and five subdomains of psychosocial functioning (work/study, relationships, self-care, disturbing behaviour and general psychosocial functioning) were measured. Neurocognitive and social cognitive factors were identified through principal component analyses (PCA) of a 15-measure cognitive battery. Stepwise backward regression models were computed to identify the determinants of psychosocial functioning. The three neurocognitive and four social cognitive factors identified through PCA were largely independent of psychopathology. The strongest associations were between cognitive factors and anxiety. Higher levels of negative symptoms, poor general neurocognition and poor general social cognition showed strongest associations with impaired psychosocial functioning, followed by low verbal processing speed and low emotion processing speed. Together, these factors accounted for 39.4% of the variance in psychosocial functioning. The results suggest that negative symptoms, impaired neurocognition and poor social cognition are related to psychosocial problems in patients with first-episode psychosis. None of the affective or positive symptoms had a marked impact on psychosocial functioning. © 2015 Wiley Publishing Asia Pty Ltd.

  12. Long-term psychosocial consequences of surgical congenital malformations.

    PubMed

    Diseth, Trond H; Emblem, Ragnhild

    2017-10-01

    Surgical congenital malformations often represent years of treatment, large number of hospital stays, treatment procedures, and long-term functional sequels affecting patients' psychosocial functioning. Both functional defects and psychosocial difficulties that occur commonly in childhood may pass through adolescence on to adulthood. This overview presents reports published over the past 3 decades to elucidate the long-term psychosocial consequences of surgical congenital malformations. Literature searches conducted on PubMed database revealed that less than 1% of all the records of surgical congenital malformations described long-term psychosocial consequences, but with diverse findings. This inconsistency may be due to methodological differences or deficiencies; especially in study design, patient sampling, and methods. Most of the studies revealed that the functional deficits may have great impact on patients' mental health, psychosocial functioning, and QoL; both short- and long-term negative consequences. Factors other than functional problems, e.g., repeated anesthesia, multiple hospitalization, traumatic treatment procedures, and parental dysfunctioning, may also predict long-term mental health and psychosocial functioning. Through multidisciplinary approach, pediatric surgeons should also be aware of deficits in emotional and psychosocial functioning. To achieve overall optimal psychosocial functioning, the challenge is to find a compromise between physically optimal treatment procedures and procedures that are not psychologically detrimental. Copyright © 2017. Published by Elsevier Inc.

  13. Relationships between psychosocial outcomes in adolescents who are obese and their parents during a multi-disciplinary family-based healthy lifestyle intervention: One-year follow-up of a waitlist controlled trial (Curtin University's Activity, Food and Attitudes Program).

    PubMed

    Fenner, Ashley A; Howie, Erin K; Davis, Melissa C; Straker, Leon M

    2016-07-07

    Limited studies have investigated relationships in psychosocial outcomes between adolescents who are obese and their parents and how psychosocial outcomes change during participation in a physical activity and healthy eating intervention. This study examined both adolescent and parent psychosocial outcomes while participating in a one - year multi-disciplinary family-based intervention: Curtin University's Activity, Food, and Attitudes Program (CAFAP). Following a waitlist control period, the intervention was delivered to adolescent (n = 56, ages 11-16) and parent participants over 8 weeks, with one-year maintenance follow-up. Adolescent depression and quality of life, family functioning, and parent depression, anxiety, and stress were assessed at six time points: baseline and prior to intervention (e.g., waitlist control period), immediately following intervention, and at 3, 6, and 12 months post-intervention. Relationships between adolescent and parent psychosocial outcomes were assessed using Spearman correlations and changes in both adolescent and parent outcomes were assessed using linear mixed models. Changes in adolescent psychosocial outcomes were compared to changes in behavioural (physical activity and healthy eating) and physical (weight) outcomes using independent samples t-tests. The majority of psychosocial outcomes were significantly correlated between adolescents and parents across the one-year follow-up. Adolescent depression, psychosocial and physical quality of life outcomes significantly improved before or following intervention and were maintained at 6-months or one-year follow-up. Parent symptoms of depression, anxiety, and stress were reduced during waitlist and primarily remained improved. Changes in adolescent psychosocial outcomes were shown to be partially associated with behavioural changes and independent of physical changes. Adolescents in CAFAP improved psychosocial and physical quality of life and reversed the typical trajectory of depressive symptoms in adolescents who are obese during a one-year maintenance period. CAFAP was also effective at maintaining reductions in parent symptoms of depression, anxiety, and stress demonstrated during the waitlist period. The trial was registered with the Australian and New Zealand Clinical Trials Registry (No. 12611001187932 ).

  14. The Psychosocial Treadmill: the Road to Improving High-risk Behavior in Advanced Therapy Candidates.

    PubMed

    Newman, Laura

    2018-04-01

    The purpose of this review is to explore the evaluation and identification of psychosocial risk factors during the heart transplant evaluation process with the goal of improving psychosocial candidacy prior to transplant listing. Subsequently, more patients will be able to receive life-saving heart transplant and experience success after transplant. Evaluating and identifying psychosocial risk factors is an essential component of the transplant evaluation process. Less research exists demonstrating how patients may be able to reduce psychosocial risk factors over time to improve their candidacy for transplant. This review will describe a program developed for patients undergoing heart transplant evaluation at The Ohio State University Wexner Medical Center to improve their psychosocial risk. By implementing a comprehensive, multidisciplinary intervention to address psychosocial risk factors pre-transplant, patients can improve their psychosocial candidacy and go on to be listed for heart transplant.

  15. Subject-chosen activities in occupational therapy for the improvement of psychiatric symptoms of inpatients with chronic schizophrenia: a controlled trial.

    PubMed

    Hoshii, Junko; Yotsumoto, Kayano; Tatsumi, Eri; Tanaka, Chito; Mori, Takashi; Hashimoto, Takeshi

    2013-07-01

    To compare the therapeutic effects of subject-chosen and therapist-chosen activities in occupational therapy for inpatients with chronic schizophrenia. Prospective comparative study. A psychiatric hospital in Japan. Fifty-nine patients with chronic schizophrenia who had been hospitalized for many years. The subjects received six-months occupational therapy, participating in either activities of their choice (subject-chosen activity group, n = 30) or activities chosen by occupational therapists based on treatment recommendations and patient consent (therapist-chosen activity group, n = 29). The Positive and Negative Syndrome Scale and the Global Assessment of Functioning (GAF) Scale were used to evaluate psychiatric symptoms and psychosocial function, respectively. After six-months occupational therapy, suspiciousness and hostility scores of the positive scale and preoccupation scores of the general psychopathology scale significantly improved in the subject-chosen activity group compared with the therapist-chosen activity group, with 2(2) (median (interquartile range)) and 3(1.25), 2(1) and 2.5(1), and 2(1) and 3(1), respectively. There were no significant differences in psychosocial functions between the two groups. In within-group comparisons before and after occupational therapy, suspiciousness scores of the positive scale, preoccupation scores of the general psychopathology scale, and psychosocial function significantly improved only in the subject-chosen activity group, with 3(1) to 2(2), 3(1) to 2(1), and 40(9) to 40(16) respectively, but not in the therapist-chosen activity group. The results suggested that the subject-chosen activities in occupational therapy could improve the psychiatric symptoms, suspiciousness, and preoccupation of the inpatients with chronic schizophrenia.

  16. Effectiveness of Interventions to Improve Occupational Performance for People With Psychosocial, Behavioral, and Emotional Impairments After Brain Injury: A Systematic Review.

    PubMed

    Wheeler, Steven; Acord-Vira, Amanda; Davis, Diana

    2016-01-01

    This systematic review evaluates the effectiveness of interventions to improve occupational performance for people with psychosocial, behavioral, or emotional impairments after traumatic brain injury (TBI). Medline, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews were searched. Of the 1,512 articles initially identified, 35 met the inclusion criteria. Six types of interventions were identified: (1) education, (2) peer mentoring, (3) goal-directed therapy, (4) physical activity, (5) skills training, and (6) cognitive-behavioral therapy (CBT). Strong evidence from well-conducted research supports the use of CBT in individual and group settings. Moderate evidence supports goal-directed interventions, aquatic exercise, and functional skills training. Limited evidence supports peer mentoring, aerobic exercise, educational interventions, and various skills training. An increasing body of evidence supports specific interventions to improve occupational performance and participation for people with psychosocial, behavioral, or emotional impairments after TBI. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  17. Psychosocial treatments for negative symptoms in schizophrenia: Current practices and future directions

    PubMed Central

    Elis, Ori; Caponigro, Janelle M.; Kring, Ann M.

    2014-01-01

    Schizophrenia can be a chronic and debilitating psychiatric disorder. Though advancements have been made in the psychosocial treatment of some symptoms of schizophrenia, people with schizophrenia often continue to experience some level of symptoms, particularly negative symptoms, throughout their lives. Because negative symptoms are associated with poor functioning and quality of life, the treatment of negative symptoms is a high priority for intervention development. However, current psychosocial treatments primarily focus on the reduction of positive symptoms with comparatively few studies investigating the efficacy of psychosocial treatments for negative symptoms. In this article, we review and evaluate the existing literature on three categories of psychosocial treatments – cognitive behavioral therapy (CBT), social skills training (SST), and combined treatment interventions – and their impact on the negative symptoms of schizophrenia. Of the interventions reviewed, CBT and SST appear to have the most empirical support, with some evidence suggesting that CBT is associated with maintenance of negative symptom improvement beyond six months after treatment. It remains unclear if a combined treatment approach provides improvements above and beyond those associated with each individual treatment modality. Although psychosocial treatments show promise for the treatment of negative symptoms, there are many unanswered questions about how best to intervene. We conclude with a general discussion of these unanswered questions, future directions and methodological considerations, and suggestions for the further development of negative symptom interventions. PMID:23988452

  18. Mood, body image, fear of kidney failure, life satisfaction, and decisional stability following living kidney donation: Findings from the KDOC study.

    PubMed

    Rodrigue, J R; Schold, J D; Morrissey, P; Whiting, J; Vella, J; Kayler, L K; Katz, D; Jones, J; Kaplan, B; Fleishman, A; Pavlakis, M; Mandelbrot, D A

    2018-06-01

    Prior studies demonstrate that most living kidney donors (LKDs) report no adverse psychosocial outcomes; however, changes in psychosocial functioning at the individual donor level have not been routinely captured. We studied psychosocial outcomes predonation and at 1, 6, 12, and 24 months postdonation in 193 LKDs and 20 healthy controls (HCs). There was minimal to no mood disturbance, body image concerns, fear of kidney failure, or life dissatisfaction, indicating no incremental changes in these outcomes over time and no significant differences between LKDs and HCs. The incidence of any new-onset adverse outcomes postdonation was as follows: mood disturbance (16%), fear of kidney failure (21%), body image concerns (13%), and life dissatisfaction (10%). Multivariable analyses demonstrated that LKDs with more mood disturbance symptoms, higher anxiety about future kidney health, low body image, and low life satisfaction prior to surgery were at highest risk of these same outcomes postdonation. It is important to note that some LKDs showed improvement in psychosocial functioning from pre- to postdonation. Findings support the balanced presentation of psychosocial risks to potential donors as well as the development of a donor registry to capture psychosocial outcomes beyond the mandatory 2-year follow-up period in the United States. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  19. Mindfulness-based Cognitive Therapy for Non-remitted Patients with Bipolar Disorder

    PubMed Central

    Deckersbach, Thilo; Hölzel, Britta K.; Eisner, Lori R.; Stange, Jonathan P.; Peckham, Andrew D.; Dougherty, Darin D.; Rauch, Scott L.; Lazar, Sara; Nierenberg, Andrew A.

    2013-01-01

    Introduction Bipolar disorder is characterized by recurrent episodes of depression and/or mania along with inter-episodic mood symptoms that interfere with psychosocial functioning. Despite periods of symptomatic recovery, many individuals with bipolar disorder continue to experience substantial residual mood symptoms that often lead to the recurrence of mood episodes. Aims The present study explored whether a new mindfulness-based cognitive therapy (MBCT) for bipolar disorder would increase mindfulness, reduce residual mood symptoms, and increase emotion regulation abilities, psychological well-being, positive affect and psychosocial functioning. Following a baseline clinical assessment, 12 individuals with DSM-IV bipolar disorder were treated with 12 group sessions of MBCT. Results At the end of treatment, as well as at the 3-months follow-up, participants showed increased mindfulness, lower residual depressive mood symptoms, less attentional difficulties, and increased emotion regulation abilities, psychological well-being, positive affect and psychosocial functioning. Conclusions These findings suggest that treating residual mood symptoms with MBCT may be another avenue to improving mood, emotion regulation, well-being and functioning in individuals with bipolar disorder. PMID:22070469

  20. Psychological well-being, dental esthetics, and psychosocial impacts in adolescent orthodontic patients: A prospective longitudinal study.

    PubMed

    Deng, Xiao; Wang, Yun-Ji; Deng, Feng; Liu, Pang-Li; Wu, Yan

    2018-01-01

    We examined the role of adolescent orthodontic patients' psychological well-being attributes (self-esteem, general body image, and positive and negative affects) and the clinical indicators of dental esthetics (orthodontists' ratings on the Index of Orthodontic Treatment Need-Aesthetic Component [IOTN-AC]), and their changes from pretreatment to posttreatment as predictors of the psychosocial impact of dental esthetics. In this prospective longitudinal study, 1090 adolescent orthodontic patients seeking treatment at the Stomatological Hospital of Chongqing Medical University in China (mean age, 14.25 years; SD, 2.03 years) were assessed before treatment, and 68.99% (n = 752) were assessed after treatment. All subjects completed a questionnaire measuring psychological well-being attributes and 3 components of the Psychosocial Impact of Dental Aesthetics (perceptive, cognitive-affective, and social-functional). Clinical indicators of dental esthetics were measured by 3 orthodontists using the IOTN-AC. Substantial enhancement from pretreatment to posttreatment was found in all 3 Psychosocial Impacts of Dental Aesthetics components, confirming the positive effects of orthodontic treatment on oral health-related quality of life. Psychosocial impact of dental esthetics at baseline and improvement from pretreatment to posttreatment were found to be predicted by the patients' psychological well-being attributes (self-esteem, general body image, and negative affect) and the clinical indicators (orthodontists' rating on the IOTN-AC) at baseline, as well as their pretreatment to posttreatment change. Psychological well-being attributes had comparable or greater contribution to the Psychosocial Impact of Dental Aesthetics at baseline as well as greater improvement after treatment than the clinical indicators. These biopsychological models explained 29% to 43% of the variances in psychosocial impacts of dental esthetics outcome at baseline and about 33% of the variance in pretreatment to posttreatment improvement. This study establishes a biopsychological model for understanding the psychosocial impact of dental esthetics and its improvement after orthodontic treatment among adolescent orthodontic patients. The findings highlight the importance of psychological parameters in orthodontic research and clinical practice. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  1. Cognitive Remediation and Bias Modification Strategies in Mood and Anxiety Disorders

    PubMed Central

    Gold, Alexandra K.; Montana, Rebecca E.; Sylvia, Louisa G.; Nierenberg, Andrew A.; Deckersbach, Thilo

    2016-01-01

    Purpose of review Cognitive impairments and biases, which are prevalent in patients with mood and anxiety disorders, can affect quality of life and functioning. Traditional treatments are only insufficiently addressing these impairments and biases. We review the cognitive impairments and biases present in these disorders as well as treatments targeting these domains. Recent findings Interventions aimed at improving cognitive impairments and biases may help improve cognitive deficits and overall functioning in patients with mood and anxiety disorders. Direct comparisons of treatments for cognitive impairments or biases versus more traditional psychosocial interventions have produced diverse results. Summary Overall, treatments for cognitive impairments and cognitive biases warrant additional study in clinical trials. Future research should explore cognitive remediation and cognitive bias modification adjunctive to psychosocial treatments to optimize patient outcomes in mood and anxiety disorders. PMID:27917364

  2. Community-Based Psychosocial Treatment Has an Impact on Social Processing and Functional Outcome in Schizophrenia.

    PubMed

    Varga, Eszter; Endre, Szilvia; Bugya, Titusz; Tényi, Tamás; Herold, Róbert

    2018-01-01

    Schizophrenic patients have serious impairments in social cognition, which often persists after significant reduction in clinical symptoms. Community-based psychosocial treatments aim to recover social functioning for mentally ill individuals. Our aim was to examine prospective changes in social cognition and functional outcomes in two groups of schizophrenic patients involved in two forms of community-based psychosocial treatments namely case management (CM) and community-based club (CC) compared to a matched, treatment as usual (TAU) group of patients. We hypothesized that CC and CM groups would exhibit better functional and social cognitive outcomes after a 6-month long psychosocial treatment period. Seventy-five patients participated either in CC, CM or TAU. Both CC and CM took part in community-based psychosocial treatment programs including trainings, such as communication and assertiveness trainings. In addition, CC provided group therapeutic treatments and a continuously available day care where patients had the possibility to participate in various social interactions. All participants were in remission, and on maintenance antipsychotic treatment. Participants were assessed on all study variables at two time points: baseline and after 6 months with a battery of questionnaires that examined affective face perception, affective prosody perception, pragmatic language comprehension and ToM. Our results showed that functional outcomes improved significantly in the CC as well as in the CM groups, in contrast to the TAU group. While analyzing summary scores of social cognition, it was found that only the CC group increased its performance in social cognition. In addition, a significant between-group difference in social cognitive function was found after 6 months between the three groups, with the CC group performing best. When investigating associations between changes in social cognition and changes in functional outcomes during a 6-month long treatment period, we found significant correlations between the two variables both in the CC and in the CM groups. Based on our results, we suggest that a rich interpersonal network and social support have highly beneficial effects on social cognition and we would like to emphasize the necessity of offering community-based psychosocial treatments beside antipsychotic medications as early as possible as a crucial part of the complex therapy of schizophrenia.

  3. Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Psychosocial Domain.

    PubMed

    Sutin, Angelina R; Boutelle, Kerri; Czajkowski, Susan M; Epel, Elissa S; Green, Paige A; Hunter, Christine M; Rice, Elise L; Williams, David M; Young-Hyman, Deborah; Rothman, Alexander J

    2018-04-01

    Within the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project, the psychosocial domain addresses how psychosocial processes underlie the influence of obesity treatment strategies on weight loss and weight maintenance. The subgroup for the psychosocial domain identified an initial list of high-priority constructs and measures that ranged from relatively stable characteristics about the person (cognitive function, personality) to dynamic characteristics that may change over time (motivation, affect). This paper describes (a) how the psychosocial domain fits into the broader model of weight loss and weight maintenance as conceptualized by ADOPT; (b) the guiding principles used to select constructs and measures for recommendation; (c) the high-priority constructs recommended for inclusion; (d) domain-specific issues for advancing the science; and (e) recommendations for future research. The inclusion of similar measures across trials will help to better identify how psychosocial factors mediate and moderate the weight loss and weight maintenance process, facilitate research into dynamic interactions with factors in the other ADOPT domains, and ultimately improve the design and delivery of effective interventions. © 2018 The Obesity Society.

  4. Mental Health Problems in Parents of Children with Congenital Heart Disease.

    PubMed

    Kolaitis, Gerasimos A; Meentken, Maya G; Utens, Elisabeth M W J

    2017-01-01

    This review will provide a concise description of mental health problems in parents of children with a (non-syndromic) congenital heart disease (CHD) during different stressful periods. Predictors of these problems and also implications for clinical practice will be mentioned. Having a child with CHD can be very stressful for parents, who have to face overwhelming emotions and also extra physical, financial, and other practical challenges. Parental distress has been reported in 30-80% of parents and appears not to be related to severity of CHD. Parental mental health, parenting, the parent-child relationship, and parental quality of life can all be affected. Parents, and especially mothers, are at risk of psychological distress, anxiety, depression, somatization, hopelessness, and posttraumatic stress symptoms, which in turn may influence mother's responsiveness. In the long term, the majority of parents adapt successfully to living with a child with CHD, but approximately 40% report a need for psychosocial care. These families may be helped by early psychosocial interventions to alleviate stress and reduce children's emotional and behavioral problems. A holistic approach to early psychosocial interventions should aim at improving coping and enhance parenting. During routine medical checkups, medical professionals should ask about parental stress, family functioning, and psychosocial functioning of the child and, when needed, adequate psychosocial care should be provided.

  5. Executive functioning independently predicts self-rated health and improvement in self-rated health over time among community-dwelling older adults.

    PubMed

    McHugh, Joanna Edel; Lawlor, Brian A

    2016-01-01

    Self-rated health, as distinct from objective measures of health, is a clinically informative metric among older adults. The purpose of our study was to examine the cognitive and psychosocial factors associated with self-rated health. 624 participants over the age of 60 were assessed at baseline, and of these, 510 were contacted for a follow-up two years later. Measures of executive function and self-rated health were assessed at baseline, and self-rated health was assessed at follow-up. We employed multiple linear regression analyses to investigate the relationship between executive functioning and self-rated health, while controlling for demographic, psychosocial and biological variables. Controlling for other relevant variables, executive functioning independently and solely predicted self-rated health, both at a cross-sectional level, and also over time. Loneliness was also found to cross-sectionally predict self-rated health, although this relationship was not present at a longitudinal level. Older adults' self-rated health may be related to their executive functioning and to their loneliness. Self-rated health appeared to improve over time, and the extent of this improvement was also related to executive functioning at baseline. Self-rated health may be a judgement made of one's functioning, especially executive functioning, which changes with age and therefore may be particularly salient in the reflections of older adults.

  6. Objective and subjective psychosocial functioning in bipolar disorder: an investigation of the relative importance of neurocognition, social cognition and emotion regulation.

    PubMed

    Van Rheenen, Tamsyn E; Rossell, Susan L

    2014-06-01

    People with bipolar disorder (BD) experience significant psychosocial impairment. Understandings of the nature and causes of such impairment is limited by the lack of research exploring the extent to which subjectively reported functioning should be valued as an indicator of objective dysfunction, or examining the relative influence of neurocognition, social cognition and emotion regulation on these important, but different aspects of psychosocial functioning in the context of mania and depression symptoms. This study aimed to address this paucity of research by conducting a comprehensive investigation of psychosocial functioning in a well characterised group of BD patients. Fifty-one BD patients were compared to 52 healthy controls on objectively and subjectively assessed psychosocial outcomes. Relationships between current mood symptoms, psychosocial function and neurocognitive, social cognitive and emotion regulation measures were also examined in the patient group. Patients had significantly worse scores on the global objective and subjective functioning measures relative to controls. In the patient group, although these scores were correlated, regression analyses showed that variance in each of the measures was explained by different predictors. Depressive symptomatology was the most important predictor of global subjective functioning, and neurocognition had a concurrent and important influence with depressive symptoms on objective psychosocial function. Emotion regulation also had an indirect effect on psychosocial functioning via its influence on depressive symptomatology. As this study was cross-sectional in nature, we are unable to draw precise conclusions regarding contributing pathways involved in psychosocial functioning in BD. These results suggest that patients' own evaluations of their subjective functioning represent important indicators of the extent to which their observable function is impaired. They also highlight the importance of incorporating cognitive and emotion regulation assessments into clinical practice when working to reduce psychosocial dysfunction with patients diagnosed with BD. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Beyond emotional benefits: physical activity and sedentary behaviour affect psychosocial resources through emotions.

    PubMed

    Hogan, Candice L; Catalino, Lahnna I; Mata, Jutta; Fredrickson, Barbara L

    2015-01-01

    Physical activity is known to improve emotional experiences, and positive emotions have been shown to lead to important life outcomes, including the development of psychosocial resources. In contrast, time spent sedentary may negatively impact emotional experiences and, consequently, erode psychosocial resources. Two studies tested whether activity independently influenced emotions and psychosocial resources, and whether activity indirectly influenced psychosocial resources through emotional experiences. Using cross-sectional (Study 1a) and longitudinal (Study 1b) methods, we found that time spent physically active independently predicted emotions and psychosocial resources. Mediation analyses suggested that emotions may account for the relation between activity and psychosocial resources. The improved emotional experiences associated with physical activity may help individuals build psychosocial resources known to improve mental health. Study 1a provided first indicators to suggest that, in contrast, sedentary behaviour may reduce positive emotions, which could in turn lead to decrements in psychosocial resources.

  8. The Mediating Role of Posttraumatic Stress Disorder with Tendency to Forgive, Social Support, and Psychosocial Functioning of Terror Survivors.

    PubMed

    Weinberg, Michael

    2018-06-12

    The study reported in this article examined the relationship between psychosocial functioning and tendency to forgive, social support, and posttraumatic stress disorder (PTSD) symptoms of terror survivors (N = 108). Structural equation modeling was used to examine whether PTSD symptoms mediated the association between tendency to forgive, social support, and psychosocial functioning. The findings demonstrated that the association between tendency to forgive and psychosocial functioning was mediated exclusively by PTSD symptoms, whereas the association between social support and psychosocial functioning was partially mediated by PTSD symptoms. The study reinforces the importance of addressing trauma survivors' psychosocial functioning as an emotional state associated with tendency to forgive, social support, and PTSD symptoms. In addition, the findings suggest that when treating trauma survivors, therapists should be aware of PTSD not only as an emotional consequence of trauma, but also as a mediator of numerous emotional and cognitive coping mechanisms.

  9. Psychosocial functioning in patients with schizophrenia treated with aripiprazole - an office-based real-world setting. Results from the German post-marketing surveillance study.

    PubMed

    Bergmann, F; Zacher, A; Nass, A; Urban, R; Werner, C; Spevakné-Göröcs, T; Kungel, M; Ebrecht, M; Modell, S

    2009-05-01

    Aripiprazole (ABILIFY) is an effective antipsychotic used in a dose range from 10 to 30 mg, administered once daily. Soon after its approval in Germany for treatment of schizophrenia, a 12-month post-marketing surveillance study was initiated that included 1 096 patients cared for by 408 office-based psychiatrists and/or neurologists in private practice. The aim was to gain further insights into safety and efficacy of aripiprazole in an outpatient real-life setting focusing on general health, well-being and psychosocial functioning. Efficacy was rated by using standard CGI, SF-12 and SIWM-PsySo instruments for severity of disease, physical and mental health outcomes and psychosocial state, respectively. Safety was evaluated according to the reports of adverse events. Mean total daily dose of aripiprazole increased from 15.4 mg at the visit after 1 month to 17.6 mg at the visits after 6 to 12 months, the most frequently administered maintenance dose being 15 mg. Within the observation period significant improvements of CGI, SF-12 and SIWM-PsySo scores over time versus baseline values were observed (p<0.001) when starting with or switching to aripiprazole. Physicians observed improvements in 80.7% of the patients at endpoint; in 62% of the patients the disease state was considered "much" or "very much" improved. Aripiprazole was overall well tolerated; 19.9% of patients discontinued treatment after 12 months. Adverse effects in general were moderate to mild and corresponded to the known tolerability profile of aripiprazole. Psychotic side effects reported were probably due to a recurrence of the underlying schizophrenic disorder. The results indicate that aripiprazole may be an efficacious and safe treatment option for pre-treated patients with schizophrenia also in a naturalistic psychiatrist/neurologist practice setting with effects on health and psychosocial functioning and a comparably low dropout rate.

  10. Impact of Michelangelo prosthetic hand: Findings from a crossover longitudinal study.

    PubMed

    Luchetti, Martina; Cutti, Andrea G; Verni, Gennaro; Sacchetti, Rinaldo; Rossi, Nicolino

    2015-01-01

    This work explores the functional and psychosocial impact of the multigrip Michelangelo (M) prosthetic hand. Transradial myoelectric prosthesis users (6 men, median age: 47 y) participated in a crossover longitudinal study. A multifactorial assessment protocol was applied before the application of M and after 3 mo (functional assessment) and 6 mo (psychosocial assessment) of home use. Functional assessment included both practical tests (i.e., Southampton Hand Assessment Procedure [SHAP], Box and Blocks Test [BBT], and Minnesota Manual Dexterity Test [MMDT]) and self-report functional scales. Psychosocial assessment consisted of a clinical interview and a battery of self-report questionnaires concerning current anxious-depressive symptoms and health-related quality of life, body image concerns, adjustment and satisfaction with prosthesis, social support, coping style, and personality. Increased manual dexterity was observed after 3 mo based on improvements in the SHAP, BBT, and MMDT. Two important themes emerged from the clinical interviews at the 6 mo follow-up: (1) the enhanced functionality and (2) the "like a real hand" aspect of the M, which further increased prosthesis integration to the Self. A few patients expressed concerns about M dimension, noise, and weight. The M appeared to restore hand function and natural appearance. The present findings provide preliminary evidence, and additional studies are needed.

  11. Predicting functional remission in patients with schizophrenia: a cross-sectional study of symptomatic remission, psychosocial remission, functioning, and clinical outcome

    PubMed Central

    Valencia, Marcelo; Fresán, Ana; Barak, Yoram; Juárez, Francisco; Escamilla, Raul; Saracco, Ricardo

    2015-01-01

    Background New approaches to assess outcome in schizophrenia include multidimensional measures such as remission, cognition, psychosocial functioning, and quality of life. Clinical and psychosocial measures have been recently introduced to assess functional outcome. Objective The study presented here was designed to examine the rates of symptomatic remission, psychosocial remission, global functioning, and clinical global impressions in a sample of schizophrenia outpatients in order to assess functional remission and to identify predictive factors for functional remission. Methods A total of 168 consecutive Mexican outpatients receiving pharmacological treatment at the National Institute of Psychiatry in Mexico City were enrolled in a cross-sectional study. Symptomatic remission was assessed according to the definition and criteria proposed by the Remission in Schizophrenia Working Group using the Positive and Negative Symptom Scale. Psychosocial remission was assessed according to Barak criteria using the Psychosocial Remission in Schizophrenia scale. Functioning was measured with the Global Assessment of Functioning, and clinical outcome with the Clinical Global Impressions (CGI) Scale. Results Findings showed that 45.2% of patients fulfilled the symptomatic remission criteria, 32.1% achieved psychosocial remission, and 53% reported adequate functioning. However, the combination of these three outcome criteria – symptomatic, psychosocial remission, and functioning – indicated that 14.9% of the patients achieved our predefined functional remission outcome. The logistic regression model included five predictive variables for functional remission: (1) being employed, (2) use of atypical antipsychotics, (3) lower number of medications, (4) lower negative symptom severity, and (5) lower excitement symptom severity. Conclusion The study demonstrated that symptomatic remission, psychosocial remission, and functioning could be achievable goals for a considerable number of patients. The outcome of functional remission was achieved by a minority of patients, less than 15%. New approaches should include multidimensional measures to assess functional outcome in schizophrenia research. PMID:26396518

  12. Psychosocial morbidity associated with bipolar disorder and borderline personality disorder in psychiatric out-patients: comparative study.

    PubMed

    Zimmerman, Mark; Ellison, William; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy

    2015-10-01

    The morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such commentary exists for the improved detection of borderline personality disorder. Clinical experience suggests that it is as disabling as bipolar disorder, but no study has directly compared the two disorders. To compare the levels of psychosocial morbidity in patients with bipolar disorder and borderline personality disorder. Patients were assessed with semi-structured interviews. We compared 307 patients with DSM-IV borderline personality disorder but without bipolar disorder and 236 patients with bipolar disorder but without borderline personality disorder. The patients with borderline personality disorder less frequently were college graduates, were diagnosed with more comorbid disorders, more frequently had a history of substance use disorder, reported more suicidal ideation at the time of the evaluation, more frequently had attempted suicide, reported poorer social functioning and were rated lower on the Global Assessment of Functioning. There was no difference between the two patient groups in history of admission to psychiatric hospital or time missed from work during the past 5 years. The level of psychosocial morbidity associated with borderline personality disorder was as great as (or greater than) that experienced by patients with bipolar disorder. From a public health perspective, efforts to improve the detection and treatment of borderline personality disorder might be as important as efforts to improve the recognition and treatment of bipolar disorder. © The Royal College of Psychiatrists 2015.

  13. Assessment of subjective and objective cognitive function in bipolar disorder: Correlations, predictors and the relation to psychosocial function.

    PubMed

    Demant, Kirsa M; Vinberg, Maj; Kessing, Lars V; Miskowiak, Kamilla W

    2015-09-30

    Cognitive dysfunction is prevalent in bipolar disorder (BD). However, the evidence regarding the association between subjective cognitive complaints, objective cognitive performance and psychosocial function is sparse and inconsistent. Seventy seven patients with bipolar disorder who presented cognitive complaints underwent assessment of objective and subjective cognitive function and psychosocial functioning as part of their participation in two clinical trials. We investigated the association between global and domain-specific objective and subjective cognitive function and between global cognitive function and psychosocial function. We also identified clinical variables that predicted objective and subjective cognitive function and psychosocial functioning. There was a correlation between global subjective and objective measures of cognitive dysfunction but not within the individual cognitive domains. However, the correlation was weak, suggesting that cognitive complaints are not an assay of cognition per se. Self-rated psychosocial difficulties were associated with subjective (but not objective) cognitive impairment and both subjective cognitive and psychosocial difficulties were predicted by depressive symptoms. Our findings indicate that adequate assessment of cognition in the clinical treatment of BD and in drug trials targeting cognition requires implementation of not only subjective measures but also of objective neuropsychological tests. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Recommendations for enhancing psychosocial support of NICU parents through staff education and support

    PubMed Central

    Hall, S L; Cross, J; Selix, N W; Patterson, C; Segre, L; Chuffo-Siewert, R; Geller, P A; Martin, M L

    2015-01-01

    Providing psychosocial support to parents whose infants are hospitalized in the neonatal intensive care unit (NICU) can improve parents' functioning as well as their relationships with their babies. Yet, few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. Staff who develop burnout may have further reduced ability to provide effective support to parents and babies. Recommendations for providing NICU staff with education and support are discussed. The goal is to deliver care that exemplifies the belief that providing psychosocial care and support to the family is equal in importance to providing medical care and developmental support to the baby. PMID:26597803

  15. Psychosocial interventions in bipolar disorder: a review.

    PubMed

    Lolich, María; Vázquez, Gustavo H; Alvarez, Lina M; Tamayo, Jorge M

    2012-01-01

    Multiple psychosocial interventions for bipolar disorder have been proposed in recent years. Therefore, we consider that a critical review of empirically validated models would be useful. A review of the literature was conducted in Medline/PubMed for articles published during 2000-2010 that respond to the combination of "bipolar disorder" with the following key words: "psychosocial intervention", "psychoeducational intervention" and "psychotherapy". Cognitive-behavioral, psychoeducational, systematic care models, interpersonal and family therapy interventions were found to be empirically validated. All of them reported significant improvements in therapeutic adherence and in the patients' functionality. Although there are currently several validated psychosocial interventions for treating bipolar disorder, their efficacy needs to be specified in relation to more precise variables such as clinical type, comorbid disorders, stages or duration of the disease. Taking into account these clinical features would enable a proper selection of the most adequate intervention according to the patient's specific characteristics.

  16. Five-Year Tracking of Psychosocial Changes in People with Severe Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    Kaplan, Steven P.

    1993-01-01

    Interviewed 25 individuals with severe brain injury and their significant others 1, 3, and 5 years after injury. Found trend of improvement in psychological and social functioning between one and five years. Physical capabilities were significantly improved between one and three years. Many participants continued to have deficits in certain…

  17. Does Classification of Chronic Musculoskeletal Disorder Patients Into Psychosocial Subgroups Predict Differential Treatment Responsiveness and 1-Year Outcomes After a Functional Restoration Program?

    PubMed

    Asih, Sali; Mayer, Tom G; Williams, Mark; Choi, Yun Hee; Gatchel, Robert J

    2015-12-01

    The objectives of this study: (1) to assess whether Multidimensional Pain Inventory (MPI) profiles predicted differential responses to a functional restoration program (FRP) in chronic disabling occupational musculoskeletal disorder (CDOMD) patients; (2) to examine whether coping style improves following FRP; and (3) to determine whether discharge MPI profiles predict discharge psychosocial and 1-year socioeconomic outcomes. Consecutive CDOMD patients (N=716) were classified into Adaptive Coper (AC, n=209), Interpersonally Distressed (ID, n=154), Dysfunctional (DYS, n=310), and Anomalous (n=43) using the MPI, and reclassified at discharge. Profiles were compared on psychosocial measures and 1-year socioeconomic outcomes. An intent-to-treat sample analyzed the effect of drop-outs on treatment responsiveness. The MPI classification significantly predicted program completion (P=0.001), although the intent-to-treat analyses found no significant effects of drop-out on treatment responsiveness. There was a significant increase in the number of patients who became AC or Anomalous at FRP discharge and a decrease in those who were ID or DYS. Patients who changed or remained as DYS at FRP discharge reported the highest levels of pain, disability, and depression. No significant interaction effect was found between MPI group and time for pain intensity or disability. All groups improved on psychosocial measures at discharge. DYS patients had decreased work retention and a greater health care utilization at 1 year. An FRP was clinically effective for CDOMD patients regardless of initial MPI profiles. The FRP modified profiles, with patients changing from negative to positive profiles. Discharge DYS were more likely to have poor 1-year outcomes. Those classified as Anomalous had a good prognosis for functional recovery similar to ACs.

  18. Health-related quality of life and psychosocial functioning in children with Tourette syndrome: parent-child agreement and comparison to healthy norms.

    PubMed

    Gutierrez-Colina, Ana M; Eaton, Cyd K; Lee, Jennifer L; LaMotte, Julia; Blount, Ronald L

    2015-03-01

    This study aimed to evaluate the degree of agreement between parent proxy- and child self-report on measures of child psychosocial functioning and health-related quality of life in children with Tourette syndrome. Participants included 28 children with Tourette syndrome and their parents. All participants provided ratings of children's level of quality of life and psychosocial functioning. Results revealed strong, positive relationships between child self- and parent proxy-reports on all quality of life and psychosocial functioning domains. Parents perceived significantly higher levels of depression compared to their children, whereas children reported significantly lower Physical quality of life compared to their parents. Results suggest that assessment of quality of life and psychosocial functioning should include multiple reporters whenever feasible. Caution should be used when exclusively relying on parent proxy-reports of quality of life and psychosocial functioning, as these reports may not accurately reflect children's difficulties or perceptions of their functioning. © The Author(s) 2014.

  19. Psychosocial functioning in the context of diagnosis: assessment and theoretical issues.

    PubMed

    Ro, Eunyoe; Clark, Lee Anna

    2009-09-01

    Psychosocial functioning is an important focus of attention in the revision of the Diagnostic and Statistical Manual of Mental Disorders. Researchers and clinicians are converging upon the opinion that psychometrically strong, comprehensive assessment of individuals' functioning is needed to characterize disorder fully. Also shared is the realization that existing theory and research in this domain have critical shortcomings. The authors urge that the field reexamine the empirical evidence and address theoretical issues to guide future development of the construct and its measurement. The authors first discuss several theoretical issues relevant to the conceptualization and assessment of functioning: (a) definitions of functioning, (b) the role of functioning in defining disorder, and (c) understanding functioning within environmental contexts. The authors then present data regarding empirical domains of psychosocial functioning and their interrelations. Self-reported data on multiple domains of psychosocial functioning were collected from 429 participants. Factor-analytic results (promax rotation) suggest a 4-factor structure of psychosocial functioning: Well-Being, Basic Functioning, Self-Mastery, and Interpersonal and Social Relationships. Finally, the authors propose an integration of theory and empirical findings, which they believe will better incorporate psychosocial functioning into future diagnostic systems. Copyright 2009 APA, all rights reserved.

  20. Efficacy of exercise interventions in patients with advanced cancer: A systematic review.

    PubMed

    Heywood, Reginald; McCarthy, Alexandra L; Skinner, Tina L

    2018-05-05

    To critically analyse the literature surrounding the efficacy of exercise interventions in patients with advanced cancer. A literature search was undertaken of health and medical electronic databases (PubMED, Medline, CINAHL, Embase, PEDRO, Web of Science and Scopus) until 1 st March 2017. Studies were included if they were published in the English language and met the following criteria: structured exercise as the primary intervention, ≥80% study participants diagnosed with advanced cancer that is unlikely to be cured; reported outcomes concerning physical function, quality of life, fatigue, body composition, psychosocial function, sleep quality pain and/or survival. Following title and abstract screening, 68 articles were eligible for full-text review, with a total of 25 studies (n=1188; 16 controlled trials, 9 non-controlled trials) included in the quantitative synthesis. Two reviewers assessed methodological quality using the Cochrane Risk of Bias Tool for controlled trials and a modified Newcastle-Ottawa Scale for non-controlled trials. Aerobic exercise was utilised in six studies, resistance training in three studies and combination training (aerobic and resistance) in 15 studies. Significant between- and within-group improvements were reported with exercise in ≥50% of studies assessing physical function (83%), quality of life (55%), fatigue (50%), body composition (56%), psychosocial function (56%), and sleep quality (100%). Improvement within or between groups in pain following exercise was only observed in two studies (25%), while survival was unaffected in any study. Most studies reported significant between- and/or within-group improvements in physical function, quality of life, fatigue, body composition, psychosocial function and sleep quality in patients with advanced cancer, although the effects on pain and survival rates are unclear. Exercise appears to be an effective adjunct therapy in the advanced cancer context, although targeted studies are required to determine the optimal exercise dose to enhance outcomes for specific cancer diagnoses. Copyright © 2018. Published by Elsevier Inc.

  1. Determinants and implications of cancer patients' psychosocial needs.

    PubMed

    Ernstmann, N; Neumann, M; Ommen, O; Galushko, M; Wirtz, M; Voltz, R; Hallek, M; Pfaff, H

    2009-11-01

    Cancer patients often experience distress. However, the majority of newly diagnosed patients gradually adapt to the crisis. When symptoms of distress and anxiety persist over months, patients require psychosocial support. The aim of the present study was to determine the proportion of cancer patients who indicate the need for psychosocial support and to identify sociodemographic, psychological and illness-related factors predicting the need for psychosocial support in a German sample. The cross-sectional retrospective study was administered to 710 cancer patients who had been inpatients at the University Hospital of Cologne. The response rate was 49.5%. Patients suffering from bronchial, oesophageal, colorectal, breast, prostate and skin cancer participated in the study. The severity of depressive symptoms was assessed using the German version of the Major Depression Inventory. The level of anxiety was assessed with the state subscale of the German version of the State-Trait Anxiety Inventory. To measure the functional aspects of health-related quality of life, the scales "physical functioning", "role functioning", "emotional functioning", "cognitive functioning" and "role functioning" of the European Organisation for Research and Treatment of Cancer QLQ-C30 Questionnaire (EORTC QLQ-C30) were used. Of the cancer patients, 18.9% indicate an unmet need for psychosocial support and 9.5% are actually using psychosocial services. In a multiple logistic regression, significant indicators of the need for psychosocial support are gender [p = 0.014; standardised effect coefficient (sc) = 1.615] and emotional functioning (p < 0.001; sc = 1.533). The estimated model has a specificity of 92.2% and a sensitivity of 54.0%. Almost a third of the cancer patient population indicates an unmet need for psychosocial support or is actually using psychosocial services. Emotional functioning is a central predictor of the requirement for psychosocial support. Women are emotionally more affected than men and need more psychosocial support. The prognostic validity of the severity of depression and anxiety is limited.

  2. A Transdiagnostic Minority Stress Treatment Approach for Gay and Bisexual Men’s Syndemic Health Conditions

    PubMed Central

    Pachankis, John E.

    2015-01-01

    Developing and deploying separate treatments for separate conditions seems ill-suited to intervening upon the co-occurring, and possibly functionally similar, psychosocial conditions facing gay and bisexual men. This article argues for the need to create transdiagnostic interventions that reduce multiple syndemic conditions facing gay and bisexual men at the level of their shared source in minority stress pathways. This article first reviews psychosocial syndemic conditions affecting gay and bisexual men, then suggests pathways that might link minority stress to psychosocial syndemics based on recent advancements in emotion science, psychiatric nosology, and cognitive-affective neuroscience, and finally suggests cross-cutting psychosocial treatment principles to reduce minority stress–syndemic pathways among gay and bisexual men. Because minority stress serves as a common basis of all psychosocial syndemic conditions reviewed here, locating the pathways through which minority stress generates psychosocial syndemics and employing overarching treatment principles capable of simultaneously alleviating these pathways will ultimately create a transdiagnostic approach to improving gay and bisexual men’s health. Clinical research and training approaches are suggested to further validate the pathways suggested here, establish the efficacy of treatment approaches tied to those pathways, and generate effective methods for disseminating a transdiagnostic minority stress treatment approach for gay and bisexual men’s psychosocial syndemic health. PMID:26123065

  3. Development and pilot of an international survey: 'Radiation Therapists and Psychosocial Support'.

    PubMed

    Elsner, Kelly L; Naehrig, Diana; Halkett, Georgia K B; Dhillon, Haryana M

    2018-06-07

    Up to one third of radiation therapy patients are reported to have unmet psychosocial needs. Radiation therapists (RTs) have daily contact with patients and can provide daily psychosocial support to reduce patient anxiety, fear and loneliness. However, RTs vary in their values, skills, training, knowledge and involvement in providing psychosocial support. The aims of this study were to: (1) develop an online survey instrument to explore RT values, skills, training and knowledge regarding patient anxiety and psychosocial support, and (2) pilot the instrument with RT professionals to assess content validity, functionality and length. An online cross-sectional survey, titled 'Radiation therapists and psychosocial support' was developed. Items included patient vignettes, embedded items from RT research, and the Professional Quality of Life Scale (ProQOL5). Four radiation oncology departments volunteered to pilot the survey; each nominated four RT staff to participate. Survey data were analysed descriptively and qualitative feedback grouped and coded to determine whether the survey needed to be refined. Thirteen of sixteen RTs completed the pilot survey and feedback form. Median time to completion was 35 mins, with 54% of respondents stating this was too long. Respondents reported content, questions and response options were relevant and appropriate. Feedback was used to: refine the survey instrument, minimise responder burden and drop out and improve functionality and quality of data collection. This pilot of the 'Radiation therapists and psychosocial support' survey instrument demonstrated content validity and usability. The main survey will be circulated to a representative sample of RTs for completion. © 2018 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

  4. Low- and high-anxious hypermobile Ehlers-Danlos syndrome patients: comparison of psychosocial and health variables.

    PubMed

    Baeza-Velasco, Carolina; Bourdon, Caroline; Montalescot, Lucile; de Cazotte, Cécile; Pailhez, Guillem; Bulbena, Antonio; Hamonet, Claude

    2018-05-01

    Despite the frequent co-ocurrence of hypermobile Ehler-Danlos syndrome (hEDS) and pathological anxiety, little is known about the psychosocial and health implications of such comorbidity. Our aim was to explore the association between high levels of anxiety and psychosocial (catastrophizing, kinesiophobia, somatosensory amplification, social support and functioning), health (pain, fatigue, BMI, tobacco/alcohol use, depression, diagnosis delay, general health), and sociodemographic factors in people with hEDS. In this cross-sectional study, 80 hEDS patients were divided into two groups according to self-reported anxiety levels: low and high. Psychosocial, sociodemographic and health variables were compared between the groups. Forty-one participants reported a high level of anxiety (51.2%). No differences were found in the sociodemographic variables between high-anxious and low-anxious patients. The percentage of participants with severe fatigue and high depressive symptomatology was significantly higher in the high-anxious group (80.5 vs 56.4; 26.8 vs 12.8%, respectively). High-anxious hEDS patients also showed significantly higher levels of pain catastrophizing, somatosensory amplification as well as a poorer social functioning and general health. Multivariate analyses showed that somatosensory amplification, pain catastrophizing and poor social functioning are variables that increase the probability of belonging to the high-anxious group. Despite limitations, this first study comparing high-anxious versus low-anxious hEDS patients with respect to health aspects, highlight the importance of considering the psychosocial factors (many susceptible to modification), to improve the adjustment to this chronic condition and provide support to those affected through a biopsychosocial approach.

  5. A pilot study of psychosocial functioning and vascular endothelial growth factor in head and neck cancer patients

    PubMed Central

    Fang, Carolyn Y.; Egleston, Brian L.; Ridge, John A.; Lango, Miriam N.; Bovbjerg, Dana H.; Studts, Jamie L.; Burtness, Barbara A.; Einarson, Margret B.; Klein-Szanto, Andres J. P.

    2013-01-01

    Background Psychosocial functioning is associated with vascular endothelial growth factor (VEGF) in various patient populations. This study examined whether psychosocial functioning in patients with head and neck squamous cell carcinoma (HNSCC) is associated with tumor VEGF expression, a protein that stimulates angiogenesis and is associated with poor prognosis. Methods Forty-two newly diagnosed patients completed assessments of psychosocial functioning (i.e. depressive symptoms, perceived stress, anxiety, social support) prior to surgery. Tumor samples were obtained for VEGF analysis and HPV-typing. Results Poorer psychosocial functioning was associated with greater VEGF expression controlling for disease stage (OR=4.55, 95% CI = 1.72, 12.0, p < 0.01). When examined by HPV-status, the association between psychosocial functioning and VEGF remained significant among HPV-negative patients (OR=5.50, 95% CI = 1.68, 17.3, p < 0.01), but not among HPV-positive patients. Conclusions These findings inform our understanding of the biobehavioral pathways that may contribute to poor outcomes in non-HPV-associated HNSCCs. PMID:23804308

  6. The Effects of a Culturally Tailored, Patient-Centered Psychosocial Intervention in South Korean Cancer Survivors.

    PubMed

    Kim, Dohun; Chang, Sun Ju; Lee, Hyun Ok; Lee, Seung Hee

    2018-01-01

    This study aimed to develop a culturally tailored, patient-centered psychosocial intervention program and to investigate the effects of the program on health-related quality of life, sleep disturbance, and depression in cancer survivors. This was a one-group pretest and posttest design. A total of 19 cancer survivors participated in the program. The program was designed to have an 8-week duration with one class per week. Every class was composed of a 90-min education session and a 90-min exercise. Among the health-related quality of life subscales, the scores of global health status/quality of life, physical functioning, and emotional functioning at posttest were statistically increased than those at pretest. Fatigue scores significantly decreased, whereas no changes were observed in sleep disturbance or depression scores. The findings of this study suggested that a culturally tailored, patient-centered psychosocial intervention could be applied in clinical settings to improve health-related quality of life in cancer survivors.

  7. Non-Specialist Psychosocial Interventions for Children and Adolescents with Intellectual Disability or Lower-Functioning Autism Spectrum Disorders: A Systematic Review

    PubMed Central

    Yasamy, M. Taghi; Barbui, Corrado; Saxena, Shekhar

    2013-01-01

    Background The development of effective treatments for use by non-specialists is listed among the top research priorities for improving the lives of people with mental illness worldwide. The purpose of this review is to appraise which interventions for children with intellectual disabilities or lower-functioning autism spectrum disorders delivered by non-specialist care providers in community settings produce benefits when compared to either a no-treatment control group or treatment-as-usual comparator. Methods and Findings We systematically searched electronic databases through 24 June 2013 to locate prospective controlled studies of psychosocial interventions delivered by non-specialist providers to children with intellectual disabilities or lower-functioning autism spectrum disorders. We screened 234 full papers, of which 34 articles describing 29 studies involving 1,305 participants were included. A majority of the studies included children exclusively with a diagnosis of lower-functioning autism spectrum disorders (15 of 29, 52%). Fifteen of twenty-nine studies (52%) were randomized controlled trials and just under half of all effect sizes (29 of 59, 49%) were greater than 0.50, of which 18 (62%) were statistically significant. For behavior analytic interventions, the best outcomes were shown for development and daily skills; cognitive rehabilitation, training, and support interventions were found to be most effective for improving developmental outcomes, and parent training interventions to be most effective for improving developmental, behavioral, and family outcomes. We also conducted additional subgroup analyses using harvest plots. Limitations include the studies' potential for performance bias and that few were conducted in lower- and middle-income countries. Conclusions The findings of this review support the delivery of psychosocial interventions by non-specialist providers to children who have intellectual disabilities or lower-functioning autism spectrum disorders. Given the scarcity of specialists in many low-resource settings, including many lower- and middle-income countries, these findings may provide guidance for scale-up efforts for improving outcomes for children with developmental disorders or lower-functioning autism spectrum disorders. Protocol Registration PROSPERO CRD42012002641 Please see later in the article for the Editors' Summary PMID:24358029

  8. Prospective Pilot Study of the Mastering Each New Direction Psychosocial Family Systems Program for Pediatric Chronic Illness.

    PubMed

    Distelberg, Brian; Tapanes, Daniel; Emerson, Natacha D; Brown, Whitney N; Vaswani, Deepti; Williams-Reade, Jackie; Anspikian, Ara M; Montgomery, Susanne

    2018-03-01

    Psychosocial interventions for pediatric chronic illness (CI) have been shown to support health management. Interventions that include a family systems approach offer potentially stronger and more sustainable improvements. This study explores the biopsychosocial benefits of a novel family systems psychosocial intervention (MEND: Mastering Each New Direction). Forty-five families participated in a 21-session intensive outpatient family systems-based program for pediatric CI. Within this single arm design, families were measured on five domains of Health-Related Quality of Life (HRQL) self-report measures; Stress, Cognitive Functioning, Mental Health, Child HRQL, Family Functioning. Both survey and biological measures (stress: catecholamine) were used in the study. Results from multivariate general linear models showed positive pre-, post-, and 3-month posteffects in all five domains. The program effects ranged from small to moderate (η 2  = .07-.64). The largest program effects were seen in the domains of cognitive functioning (η 2  = .64) and stress (η 2  = .27). Also, between disease groups, differences are noted and future implications for research and clinical practice are discussed. Conclusions suggest that the MEND program may be useful in helping families manage pediatric chronic illnesses. Study results also add to the growing body of literature suggesting that psychosocial interventions for pediatric chronic illness benefit from a family systems level of intervention. © 2017 Family Process Institute.

  9. Psychosocial functioning in adolescents with complex partial seizures.

    PubMed

    Elliott, I

    1992-03-01

    This pilot study examined psychosocial functioning in adolescents (age 12.5-18.5 years) with complex partial seizures. Twenty-five subjects were divided into three groups: Group I (N = 11), medically treated with uncontrolled seizures; Group II (N = 6), medically managed with controlled seizures; and Group III (N = 8), epilepsy refractory to medical management with seizure control following surgery. Psychosocial functioning was measured using the "Adolescent Psychosocial Inventory" of Batzel and Dodrill. Findings revealed significant differences (F 4.80. p less than 0.02) in psychosocial functioning between the three groups. Group I showed the poorest overall adjustment; Group II, the best adjustment; Group III was better adjusted than Group I, but less than Group II. Significant difficulties were evident in the areas of school, interpersonal, emotional, seizure adjustment and overall psychosocial functioning in Group III. No problems were evident in Group II. School, emotional and overall adjustment were moderately problematic in Group III. Analysis of biological and demographic data revealed a significant association between increased numbers of medications and poorer psychosocial functioning (r = 58, p less than 0.02). The study results provide direction for clinic and community nurse specialists to set priorities with regard to assessment and supportive interventions.

  10. Animal Assisted Therapy (AAT) Program As a Useful Adjunct to Conventional Psychosocial Rehabilitation for Patients with Schizophrenia: Results of a Small-scale Randomized Controlled Trial

    PubMed Central

    Calvo, Paula; Fortuny, Joan R.; Guzmán, Sergio; Macías, Cristina; Bowen, Jonathan; García, María L.; Orejas, Olivia; Molins, Ferran; Tvarijonaviciute, Asta; Cerón, José J.; Bulbena, Antoni; Fatjó, Jaume

    2016-01-01

    Currently, one of the main objectives of human–animal interaction research is to demonstrate the benefits of animal assisted therapy (AAT) for specific profiles of patients or participants. The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6–month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre–program with post–program scores for the Positive and Negative Syndrome Scale (PANSS) and the EuroQoL-5 dimensions questionnaire (EuroQol-5D), pre–session with post–session salivary cortisol and alpha–amylase for the last four AAT sessions, and adherence rates between different elements of the program. We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty–two institutionalized patients with chronic schizophrenia completed the 6–month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning), a community program (intended to facilitate community reintegration) and a family program. Each member of the control group (n = 8) participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT–treatment group (n = 14) participated in twice–weekly 1–h sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT–treatment) showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT–treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT-treatment was significantly higher than overall adherence to the control group’s functional rehabilitation activities. Cortisol level was significantly reduced after participating in an AAT session, which could indicate that interaction with the therapy dogs reduced stress. In conclusion, the results of this small-scale RCT suggest that AAT could be considered a useful adjunct to conventional psychosocial rehabilitation for people with schizophrenia. PMID:27199859

  11. Psychosocial and Family Functioning in Spina Bifida

    ERIC Educational Resources Information Center

    Holmbeck, Grayson N.; Devine, Katie A.

    2010-01-01

    A developmentally oriented bio-neuropsychosocial model is introduced to explain the variation in family functioning and psychosocial adjustment in youth and young adults with spina bifida (SB). Research on the family functioning and psychosocial adjustment of individuals with SB is reviewed. The findings of past research on families of youth with…

  12. Residual depressive symptoms, sleep disturbance and perceived cognitive impairment as determinants of functioning in patients with bipolar disorder.

    PubMed

    Samalin, Ludovic; Boyer, Laurent; Murru, Andrea; Pacchiarotti, Isabella; Reinares, María; Bonnin, Caterina Mar; Torrent, Carla; Verdolini, Norma; Pancheri, Corinna; de Chazeron, Ingrid; Boucekine, Mohamed; Geoffroy, Pierre-Alexis; Bellivier, Frank; Llorca, Pierre-Michel; Vieta, Eduard

    2017-03-01

    Many patients with bipolar disorder (BD) experience residual symptoms during their inter-episodic periods. The study aimed to analyse the relationship between residual depressive symptoms, sleep disturbances and self-reported cognitive impairment as determinants of psychosocial functioning in a large sample of euthymic BD patients. This was a cross-sectional study of 468 euthymic BD outpatients. We evaluated the residual depressive symptoms with the Bipolar Depression Rating Scale, the sleep disturbances with the Pittsburgh Sleep Quality Index, the perceived cognitive performance using visual analogic scales and functioning with the Functioning Assessment Short Test. Structural equation modelling (SEM) was used to describe the relationships among the residual depressive symptoms, sleep disturbances, perceived cognitive performance and functioning. SEM showed good fit with normed chi square=2.46, comparative fit index=0.94, root mean square error of approximation=0.05 and standardized root mean square residuals=0.06. This model revealed that residual depressive symptoms (path coefficient =0.37) and perceived cognitive performance (path coefficient=0.27) were the most important features significantly related to psychosocial functioning. Sleep disturbances were indirectly associated with functioning via residual depressive symptoms and perceived cognitive performance (path coefficient=0.23). This study contributes to a better understanding of the determinants of psychosocial functioning during the inter-episodic periods of BD patients. These findings should facilitate decision-making in therapeutics to improve the functional outcomes of BD during this period. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Surgical repair of pectus excavatum markedly improves body image and perceived ability for physical activity: multicenter study.

    PubMed

    Kelly, Robert E; Cash, Thomas F; Shamberger, Robert C; Mitchell, Karen K; Mellins, Robert B; Lawson, M Louise; Oldham, Keith; Azizkhan, Richard G; Hebra, Andre V; Nuss, Donald; Goretsky, Michael J; Sharp, Ronald J; Holcomb, George W; Shim, Walton K T; Megison, Stephen M; Moss, R Lawrence; Fecteau, Annie H; Colombani, Paul M; Bagley, Traci; Quinn, Amy; Moskowitz, Alan B

    2008-12-01

    This study evaluated changes in both physical and psychosocial quality of life reported by the parent and child after surgical repair of pectus excavatum. As part of a multicenter study of pectus excavatum, a previously validated tool called the Pectus Excavatum Evaluation Questionnaire was administered by the research coordinator, via telephone, to parents and patients (8-21 years of age) before and 1 year after surgery. Eleven North American children's hospitals participated. From 2001 to 2006, 264 patients and 291 parents completed the initial questionnaire, and 247 patients and 274 parents completed the postoperative questionnaire. Responses used a Likert-type scale of 1 to 4, reflecting the extent or frequency of a particular experience, with higher values conveying less-desirable experience. Preoperative psychosocial functioning was unrelated to objective pectus excavatum severity (computed tomographic index). Patients and their parents reported significant positive postoperative changes. Improvements occurred in both physical and psychosocial functioning, including less social self-consciousness and a more-favorable body image. For children, the body image component improved from 2.30+/-0.62 (mean+/-SD) to 1.40+/-0.42 after surgery and the physical difficulties component improved from 2.11+/-0.82 to 1.37+/-0.44. For the parent questionnaire, the child's emotional difficulties improved from 1.81+/-0.70 to 1.24+/-0.36, social self-consciousness improved from 2.86+/-1.03 to 1.33+/-0.68, and physical difficulties improved from 2.14+/-0.75 to 1.32+/-0.39. Ninety-seven percent of patients thought that surgery improved how their chest looked. Surgical repair of pectus excavatum can significantly improve the body image difficulties and limitations on physical activity experienced by patients. These results should prompt physicians to consider the physiologic and psychological implications of pectus excavatum just as they would any other physical deformity known to have such consequences.

  14. A feasibility study of group cognitive rehabilitation for cancer survivors: enhancing cognitive function and quality of life.

    PubMed

    Schuurs, Alana; Green, Heather J

    2013-05-01

    This research aimed to address the gap in evidence-based treatment available for cancer survivors who are experiencing cognitive dysfunction, through piloting a novel treatment intervention. The overall research question was whether a group cognitive rehabilitation intervention would be feasible for improving cognitive function and quality of life for people who have completed cancer treatment. Three groups of adults were recruited as follows: an intervention group of 23 cancer survivors who completed a 4-week group cognitive rehabilitation treatment, a comparison group of nine cancer survivors, and a community sample of 23 adults who had never experienced cancer. Measures of objective and subjective cognitive function, quality of life, psychosocial distress, and illness perceptions were used. The research design was non-randomised. The results indicated that the intervention was effective in improving overall cognitive function, visuospatial/constructional performance, immediate memory, and delayed memory beyond practice effects alone. It was helpful in reducing participants' perceptions of cognitive impairment and psychosocial distress, as well as promoting social functioning and understanding of cognition. The improvements were maintained at 3 months after the intervention. Participants reported a high level of satisfaction with the treatment. The results provided evidence for the feasibility of a brief group-based cognitive rehabilitation intervention to treat cognitive problems experienced by cancer survivors. Copyright © 2012 John Wiley & Sons, Ltd.

  15. Racial and ethnic disparities in functional, psychosocial, and neurobehavioral outcomes after brain injury.

    PubMed

    Arango-Lasprilla, Juan Carlos; Kreutzer, Jeffrey S

    2010-01-01

    Because of the growing minority population in the past 3 decades in the United States and the increasing numbers of individuals who sustain a traumatic brain injury (TBI), researchers and clinicians have started to pay more attention to the role of race and ethnicity in outcomes after TBI, with the goal of better serving this population. The aim of this article is to review the literature on the influence of race/ethnicity on functional, psychosocial, and neurobehavioral outcomes after TBI. Specifically, the following 8 areas of outcomes will be examined: (1) treatment outcomes, (2) neuropsychological outcomes, (3) employment/productivity, (4) functional outcomes, (5) community integration, (6) marital status, (7) quality of life/life satisfaction, and (8) emotional/neurobehavioral outcomes. To conclude this review, suggestions for improvements in professional competency, research, systems of care, and training are proposed.

  16. Resilience amongst Australian Aboriginal Youth: An Ecological Analysis of Factors Associated with Psychosocial Functioning in High and Low Family Risk Contexts

    PubMed Central

    Hopkins, Katrina D.; Zubrick, Stephen R.; Taylor, Catherine L.

    2014-01-01

    We investigate whether the profile of factors protecting psychosocial functioning of high risk exposed Australian Aboriginal youth are the same as those promoting psychosocial functioning in low risk exposed youth. Data on 1,021 youth aged 12–17 years were drawn from the Western Australian Aboriginal Child Health Survey (WAACHS 2000–2002), a population representative survey of the health and well-being of Aboriginal children, their families and community contexts. A person-centered approach was used to define four groups of youth cross-classified according to level of risk exposure (high/low) and psychosocial functioning (good/poor). Multivariate logistic regression was used to model the influence of individual, family, cultural and community factors on psychosocial outcomes separately for youth in high and low family-risk contexts. Results showed that in high family risk contexts, prosocial friendship and low area-level socioeconomic status uniquely protected psychosocial functioning. However, in low family risk contexts the perception of racism increased the likelihood of poor psychosocial functioning. For youth in both high and low risk contexts, higher self-esteem and self-regulation were associated with good psychosocial functioning although the relationship was non-linear. These findings demonstrate that an empirical resilience framework of analysis can identify potent protective processes operating uniquely in contexts of high risk and is the first to describe distinct profiles of risk, protective and promotive factors within high and low risk exposed Australian Aboriginal youth. PMID:25068434

  17. Facial transplantation in a blind patient: psychologic, marital, and family outcomes at 15 months follow-up.

    PubMed

    Lemmens, Gilbert M D; Poppe, Carine; Hendrickx, Hannelore; Roche, Nathalie A; Peeters, Patrick C; Vermeersch, Hubert F; Rogiers, Xavier; Lierde, Kristiane Van; Blondeel, Phillip N

    2015-01-01

    Quality of life has frequently been reported to improve after vascularized composite allotransplantation of the face. However, psychosocial functioning of the partner or of particular patient groups such as blind patients are until now less well investigated. The aim of this study is to investigate psychologic, marital, and family functioning of a blind 54-year-old patient, Mr. A, and his partner after facial transplantation. Depressive and anxiety symptoms, hopelessness, personality, coping, resilience, illness cognitions, marital support, dyadic adjustment, family functioning, and quality of life of Mr. A and his partner were assessed before and after facial transplantation and at 15 months follow-up. Reliable change index (RCI) was further calculated to evaluate the magnitude of change. Most psychologic, marital, and family scores of both Mr. A and his partner were within a normative and healthy range before and after transplant and at 15 months follow-up. Resilience (RCI: 3.6), affective responsiveness (RCI: -3.6), and disease benefits (RCI: 2.6) of Mr. A further improved at 15 months follow-up whereas the physical quality of life (RCI: -14.8) strongly decreased. Only marital support (RCI: -2.1) and depth (RCI: -2.0) of the partner decreased at 15 months. The results of this study point to positive psychosocial outcomes in a blind patient after facial transplantation. Further, they may underscore the importance of good psychosocial functioning before transplantation of both partners and of their involvement in psychologic and psychiatric treatment. Therapeutic, V. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  18. The effect of Polygonum minus extract on cognitive and psychosocial parameters according to mood status among middle-aged women: a randomized, double-blind, placebo-controlled study

    PubMed Central

    Shahar, Suzana; Aziz, Ainor Farahin; Ismail, Siti Nur Arina; Yahya, Hanis Mastura; Din, Normah Che; Manaf, Zahara Abdul; Badrasawi, Manal M

    2015-01-01

    Background Polygonum minus (PM) or locally known in Malaysia, as “kesum” is rich in micronutrients and natural antioxidants. However, its beneficial effect on outcome associates with oxidative stress including cognitive function is yet to be discovered. We assessed the efficacy of PM extract (LineMinus™) on cognitive function and psychosocial status among middle-aged women in Klang Valley of Malaysia. Methods A randomized, double-blind, placebo-controlled trial among 35 healthy middle-aged women was performed, and subjects were randomized to receive either 250 mg PM or placebo of 100 mg maltodextrin each were taken twice daily for 6 weeks. Subjects were assessed for neuropsychological test, psychosocial status, and anthropometric at baseline, week 3, and week 6. Biomarkers were also determined at baseline and week 6. Results The supplementation of PM showed significant intervention effect on Digit Span test (P<0.05) social functioning domain of 36-Item Short Form Health Survey (P<0.05) among subjects with mood disturbance. While, among subjects with good mood, PM supplementation improved Wechsler Abbreviated Scale of Intelligence (WASI) for IQ verbal (P=0.016) and Full Scale IQ of WASI (P=0.004). There were no adverse effects reported for the supplementation as indicated using biomarkers, including liver function and clinical symptoms. Conclusion Supplementation of PM is safe to be consumed for 6 weeks, with potential benefits to attention, short-term memory, improved quality of life, and mood, as well as IQ. PMID:26445532

  19. A critical review of the use of technology to provide psychosocial support for children and young people with long-term conditions.

    PubMed

    Aldiss, Susie; Baggott, Christina; Gibson, Faith; Mobbs, Sarah; Taylor, Rachel M

    2015-01-01

    Advances in technology have offered health professionals alternative mediums of providing support to patients with long-term conditions. This critical review evaluated and assessed the benefit of electronic media technologies in supporting children and young people with long-term conditions. Of 664 references identified, 40 met the inclusion criteria. Supportive technology tended to increase disease-related knowledge and improve aspects of psychosocial function. Supportive technology did not improve quality of life, reduce health service use or decrease school absences. The poor methodological quality of current evidence and lack of involvement of users in product development contribute to the uncertainty that supportive technology is beneficial. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Supportive therapy for schizophrenia: possible mechanisms and implications for adjunctive psychosocial treatments.

    PubMed

    Penn, David L; Mueser, Kim T; Tarrier, Nick; Gloege, Andrew; Cather, Corrine; Serrano, Daniel; Otto, Michael W

    2004-01-01

    This article posits that the positive findings for supportive therapy (ST) in recent trials may indicate an important but undervalued aspect of psychosocial interventions for schizophrenia. In developing this thesis, we consider the possible mechanisms underlying the beneficial effects of ST observed in recent trials of cognitive behavioral therapy for schizophrenia. We place this evidence in the context of a review of psychological models of mental health, the therapeutic alliance, and research on social cognition and social support in schizophrenia. We conclude this article by describing a new theoretically driven intervention for schizophrenia, functional cognitive-behavioral therapy (FCBT), which improves functional outcomes by integrating evidence-based advances in cognitive behavioral therapy with the strengths of ST approaches.

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

    PubMed

    Newcomb, Michael D; Locke, Thomas F; Goodyear, Rodney K

    2003-08-01

    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.

  2. Language and Psychosocial Functioning among Deaf Learners with and without Cochlear Implants

    ERIC Educational Resources Information Center

    Marschark, Marc; Machmer, Elizabeth; Spencer, Linda J.; Borgna, Georgianna; Durkin, Andreana; Convertino, Carol

    2018-01-01

    Various studies have examined psychosocial functioning and language abilities among deaf children with and without cochlear implants (CIs). Few, however, have explored how relations among those abilities might change with age and setting. Most relevant studies also have failed to consider that psychosocial functioning among both CI users and…

  3. Psychosocial Development of 5-year-old Children with Hearing Loss: Risks and protective factors

    PubMed Central

    Wong, Cara L.; Ching, Teresa YC; Leigh, Greg; Cupples, Linda; Button, Laura; Marnane, Vivienne; Whitfield, Jessica; Gunnourie, Miriam; Martin, Louise

    2016-01-01

    Objective The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes. Design A cross-sectional analysis of data collected from a prospective, population-based longitudinal study. Study Sample Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardised assessments of non-verbal cognitive ability (WNV) and language (PLS-4). Results On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not. Conclusion The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. . The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development. PMID:27541363

  4. History of religious delusions and psychosocial functioning among Mexican patients with paranoid schizophrenia.

    PubMed

    Robles-García, Rebeca; López-Luna, Sonia; Páez, Francisco; Escamilla, Raúl; Camarena, Beatriz; Fresán, Ana

    2014-12-01

    The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia.

  5. Effects of a Hospital Based Wellness and Exercise Program on Quality of Life of Children with Severe Burns

    PubMed Central

    Rosenberg, Marta; Celis, Mario M; Meyer, Walter; Tropez-Arceneaux, Lisa; McEntire, Serina J.; Fuchs, Helen; Richardson, Lisa; Holzer, Charles; Herndon, David N.; Suman, Oscar E.

    2012-01-01

    Objective To examine the effect of a 12-week Wellness and Exercise (W&E) program on the quality of life of pediatric burn survivors with burns of ≥ 40% total body surface area. We hypothesized this comprehensive regimen would improve physical and psychosocial outcomes. Methods Children were recruited for participation upon their discharge from the ICU. They were not taking anabolic/cardiovascular agents. Seventeen children participated in the W&E group and 14 children in the Standard of Care (SOC) group. Quality of life was assessed with the Child Health Questionnaire (CHQ) at discharge and 3 months. Children completed the CHQ-CF 87 and caregivers completed the CHQ-PF 28. Results The mean age of children in the W&E group was 14.07y±3.5 and mean TBSA was 58%±11.8. The mean age of children in the SOC group was 13.9y±3.1 and mean TBSA was 49%±7.8. ANOVA did not reveal statistically significant differences between the groups. Matched paired t-tests revealed that parents with children in the W&E group reported significant improvements with their children’s physical functioning, role/social physical functioning, mental health, overall physical and psychosocial functioning post-exercise. Conclusions These results are clinically relevant in that a comprehensive W&E program may be beneficial in promoting physical and psychosocial outcomes. PMID:22985974

  6. The role of cognitive impairment in psychosocial functioning in remitted depression.

    PubMed

    Knight, Mattew J; Air, Tracy; Baune, Bernhard T

    2018-08-01

    Cognitive dysfunction is a prevalent and disabling symptom of Major Depressive Disorder (MDD), and is often retained in the remitted stage of illness. Emerging evidence suggests that cognitive impairment may be associated with dysfunction in a number of psychosocial domains (e.g., workplace productivity, social relationships). The current study explored the relationship between cognition and psychosocial functioning in remitted MDD and in healthy controls. Data were obtained from 182 participants of the Cognitive Function and Mood Study (CoFaM-S), a cross-sectional study of cognition, mood, and social cognition in mood disorders. Participants' (Remitted MDD n = 72, Healthy n = 110) cognition was assessed with a battery of cognitive tests including the Repeatable Battery for the Assessment of Neuropsychological Function (RBANS) and other standard measures of cognition (e.g., The Tower of London task). Psychosocial functioning was clinically evaluated with the Functioning Assessment Short Test (FAST). The results indicated that executive functioning was the strongest independent predictor of functioning in remitted MDD patients, whereas various cognitive domains predicted psychosocial functioning in healthy individuals. Psychosocial functioning was measured with a clinical interview, and was therefore reliant on clinicians' judgement of impairment, as opposed to more objective measures of functioning. These findings suggest that executive cognition plays an important role in functional recovery in remitted depression, and may be a crucial target in adjunctive treatment. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Psychosocial impact on anophthalmic patients wearing ocular prosthesis.

    PubMed

    Goiato, M C; dos Santos, D M; Bannwart, L C; Moreno, A; Pesqueira, A A; Haddad, M F; dos Santos, E G

    2013-01-01

    The aim of this study was to assess the improvement in psychosocial awareness of anophthalmic patients wearing ocular prostheses and its relationship with demographic characteristics, factors of loss/treatment, social activity, and relationship between professional and patient. Surveys including a form for evaluation of psychosocial pattern were conducted with 40 anophthalmic patients rehabilitated with ocular prosthesis at the Center of Oral Oncology in the authors' dental school from January 1998 to November 2010. The improvement in psychosocial awareness was assessed by comparing the perception of some feelings reported in the period of eye loss and currently. Wilcoxon tests were applied for comparison of patients' perception between the periods. χ(2) tests were used to assess the relationship between the improvement in psychosocial awareness and the variables of the study. In addition, the logistic regression model measured this relationship with the measure of odds ratio. The feelings of shame, shyness, preoccupation with hiding it, sadness, insecurity and fear were significant for improvement in psychosocial awareness. It was concluded that the anophthalmic patients wearing an ocular prosthesis has significant improvement in psychosocial awareness after rehabilitation. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Oxidative stress markers, cognitive functions, and psychosocial functioning in bipolar disorder: an empirical cross-sectional study.

    PubMed

    Aydemir, Ömer; Çubukçuoğlu, Zeynep; Erdin, Soner; Taş, Cumhur; Onur, Ece; Berk, Michael

    2014-01-01

    This study aimed to evaluate the relationship between oxidative stress markers and cognitive functions and domains of psychosocial functioning in bipolar disorder. Oxidative stress markers, cognitive functions, and domains of psychosocial functioning were evaluated in 51 patients with bipolar disorder who were in remission. Correlation analyses between these parameters were calculated with data controlled for duration of illness and number of episodes. There was no statistically significant correlation between oxidative stress markers and cognitive functions. In terms of psychosocial functioning, significant correlations were found between malondialdehyde and sense of stigmatization (r = -0.502); household activities and superoxide dismutase (r = 0.501); participation in social activities and nitric oxide (r = 0.414); hobbies and leisure time activities and total glutathione (r = -0.567), superoxide dismutase (r = 0.667), and neurotrophin 4 (r = 0.450); and taking initiative and self-sufficiency and superoxide dismutase (r = 0.597). There was no correlation between other domains of psychosocial functioning and oxidative stress markers. These results imply that oxidative stress markers do not appear to correlate clearly with cognitive impairment and reduced psychosocial functioning. However, there were some associations between selected oxidative markers and activity-oriented functional markers. This may represent a true negative association, or may be an artifact of oxidative stress being a state rather than a trait marker.

  9. Symptoms of depression and anxiety in adolescents with sickle cell disease: the role of intrapersonal characteristics and stress processing variables.

    PubMed

    Simon, Katherine; Barakat, Lamia P; Patterson, Chavis A; Dampier, Carlton

    2009-06-01

    Sickle cell disease (SCD) complications place patients at risk for poor psychosocial adaptation, including depression and anxiety symptoms. This study aimed to test a mediator model based on the Risk and Resistance model to explore the role of intrapersonal characteristics and stress processing variables in psychosocial functioning. Participants were 44 adolescents with SCD, 15 healthy siblings, and 43 primary caregivers, recruited from an East Coast comprehensive sickle cell center. The participants completed paper and pencil measures of resilience factors (attributional style, hope, coping) and internalizing symptoms (depression, anxiety). Internalizing symptoms among adolescents with SCD and healthy siblings did not differ and were within non-clinical ranges. Self-esteem of adolescents with SCD was correlated with less depression and anxiety and sense of inadequacy was associated with poorer functioning. There were no findings to support the role of coping in psychosocial adjustment. Although the mediation hypothesis was not supported, findings highlighted the resilience of this sample of adolescents with SCD. Determining how these resilience factors protect adolescents with SCD may aid in the development of psychosocial interventions. In particular, interventions should focus on improving intrapersonal skills and coping with stress and investigate ways to tailor these interventions to African-American populations.

  10. Motor and psychosocial impact of robot-assisted gait training in a real-world rehabilitation setting: A pilot study.

    PubMed

    Fundarò, Cira; Giardini, Anna; Maestri, Roberto; Traversoni, Silvia; Bartolo, Michelangelo; Casale, Roberto

    2018-01-01

    In the last decade robotic devices have been applied in rehabilitation to overcome walking disability in neurologic diseases with promising results. Robot assisted gait training (RAGT) using the Lokomat seems not only to improve gait parameters but also the perception of well-being. Data on the psychosocial patient-robot impact are limited, in particular in the real-world of RAGT, in the rehabilitation setting. During rehabilitation training, the Lokomat can be considered an "assistive device for movement". This allowed the use of the Psychosocial Impact of Assistive Device Scale- PIADS to describe patient interaction with the Lokomat. The primary aim of this pilot study was to evaluate the psychosocial impact of the Lokomat in an in-patient rehabilitation setting using the PIADS; secondary aims were to assess whether the psychosocial impact of RAGT is different between pathological sub-groups and if the Lokomat influenced functional variables (Functional Independence Measure scale-FIM and parameters provided by the Lokomat itself). Thirty-nine consecutive patients (69% males, 54.0±18.0 years) eligible for Lokomat training, with etiologically heterogeneous walking disabilities (Parkinson's Disease, n = 10; Spinal Cord Injury, n = 21; Ictus Event, n = 8) were enrolled. Patients were assessed with the FIM before and after rehabilitation with Lokomat, and the PIADS was administered after the rehabilitative period with Lokomat. Overall the PIADS score was positive (35.8±21.6), as well as the three sub-scales, pertaining to "ability", "adaptability" and "self-esteem" (17.2±10.4, 8.9±5.5 and 10.1±6.6 respectively) with no between-group differences. All patients significantly improved in gait measure and motor FIM scale (difference after-before treatment values: 11.7±9.8 and 11.2±10.3 respectively), increased treadmill speed (0.4 ± 0.2m/s), reduced body weight support (-14.0±9.5%) and guidance force (-13.1 ± 10.7%). This pilot study indicates that Lokomat, in a real-world in-patient setting, may have a generalised approval, independent of disease, underlining the importance of the psycho-social framework for patients training with assistive robotic-devices.

  11. Perceived Neighborhood Risk as a Predictor of Drug Use among Urban Ethnic Minority Adolescents: Moderating Influences of Psychosocial Functioning.

    ERIC Educational Resources Information Center

    Scheier, Lawrence M.; Miller, Nicole L.; Ifill-Williams, Michelle; Botvin, Gilbert J.

    2001-01-01

    Examines the moderating influences of psychosocial functioning on the relation between perceived neighborhood risk and alcohol, cigarette, and marijuana use in inner-city, ethnic minority youths. Neighborhood risk uniquely predicted alcohol, cigarette, and marijuana use; however, some relations were qualified by level of psychosocial functioning.…

  12. An Assessment of Mentoring Functions and Barriers to Mentoring

    DTIC Science & Technology

    1999-12-01

    were similarity between mentor and mentee and the quality of the supervisory relationship in terms of LMX and psychosocial and career development ... psychosocial (1985). These broad categories have remained at the core of mentoring from the time they were developed . Career development functions "help...internal consistency reported by Noe for the career development functions scale (7 items) was .89. The psychosocial functions scale, made up of 14 items

  13. PTSD symptom severity relates to cognitive and psycho-social dysfunctioning – a study with Congolese refugees in Uganda

    PubMed Central

    Ainamani, Herbert E.; Elbert, Thomas; Olema, David K.; Hecker, Tobias

    2017-01-01

    ABSTRACT Background: In the ongoing conflict in the Democratic Republic of the Congo (DRC), civilians have been heavily exposed to traumatic stressors. Traumatizing experiences cumulatively heighten the risk for trauma-related disorders, and with it affect cognitive and psycho-social functioning. Objectives: We aimed at investigating the association between trauma-related disorders and cognitive and psycho-social functioning and hypothesized that PTSD symptom severity would negatively correlate with executive functioning, working memory and psycho-social functioning in everyday life. Method: In total, 323 Congolese refugees (mean age: 31.3 years) who arrived in the Ugandan Nakivale refugee settlement after January 2012 were assessed regarding their exposure to traumatic events, PTSD symptom severity (posttraumatic symptom scale interview), executive functioning (Tower of London), working memory performance (Corsi block tapping task) and psycho-social dysfunctioning (Luo functioning scale). Results: Hierarchical regression analyses indicated a significant negative association between PTSD symptom severity and working memory (β = –0.32, p < 0.001), as well as executive functions (β = –0.19, p = 0.003). Furthermore, the impairment of psycho-social functioning in everyday life was positively related with PTSD symptom severity (β = 0.70, p < 0.001), and negatively with executive functioning (β = –0.15, p = 0.003). However, working memory performance was not significantly related to psycho-social dysfunctioning (β = 0.09, p > 0.05). Conclusion: Trauma survivors not only suffer from the core PTSD symptoms but also from impaired cognitive functioning. PTSD symptom severity seems furthermore to be related to impaired psycho-social functioning. Our findings suggest that trauma-related mental health problems may heighten the risk for poverty and lack of prospect and further aggravate the consequences of war and conflict. PMID:28326164

  14. Psychosocial issues related to sexual functioning among African-American prostate cancer survivors and their spouses†

    PubMed Central

    Rivers, Brian M.; August, Euna M.; Gwede, Clement K.; Hart, Alton; Donovan, Kristine A.; Pow-Sang, Julio M.; Quinn, Gwendolyn P.

    2015-01-01

    Objective Focus on cancer survivorship and quality of life (QOL) is a growing priority. The aim of this study was to identify and describe the most salient psychosocial concerns related to sexual functioning among African-American (AA) prostate cancer survivors and their spouses. Methods Twelve AA prostate cancer survivors and their spouses participated in semi-structured individual interviews. The interviews assessed couples’ experiences with psychosocial adjustment and sexual functioning posttreatment for localized prostate cancer. The data were analyzed using the constant comparison method and content analysis. Results In this qualitative study of couples surviving prostate cancer, there were divergent views between the male prostate cancer survivors and their female partners, particularly regarding sexual functioning. For the males, QOL issues emerged as the primary area of concern, whereas survival of their husbands was considered most important among the female spouses. The male respondents expressed unease with the sexual side effects of their cancer treatment, such as erectile dysfunction and decreased sexual desire and satisfaction. Female spouses recognized decreased sexual desire in their partners following treatment, but this was not considered a primary concern. Conclusions Patients and their spouses may have differing perceptions regarding QOL and the impact of sexual functioning on survivorship. This study points to the need for further research and intervention development to address these domains with a goal to improve QOL. PMID:20187071

  15. The Ontario Psychosocial Oncology Framework: a quality improvement tool.

    PubMed

    Li, Madeline; Green, Esther

    2013-05-01

    To overview the newly developed Psychosocial Health Care for Cancer Patients and Their Families: A Framework to Guide Practice in Ontario and Guideline Recommendations in the context of Canadian psychosocial oncology care and propose strategies for guideline uptake and implementation. Recommendations from the 2008 Institute of Medicine standard Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs were adapted into the Ontario Psychosocial Oncology (PSO) Framework. Existing practice guidelines developed by the Canadian Partnership against Cancer and Cancer Care Ontario and standards developed by the Canadian Association of Psychosocial Oncology are supporting resources for adopting a quality improvement (QI) approach to the implementation of the framework in Ontario. The developed PSO Framework, including 31 specific actionable recommendations, is intended to improve the quality of comprehensive cancer care at both the provider and system levels. Important QI change management processes are described as Educate - raising awareness among medical teams of the significance of psychosocial needs of patients, Evidence - developing a research evidence base for patient care benefits from psychosocial interventions, and Electronics - using technology to collect patient reported outcomes of both physical and emotional symptoms. The Ontario PSO Framework is unique and valuable in providing actionable recommendations that can be implemented through QI processes. Overall, the result will be improved psychosocial health care for the cancer population. Copyright © 2012 John Wiley & Sons, Ltd.

  16. Mental health system funding of cognitive enhancement interventions for schizophrenia: summary and update of the New York Office of Mental Health expert panel and stakeholder meeting.

    PubMed

    McGurk, Susan R; Mueser, Kim T; Covell, Nancy H; Cicerone, Keith D; Drake, Robert E; Silverstein, Steven M; Medialia, Alice; Myers, Robert; Bellack, Alan S; Bell, Morris D; Essock, Susan M

    2013-09-01

    A growing research literature indicates that cognitive enhancement (CE) interventions for people with schizophrenia can improve cognitive functioning and may benefit psychosocial functioning (e.g., competitive employment, quality of social relationships). Debate continues regarding the strength of evidence for CE and related policy implications, such as the appropriateness of funding CE services. This paper summarizes and updates a meeting of experts and stakeholders convened in 2008 by the New York Office of Mental Health to review evidence on the impact of CE for people with schizophrenia and other serious mental illnesses, and addresses whether the evidence base for CE interventions is sufficient to warrant funding. Specific recommendations based on the extant literature are provided regarding the structure and components of CE programs that should be present in order to improve cognitive and psychosocial outcomes and therefore merit consideration of funding. These recommendations may serve as a starting point in developing standards for CE programs. Establishing evidence-based practice standards for implementing CE interventions for people with serious mental illnesses may facilitate dissemination of programs that have the greatest potential for improving individuals' functional outcomes while minimizing incremental costs associated with providing CE services. Important open questions include how the performance of CE programs should be monitored and which individuals might be expected to benefit from CE as evidenced by improved functioning in their everyday lives. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  17. Parent, Teacher, and Student Perspectives on how Corrective Lenses Improve Child Wellbeing and School Function

    PubMed Central

    Dudovitz, Rebecca N; Izadpanah, Nilufar; Chung, Paul J.; Slusser, Wendelin

    2015-01-01

    Objectives Up to 20% of school-age children have a vision problem identifiable by screening, over 80% of which can be corrected with glasses. While vision problems are associated with poor school performance, few studies describe whether and how corrective lenses affect academic achievement and health. Further, there are virtually no studies exploring how children with correctable visual deficits, their parents, and teachers perceive the connection between vision care and school function. Methods We conducted a qualitative evaluation of Vision to Learn (VTL), a school-based program providing free corrective lenses to low-income students in Los Angeles. Nine focus groups with students, parents, and teachers from three schools served by VTL explored the relationships between poor vision, receipt of corrective lenses, and school performance and health. Results Twenty parents, 25 teachers, and 21 students from three elementary schools participated. Participants described how uncorrected visual deficits reduced students’ focus, perseverance, and class participation, affecting academic functioning and psychosocial stress; how receiving corrective lenses improved classroom attention, task persistence, and willingness to practice academic skills; and how serving students in school rather than in clinics increased both access to and use of corrective lenses. Conclusions for Practice Corrective lenses may positively impact families, teachers, and students coping with visual deficits by improving school function and psychosocial wellbeing. Practices that increase ownership and use of glasses, such as serving students in school, may significantly improve both child health and academic performance. PMID:26649878

  18. Parent, Teacher, and Student Perspectives on How Corrective Lenses Improve Child Wellbeing and School Function.

    PubMed

    Dudovitz, Rebecca N; Izadpanah, Nilufar; Chung, Paul J; Slusser, Wendelin

    2016-05-01

    Up to 20 % of school-age children have a vision problem identifiable by screening, over 80 % of which can be corrected with glasses. While vision problems are associated with poor school performance, few studies describe whether and how corrective lenses affect academic achievement and health. Further, there are virtually no studies exploring how children with correctable visual deficits, their parents, and teachers perceive the connection between vision care and school function. We conducted a qualitative evaluation of Vision to Learn (VTL), a school-based program providing free corrective lenses to low-income students in Los Angeles. Nine focus groups with students, parents, and teachers from three schools served by VTL explored the relationships between poor vision, receipt of corrective lenses, and school performance and health. Twenty parents, 25 teachers, and 21 students from three elementary schools participated. Participants described how uncorrected visual deficits reduced students' focus, perseverance, and class participation, affecting academic functioning and psychosocial stress; how receiving corrective lenses improved classroom attention, task persistence, and willingness to practice academic skills; and how serving students in school rather than in clinics increased both access to and use of corrective lenses. for Practice Corrective lenses may positively impact families, teachers, and students coping with visual deficits by improving school function and psychosocial wellbeing. Practices that increase ownership and use of glasses, such as serving students in school, may significantly improve both child health and academic performance.

  19. Breast cancer in older women: quality of life and psychosocial adjustment in the 15 months after diagnosis.

    PubMed

    Ganz, Patricia A; Guadagnoli, Edward; Landrum, Mary Beth; Lash, Timothy L; Rakowski, William; Silliman, Rebecca A

    2003-11-01

    We examined the health-related quality of life (QOL) of a cohort of older women with breast cancer after their diagnosis. Six hundred ninety-one women aged 65 years and older were interviewed approximately 3 months after breast cancer surgery and two additional times in the following year using standardized QOL measures. Demographic factors, breast cancer treatments, and comorbid conditions were used to model ratings of health-related QOL over time. Self-perceived health and psychosocial adjustment at 15 months after surgery were modeled. Physical and mental health scores declined significantly in the follow-up year, independent of age. However, a cancer-specific psychosocial instrument showed significant improvement in scores. Better 3-month physical and mental health scores, as well as better emotional social support, predicted more favorable self-perceived health 15 months after surgery. Psychosocial adjustment at 15 months was significantly predicted by better mental health, emotional social support, and better self-rated interaction with health care providers assessed at 3 months. Contrary to reports from younger women with breast cancer, we observed significant declines in the physical and mental health of older women in the 15 months after breast cancer surgery, whereas scores on a cancer-specific psychosocial QOL measure improved over time, consistent with patterns in younger women. Predictive models indicate that older women with impaired physical functioning, mental health, and emotional social support after surgery have poorer self-perceived health and psychosocial adjustment 1 year later. Interventions to address the physical and emotional needs of older women with breast cancer should be developed and evaluated to determine their impact on subsequent health-related QOL.

  20. Social Functioning in Children with ADHD Treated with Long-Term Methylphenidate and Multimodal Psychosocial Treatment

    ERIC Educational Resources Information Center

    Abikoff, Howard; Hechtman, Lily; Klein, Rachel G.; Gallagher, Richard; Fleiss, Karen; Etcovitch, Joy; Cousins, Lorne; Greenfield, Brian; Martin, Diane; Pollack, Simcha

    2004-01-01

    Objective: To test that methylphenidate combined with intensive multimodal psychosocial intervention, which includes social skills training, significantly enhances social functioning in children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and methylphenidate plus nonspecific psychosocial treatment…

  1. The effects of music-supported therapy on motor, cognitive, and psychosocial functions in chronic stroke.

    PubMed

    Fujioka, Takako; Dawson, Deirdre R; Wright, Rebecca; Honjo, Kie; Chen, Joyce L; Chen, J Jean; Black, Sandra E; Stuss, Donald T; Ross, Bernhard

    2018-05-24

    Neuroplasticity accompanying learning is a key mediator of stroke rehabilitation. Training in playing music in healthy populations and patients with movement disorders requires resources within motor, sensory, cognitive, and affective systems, and coordination among these systems. We investigated effects of music-supported therapy (MST) in chronic stroke on motor, cognitive, and psychosocial functions compared to conventional physical training (GRASP). Twenty-eight adults with unilateral arm and hand impairment were randomly assigned to MST (n = 14) and GRASP (n = 14) and received 30 h of training over a 10-week period. The assessment was conducted at four time points: before intervention, after 5 weeks, after 10 weeks, and 3 months after training completion. As for two of our three primary outcome measures concerning motor function, all patients slightly improved in Chedoke-McMaster Stroke Assessment hand score, while the time to complete Action Research Arm Test became shorter in the MST group. The third primary outcome measure for well-being, Stroke Impact Scale, was improved for emotion and social communication earlier in MST and coincided with the improved executive function for task switching and music rhythm perception. The results confirmed previous findings and expanded the potential usage of MST for enhancing quality of life in community-dwelling chronic-stage survivors. © 2018 New York Academy of Sciences.

  2. Web-based cognitive rehabilitation for survivors of adult cancer: A randomised controlled trial.

    PubMed

    Mihuta, Mary E; Green, Heather J; Shum, David H K

    2018-04-01

    Cognitive dysfunction associated with cancer is frequently reported and can reduce quality of life. This study evaluated a Web-based cognitive rehabilitation therapy program (eReCog) in cancer survivors compared with a waitlist control group. Adult cancer survivors with self-reported cognitive symptoms who had completed primary treatment at least 6 months prior were recruited. Participants completed telephone screening and were randomly allocated to the 4-week online intervention or waitlist. Primary outcome was perceived cognitive impairment assessed with the Functional Assessment of Cancer Therapy-Cognitive Function version 3. Secondary outcomes were additional measures of subjective cognitive functioning, objective cognitive functioning, and psychosocial variables. Seventy-six women were allocated to the intervention (n = 40) or waitlist (n = 36). A significant interaction was found on the instrumental activities of daily living measure of self-reported prospective memory whereby the intervention group reported a greater reduction in prospective memory failures than the waitlist group. Interaction trends were noted on perceived cognitive impairments (P = .089) and executive functioning (P = .074). No significant interactions were observed on other measures of objective cognitive functioning or psychosocial variables. The Web-based intervention shows promise for improving self-reported cognitive functioning in adult cancer survivors. Further research is warranted to better understand the mechanisms by which the intervention might contribute to improved self-reported cognition. Copyright © 2017 John Wiley & Sons, Ltd.

  3. Multiple benefits of personal FM system use by children with auditory processing disorder (APD).

    PubMed

    Johnston, Kristin N; John, Andrew B; Kreisman, Nicole V; Hall, James W; Crandell, Carl C

    2009-01-01

    Children with auditory processing disorders (APD) were fitted with Phonak EduLink FM devices for home and classroom use. Baseline measures of the children with APD, prior to FM use, documented significantly lower speech-perception scores, evidence of decreased academic performance, and psychosocial problems in comparison to an age- and gender-matched control group. Repeated measures during the school year demonstrated speech-perception improvement in noisy classroom environments as well as significant academic and psychosocial benefits. Compared with the control group, the children with APD showed greater speech-perception advantage with FM technology. Notably, after prolonged FM use, even unaided (no FM device) speech-perception performance was improved in the children with APD, suggesting the possibility of fundamentally enhanced auditory system function.

  4. A Geriatric Day Hospital: Who Improves the Most?

    ERIC Educational Resources Information Center

    Desrosiers, Johanne; Hebert, Rejean; Payette, Helene; Roy, Pierre-Michel; Tousignant, Michel; Cote, Sylvie; Trottier, Lise

    2004-01-01

    This study compared the changes in some bio-psychosocial variables (functional independence, nutritional risk, pain, balance and walking, grip strength, general well-being, psychiatric profile, perception of social support, leisure satisfaction, and caregivers' feeling of burden) in four categories of clients during their program at a geriatric…

  5. Psychosocial interventions in patients with dual diagnosis

    PubMed Central

    Subodh, B.N; Sharma, Nidhi; Shah, Raghav

    2018-01-01

    Management of patients with dual diagnosis (Mental illness and substance use disorders) is a challenge. A lack of improvement in either disorder can lead to a relapse in both. The current consensus opinion favours an integrated approach to management of both the disorders wherein the same team of professionals manages both the disorders in the same setting. The role of pharmacotherapy for such dual diagnosis patients is well established but the non-pharmacological approaches for their management are still evolving. After stabilization of the acute phase of illnesses, non-pharmacological management takes centre stage. Evidence points to the beneficial effect of psychosocial approaches in maintaining abstinence, adherence to medication, maintenance of a healthy life style, better integration in to community, occupational rehabilitation and an overall improvement in functioning. Psychosocial approaches although beneficial, are difficult to implement. They require teamwork, involving professionals other than psychiatrists and psychologists alone. These approaches need to be comprehensive, individualized and require training to various levels that is difficult to achieve in most Indian settings. In this article we provide a brief review of these approaches. PMID:29540920

  6. Physical activity and psychosocial benefits among breast cancer patients.

    PubMed

    Pinto, Bernardine M; Dunsiger, Shira; Waldemore, Marissa

    2013-10-01

    Physical activity (PA) has been shown to provide health benefits for breast cancer patients. The effects of augmenting oncology healthcare provider (HCP) advice for PA with 3 months of telephone counseling versus contact control were evaluated in a randomized trial. Our goal in this secondary analysis was to examine the amount of PA (min/week) needed for psychosocial benefits among both groups. After receiving brief HCP advice to become physically active, 192 women (age in years: mean = 60.0, SD = 9.9) who had completed treatment for Stage 0-IV breast cancer were randomized to telephone counseling to support PA (n = 106) or contact control (n = 86). Their PA, fatigue, physical functioning, and quality of life were assessed at baseline (before receiving HCP advice), 3, 6, and 12 months. A non-randomized design was used to examine the dose-response relationship between PA and psychosocial outcomes. Exercising for at least 150 min/week at moderate intensity was associated with improved physical functioning (b = 5.9, SE = 2.9, p = 0.04) and quality of life (b = 3.6, SE = 1.9, p = 0.05) at 3 months. These relationships were not found at 6 and 12 months (p's > 0.05). However, women who reported at least 150 min/week of PA at both 3 and 6 months had significantly reduced fatigue (b = 1.3, SE = 0.7, p = 0.05) and improved physical functioning (b = 3.1, SE = 1.3, p = 0.02) and quality of life (b = 2.0, SE = 0.9, p = 0.02) compared with women who did not meet this criterion. Women who exercised at recommended levels (at least 150 min/week) and sustained this level of activity for at least 6 months accrued psychosocial benefits. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Psychosocial Functioning of Young Children with Learning Problems

    ERIC Educational Resources Information Center

    Gadeyne, Els; Ghesquiere, Pol; Onghena, Patrick

    2004-01-01

    Background: In this study, psychosocial functioning of different groups of young children with learning problems was investigated using a diverse set of psychosocial variables (including behaviour problems, academic motivation, social preference, and self-concept). Methods: For this purpose, children with low academic achievement, with a specific…

  8. Predicting cognitive function of the Malaysian elderly: a structural equation modelling approach.

    PubMed

    Foong, Hui Foh; Hamid, Tengku Aizan; Ibrahim, Rahimah; Haron, Sharifah Azizah; Shahar, Suzana

    2018-01-01

    The aim of this study was to identify the predictors of elderly's cognitive function based on biopsychosocial and cognitive reserve perspectives. The study included 2322 community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, biomarkers, psychosocial status, disability, and cognitive function. A biopsychosocial model of cognitive function was developed to test variables' predictive power on cognitive function. Statistical analyses were performed using SPSS (version 15.0) in conjunction with Analysis of Moment Structures Graphics (AMOS 7.0). The estimated theoretical model fitted the data well. Psychosocial stress and metabolic syndrome (MetS) negatively predicted cognitive function and psychosocial stress appeared as a main predictor. Socio-demographic characteristics, except gender, also had significant effects on cognitive function. However, disability failed to predict cognitive function. Several factors together may predict cognitive function in the Malaysian elderly population, and the variance accounted for it is large enough to be considered substantial. Key factor associated with the elderly's cognitive function seems to be psychosocial well-being. Thus, psychosocial well-being should be included in the elderly assessment, apart from medical conditions, both in clinical and community setting.

  9. The relative contributions of function, perceived psychological burden and partner support to cognitive distress in bladder cancer.

    PubMed

    Heyes, Susan M; Bond, Malcolm J; Harrington, Ann; Belan, Ingrid

    2016-09-01

    Bladder cancer is a genitourinary disease of increasing incidence. Despite improvements in treatment, outcomes remain equivocal with high recurrence rates. It is associated with poor psychosocial outcomes due to reduced functioning of the genitourinary system. The objective of these analyses was to query whether reported loss of function or the perception of psychological burden caused by this functional impedance was the key to understanding psychosocial outcomes. The sample comprised 119 participants with a confirmed diagnosis of bladder cancer. They completed a self-report questionnaire comprising the Bladder Cancer Index, Mini-mental Adjustment to Cancer Scale, Psychosocial Adjustment to Illness Scale and standard sociodemographic details. Simple mediation and serial mediation were used to explore the potential for psychological burden to mediate associations between loss of function and cognitive distress, and the potential additional contribution of positive partner support on these relationships. Age and duration of cancer were considered as covariates. Simple mediation demonstrated that the association between function and cognitive distress was fully mediated by perceived psychological burden. Serial mediation, which allowed for the addition of partner support, again demonstrated full mediation, with partner support being the key predictive variable. These analyses emphasise the importance of an appreciation of individuals' interpretation of the burden occasioned by bladder cancer and the role of a supportive partner. The implications for management discussions and support services in alleviating negative psychological outcomes in bladder cancer are highlighted. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  10. The association between exposure to psychosocial work factors and mental health in older employees, a 3-year follow-up study.

    PubMed

    Havermans, Bo M; Boot, Cécile R L; Hoekstra, Trynke; Houtman, Irene L D; Brouwers, Evelien P M; Anema, Johannes R; van der Beek, Allard J

    2018-01-01

    Unfavourable exposure to psychosocial work factors threatens older employees' mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in mental health in older employees at 3-year follow-up. The current study used data from the Study on Transitions in Employment, Ability and Motivation (STREAM), in workers aged 45-65 years (n = 5249). Two-year (2010-2012) exposure was assessed for psychological demands, autonomy, support, mental load, and distributive justice. Linear regression analyses were performed to compare improved exposure to unfavourable psychosocial work factors with stable unfavourable and stable favourable exposure and mental health at follow-up (2013), corrected for confounders. Analyses were stratified for age groups (45-54 and 55-65 years) and gender. In certain subgroups, stable unfavourable exposure to psychological demands, autonomy, support, and distributive justice was associated with a significantly lower mental health score than improved exposure. Stable favourable exposure to support was associated with a higher mental health score than improved support, whereas stable favourable exposure to autonomy was associated with a lower mental health score compared to improved exposure. There is a longitudinal association between changes in exposure to psychosocial work factors and mental health. Improvement in unfavourable exposure to psychosocial work factors was associated with improved mental health. This is important information for organisations that consider deploying measures to improve the psychosocial work environment of older workers.

  11. Systemic Therapy for Youth at Clinical High Risk for Psychosis: A Pilot Study.

    PubMed

    Shi, Jingyu; Wang, Lu; Yao, Yuhong; Zhan, Chenyu; Su, Na; Zhao, Xudong

    2017-01-01

    Psychosocial intervention trials for youth at clinical high risk (CHR) for psychosis have shown promising effects on treating psychotic symptoms but have not focused on psychosocial functional outcomes, and those studies have been conducted among help-seeking patients; there is a lack of research on non-clinical young CHR individuals. Systemic therapy (ST) is grounded in systemic-constructivist and psychosocial resilience theories. It has a number of advantages that makes it attractive for use with CHR individuals in non-clinical context. The present study evaluated the effect of ST for students at CHR on reducing symptoms and enhancing psychosocial function. This was a single-blind randomized controlled trial for CHR young people comparing ST to supportive therapy with a 6-month treatment. Psychotic and depressive symptoms (DS) as well as self-esteem and social support (SS) were assessed at pre- and posttreatment. 26 CHR individuals were randomly divided into intervention group ( n  = 13) and control group ( n  = 13). There were no significant differences in severity of symptoms, level of SS and self-esteem at baseline between the two groups ( P  > 0.05). At posttreatment, significant improvements in positive and DS as well as SS and self-esteem were observed in the ST group ( P  < 0.05); in the control group, these improvements were not significant ( P  > 0.05). The findings indicated that systemic intervention for university students at CHR for psychosis may have a positive effect on symptoms and self-esteem as well as SS in short term. More long-term research is needed to further evaluate this intervention.

  12. Variation in Functioning, Psychosocial Characteristics, and Six-Month Outcomes among Suicidal Youth in Comprehensive Community Mental Health Services

    ERIC Educational Resources Information Center

    Mandell, David S.; Walrath, Christine M.; Goldston, David B.

    2006-01-01

    In this study we compared the psychosocial (n = 7,896) and clinical (n = 4,664) characteristics and 6-month functional outcomes (n = 2,594) of suicidal and nonsuicidal youth. Repeat and previous attempters were more likely than first-time and never attempters to experience psychosocial problems and to be functionally impaired in a variety of…

  13. Changes in working conditions and physical health functioning among midlife and ageing employees.

    PubMed

    Mänty, Minna; Kouvonen, Anne; Lallukka, Tea; Lahti, Jouni; Lahelma, Eero; Rahkonen, Ossi

    2015-11-01

    The aim this study was to examine the effect of changes in physical and psychosocial working conditions on physical health functioning among ageing municipal employees. Follow-up survey data were collected from midlife employees of the City of Helsinki, Finland, at three time points: wave 1 (2000-2002), wave 2 (2007), and wave 3 (2012). Changes in physical and psychosocial working conditions were assessed between waves 1 and 2. Physical health functioning was measured by the physical component summary (PCS) of the Short-Form 36 questionnaire at each of the three waves. In total, 2784 respondents (83% women) who remained employed over the follow-up were available for the analyses. Linear mixed-effect models were used to assess the associations and adjust for key covariates (age, gender, obesity, chronic diseases, and health behaviors). Repeated and increased exposure to adverse physical working conditions was associated with greater decline in physical health functioning over time. In contrast, decrease in exposures reduced the decline. Of the psychosocial working conditions, changes in job demands had no effects on physical health functioning. However, decreased job control was associated with greater decline and repeated high or increased job control reduced the decline in physical health functioning over time. Adverse changes in physical working conditions and job control were associated with greater decline in physical health functioning over time, whereas favorable changes in these exposures reduced the decline. Preventing deterioration and promoting improvement of working conditions are likely to help maintain better physical health functioning among ageing employees.

  14. Psychosocial impact of dysthymia: a study among married patients.

    PubMed

    Subodh, B N; Avasthi, A; Chakrabarti, S

    2008-07-01

    Unlike major depression, the psychosocial impact of dysthymia has received far less research attention. This study attempted to assess the psychosocial consequences of dysthymia. The sample consisted of 30 married patients with DSM-IV dysthymic disorder and a matched control group of 30 married patients with recurrent major depressive disorder (RDD), diagnosed using structured interviews. Apart from ratings of severity of depression, assessments of psychosocial impact included quality of life (QOL), disability, perceived social support and marital adjustment. Psychosocial parameters were evaluated using vernacular versions of well-validated scales previously used in similar populations. Matched normal/medically ill controls were derived from Indian studies which had assessed the same parameters using the same instruments. Patients with dysthymia were significantly impaired on measures of QOL, disability, social support and marital adjustment compared to normal/medically ill controls. On the other hand, the two groups of dysthymia and RDD were comparable on these measures apart from significantly lower social support among patients with dysthymia. Duration of illness and severity of depression emerged as the most important correlates, particularly of impaired QOL and disability levels. Small hospital-based sample, normal/medically ill controls derived from other studies and cross-sectional assessments were the major limitations. Dysthymia had considerable adverse psychosocial impact in terms of QOL, functioning (disability), social support and marital adjustment. Severity and chronicity appeared to be important mediators of this negative psychosocial impact. Increased awareness, improved recognition and adequate treatment might help negate some of the untoward social consequences of this condition.

  15. 42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

  16. 42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

  17. 42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

  18. 42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

  19. The Effects of Group Work with Institutionalized Elderly Persons

    ERIC Educational Resources Information Center

    Duyan, Veli; Sahin-Kara, Gülay; Camur Duyan, Gülsüm; Özdemir, Burcu; Megahead, Hamido A.

    2017-01-01

    Objectives: This research article aims to measure the effects of group therapy on institutionalized elderly in terms of reducing depression and improving psychosocial functioning. Methods: Thirty elderly nursing home residents were recruited, and 16 of them elected to receive group treatment for depression and 14 declined treatment. The…

  20. Developing a dimensional model for successful cognitive and emotional aging.

    PubMed

    Vahia, Ipsit V; Thompson, Wesley K; Depp, Colin A; Allison, Matthew; Jeste, Dilip V

    2012-04-01

    There is currently a lack of consensus on the definition of successful aging (SA) and existing implementations have omitted constructs associated with SA. We used empirical methods to develop a dimensional model of SA that incorporates a wider range of associated variables, and we examined the relationship among these components using factor analysis and Bayesian Belief Nets. We administered a successful aging questionnaire comprising several standardized measures related to SA to a sample of 1948 older women enrolled in the San Diego site of the Women's Health Initiative study. The SA-related variables we included in the model were self-rated successful aging, depression severity, physical and emotional functioning, optimism, resilience, attitude towards own aging, self-efficacy, and cognitive ability. After adjusting for age, education and income, we fitted an exploratory factor analysis model to the SA-related variables and then, in order to address relationships among these factors, we computed a Bayesian Belief Net (BBN) using rotated factor scores. The SA-related variables loaded onto five factors. Based on the loading, we labeled the factors as follows: self-rated successful aging, cognition, psychosocial protective factors, physical functioning, and emotional functioning. In the BBN, self-rated successful aging emerged as the primary downstream factor and exhibited significant partial correlations with psychosocial protective factors, physical/general status and mental/emotional status but not with cognitive ability. Our study represents a step forward in developing a dimensional model of SA. Our findings also point to a potential role for psychiatry in improving successful aging by managing depressive symptoms and developing psychosocial interventions to improve self-efficacy, resilience, and optimism.

  1. A naturalistic study on the relationship among resilient factors, psychiatric symptoms, and psychosocial functioning in a sample of residential patients with psychosis.

    PubMed

    Poloni, Nicola; Zizolfi, Daniele; Ielmini, Marta; Pagani, Roberto; Caselli, Ivano; Diurni, Marcello; Milano, Anna; Callegari, Camilla

    2018-01-01

    Resilience is a multidimensional process of adaptation aimed to overcome stressful or traumatic life experiences; only in the last few years it has been considered as a personal resource in psychosis and schizophrenia. This study aimed to assess the relationship between intrapersonal and interpersonal resilience factors and schizophrenia, particularly whether and how resilience can improve the course of psychotic illness. In this observational study, all patients recruited had to fulfill the following inclusion criteria: diagnosis of schizophrenia spectrum disorder ( Diagnostic and Statistical Manual of Mental Disorders-5 ); aged between 18 and 65 years; provided written informed consent; to be clinically stable (Clinical Global Impression Scale <3); history of illness ≥5 years; to be compliant with antipsychotic therapy over the last year; and regular submission to periodic monthly psychiatric visits. Patients were evaluated through the following scales: Resilience Scale for Adults (RSA) for resilience; Brief Psychiatric Rating Scale-Anchored version (BPRS-A), Scale for the Assessment of Negative Symptoms (SANS), and Scale for the Assessment of Positive Symptoms (SAPS) for psychotic symptomatology; and Life Skills Profile (LSP) for psychosocial functioning. Statistical analysis was performed by SPSS. Partial correlations were evaluated to assess the relationship between RSA total scores and subscores and BPRS-A, SANS, SAPS, and LSP total scores, removing the common variance among variables. Then, a series of hierarchical multiple linear regression models were used to examine the association between resilience, psychopathology, and psychosocial functioning. A statistically significant negative correlation among intrapersonal resilience factors and BPRS-A total score emerged, predicting psychiatric symptoms severity and explaining approximately 31% of the BPRS-A variance; otherwise, only the interpersonal resilience factors associated with social support were statistically and positively correlated with LSP total score, predicting psychosocial functioning and explaining the 11% of LSP variance. The specific contribution that resilience factors may have in predicting the severity of symptoms and the extent of psychosocial functioning emphasizes the importance of personalizing treatment for patients affected by schizophrenia, promoting personal resources, and translating them into better outcomes.

  2. Improving antenatal risk assessment in women exposed to high risks.

    PubMed

    Perry, Natasha; Newman, Louise K; Hunter, Mick; Dunlop, Adrian

    2015-01-01

    Antenatal substance use and related psychosocial risk factors are known to increase the likelihood of child protection involvement; less is known about the predictive nature of maternal reflective functioning (RF) in this population. This preliminary study assessed psychosocial and psychological risk factors for a group of substance dependent women exposed to high risks in pregnancy, and their impact on child protection involvement. Pregnant women on opiate substitution treatment (n = 11) and a comparison group (n = 15) were recruited during their third trimester to complete measures of RF (Pregnancy Interview), childhood trauma, mental health and psychosocial assessments. At postnatal follow-up, RF was reassessed (Parent Development Interview - Revised Short Version) and mother-infant dyads were videotaped to assess emotional availability (EA). Child protection services were contacted to determine if any concerns had been raised for infant safety. Significant between-group differences were observed for demographics, psychosocial factors, trauma and mental health symptoms. Unexpectedly, no significant differences were found for RF or EA between groups. Eight women in the 'exposed to high risks' group became involved with child protection services. Reflective functioning was not significantly associated with psychosocial risk factors, and therefore did not mediate the outcome of child protection involvement. Women 'exposed to high risks' were equally able to generate a model of their own and their infants' mental states and should not be seen within a deficit perspective. Further research is required to better understand the range of risk factors that predict child protection involvement in high risk groups. © The Author(s) 2013.

  3. Aligning organizational priorities with ARC to improve youth mental health service outcomes.

    PubMed

    Glisson, Charles; Williams, Nathaniel J; Hemmelgarn, Anthony; Proctor, Enola; Green, Philip

    2016-08-01

    The Availability, Responsiveness, and Continuity (ARC) organizational intervention is designed to improve community-based youth mental health services by aligning organizational priorities with 5 principles of effective service organizations (i.e., mission driven, results oriented, improvement directed, relationship centered, participation based). This study assessed the effect of the ARC intervention on youth outcomes and the mediating role of organizational priorities as a mechanism linking the ARC intervention to outcomes. Fourteen community-based mental health agencies in a midwestern metropolis along with 475 clinicians and 605 youth (ages 5-18) served by those agencies were randomly assigned to the 3-year ARC intervention or control condition. The agencies' priorities were measured with the ARC Principles Questionnaire (APQ) completed by clinicians at the end of the intervention. Youth outcomes were measured as total problems in psychosocial functioning described by their caregivers using the Shortform Assessment for Children (SAC) at 6 monthly intervals. The rate of improvement in youths' psychosocial functioning in agencies assigned to the ARC condition was 1.6 times the rate of improvement in agencies assigned to the control condition, creating a standardized difference in functioning of d = .23 between the 2 groups at the 6-month follow-up. The effect on youth outcomes was fully mediated by the alignment of organizational priorities described in the 5 ARC principles (d = .21). The ARC organizational intervention improves youth outcomes by aligning organizational priorities with the 5 ARC principles. The findings suggest that organizational priorities explain why some community mental health agencies are more effective than others. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. Aligning Organizational Priorities with ARC to Improve Youth Mental Health Service Outcomes

    PubMed Central

    Glisson, Charles; Williams, Nathaniel J.; Hemmelgarn, Anthony; Procter, Enola; Green, Philip

    2016-01-01

    Objective The ARC organizational intervention was designed to improve community-based youth mental health services by aligning organizational priorities with five principles of effective service organizations (i.e., mission-driven, results-oriented, improvement-directed, relationship-centered, participation-based). This study assessed the effect of the ARC intervention on youth outcomes and the mediating role of organizational priorities as a mechanism linking the ARC intervention to outcomes. Methodology Fourteen community-based mental health agencies in a Midwestern metropolis along with 475 clinicians and 605 youth (aged 5–18) served by those agencies were randomly assigned to the three-year ARC intervention or control condition. The agencies’ priorities were measured with the ARC Principles Questionnaire (APQ) completed by clinicians at the end of the intervention. Youth outcomes were measured as total problems in psychosocial functioning described by their caregivers using the Shortform Assessment for Children (SAC) at six monthly intervals. Results The rate of improvement in youths’ psychosocial functioning in agencies assigned to the ARC condition was 1.6 times the rate of improvement in agencies assigned to the control condition, creating a standardized difference in functioning of d = .23 between the two groups at the six month follow-up. The effect on youth outcomes was fully mediated by the alignment of organizational priorities described in the five ARC principles (d = .21). Conclusions The ARC organizational intervention improves youth outcomes by aligning organizational priorities with the five ARC principles. The findings suggest that organizational priorities explain why some community mental health agencies are more effective than others. PMID:27253202

  5. Does the use of the revised psychosocial assessment tool (PATrev) result in improved quality of life and reduced psychosocial risk in Canadian families with a child newly diagnosed with cancer?

    PubMed

    Barrera, M; Hancock, K; Rokeach, A; Atenafu, E; Cataudella, D; Punnett, A; Johnston, D; Cassidy, M; Zelcer, S; Silva, M; Jansen, P; Bartels, U; Nathan, P C; Shama, W; Greenberg, C

    2014-02-01

    Early psychosocial screening may guide interventions and ameliorate the adverse psychosocial effects of childhood cancer. The revised psychosocial assessment tool provides risk information - Universal (typical distress), Targeted (additional specific distress), and Clinical (severe distress) - about the child with cancer and his or her family. This pilot study investigated the benefits of providing a summary of family psychosocial risk information to the medical team treating the newly diagnosed child (Experimental Group, EG). We conducted a pilot randomized control trial with a sample of 67 parents, comparing the EG to the control group (CG) on parental perception of family psychosocial difficulties (revised psychosocial assessment tool risk levels), child behavior (behavior assessment scale for children-2), pediatric quality of life (PedsQL), and parental anxiety (state-anxiety scale of the state-trait anxiety inventory ), 2-4 weeks after diagnosis (Time 1) and 6 months later (Time 2). Compared to the CG, participants in the EG had significantly reduced targeted and clinical risk (p < 0.001), and improved pain related PedsQL at Time 2 (p < 0.05). Scores for PedsQL total and nearly all subscales improved over time in both groups (p < 0.05 to p < 0.001). No changes in behavior scores were noted. Preliminary findings suggest that providing a summary of the Psychosocial Assessment Tool to the treating team shortly after diagnosis may help reduce family wide psychosocial risk 6 months later and improve quality of life related to pain for children who are undergoing treatment for cancer. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment.

    PubMed

    Hechtman, Lily; Abikoff, Howard; Klein, Rachel G; Weiss, Gabrielle; Respitz, Chara; Kouri, Joan; Blum, Carol; Greenfield, Brian; Etcovitch, Joy; Fleiss, Karen; Pollack, Simcha

    2004-07-01

    To test the hypothesis that intensive multimodal psychosocial intervention (that includes academic assistance and psychotherapy) combined with methylphenidate significantly enhances the academic performance and emotional status of children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and with methylphenidate combined with nonspecific psychosocial treatment (attention control). One hundred three children with ADHD (ages 7-9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to receive one of three treatments: (1) methylphenidate alone, (2) methylphenidate plus psychosocial treatment that included academic remediation, organizational skills training, and psychotherapy as well as parent training and counseling and social skills training, or (3) methylphenidate plus attention control treatment. Children's function was assessed through academic testing, parent ratings of homework problems, and self-ratings of depression and self-esteem. No advantage was found on any measure of academic performance or emotional status for the combination treatment over methylphenidate alone and over methylphenidate plus attention control. Significant improvement occurred across all treatments and was maintained over 2 years. In stimulant-responsive young children with ADHD without learning and conduct disorders, there is no support for academic assistance and psychotherapy to enhance academic achievement or emotional adjustment. Significant short-term improvements were maintained over 2 years. Copyright 2004 American Academy of Child and Adolescent Psychiatry

  7. Psychosocial profile of pediatric brain tumor survivors with neurocognitive complaints.

    PubMed

    de Ruiter, Marieke Anna; Schouten-van Meeteren, Antoinette Yvonne Narda; van Vuurden, Dannis Gilbert; Maurice-Stam, Heleen; Gidding, Corrie; Beek, Laura Rachel; Granzen, Bernd; Oosterlaan, Jaap; Grootenhuis, Martha Alexandra

    2016-02-01

    With more children surviving a brain tumor, neurocognitive consequences of the tumor and its treatment become apparent, which could affect psychosocial functioning. The present study therefore aimed to assess psychosocial functioning of pediatric brain tumor survivors (PBTS) in detail. Psychosocial functioning of PBTS (8-18 years) with parent-reported neurocognitive complaints was compared to normative data on health-related quality of life (HRQOL), self-esteem, psychosocial adjustment, and executive functioning (one-sample t tests) and to a sibling control group on fatigue (independent-samples t test). Self-, parent-, and teacher-report questionnaires were included, where appropriate, providing complementary information. Eighty-two PBTS (mean age 13.4 years, SD 3.2, 49 % males) and 43 healthy siblings (mean age 14.3, SD 2.4, 40 % males) were included. As compared to the normative population, PBTS themselves reported decreased physical, psychological, and generic HRQOL (d = 0.39-0.62, p < 0.008). Compared to siblings, increased fatigue-related concentration problems (d = 0.57, p < 0.01) were reported, although self-reported self-esteem and psychosocial adjustment seemed not to be affected. Parents of PBTS reported more psychosocial (d = 0.81, p < 0.000) and executive problems (d = 0.35-0.43, p < 0.016) in their child than parents of children in the normative population. Teachers indicated more psychosocial adjustment problems for female PBTS aged 8-11 years than for the female normative population (d = 0.69, p < 0.025), but they reported no more executive problems. PBTS with parent-reported neurocognitive complaints showed increased psychosocial problems, as reported by PBTS, parents, and teachers. Systematic screening of psychosocial functioning is necessary so that tailored support from professionals can be offered to PBTS with neurocognitive complaints.

  8. Psychosocial implications of blepharoptosis and dermatochalasis.

    PubMed Central

    Bullock, J D; Warwar, R E; Bienenfeld, D G; Marciniszyn, S L; Markert, R J

    2001-01-01

    PURPOSE: To investigate, for the first time, the psychosocial implications of blepharoptosis and dermatochalasis. METHODS: Two hundred ten individuals rated whole-face photographs of a series of patients on the basis of 11 different personal characteristics: intelligence, throat, friendliness, health, trustworthiness, hard work, mental illness, financial success, attractiveness, alcoholism, and happiness. Preoperative and postoperative photographs of both male and female patients with bilateral blepharoptosis and/or dermatochalasis were used. The paired t test was used to compare preoperative and postoperative ratings on the 11 characteristics. RESULTS: The preoperative photographs were rated more negatively than the postoperative photographs (P < .01-P < .001) on all 11 characteristics for both male and female patients by the 210 study subjects. CONCLUSIONS: Members of society seem to view individuals with blepharoptosis and dermatochalasis negatively. These psychosocial attitudes may lead to unjust bias toward affected patients, and surgical correction likely provides benefits beyond improved visual function. PMID:11797321

  9. Taking a "Snapshot": Evaluation of a Conversation Aid for Identifying Psychosocial Needs in Young Adults with Cancer.

    PubMed

    Poort, Hanneke; Souza, Phoebe M; Malinowski, Paige K; MacDougall, Katelyn M; Barysauskas, Constance M; Lau Greenberg, Teresa; Tulsky, James A; Fasciano, Karen M

    2018-05-21

    Young adults (YAs) aged 18-35 years with cancer often experience unmet psychosocial needs. We aimed to evaluate a conversation aid ("Snapshot") that offered a framework for discussing YA-specific psychosocial concerns between patients and clinicians. We developed and implemented Snapshot between 2014 and 2016 as part of a quality improvement initiative at Dana-Farber Cancer Institute. We extracted pre- and postimplementation data from chart documentation of psychosocial concerns. YAs and social workers provided qualitative feedback on the use of Snapshot in clinical care. Postintervention chart reviews revealed a significant increase in the median number of topics documented in charts after implementation of Snapshot (preintervention median = 9 [range: 1-15] vs. postintervention median = 11 [range 6-15]; p = 0.003). Overall, YAs and social workers reported that using Snapshot improved communication and consistency of psychosocial care, with documented improvement in the following domains: understanding illness (p < 0.001), sexuality and intimacy (p = 0.03), symptom burden (p = 0.003), care planning (p < 0.001), support for caregivers and children (p = 0.02), and social, work, and home changes (p = 0.05). Snapshot improved the quality of psychosocial needs assessment among YAs with cancer. Implementation was successful in reducing variability identified in the preintervention cohort and increasing the number of YA-specific psychosocial topics discussed. A standardized conversation aid has the potential to improve quality of care for YAs by enabling early identification and intervention of psychosocial issues for all patients.

  10. Pre-post changes in psychosocial functioning among relatives of patients with depressive disorders after Brief Multifamily Psychoeducation: a pilot study.

    PubMed

    Katsuki, Fujika; Takeuchi, Hiroshi; Konishi, Mizuho; Sasaki, Megumi; Murase, Yuka; Naito, Atsuko; Toyoda, Hiroko; Suzuki, Masako; Shiraishi, Nao; Kubota, Yosuke; Yoshimatsu, Yoshiko; Furukawa, Toshiaki A

    2011-04-11

    Depressive disorder is often chronic and recurrent, and results in a heavy psychosocial burden on the families of patients with this disorder. This study aims to examine the effectiveness of brief multifamily psychoeducation designed to alleviate their psychosocial burden. Thirty-two relatives of patients with major depressive disorder participated in an open study testing the effectiveness of brief multifamily psychoeducation. The intervention consisted of four sessions over the course of 6 weeks. Outcome measures focused on emotional distress, care burden and Expressed Emotion (EE). The emotional distress, care burden and EE of the family all showed statistically significant improvements from baseline to after the family intervention. The proportion of relatives scoring 9 or more on K6, which indicates possible depressive or anxiety disorder, decreased from sixteen relatives (50.0%) at baseline, to only 3 relatives (9.3%) after the intervention. This study suggests that brief multifamily psychoeducation is a useful intervention to reduce the psychosocial burden of the relatives of patients with depressive disorder. Further evaluation of family psychoeducation for relatives of patients with depressive disorder is warranted.

  11. Social support is associated with blood pressure responses in parents caring for children with developmental disabilities.

    PubMed

    Gallagher, Stephen; Whiteley, Jenny

    2012-01-01

    The present study tested whether parents caring for children with developmental disabilities would have higher blood pressure compared to parents of typically developing children (controls). It also examined the psychosocial factors underlying this observation. Thirty-five parents of children with developmental disability and thirty controls completed standard measures of perceived stress, child challenging behaviours and social support and wore an ambulatory blood pressure (BP) monitor throughout the day, for one day. Relative to controls, parents caring for children with developmental disabilities reported poorer psychosocial functioning and had a higher mean systolic BP. Of the psychosocial predictors, only social support was found to be predictive. Moreover, variations in social support accounted for some of the between group differences with the β for parental group attenuated from .42 to .34 in regression analyses. It appears that social support may influence blood pressure responses in parental caregivers. Finally, our findings underscore the importance of providing psychosocial interventions to improve the health of family caregivers. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Considerations in Spinal Fusion Surgery for Chronic Lumbar Pain: Psychosocial Factors, Rating Scales, and Perioperative Patient Education-A Review of the Literature.

    PubMed

    Gaudin, Daniel; Krafcik, Brianna M; Mansour, Tarek R; Alnemari, Ahmed

    2017-02-01

    Despite widespread use of lumbar spinal fusion as a treatment for back pain, outcomes remain variable. Optimizing patient selection can help to reduce adverse outcomes. This literature review was conducted to better understand factors associated with optimal postoperative results after lumbar spinal fusion for chronic back pain and current tools used for evaluation. The PubMed database was searched for clinical trials related to psychosocial determinants of outcome after lumbar spinal fusion surgery; evaluation of commonly used patient subjective outcome measures; and perioperative cognitive, behavioral, and educational therapies. Reference lists of included studies were also searched by hand for additional studies meeting inclusion and exclusion criteria. Patients' perception of good health before surgery and low cardiovascular comorbidity predict improved postoperative physical functional capacity and greater patient satisfaction. Depression, tobacco use, and litigation predict poorer outcomes after lumbar fusion. Incorporation of cognitive-behavioral therapy perioperatively can address these psychosocial risk factors and improve outcomes. The 36-Item Short Form Health Survey, European Quality of Life five dimensions questionnaire, visual analog pain scale, brief pain inventory, and Oswestry Disability Index can provide specific feedback to track patient progress and are important to understand when evaluating the current literature. This review summarizes current information and explains commonly used assessment tools to guide clinicians in decision making when caring for patients with lower back pain. When determining a treatment algorithm, physicians must consider predictive psychosocial factors. Use of perioperative cognitive-behavioral therapy and patient education can improve outcomes after lumbar spinal fusion. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Psychosocial Functioning of Adult Epileptic and MS Patients and Adult Normal Controls on the WPSI.

    ERIC Educational Resources Information Center

    Tan, Siang-Yang

    1986-01-01

    Psychosocial functioning of adult epileptic outpatients as assessed by the Washington Psychosocial Seizure Inventory (WPSI) was compared to that of adult multiple sclerosis (MS) outpatients and normal subjects. When only valid WPSI profiles were considered, the only significant finding was that the epilepsy group and the MS group had more…

  14. Stability of the DSM-5 Section III pathological personality traits and their longitudinal associations with psychosocial functioning in personality disordered individuals.

    PubMed

    Wright, Aidan G C; Calabrese, William R; Rudick, Monica M; Yam, Wern How; Zelazny, Kerry; Williams, Trevor F; Rotterman, Jane H; Simms, Leonard J

    2015-02-01

    This study was conducted to establish (a) the stability of the DSM-5 Section III personality disorder (PD) traits, (b) whether these traits predict future psychosocial functioning, and (c) whether changes in traits track with changes in psychosocial functioning across time. Ninety-three outpatients (61% female) diagnosed with at least 1 PD completed patient-report measures at 2 time-points (M time between assessments = 1.44 years), including the Personality Inventory for the DSM-5 and several measures of psychosocial functioning. Effect sizes of rank-order and mean-level change were calculated. In addition, Time 1 traits were used to predict functioning measures at Time 2. Finally, latent change score models were estimated for DSM-5 Section III traits and functioning measures, and correlations among latent change scores were calculated to establish the relationship between change in traits and functional outcomes. Findings demonstrated that the DSM-5 Section III traits were highly stable in terms of normative (i.e., mean-level) change and rank-order stability over the course of the study. Furthermore, traits prospectively predicted psychosocial functioning. However, at the individual level traits and functioning were not entirely static over the study, and change in individuals' functioning tracked with changes in trait levels. These findings demonstrate that the DSM-5 Section III traits are highly stable consistent with the definition of PD, prospectively predictive of psychosocial functioning, and are dynamically associated with functioning over time. This study provides important evidence in support of the DSM-5 Section III PD model. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  15. Psychosocial Outcomes in Long-Term Cochlear Implant Users.

    PubMed

    Castellanos, Irina; Kronenberger, William G; Pisoni, David B

    The objectives of this study were to investigate psychosocial outcomes in a sample of prelingually deaf, early-implanted children, adolescents, and young adults who are long-term cochlear implant (CI) users and to examine the extent to which language and executive functioning predict psychosocial outcomes. Psychosocial outcomes were measured using two well-validated, parent-completed checklists: the Behavior Assessment System for Children and the Conduct Hyperactive Attention Problem Oppositional Symptom. Neurocognitive skills were measured using gold standard, performance-based assessments of language and executive functioning. CI users were at greater risk for clinically significant deficits in areas related to attention, oppositional behavior, hyperactivity-impulsivity, and social-adaptive skills compared with their normal-hearing peers, although the majority of CI users scored within average ranges relative to Behavior Assessment System for Children norms. Regression analyses revealed that language, visual-spatial working memory, and inhibition-concentration skills predicted psychosocial outcomes. Findings suggest that underlying delays and deficits in language and executive functioning may place some CI users at a risk for difficulties in psychosocial adjustment.

  16. Domains of psychosocial disability and mental disorders.

    PubMed

    Ro, Eunyoe; Watson, David; Clark, Lee Anna

    2018-06-07

    This study examined relations between comprehensive domains of psychosocial disability and mental disorders to determine (1) whether differential patterns of associations exist between psychosocial disability dimensions and commonly diagnosed mental disorders and (2) whether these relations differ between self-reported and interviewer-rated psychosocial disability domains. Self-reported and interviewer-rated psychosocial functioning measures and an interviewer-rated diagnostic assessment tool were administered to 181 psychiatric outpatients. Internalizing disorders showed the strongest and most pervasive associations with psychosocial impairment across both self-reported and interviewer-rated measures, followed by thought disorder; externalizing showed the weakest associations. More specifically, logistic regression analyses indicated that lower well-being factor score significantly increased the odds of distress-disorder diagnoses, and poor basic functioning increased the odds of PTSD. Results clearly showed differences in the magnitude of associations between three dimensions of psychosocial-disability and commonly diagnosed disorders, and that these differences were similar regardless of rater type. © 2018 Wiley Periodicals, Inc.

  17. Cognitive impairment as measured by the THINC-integrated tool (THINC-it): Association with psychosocial function in major depressive disorder.

    PubMed

    Cha, Danielle S; Carmona, Nicole E; Subramaniapillai, Mehala; Mansur, Rodrigo B; Lee, Yena; Hon Lee, Jae; Lee, JungGoo; Rosenblat, Joshua D; Shekotikhina, Margarita; Park, Caroline; Rong, Carola; Greer, Tracy L; Lam, Raymond; Baune, Bernhard T; Harrison, John; McIntyre, Roger S

    2017-11-01

    Psychosocial impairment represents an important treatment target in major depressive disorder (MDD). The majority of patients with MDD do not regain premorbid levels of psychosocial functioning despite the resolution of core depressive symptoms. This study aimed to investigate the respective effects of cognitive function and depression severity on impaired psychosocial function in MDD. Adults aged 18-65 with moderate-to-severe MDD (n = 100) and age-, sex-, and education-matched healthy controls participated in a cross-sectional study validating the THINC-integrated tool (THINC-it), a cognitive screening tool comprised of objective and subjective measures of cognitive function. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale and psychosocial function was assessed using the Sheehan Disability Scale (SDS). Subjects with MDD reported greater impairment in psychosocial function than healthy controls, with significant differences in SDS total and domain scores (ps < .01) after controlling for age, sex, and education. Generalized linear models indicated that subjective cognitive function was most strongly associated with SDS total score (RR = .14, p = .01) and SDS domains of work/school (RR = .15, p = .03), family and home responsibilities (RR = .15, p = .02), and economic days lost (RR = .18, p =.03). Depression severity was most strongly associated with SDS social life (RR = .08, p < .01) and economic days underproductive (RR = .07, p < .01). Objective cognitive function was not significantly associated with any SDS outcomes. The cross-sectional, observational study design limits temporal inferences. The self-report nature of measures included may have influenced associations observed. Potential medication effects are not noted. Cognitive deficits, as measured by the THINC-it, are associated with significant psychosocial impairment in MDD. These results provide empirical support for the assessment of both subjective and objective measures of cognition, as they are not associated with each other and have differential effects on functional trajectory. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Factors accounting for psychosocial functioning in patients with low back pain

    PubMed Central

    Steuden, Stanisława; Kuryłowicz, Joanna

    2009-01-01

    Low back pain (LBP) is a chronic disorder which exerts a profound impact on various spheres of psychosocial functioning, including emotional distress, functional limitations and decrements in social contacts. The objective of this study was to investigate the associations between the indices of psychosocial functioning in patients with chronic LBP and a range of psychological factors. Specifically, the study aimed at exploring the relative participation of personality, social support, disease-related cognitive appraisals and coping styles in accounting for the differences in psychosocial functioning of patients with LBP. One-hundred-twenty patients with LBP took part in the study and completed a battery of psychological questionnaires: NEO–Five Factors Inventory, Ways of Coping Questionnaire, Disease-Related Social Support Scale, Disease-Related Appraisals Scale and Psychosocial Functioning Questionnaire (PFQ). The PFQ dimensions were used as dependent variables in a series of stepwise regression analysis models with the scores from other questionnaires entered as independent variables. A cognitive appraisal of the disease in terms of an obstacle was strongly related to all domains of functioning; however, other appraisals (threat, challenge, harm, profit and overall disease importance) were uniquely associated with particular domains of functioning. Deprivation of social support was a significant predictor of distress experienced in interpersonal context and of sense of being disabled. Among basic personality traits, agreeableness was negatively associated with distress in interpersonal context, and conscientiousness was positively related to acceptance of life with the disease. Problem-focus coping was linked to higher acceptance of life with the disease. Among sociodemographic variables, older age and lower educational level were related to greater subjective feelings of being disabled. Pain severity was found unrelated to any of psychosocial functioning domains. Different aspects of psychosocial functioning are best accounted for by diverse patterns of psychological factors, which suggests involvement of different psychological mechanisms in development of LBP-related disability. PMID:19756782

  19. The relationship between oral health status and biological and psychosocial function in the bedridden elderly.

    PubMed

    Hanada, N; Tada, A

    2001-01-01

    The present study was conducted in order to determine what item of biological and psychosocial function is related to oral health status in the bedridden elderly. The subjects were 94 elderly individuals (30 males, 64 females) who had been admitted to a nursing home in Chiba city, Japan. We assessed the number of remaining teeth and the number of functional teeth as oral health status variables. Biological and psychosocial function levels were determined using the functional independence measure method developed by the State University of New York at Buffalo. More than 70% of subjects had less than ten remaining teeth. Almost all subjects needed prosthesis treatment. More than 50% of subjects had 27 or less functional teeth. Mann-Whitney U-test and logistic regression models showed that 'expression' was concerned with the number of remaining teeth and 'bladder management', 'locomotion', 'transfers' were related to the number of functional teeth. These data suggest close relation between oral health status and biological and psychosocial function levels in the bedridden elderly.

  20. Motor and psychosocial impact of robot-assisted gait training in a real-world rehabilitation setting: A pilot study

    PubMed Central

    Giardini, Anna; Maestri, Roberto; Traversoni, Silvia; Bartolo, Michelangelo; Casale, Roberto

    2018-01-01

    In the last decade robotic devices have been applied in rehabilitation to overcome walking disability in neurologic diseases with promising results. Robot assisted gait training (RAGT) using the Lokomat seems not only to improve gait parameters but also the perception of well-being. Data on the psychosocial patient-robot impact are limited, in particular in the real-world of RAGT, in the rehabilitation setting. During rehabilitation training, the Lokomat can be considered an “assistive device for movement”. This allowed the use of the Psychosocial Impact of Assistive Device Scale- PIADS to describe patient interaction with the Lokomat. The primary aim of this pilot study was to evaluate the psychosocial impact of the Lokomat in an in-patient rehabilitation setting using the PIADS; secondary aims were to assess whether the psychosocial impact of RAGT is different between pathological sub-groups and if the Lokomat influenced functional variables (Functional Independence Measure scale–FIM and parameters provided by the Lokomat itself). Thirty-nine consecutive patients (69% males, 54.0±18.0 years) eligible for Lokomat training, with etiologically heterogeneous walking disabilities (Parkinson’s Disease, n = 10; Spinal Cord Injury, n = 21; Ictus Event, n = 8) were enrolled. Patients were assessed with the FIM before and after rehabilitation with Lokomat, and the PIADS was administered after the rehabilitative period with Lokomat. Overall the PIADS score was positive (35.8±21.6), as well as the three sub-scales, pertaining to “ability”, “adaptability” and “self-esteem” (17.2±10.4, 8.9±5.5 and 10.1±6.6 respectively) with no between-group differences. All patients significantly improved in gait measure and motor FIM scale (difference after—before treatment values: 11.7±9.8 and 11.2±10.3 respectively), increased treadmill speed (0.4 ± 0.2m/s), reduced body weight support (-14.0±9.5%) and guidance force (-13.1 ± 10.7%). This pilot study indicates that Lokomat, in a real-world in-patient setting, may have a generalised approval, independent of disease, underlining the importance of the psycho-social framework for patients training with assistive robotic-devices. PMID:29444172

  1. The Association between Quality Improvement Initiatives in Dementia Care and Supportive Psychosocial Work Environments in Nursing Homes.

    PubMed

    Nakanishi, Miharu; Tei-Tominaga, Maki

    2018-05-08

    Background : Quality improvement initiatives can help nursing homes strengthen psychosocial work environments. The aim of the present study was to examine the association between supportive psychosocial work environment, and professional and organizational characteristics regarding quality improvement initiatives in dementia care. Methods : A paper questionnaire survey was administered to a convenience sample of 365 professional caregivers in 12 special nursing homes in Japan. Psychosocial work environment was assessed using the Social Capital and Ethical Climate at the Workplace Scale to calculate a score of social capital in the workplace, ethical leadership, and exclusive workplace climate. Variables for quality improvement initiatives included type of home (unit-type or traditional), presence of additional benefit for dementia care, and professionalism in dementia care among caregivers evaluated using the Japanese version of the Sense of Competence in Dementia Care Staff Scale. Results : Elevated professionalism and unit-type home were significantly associated with high social capital, strong ethical leadership, and low exclusive workplace climate. The presence of dementia care benefit was not associated with any subscale of psychosocial work environment. Conclusions : Quality improvement initiatives to foster supportive psychosocial work environment should enhance professionalism in dementia care with unit-based team building of professional caregivers in special nursing homes.

  2. Do problem-solving interventions improve psychosocial outcomes in vision impaired adults: a systematic review and meta-analysis.

    PubMed

    Holloway, Edith E; Xie, Jing; Sturrock, Bonnie A; Lamoureux, Ecosse L; Rees, Gwyneth

    2015-05-01

    To evaluate the effectiveness of problem-solving interventions on psychosocial outcomes in vision impaired adults. A systematic search of randomised controlled trials (RCTs), published between 1990 and 2013, that investigated the impact of problem-solving interventions on depressive symptoms, emotional distress, quality of life (QoL) and functioning was conducted. Two reviewers independently selected and appraised study quality. Data permitting, intervention effects were statistically pooled and meta-analyses were performed, otherwise summarised descriptively. Eleven studies (reporting on eight trials) met inclusion criteria. Pooled analysis showed problem-solving interventions improved vision-related functioning (standardised mean change [SMC]: 0.15; 95% CI: 0.04-0.27) and emotional distress (SMC: -0.36; 95% CI: -0.54 to -0.19). There was no evidence to support improvements in depressive symptoms (SMC: -0.27, 95% CI: -0.66 to 0.12) and insufficient evidence to determine the effectiveness of problem-solving interventions on QoL. The small number of well-designed studies and narrow inclusion criteria limit the conclusions drawn from this review. However, problem-solving skills may be important for nurturing daily functioning and reducing emotional distress for adults with vision impairment. Given the empirical support for the importance of effective problem-solving skills in managing chronic illness, more well-designed RCTs are needed with diverse vision impaired samples. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. RELIGIOUS EXCLUSIVITY AND PSYCHOSOCIAL FUNCTIONING.

    PubMed

    Gegelashvili, M; Meca, A; Schwartz, S J

    2015-01-01

    In the present study we sought to clarify links between religious exclusivity, as form of intergroup favoritism, and indices of psychosocial functioning. The study of in group favoritism has generally been invoked within Social Identity Theory and related perspectives. However, there is a lack of literature regarding religious exclusivity from the standpoint of social identity. In particular, the ways in which religious exclusivity is linked with other dimensions of religious belief and practice, and with psychosocial functioning, among individuals from different religious backgrounds are not well understood. A sample of 8545 emerging-adult students from 30 U.S. universities completed special measures. Measure of religious exclusivity was developed and validated for this group. The results suggest that exclusivity appears as predictor for impaired psychosocial functioning, low self-esteem and low psychosocial well-being for individuals from organized faiths, as well as for those identifying as agnostic, atheist, or spiritual/nonreligious. These findings are discussed in terms of Social Identity Theory and Terror Management Theory (TMT).

  4. Cognitive Enhancement Therapy Improves Resting-State Functional Connectivity in Early Course Schizophrenia

    PubMed Central

    Eack, Shaun M.; Newhill, Christina E.; Keshavan, Matcheri S.

    2016-01-01

    Objective Cognitive remediation is emerging as an effective psychosocial intervention for addressing untreated cognitive and functional impairments in persons with schizophrenia, and might achieve its benefits through neuroplastic changes in brain connectivity. This study seeks to examine the effects of cognitive enhancement therapy (CET) on fronto-temporal brain connectivity in a randomized controlled trial with individuals in the early course of schizophrenia. Method Stabilized, early course outpatients with schizophrenia or schizoaffective disorder (N = 41) were randomly assigned to CET (n = 25) or an active enriched supportive therapy (EST) control (n = 16) and treated for 2 years. Functional MRI data were collected annually, and pseudo resting-state functional connectivity analysis was used to examine differential changes in fronto-temporal connectivity between those treated with CET compared with EST. Results Individuals receiving CET evidenced significantly less functional connectivity loss between the resting-state network and the left dorsolateral prefrontal cortex as well as significantly increased connectivity with the right insular cortex compared to EST (all corrected p < .01). These neural networks are involved in emotion processing and problem-solving. Increased connectivity with the right insula significantly mediated CET effects on improved emotion perception (z′ = −1.96, p = .021), and increased connectivity with the left dorsolateral prefrontal cortex mediated CET-related improvements in emotion regulation (z′ = −1.71, p = .052). Conclusions These findings provide preliminary evidence that CET, a psychosocial cognitive remediation intervention, may enhance connectivity between frontal and temporal brain regions implicated in problem-solving and emotion processing in service of cognitive enhancement in schizophrenia. PMID:27713804

  5. Development of a Psychosocial Risk Screener for Siblings of Children With Cancer: Incorporating the Perspectives of Parents.

    PubMed

    Long, Kristin A; Pariseau, Emily M; Muriel, Anna C; Chu, Andrea; Kazak, Anne E; Alderfer, Melissa A

    2018-04-03

    Although many siblings experience distress after a child's cancer diagnosis, their psychosocial functioning is seldom assessed in clinical oncology settings. One barrier to systematic sibling screening is the lack of a validated, sibling-specific screening instrument. Thus, this study developed sibling-specific screening modules in English and Spanish for the Psychosocial Assessment Tool (PAT), a well-validated screener of family psychosocial risk. A purposive sample of English- and Spanish-speaking parents of children with cancer (N = 29) completed cognitive interviews to provide in-depth feedback on the development of the new PAT sibling modules. Interviews were transcribed verbatim, cleaned, and analyzed using applied thematic analysis. Items were updated iteratively according to participants' feedback. Data collection continued until saturation was reached (i.e., all items were clear and valid). Two sibling modules were developed to assess siblings' psychosocial risk at diagnosis (preexisting risk factors) and several months thereafter (reactions to cancer). Most prior PAT items were retained; however, parents recommended changes to improve screening format (separately assessing each sibling within the family and expanding response options to include "sometimes"), developmental sensitivity (developing or revising items for ages 0-2, 3-4, 5-9, and 10+ years), and content (adding items related to sibling-specific social support, global assessments of sibling risk, emotional/behavioral reactions to cancer, and social ecological factors such as family and school). Psychosocial screening requires sibling-specific screening items that correspond to preexisting risk (at diagnosis) and reactions to cancer (several months after diagnosis). Validated, sibling-specific screeners will facilitate identification of siblings with elevated psychosocial risk.

  6. Psychosocial Work Characteristics Predict Cardiovascular Disease Risk Factors and Health Functioning in Rural Women: The Wisconsin Rural Women's Health Study

    ERIC Educational Resources Information Center

    Chikani, Vatsal; Reding, Douglas; Gunderson, Paul; McCarty, Catherine A.

    2005-01-01

    Background: The aim of the present study is to investigate the association between psychosocial work characteristics and health functioning and cardiovascular disease risk factors among rural women of central Wisconsin and compare psychosocial work characteristics between farm and nonfarm women. Methods: Stratified sampling was used to select a…

  7. Quantifying the Relationship Among Hospital Design, Satisfaction, and Psychosocial Functioning in a Pediatric Hematology-Oncology Inpatient Unit

    PubMed Central

    Sherman-Bien, Sandra A.; Malcarne, Vanessa L.; Roesch, Scott; Varni, James W.; Katz, Ernest R.

    2013-01-01

    Increasingly, empirical support demonstrates that the built environment may affect the physical and psychosocial well-being of patients, their families, and hospital staff (Beauchemin & Hays, 1996; Rubin, Owens, & Golden, 1998; Sherman, Varni, Ulrich, & Malcarne, 2005; Ulrich, 1991; Varni et al., 2004; Whitehouse et al., 2001). Investigators posit two mechanisms through which the built environment can impact patients: indirectly, by enhancing the quality of care and helping a patient feel more relaxed; and/or directly, by altering the physiological recovery process (Malcolm, 1992). Several literature reviews have been published on the relationship between the hospital built environment and patient outcomes (Joseph, Keller, & Kronick, 2008; Rubin et al., 1998; Sherman, Shepley, & Varni, 2005; Ulrich, Quan, Zimring, Joseph, & Choudhary, 2004). In their 1998 review, Rubin et al. found studies linking environment with a number of health and satisfaction outcomes but little research that had been conducted in a scientifically valid manner. Ulrich et al.'s 2004 review of the role of the physical environment in hospital design identified a number of more rigorously conducted studies, focusing mainly on adult environments and on issues of medical safety and hospital-acquired infection rates. Their conclusions linked environmental features such as noise to an increase in perceived stress and physiological arousal; exposure to natural light to reductions in depression, length of hospital stay, and pain medications and to improved sleep; and hospital gardens to improved physical and psychosocial functioning (Ulrich et al., 2004). PMID:21960191

  8. Exploring the Psychosocial Impact of Wheelchair and Contextual Factors on Quality of Life of People with Neuromuscular Disorders.

    PubMed

    Pousada García, Thais; Groba González, Betania; Nieto Rivero, Laura; Pereira Loureiro, Javier; Díez Villoria, Emiliano; Pazos Sierra, Alejandro

    2015-01-01

    Neuromuscular disorders (NMDs) are a group of heterogeneous diseases that show differences in incidence, hereditary, etiology, prognosis, or functional impairments. Wheelchair use (manual or powered) is influenced by several factors, including personal and contextual factors, and comprehensive evaluation of their impact is required in order to optimize prescription and provision of wheelchairs. The authors therefore assessed the influence of wheelchair use on the quality of life (QoL) of 60 participants with NMD using the Psychosocial Impact of Assistive Devices Scale (PIADS). The Functional Independence Measure (FIM) and a specially developed questionnaire were used to obtain information about contextual factors and participants' activity profile of activities of the participants. The results showed that using a wheelchair has psychosocial benefits, with the main determinants of benefit being type of wheelchair (powered), non-ambulation ability, and independence in mobility. Ensuring a good match between user and assistive technology (AT; e.g., wheelchair), as well as the effectiveness of the particular device, will increase the likelihood that the user will adopt it and use it effectively in daily life. Clinical prescription of AT would be improved by making appropriate use of outcome measures.

  9. Impact of a brief exercise program on the physical and psychosocial health of prostate cancer survivors: A pilot study.

    PubMed

    Skinner, Tina L; Peeters, Gmme Geeske; Croci, Ilaria; Bell, Katherine R; Burton, Nicola W; Chambers, Suzanne K; Bolam, Kate A

    2016-09-01

    It is well established that exercise is beneficial for prostate cancer survivors. The challenge for health professionals is to create effective strategies to encourage survivors to exercise in the community. Many community exercise programs are brief in duration (e.g. <5 exercise sessions); whilst evidence for the efficacy of exercise within the literature are derived from exercise programs ≥8 weeks in duration, it is unknown if health benefits can be obtained from a shorter program. This study examined the effect of a four-session individualized and supervised exercise program on the physical and psychosocial health of prostate cancer survivors. Fifty-one prostate cancer survivors (mean age 69±7 years) were prescribed 1 h, individualized, supervised exercise sessions once weekly for 4 weeks. Participants were encouraged to increase their physical activity levels outside of the exercise sessions. Objective measures of muscular strength, exercise capacity, physical function and flexibility; and self-reported general, disease-specific and psychosocial health were assessed at baseline and following the intervention. Improvements were observed in muscle strength (leg press 17.6 percent; P < 0.001), exercise capacity (400-m walk 9.3 percent; P < 0.001), physical function (repeated chair stands 20.1 percent, usual gait speed 19.3 percent, timed up-and-go 15.0 percent; P < 0.001), flexibility (chair sit and reach +2.9 cm; P < 0.001) and positive well-being (P = 0.014) following the exercise program. A four-session exercise program significantly improved the muscular strength, exercise capacity, physical function and positive well-being of prostate cancer survivors. This short-duration exercise program is safe and feasible for prostate cancer survivors and a randomized controlled trial is now required to determine whether a similar individualized exercise regimen improves physical health and mental well-being over the short, medium and long term. © 2016 John Wiley & Sons Australia, Ltd.

  10. Efficacy of cognitive-behavioral therapy in patients with bipolar disorder: A meta-analysis of randomized controlled trials.

    PubMed

    Chiang, Kai-Jo; Tsai, Jui-Chen; Liu, Doresses; Lin, Chueh-Ho; Chiu, Huei-Ling; Chou, Kuei-Ru

    2017-01-01

    Although cognitive behavioral therapy (CBT) is considered a promising adjuvant to pharmacotherapy for treating bipolar disorder (BD), its efficacy is unproven. The present review and meta-analysis evaluated the treatment outcomes of patients with BD treated with CBT plus medication and compared these data with the outcomes of those who received standard care alone. Electronic searches from inception to July 31, 2016, were performed using PubMed, Medline OVID, Cochrane Library, EMBASE, CINAHL plus, and PsycINFO. In the extensive electronic literature search, keywords such as "bipolar disorder," "manic-depressive psychosis," "bipolar affective disorder," "bipolar depression," "cognitive therapy," "cognitive-behavioral therapy," and "psychotherapy" were transformed into MeSH terms, and only randomized controlled trials (RCTs) were included. The pooled odds ratios (ORs) of relapse rates and Hedges's g, along with 95% confidence intervals (CIs), for the mean differences in the levels of depression, mania, and psychosocial functioning were calculated. Further subgroup analyses were conducted according to the characteristics of the CBT approaches, patients, and therapists, if the data were available. A total of 19 RCTs comprising 1384 patients with type I or II BD were enrolled in our systematic review and meta-analysis. The main analysis revealed that CBT could lower the relapse rate (pooled OR = 0.506; 95% CI = 0.278 -0.921) and improve depressive symptoms (g = -0.494; 95% CI = -0.963 to -0.026), mania severity (g = -0.581; 95% CI = -1.127 to -0.035), and psychosocial functioning (g = 0.457; 95% CI = 0.106-0.809). CBT is effective in decreasing the relapse rate and improving depressive symptoms, mania severity, and psychosocial functioning, with a mild-to-moderate effect size. Subgroup analyses indicated that improvements in depression or mania are more potent with a CBT treatment duration of ≥90 min per session, and the relapse rate is much lower among patients with type I BD.

  11. Improving Outcome of Psychosocial Treatments by Enhancing Memory and Learning

    PubMed Central

    Harvey, Allison G.; Lee, Jason; Williams, Joseph; Hollon, Steven D.; Walker, Matthew P.; Thompson, Monique A.; Smith, Rita

    2014-01-01

    Mental disorders are prevalent and lead to significant impairment. Progress toward establishing treatments has been good. However, effect sizes are small to moderate, gains may not persist, and many patients derive no benefit. Our goal is to highlight the potential for empirically-supported psychosocial treatments to be improved by incorporating insights from cognitive psychology and research on education. Our central question is: If it were possible to improve memory for content of sessions of psychosocial treatments, would outcome substantially improve? This question arises from five lines of evidence: (a) mental illness is often characterized by memory impairment, (b) memory impairment is modifiable, (c) psychosocial treatments often involve the activation of emotion, (d) emotion can bias memory and (e) memory for psychosocial treatment sessions is poor. Insights from scientific knowledge on learning and memory are leveraged to derive strategies for a transdiagnostic and transtreatment cognitive support intervention. These strategies can be applied within and between sessions and to interventions delivered via computer, the internet and text message. Additional novel pathways to improving memory include improving sleep, engaging in exercise and imagery. Given that memory processes change across the lifespan, services to children and older adults may benefit from cognitive support. PMID:25544856

  12. Influence of cognition, premorbid adjustment and psychotic symptoms on psycho-social functioning in first-episode psychosis.

    PubMed

    Grau, Norma; Rubio-Abadal, Elena; Usall, Judith; Barajas, Ana; Butjosa, Anna; Dolz, Montserrat; Baños, Iris; Sánchez, Bernardo; Rodríguez, Maria José; Peláez, Trinidad; Sammut, Stephanie; Carlson, Janina; Huerta-Ramos, Elena; Ochoa, Susana

    2016-08-30

    The aim of this study is to evaluate the relationship between psycho-social functioning and symptoms, cognitive function, and premorbid adjustment, in patients with a first-episode psychosis. Clinical data were obtained from 90 patients, who were assessed with the Disability Assessment Scale (DAS-sv), the Positive and Negative Syndrome Scale (PANSS), the Premorbid Adjustment Scale (PAS-S) and with a battery of cognitive tests including Trail Making Tests A and B (TMTA- B), Continous Performance Test (CPT), some subscales of the Wechler Adult Intelligence Scale (WAIS), and the Verbal Learning Test España-Complutense (TAVEC). The results of the study suggest that psycho-social functioning in first-episode psychosis is significantly related to: positive, negative, excitative, affective and disorganized symptoms, social premorbid adjustment, cognitive flexibility, working memory, short term and long term memory. Of these, those which best explained psycho-social functioning are the positive and excitative symptoms, premorbid adjustment, flexibility and memory. These findings highlight the importance early intervention on cognitive and clinical variables to help provide a better psycho-social functioning in people with a first-episode of psychosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Associations of cytokines, sleep patterns, and neurocognitive function in youth with HIV infection.

    PubMed

    Foster, Samuel B; Lu, Ming; Glaze, Daniel G; Reuben, James M; Harris, Lynnette L; Cohen, Evan N; Lee, Bang-Ning; Zhao, Enxu; Paul, Mary E; Schwarzwald, Heidi; McMullen-Jackson, Chivon; Clark, Charla; Armstrong, F Daniel; Brouwers, Pim Y; Miller, Tracie L; Colin, Andrew A; Scott, Gwendolyn B; Shahzeidi, Shahriar; Willen, Elizabeth J; Asthana, Deshratn; Lipshultz, Steven E; Thompson, Bruce W; Shearer, William T

    2012-07-01

    Youth infected with HIV at birth often have sleep disturbances, neurocognitive deficits, and abnormal psychosocial function which are associated with and possibly resulted from elevated blood cytokine levels that may lead to a decreased quality of life. To identify molecular pathways that might be associated with these disorders, we evaluated 38 HIV-infected and 35 uninfected subjects over 18-months for intracellular cytokine levels, sleep patterns and duration of sleep, and neurodevelopmental abilities. HIV infection was significantly associated with alterations of intracellular pro-inflammatory cytokines (TNF-α, IFN-γ, IL-12), sleep factors (total time asleep and daytime sleep patterns), and neurocognitive factors (parent and patient reported problems with socio-emotional, behavioral, and executive functions; working memory-mental fatigue; verbal memory; and sustained concentration and vigilance. By better defining the relationships between HIV infection, sleep disturbances, and poor psychosocial behavior and neurocognition, it may be possible to provide targeted pharmacologic and procedural interventions to improve these debilitating conditions. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Associations of Cytokines, Sleep Patterns, and Neurocognitive Function in Youth with HIV Infection

    PubMed Central

    Foster, Samuel B.; Lu, Ming; Glaze, Daniel G.; Reuben, James M; Harris, Lynnette L.; Cohen, Evan N.; Lee, Bang-Ning; Zhao, Enxu; Paul, Mary E.; Schwarzwald, Heidi; McMullen-Jackson, Chivon; Clark, Charla; Armstrong, F. Daniel; Brouwers, Pim Y.; Miller, Tracie L.; Colin, Andrew A.; Scott, Gwendolyn B.; Shahzeidi, Shahriar; Willen, Elizabeth J.; Asthana, Deshratn; Lipshultz, Steven E.; Thompson, Bruce; Shearer, William T.

    2012-01-01

    Youth infected with HIV at birth often have sleep disturbances, neurocognitive deficits, and abnormal psychosocial function which are associated with and possibly resulted from elevated blood cytokine levels that may lead to a decreased quality of life. To identify molecular pathways that might be associated with these disorders, we evaluated 38 HIV-infected and 35 uninfected subjects over 18-months for intracellular cytokine levels, sleep patterns and duration of sleep, and neurodevelopmental abilities. HIV infection was significantly associated with alterations of intracellular pro-inflammatory cytokines (TNF-α, IFN-γ, IL-12), sleep factors (total time asleep and daytime sleep patterns), and neurocognitive factors (parent and patient reported problems with socio-emotional, behavioral, and executive functions; working memory-mental fatigue; verbal memory; and sustained concentration and vigilance. By better defining the relationships between HIV infection, sleep disturbances, and poor psychosocial behavior and neurocognition, it may be possible to provide targeted pharmacologic and procedural interventions to improve these debilitating conditions. PMID:22659030

  15. Modifiable Disease Risk, Readiness to Change, and Psychosocial Functioning Improve With Integrative Medicine Immersion Model

    PubMed Central

    Wolever, Ruth Q.; Webber, Daniel M.; Meunier, Justin P.; Greeson, Jeffrey M.; Lausier, Evangeline R.; Gaudet, Tracy W.

    2013-01-01

    Background Stroke, diabetes, and coronary heart disease (CHD) remain leading causes of death in the United States and are largely attributable to lifestyle behaviors. Integrative medicine can provide a supportive partnership that focuses on improving health by identifying and implementing lifestyle changes based upon personal values and goals. Objective This prospective observational study was designed to assess the effectiveness of an integrative medicine intervention on modifiable disease risk, patient activation, and psychosocial risk factors for stroke, diabetes, and CHD. Design Sixty-three adults participated in a 3-day comprehensive, multimodal health immersion program at Duke Integrative Medicine, Duke University Medical Center, Durham, North Carolina. Participants received follow-up education, physician support, and telephonic health coaching between the immersion program and the endpoint 7 to 9 months later. Primary Outcome Measures Psychosocial functioning, read iness to change health behaviors, and risk of developing diabetes, stroke, and CHD were assessed at baseline and endpoint. Results Although cardiac risk remained unchanged (P = .19) during the study period, risk of diabetes (P = .02) and stroke (P < .01) decreased significantly. Perceived stress remained unchanged, but improvements were seen in mood (P < .05) and relationship satisfaction (P < .004). Patients became more activated towards self-management of health (P <.001), endorsed greater readiness to change health behaviors (P <.01), and reported increased aerobic exercise (P <.001) and stretching (P = .006) following the intervention. Conclusion An integrative health model can help patients become more engaged in self-management of health and support them in making and maintaining healthy lifestyle changes. These findings provide support for use of an integrative health model in adult disease risk reduction. PMID:22314632

  16. Psychosocial outcomes in a weight loss camp for overweight youth

    PubMed Central

    QUINLAN, NICOLE P.; KOLOTKIN, RONETTE L.; FUEMMELER, BERNARD F.; COSTANZO, PHILIP R.

    2015-01-01

    Objective There is good evidence that youth attending weight loss camps in the UK and US are successful at achieving weight loss. Limited research suggests improvement in body image and self-esteem as well. This study evaluated changes in eight psychosocial variables following participation in a weight loss camp and examined the role of gender, age, length of stay, and body mass index (BMI) in these changes. Methods This was an observational and self-report study of 130 participants (mean age=12.8; mean BMI=33.5; 70% female; 77% Caucasian). The program consisted of an 1 800 kcal/day diet, daily supervised physical activities, cooking/nutrition classes, and weekly psycho-educational/support groups led by psychology staff. Participants completed measures of anti-fat attitudes, values (e.g., value placed on appearance, athletic ability, popularity), body- and self-esteem, weight- and health-related quality of life, self-efficacy, and depressive symptoms. Results Participants experienced significant BMI reduction (average decrease of 7.5 kg [standard deviation, SD=4.2] and 2.9 BMI points [SD=1.4]). Participants also exhibited significant improvements in body esteem, self-esteem, self-efficacy, generic and weight-related quality of life, anti-fat attitudes, and the importance placed on appearance. Changes in self-efficacy, physical functioning and social functioning remained significant even after adjusting for initial zBMI, BMI change, and length of stay. Gender differences were found on changes in self-efficacy, depressive symptoms, and social functioning. Conclusion Participation in weight loss programs in a group setting, such as a camp, may have added benefit beyond BMI reduction. Greater attention to changes in psychosocial variables may be warranted when designing such programs for youth. PMID:19107660

  17. Changes in self-reported pre- to postinjury coping styles in the first 3 years after traumatic brain injury and the effects on psychosocial and emotional functioning and quality of life.

    PubMed

    Gregório, Gisela Wolters; Gould, Kate R; Spitz, Gershon; van Heugten, Caroline M; Ponsford, Jennie L

    2014-01-01

    To examine the influence of self-reported preinjury coping on postinjury coping, psychosocial functioning, emotional functioning, and quality of life at 1 year following traumatic brain injury (TBI). Inpatient hospital and community. One hundred seventy-four participants with TBI. Prospective, longitudinal design. Participants were assessed at 5 time points: after emerging from posttraumatic amnesia, and at 6, 12, 24, and 36 months postinjury. Coping Scale for Adults-Short Version; Quality of Life Inventory; Sydney Psychosocial Reintegration Scale; Hospital Anxiety and Depression Scale. High preinjury use of nonproductive coping style predicted high use of nonproductive coping, more anxiety, and lower psychosocial functioning at 1 year postinjury. Increased use of nonproductive coping and decreased use of productive coping predicted poorer psychosocial outcome at 1 year post-TBI. Use of both productive and nonproductive coping decreased in the first 6 to 12 months post-TBI relative to preinjury. Unlike productive coping, nonproductive coping reached preinjury levels within 3 years postinjury. The findings support identification of individuals at risk of relying on nonproductive coping and poorer psychosocial outcome following TBI. In addition, the results emphasize the need to implement timely interventions to facilitate productive coping and reduce the use of nonproductive coping in order to maximize favorable long-term psychosocial outcome.

  18. Dose-Response Effects of Aerobic Exercise on Quality of Life in Postmenopausal Women: Results from the Breast Cancer and Exercise Trial in Alberta (BETA).

    PubMed

    Courneya, Kerry S; McNeil, Jessica; O'Reilly, Rachel; Morielli, Andria R; Friedenreich, Christine M

    2017-06-01

    Exercise generally improves quality of life (QoL) and psychosocial functioning in adult populations but few randomized trials have examined dose-response effects. The purpose of the present study was to report the QoL and psychosocial outcomes from the Breast Cancer and Exercise Trial in Alberta (BETA). Healthy but inactive postmenopausal women at risk for breast cancer were randomized to a year-long aerobic exercise intervention consisting of either 150 min/week (moderate volume group, n = 200) or 300 min/week (high volume group, n = 200). QoL was assessed at baseline and 1 year using the short form-36 health survey. Sleep quality, depression, anxiety, stress, self-esteem, and happiness were also assessed. Participant preference for group assignment (i.e., exercise volume) was assessed at baseline and tested as a moderator. There were no statistically significant dose-response effects of aerobic exercise on any QoL, sleep quality, or psychosocial outcome. Participant preference for group assignment did not moderate any QoL, sleep quality, or psychosocial responses. Marital status was a significant moderator (p for interaction = 0.01) and obesity showed a trend towards being a moderator (p for interaction = 0.08) of the dose-response effects of aerobic exercise on global sleep quality such that unmarried and obese women improved sleep quality with the higher volume of aerobic exercise. A higher volume of aerobic exercise, approximately double the minimum public health guideline, did not provide additional QoL or psychosocial benefits compared to the minimum public health guideline in inactive postmenopausal women, even for women who preferred the higher volume of exercise at baseline. Trial Registration clinicaltrials.gov identifier: NCT1435005.

  19. Social disinterest attitudes and group cognitive-behavioral social skills training for functional disability in schizophrenia.

    PubMed

    Granholm, Eric; Ben-Zeev, Dror; Link, Peter C

    2009-09-01

    The majority of clinical trials of cognitive-behavioral therapy (CBT) for schizophrenia have used individual therapy to target positive symptoms. Promising results have been found, however, for group CBT interventions and other treatment targets like psychosocial functioning. CBT for functioning in schizophrenia is based on a cognitive model of functional outcome in schizophrenia that incorporates dysfunctional attitudes (eg, social disinterest, defeatist performance beliefs) as mediators between neurocognitive impairment and functional outcome. In this report, 18 clinical trials of CBT for schizophrenia that included measures of psychosocial functioning were reviewed, and two-thirds showed improvements in functioning in CBT. The cognitive model of functional outcome was also tested by examining the relationship between social disinterest attitudes and functional outcome in 79 people with schizophrenia randomized to either group cognitive-behavioral social skills training or a goal-focused supportive contact intervention. Consistent with the cognitive model, lower social disinterest attitudes at baseline and greater reduction in social disinterest during group therapy predicted better functional outcome at end of treatment for both groups. However, the groups did not differ significantly with regard to overall change in social disinterest attitudes during treatment, suggesting that nonspecific social interactions during group therapy can lead to changes in social disinterest, regardless of whether these attitudes are directly targeted by cognitive therapy interventions.

  20. Less reduction of psychosocial problems among adolescents with unmet communication needs.

    PubMed

    Jager, Margot; Reijneveld, Sijmen A; Almansa, Josue; Metselaar, Janneke; Knorth, Erik J; De Winter, Andrea F

    2017-04-01

    Patient-professional communication has been suggested to be a major determinant of treatment outcomes in psychosocial care for children and adolescents. However, the mechanisms involved are largely unknown and no longitudinal studies have been performed. Our aim was, therefore, to assess over the course of 1 year, the impact of patient-centered communication on psychosocial problems of adolescents in psychosocial care, including the routes mediating this impact. We obtained data on 315 adolescents, aged 12-18 years, enrolled in child and adolescent social or mental health care. We assessed patient-centered communication by comparing the needs and experiences of adolescents with regard to three aspects of communication: affective quality, information provision, and shared decision-making. Changes in psychosocial problems comprised those reported by adolescents and their parents between baseline and 1 year thereafter. Potential mediators were treatment adherence, improvement of understanding, and improvement in self-confidence. We found a relationship between unmet needs for affective quality, information provision, and shared decision-making and less reduction of psychosocial problems. The association between the unmet need to share in decision-making and less reduction of psychosocial problems were partially mediated by less improvement in self-confidence (30 %). We found no mediators regarding affective quality and information provision. Our findings confirm that patient-centered communication is a major determinant of treatment outcomes in psychosocial care for adolescents. Professionals should be aware that tailoring their communication to individual patients' needs is vital to the effectiveness of psychosocial care.

  1. The Impact of Short-Term Video Games on Performance among Children with Developmental Delays: A Randomized Controlled Trial

    PubMed Central

    Hsieh, Ru-Lan; Lee, Wen-Chung; Lin, Jui-Hsiang

    2016-01-01

    This prospective, randomized controlled study investigated the effects of short-term interactive video game playing among children with developmental delays participating in traditional rehabilitation treatment at a rehabilitation clinic. One hundred and one boys and 46 girls with a mean age of 5.8 years (range: 3 to 12 years) were enrolled in this study. All patients were confirmed to suffer from developmental delays, and were participating in traditional rehabilitation treatment. Children participated in two periods of 4 weeks each, group A being offered intervention of eight 30-minute sessions of interactive video games in the first period, and group B in the second, in addition to the traditional rehabilitation treatment. The physical, psychosocial, and total health of the children was periodically assessed using the parent-reported Pediatric Quality of Life Inventory-Generic Core Scales (PedsQL); and the children’s upper extremity and physical function, transfer and basic mobility, sports and physical functioning, and global functioning were assessed using the Pediatric Outcomes Data Collection Instrument. Parental impact was evaluated using the PedsQL-Family Impact Module for family function, PedsQL-Health Satisfaction questionnaire for parents’ satisfaction with their children’s care and World Health Organization-Quality of Life-Brief Version for quality of life. Compared with the baseline, significant improvements of physical function were observed in both groups (5.6 ± 19.5, p = 0.013; 4.7 ± 13.8, p = 0.009) during the intervention periods. No significant improvement of psychosocial health, functional performance, or family impact was observed in children with developmental delays. Short-term interactive video game play in conjunction with traditional rehabilitation treatment improved the physical health of children with developmental delays. Trial Registration: ClinicalTrials.gov NCT02184715 PMID:26983099

  2. The Impact of Short-Term Video Games on Performance among Children with Developmental Delays: A Randomized Controlled Trial.

    PubMed

    Hsieh, Ru-Lan; Lee, Wen-Chung; Lin, Jui-Hsiang

    2016-01-01

    This prospective, randomized controlled study investigated the effects of short-term interactive video game playing among children with developmental delays participating in traditional rehabilitation treatment at a rehabilitation clinic. One hundred and one boys and 46 girls with a mean age of 5.8 years (range: 3 to 12 years) were enrolled in this study. All patients were confirmed to suffer from developmental delays, and were participating in traditional rehabilitation treatment. Children participated in two periods of 4 weeks each, group A being offered intervention of eight 30-minute sessions of interactive video games in the first period, and group B in the second, in addition to the traditional rehabilitation treatment. The physical, psychosocial, and total health of the children was periodically assessed using the parent-reported Pediatric Quality of Life Inventory-Generic Core Scales (PedsQL); and the children's upper extremity and physical function, transfer and basic mobility, sports and physical functioning, and global functioning were assessed using the Pediatric Outcomes Data Collection Instrument. Parental impact was evaluated using the PedsQL-Family Impact Module for family function, PedsQL-Health Satisfaction questionnaire for parents' satisfaction with their children's care and World Health Organization-Quality of Life-Brief Version for quality of life. Compared with the baseline, significant improvements of physical function were observed in both groups (5.6 ± 19.5, p = 0.013; 4.7 ± 13.8, p = 0.009) during the intervention periods. No significant improvement of psychosocial health, functional performance, or family impact was observed in children with developmental delays. Short-term interactive video game play in conjunction with traditional rehabilitation treatment improved the physical health of children with developmental delays. ClinicalTrials.gov NCT02184715.

  3. The Importance of Social Cognition in Improving Functional Outcomes in Schizophrenia

    PubMed Central

    Javed, Afzal; Charles, Asha

    2018-01-01

    Social cognition has become recognized as an important driver of functional outcomes and overall recovery in patients with schizophrenia, mediating the relationship between neurocognition and social functioning. Since antipsychotic therapy targeting remission of clinical symptoms has been shown to have a limited impact on social cognition, there has been an increasing drive to develop therapeutic strategies to specifically improve social cognition in schizophrenia. We sought to review current evidence relating to social cognition in schizophrenia and its clinical implications, including interventions designed to target the core domains of social cognition (emotion processing, theory of mind, attributional bias, and social perception) as a means of improving functional outcomes and thereby increasing the likelihood of recovery. Relevant articles were identified by conducting a literature search in PubMed using the search terms “schizophrenia” AND “cognition” AND “social functioning,” limited to Title/Abstract, over a time period of the past 10 years. Current evidence demonstrates that schizophrenia is associated with impairments in all four core domains of social cognition, during the pre-first-episode, first-episode, early, and chronic phases of the disease, and that such impairments are important determinants of functional outcome. Interventions targeting the four core domains of social cognition comprise psychosocial approaches (social cognition training programs) and pharmacological therapies. Social cognition training programs targeting multiple and specific core domains of social cognition have shown promise in improving social cognition skills, which, in some cases, has translated into improvements in functional outcomes. Use of some psychosocial interventions has additionally resulted in improvements in clinical symptoms and/or quality of life. Pharmacological therapies, including oxytocin and certain antipsychotics, have yielded more mixed results, due in part to the confounding impact of factors including variation in receptor genetics, bioavailability, pharmacokinetics, and drug–drug interactions, and inconsistencies between study designs and medication dosages. Additional research is required to advance our understanding of the role of social cognition in schizophrenia, and to further establish the utility of targeted interventions in this setting. PMID:29740360

  4. Efficacy of cognitive rehabilitation using computer software with individuals living with schizophrenia: A randomized controlled trial in Japan.

    PubMed

    Iwata, Kazuhiko; Matsuda, Yasuhiro; Sato, Sayaka; Furukawa, Shunichi; Watanabe, Yukako; Hatsuse, Norifumi; Ikebuchi, Emi

    2017-03-01

    Cognitive impairment is common in schizophrenia, and is associated with poor psychosocial functioning. Previous studies had inconsistently shown improvement in cognitive functions with cognitive remediation therapy. This study examined whether cognitive remediation is effective in improving both cognitive and social functions in schizophrenia in outpatient settings that provide learning-based psychiatric rehabilitation. This study is the first randomized controlled trial of cognitive remediation in Japan. Study participants were individuals with schizophrenia from 6 outpatient psychiatric medical facilities who were randomly assigned either a cognitive remediation program or treatment as usual. The cognitive remediation intervention includes Cognitive training using computer software (CogPack; Japanese version) administered twice a week and a weekly group over 12 weeks and was based on the Thinking Skills for Work program. Most study participants were attending day treatment services where social skills training, psychoeducation for knowledge about schizophrenia, group activities such as recreation and sport, and other psychosocial treatment were offered. Cognitive and social functioning were assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) and Life Assessment Scale for Mentally Ill (LASMI) at pre- and postintervention. Of the 60 people with schizophrenia enrolled, 29 were allocated to the cognitive remediation group and 31 were allocated to the treatment as usual group. Processing speed, executive function, and the composite score of the BACS showed significantly greater improvement for the cognitive remediation group than the treatment as usual group. In addition, there was significant improvement in interpersonal relationships and work skills on the LASMI for the cognitive remediation group compared with the treatment as usual group. Changes from pretreatment to posttreatment in verbal fluency and interpersonal relationships were significantly correlated, as well as changes in attention and work skills. The present findings showed that providing cognitive remediation on addition to psychiatric rehabilitation contributed to greater improvement in both cognitive and social functioning than psychiatric rehabilitation alone. Cognitive remediation may enhance the efficacy of psychiatric rehabilitation improving social functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Effects of structured group psychosocial support sessions on psychosocial wellbeing of children and their caregivers: a descriptive study.

    PubMed

    Humeid, Jasem

    2018-02-21

    Children aged 7-12 years and their caregivers participated in a series of group psychosocial support sessions, using standard manuals specifically developed for facilitating such sessions such as Children Affected by Armed Conflict and Joint Sessions. The sessions used various activities, including drawing, storytelling, folk games, and other activities, to provide participants with opportunities to express their feelings, learn and practice new coping skills, and interact with others. The aim of this study was to measure the effects of structured psychosocial support sessions on the psychosocial wellbeing of children and their caregivers in the Gaza Strip. This descriptive study involved children and female caregivers selected from six locations using a stratified sampling technique. External numerators collected data before and after the group sessions. Two interview questionnaires with questions about psychological and social status were used, one for children and one for caregivers. The caregivers' questionnaire also assessed their psychosocial knowledge. Adult participants and caregivers of participating children provided verbal consent. Data were analysed with SPSS, and a p value less than 0·05 indicated significance. 155 children (77 [50%] boys and 78 [50%] girls) and 155 female caregivers were enrolled from a population of 1720 children (50% boys and 50% girls) and 1720 female caregivers. The sessions improved psychosocial wellbeing in participants, with the average psychosocial wellbeing score increasing from 58% to 87% in children and from 69% to 84% in caregivers. Caregivers' knowledge increased from 70% to 82%. Improvement was found in the various aspects of psychosocial wellbeing. No differences were found with respect to location, sex, and age. Structured group sessions improved psychosocial wellbeing in children and caregivers and improved caregivers' knowledge. Given the design of this study, it is difficult to fully attribute these results to the intervention. None. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Early life stress and physical and psychosocial functioning in late adulthood.

    PubMed

    Alastalo, Hanna; von Bonsdorff, Mikaela B; Räikkönen, Katri; Pesonen, Anu-Katriina; Osmond, Clive; Barker, David J P; Heinonen, Kati; Kajantie, Eero; Eriksson, Johan G

    2013-01-01

    Severe stress experienced in early life may have long-term effects on adult physiological and psychological health and well-being. We studied physical and psychosocial functioning in late adulthood in subjects separated temporarily from their parents in childhood during World War II. The 1803 participants belong to the Helsinki Birth Cohort Study, born 1934-44. Of them, 267 (14.8%) had been evacuated abroad in childhood during WWII and the remaining subjects served as controls. Physical and psychosocial functioning was assessed with the Short Form 36 scale (SF-36) between 2001 and 2004. A test for trends was based on linear regression. All analyses were adjusted for age at clinical examination, social class in childhood and adulthood, smoking, alcohol intake, physical activity, body mass index, cardiovascular disease and diabetes. Physical functioning in late adulthood was lower among the separated men compared to non-separated men (b = -0.40, 95% confidence interval [95% CI]: -0.71 to -0.08). Those men separated in school age (>7 years) and who were separated for a duration over 2 years had the highest risk for lower physical functioning (b = -0.89, 95% CI: -1.58 to -0.20) and (b = -0.65, 95% CI: -1.25 to -0.05), respectively). Men separated for a duration over 2 years also had lower psychosocial functioning (b = -0.70, 95% CI: -1.35 to -0.06). These differences in physical and psychosocial functioning were not observed among women. Early life stress may increase the risk for impaired physical functioning in late adulthood among men. Timing and duration of the separation influenced the physical and psychosocial functioning in late adulthood.

  7. Health-related quality of life trajectories of methamphetamine-dependent individuals as a function of treatment completion and continued care over a 1-year period.

    PubMed

    Gonzales, Rachel; Ang, Alfonso; Marinelli-Casey, Patricia; Glik, Deborah C; Iguchi, Martin Y; Rawson, Richard A

    2009-12-01

    This study applies a chronic illness framework to evaluate treatment outcomes among individuals dependent on methamphetamine (MA). Using growth curve modeling, health-related quality of life (HRQOL) trajectories of MA-dependent individuals (N = 723) were examined over a 1-year period. Results show greater improvements in mental HRQOL trajectories as a function of treatment completion and continued care, although fairly static trajectories in physical health status. Other factors affecting HRQOL trajectories included gender, psychosocial functioning, drug use severity, and health impairment. Results extend research on treatment evaluations for MA dependence, highlighting the importance of continued service utilization for improved quality of life outcomes.

  8. Development of a vision-targeted health-related quality of life item measure

    PubMed Central

    Slotkin, Jerry; McKean-Cowdin, Roberta; Lee, Paul; Owsley, Cynthia; Vitale, Susan; Varma, Rohit; Gershon, Richard; Hays, Ron D.

    2013-01-01

    Purpose To develop a vision-targeted health-related quality of life (HRQOL) measure for the NIH Toolbox for the Assessment of Neurological and Behavioral Function. Methods We conducted a review of existing vision-targeted HRQOL surveys and identified color vision, low luminance vision, distance vision, general vision, near vision, ocular symptoms, psychosocial well-being, and role performance domains. Items in existing survey instruments were sorted into these domains. We selected non-redundant items and revised them to improve clarity and to limit the number of different response options. We conducted 10 cognitive interviews to evaluate the items. Finally, we revised the items and administered them to 819 individuals to calibrate the items and estimate the measure’s reliability and validity. Results The field test provided support for the 53-item vision-targeted HRQOL measure encompassing 6 domains: color vision, distance vision, near vision, ocular symptoms, psychosocial well-being, and role performance. The domain scores had high levels of reliability (coefficient alphas ranged from 0.848 to 0.940). Validity was supported by high correlations between National Eye Institute Visual Function Questionnaire scales and the new-vision-targeted scales (highest values were 0.771 between psychosocial well-being and mental health, and 0.729 between role performance and role difficulties), and by lower mean scores in those groups self-reporting eye disease (F statistic with p < 0.01 for all comparisons except cataract with ocular symptoms, psychosocial well-being, and role performance scales). Conclusions This vision-targeted HRQOL measure provides a basis for comprehensive assessment of the impact of eye diseases and treatments on daily functioning and well-being in adults. PMID:23475688

  9. Longitudinal Impact on Quality of Life for School-aged Children with Amblyopia Treatment: Perspective from Children.

    PubMed

    Chen, Yanyan; Chen, Xinhong; Chen, Jie; Zheng, Jingwei; Xu, Jinling; Yu, Xinping

    2016-01-01

    To evaluate the longitudinal impact on health-related quality of life (HRQOL) during amblyopia treatment for school-aged children from children's perspective. School-aged children prescribed amblyopia treatment for the first time were recruited into the current study. Using a questionnaire, subjects' HRQOL was assessed before patching treatment, and at 8 weeks and 16 weeks after the commencement of patching treatment. Evaluation of visual function and psychosocial aspect was included in the questionnaire. Visual acuity and demographic data of the subjects were recorded. Forty-four children, aged 7-12 years, with anisometropic amblyopia were included in the study. Visual acuity in the amblyopic eye improved 1.90 (0.41-3.74) and 3.98 (2.22-5.11) lines at follow-up weeks 8 and 16, respectively. Both the total score and subscales of the questionnaire were reduced at the first follow-up and recovered at the second follow-up. Scores at week 16 were higher than those before treatment in the psychosocial aspect (p = 0.003), and lower in the visual function aspect (p < 0.001), without significant difference in total score (p = 0.207). Visual acuity in the amblyopic eye and psychosocial expectations for treatment were the most important factors that influenced HRQOL during treatment. From the children's perspective, the impacts on visual function and psychosocial aspect were significant in the first two months of treatment, and could be adapted during therapy for school-aged children. More attention should be paid to negative effects of treatment on daily life and study at the stage of amblyopia treatment for school-aged children. Meanwhile, necessary precautions should be taken to help reduce the impacts.

  10. The enduring psychosocial consequences of mania and depression.

    PubMed

    Coryell, W; Scheftner, W; Keller, M; Endicott, J; Maser, J; Klerman, G L

    1993-05-01

    The authors sought to determine the scope, severity, and persistence of psychosocial impairment arising from bipolar and unipolar affective disorder. Patients with bipolar (N = 148) or unipolar (N = 240) major affective disorder were assessed as they sought treatment and again after a 5-year follow-up. Concurrently, parents, siblings, and adult children underwent similar assessments and were followed for 6 years. To quantify the impact of affective disorder, probands were individually matched to relatives who had no lifetime history of affective disorder. Sixty-nine relatives who were depressed at intake constituted a separate, nonclinical study group and were also matched to relatives who were well. Both unipolar and bipolar patients began follow-up with deficits in annual income. Relative to comparison subjects, affective disorder groups were significantly more likely to report declines in job status and income at the end of follow-up and significantly less likely to report improvements. Similarly, both bipolar and unipolar patients showed significant deficits in nearly all other areas of psychosocial functioning measured at follow-up. Except for relationships with spouses, deficits did not differ significantly by polarity. Surprisingly, probands with recovery sustained throughout the final 2 years of follow-up also showed severe and widespread impairment. Relatives with major depression exhibited substantial deficits on follow-up, but job status and income were not significantly affected. The psychosocial impairment associated with mania and major depression extends to essentially all areas of functioning and persists for years, even among individuals who experience sustained resolution of clinical symptoms.

  11. Prospective Predictors of Suicidal Behavior in BPD at 6 Year Follow-up

    PubMed Central

    Soloff, Paul H.; Chiappetta, Laurel

    2012-01-01

    Objective Recurrent suicidal behavior is a defining characteristic of BPD. Although most patients achieve remission of suicidal behaviors over time, 3% to 10% die by suicide, raising the question of whether there is a high risk suicidal subtype in BPD. We are conducting the first longitudinal study of suicidal behavior in BPD to identify prospective predictors of suicide attempts, and characterize BPD patients at highest risk for suicide completion. Method Demographic, diagnostic, clinical and psychosocial risk factors assessed at baseline were examined for predictive association with medically significant suicide attempts using Cox proportional hazards models. Prospective predictors were defined for subjects completing 6 or more years in the study and compared to earlier intervals. Results Among 90 subjects, 25 (27.8%) made at least one suicide attempt in the interval, most occurring in the first two years. Risk of attempt was increased by: a.) low socioeconomic status, b.) poor psychosocial adjustment, c.) a family history of suicide d.) prior psychiatric hospitalization; e.) absence of any outpatient treatment prior to the attempt. Higher global functioning at baseline decreased risk. Conclusion Risk factors predictive of suicide attempts change over time. Acute stressors such as MDD were predictive only in the short term (12 mos.), while poor psychosocial functioning had persistent and long term effects on suicide risk. Half of BPD patients have poor psychosocial outcomes despite symptomatic improvement. A social and vocational rehabilitation model of treatment is needed to decrease suicide risk and optimize long term outcomes in BPD. PMID:22549208

  12. Measuring the impact of cognitive and psychosocial interventions in persons with mild cognitive impairment with a randomized single-blind controlled trial: rationale and design of the MEMO+ study.

    PubMed

    Bier, Nathalie; Grenier, Sébastien; Brodeur, Catherine; Gauthier, Serge; Gilbert, Brigitte; Hudon, Carol; Lepage, Émilie; Ouellet, Marie-Christine; Viscogliosi, Chantal; Belleville, Sylvie

    2015-03-01

    Several studies have suggested that cognitive training is a potentially effective way to improve cognition and postpone cognitive decline in older adults with mild cognitive impairment (MCI). The MEMO+ study is a randomized, controlled, single-blind trial designed to test the efficacy, specificity, and long-term effect of a cognitive training intervention and a psychosocial intervention in persons with MCI. One hundred and sixty-two participants with MCI will be recruited. They will be randomized into three groups: cognitive training, psychosocial intervention, and no-contact. Each intervention will last for eight weeks (one session per week) and a booster training session will be provided three months after the end of the intervention. Various proximal and distal outcomes will be measured at pre-intervention as well as at one week, three months, and six months post-training. Proximal outcomes include memory and psychological health measures. Distal outcomes focus on self-rated functioning in complex daily activities and strategies used in daily life to enhance function. Socio-demographic factors (age, gender, and education), general cognition, personality traits, engagement in activities, and self-efficacy will be used as moderators. Enrolment began in April 2012 and will be completed by December 2014. This study is likely to have a significant impact on the well-being of persons with MCI by contributing to the development of adapted and scientifically supported cognitive and psychosocial interventions.

  13. Psychosocial functioning in consultation-liaison psychiatry patients: influence of psychosomatic syndromes, psychopathology and somatization.

    PubMed

    Porcelli, Piero; Bellomo, Antonello; Quartesan, Roberto; Altamura, Mario; Iuso, Salvatore; Ciannameo, Ida; Piselli, Massimiliano; Elisei, Sandro

    2009-01-01

    This study investigated whether the Diagnostic Criteria for Psychosomatic Research (DCPR) were able to predict psychosocial functioning in addition to psychiatric diagnoses and somatization in consultation-liaison psychiatry (CLP) patients. A consecutive sample of 208 CLP patients were recruited and assessed for sociodemographic and medical data, psychopathology (SCID), psychosomatic syndromes (DCPR structured interview) and somatization (SCL-90-R SOM scale and multisomatoform disorder, MSD). The main endpoints were the mental and physical components of psychosocial functioning (SF-36). A total of 185 (89%) patients had any psychiatric diagnosis, 51 (25%) had MSD positive criteria, 176 (85%) had any DCPR syndrome, and 105 (51%) had multiple DCPR syndromes. Although psychiatric and psychosomatic syndromes were variously associated with psychosocial functioning, hierarchical regression and effect size analyses showed that only DCPR syndromes, particularly demoralization and health anxiety, with somatization but not DSM-IV psychopathology independently predicted poor psychosocial functioning. The presence of psychosomatic syndromes, assessed with DCPR criteria, and high levels of somatization had larger effect size and were independent predictors of the mental and physical components of psychosocial dysfunction, over and above psychopathology. The DCPR classification can provide CLP professionals with a set of sensitive diagnostic criteria for a comprehensive clinical evaluation of psychosomatic syndromes that might play a significant mediating role in the course and the outcome of medical patients referred for psychiatric consultation. Copyright 2009 S. Karger AG, Basel.

  14. Age of onset and course of major depressive disorder: associations with psychosocial functioning outcomes in adulthood.

    PubMed

    Wilson, S; Hicks, B M; Foster, K T; McGue, M; Iacono, W G

    2015-02-01

    Major depressive disorder (MDD) that onsets by adolescence is associated with various deficits in psychosocial functioning. However, adolescent-onset MDD often follows a recurrent course that may drive its associated impairment. To tease apart these two clinical features, we examined the relative associations of age of onset (adolescent versus adult) and course (recurrent versus single episodes) of MDD with a broad range of psychosocial functioning outcomes assessed in early adulthood. Participants comprised a large, population-based sample of male and female twins from the Minnesota Twin Family Study (MTFS; n = 1252) assessed prospectively from ages 17 to 29 years. A recurrent course of MDD predicted impairment in several psychosocial domains in adulthood, regardless of whether the onset was in adolescence or adulthood. By contrast, adolescent-onset MDD showed less evidence of impairment in adulthood after accounting for recurrence. Individuals with both an adolescent onset and recurrent episodes of MDD represented a particularly severe group with pervasive psychosocial impairment in adulthood. The negative implications of adolescent-onset MDD for psychosocial functioning in adulthood seem to be due primarily to its frequently recurrent course, rather than its early onset, per se. The results highlight the importance of considering both age of onset and course for understanding MDD and its implications for functioning, and also in guiding targeted intervention efforts.

  15. Numbing and Dysphoria Symptoms of Posttraumatic Stress Disorder among Iraq and Afghanistan War Veterans: A Review of Findings and Implications for Treatment

    ERIC Educational Resources Information Center

    Hassija, Christina M.; Jakupcak, Matthew; Gray, Matt J.

    2012-01-01

    Iraq and Afghanistan war veterans experience significant rates of posttraumatic stress disorder (PTSD) and other trauma-related mental health conditions. Understanding how specific PTSD symptomatology affects physical health and psychosocial functioning may be useful in improving the conceptualization of PTSD nosology and informing treatment…

  16. The relationship between change in cognition and change in functional ability in schizophrenia during cognitive and psychosocial rehabilitation.

    PubMed

    Rispaud, Samuel G; Rose, Jennifer; Kurtz, Matthew M

    2016-10-30

    While a wealth of studies have evaluated cross-sectional links between cognition and functioning in schizophrenia, few have investigated the relationship between change in cognition and change in functioning in the context of treatment trials targeted at cognition. Identifying cognitive skills that, when improved, predict improvement in functioning will guide the development of more targeted rehabilitation for this population. The present study identifies the relationship between change in specific cognitive skills and change in functional ability during one year of cognitive rehabilitation. Ninety-six individuals with schizophrenia were assessed with a battery of cognitive measures and a measure of performance-based functioning before and after cognitive training consisting of either drill-and-practice cognitive remediation or computer skills training. Results revealed that while working and episodic memory, problem-solving, and processing speed skills all improved during the trial, only improved working memory and processing speed skills predicted improvement in functional ability. Secondary analyses revealed these relationships were driven by individuals who showed a moderate level (SD≥0.5) of cognitive improvement during the trial. These findings suggest that while a variety of cognitive skills may improve during training targeted at cognition, only improvements in a subset of cognitive functions may translate into functional gains. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Prefrontal glucose deficits in murderers lacking psychosocial deprivation.

    PubMed

    Raine, A; Phil, D; Stoddard, J; Bihrle, S; Buchsbaum, M

    1998-01-01

    Previous research has suggested that links between autonomic nervous system functioning and violence are strongest in those who come from benign home backgrounds, but there appears to be no similar research using brain-imaging measures of central nervous system functioning. It was hypothesized that murderers who had no early psychosocial deprivation (e.g., no childhood abuse, family neglect) would demonstrate lower prefrontal glucose metabolism than murderers with early psychosocial deprivation and a group of normal controls. Murderers from a previous study, which showed prefrontal deficits in murderers, were assessed for psychosocial deprivation and divided into those with and without deprivation. Murderers without any clear psychosocial deficits were significantly lower on prefrontal glucose metabolism than murderers with psychosocial deficits and controls. These results suggest that murderers lacking psychosocial deficits are characterized by prefrontal deficits. It is argued that among violent offenders without deprived home backgrounds, the "social push" to violence is minimized, and consequently, brain abnormalities provide a relatively stronger predisposition to violence in this group.

  18. [Psychosocial Interventions in Acute and Maintenance Treatment of Adult Patients Diagnosed With Schizophrenia].

    PubMed

    Ahunca Velásquez, Luisa Fernanda; García Valencia, Jenny; Bohórquez Peñaranda, Adriana Patricia; Gómez-Restrepo, Carlos; Jaramillo González, Luis Eduardo; Palacio Acosta, Carlos

    2014-01-01

    To determine the effectiveness of the psychosocial strategies designed to improve the outcomes in adults with schizophrenia in both, acute and stable phase of the disorder. This evidence is used to propose recommendation in the guidelines of integral attention for the diagnosis, treatment and psychosocial rehabilitation of adults with schizophrenia. A guideline for clinical practice was developed using the methodological framework of the Ministerio de la Protección Social to collect evidence and grading recommendations. A search, evaluation and synthesis of evidence were carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The psychoeducation and family intervention showed higher efficacy, compared with the usual treatment, to prevent relapses and hospital readmissions, to reduce family burden and to improve adherence to treatment. The social skill training was effective to improve symptoms, social functioning and quality of life. However, the quality of evidence was low. There was not enough evidence about the efficacy of occupational therapy, but considering patients preferences and its wide clinical utilization, the GDG suggested its inclusion. Psychoeducation, family intervention and social skill training are recommended to be offered for the treatment of schizophrenia. Furthermore, occupational therapy is suggested for inpatients and outpatients with the disorder. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  19. Improved functional status by comprehensive physical and psychosocial approach through right insula activation in poststroke vascular dementia.

    PubMed

    Tanaka, Naofumi; Meguro, Kenichi; Ishikawa, Hiroyasu; Yamaguchi, Satoshi

    2013-10-01

    The aim is to investigate the effect of a comprehensive physical and psychosocial approach on functional outcome and cerebral glucose metabolism in poststroke vascular dementia (PSVaD). Ten PSVaD patients participated in the study. They were diagnosed according to the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherché et l'Enseignement en Neurosciences (NINDS-AIREN) criteria and needed physical assistance in sit-to-stand transfer activities. Six were enrolled in a comprehensive program consisted of an individualized task-specific exercise regimen of transfer training and a psychosocial intervention program. The other 4 patients participated in the control group. The programs were undertaken over a period of 2 months. Outcomes were the scores on the Mini-Mental State Examination and the Functional Independence Measure (FIM), and on cerebral glucose metabolism determined by (18)F-fluorodeoxyglucose positron emission tomography performed before and at the end of the program. The score on the transfer mobility subscale of the FIM increased at the end of the program in all patients who received the comprehensive program. Regional glucose metabolism was increased in the right insular cortex at the end of the combined program. Control patients showed no change in FIM score or regional cerebral metabolism. A combined approach may be associated with an increase in glucose metabolism of the right insula cortex in PSVaD patients.

  20. Does strabismus surgery improve quality and mood, and what factors influence this?

    PubMed

    McBain, H B; MacKenzie, K A; Hancox, J; Ezra, D G; Adams, G G W; Newman, S P

    2016-05-01

    AimsTo establish the impact of adult strabismus surgery on clinical and psychosocial well-being and determine who experiences the greatest benefit from surgery and how one could intervene to improve quality of life post-surgery.MethodsA longitudinal study, with measurements taken pre-surgery and at 3 and 6 months post-surgery. All participants completed the AS-20 a disease specific quality of life scale, along with measures of mood, strabismus and appearance-related beliefs and cognitions and perceived social support. Participants also underwent a full orthoptic assessment at their preoperative visit and again 3 months postoperatively. Clinical outcomes of surgery were classified as success, partial success or failure, using the largest angle of deviation, diplopia and requirement for further therapy.Results210 participants took part in the study. Strabismus surgery led to statistically significant improvements in psychosocial and functional quality of life. Those whose surgery was deemed a partial success did however experience a deterioration in quality of life. A combination of clinical variables, high expectations, and negative beliefs about the illness and appearance pre-surgery were significant predictors of change in quality of life from pre- to post-surgery.ConclusionsStrabismus surgery leads to significant improvements in quality of life up to 6 months postoperatively. There are however a group of patients who do not experience these benefits. A series of clinical and psychosocial factors have now been identified, which will enable clinicians to identify patients who may be vulnerable to poorer outcomes post-surgery and allow for the development of interventions to improve quality of life after surgery.

  1. Physiologic and psychosocial approaches to global management of the hemodialysis patient in the Southern Alberta Renal Program.

    PubMed

    Cormier, Tina; Magat, Ofelia; Hager, Suzy; Ng, Fanny; Lee, Miran

    2012-01-01

    As frontline nurses, we know firsthand the many challenges of renal disease faced by our patients and the impact on their lives and their families. How can we help them cope with their illness? How can we improve their quality of life? How can we prevent the complications inherent to the disease? How do we know we are doing a good job? Where do we start? The purpose of this presentation is to showcase the global management of the hemodialysis (HD) patient. It provides a collaborative and systematic approach to assessing, implementing, evaluating and coordinating the physiologic and the psychosocial aspects of their care. It is a model of case management followed by the Southern Alberta Renal Program (SARP) in meeting the many and complex needs of our hemodialysis patients. The quality indicators, to name a few, that relate to the physiologic aspects of their care are dialysis adequacy and fluid removal, improved blood pressure (BP) control, maintenance and improved vascular access function, anemia, bone and mineral disease management, nutritional, and diabetes management. The psychosocial aspects of care encompass goals of care, residential support, transportation, and mobility programs in the community. There may be positive implications resulting from our practice that we believe would be invaluable in terms of improved patient care, increased adherence to therapeutic regimens, improved mortality and morbidity and overall enhanced quality of life. Moreover, better communication would possibly be fostered and wise and prompt use of resources may be a result. To date, we have not done studies to prove or disprove these outcomes.

  2. Neuropsychological functioning in preschool-age children with sickle cell disease: the role of illness-related and psychosocial factors.

    PubMed

    Tarazi, Reem A; Grant, Mitzie L; Ely, Elizabeth; Barakat, Lamia P

    2007-03-01

    Cognitive and academic deficits have been identified in school-aged children with sickle cell disease (SCD). However, there have been very few identified studies that examine neuropsychological functioning in preschool-age children with SCD. It is important to understand effects of SCD from a developmental perspective and to consider the contribution of environmental factors in this at-risk population. Neuropsychological functioning of preschool-age children with SCD and no history of overt stroke (n = 26) was examined across several domains (language, immediate memory/brief attention, visuospatial/visuoconstructional, motor/visuomotor). The mean Full Scale IQ for the sample was 89.0. Performance on the Immediate Memory/ Brief Attention domain was significantly higher than the other domains, although the pattern of performance was relatively consistent, with mean standard scores ranging from 88.0 to 95.0. Disease severity was not significantly related to cognitive functioning in this group of young children with SCD. Socioeconomic status (SES) was significantly correlated with most domain scores and, based on regression analyses, accounted for 18% to 47% of the variance in functioning. Psychosocial factors, such as number of children living in the home and parental stress levels, were negatively associated with Motor/Visuomotor skills, and weekly hours in school/day care was positively associated with language-related skills. Results suggest that, at this young age, psychosocial risk factors appear to be appropriate targets for intervention, with the goal of improving long-term outcome in children with SCD. Further investigations should include comparison to a matched control group.

  3. Effect on mental health of a participatory intervention to improve psychosocial work environment: a cluster randomized controlled trial among nurses.

    PubMed

    Uchiyama, Ayako; Odagiri, Yuko; Ohya, Yumiko; Takamiya, Tomoko; Inoue, Shigeru; Shimomitsu, Teruichi

    2013-01-01

    Improvement of psychosocial work environment has proved to be valuable for workers' mental health. However, limited evidence is available for the effectiveness of participatory interventions. The purpose of this study was to investigate the effect on mental health among nurses of a participatory intervention to improve the psychosocial work environment. A cluster randomized controlled trial was conducted in hospital settings. A total of 434 nurses in 24 units were randomly allocated to 11 intervention units (n=183) and 13 control units (n=218). A participatory program was provided to the intervention units for 6 months. Depressive symptoms as mental health status and psychosocial work environment, assessed by the Job Content Questionnaire, the Effort-Reward Imbalance Questionnaire, and the Quality Work Competence questionnaire, were measured before and immediately after the 6-month intervention by a self-administered questionnaire. No significant intervention effect was observed for mental health status. However, significant intervention effects were observed in psychosocial work environment aspects, such as Coworker Support (p<0.01) and Goals (p<0.01), and borderline significance was observed for Job Control (p<0.10). It is suggested that a 6-month participatory intervention is effective in improving psychosocial work environment, but not mental health, among Japanese nurses.

  4. Pre-post changes in psychosocial functioning among relatives of patients with depressive disorders after Brief Multifamily Psychoeducation: A pilot study

    PubMed Central

    2011-01-01

    Background Depressive disorder is often chronic and recurrent, and results in a heavy psychosocial burden on the families of patients with this disorder. This study aims to examine the effectiveness of brief multifamily psychoeducation designed to alleviate their psychosocial burden. Methods Thirty-two relatives of patients with major depressive disorder participated in an open study testing the effectiveness of brief multifamily psychoeducation. The intervention consisted of four sessions over the course of 6 weeks. Outcome measures focused on emotional distress, care burden and Expressed Emotion (EE). Results The emotional distress, care burden and EE of the family all showed statistically significant improvements from baseline to after the family intervention. The proportion of relatives scoring 9 or more on K6, which indicates possible depressive or anxiety disorder, decreased from sixteen relatives (50.0%) at baseline, to only 3 relatives (9.3%) after the intervention. Conclusions This study suggests that brief multifamily psychoeducation is a useful intervention to reduce the psychosocial burden of the relatives of patients with depressive disorder. Further evaluation of family psychoeducation for relatives of patients with depressive disorder is warranted. PMID:21477384

  5. Psychological aspects of adductor spasmodic dysphonia: a prospective population controlled questionnaire study.

    PubMed

    Kaptein, A A; Hughes, B M; Scharloo, M; Hondebrink, N; Langeveld, T P M

    2010-02-01

    To examine psychosocial concomitants, illness perceptions, and treatment perceptions in patients with adductor spasmodic dysphonia. Prospective controlled cohort study. A tertiary care facility. Forty-nine out-patients (38 women, 11 men; average age of 52 years) with adductor spasmodic dysphonia completed a battery of reliable and validated psychometric assessment instruments. Control patients' data were derived from scores in questionnaires by samples in the formal Manuals of the questionnaires used. Psychosocial functioning, illness perceptions, and treatment perceptions. Scores on psychosocial measures were elevated in male patients especially, indicating levels of psychological morbidity significantly above those seen in the general population. Assessments of illness perceptions and treatment perceptions indicated that patients perceive that they have a very low degree of control over the disorder, and experience a high emotional impact from it. Voice Handicap Index scores illustrated substantial degrees of perceived handicap. Adductor spasmodic dysphonia is associated with significant negative psychosocial concomitants, coupled with low perceived control over the condition. Future research should elucidate the implications of illness perceptions and treatment perceptions for the biopsychosocial care of persons with adductor spasmodic dysphonia in order to improve self-management and enhance quality of life.

  6. Erectile Dysfunction after Radical Prostatectomy: Prevalence, Medical Treatments, and Psychosocial Interventions

    PubMed Central

    Emanu, Jessica C.; Avildsen, Isabelle K.; Nelson, Christian J.

    2016-01-01

    Purpose of review This review will discuss erectile dysfunction (ED) in prostate cancer patients following radical prostatectomy (RP). It will focus on the prevalence and current treatments for ED as well as the emotional impact of ED and the current psychosocial interventions designed to help patients cope with this side effect. Recent findings While there is a large discrepancy in prevalence rates of ED after RP, several recent studies have cited rates as high as 85%. The concept of “penile rehabilitation” is now the standard of practice to treat ED following RP. However, many men avoid seeking help or utilizing ED treatments. This avoidance is related to the shame, frustration, and distress many men with ED and their partners experience. Recent psychosocial interventions have been developed to facilitate the use of treatments and help men cope with ED. These interventions have shown initial promise, however, continued intervention development is needed to reduce distress and improve long-term erectile function (EF) outcomes. Summary ED is a significant problem following prostate cancer surgery. While there are effective medical treatments, the development of psychosocial interventions should continue to evolve to maximize the assistance we can give to men and their partners. PMID:26808052

  7. Does routine psychosocial screening improve referral to psychosocial care providers and patient-radiotherapist communication? A cluster randomized controlled trial.

    PubMed

    Braeken, Anna P B M; Lechner, Lilian; Eekers, Daniëlle B P; Houben, Ruud M A; van Gils, Francis C J M; Ambergen, Ton; Kempen, Gertrudis I J M

    2013-11-01

    This study tests whether using a screening instrument improves referral to psychosocial care providers (e.g. psychologist) and facilitates patient-radiotherapist communication. A cluster randomized controlled trial was used. Fourteen radiotherapists were randomly allocated to the experimental or control group and 568 of their patients received care in accordance with the group to which their radiotherapist was allocated. Patients in the experimental group were asked to complete a screening instrument before and at the end of the radiation treatment period. All patients were requested to complete questionnaires concerning patient-physician communication after the first consultation and concerning psychosocial care 3 and 12 months post-intervention. Patients who completed the screening instrument were referred to social workers at an earlier stage than patients who did not (P<0.01). No effects were observed for numbers of referred patients, or for improved patient-radiotherapist communication. Our results suggest that a simple screening procedure can be valuable for the timely treatment of psychosocial problems in patients. Future efforts should be directed at appropriate timing of screening and enhancing physicians' awareness regarding the importance of identifying, discussing and treating psychosocial problems in cancer patients. Psychosocial screening can be enhanced by effective radiotherapist-patient communication. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Long-Term Efficacy of Psychosocial Treatments for Adults With Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review

    PubMed Central

    López-Pinar, Carlos; Martínez-Sanchís, Sonia; Carbonell-Vayá, Enrique; Fenollar-Cortés, Javier; Sánchez-Meca, Julio

    2018-01-01

    Background: Recent evidence suggests that psychosocial treatments, particularly cognitive-behavioral therapy (CBT), are effective interventions for adult attention deficit hyperactivity disorder (ADHD). The objective of this review was to determine the long-term efficacy of psychosocial interventions in improving clinically relevant variables, including ADHD core symptoms, clinical global impression (CGI), and global functioning. Methods: In total, nine randomized controlled trials and three uncontrolled single-group pretest-posttest studies were included. The data from these studies were combined using the inverse variance method. Heterogeneity and risk of bias were assessed. Subgroup analyses and meta-regressions were performed, to determine the influence of different potential moderator variables (risk of bias, medication status, follow-up length, therapy type and setting, and control group type) on effect size (ES) estimates. Results: Up to 680 of a total of 1,073 participants assessed pre-treatment were retained at follow-up. Treatment groups showed greater improvement than control groups in self-reported total ADHD symptoms, inattention, and hyperactivity/impulsivity, in addition to CGI and global functioning. Blind assessors also reported a large ES in within-subject outcomes. Studies using dialectical behavioral therapy (DBT) in a group setting, with active control matching, and that were rated as having an unclear risk of bias, achieved significantly lower ES estimates for most outcomes. Treatment effectiveness, according to the CGI measure, and global functioning were significantly increased when the percentage of medicated participants was greater. Conclusions: Our results indicate that the post-treatment gains reported in previous reviews are sustained for at least 12 months. Nevertheless, these results must be interpreted with caution, because of a high level of heterogeneity among studies and the risk of bias observed in the majority of outcomes. Thus, these findings indicate that psychological interventions are a highly valuable and stable clinical tool for the treatment of core symptoms and global functioning in adults with ADHD. PMID:29780342

  9. Long-Term Efficacy of Psychosocial Treatments for Adults With Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review.

    PubMed

    López-Pinar, Carlos; Martínez-Sanchís, Sonia; Carbonell-Vayá, Enrique; Fenollar-Cortés, Javier; Sánchez-Meca, Julio

    2018-01-01

    Background: Recent evidence suggests that psychosocial treatments, particularly cognitive-behavioral therapy (CBT), are effective interventions for adult attention deficit hyperactivity disorder (ADHD). The objective of this review was to determine the long-term efficacy of psychosocial interventions in improving clinically relevant variables, including ADHD core symptoms, clinical global impression (CGI), and global functioning. Methods: In total, nine randomized controlled trials and three uncontrolled single-group pretest-posttest studies were included. The data from these studies were combined using the inverse variance method. Heterogeneity and risk of bias were assessed. Subgroup analyses and meta-regressions were performed, to determine the influence of different potential moderator variables (risk of bias, medication status, follow-up length, therapy type and setting, and control group type) on effect size (ES) estimates. Results: Up to 680 of a total of 1,073 participants assessed pre-treatment were retained at follow-up. Treatment groups showed greater improvement than control groups in self-reported total ADHD symptoms, inattention, and hyperactivity/impulsivity, in addition to CGI and global functioning. Blind assessors also reported a large ES in within-subject outcomes. Studies using dialectical behavioral therapy (DBT) in a group setting, with active control matching, and that were rated as having an unclear risk of bias, achieved significantly lower ES estimates for most outcomes. Treatment effectiveness, according to the CGI measure, and global functioning were significantly increased when the percentage of medicated participants was greater. Conclusions: Our results indicate that the post-treatment gains reported in previous reviews are sustained for at least 12 months. Nevertheless, these results must be interpreted with caution, because of a high level of heterogeneity among studies and the risk of bias observed in the majority of outcomes. Thus, these findings indicate that psychological interventions are a highly valuable and stable clinical tool for the treatment of core symptoms and global functioning in adults with ADHD.

  10. Psychosocial interventions for fatigue during cancer treatment with palliative intent.

    PubMed

    Poort, Hanneke; Peters, Marlies; Bleijenberg, Gijs; Gielissen, Marieke Fm; Goedendorp, Martine Margaretha; Jacobsen, Paul; Verhagen, Stans; Knoop, Hans

    2017-07-14

    Fatigue is a prevalent and burdensome symptom for patients with incurable cancer receiving cancer treatment with palliative intent and is associated with reduced quality of life. Psychosocial interventions seem promising for management of fatigue among cancer patients. To assess the effects of psychosocial interventions for fatigue in adult patients with incurable cancer receiving cancer treatment with palliative intent. We searched the following databases: CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, and seven clinical trial registries; we also searched the reference lists of articles. The date of our most recent search was 29 November 2016. We included randomised controlled trials that compared psychosocial interventions in adults aged 18 years or over undergoing cancer treatment with palliative intent for incurable cancer versus usual care or other controls. Psychosocial interventions were defined as various kinds of interventions provided to influence or change cognitions, emotions, behaviours, social interactions, or a combination of these. Psychosocial interventions of interest to this review had to involve at least two interactions between the patient and the care provider in which the care provider gave the patient personal feedback concerning changes sought by these interventions. We included trials that reported fatigue as an outcome of interest. We used standard methodological procedures expected by Cochrane. Two review authors independently considered trials for inclusion in the review, assessed risk of bias, and extracted data, including information on adverse events. We assessed the quality of evidence using GRADE (Grading of Recommendations Assessment, Development, and Evaluation) and created a 'Summary of findings' table. We identified 14 studies (16 reports) that met inclusion criteria for this review and involved 3077 randomised participants in total. Most of these studies included a mixed sample of participants; we obtained data for the subset of interest for this review (diagnosis of incurable cancer and receiving cancer treatment) from the study investigators of 12 studies, for which we included 535 participants in the subset meta-analysis for fatigue post intervention. Researchers investigated a broad range of psychosocial interventions with different intervention aims and durations. We identified sources of potential bias, including lack of description of methods of blinding and allocation concealment and inclusion of small study populations.Findings from our meta-analysis do not support the effectiveness of psychosocial interventions for reducing fatigue post intervention (standardised mean difference (SMD) -0.25, 95% confidence interval (CI) -0.50 to 0.00; not significant; 535 participants, 12 studies; very low-quality evidence). First follow-up findings on fatigue suggested benefit for participants assigned to the psychosocial intervention compared with control (SMD -0.66, 95% CI -1.00 to -0.32; 147 participants, four studies; very low-quality evidence), which was not sustained at second follow-up (SMD -0.41, 95% CI -1.12 to 0.30; not significant; very low-quality evidence).Results for our secondary outcomes revealed very low-quality evidence for the efficacy of psychosocial interventions in improving physical functioning post intervention (SMD 0.32, 95% CI 0.01 to 0.63; 307 participants, seven studies). These findings were not sustained at first follow-up (SMD 0.37, 95% CI -0.20 to 0.94; not significant; 122 participants, two studies; very low-quality evidence). Findings do not support the effectiveness of psychosocial interventions for improving social functioning (mean difference (MD) 4.16, 95% CI -11.20 to 19.53; not significant; 141 participants, four studies), role functioning (MD 3.49, 95% CI -12.78 to 19.76; not significant; 143 participants, four studies), emotional functioning (SMD -0.11, 95% CI -0.56 to 0.35; not significant; 115 participants, three studies), or cognitive functioning (MD -2.23, 95% CI -12.52 to 8.06; not significant; 86 participants, two studies) post intervention. Only three studies evaluated adverse events. These studies found no difference between the number of adverse events among participants in the intervention versus control group.Using GRADE, we considered the overall quality of evidence for our primary and secondary outcomes to be very low. Therefore, we have very little confidence in the effect estimate, and the true effect is likely to be substantially different from the estimate of effect. Limitations in study quality and imprecision due to sparse data resulted in downgrading of the quality of data. Additionally, most studies were at high risk of bias owing to their small sample size for the subset of patients with incurable cancer (fewer than 50 participants per arm), leading to uncertainty about effect estimates. We found little evidence around the benefits of psychosocial interventions provided to reduce fatigue in adult patients with incurable cancer receiving cancer treatment with palliative intent. Additional studies with larger samples are required to assess whether psychosocial interventions are beneficial for addressing fatigue in patients with incurable cancer.

  11. Advancing the evidence base in cancer: psychosocial multicenter trials

    PubMed Central

    2012-01-01

    Background The diagnosis and treatment of cancer is associated with significant distress and psychosocial morbidity. Although psychosocial interventions have been developed in an attempt to improve psychosocial outcomes in cancer patients and survivors, there is continued debate about whether there is adequate high-level evidence to establish the effectiveness of these interventions. The evidence base is limited as a result of numerous challenges faced by those attempting to conduct psychosocial intervention trials within the health system. Barriers include insufficient participant recruitment, difficulty generalizing from single-trial studies, difficulty in building and managing research teams with multidisciplinary expertise, lack of research design expertise and a lack of incentives for researchers conducting intervention research. To strengthen the evidence base, more intervention studies employing methodologically rigorous research designs are necessary. Methods In order to advance the evidence base of interventions designed to improve psychosocial outcomes for cancer patients and survivors, we propose the formation of a collaborative trials group that conducts multicenter trials to test the effectiveness of such interventions. Results Establishment of such a group would improve the quality of the evidence base in psychosocial research in cancer patients, by increasing support for conducting intervention research and providing intervention research training opportunities. A multidisciplinary collaborative group conducting multicenter trials would have the capacity to overcome many of the barriers that currently exist. Conclusions A stronger evidence base is necessary to identify effective psychosocial interventions for cancer patients. The proposed formation of a psycho-oncology collaborative trials group that conducts multicenter trials to test the effectiveness of psychosocial interventions would assist in achieving this outcome. PMID:22992443

  12. Development of a virtual reality assessment of everyday living skills.

    PubMed

    Ruse, Stacy A; Davis, Vicki G; Atkins, Alexandra S; Krishnan, K Ranga R; Fox, Kolleen H; Harvey, Philip D; Keefe, Richard S E

    2014-04-23

    Cognitive impairments affect the majority of patients with schizophrenia and these impairments predict poor long term psychosocial outcomes.  Treatment studies aimed at cognitive impairment in patients with schizophrenia not only require demonstration of improvements on cognitive tests, but also evidence that any cognitive changes lead to clinically meaningful improvements.  Measures of "functional capacity" index the extent to which individuals have the potential to perform skills required for real world functioning.  Current data do not support the recommendation of any single instrument for measurement of functional capacity.  The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is a novel, interactive gaming based measure of functional capacity that uses a realistic simulated environment to recreate routine activities of daily living. Studies are currently underway to evaluate and establish the VRFCAT's sensitivity, reliability, validity, and practicality. This new measure of functional capacity is practical, relevant, easy to use, and has several features that improve validity and sensitivity of measurement of function in clinical trials of patients with CNS disorders.

  13. Midlife Eriksonian Psychosocial Development: Setting the Stage for Cognitive and Emotional Health in Late Life

    PubMed Central

    Malone, Johanna C.; Liu, Sabrina R.; Vaillant, George E.; Rentz, Dorene M.; Waldinger, Robert J.

    2017-01-01

    Erikson’s (1950) model of adult psychosocial development outlines the significance of successful involvement within one’s relationships, work, and community for healthy aging. He theorized that the consequences of not meeting developmental challenges included stagnation and emotional despair. Drawing on this model, the present study uses prospective longitudinal data to examine how the quality of assessed Eriksonian psychosocial development in midlife relates to late-life cognitive and emotional functioning. In particular we were interested to see whether late-life depression mediated the relationship between Eriksonian development and specific domains of cognitive functioning (i.e., executive functioning and memory). Participants were 159 men from the over 75 year longitudinal Study of Adult Development. The sample was comprised of men from both higher and lower socio-economic strata. Eriksonian psychosocial development was coded from men’s narrative responses to interviews between the ages of 30–47 (Vaillant and Milofsky, 1980). In late life (ages 75–85) men completed a performance - based neuropsychological assessment measuring global cognitive status, executive functioning, and memory. In addition depressive symptomatology was assessed using the Geriatric Depression Scale. Our results indicated that higher midlife Eriksonian psychosocial development was associated with stronger global cognitive functioning and executive functioning, and lower levels of depression three to four decades later. There was no significant association between Eriksonian development and late-life memory. Late-life depression mediated the relationship between Eriksonian development and both global cognition and executive functioning. All of these results controlled for highest level of education and adolescent intelligence. Findings have important implications for understanding the lasting benefits of psychosocial engagement in mid-adulthood for late-life cognitive and emotional health. In addition, it may be that less successful psychosocial development increases levels of depression making individuals more vulnerable to specific areas of cognitive decline. PMID:26551530

  14. Feeling well and talking about sex: psycho-social predictors of sexual functioning after cancer

    PubMed Central

    2014-01-01

    Background Changes to sexual wellbeing are acknowledged to be a long-term negative consequence of cancer and cancer treatment. These changes can have a negative effect on psychological well-being, quality of life and couple relationships. Whilst previous conclusions are based on univariate analysis, multivariate research can facilitate examination of the complex interaction between sexual function and psycho-social variables such as psychological wellbeing, quality of life, and relationship satisfaction and communication in the context of cancer, the aim of the present study. Method Six hundred and fifty seven people with cancer (535 women, 122 men) and 148 partners (87 women, 61 men), across a range of sexual and non-sexual cancers, completed a survey consisting of standardized measures of sexual functioning, depression and anxiety, quality of life, relationship satisfaction, dyadic sexual communication, and self-silencing, as well as ratings of the importance of sex to life and relationships. Results Men and women participants, reported reductions in sexual functioning after cancer across cancer type, for both people with cancer and partners. Multiple regression analysis examined psycho-social predictors of sexual functioning. Physical quality of life was a predictor for men and women with cancer, and for male partners. Dyadic sexual communication was a predictor for women with cancer, and for men and women partners. Mental quality of life and depression were also predictors for women with cancer, and the lower self-sacrifice subscale of self-silencing a predictor for men with cancer. Conclusion These results suggest that information and supportive interventions developed to alleviate sexual difficulties and facilitate sexual renegotiation should be offered to men and women with both sexual and non-sexual cancers, rather than primarily focused on individuals with sexual and reproductive cancers, as is the case currently. It is also important to include partners in supportive interventions. Interventions aimed at improving sexual functioning should include elements aimed at improving physical quality of life and sexual communication, with a focus on psychological wellbeing also being important for women with cancer. PMID:24673768

  15. [Factors associated with perception of improvement by users of Centers for Psychosocial Care in the South of Brazil].

    PubMed

    Franzmann, Uiasser Thomas; Kantorski, Luciane Prado; Jardim, Vanda Maria da Rosa; Treichel, Carlos Alberto Dos Santos; Oliveira, Michele Mandagará de; Pavani, Fabiane Machado

    2017-08-07

    This study aimed to investigate factors associated with perceived improvement among users of Centers for Psychosocial Care. This was a cross-sectional study of 1,493 users of Centers for Psychosocial Care in the South of Brazil. Users' perceived improvement was assessed by Perceived Change Scale - Patients (PCS-Patients). Associated factors were investigated using logistic regression guided by a hierarchical model, with statistical significance set at p < 0.05. Factors associated with the outcome were: state where the Center for Psychosocial Care was located, paid work, diagnosis of schizophrenia, age at diagnosis < 18 years, longer time attending the center, ease of access, and involvement in the evaluation. The factors that actually involve improvement in users include those pertaining to characteristics of the illness and aspects related to services in the implementation of mental health policies and their organization.

  16. Psychosocial Functioning in the Context of Diagnosis: Assessment and Theoretical Issues

    ERIC Educational Resources Information Center

    Ro, Eunyoe; Clark, Lee Anna

    2009-01-01

    Psychosocial functioning is an important focus of attention in the revision of the "Diagnostic and Statistical Manual of Mental Disorders". Researchers and clinicians are converging upon the opinion that psychometrically strong, comprehensive assessment of individuals' functioning is needed to characterize disorder fully. Also shared is the…

  17. Relationship between Psychosocial Functioning and Body Fat in Preschool Children: A Longitudinal Investigation.

    ERIC Educational Resources Information Center

    Klesges, Robert C.; And Others

    1992-01-01

    Examined whether 132 preschool children who varied in levels of body fat differed on psychosocial functioning. Children did not differ in self-esteem and family functioning as function of body fat. Prospectively, physical self-esteem weakly but significantly correlated with body fat at one and two years; father's perception of family functioning…

  18. Physical activity, psychosocial health, and life goals among youth.

    PubMed

    Piko, Bettina F; Keresztes, Noemi

    2006-04-01

    The main goal of the present study is to investigate the relationship between youth's physical activity, their psychosocial health and well-being, and their life goals. Data were collected among students (n = 1109, age range between 14 and 21 years of age, mean: 16.5 years, SD = 1.3 years) enrolled in the secondary schools of the Southern Plain Region (three counties), Hungary. Our findings support previous results that more active students have a better self-perceived health and fitness, lower levels of depressive symptoms and higher levels of life satisfaction. In addition, students who are regularly active prefer less extrinsic values as life goals for their future. However, there are no significant differences by physical activity status in terms of intrinsic values (except for physical health). These findings suggest that physical activity is not per se a beneficial health behavior only through its functions. In community health programs, a health-related physical education approach should be addressed to improve the psychosocial benefits of physical activity.

  19. Disability and schizophrenia: a systematic review of experienced psychosocial difficulties

    PubMed Central

    2012-01-01

    Background Schizophrenia is a significantly disabling disease that affects all major areas of life. There is a lack of comprehensive synthesis of research findings on the full extent of psychosocial difficulties (PSDs) experienced by people living with schizophrenia. This paper provides a systematic review of the literature concerning PSDs and their associated factors in schizophrenia. PSDs were conceptualized in accordance with the International Classification of Functioning, Disability and Health (ICF) as disabilities, in particular impairments of mental functions, activity limitations and participation restrictions. Methods An electronic search using MEDLINE and PsychINFO plus a manual search of the literature was performed for qualitative and longitudinal studies published in English between 2005 and 2010 that examined PSDs in persons with schizophrenia. The ICF was used as a conceptual framework. Results A total of 104 papers were included. The most frequent PSDs addressed in the literature were not specific ones, directly linkable to the ICF categories of mental functions, activity limitations or participation restrictions, but broad areas of psychosocial functioning, such as psychopathological symptoms (53% of papers) or global disability and functioning (37%). Among mental functions, the most extensively studied were cognitive functions (27%) and emotional functions (27%). Within the domain of activities and participation, the most widely investigated were difficulties in relationships with others (31%) and employment (20%). Of the factors associated with the intensity or course of PSDs, the most commonly identified were treatment modalities (56%), psychopathological symptoms (26%), and socio-demographic variables (24%). Medication tended to improve the most relevant PSD, but at the same time was the only consistently reported determinant of onset of PSDs (emerging as unwanted side-effects). Conclusions The present review illustrates the remarkably broad scope and diversity of psychosocial areas affected in schizophrenia and shows how these areas are interconnected and how they interact with contextual factors. The need for a shift in focus of schizophrenia research is suggested – from an excessive reliance on global measures of psychopathology and disability for defining outcomes to the creation of profiles of specific PSDs that have a more direct bearing on the disabling experience and real-world functioning of patients and can serve to guide interventions and monitoring over time. PMID:23137171

  20. Assessing psychosocial functioning following childhood acquired brain injury: The Sydney Psychosocial Reintegration Scale for Children.

    PubMed

    Soo, Cheryl; Tate, Robyn L; Anderson, Vicki; Beauchamp, Miriam H; Brookes, Naomi; Catroppa, Cathy; Galvin, Jane; Muscara, Frank

    2016-12-01

    The Sydney Psychosocial Reintegration Scale for Children (SPRS-C) assesses psychosocial functioning in children with acquired brain injury (ABI). This article aims to: (1) describe normative data for the parent-rated SPRS-C and, (2) evaluate the discriminant validity of the SPRS-C. For Aim 1, participants were parents of typically developing children (TDC) aged 5-14 years (N = 200). For Aim 2, participants with ABI were aged 5-14 years (n = 26). A matched group of TDC was sampled from the larger normative sample to serve as a control group (n = 26). For Aim 1, SPRS-C scores across the 10 age-bands were in the higher ranges. Correlation coefficients of SPRS-C total score with child's age and parent occupational skill level were not statistically significant. For Aim 2, SPRS-C scores for the ABI group were significantly lower than the control group. These data provide a guide for clinical interpretation of the SPRS-C for measuring psychosocial functioning in children with ABI.

  1. Walking in School-Aged Children in a Dual-Task Paradigm Is Related to Age But Not to Cognition, Motor Behavior, Injuries, or Psychosocial Functioning

    PubMed Central

    Hagmann-von Arx, Priska; Manicolo, Olivia; Lemola, Sakari; Grob, Alexander

    2016-01-01

    Age-dependent gait characteristics and associations with cognition, motor behavior, injuries, and psychosocial functioning were investigated in 138 typically developing children aged 6.7–13.2 years (M = 10.0 years). Gait velocity, normalized velocity, and variability were measured using the walkway system GAITRite without an additional task (single task) and while performing a motor or cognitive task (dual task). Assessment of children’s cognition included tests for intelligence and executive functions; parents reported on their child’s motor behavior, injuries, and psychosocial functioning. Gait variability (an index of gait regularity) decreased with increasing age in both single- and dual-task walking. Dual-task gait decrements were stronger when children walked in the motor compared to the cognitive dual-task condition and decreased with increasing age in both dual-task conditions. Gait alterations from single- to dual-task conditions were not related to children’s cognition, motor behavior, injuries, or psychosocial functioning. PMID:27014158

  2. Fitness and Mobility Exercise (FAME) Program for stroke

    PubMed Central

    Eng, Janice J.

    2011-01-01

    Given the potential of exercise to positively influence so many physical and psychosocial domains, the Fitness and Mobility Exercise (FAME) Program was developed to address the multiple impairments arising from the chronic health condition of stroke. We present the details of this exercise program and the evidence which has shown that the FAME Program can improve motor function (muscle strength, balance, walking), cardiovascular fitness, bone density, executive functions and memory. The FAME Program can help to improve the physical and cognitive abilities of people living with a stroke and reduce the risk of secondary complications such as falls, fractures and heart disease. PMID:22287825

  3. Randomized Trial of Social Rehabilitation and Integrated Health Care for Older People with Severe Mental Illness

    ERIC Educational Resources Information Center

    Mueser, Kim T.; Pratt, Sarah I.; Bartels, Stephen J.; Swain, Karin; Forester, Brent; Cather, Corinne; Feldman, James

    2010-01-01

    Objective: The Helping Older People Experience Success (HOPES) program was developed to improve psychosocial functioning and reduce long-term medical burden in older people with severe mental illness (SMI) living in the community. HOPES includes 1 year of intensive skills training and health management, followed by a 1-year maintenance phase.…

  4. The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature.

    PubMed

    Louw, Adriaan; Zimney, Kory; Puentedura, Emilio J; Diener, Ina

    2016-07-01

    Systematic review of randomized control trials (RCTs) for the effectiveness of pain neuroscience education (PNE) on pain, function, disability, psychosocial factors, movement, and healthcare utilization in individuals with chronic musculoskeletal (MSK) pain. Systematic searches were conducted on 11 databases. Secondary searching (PEARLing) was undertaken, whereby reference lists of the selected articles were reviewed for additional references not identified in the primary search. All experimental RCTs evaluating the effect of PNE on chronic MSK pain were considered for inclusion. Additional Limitations: Studies published in English, published within the last 20 years, and patients older than 18 years. No limitations were set on specific outcome measures. Data were extracted using the participants, interventions, comparison, and outcomes (PICO) approach. Study quality of the 13 RCTs used in this review was assessed by 2 reviewers using the PEDro scale. Narrative summary of results is provided for each study in relation to outcomes measurements and effectiveness. Current evidence supports the use of PNE for chronic MSK disorders in reducing pain and improving patient knowledge of pain, improving function and lowering disability, reducing psychosocial factors, enhancing movement, and minimizing healthcare utilization.

  5. The effects of aerobic exercise training on psychosocial aspects of men with type 2 diabetes mellitus.

    PubMed

    Sardar, Mohammad Ali; Boghrabadi, Vahdat; Sohrabi, Mehdi; Aminzadeh, Reza; Jalalian, Mehrdad

    2014-01-20

    This study was conducted to examine the effects of aerobic exercise training on psychosocial aspects (mental health, the aspects of physical symptoms, anxiety and insomnia, social functioning, and depression) in patients with type 2 diabetes mellitus. 53 men who had type 2 diabetes mellitus for a mean duration of the disease for 3±5 years were selected purposely and classified randomly into experimental (27 patients) and a control group (26 patients). Patients in the experimental group did aerobic exercise training three times a week for eight weeks. The exercise included an aerobic activity for 45 to 60 minutes during which the patients' heart rates were maintained at 60-70 percent of heart rate reserve on ergo meter bikes. The eight-week aerobic exercise training had significant effects on mental health (p = 0.002), subscales of physical symptoms (p = 0.006), and anxiety and insomnia (p = 0.001). It had no significant effects on subscales related to disorder of social functioning (p = 0.117) and depression (p = 0.657). Aerobic exercise training can be considered as an appropriate program for improving the health of the patients with type 2 diabetes mellitus, and it also can improve their mental health.

  6. Positive psychology perspective on traumatic brain injury recovery and rehabilitation.

    PubMed

    Rabinowitz, Amanda R; Arnett, Peter A

    2018-01-01

    Recovery from traumatic brain injury (TBI) is heterogeneous, with injury characteristics and neuropathological findings accounting for a relatively modest proportion of the variance in clinical outcome. Furthermore, premorbid personality traits and psychological characteristics may moderate psychosocial recovery. Constructs from the field of positive psychology have been examined in multiple illness populations and are increasingly gaining attention as factors that may influence recovery from TBI. Positive affect, hope, optimism, adaptive coping style, and resilience have all been examined in the context of TBI. These phenomena are of particular interest because they may inform treatment, either by reducing psychological distress and promoting better adjustment, or by augmenting existing therapies to improve engagement. In general, research suggests that higher levels of these factors predict better psychosocial functioning after injury. However, brain injury itself is associated with reduced levels of many of these positive traits, either relative to uninjured control samples or preinjury functioning. There have been proposals for targeting these positive traits in the context of TBI rehabilitation. Although more research is needed, the few controlled trials aimed at improving adaptive coping skills have shown promising results. Other positive psychological phenomena, such as grit, optimism, and positive affect are deserving of further study as potential intervention targets.

  7. Individual Differences in Adolescents' Sympathetic and Parasympathetic Functioning Moderate Associations between Family Environment and Psychosocial Adjustment

    ERIC Educational Resources Information Center

    Diamond, Lisa M.; Fagundes, Christopher P.; Cribbet, Matthew R.

    2012-01-01

    The present study tested whether individual differences in autonomic nervous system functioning interact with environmental risk factors to predict adolescents' psychosocial functioning. The authors assessed skin conductance and respiratory sinus arrhythmia at rest and during laboratory stressors in 110 14-year-olds. Subsequently, adolescents and…

  8. Improving the psychosocial work environment at multi-ethnic workplaces: a multi-component intervention strategy in the cleaning industry.

    PubMed

    Smith, Louise Hardman; Hviid, Kirsten; Frydendall, Karen Bo; Flyvholm, Mari-Ann

    2013-10-14

    Global labour migration has increased in recent years and immigrant workers are often recruited into low status and low paid jobs such as cleaning. Research in a Danish context shows that immigrants working in the cleaning industry often form social networks based on shared languages and backgrounds, and that conflict between different ethnic groups may occur. This paper evaluates the impact of a multi-component intervention on the psychosocial work environment at a multi-ethnic Danish workplace in the cleaning sector. The intervention included Danish lessons, vocational training courses, and activities to improve collaboration across different groups of cleaners. Interviews about the outcome of the intervention were conducted with the cleaners and their supervisor. The Copenhagen Psychosocial Questionnaire was used as a supplement to the interviews. The results suggest that the psychosocial work environment had improved after the intervention. According to the interviews with the cleaners, the intervention had led to improved communication, trust, and collaboration. These findings are supported by the questionnaire where social support from supervisor and colleagues, social community, trust, and teamwork seem to have improved together with meaning of work, rewards, and emotional demands. The design of the intervention may provide inspiration for future psychosocial work environment interventions at multi-ethnic work places.

  9. Improving the Psychosocial Work Environment at Multi-Ethnic Workplaces: A Multi-Component Intervention Strategy in the Cleaning Industry

    PubMed Central

    Smith, Louise Hardman; Hviid, Kirsten; Frydendall, Karen Bo; Flyvholm, Mari-Ann

    2013-01-01

    Global labour migration has increased in recent years and immigrant workers are often recruited into low status and low paid jobs such as cleaning. Research in a Danish context shows that immigrants working in the cleaning industry often form social networks based on shared languages and backgrounds, and that conflict between different ethnic groups may occur. This paper evaluates the impact of a multi-component intervention on the psychosocial work environment at a multi-ethnic Danish workplace in the cleaning sector. The intervention included Danish lessons, vocational training courses, and activities to improve collaboration across different groups of cleaners. Interviews about the outcome of the intervention were conducted with the cleaners and their supervisor. The Copenhagen Psychosocial Questionnaire was used as a supplement to the interviews. The results suggest that the psychosocial work environment had improved after the intervention. According to the interviews with the cleaners, the intervention had led to improved communication, trust, and collaboration. These findings are supported by the questionnaire where social support from supervisor and colleagues, social community, trust, and teamwork seem to have improved together with meaning of work, rewards, and emotional demands. The design of the intervention may provide inspiration for future psychosocial work environment interventions at multi-ethnic work places. PMID:24129115

  10. A dual change model of life satisfaction and functioning for individuals with schizophrenia

    PubMed Central

    Edmondson, Melissa; Pahwa, Rohini; Lee, Karen Kyeunghae; Hoe, Maanse; Brekke, John S.

    2013-01-01

    Despite the notion that increases in functioning should be associated with increases in life satisfaction in schizophrenia, research has often found no association between the two. Dual change models of global and domain-specific life satisfaction and functioning were examined in 145 individuals with schizophrenia receiving community-based services over 12 months. Functioning and satisfaction were measured using the Role Functioning Scale and Satisfaction with Life Scale. Data were analyzed using latent growth curve modeling. Improvement in global life satisfaction was associated with improvement in overall functioning over time. Satisfaction with living situation also improved as independent functioning improved. Work satisfaction did not improve as work functioning improved. Although social functioning improved, satisfaction with social relationships did not. The link between overall functioning and global life satisfaction provides support for a recovery-based orientation to community based psychosocial rehabilitation services. When examining sub-domains, the link between outcomes and subjective experience suggests a more complex picture than previously found. These findings are crucial to interventions and programs aimed at improving functioning and the subjective experiences of consumers recovering from mental illness. Interventions that show improvements in functional outcomes can assume that they will show concurrent improvements in global life satisfaction as well and in satisfaction with independent living. Interventions geared toward improving social functioning will need to consider the complexity of social relationships and how they affect satisfaction associated with personal relationships. Interventions geared towards improving work functioning will need to consider how the quality and level of work affect satisfaction with employment. PMID:22591780

  11. Gender differences in psychosocial determinants of self-perceived health among Portuguese older adults in nursing homes.

    PubMed

    Alarcão, Violeta; Madeira, Teresa; Peixoto-Plácido, Catarina; Sousa-Santos, Nuno; Fernandes, Elisabete; Nicola, Paulo; Santos, Osvaldo; Gorjão-Clara, João

    2018-05-23

    Self-perceived health declines with age, varies by gender and is a predictor of mortality, morbidity, physical and psychological functioning. However, gender differences in health and illness perception are complex and not yet fully understood. This study aimed to explore gender-related differences in psychosocial determinants of self-perceived health among older adults living in nursing homes. Nationwide face-to-face survey of the Portuguese population aged 65 and over. A representative sample of nursing homes residents was obtained through a multistage cluster random sampling of nursing homes, stratified by main Portuguese administrative regions (NUTS II). Overall, 1186 nursing homes residents voluntarily enrolled in this study (participation rate, 93%) and a total of 515 participants (70.1% women) were considered to have adequate cognitive functioning to answer all questionnaires. A significant association between self-rated health and gender was found: 90.6% of all women (95% CI: 85.7-93.9) and 82.3% of all men (95% CI: 72.9-88.9) rated their health as less than good (p = 0.023). Gender-stratified analyses showed differences in psychosocial determinants of self-perceived health. While symptoms of depression and loneliness feelings were the major psychosocial determinants of poor self-perceived health among women, age and subjective financial well-being were the only determinants among men. Factors associated with perceived health, as representative of healthy ageing, were identified by gender, leading to future avenues for fruitful investigation. The acknowledgement of interpersonal and socioeconomic factors that determine the experience of ageing at a national level is crucial to improve the health of elders.

  12. The Treatment of Juvenile Fibromyalgia with an Intensive Physical and Psychosocial Program.

    PubMed

    Sherry, David D; Brake, Lori; Tress, Jenna L; Sherker, Jennifer; Fash, Katherine; Ferry, Kelly; Weiss, Pamela F

    2015-09-01

    To assess the short-term and 1-year outcomes of children with fibromyalgia treated with intensive physical and occupational therapy (PT/OT) and psychotherapy. Children with fibromyalgia seen at a tertiary care hospital were treated with 5-6 hours of intensive PT/OT daily and at least 4 hours of psychosocial services weekly. All medications used for fibromyalgia were discontinued. Children underwent standardized testing, including a visual analog scale for pain; the Bruininks-Oseretsky Test of Motor Performance, Second Edition; the Bruce treadmill protocol; the Functional Disability Inventory; the Pain Stages of Change Questionnaire, adolescent version; and the Pediatric Quality of Life Inventory, Teen Report, at 3 time points: at program entry, at the end of the intensive program, and 1 year after the end of the program. Sixty-four children (median age, 16 years; 95% Caucasian; 94% female; median duration of symptoms, 21 months) were studied. The mean pain score decreased significantly from program entry to the end of the program (from 66 of 100 to 25 of 100; P = .001). At the 1-year follow-up, 33% reported no pain. All measures of function on the Bruininks-Oseretsky Test of Motor Performance, Second Edition improved significantly and remained at that level or continued to improve over the subsequent year. The mean Bruce treadmill protocol time first increased from 588 seconds to 801 seconds (P < .001) and then dropped to 750 seconds (P = .005), which is at the 90th percentile for age and sex. All Pain Stages of Change Questionnaire, adolescent version subset scores improved significantly initially and were stable or improved at 1 year, as did the Pediatric Quality of Life Inventory, Teen Report total score. Children with fibromyalgia can be successfully treated without medications with a very intensive PT/OT and psychotherapy program. They have significantly improved pain and function by subject report and objective measures of function. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  13. Efficacy of technology-based interventions for obesity prevention in adolescents: a systematic review.

    PubMed

    Chen, Jyu-Lin; Wilkosz, Mary Ellen

    2014-01-01

    About one third of adolescents in the USA are overweight and/or obese. Obesity during the adolescent years is associated with many adverse health consequences, including type 2 diabetes, hypertension, hyperlipidemia, and psychosocial problems. Because of substantial advances in technologies and wide acceptance by adolescents, it is now possible to use technology for healthy weight management and prevention of obesity. This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and aimed to evaluate the existing literature reported on the effectiveness of technology-based intervention (web-based, e-learning, and active video games) in preventing obesity in adolescents. The primary aim of this review was to explore if components of specific interventions were associated with a reduction in body mass index. Research articles obtained from CINAHL, Embase, PubMed, PsycInfo, and the Cochrane database from1990 to 2014 were reviewed. A total of 131 published articles were identified, and 14 met the inclusion criteria of a randomized or nonrandomized clinical study with body mass index as primary outcome and/or secondary outcomes of diet/physical activity and/or psychosocial function, tested lifestyle interventions to prevent obesity, used technology, and studied adolescents (aged 12-18 years). The results indicated that six of 14 studies found body mass index and/or body fat decreased at short-term (less than 12 months) follow-up. Six of eleven studies that examined physical activity or physical activity-related outcomes found an improved physical activity outcome (time playing active video games and increase in physical activity time), while five of seven studies which assessed dietary outcomes indicated improvement in dietary behaviors. Five of seven studies suggested an improvement in psychosocial function (reduced depression, improved self-esteem and efficacy, improvement on Behavior Assessment Scale) in adolescents involved in the technology-based intervention. All effective interventions utilized dietary and physical activity strategies as part of intervention components. Because of the variation in duration of intervention (range 10 weeks to 2 years), it is not clear what length of intervention is most effective. Future research should assess the long-term impact of technology-based interventions and evaluate mediators and moderators for weight change in adolescents.

  14. What interventions can improve quality of life or psychosocial factors of individuals with knee osteoarthritis? A systematic review with meta-analysis of primary outcomes from randomised controlled trials.

    PubMed

    Briani, Ronaldo Valdir; Ferreira, Amanda Schenatto; Pazzinatto, Marcella Ferraz; Pappas, Evangelos; De Oliveira Silva, Danilo; Azevedo, Fábio Mícolis de

    2018-03-16

    To systematically review evidence of primary outcomes from randomised controlled trials (RCTs) examining the effect of treatment strategies on quality of life (QoL) or psychosocial factors in individuals with knee osteoarthritis (OA). Systematic review with meta-analysis. Medline, Embase, SPORTDiscus, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science were searched from inception to November 2017. We included RCTs investigating the effect of conservative interventions on QoL or psychosocial factors in individuals with knee OA. Only RCTs considering these outcomes as primary were included. Pooled data supported the use of exercise therapy compared with controls for improving health-related and knee-related QoL. There was limited evidence that a combined treatment of yoga, transcutaneous electrical stimulation and ultrasound may be effective in improving QoL. Limited evidence supported the use of cognitive behavioural therapies (with or without being combined with exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress. Exercise therapy (with or without being combined with other interventions) seems to be effective in improving health-related and knee-related QoL or psychosocial factors of individuals with knee OA. In addition, evidence supports the use of cognitive behavioural therapies (with or without exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress in individuals with knee OA. CRD42016047602. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Body image, psychosocial functioning, and personality: how different are adolescents and young adults applying for plastic surgery?

    PubMed

    Simis, K J; Verhulst, F C; Koot, H M

    2001-07-01

    This study addressed three questions: (1) Do adolescents undergoing plastic surgery have a realistic view of their body? (2) How urgent is the psychosocial need of adolescents to undergo plastic surgery? (3) Which relations exist between bodily attitudes and psychosocial functioning and personality? From 1995 to 1997, 184 plastic surgical patients aged 12 to 22, and a comparison group of 684 adolescents and young adults from the general population aged 12 to 22 years, and their parents, were interviewed and completed questionnaires and standardised rating scales. Adolescents accepted for plastic surgery had realistic appearance attitudes and were psychologically healthy overall. Patients were equally satisfied with their overall appearance as the comparison group, but more dissatisfied with the specific body parts concerned for operation, especially when undergoing corrective operations. Patients had measurable appearance-related psychosocial problems. Patient boys reported less self-confidence on social areas than all other groups. There were very few patient-comparison group differences in correlations between bodily and psychosocial variables, indicating that bodily attitudes and satisfaction are not differentially related to psychosocial functioning and self-perception in patients than in peers. We concluded that adolescents accepted for plastic surgery have considerable appearance-related psychosocial problems, patients in the corrective group reporting more so than in the reconstructive group. Plastic surgeons may assume that these adolescents in general have a realistic attitude towards their appearance. are psychologically healthy, and are mainly dissatisfied about the body parts concerned for operation. corrective patients more so than reconstructive patients. Introverted patients may need more attention from plastic surgeons during the psychosocial assessment.

  16. Clinical predictors associated with full remission versus episode of major depressive disorder outpatients: the experience at a teaching hospital in Taiwan.

    PubMed

    Yeh, Mei-Yu; Lee, Yu; Sung, Su-Ching; Tung, Tao-Hsin

    2014-09-24

    When depressed patients are in remission, the clinical characteristics indicate that they are able to participate in social activities more regularly, and their impairment in daily functioning is improved. The present study examines the clinical characteristics associated with one- and two month clinical response in outpatients with Major Depressive Disorder (MDD) in Taiwan. A total of 160 outpatients were initially recruited from the medical centre in Taiwan. Of these participants, 151 MDD patients completed the baseline-assessment interview, 111 were interviewed and assessed again 4 weeks later, and 78 completed the final interview and assessment 8 weeks later. In the present study, asymptomatic was defined as scoring ≤ 7 on the Hamilton Depression Rating Scale (HAM-D); partially symptomatic was defined as scoring 8-14; fully symptomatic was defined as scoring ≥15. Finally, asymptomatic, partially symptomatic, and fully symptomatic were defined in patients with MDD respectively as in full remission, in persistent depressive symptom, and in episode. Of the remaining 78 patients, a total of 21 (26.9%) were in full remission, 35 (44.9%) were in persistent depressive symptom, and 22 (28.2%) were in episode. Patients in full remission were older (p = 0.03), exhibited greater psychosocial functioning, (p < 0.001), held more-positive beliefs regarding antidepressant medication (p = 0.03), had higher self-efficacy (p = 0.001), and scored lower for neuroticism (p = 0.003), as compared to patients in episode. Younger patients were more prevalent in persistent depression. Repeated-measures ANOVA revealed that differences in four factors (psychosocial functioning, beliefs regarding antidepressant medication, self-efficacy in managing and preventing depression, and neuroticism) were significantly different between full remission and episode. Episode was significantly associated with psychosocial-functioning impairment (OR = 1.12, 95% CI: 1.00-1.26) and poorer self-efficacy (OR = 0.91, 95% CI: 0.82-1.00). Our findings identify significant factors of full remission, persistent depressive symptom, and episode. We highlight the importance of enhancing patients' psychosocial functioning and self-efficacy until achieving full remission. Suggestions are provided for clinical health-care management services in Taiwan.

  17. On the Association between Adolescent Autonomy and Psychosocial Functioning: Examining Decisional Independence from a Self-Determination Theory Perspective

    ERIC Educational Resources Information Center

    Van Petegem, Stijn; Beyers, Wim; Vansteenkiste, Maarten; Soenens, Bart

    2012-01-01

    In the present study, we focus on the concept of adolescent autonomy and its relation with psychosocial functioning. Specifically, we aim to differentiate between 2 prevailing conceptualizations of autonomy, that is, (a) autonomy defined as independence versus dependence and (b) autonomy defined as self-endorsed versus controlled functioning. A…

  18. Long-Term Effects of Psychological Trauma on Psychosocial Functioning

    ERIC Educational Resources Information Center

    Bolton, Derek; Hill, Jonathan; O'Ryan, Dominic; Udwin, Orlee; Boyle, Stephanie; Yule, William

    2004-01-01

    Background: Most studies of the effects of trauma on mental health have generally not separately assessed psychosocial functioning, and in those that have key issues have received little attention, such as the relation between the time courses of the two kinds of outcome, and detailed assessment of social functioning in a range of domains. The…

  19. Mixed Feelings of Children and Adolescents with Unilateral Congenital Below Elbow Deficiency: An Online Focus Group Study

    PubMed Central

    de Jong, Ingrid G.M.; Reinders-Messelink, Heleen A.; Janssen, Wim G.M.; Poelma, Margriet J.; van Wijk, Iris; van der Sluis, Corry K.

    2012-01-01

    The existing literature is inconsistent about the psychosocial functioning of children and adolescents with Unilateral Congenital Below Elbow Deficiency (UCBED). The objective of this qualitative study was to explore the psychosocial functioning of children and adolescents with UCBED in terms of their feelings about the deficiency and what helps them to cope with those feelings. Additionally, the perspectives of prosthesis wearers and non-wearers were compared, as were the perspectives of children, adolescents, parents and health professionals. Online focus group interviews were carried out with 42 children and adolescents (aged 8–12, 13–16 and 17–20), 16 parents and 19 health professionals. Questions were asked about psychosocial functioning, activities, participation, prosthetic use or non-use, and rehabilitation care. This study concerned remarks about psychosocial functioning. Children and adolescents with UCBED had mixed feelings about their deficiency. Both negative and positive feelings were often felt simultaneously and mainly depended on the way people in the children’s environment reacted to the deficiency. People staring affected the children negatively, while support from others helped them to cope with the deficiency. Wearing a prosthesis and peer-to-peer contact were also helpful. Non-wearers tended to be more resilient than prosthesis wearers. Wearers wore their prosthesis for cosmetic reasons and to prevent them from negative reactions from the environment. We recommend that rehabilitation teams make parents aware of their great influence on the psychosocial functioning of their child with UCBED, to adjust or extend the currently available psychosocial help, and to encourage peer-to-peer contact. PMID:22715362

  20. Mixed feelings of children and adolescents with unilateral congenital below elbow deficiency: an online focus group study.

    PubMed

    de Jong, Ingrid G M; Reinders-Messelink, Heleen A; Janssen, Wim G M; Poelma, Margriet J; van Wijk, Iris; van der Sluis, Corry K

    2012-01-01

    The existing literature is inconsistent about the psychosocial functioning of children and adolescents with Unilateral Congenital Below Elbow Deficiency (UCBED). The objective of this qualitative study was to explore the psychosocial functioning of children and adolescents with UCBED in terms of their feelings about the deficiency and what helps them to cope with those feelings. Additionally, the perspectives of prosthesis wearers and non-wearers were compared, as were the perspectives of children, adolescents, parents and health professionals. Online focus group interviews were carried out with 42 children and adolescents (aged 8-12, 13-16 and 17-20), 16 parents and 19 health professionals. Questions were asked about psychosocial functioning, activities, participation, prosthetic use or non-use, and rehabilitation care. This study concerned remarks about psychosocial functioning. Children and adolescents with UCBED had mixed feelings about their deficiency. Both negative and positive feelings were often felt simultaneously and mainly depended on the way people in the children's environment reacted to the deficiency. People staring affected the children negatively, while support from others helped them to cope with the deficiency. Wearing a prosthesis and peer-to-peer contact were also helpful. Non-wearers tended to be more resilient than prosthesis wearers. Wearers wore their prosthesis for cosmetic reasons and to prevent them from negative reactions from the environment. We recommend that rehabilitation teams make parents aware of their great influence on the psychosocial functioning of their child with UCBED, to adjust or extend the currently available psychosocial help, and to encourage peer-to-peer contact.

  1. [Adding the perspective of emotion on cognitive rehabilitation].

    PubMed

    Nakagome, Kazuyuki

    2011-01-01

    Cognitive rehabilitation has been gradually disseminated in Japan lately. Cognitive rehabilitation is distinct from other psychosocial rehabilitation methods, which aims to enhance cognitive function per se, by various training tools, using paper and pencil tasks, computer games, etc. It stands on the hypothesis that enhancing cognitive function should lead to improvement in social functioning. However, it is becoming clear that cognitive rehabilitation on its own is not strongly effective on social functioning, but rather it appears effective when combined with other methods of rehabilitation. Moreover, it does not treat the emotional problems, which is essential considering the treatment endpoint, to enhance "subjective well-being". Emotional problems arise much often at social interaction in patients with schizophrenia, which can be amended by improving their social cognition as well as social skills. Recently, one of the social cognition training programs has been developed in USA by Penn and his colleagues, named SCIT (Social Cognition and Interaction Training) . The program treats a number of factors involved in social cognition, a) emotion perception, b) attributional style, and c) theory of mind, using various techniques such as Socrates quotes. In previous studies, SCIT showed good effectiveness in various aspects of social cognition for inpatients, whereas the finding was not as clear for outpatients. It may be assumed that integrating SCIT into a cognitive rehabilitation program should alleviate emotional stress the patients often encounter at social interaction in their daily activities. Presumably the next candidate target for psychosocial treatments coming after cognition and emotion should be "intrinsic motivation".

  2. [Psychosocial issues of long-term cancer survivors].

    PubMed

    Weis, J; Faller, H

    2012-04-01

    Although cancer incidence rates are increasing, recent statistical studies suggest that cancer patients are showing higher cure rates as well as improved overall survival rates for most cancer locations. These advances are explained by improved strategies in early diagnoses as well as improved cancer therapies. Therefore, the number of long-term cancer survivors has also increased, but only few studies, especially within the last years, have focused on psychosocial issues of this subgroup. Some studies show that overall quality of life of long-term cancer survivors is quite high and comparable to that of the normal population. Nevertheless, a substantial percentage of former patients shows reduced quality of life and suffers from various sequelae of cancer and its treatment. This review focuses on the most common psychosocial issue of long-term survivors such as reduced psychological wellbeing, neuropsychological deficits and cancer-related fatigue syndrome. Finally, recommendations for problem-oriented interventions as well as improvement of psychosocial care of long-term survivors are given.

  3. Impact of Horticultural Therapy on Psychosocial Functioning among Urban Jail Inmates.

    ERIC Educational Resources Information Center

    Rice, Jay Stone; Remy, Linda L.

    1998-01-01

    Investigates the impact of a horticultural therapy program on 48 county jail inmates. Examines the changes in psychosocial functioning of the participants while in treatment and in post-release. Explores the clinical relevance of horticultural therapy in cultivating healthy self-development. (MKA)

  4. Same-sex attraction, social relationships, psychosocial functioning, and school performance in early adolescence.

    PubMed

    Bos, Henny M W; Sandfort, Theo G M; de Bruyn, Eddy H; Hakvoort, Esther M

    2008-01-01

    The authors examined whether 13- to 15-year-old adolescents who experience feelings of same-sex attraction (SSA) differ from those without such feelings in the quality of relationships with parents, peers, and class mentors and in psychosocial functioning (health status and school performance). The authors also assessed whether differences in psychosocial functioning resulted from differences in the quality of social relationships. Data were collected from 866 Dutch high school students (mean age 13.61 years) by means of a computer-based questionnaire. Of the participants, 74 (8.5%) reported having feelings of SSA. The participants with SSA rated the quality of their relationships with their fathers and their peers lower than did those without SSA. Participants with SSA also had poorer mental health (higher levels of depression and lower levels of self-esteem) and lower school performance. A mediation analysis revealed that differences in psychosocial functioning resulted from differences in the quality of the same-sex attracted youths' social relationships, especially with fathers and peers. Copyright (c) 2008 APA.

  5. Psychosocial Functioning and Health-Related Quality of Life Associated with Posttraumatic Stress Disorder in Male and Female Iraq and Afghanistan War Veterans: The VALOR Registry.

    PubMed

    Fang, Shona C; Schnurr, Paula P; Kulish, Andrea L; Holowka, Darren W; Marx, Brian P; Keane, Terence M; Rosen, Raymond

    2015-12-01

    Iraq and Afghanistan war veterans suffer from high rates of posttraumatic stress disorder (PTSD). Given the growing number of women in the military, there is a critical need to understand the nature and extent of potential gender differences in PTSD-associated psychosocial functioning and health-related quality of life (HRQOL) in Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans, which has not been studied to date. We used data from a gender-balanced national patient registry of warzone-deployed OEF/OIF veterans (Project VALOR: Veterans After-Discharge Longitudinal Registry) to determine the impact of gender on PTSD-related psychosocial functioning and HRQOL in 1,530 United States Iraq and Afghanistan war veterans (50% female) with and without PTSD. Overall psychosocial functioning was assessed with the Inventory of Psychosocial Functioning (IPF) and mental and physical HRQOL with the Veterans RAND 12-item Health Survey (VR-12) Mental and Physical Component Summary scores, respectively. Stratified linear regression models estimated gender-specific associations, controlling for demographic, deployment, and postdeployment factors. Interaction models tested for significant effect moderation by gender. In gender-stratified models, PTSD was strongly associated with higher IPF scores (greater functional impairment), with similar associations by gender. PTSD was also associated with lower Mental Component Summary scores (lower mental HRQOL) in both men and women, with no evidence of effect moderation by gender. PTSD was associated with lower Physical Component Summery scores in women but not men in adjusted models; however, interactions were not significant. PTSD among warzone-deployed OEF/OIF veterans is associated with significant impairments in both overall psychosocial functioning and HRQOL, with associations that are largely similar by gender. Findings support the need for thorough and continuous assessment of functional impairment and HRQOL during treatment of PTSD for both male and female OEF/OIF veterans.

  6. Psychopathology, cognition and outcome in Dutch and immigrant first-episode psychosis patients.

    PubMed

    Stouten, Luyken H; Veling, Wim; Laan, Winfried; Van der Gaag, Mark

    2018-03-30

    The primary aim was to examine differences in baseline symptom expression, neurocognition, social cognition and psychosocial functioning between Dutch, first-generation immigrants and second-generation immigrants with a first-episode psychosis (FEP). The secondary aim was to examine functional and symptomatic change and between-group differences at 12-months follow-up. Associations between migration, baseline characteristics and outcome were explored. Forty-six Dutch, 56 second-generation- and 60 first-generation immigrant patients completed baseline measures for 6 symptom dimensions (positive symptoms, negative symptoms, neurocognitive functioning, social cognitive functioning, excitement and emotional distress) and 5 domains of psychosocial functioning (general functioning, work and study, relationships, self-care and disturbing behaviour). Functioning and psychotic symptoms were assessed at baseline and 12-months follow-up. ANCOVA and t tests were used to assess between-group differences. General linear models were used to explore within-group differences. Backward-regression was used to explore predictors of outcome. Levels of positive symptoms, excitement and emotional distress did not differ between groups at baseline or follow-up. Dutch patients had lower levels of negative symptoms than both immigrant groups at follow-up. On neurocognition and social cognition, Dutch performed better than second-generation immigrants, who in turn performed better than first-generation immigrants. Psychosocial functioning across all domains at baseline and at 12-months follow-up was similar across groups. Baseline levels of general psychosocial functioning and income were the strongest predictors of outcome at follow-up. Psychosocial functioning and symptom profiles are comparable between Dutch, first-generation immigrant and second-generation immigrant FEP patients, excluding neurocognitive and social cognitive deficits. A range of baseline characteristics predicted outcome. © 2018 John Wiley & Sons Australia, Ltd.

  7. Assessment of psychosocial risks faced by workers in Almería-type greenhouses, using the Mini Psychosocial Factor method.

    PubMed

    Montoya-García, M E; Callejón-Ferre, A J; Pérez-Alonso, J; Sánchez-Hermosilla, J

    2013-03-01

    This work reports the use of the Mini Psychosocial Factor (MPF) method for assessing the psychosocial risks faced by agricultural workers in the greenhouses of Almería (Spain) with the aim of improving their health. The variables Rhythm, Mobbing, Relationships, Health, Recognition, Autonomy, Emotional Involvement, Support, Compensation, Control, Demands, and Mental Load were recorded using a pre-validated questionnaire containing 15 questions. The sex, age, and nationality of the respondents (n = 310) were also recorded, as were the type of greenhouse in which each worked, the size of the greenhouse, and the crop grown. The results showed psychosocial risks to exist for the workers. Multiple correspondence analysis, however, showed that moderate risks can be offset by new prevention programmes that improve Spanish legislation in terms of workers' salaries, worker-employer social days, work timetables to facilitate family life, and training courses. This could improve the work environment and health of Almería's greenhouse workers as well as their productivity. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  8. Enrolment of children in psychosocial care: problems upon entry, care received, and outcomes achieved.

    PubMed

    Nanninga, Marieke; Jansen, Danielle E M C; Knorth, Erik J; Reijneveld, Sijmen A

    2018-05-01

    Psychosocial care systems have been designed so that specific problems are treated by specific care types. There is insufficient evidence as to which problem types are actually presented to the various care types. This study assessed types and severity of problems among children and adolescents upon enrolment in psychosocial care, compared to children not enrolled; also outcomes after 3 and 12 months, overall and per care type. We obtained data on a cohort of 1382 Dutch children aged 4-18 years (response rate 56.6%), included upon enrolment in psychosocial care, and on 443 not-enrolled children (response rate 70.3%), all from one region. Results showed that enrolled children had more problems than children not enrolled in care. In child and adolescent mental healthcare (CAMH), relatively many children had internalizing problems, and in child and adolescent social care (CASC) relatively many children had externalizing, parenting, family and multiple problems. Regardless of the type of problem, care duration in preventive child healthcare (PCH) was relatively short; and in CASC and CAMH longer. After 3 and 12 months, rates of problem solution were highest in PCH. These rates were also substantial among children not in care. To conclude, our findings show that the system of psychosocial care functions as intended regarding the distribution of problems across care types. Extended demarcation of clients by problem type and severity towards type and contents of care may further improve the system.

  9. Writing About Past Failures Attenuates Cortisol Responses and Sustained Attention Deficits Following Psychosocial Stress

    PubMed Central

    DiMenichi, Brynne C.; Lempert, Karolina M.; Bejjani, Christina; Tricomi, Elizabeth

    2018-01-01

    Acute stress can harm performance. Paradoxically, writing about stressful events—such as past failures—has been shown to improve cognitive functioning and performance, especially in tasks that require sustained attention. Yet, there is little physiological evidence for whether writing about past failures or other negative events improves performance by reducing stress. In this experiment, we studied the effects of an acute psychosocial stressor, the Trier Social Stress Test, on attentional performance and salivary cortisol release in humans. Additionally, we investigated whether an expressive writing task could reduce the detrimental effects of stress, both on performance and physiological response. We found that when individuals were asked to write about a past failure before experiencing a stressor, they exhibited attenuated stress responses. Moreover, those who wrote about a past failure before being exposed to stress also exhibited better behavioral performance. Our results suggest that writing about a previous failure may allow an individual to experience a new stressor as less stressful, reducing its physiological and behavioral effects. PMID:29628878

  10. Speech Intelligibility and Psychosocial Functioning in Deaf Children and Teens with Cochlear Implants

    ERIC Educational Resources Information Center

    Freeman, Valerie; Pisoni, David B.; Kronenberger, William G.; Castellanos, Irina

    2017-01-01

    Deaf children with cochlear implants (CIs) are at risk for psychosocial adjustment problems, possibly due to delayed speech-language skills. This study investigated associations between a core component of spoken-language ability--speech intelligibility--and the psychosocial development of prelingually deaf CI users. Audio-transcription measures…

  11. A cohort study on the evolution of psychosocial problems in older patients with breast or colorectal cancer: comparison with younger cancer patients and older primary care patients without cancer.

    PubMed

    Deckx, Laura; van Abbema, Doris L; van den Akker, Marjan; van den Broeke, Carine; van Driel, Mieke; Bulens, Paul; Tjan-Heijnen, Vivianne C G; Kenis, Cindy; de Jonge, Eric T; Houben, Bert; Buntinx, Frank

    2015-07-09

    Although older cancer survivors commonly report psychosocial problems, the impact of both cancer and ageing on the occurrence of these problems remains largely unknown. The evolution of depression, cognitive functioning, and fatigue was evaluated in a group of older cancer patients in comparison with a group of younger cancer patients and older persons without cancer. Older (≥70 years) and younger cancer patients (50-69 years) with breast or colorectal cancer stage I-III, and older persons without cancer (≥70 years) were included. Data were collected at baseline and one year follow-up and were available for 536 persons. Depression was evaluated with the 15-item Geriatric Depression Scale. Cognitive functioning was measured with the cognitive functioning subscale of the European Organization for Research and Treatment of Cancer. Fatigue was measured with a Visual Analogue Scale. Risk factors for depression, cognitive functioning, and fatigue were analysed using multivariate logistic regression analyses. Risk factors included cancer- and ageing-related factors such as functional status, cancer treatment, and comorbidities. The evolution of psychosocial problems was similar for the group of older (N = 125) and younger cancer patients (N = 196): an increase in depression (p < 0.01), slight worsening in cognitive functioning (p = 0.01), and no clear change in fatigue. Also, compared to the group of people without cancer (N = 215), the differences were small and after one year of follow-up only depression was more frequent in older cancer patients compared to older persons without cancer (18% versus 9%, p = 0.04). In multivariate analyses the main risk factors for psychosocial problems after one year follow-up were changes in functional status and presence of baseline depression, fatigue, or cognitive impairment. Over the course of one year after a diagnosis of cancer, cancer patients face increasing levels of depression and increasing difficulties in cognitive functioning. The main risk factor for psychosocial problems was presence of the problem at baseline. This calls for regular screening for psychosocial problems and exchange of information on psychosocial functioning between different health care providers and settings during the treatment and follow-up trajectory of cancer patients.

  12. Design of psychosocial factors questionnaires: a systematic measurement approach

    PubMed Central

    Vargas, Angélica; Felknor, Sarah A

    2012-01-01

    Background Evaluation of psychosocial factors requires instruments that measure dynamic complexities. This study explains the design of a set of questionnaires to evaluate work and non-work psychosocial risk factors for stress-related illnesses. Methods The measurement model was based on a review of literature. Content validity was performed by experts and cognitive interviews. Pilot testing was carried out with a convenience sample of 132 workers. Cronbach’s alpha evaluated internal consistency and concurrent validity was estimated by Spearman correlation coefficients. Results Three questionnaires were constructed to evaluate exposure to work and non-work risk factors. Content validity improved the questionnaires coherence with the measurement model. Internal consistency was adequate (α=0.85–0.95). Concurrent validity resulted in moderate correlations of psychosocial factors with stress symptoms. Conclusions Questionnaires´ content reflected a wide spectrum of psychosocial factors sources. Cognitive interviews improved understanding of questions and dimensions. The structure of the measurement model was confirmed. PMID:22628068

  13. Improving quality of life for people with dementia in care homes: making psychosocial interventions work.

    PubMed

    Lawrence, Vanessa; Fossey, Jane; Ballard, Clive; Moniz-Cook, Esme; Murray, Joanna

    2012-11-01

    Psychosocial interventions can improve behaviour and mood in people with dementia, but it is unclear how to maximise their effectiveness or acceptability in residential settings. To understand what underlies the successful implementation of psychosocial interventions in care homes. Systematic review and meta-synthesis of qualitative research. The synthesis of 39 qualitative papers revealed that beneficial psychosocial interventions met the needs of people with dementia to connect with others, make a meaningful contribution and reminisce. Successful implementation rested on the active engagement of staff and family and the continuing provision of tailored interventions and support. This necessitated staff time, and raised issues around priorities and risk, but ultimately helped redefine staff attitudes towards residents and the caregiving role. The findings from the meta-synthesis can help to inform the development and evaluation of psychosocial interventions in care homes and support their widespread implementation in clinical settings.

  14. Psychosocial determinants of out of school activity participation for children with and without physical disabilities.

    PubMed

    King, Gillian; Law, Mary; Petrenchik, Theresa; Hurley, Patricia

    2013-11-01

    Psychosocial determinants of children's out of school participation were examined, using secondary analyses of data from 427 children with physical disabilities (from 12 service locations in Ontario Canada) and 354 children without disabilities, ages 6 to 14. For both groups of children, hierarchical regression analyses indicated that psychosocial variables added significant incremental variance (6% to 14%) to the prediction of active physical intensity and social activity enjoyment, beyond that accounted for by family income, child age and sex, and physical functioning. As well, there were significant psychosocial determinants, with medium to large effect sizes. Athletic competence and hyperactivity had specific effects on active physical activities and social activities, respectively, for both groups of children. Disability-specific determinants included social acceptance, emotional functioning, and peer difficulties (only significant for children with disabilities). It was concluded that psychosocial variables play an important role in children's enjoyment and intensity of participation in leisure activities.

  15. The Older Woman: Increased Psychosocial Benefits from Physical Activity.

    ERIC Educational Resources Information Center

    Wakat, Diane; Odom, Sarah

    1982-01-01

    Older women who participate in physical activity programs find physical benefits in the improvement of cardiovascular and musculoskeletal systems. The psychosocial benefits which result from physical activity include an increase in self-esteem, increased social contacts, a counteraction to depression, and improved stress management. Suggestions…

  16. Neuroticism in temporal lobe epilepsy: assessment and implications for pre- and postoperative psychosocial adjustment and health-related quality of life.

    PubMed

    Rose, K J; Derry, P A; McLachlan, R S

    1996-05-01

    We assessed 77 candidates for epilepsy surgery to determine the association among neuroticism (a dimension of personality characterized by chronic negative emotions and behaviors), psychosocial adjustment as measured by the Washington Psychosocial Seizure Inventory (WPSI), and health-related quality of life (HRQOL) as measured by the Epilepsy Surgery Inventory 55 (ESI-55). Minnesota Multiphasic Personality Inventory 2 (MMPI-2) Neuroticism scale scores were significantly correlated with many domains of patient -perceived psychosocial adjustment and HRQOL regardless of frequency or type of seizures. We then followed 45 of the patients who subsequently underwent epilepsy surgery to determine the influence of neuroticism on postoperative functioning. Two-way analysis of variance (ANOVA) indicated that patients with high preoperative neuroticism had significantly poorer postoperative psychosocial adjustment and HRQOL scores than patients who had low or moderate preoperative neuroticism scores. These results support the validity of the MMPI-2 as a useful measure of neuroticism. Preoperative neuroticism has an important influence on postoperative psychosocial adjustment and HRQOL that is independent of postoperative seizure outcome. Understanding the influence of personality variables, such as neuroticism, on psychosocial functioning both before and after epilepsy surgery is essential in managing intractable seizures.

  17. Culture and psychosocial function in british and Japanese people with an ostomy.

    PubMed

    Simmons, Kingsley L; Maekawa, Atsuko; Smith, Jane A

    2011-01-01

    We compared social and psychological adjustment to surgery ending with an ostomy in British and Japanese patients. In response to a postal survey, 948 ostomy patients (464 British and 484 Japanese), selected at random from respective national databases, provided assessable data on the Ostomy Adjustment Inventory-23 (OAI-23), a validated scale for measurement of psychosocial adjustment to an ostomy. Analysis of variance revealed that country of residence (F1,876 = 50.9, P < .001) and time since surgery (F3,876 = 9.9, P < .001) significantly influenced psychosocial adjustment to an ostomy. British persons with an ostomy experienced higher psychosocial adjustment to an ostomy than did Japanese respondents. Multivariate analysis based on acceptance, social engagement, anxious-preoccupation, and anger also found that country of residence and time since surgery influenced psychosocial adjustment (Pillai's Trace: V = 0.22, F = 67.15, P < 0.001, and V = 0.05, F = 3.6, P ≤ .001, respectively). Acceptance and social engagement (discriminant coefficient = 0.92 and 0.56, respectively) made the largest contribution. Psychosocial functioning differed in British and Japanese persons with an ostomy, suggesting that culture influences psychosocial adjustment to life with an ostomy. These findings support the need for culturally informed ostomy care.

  18. Anxiety Disorders in Adolescents and Psychosocial Outcomes at Age 30

    PubMed Central

    Essau, Cecilia A.; Lewinsohn, Peter M.; Olaya, Beatriz; Seeley, John R.

    2014-01-01

    Background Anxiety disorders are associated with adverse psychosocial functioning, and are predictive of a wide range of psychiatric disorders in adulthood. Objective The present study examined the associations between anxiety disorders during childhood and adolescence and psychosocial outcomes at age 30, and sought to address the extent to which psychopathology after age 19 mediated these relations. Method Eight hundred and sixteen participants from a large community sample were interviewed twice during adolescence, at age 24, and at age 30. They completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and young adulthood. Results Childhood anxiety only predicted less years of completed education at age 30, whereas adolescent anxiety predicted income, unemployment, maladjustment, poor coping skills, more chronic stress and life events. Adult major depressive disorder (MDD) was the only disorder predicted by childhood anxiety, whereas adolescent anxiety predicted MDD, substance (SUD) and alcohol abuse/dependence (AUD) in adulthood. No adult psychopathology mediated the relationship between childhood anxiety disorders and psychosocial outcomes at age 30. Adult MDD, SUD and AUD partially or completely mediated the association between adolescent anxiety and most domains of psychosocial functioning at age 30. Limitations The participants are ethically and geographically homogenous, and changes in the diagnostic criteria and the interview schedules across the assessment periods. Conclusion Adolescent anxiety, compared to childhood anxiety, is associated with more adverse psychosocial outcomes at age 30. Adolescent anxiety affects negative outcomes at age 30 directly and through MDD, SUD and AUD. PMID:24456837

  19. Examining Correlates of Problematic Internet Pornography Use Among University Students.

    PubMed

    Harper, Cody; Hodgins, David C

    2016-06-01

    Background and aims The phenomenon of Internet pornography (IP) addiction is gainingincreasing attention in the popular media and psychological research.What has not been tested empirically is how frequency and amount ofIP use, along with other individual characteristics, are related tosymptoms of IP addiction. Methods 105 female and 86 male university students (mean age 21) from Calgary,Canada, were administered measures of IP use, psychosocial functioning(anxiety and depression, life and relationship satisfaction), addictivepropensities, and addictive IP use. Results Men reported earlier age of exposure and more frequent currentIP use than women. Individuals not in relationships reported morefrequent use than those in relationships. Frequency of IP use wasnot generally correlated with psychosocial functioning but was significantlypositively correlated with level of IP addiction. Higher level ofIP addiction was associated with poorer psychosocial functioning andproblematic alcohol, cannabis, gambling and, in particular, videogame use. A curvilinear association was found between frequency ofIP use and level of addiction such that daily or greater IP use wasassociated with a sharp rise in addictive IP scores. Discussion The failure to find a strong significant relationship between IPuse and general psychosocial functioning suggests that the overalleffect of IP use is not necessarily harmful in and of itself. Addictiveuse of IP, which is associated with poorer psychosocial functioning,emerges when people begin to use IP daily.

  20. Psychosocial Stress and Brain Function in Adolescent Psychopathology.

    PubMed

    Quinlan, Erin Burke; Cattrell, Anna; Jia, Tianye; Artiges, Eric; Banaschewski, Tobias; Barker, Gareth; Bokde, Arun L W; Bromberg, Uli; Büchel, Christian; Brühl, Rüdiger; Conrod, Patricia J; Desrivieres, Sylvane; Flor, Herta; Frouin, Vincent; Gallinat, Jürgen; Garavan, Hugh; Gowland, Penny; Heinz, Andreas; Martinot, Jean-Luc; Paillère Martinot, Marie-Laure; Nees, Frauke; Papadopoulos-Orfanos, Dimitri; Paus, Tomáš; Poustka, Luise; Smolka, Michael N; Vetter, Nora C; Walter, Henrik; Whelan, Robert; Glennon, Jeffrey C; Buitelaar, Jan K; Happé, Francesca; Loth, Eva; Barker, Edward D; Schumann, Gunter

    2017-08-01

    The authors sought to explore how conduct, hyperactivity/inattention, and emotional symptoms are associated with neural reactivity to social-emotional stimuli, and the extent to which psychosocial stress modulates these relationships. Participants were community adolescents recruited as part of the European IMAGEN study. Bilateral amygdala regions of interest were used to assess the relationship between the three symptom domains and functional MRI neural reactivity during passive viewing of dynamic angry and neutral facial expressions. Exploratory functional connectivity and whole brain multiple regression approaches were used to analyze how the symptoms and psychosocial stress relate to other brain regions. In response to the social-emotional stimuli, adolescents with high levels of conduct or hyperactivity/inattention symptoms who had also experienced a greater number of stressful life events showed hyperactivity of the amygdala and several regions across the brain. This effect was not observed with emotional symptoms. A cluster in the midcingulate was found to be common to both conduct problems and hyperactivity symptoms. Exploratory functional connectivity analyses suggested that amygdala-precuneus connectivity is associated with hyperactivity/inattention symptoms. The results link hyperactive amygdala responses and regions critical for top-down emotional processing with high levels of psychosocial stress in individuals with greater conduct and hyperactivity/inattention symptoms. This work highlights the importance of studying how psychosocial stress affects functional brain responses to social-emotional stimuli, particularly in adolescents with externalizing symptoms.

  1. Examining Correlates of Problematic Internet Pornography Use Among University Students

    PubMed Central

    Harper, Cody; Hodgins, David C.

    2016-01-01

    Background and aims The phenomenon of Internet pornography (IP) addiction is gainingincreasing attention in the popular media and psychological research. What has not been tested empirically is how frequency and amount ofIP use, along with other individual characteristics, are related tosymptoms of IP addiction. Methods 105 female and 86 male university students (mean age 21) from Calgary,Canada, were administered measures of IP use, psychosocial functioning (anxiety and depression, life and relationship satisfaction), addictivepropensities, and addictive IP use. Results Men reported earlier age of exposure and more frequent current IP use than women. Individuals not in relationships reported more frequent use than those in relationships. Frequency of IP use wasnot generally correlated with psychosocial functioning but was significantly positively correlated with level of IP addiction. Higher level of IP addiction was associated with poorer psychosocial functioning and problematic alcohol, cannabis, gambling and, in particular, video game use. A curvilinear association was found between frequency of IP use and level of addiction such that daily or greater IP use was associated with a sharp rise in addictive IP scores. Discussion The failure to find a strong significant relationship between IP use and general psychosocial functioning suggests that the overall effect of IP use is not necessarily harmful in and of itself. Addictiveuse of IP, which is associated with poorer psychosocial functioning, emerges when people begin to use IP daily. PMID:27156383

  2. Psychosocial and Physical Effects of Adjuvant Chemotherapy

    PubMed Central

    Hislop, Thomas Gregory; Elwood, J. Mark; Waxler-Morrison, Nancy; Ragaz, Joseph; Skippen, Diane Hazel; Turner, I.D.

    1991-01-01

    Breast cancer patients younger than 55 completed a questionnaire on psychosocial factors and physical side effects shortly after diagnosis and 9 to 15 months after diagnosis. Those who had used adjuvant chemotherapy were more likely than those who had not to report physical side effects; there was little difference in psychosocial factors. Recent users were more likely than ex-users to report physical side effects, difficulties with domestic chores, and improvement in psychosocial factors. PMID:21229020

  3. Expressive writing for gay-related stress: psychosocial benefits and mechanisms underlying improvement.

    PubMed

    Pachankis, John E; Goldfried, Marvin R

    2010-02-01

    This study tested the effectiveness of an expressive writing intervention for gay men on outcomes related to psychosocial functioning. Seventy-seven gay male college students (mean age = 20.19 years, SD = 1.99) were randomly assigned to write for 20 min a day for 3 consecutive days about either (a) the most stressful or traumatic gay-related event in their lives or (b) a neutral topic. We tested an exposure-based hypothesis of written emotional expression by asking half of the participants who were assigned to write about gay-related stress to read their previous day's narrative before writing, whereas the other half did not. Posttest and 3-month follow-up outcomes were assessed with common measures of overall psychological distress, depression, physical health symptoms, and positive and negative affect. Gay-specific social functioning was assessed with measures of gay-related rejection sensitivity, gay-specific self-esteem, and items regarding openness and comfort with one's sexual orientation. Participants who wrote about gay-related stress, regardless of whether they read their previous day's writing, reported significantly greater openness with their sexual orientation 3 months following writing than participants who wrote about a neutral topic, F(1, 74) = 6.66, p < .05, eta(2) = .08. Additional analyses examined the impact of emotional engagement in the writing, severity of the expressed topic, previous disclosure of writing topic, tendency to conceal, and level of perceived social support on mental health outcomes. The findings suggest that an expressive writing task targeting gay-related stress can improve gay men's psychosocial functioning, especially openness with sexual orientation. The intervention seems to be particularly beneficial for those men who write about more severe topics and for those with lower levels of social support. The findings suggest future tests of expressive writing tasks for different aspects of stigma-related stress.

  4. Subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care.

    PubMed

    Barbe, Tammy; Kimble, Laura P; Rubenstein, Cynthia

    2018-04-01

    The aim of this study was to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care. Cognitive functioning is a critical component for nurses in the assurance of error prevention, identification and correction when caring for patients. Negative changes in nurses' cognitive and psychosocial functioning can adversely affect nursing care and patient outcomes. A descriptive correlational design with stratified random sampling. The sample included 96 nurses from the major geographic regions of the United States. Over 9 months in 2016-2017, data were collected using a web-based survey. Stepwise multiple linear regression analyses were used to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function. Overall, participants reported minimal work function impairment and low levels of subjective cognitive complaints, depression and stress. In multivariate analyses, depression was not associated with nurses' work function. However, perceived stress and subjective concerns about cognitive function were associated with greater impairment of work function. Nurses experiencing subjective cognitive complaints should be encouraged to address personal and environmental factors that are associated with their cognitive status. Additionally, stress reduction in nurses should be a high priority as a potential intervention to promote optimal functioning of nurses providing direct patient care. Healthcare institutions should integrate individual and institutional strategies to reduce factors contributing to workplace stress. © 2017 John Wiley & Sons Ltd.

  5. Social Ecology of Child Soldiers: Child, Family, and Community Determinants of Mental Health, Psychosocial Wellbeing, and Reintegration in Nepal

    PubMed Central

    Kohrt, Brandon A.; Jordans, Mark J.D.; Tol, Wietse A.; Perera, Em; Karki, Rohit; Koirala, Suraj; Upadhaya, Nawaraj

    2013-01-01

    This study employs social ecology to evaluate psychosocial wellbeing in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Scale (CPSS), and locally developed measures of function impairment and reintegration. At the child level, traumatic exposures, especially torture, predicted poor outcomes, while education improved outcomes. At the family level, conflict-related death of a relative, physical abuse in the household, and loss of wealth during the conflict predicted poor outcomes. At the community level, living in high caste Hindu communities predicted fewer reintegration supports. Ultimately, social ecology is well-suited to identify intervention foci across ecological levels, based on community differences in vulnerability and protective factors. PMID:21088102

  6. Development of a Virtual Reality Assessment of Everyday Living Skills

    PubMed Central

    Ruse, Stacy A.; Davis, Vicki G.; Atkins, Alexandra S.; Krishnan, K. Ranga R.; Fox, Kolleen H.; Harvey, Philip D.; Keefe, Richard S.E.

    2014-01-01

    Cognitive impairments affect the majority of patients with schizophrenia and these impairments predict poor long term psychosocial outcomes.  Treatment studies aimed at cognitive impairment in patients with schizophrenia not only require demonstration of improvements on cognitive tests, but also evidence that any cognitive changes lead to clinically meaningful improvements.  Measures of “functional capacity” index the extent to which individuals have the potential to perform skills required for real world functioning.  Current data do not support the recommendation of any single instrument for measurement of functional capacity.  The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is a novel, interactive gaming based measure of functional capacity that uses a realistic simulated environment to recreate routine activities of daily living. Studies are currently underway to evaluate and establish the VRFCAT’s sensitivity, reliability, validity, and practicality. This new measure of functional capacity is practical, relevant, easy to use, and has several features that improve validity and sensitivity of measurement of function in clinical trials of patients with CNS disorders. PMID:24798174

  7. The Effects of Occupational Therapy and Psychosocial Interventions on Interpersonal Functioning and Personal and Social Performance Levels of Corresponding Patients.

    PubMed

    Çakmak, Soner; Süt, Hüzün; Öztürk, Sibel; Tamam, Lut; Bal, Ufuk

    2016-09-01

    In this study, we aimed to investigate the effects of occupational therapy and psychosocial interventions on the interpersonal functioning and individual and social performance levels of corresponding patients under the heading of psychosocial treatment approaches in psychiatry clinics as well as the attitudes of the patients in regard to those interventions. In 2013, out of psychotic (schizophrenia, bipolar disorder/mania) and nonpsychotic (depression, obsessive compulsive disorder, alcohol dependence) inpatients in our clinic, 48 patients who participated in occupational activities were included in the study group and 43 patients who did not participate in these activities were included in the control group. We prepared and implemented a 3-item questionnaire constructed by our team, which probed the patients' thoughts on these occupational activities. The Interpersonal Functioning Scale (IFS) and Personal and Social Performance Scale (PSP) were applied to both groups on hospital admission and discharge; variations in scale scores were evaluated on par with sociodemographic variables, and the study and control groups were compared. In total, 91% of the study group provided positive feedback regarding the aforementioned interventions. When comparing the study and control groups, the IFS variance score of the study group did not show a significant difference with respect to that of the control group. A statistically significant difference (p<0.0001) was observed in the PSP scores. Evaluation of the PSP of the occupational activities, focusing on sociodemographics and diagnostic labels, revealed a significant improvement in nonpsychotic patients (p=0.002) compared with psychotic patients, in females (p=0.001) compared with males, in unemployed patients (p=0.0001) compared with employed patients, in single patients (p=0.002) compared with married patients, in less-educated patients (p=0.004) compared with high school graduates, and in patients younger than 45 years (p=0.002) compared with those older than 45 years. The findings of our study showed coherence with the literature regarding similar studies conducted on psychotic subgroups. The results demonstrated significantly positive repercussions, specifically in the treatment of nonpsychotic patients; both groups benefited from occupational activities, as shown by improvements in all psychiatric inpatients' PSP scores in comparison with scores of the control group. We concluded that the recruitment of psychosocial treatment approaches enhanced personal and social performance in the patient groups, thereby leading to additional clinical benefits.

  8. Psychosocial Aspects of Siblings' Experiences of Pediatric Cancer.

    ERIC Educational Resources Information Center

    Shapiro, Marla; Brack, Gregory

    1994-01-01

    Identified those aspects of experiences of siblings of children with cancer that might have impact on school functioning. Also examined extent to which parents and siblings concurred in their reports of siblings' psychosocial functioning and adjustment. Findings from 15 children and adults attending pediatric oncology camp revealed that most…

  9. Social Networks, Support, and Psychosocial Functioning among American Indian Women in Treatment

    ERIC Educational Resources Information Center

    Chong, Jenny; Lopez, Darlene

    2005-01-01

    The relationship of social networks and social support to the psychosocial functioning (self-efficacy, self-esteem, anxiety, depression, and hostility) of 159 American Indian women undergoing residential substance abuse treatment at Native American Connections was assessed. Social support and active participation by clients' families during…

  10. A Genetically Informed Study of Associations between Family Functioning and Child Psychosocial Adjustment

    ERIC Educational Resources Information Center

    Schermerhorn, Alice C.; D'Onofrio, Brian M.; Turkheimer, Eric; Ganiban, Jody M.; Spotts, Erica L.; Lichtenstein, Paul; Reiss, David; Neiderhiser, Jenae M.

    2011-01-01

    Research has documented associations between family functioning and offspring psychosocial adjustment, but questions remain regarding whether these associations are partly due to confounding genetic factors and other environmental factors. The current study used a genetically informed approach, the Children of Twins design, to explore the…

  11. Associations between Past Bullying Experiences and Psychosocial and Academic Functioning among College Students

    ERIC Educational Resources Information Center

    Holt, Melissa K.; Greif Green, Jennifer; Reid, Gerald; DiMeo, Amanda; Espelage, Dorothy L.; Felix, Erika D.; Furlong, Michael J.; Poteat, V. Paul; Sharkey, Jill D.

    2014-01-01

    Objectives: This study examined whether childhood bullying victimization was associated with psychosocial and academic functioning at college. Participants: The sample consisted of 413 first-year students from a large northeastern university. Methods: Students completed an online survey in February 2012 that included items assessing past bullying…

  12. Parent Autonomy Support, Academic Achievement, and Psychosocial Functioning: A Meta-Analysis of Research

    ERIC Educational Resources Information Center

    Vasquez, Ariana C.; Patall, Erika A.; Fong, Carlton J.; Corrigan, Andrew S.; Pine, Lisa

    2016-01-01

    A meta-analysis of 36 studies examining the relations between parent autonomy support (PAS) and child outcomes indicated that PAS was related to greater academic achievement and indicators of adaptive psychosocial functioning, including autonomous motivation, psychological health, perceived competence, engagement, and positive attitudes toward…

  13. Psychosocial Functioning of Learning-Disabled Children: Replicability of Statistically Derived Subtypes.

    ERIC Educational Resources Information Center

    Fuerst, Darren R.; And Others

    1989-01-01

    Investigated Personality Inventory for Children scores of 132 learning-disabled children between ages of 6 and 12 years. Results indicated that learning-disabled children comprised heterogeneous population in terms of psychosocial functioning and that subtypes of learning-disabled children with similar patterns of socioemotional adjustment can be…

  14. Clinical Evidence of Exercise Benefits for Stroke.

    PubMed

    Han, Peipei; Zhang, Wen; Kang, Li; Ma, Yixuan; Fu, Liyuan; Jia, Liye; Yu, Hairui; Chen, Xiaoyu; Hou, Lin; Wang, Lu; Yu, Xing; Kohzuki, Masahiro; Guo, Qi

    2017-01-01

    Even though stroke is the third, not the first, most common cause of disability-adjusted life years in developed countries, it is one of the most expensive to treat. Part of the expense is due to secondary problems in the post-stroke period including: cognition, memory, attention span, pain, sensation loss, psychological issues, and problems with mobility and balance. Research has identified that exercise has both positive physical and psychosocial effects for post-stroke patients. Therefore, this scientific statement provides an overview on exercise rehabilitation for post-stroke patients.We will use systematic literature reviews, clinical and epidemiology reports, published morbidity and mortality studies, clinical and public health guidelines, patient files, and authoritative statements to support this overview.Evidence clearly supports the use of various kinds of exercise training (e.g., aerobic, strength, flexibility, neuromuscular, and traditional Chinese exercise) for stroke survivors. Aerobic exercise, the main form of cardiac rehabilitation, may play an important role in improving aerobic fitness, cardiovascular fitness, cognitive abilities, walking speed and endurance, balance, quality of life, mobility, and other health outcomes among stroke patients. Strength exercise, included in national stroke guidelines and recommended for general health promotion for stroke survivors, can lead to improvements in functionality, psychosocial aspects, and quality of life for post-stroke patients. Flexibility exercises can relieve muscle spasticity problems, improve motor function, range of motion, and prevent contractures. Stretching exercises can also prevent joint contractures, muscle shortening, decrease spasticity, reduce joint stiffness and improve a post-stroke patient's overall function. Neuromuscular exercises can improve activities of daily living (ADL) through coordination and balance activities. Traditional Chinese exercises are used to improve walking and balance ability as well as increase muscle strength, which is important for post-stroke patients.The present evidence strongly supports the power of exercise for post-stroke patients, which in this study combined aerobic exercises, strength training, flexibility exercises, neuromuscular exercises, and traditional Chinese exercises. This research can encourage post-stroke survivors to consider the importance of exercise in the rehabilitation process.

  15. Athletic Training Educators' Instructional Methods and Confidence in Graduating Students' Abilities regarding Psychosocial Intervention and Referral

    ERIC Educational Resources Information Center

    Hamson-Utley, Jennifer Jordan; Stiller-Ostrowski, Jennifer L.

    2011-01-01

    Context: Graduating athletic training students must consider both physical and mental aspects of injury to fully rehabilitate the injured athlete; however, programs may not be preparing students to apply psychosocial strategies that can improve the recovery process. Objective: To examine Psychosocial Intervention and Referral (PIR) content area…

  16. A Systematic Review of Psychosocial Interventions for Adults with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Bishop-Fitzpatrick, Lauren; Minshew, Nancy J.; Eack, Shaun M.

    2013-01-01

    Individuals with autism spectrum disorders (ASD) spend the majority of their lives as adults, and psychosocial interventions show promise for improving outcomes in this population. This research conducted a systematic review of all peer-review studies evaluating psychosocial interventions for adults with ASD. A total of 1,217 studies were…

  17. Family Violence and Aggression and Their Associations with Psychosocial Functioning in Jamaican Adolescents

    ERIC Educational Resources Information Center

    Smith, Delores E.; Moore, Todd M.

    2013-01-01

    The purpose of the current study was to examine the relationships among selected family interaction variables and psychosocial outcomes in a sample of Jamaican adolescents. The authors hypothesized that adolescent psychosocial outcomes would be negatively associated with physical violence, verbal aggression would be more potent than physical…

  18. A randomized controlled trial of a resilience-based intervention on psychosocial well-being of children affected by HIV/AIDS: Effects at 6- and 12-month follow-up.

    PubMed

    Li, Xiaoming; Harrison, Sayward E; Fairchild, Amanda J; Chi, Peilian; Zhao, Junfeng; Zhao, Guoxiang

    2017-10-01

    Global literature suggests that resilience-based interventions may yield improvements in psychosocial well-being for vulnerable children, but limited data are available regarding the efficacy of such interventions among children affected by parental HIV/AIDS. To evaluate initial efficacy of a multi-level resilience-based intervention among children affected by parental HIV/AIDS in China in improving children's psychosocial well-being and resilience-related outcomes. Seven hundred-ninety children, 6-17 years of age, were recruited from rural China. Children were either AIDS orphans or were living with one or two parents infected with HIV/AIDS. Children and primary caregivers were randomly assigned to participate in a 4-arm trial to evaluate the Child-Caregiver-Advocacy Resilience (ChildCARE) intervention. This resilience-based psychosocial intervention provides programming at three levels (child, caregiver, community). Survey data were collected at baseline, 6-months, and 12-months in order to examine efficacy of the child-only and child + caregiver arms in improving children's psychological resilience. Intervention groups displayed improvements in several resilience-related outcomes at 6- and 12-month follow-ups, including self-reported coping, hopefulness, emotional regulation, and self-control. The child-only intervention arm showed some fading of intervention effects by 12-months. Preliminary findings suggest that the ChildCARE intervention is efficacious in promoting psychosocial well-being of children affected by parental HIV/AIDS in rural China. Targeting both children and caregivers for psychosocial intervention may be effective in improving children's resilience. Additional evaluation and modifications, including the inclusion of booster sessions, should be considered to further strengthen the program. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. A cognitive behavioral based group intervention for children with a chronic illness and their parents: a multicentre randomized controlled trial.

    PubMed

    Scholten, Linde; Willemen, Agnes M; Grootenhuis, Martha A; Maurice-Stam, Heleen; Schuengel, Carlo; Last, Bob F

    2011-07-14

    Coping with a chronic illness (CI) challenges children's psychosocial functioning and wellbeing. Cognitive-behavioral intervention programs that focus on teaching the active use of coping strategies may prevent children with CI from developing psychosocial problems. Involvement of parents in the intervention program may enhance the use of learned coping strategies in daily life, especially on the long-term. The primary aim of the present study is to examine the effectiveness of a cognitive behavioral based group intervention (called 'Op Koers') 1 for children with CI and of a parallel intervention for their parents. A secondary objective is to investigate why and for whom this intervention works, in order to understand the underlying mechanisms of the intervention effect. This study is a multicentre randomized controlled trial. Participants are children (8 to 18 years of age) with a chronic illness, and their parents, recruited from seven participating hospitals in the Netherlands. Participants are randomly allocated to two intervention groups (the child intervention group and the child intervention combined with a parent program) and a wait-list control group. Primary outcomes are child psychosocial functioning, wellbeing and child disease related coping skills. Secondary outcomes are child quality of life, child general coping skills, child self-perception, parental stress, quality of parent-child interaction, and parental perceived vulnerability. Outcomes are evaluated at baseline, after 6 weeks of treatment, and at a 6 and 12-month follow-up period. The analyses will be performed on the basis of an intention-to-treat population. This study evaluates the effectiveness of a group intervention improving psychosocial functioning in children with CI and their parents. If proven effective, the intervention will be implemented in clinical practice. Strengths and limitations of the study design are discussed. Current Controlled Trials ISRCTN60919570.

  20. Group-based parent training programmes for improving parental psychosocial health.

    PubMed

    Barlow, Jane; Smailagic, Nadja; Huband, Nick; Roloff, Verena; Bennett, Cathy

    2014-05-17

    Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting programmes have been shown to have an impact on the emotional and behavioural adjustment of children, but there have been no reviews to date of their impact on parental psychosocial wellbeing. To address whether group-based parenting programmes are effective in improving parental psychosocial wellbeing (for example, anxiety, depression, guilt, confidence). We searched the following databases on 5 December 2011: CENTRAL (2011, Issue 4), MEDLINE (1950 to November 2011), EMBASE (1980 to week 48, 2011), BIOSIS (1970 to 2 December 2011), CINAHL (1982 to November 2011), PsycINFO (1970 to November week 5, 2011), ERIC (1966 to November 2011), Sociological Abstracts (1952 to November 2011), Social Science Citation Index (1970 to 2 December 2011), metaRegister of Controlled Trials (5 December 2011), NSPCC Library (5 December 2011). We searched ASSIA (1980 to current) on 10 November 2012 and the National Research Register was last searched in 2005. We included randomised controlled trials that compared a group-based parenting programme with a control condition and used at least one standardised measure of parental psychosocial health. Control conditions could be waiting-list, no treatment, treatment as usual or a placebo. At least two review authors extracted data independently and assessed the risk of bias in each study. We examined the studies for any information on adverse effects. We contacted authors where information was missing from trial reports. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation. We included 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive-behavioural and multimodal. Overall, we found that group-based parenting programmes led to statistically significant short-term improvements in depression (standardised mean difference (SMD) -0.17, 95% confidence interval (CI) -0.28 to -0.07), anxiety (SMD -0.22, 95% CI -0.43 to -0.01), stress (SMD -0.29, 95% CI -0.42 to -0.15), anger (SMD -0.60, 95% CI -1.00 to -0.20), guilt (SMD -0.79, 95% CI -1.18 to -0.41), confidence (SMD -0.34, 95% CI -0.51 to -0.17) and satisfaction with the partner relationship (SMD -0.28, 95% CI -0.47 to -0.09). However, only stress and confidence continued to be statistically significant at six month follow-up, and none were significant at one year. There was no evidence of any effect on self-esteem (SMD -0.01, 95% CI -0.45 to 0.42). None of the trials reported on aggression or adverse effects.The limited data that explicitly focused on outcomes for fathers showed a statistically significant short-term improvement in paternal stress (SMD -0.43, 95% CI -0.79 to -0.06). We were unable to combine data for other outcomes and individual study results were inconclusive in terms of any effect on depressive symptoms, confidence or partner satisfaction. The findings of this review support the use of parenting programmes to improve the short-term psychosocial wellbeing of parents. Further input may be required to ensure that these results are maintained. More research is needed that explicitly addresses the benefits for fathers, and that examines the comparative effectiveness of different types of programme along with the mechanisms by which such programmes bring about improvements in parental psychosocial functioning.

  1. Group-based parent training programmes for improving parental psychosocial health.

    PubMed

    Barlow, Jane; Smailagic, Nadja; Huband, Nick; Roloff, Verena; Bennett, Cathy

    2012-06-13

    Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting programmes have been shown to have an impact on the emotional and behavioural adjustment of children, but there have been no reviews to date of their impact on parental psychosocial wellbeing. To address whether group-based parenting programmes are effective in improving parental psychosocial wellbeing (for example, anxiety, depression, guilt, confidence). We searched the following databases on 5 December 2012: CENTRAL (2011, Issue 4), MEDLINE (1950 to November 2011), EMBASE (1980 to week 48, 2011), BIOSIS (1970 to 2 December 2011), CINAHL (1982 to November 2011), PsycINFO (1970 to November week 5, 2011), ERIC (1966 to November 2011), Sociological Abstracts (1952 to November 2011), Social Science Citation Index (1970 to 2 December 2011), metaRegister of Controlled Trials (5 December 2011), NSPCC Library (5 December 2011). We searched ASSIA (1980 to current) on 10 November 2012 and the National Research Register was last searched in 2005. We included randomised controlled trials that compared a group-based parenting programme with a control condition and used at least one standardised measure of parental psychosocial health. Control conditions could be waiting-list, no treatment, treatment as usual or a placebo. At least two review authors extracted data independently and assessed the risk of bias in each study. We examined the studies for any information on adverse effects. We contacted authors where information was missing from trial reports. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation. We included 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive-behavioural and multimodal. Overall, we found that group-based parenting programmes led to statistically significant short-term improvements in depression (standardised mean difference (SMD) -0.17, 95% confidence interval (CI) -0.28 to -0.07), anxiety (SMD -0.22, 95% CI -0.43 to -0.01), stress (SMD -0.29, 95% CI -0.42 to -0.15), anger (SMD -0.60, 95% CI -1.00 to -0.20), guilt (SMD -0.79, 95% CI -1.18 to -0.41), confidence (SMD -0.34, 95% CI -0.51 to -0.17) and satisfaction with the partner relationship (SMD -0.28, 95% CI -0.47 to -0.09). However, only stress and confidence continued to be statistically significant at six month follow-up, and none were significant at one year. There was no evidence of any effect on self-esteem (SMD -0.01, 95% CI -0.45 to 0.42). None of the trials reported on aggression or adverse effects.The limited data that explicitly focused on outcomes for fathers showed a statistically significant short-term improvement in paternal stress (SMD -0.43, 95% CI -0.79 to -0.06). We were unable to combine data for other outcomes and individual study results were inconclusive in terms of any effect on depressive symptoms, confidence or partner satisfaction. The findings of this review support the use of parenting programmes to improve the short-term psychosocial wellbeing of parents. Further input may be required to ensure that these results are maintained. More research is needed that explicitly addresses the benefits for fathers, and that examines the comparative effectiveness of different types of programme along with the mechanisms by which such programmes bring about improvements in parental psychosocial functioning.

  2. One-year prospective replication study of an untreated sample of community dysthymia subjects.

    PubMed

    McCullough, J P; McCune, K J; Kaye, A L; Braith, J A; Friend, R; Roberts, W C; Belyea-Caldwell, S; Norris, S L; Hampton, C

    1994-07-01

    This study replicates an earlier naturalistic-prospective investigation of nontreatment, community DSM-III-R dysthymia subjects. Major goals were to determine spontaneous remission rates and monitor the stability of psychosocial functioning levels over time. Twenty-four dysthymia subjects were followed for 1 year. Three remissions (13%) were diagnosed at the final interview. At a 4-year diagnostic follow-up contact with the remitters only, one remitter had relapsed and two remained in remission. Subjects were monitored for depressive symptom intensity, personality functioning, general medical distress, cognitive functioning, coping stylistics, interpersonal functioning, quality of their social support resources, and general family functioning. Stable levels of psychosocial functioning were maintained across all measures over the 1-year period. Current psychometric findings confirm the conclusions of the earlier nontreatment prospective study that dysthymia is a chronic mood disorder with stable psychosocial features and is unlikely to remit spontaneously over time.

  3. Provision of mental health services in resource-poor settings: a randomised trial comparing counselling with routine medical treatment in North Afghanistan (Mazar-e-Sharif)

    PubMed Central

    2012-01-01

    Background Psychosocial stress caused by war, ongoing conflict, lack of security, and restricted access to resources promotes mental suffering and diseases in many resource-poor countries. In an exemplary setting, the present study compares the efficacy of psychosocial counselling with routine pharmacological treatment in a randomised trial in Mazar-e-Sharif (Afghanistan). Methods Help seeking Afghan women (N = 61), who were diagnosed with mental health symptoms by local physicians either received routine medical treatment(treatment as usual) or psychosocial counselling (5-8 sessions) following a specifically developed manualised treatment protocol. Primary outcome measures were symptoms of depression and anxiety assessed before treatment and at follow-up using the Hopkins Symptom Checklist and the Mini-International Neuropsychiatric Interview. Secondary outcome measures were psychosocial stressors and coping mechanisms. Results At 3-month follow-up, psychosocial counselling patients showed high improvements with respect to the severity of symptoms of depression and anxiety. In addition, they reported a reduction of psychosocial stressors and showed an enhancement of coping strategies. At the same time, the severity of symptoms, the quantity of psychosocial stressors and coping mechanisms did not improve in patients receiving routine medical treatment. Conclusion These results indicate that psychosocial counselling can be an effective treatment for mental illnesses even for those living in ongoing unsafe environments. Trial registration NCT01155687 PMID:22375947

  4. Salute to the sun: a new dawn in yoga therapy for breast cancer.

    PubMed

    Galliford, Melissa; Robinson, Stephanie; Bridge, Pete; Carmichael, MaryAnn

    2017-09-01

    Interest in the application of yoga for health benefits in western medicine is growing rapidly, with a significant rise in publications. The purpose of this systematic review is to determine whether the inclusion of yoga therapy to the treatment of breast cancer can improve the patient's physical and psychosocial quality of life (QoL). A search of peer reviewed journal articles published between January 2009 and July 2014 was conducted. Studies were included if they had more than 15 study participants, included interventions such as mindfulness-based stress reduction (MBSR) or yoga therapy with or without comparison groups and had stated physical or psychological outcomes. Screening identified 38 appropriate articles. The most reported psychosocial benefits of yoga therapy were anxiety, emotional and social functioning, stress, depression and global QoL. The most reported physical benefits of yoga therapy were improved salivary cortisol readings, sleep quality and lymphocyte apoptosis. Benefits in these areas were linked strongly with the yoga interventions, in addition to significant improvement in overall QoL. The evidence supports the use of yoga therapy to improve the physical and psychosocial QoL for breast cancer patients with a range of benefits relevant to radiation therapy. Future studies are recommended to confirm these benefits. Evidence-based recommendations for implementation of a yoga therapy programme have been derived and included within this review. Long-term follow-up is necessary with these programmes to assess the efficacy of the yoga intervention in terms of sustainability and patient outcomes. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

  5. Physical and psychosocial aspects of adolescent and young adults after allogeneic hematopoietic stem-cell transplantation: results from a prospective multicenter trial.

    PubMed

    Pulewka, Kristin; Wolff, Daniel; Herzberg, Philipp Y; Greinix, Hildegard; Heussner, Pia; Mumm, Friederike H A; von Harsdorf, Stephanie; Rieger, Kathrin; Hemmati, Philipp; Hochhaus, Andreas; Hilgendorf, Inken

    2017-08-01

    Allogeneic hematopoietic stem-cell transplantation (alloHSCT) is physically and psychosocially demanding. Among transplant recipients, adolescent and young adults (AYA) represent a special group, as disease occurs early in life, resulting in the prospect of long survival time and high burden of alloHSCT sequelae. However, data focusing on AYA undergoing alloHSCT are rare. Data resulting from a prospective multicenter trial initially focusing on graft-versus-host disease (GvHD) after alloHSCT were reused to analyse the differences between AYA and elderly patients. In total, data of 205 alloHSCT recipients were evaluated. Patients completed the FACT-BMT, HAP, SF-36, 24-AM, LOT-R, BSSS, HADS, and GvHD questionnaires. Median age of AYA and non-AYA patients was 29 and 52 years. Using 24-AM-Test, evaluating personality traits, non-AYA reported to be more conscientious (p = 0.033). However, AYA described higher quality of life regarding physical role functioning (p = 0.001), physical functioning (p = 0.002), bodily pain (p = 0.023), and emotional role function (p = 0.027) in the SF-36. General health perception, vitality, social role functioning, and mental health were comparable among both groups. On HAP scale, AYA reported higher maximum (p = 0.003) and adjusted activity scores (p = 0.002), but showed similar restrictions regarding activity, self-supply, and self-determination. AYA represent a particular group characterized by higher physical well-being and activity scores, and significantly vary from non-AYA patients in psychosocial aspects. Studies covering distinctive features of AYA undergoing alloHSCT are warranted to improve awareness of the special needs of this group.

  6. Sensation seeking, coping with stress, and readiness to engage in therapy: does ego development influence the psychosocial functioning of substance-abusing mothers?

    PubMed

    David, Daryn H; McMahon, Thomas J; Luthar, Suniya L; Suchman, Nancy E

    2012-04-01

    Ego development, the capacity to derive coherent, nuanced meaning from one's life experiences, often has significant impact on psychosocial adjustment during adulthood. Research with nonclinical populations has indicated links between higher ego development and healthy emotional coping and interpersonal relationships. Emerging research with substance-abusing mothers suggests that higher levels of ego development are associated with improved parenting but also with increased rates of psychopathology. Less is known about how ego development is related to other psychosocial factors important for substance-abusing mothers' functioning and capacity to parent, including the proclivity to engage in risky behaviors, adaptive coping behaviors, and readiness to engage in psychotherapy. The present study examines these links. Participants included 182 methadonemaintained women who expressed interest in a randomized clinical trial testing the efficacy of a relational parenting intervention for substance-abusing mothers (Luthar, Suchman, & Altomare, 2007). Data were analyzed using a series of MANCOVAs and ANCOVAs controlling for maternal IQ and depression. Mothers with higher levels of ego development reported more adaptive coping techniques and greater readiness to engage in psychotherapy but also reported a heightened desire for strong sensations. Findings are discussed in light of mothers' psychological processes and parenting capacities. The significance of findings for developing parenting interventions for substance-abusing mothers is also discussed. © 2012 American Orthopsychiatric Association.

  7. Personal Identity Development in Hispanic Immigrant Adolescents: Links with Positive Psychosocial Functioning, Depressive Symptoms, and Externalizing Problems

    PubMed Central

    Unger, Jennifer B.; Meca, Alan; Lorenzo-Blanco, Elma I.; Baezconde-Garbanati, Lourdes; Cano, Miguel Ángel; Piña-Watson, Brandy; Szapocznik, José; Zamboanga, Byron L.; Córdova, David; Romero, Andrea J.; Lee, Tae Kyoung; Soto, Daniel W.; Villamar, Juan A.; Lizzi, Karina M.; Des Rosiers, Sabrina E.; Pattarroyo, Monica

    2016-01-01

    The present study was designed to examine trajectories of personal identity coherence and confusion among Hispanic recent-immigrant adolescents, as well as the effects of these trajectories on psychosocial and risk-taking outcomes. Personal identity is extremely important in anchoring young immigrants during a time of acute cultural change. A sample of 302 recently immigrated (5 years or less in the United States at baseline) Hispanic adolescents (Mage = 14.51 years at baseline; SD = 0.88 years, range 14–17) from Miami and Los Angeles (47 % girls) completed measures of personal identity coherence and confusion at the first five waves of a six-wave longitudinal study; and reported on positive psychosocial functioning, depressive symptoms, and externalizing problems at baseline and at Time 6. Results indicated that identity coherence increased linearly across time, but that there were no significant changes in confusion over time and no individual differences in confusion trajectories. Higher baseline levels of, and improvements in, coherence predicted higher levels of self-esteem, optimism, and prosocial behavior at the final study timepoint. Higher baseline levels of confusion predicted lower self-esteem, greater depressive symptoms, more aggressive behavior, and more rule breaking at the final study timepoint. These results are discussed in terms of the importance of personal identity for Hispanic immigrant adolescents, and in terms of implications for intervention. PMID:27882458

  8. Personal Identity Development in Hispanic Immigrant Adolescents: Links with Positive Psychosocial Functioning, Depressive Symptoms, and Externalizing Problems.

    PubMed

    Schwartz, Seth J; Unger, Jennifer B; Meca, Alan; Lorenzo-Blanco, Elma I; Baezconde-Garbanati, Lourdes; Cano, Miguel Ángel; Piña-Watson, Brandy; Szapocznik, José; Zamboanga, Byron L; Córdova, David; Romero, Andrea J; Lee, Tae Kyoung; Soto, Daniel W; Villamar, Juan A; Lizzi, Karina M; Des Rosiers, Sabrina E; Pattarroyo, Monica

    2017-04-01

    The present study was designed to examine trajectories of personal identity coherence and confusion among Hispanic recent-immigrant adolescents, as well as the effects of these trajectories on psychosocial and risk-taking outcomes. Personal identity is extremely important in anchoring young immigrants during a time of acute cultural change. A sample of 302 recently immigrated (5 years or less in the United States at baseline) Hispanic adolescents (M age  = 14.51 years at baseline; SD = 0.88 years, range 14-17) from Miami and Los Angeles (47 % girls) completed measures of personal identity coherence and confusion at the first five waves of a six-wave longitudinal study; and reported on positive psychosocial functioning, depressive symptoms, and externalizing problems at baseline and at Time 6. Results indicated that identity coherence increased linearly across time, but that there were no significant changes in confusion over time and no individual differences in confusion trajectories. Higher baseline levels of, and improvements in, coherence predicted higher levels of self-esteem, optimism, and prosocial behavior at the final study timepoint. Higher baseline levels of confusion predicted lower self-esteem, greater depressive symptoms, more aggressive behavior, and more rule breaking at the final study timepoint. These results are discussed in terms of the importance of personal identity for Hispanic immigrant adolescents, and in terms of implications for intervention.

  9. Sensation Seeking, Coping With Stress, and Readiness to Engage in Therapy: Does Ego Development Influence the Psychosocial Functioning of Substance-Abusing Mothers?

    PubMed Central

    David, Daryn H.; McMahon, Thomas J.; Luthar, Suniya L.; Suchman, Nancy E.

    2012-01-01

    Ego development, the capacity to derive coherent, nuanced meaning from one’s life experiences, often has significant impact on psychosocial adjustment during adulthood. Research with nonclinical populations has indicated links between higher ego development and healthy emotional coping and interpersonal relationships. Emerging research with substance-abusing mothers suggests that higher levels of ego development are associated with improved parenting but also with increased rates of psychopathology. Less is known about how ego development is related to other psychosocial factors important for substance-abusing mothers’ functioning and capacity to parent, including the proclivity to engage in risky behaviors, adaptive coping behaviors, and readiness to engage in psychotherapy. The present study examines these links. Participants included 182 methadone-maintained women who expressed interest in a randomized clinical trial testing the efficacy of a relational parenting intervention for substance-abusing mothers (Luthar, Suchman, & Altomare, 2007). Data were analyzed using a series of MANCOVAs and ANCOVAs controlling for maternal IQ and depression. Mothers with higher levels of ego development reported more adaptive coping techniques and greater readiness to engage in psychotherapy but also reported a heightened desire for strong sensations. Findings are discussed in light of mothers’ psychological processes and parenting capacities. The significance of findings for developing parenting interventions for substance-abusing mothers is also discussed. PMID:22506525

  10. Psychosocial functioning in pediatric patients with pectus excavatum and pectus carinatum.

    PubMed

    Bahadir, Aliye Tuğba; Kuru Bektaşoğlu, Pınar; Çakiroğlu Eser, Aylin; Afacan, Ceyda; Yüksel, Mustafa

    2017-06-12

    Pectus excavatum and pectus carinatum are the most commonly seen anterior chest wall deformities. Recent studies reveal that minimal invasive repair of pectus deformities improves the quality of life. Our aim is to assess the psychosocial functioning and sociodemographic characteristics of pediatric patients with pectus deformities and evaluate the differences between patients operated on with minimal invasive repair techniques and nonoperated patients.  Thirty-two patients with pectus deformities who were operated on 6 months or more before and 31 nonoperated patients participated in the study. The Children's Depression Inventory, Piers-Harris Children's Self-Concept Scale, Capa Social Phobia Scale for Children and Adolescents, Strengths and Difficulties Questionnaire - Self-Report Version (SDQ-SR), and State-Trait Anxiety Inventory for Children - Trait Version were completed by the patients. The SDQ-Parent Report Version (SDQ-PR) was completed by their parents.  There were no statistically significant differences between operated and nonoperated patient groups in terms of total scores on the psychiatric rating scales. Prosocial behavior subscale scores in SDQ-SR (P = 0.013) and SDQ-PR (P = 0.019) were lower in the operated group. Prosocial behavior levels were lower in the operated group. Further exploration of the psychosocial profile of pediatric patients with pectus deformities would better elucidate their needs in the course of their socioemotional development.

  11. Social-Emotional and Behavioral Assessment in Culturally and Linguistically Diverse Learner Populations: An Examination of the Validity and Reliability of the Social Skills Improvement System in School-Aged Spanish-Speaking English Language Learners

    ERIC Educational Resources Information Center

    Mission, Paige Lauren

    2016-01-01

    Social-emotional development, psychosocial functioning, and relational experiences have been shown to impact academic achievement and psychological well-being. Social skills have been identified as being particularly critical in promoting mental health and life-long success. Children with well-developed social skills (e.g., sharing, being…

  12. Solving medical mysteries: hidden stresses and unexplained symptoms.

    PubMed

    Clarke, David D

    2016-09-01

    Medically unexplained symptoms and chronic functional syndromes are common but few healthcare professionals have had formal training about their connection to psychosocial issues. A systematic approach to diagnosis and treatment based on experience with over 7000 of these patients is described. Outcomes improve with assessment for and treatment of current life stresses, the prolonged impact of adversity in childhood and somatic presentations of depression, post-traumatic stress, and anxiety disorders.

  13. Sex and intimacy among patients with implantable left-ventricular assist devices.

    PubMed

    Marcuccilli, Linda; Casida, Jesus Jessie; Peters, Rosalind M; Wright, Susan

    2011-01-01

    Left-ventricular assist devices (LVADs) sustain and improve the quality of life of people living with an advanced stage of heart failure. Past research focused on the development and advancement of LVAD technology, complications, and survival rates. Limited research addressed the psychosocial aspects of living with an LVAD, yet research related to sexual functioning and intimacy is lacking. The purpose of this study was to explore and describe sex and intimacy among adults living with an LVAD. We used an interpretive phenomenological study to explore the experiences of adults living with a long-term implantable LVAD, including the effect of the LVAD on their intimate and sexual functioning. Semistructured interviews were conducted with 7 men and 2 women, 31 to 70 years of age, who had lived with the LVAD at home for at least 3 months. Interviews were audiorecorded and transcribed. The wholistic and selective approach by van Manen (Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Albany, NY: SUNY Press; 1990) guided the analysis and interpretation of the transcribed interviews. Data were organized and coded into words and phrases using qualitative software. Three themes emerged from the data: (a) improved sexual relations with LVAD, (b) sexual adjustment, and (c) nonsexual intimacy. The themes identified were consistent with the concept of normalcy from the theory of self-care. Participants reported that as the LVAD improved their overall health, their sexual functioning also improved. Participants also reported an increased sense of connectedness and intimacy with their partners even in the absence of sexual intercourse. Participants discussed ways in which they continued to develop intimate relationships even in the presence of limitations in structural and functional integrity. The knowledge derived from this study can be used as a guide for healthcare providers in counseling LVAD recipients on psychosocial and sexual health essential for achieving an optimum quality of life.

  14. Parental care and overprotection of children with cystic fibrosis.

    PubMed

    Cappelli, M; McGrath, P J; MacDonald, N E; Katsanis, J; Lascelles, M

    1989-09-01

    Parental overprotection has often been clinically associated with the psychological maladjustment of children with a chronic disease. The purpose of this study was to examine parental care and overprotection in children with cystic fibrosis compared to healthy controls. Results indicated no differences in the level of parental care or overprotection between controls and children with cystic fibrosis. However, a number of significant correlations were found between parental care and overprotection and children's psychosocial functioning. In particular, positive correlations were found between parental overprotection and poor psychosocial functioning in children with cystic fibrosis, whereas, poor psychosocial functioning in healthy children was associated with lack of parental care. Parental overprotection and care appear to play important roles in the emotional and psychological functioning of healthy and chronically ill children.

  15. General functioning predicts reward and punishment learning in schizophrenia.

    PubMed

    Somlai, Zsuzsanna; Moustafa, Ahmed A; Kéri, Szabolcs; Myers, Catherine E; Gluck, Mark A

    2011-04-01

    Previous studies investigating feedback-driven reinforcement learning in patients with schizophrenia have provided mixed results. In this study, we explored the clinical predictors of reward and punishment learning using a probabilistic classification learning task. Patients with schizophrenia (n=40) performed similarly to healthy controls (n=30) on the classification learning task. However, more severe negative and general symptoms were associated with lower reward-learning performance, whereas poorer general psychosocial functioning was correlated with both lower reward- and punishment-learning performances. Multiple linear regression analyses indicated that general psychosocial functioning was the only significant predictor of reinforcement learning performance when education, antipsychotic dose, and positive, negative and general symptoms were included in the analysis. These results suggest a close relationship between reinforcement learning and general psychosocial functioning in schizophrenia. Published by Elsevier B.V.

  16. Quality of life and psychological consequences in elderly patients after a hip fracture: a review

    PubMed Central

    Alexiou, Konstantinos I; Roushias, Andreas; Varitimidis, Sokratis E; Malizos, Konstantinos N

    2018-01-01

    Fractures due to fragility of the bone around the hip joint have become a major public health issue, presenting with an increasing incidence due to the growth of the elderly population. The purpose of this review was to evaluate the impact of hip fractures on the quality of life (QoL), health status (HS), functioning, and psychological parameters, and factors influencing the outcome and the appropriate interventions for improvement of elderly patients. A systematic electronic search of the relevant literature was carried out using the CINAHL, Cochrane, EMBASE, Medline (OvidSP), and PubMed databases spanning the time period from their establishment up to January 2017. Forty-nine randomized controlled trials or prospective cohort studies reporting the QoL and psychological outcomes were assessed by using standardized questionnaires. Patients with a hip fracture who were older than 65 years, were included in the analysis. In the majority of elderly patients, the hip fracture seriously affected physical and mental functioning and exerted a severe impact on their HS and health-related QoL (HRQoL). Moreover, most of the patients did not return to prefracture levels of performance regarding both the parameters. The levels of mental, physical, and nutritional status, prior to the fracture, comorbidity, and female gender, in addition to the postoperative pain, complications, and the length of hospital stay, were the factors associated with the outcome. Psychosocial factors and symptoms of depression could increase pain severity and emotional distress. For the displaced femoral neck fractures, the treatment with total hip arthroplasty or hemiarthroplasty, when compared to the treatment with internal fixation, provided a better functional outcome. Supportive rehabilitation programs, complemented by psychotherapy and nutritional supplementation prior to and after surgery, provided beneficial effects on the HS and the psychosocial dimension of the more debilitated patients’ lives. Lack of consensus concerning the most appropriate HRQoL questionnaires to screen and identify those patients with more difficulties in the psychosocial functions, demonstrates the necessity for further research to assess the newer outcome measurement tools, which might improve our understanding for better care of patients with hip fractures. PMID:29416322

  17. Psychosocial issues in children and adolescents with HIV infection evaluated with a World Health Organization age-specific descriptor system.

    PubMed

    Giannattasio, Antonietta; Officioso, Annunziata; Continisio, Grazia Isabella; Griso, Giovanna; Storace, Cinzia; Coppini, Simonetta; Longhi, Daniela; Mango, Carmela; Guarino, Alfredo; Badolato, Raffaele; Pisacane, Alfredo

    2011-01-01

    After active antiretroviral therapy, children with HIV are clinically well, whereas psychosocial issues continue to influence their quality of life. The International Classification of Functioning, Disability and Health (ICF) of the World Health Organization evaluates health status and environmental and social factors associated with health. We investigated the efficacy of the ICF to describe the health status and needs of a cohort of children and adolescents with HIV seen at a reference center for pediatric AIDS in Europe. A quantitative analysis of structured interviews was performed. Caregivers of children and adolescents with HIV infection in follow-up at 2 reference centers for pediatric AIDS were enrolled. Four major areas included in the ICF instrument were investigated: impairments of body structures; impairments of body functions; environmental factors; and activity limitations and restrictions to social life. Forty-one families of children with HIV were enrolled. Body structures and functions were marginally impaired, whereas environmental factors and psychosocial issues had a relevant impact on quality of life. Most families considered environmental factors to be "barriers"; these were poverty, unemployment, and single-parent family structure. Activity limitations and social restrictions were also reported in a few cases. Almost all parents reported problems in disclosing their child's HIV status because of the fear of social stigma. Psychosocial issues are part of the well-being of children with HIV. The ICF is a standard tool to evaluate the clinical and psychosocial status of children and adolescents with HIV infection and to measure the impact of therapeutic interventions and strategies on psychosocial functioning.

  18. Treatment of Incarcerated, Sexually-Abused Adolescent Females: An Outcome Study

    ERIC Educational Resources Information Center

    Arnold, Elizabeth Mayfield; Kirk, Raymond S.; Roberts, Amelia C.; Griffith, Diane P.; Meadows, Katherine; Julian, Judy

    2003-01-01

    This study examined the psychosocial functioning of 100 adolescent females (ages 12-17) sentenced to secure care in a southeastern state and the impact of a gender-specific, cognitive-behavioral therapy (CBT) intervention on the psychosocial functioning of subjects who reported a history of sexual abuse. The Multidimensional Adolescent Assessment…

  19. A Test of Three Alternative Hypotheses regarding the Effects of Early Delinquency on Adolescent Psychosocial Functioning and Substance Involvement

    ERIC Educational Resources Information Center

    Mason, W. Alex; Hitchings, Julia E.; McMahon, Robert J.; Spoth, Richard L.

    2007-01-01

    This study compared alternative hypotheses (from general deviance, life course, and developmental psychopathology perspectives) regarding the effects of early adolescent delinquency on psychosocial functioning in family, school, and peer contexts, and on alcohol use. Analyses also examined parent-child negative affective quality, prosocial school…

  20. Stress, Social Support, and Psychosocial Functioning of Ethnically Diverse Students

    ERIC Educational Resources Information Center

    Farrell, Michelle; Langrehr, Kimberly J.

    2017-01-01

    This study examined the stress-buffering role of social support on indicators of psychosocial functioning among a combined and split sample of ethnically diverse college students. Although high social support significantly moderated 2 relationships in the combined sample, high and low levels of social support significantly reduced the effect of…

  1. Sticks and Stones: The Effects of Teasing on Psychosocial Functioning in an Overweight Treatment-Seeking Sample

    ERIC Educational Resources Information Center

    Quinlan, Nicole P.; Hoy, Melanie B.; Costanzo, Philip R.

    2009-01-01

    This self-report and observational study explores the relationship between perceptions of different kinds of teasing experiences and psychosocial functioning in an overweight treatment-seeking adolescent population. Participants were 96 adolescents enrolled in a residential weight-loss camp program. Prior to the start of treatment, participants'…

  2. An Investigation into the Psychosocial Functioning of Creative Children: The Impact of ADHD Symptomatology

    ERIC Educational Resources Information Center

    Healey, Dione; Rucklidge, Julia J.

    2006-01-01

    This study examined the relationship among creativity, ADHD symptomatology, temperament, and psychosocial functioning by comparing four groups of children aged 10-12 years: (1) 29 ADHD children without creativity, (2) 16 highly creative children displaying ADHD symptomatology, (3) 18 highly creative children without ADHD symptomatology, and (4) 30…

  3. The Contribution of Sleep Problems to Academic and Psychosocial Functioning

    ERIC Educational Resources Information Center

    Perfect, Michelle M.; Levine-Donnerstein, Deborah; Archbold, Kristen; Goodwin, James L.; Quan, Stuart F.

    2014-01-01

    The current study examined the concurrent and longitudinal relations among sleep problems with academic and psychosocial functioning in a prospective cohort study, the Tucson Children's Assessment of Sleep Apnea study (TuCASA). Children were assessed between the ages of 6 and 11 years and again approximately 5 years later. Sleep disordered…

  4. Impact of Relapse Predictors on Psychosocial Functioning of SUD Youth One Year after Treatment

    ERIC Educational Resources Information Center

    Anderson, Kristen G.; Ramo, Danielle E.; Schulte, Marya T.; Cummins, Kevin; Brown, Sandra A.

    2008-01-01

    This investigation examined how personal, environmental and substance use factors predicted psychosocial functioning for youth with alcohol and drug problems. Four hundred twenty-four adolescents (M = 15.9, SD = 1.3) completed comprehensive assessments, including personal characteristics (e.g., Axis I diagnosis, motivation, self-esteem),…

  5. Randomized Clinical Trial Replication of a Psychosocial Treatment for Children with High-Functioning Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Thomeer, Marcus L.; Lopata, Christopher; Volker, Martin A.; Toomey, Jennifer A.; Lee, Gloria K.; Smerbeck, Audrey M.; Rodgers, Jonathan D.; McDonald, Christin A.; Smith, Rachael A.

    2012-01-01

    This replication randomized clinical trial examined the efficacy of a comprehensive psychosocial intervention for children aged 7 to 12 years with high-functioning autism spectrum disorders (HFASDs). Participants were randomly assigned to treatment or wait-list conditions. Treatment included instruction and therapeutic activities targeting social…

  6. Characterizing adult attention-deficit/hyperactivity-disorder and comorbid borderline personality disorder: ADHD symptoms, psychopathology, cognitive functioning and psychosocial factors.

    PubMed

    O'Malley, G K; McHugh, L; Mac Giollabhui, N; Bramham, J

    2016-01-01

    To characterize adults with comorbid attention-deficit/hyperactivity-disorder (ADHD) and borderline personality disorder (BPD) with regard to ADHD symptoms, psychopathology, cognitive functioning and psychosocial factors. A between-group design compared a group of individuals diagnosed with ADHD (n=40) with a group diagnosed with BPD and who also met the criteria for ADHD (ADHD+BPD) (n=20). Significant differences were observed for both childhood and current impulsivity symptoms, whereby ADHD+BPD exhibited increased impulsivity; no differences on self-report and cognitive measures of impulsivity were reported. The ADHD+BPD group scored significantly higher on measures of depression, anxiety and numerous other axis I and II conditions. The ADHD+BPD group scored significantly lower on most measures of intellectual functioning and attention, however largely not on those relating to response inhibition. Furthermore, group differences were observed for psychosocial factors, including education, substance use and criminal record. Comorbid ADHD and BPD is characterized by more symptoms of impulsivity, additional psychopathology, comparatively lower intellectual and attentional functioning and increased psychosocial difficulties. Copyright © 2015. Published by Elsevier Masson SAS.

  7. Patient or treatment centre? Where are efforts invested to improve cancer patients' psychosocial outcomes?

    PubMed Central

    Carey, ML; Clinton-McHarg, T; Sanson-Fisher, RW; Campbell, S; Douglas, HE

    2011-01-01

    The psychosocial outcomes of cancer patients may be influenced by individual-level, social and treatment centre predictors. This paper aimed to examine the extent to which individual, social and treatment centre variables have been examined as predictors or targets of intervention for psychosocial outcomes of cancer patients. Medline was searched to find studies in which the psychological outcomes of cancer patient were primary variables. Papers published in English between 1999 and 2009 that reported primary data relevant to psychosocial outcomes for cancer patients were included, with 20% randomly selected for further coding. Descriptive studies were coded for inclusion of individual, social or treatment centre variables. Intervention studies were coded to determine if the unit of intervention was the individual patient, social unit or treatment centre. After random sampling, 412 publications meeting the inclusion criteria were identified, 169 were descriptive and 243 interventions. Of the descriptive papers 95.0% included individual predictors, and 5.0% social predictors. None of the descriptive papers examined treatment centre variables as predictors of psychosocial outcomes. Similarly, none of the interventions evaluated the effectiveness of treatment centre interventions for improving psychosocial outcomes. Potential reasons for the overwhelming dominance of individual predictors and individual-focused interventions in psychosocial literature are discussed. PMID:20646035

  8. Impairments of spatial working memory and attention following acute psychosocial stress.

    PubMed

    Olver, James S; Pinney, Myra; Maruff, Paul; Norman, Trevor R

    2015-04-01

    Few studies have investigated the effect of an acute psychosocial stress paradigm on impaired attention and working memory in humans. Further, the duration of any stress-related cognitive impairment remains unclear. The aim of this study was to examine the effect of an acute psychosocial stress paradigm, the Trier Social Stress, on cognitive function in healthy volunteers. Twenty-three healthy male and female subjects were exposed to an acute psychosocial stress task. Physiological measures (salivary cortisol, heart rate and blood pressure) and subjective stress ratings were measured at baseline, in anticipation of stress, immediately post-stress and after a period of rest. A neuropsychological test battery including spatial working memory and verbal memory was administered at each time point. Acute psychosocial stress produced significant increases in cardiovascular and subjective measures in the anticipatory and post-stress period, which recovered to baseline after rest. Salivary cortisol steadily declined over the testing period. Acute psychosocial stress impaired delayed verbal recall, attention and spatial working memory. Attention remained impaired, and delayed verbal recall continued to decline after rest. Acute psychosocial stress is associated with an impairment of a broad range of cognitive functions in humans and with prolonged abnormalities in attention and memory. Copyright © 2014 John Wiley & Sons, Ltd.

  9. From Trust to Intimacy: A New Inventory for Examining Erikson's Stages of Psychosocial Development.

    ERIC Educational Resources Information Center

    Rosenthal, Doreen A.; And Others

    1981-01-01

    A new inventory for examining the first six of Erikson's psychosocial stages is described. It is concluded that the Erikson Psychosocial Stage Inventory (EPSI), a self-report questionnaire, is a useful measure for researchers interested in development from early adolescence and in mapping changes as a function of life events. (Author/GK)

  10. Predictors of Psychosocial Outcomes in Hard-of-Hearing Preschool Children

    ERIC Educational Resources Information Center

    Laugen, Nina J.; Jacobsen, Karl H.; Rieffe, Carolien; Wichstrøm, Lars

    2016-01-01

    Children with hearing loss are at risk for developing psychosocial problems. Children with mild to severe hearing loss are less frequently subject to research, in particular in preschool, and we therefore know less about the risk in this particular group. To address this, we compared psychosocial functioning in thirty-five 4-5-year olds with…

  11. Psychosocial aspects of working with video display terminals (VDTs) and employee physical and mental health.

    PubMed

    Smith, M J

    1997-10-01

    Psychosocial aspects of using video display terminals (VDTs) have been recognized as contributors to employees' mental and physical health problems for more than 15 years. Yet, little has been done by employers to change work organization conditions to improve the psychosocial work environment of VDT users. Thus, psychosocial aspects of work are emerging as one of the biggest problems for VDT users in the late 1990s. This paper explores how psychosocial aspects of VDT work are related to job stress, and their consequences for mental and physical health. Using the research literature, it defines various aspects of work organization and job design that have been shown to be related to VDT users' ill-health. Some of the important work design aspects uncovered include a lack of employee skill use, monotonous tasks, high job demands and work pressure, a lack of control over the job, poor supervisory relations, fear of job loss, and unreliable technology. These are the same job stressors that have been defined as problematic for a variety of blue collar jobs in previous research. Work organization improvements for healthier VDT jobs are proposed. These include organizational support, employee participation, improved task content, increased job control, reasonable production standards, career development, enhanced peer socialization, and improved workstation ergonomics. These organizational improvements are derived from a more detailed organizational strategy for job stress reduction. A model of job redesign through proper 'balancing' of work organization features is discussed.

  12. Psychosocial stressors and lung function in youth ages 10-17: an examination by stressor, age and gender.

    PubMed

    Bandoli, G; Ghosh, J K; von Ehrenstein, O; Ritz, B

    2017-06-01

    Research on the impact of psychosocial stressors on child and adolescent lung function is uncommon, and has primarily relied either on parents' own stress measures or parent-reported stressors the child experienced, which may be a poor proxy for perceived stress in older children and adolescents. We performed multivariate linear regression of spirometry measures (FVC, FEV1 and FEF25-75) and psychosocial stressors in 584 adolescents in the Los Angeles Family and Neighborhood Survey. We examined family conflict, unsafe neighborhood or school, and the absence of a father in models stratified by gender, adjusting for PM2.5 and potential confounders. We observed reductions in lung function in males related to the absence of a father in the house (FEV1: -176.2 ml, 95% CI -322.7, -29.7) and family conflict (FEV1: -156.2 ml, 95% CI -327.8, 15.5); associations were stronger in older males ages 15-17 years for each stressor (P for interaction of age and sex was 0.009 and 0.06, respectively). This research informs a very small literature on psychosocial stressors and lung function in adolescents. Our finding of differential vulnerability by age and gender warrants further exploration of adolescent psychosocial stressor response on lung function. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Biomechanical, psychosocial and individual risk factors predicting low back functional impairment among furniture distribution employees

    PubMed Central

    Ferguson, Sue A.; Allread, W. Gary; Burr, Deborah L.; Heaney, Catherine; Marras, William S.

    2013-01-01

    Background Biomechanical, psychosocial and individual risk factors for low back disorder have been studied extensively however few researchers have examined all three risk factors. The objective of this was to develop a low back disorder risk model in furniture distribution workers using biomechanical, psychosocial and individual risk factors. Methods This was a prospective study with a six month follow-up time. There were 454 subjects at 9 furniture distribution facilities enrolled in the study. Biomechanical exposure was evaluated using the American Conference of Governmental Industrial Hygienists (2001) lifting threshold limit values for low back injury risk. Psychosocial and individual risk factors were evaluated via questionnaires. Low back health functional status was measured using the lumbar motion monitor. Low back disorder cases were defined as a loss of low back functional performance of −0.14 or more. Findings There were 92 cases of meaningful loss in low back functional performance and 185 non cases. A multivariate logistic regression model included baseline functional performance probability, facility, perceived workload, intermediated reach distance number of exertions above threshold limit values, job tenure manual material handling, and age combined to provide a model sensitivity of 68.5% and specificity of 71.9%. Interpretation: The results of this study indicate which biomechanical, individual and psychosocial risk factors are important as well as how much of each risk factor is too much resulting in increased risk of low back disorder among furniture distribution workers. PMID:21955915

  14. Maternal relationship security as a moderator of home visiting impacts on maternal psychosocial functioning.

    PubMed

    McFarlane, Elizabeth; Burrell, Lori; Crowne, Sarah; Cluxton-Keller, Fallon; Fuddy, Loretta; Leaf, Philip J; Duggan, Anne

    2013-02-01

    There is variability in home visiting program impacts on the outcomes achieved by high risk families. An understanding of how effects vary among families is important for refining service targeting and content. The current study assessed whether and how maternal attributes, including relationship security, moderate short- and long-term home visiting impacts on maternal psychosocial functioning. In this multisite RCT of home visiting in a population-based, ethnically-diverse sample of families at risk for maltreatment of their newborns (n = 643), families were randomly assigned to home visited (HV) and control groups. HV families were to receive intensive services by trained paraprofessionals from birth-3 years. Outcome data were collected when children were 1, 2, and 3 years old and 7, 8, and 9 years old. Overall, short- and long-term outcomes for HV and control mothers did not differ significantly. Demographic attributes, a general measure of overall maternal risk, and partner violence did not moderate program impact on psychosocial functioning outcomes. Maternal relationship security did moderate program impact. Mothers who scored high on relationship anxiety but not on relationship avoidance showed the greatest benefits, particularly at the long-term follow-up. Mothers scoring high for both relationship anxiety and avoidance experienced some adverse consequences of home visiting. Further research is needed to determine mediating pathways and to inform and test ways to improve the targeting of home visiting and the tailoring of home visit service models to extend positive home visiting impacts to targeted families not benefiting from current models.

  15. Physiological and psychosocial factors that predict HIV-related fatigue.

    PubMed

    Barroso, Julie; Hammill, Bradley G; Leserman, Jane; Salahuddin, Naima; Harmon, James L; Pence, Brian Wells

    2010-12-01

    Fatigue is one of the most common and debilitating symptoms experienced by HIV-infected people. We report the results of our longitudinal analysis of physiological and psychosocial factors that were thought to predict changes in HIV-related fatigue in 128 participants over a 1-year period, in an effort to sort out the complex interplay among a comprehensive set of physiological and psychosocial variables. Physiological measures included hepatic function (aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transpeptidase, alkaline phosphatase, total bilirubin, hepatitis C status), thyroid function (thyroid stimulating hormone, thyroxine), HIV viral load, immunologic function (CD4, CD8, CD4/CD8 ratio, CD16, CD8CD38), gonadal function (testosterone, dehydroepiandrosterone), hematologic function (hemoglobin, hematocrit, serum erythropoietin), and cellular injury (lactic acid). Psychosocial measures included childhood and adult trauma, anxiety, depression, social support, stressful life events, and post-traumatic stress disorder (PTSD). Unemployment, not being on antiretroviral therapy, having fewer years since HIV diagnosis, more childhood trauma, more stressful life events, less social support, and more psychological distress (e.g., PTSD, anxiety and depression) put HIV-infected persons at risk for greater fatigue intensity and fatigue-related impairment in functioning during 1-year follow-up. Physiological variables did not predict greater fatigue. Stressful life events had both direct and indirect effects on fatigue.

  16. Physiological and Psychosocial Factors that Predict HIV-Related Fatigue

    PubMed Central

    Hammill, Bradley G.; Leserman, Jane; Salahuddin, Naima; Harmon, James L.; Pence, Brian Wells

    2010-01-01

    Fatigue is one of the most common and debilitating symptoms experienced by HIV-infected people. We report the results of our longitudinal analysis of physiological and psychosocial factors that were thought to predict changes in HIV-related fatigue in 128 participants over a 1-year period, in an effort to sort out the complex interplay among a comprehensive set of physiological and psychosocial variables. Physiological measures included hepatic function (aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transpeptidase, alkaline phosphatase, total bilirubin, hepatitis C status), thyroid function (thyroid stimulating hormone, thyroxine), HIV viral load, immunologic function (CD4, CD8, CD4/CD8 ratio, CD16, CD8CD38), gonadal function (testosterone, dehydroepiandrosterone), hematologic function (hemoglobin, hematocrit, serum erythropoietin), and cellular injury (lactic acid). Psychosocial measures included childhood and adult trauma, anxiety, depression, social support, stressful life events, and post-traumatic stress disorder (PTSD). Unemployment, not being on antiretroviral therapy, having fewer years since HIV diagnosis, more childhood trauma, more stressful life events, less social support, and more psychological distress (e.g., PTSD, anxiety and depression) put HIV-infected persons at risk for greater fatigue intensity and fatigue-related impairment in functioning during 1-year follow-up. Physiological variables did not predict greater fatigue. Stressful life events had both direct and indirect effects on fatigue. PMID:20352317

  17. Short stature--the role of intelligence in psychosocial adjustment.

    PubMed Central

    Gilmour, J; Skuse, D

    1996-01-01

    Short children are often described as having psychosocial problems. These reports may be inaccurate as former studies have relied largely on parental report. Psychosocial functioning of short children was assessed with the aim of using them and their peers as informants. Twenty two short (mean (SD) height -2.53 (0.28) SD score) prepubertal children aged between 6 and 11 years were recruited from growth clinics. Comparison children were recruited from each case child's class at school. Cognitive and psychosocial functioning was assessed. Peer relationships were measured using sociometry. There were no significant group differences in terms of peer acceptance, self perception, and social competence. Although cases described themselves as receiving less social support from teachers, no differences were evident in other areas of social support. Little evidence was found to suggest clinic referred prepubertal short children are psychosocially maladjusted. Further analysis revealed cognitive ability was a better predictor than height for most aspects of behavioural and emotional adjustment. PMID:8813866

  18. Functional Movement Disorder

    MedlinePlus

    ... or stress-related movement disorders). A number of biological and psychosocial factors may act together to bring ... or stress-related movement disorders). A number of biological and psychosocial factors may act together to bring ...

  19. Self-perceived care needs in older adults with joint pain and comorbidity.

    PubMed

    Hermsen, Lotte A H; Hoogendijk, Emiel O; van der Wouden, Johannes C; Smalbrugge, Martin; Leone, Stephanie S; van der Horst, Henriëtte E; Dekker, Joost

    2018-05-01

    The aim of this study was to explore self-perceived care needs and determinants of identified needs in older adults with joint pain and comorbidity. This is a cross-sectional study using baseline data from a cohort study of older adults in the Netherlands (≥65 years) with joint pain and comorbidity (n = 407). We used the Camberwell Assessment of Need for the Elderly (CANE) to assess self-perceived care needs. Regression analyses were conducted to examine the associations between needs and sociodemographic factors (age, gender, partner status and educational level), physical factors (pain intensity, comorbidity, frailty and physical functioning) and psychosocial factors (anxiety, depression and social support). Older adults with joint pain and comorbidity reported on average 4.0 care needs out of 13 CANE items, of which 0.3 were unmet. High levels of environmental and physical needs were reported, such as needs with regard to physical illness (91%), household (61%) and mobility/falls (53%). However, most of these needs were met. Only few people reported psychosocial needs, but a large proportion of these needs was unmet, especially regarding company (66.7%) and daytime activities (37%). Psychosocial needs were more often present in frail participants (OR 2.40, 95% CI 1.25-4.61), and those with less perceived social support (OR 1.05, 95% CI 1.01-1.08) and more depressive symptoms (OR 1.17, 95% CI 1.07-1.26). Unmet needs are mainly present in the psychosocial domain. Specific attention targeted at these unmet needs may improve psychosocial well-being of older adults with joint pain and comorbidity.

  20. Impact of electronic aids to daily living on the lives of persons with cervical spinal cord injuries.

    PubMed

    Rigby, Patricia; Ryan, Stephen; Joos, Shone; Cooper, Barbara; Jutai, Jeffrey W; Steggles, Iielizabeth

    2005-01-01

    Structured interviews were used to evaluate the impact of electronic aids to daily living (EADL) on functional abilities and psychosocial well-being. The participants included 32 adults (26 men, 6 women; mean age of 39 years) with cervical spinal cord injuries. The experiences of 16 EADL users were compared with a control group of 16 nonusers, using the Functional Autonomy Measuring Scale, the Lincoln Outcome Measures for Environmental Controls, and the Psychosocial Impact of Assistive Devices Scale. Results show EADL users had significantly better performance (p < .05) than nonusers for instrumental activities of daily living and for 75% of 12 daily tasks. Many non-users had hands-free control of phones only, whereas EADL users had control over many other household devices, which optimized their independence. The psychosocial impact of this technology was very positive for competence, adaptability, and self-esteem. In conclusion, functional abilities were greater for a variety of daily tasks, and psychosocial impact was positive when EADLs were used.

  1. Influence of gender on Tourette syndrome beyond adolescence.

    PubMed

    Lichter, D G; Finnegan, S G

    2015-02-01

    Although boys are disproportionately affected by tics in Tourette syndrome (TS), this gender bias is attenuated in adulthood and a recent study has suggested that women may experience greater functional interference from tics than men. The authors assessed the gender distribution of adults in a tertiary University-based TS clinic population and the relative influence of gender and other variables on adult tic severity (YGTSS score) and psychosocial functioning (GAF score). We also determined retrospectively the influence of gender on change in global tic severity and overall TS impairment (YGTSS) since adolescence. Females were over-represented in relation to previously published epidemiologic surveys of both TS children and adults. Female gender was associated with a greater likelihood of tic worsening as opposed to tic improvement in adulthood; a greater likelihood of expansion as opposed to contraction of motor tic distribution; and with increased current motor tic severity and tic-related impairment. However, gender explained only a small percentage of the variance of the YGTSS global severity score and none of the variance of the GAF scale score. Psychosocial functioning was influenced most strongly by tic severity but also by a variety of comorbid neuropsychiatric disorders. Published by Elsevier Masson SAS.

  2. Psychosocial Modulators of Motor Learning in Parkinson’s Disease

    PubMed Central

    Zemankova, Petra; Lungu, Ovidiu; Bares, Martin

    2016-01-01

    Using the remarkable overlap between brain circuits affected in Parkinson’s disease (PD) and those underlying motor sequence learning, we may improve the effectiveness of motor rehabilitation interventions by identifying motor learning facilitators in PD. For instance, additional sensory stimulation and task cueing enhanced motor learning in people with PD, whereas exercising using musical rhythms or console computer games improved gait and balance, and reduced some motor symptoms, in addition to increasing task enjoyment. Yet, despite these advances, important knowledge gaps remain. Most studies investigating motor learning in PD used laboratory-specific tasks and equipment, with little resemblance to real life situations. Thus, it is unknown whether similar results could be achieved in more ecological setups and whether individual’s task engagement could further improve motor learning capacity. Moreover, the role of social interaction in motor skill learning process has not yet been investigated in PD and the role of mind-set and self-regulatory mechanisms have been sporadically examined. Here, we review evidence suggesting that these psychosocial factors may be important modulators of motor learning in PD. We propose their incorporation in future research, given that it could lead to development of improved non-pharmacological interventions aimed to preserve or restore motor function in PD. PMID:26973495

  3. Rasch analysis of the UK Functional Assessment Measure in patients with complex disability after stroke.

    PubMed

    Medvedev, Oleg N; Turner-Stokes, Lynne; Ashford, Stephen; Siegert, Richard J

    2018-02-28

    To determine whether the UK Functional Assessment Measure (UK FIM+FAM) fits the Rasch model in stroke patients with complex disability and, if so, to derive a conversion table of Rasch-transformed interval level scores. The sample included a UK multicentre cohort of 1,318 patients admitted for specialist rehabilitation following a stroke. Rasch analysis was conducted for the 30-item scale including 3 domains of items measuring physical, communication and psychosocial functions. The fit of items to the Rasch model was examined using 3 different analytical approaches referred to as "pathways". The best fit was achieved in the pathway where responses from motor, communication and psychosocial domains were summarized into 3 super-items and where some items were split because of differential item functioning (DIF) relative to left and right hemisphere location (χ2 (10) = 14.48, p = 0.15). Re-scoring of items showing disordered thresholds did not significantly improve the overall model fit. The UK FIM+FAM with domain super-items satisfies expectations of the unidimensional Rasch model without the need for re-scoring. A conversion table was produced to convert the total scale scores into interval-level data based on person estimates of the Rasch model. The clinical benefits of interval-transformed scores require further evaluation.

  4. The relationship between child- and parent-reported shared decision making and child-, parent-, and clinician-reported treatment outcome in routinely collected child mental health services data.

    PubMed

    Edbrooke-Childs, Julian; Jacob, Jenna; Argent, Rachel; Patalay, Praveetha; Deighton, Jessica; Wolpert, Miranda

    2016-04-01

    Shared decision making (SDM) between service users and providers is increasingly being suggested as a key component of good healthcare. The aim of this research was to explore whether child- and parent-reported experience of SDM was associated with child- and parent-reported improvement in psychosocial difficulties and clinician-reported functioning at the end of treatment in child and adolescent mental health services (CAMHS). The sample comprised N = 177 children (62% female; 31% aged 6-12 and 69% aged 13-18) with a variety of mental health problems from 17 services where routinely collected data consisted of presenting problems at outset, child- and parent-reported change in symptoms between Time 1 and Time 2 (Strengths and Difficulties Questionnaire; SDQ), clinician-reported change in functioning between Time 1 and Time 2 (Children's Global Assessment Scale; CGAS), and experience of SDM at Time 2 (as measured by responses to the Experience of Service Questionnaire; ESQ). Analysis revealed that both child- and parent-reported experience of SDM were associated with higher levels of child- and parent-reported improvement in psychosocial difficulties. However, child-reported experience of SDM was only associated with higher levels of child-reported improvement when their parents also reported higher levels of SDM. In CAMHS, involving both children and parents in decision making may contribute to enhanced treatment outcomes. © The Author(s) 2015.

  5. Developing a Virtual Reality-Based Vocational Rehabilitation Training Program for Patients with Schizophrenia.

    PubMed

    Sohn, Bo Kyung; Hwang, Jae Yeon; Park, Su Mi; Choi, Jung-Seok; Lee, Jun-Young; Lee, Ji Yeuon; Jung, Hee-Yeon

    2016-11-01

    Maintaining employment is difficult for patients with schizophrenia because of deterioration of psychosocial and cognitive functions. Such patients usually require vocational rehabilitation training, which is both demanding and costly. In this study, we developed a virtual reality-based vocational rehabilitation training program (VR-VRTP) for such patients and evaluated its feasibility as an alternative to traditional rehabilitation programs. We developed the VR-VRTP to include various situations commonly encountered in two types of occupations: convenience store employee and supermarket clerk. We developed practical situations, as well as a system for providing feedback, to ensure patients would not lose interest during training. Nine participants each performed the VR-VRTP repeatedly per week for a total of 8 weeks. At baseline and after training, all participants were evaluated using the following clinical and neuropsychological tests: Manchester Scale, Clinical Global Impression, Personal and Social Performance Scale (PSP), Hamilton Depression Rating Scale, Zung Depression Rating Scale, Beck Anxiety Inventory, Wisconsin Card Sorting Test, Stroop Test, Rey-Osterrieth Complex Figure Test (RCFT), and Auditory Verbal Learning Test (AVLT). After training, patient scores improved on the PSP, general symptoms on the Manchester Scale, AVLT, and delayed recall on the RCFT. The Manchester positive symptom score showed a trend of improvement. No significant changes were observed for other measures. The VR-VRTP may improve general psychosocial function and memory, potentially influencing real-world vocational performance. These findings provide preliminary evidence regarding the utility of the VR-VRTP in patients with schizophrenia.

  6. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies

    PubMed Central

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F

    2017-01-01

    Abstract Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients’ psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. PMID:28498954

  7. Effectiveness of the Challenging Horizons After-School Program for Young Adolescents With ADHD

    PubMed Central

    Evans, Steven W.; Schultz, Brandon K.; DeMars, Christine E.; Davis, Heather

    2012-01-01

    There are no empirically supported psychosocial treatments for adolescents with attention-deficit hyperactivity disorder (ADHD). This study examined the treatment benefits of the Challenging Horizons Program (CHP), a psychosocial treatment program designed to address the impairment and symptoms associated with this disorder in young adolescents. In addition to evaluating social and academic functioning outcomes, two critical questions from previous studies pertaining to the timing, duration, and family involvement in treatment were addressed. Forty-nine students recruited in two cohorts were randomly assigned to receive either the CHP or a community care condition. Outcomes suggested that students who received the CHP improved compared to students in the control condition on measures of symptoms and impairment. Implications related to timing, duration, and family involvement are reported, as well as recommendations for future studies. PMID:21658528

  8. An exploration of exercise training effects in coronary heart disease.

    PubMed

    Piperidou, Eleana; Bliss, Julie

    2008-06-01

    Coronary Heart Disease (CHD) remains the most common cause of death and disability in many developed and developing countries. The evidence presented so far, clearly shows that exercise training leads to favourable improvements in exercise capacity, lipid levels, weight and psychosocial variables for CHD patients. Nevertheless, despite recommendations and government support, the lack of physical activity remains a major health problem, particularly for people with established CHD. The aim of this review was to explore the effects of exercise training on physical and psychosocial function among CHD patients, by analysing the content of relevant research reports. The findings showed that although there is sufficient evidence that exercise training has a number of effects that are beneficial in treatment and secondary prevention of CHD, different aspects of exercise characteristics (mode, frequency, intensity and duration) for different cardiac patient groups, warrant additional investigation.

  9. Same-Sex Attraction, Social Relationships, Psychosocial Functioning, and School Performance in Early Adolescence

    ERIC Educational Resources Information Center

    Bos, Henny M. W.; Sandfort, Theo G. M.; de Bruyn, Eddy H.; Hakvoort, Esther M.

    2008-01-01

    The authors examined whether 13- to 15-year-old adolescents who experience feelings of same-sex attraction (SSA) differ from those without such feelings in the quality of relationships with parents, peers, and class mentors and in psychosocial functioning (health status and school performance). The authors also assessed whether differences in …

  10. The Broader Context of Relational Aggression in Adolescent Romantic Relationships: Predictions from Peer Pressure and Links to Psychosocial Functioning

    ERIC Educational Resources Information Center

    Schad, Megan M.; Szwedo, David E.; Antonishak, Jill; Hare, Amanda; Allen, Joseph P.

    2008-01-01

    The broader context of relational aggression in adolescent romantic relationships was assessed by considering the ways such aggression emerged from prior experiences of peer pressure and was linked to concurrent difficulties in psychosocial functioning. Longitudinal, multi-reporter data were obtained from 97 adolescents and their best friends at…

  11. A Nationwide Survey on Quality of Life and Associated Factors of Adults with High-Functioning Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Kamio, Yoko; Inada, Naoko; Koyama, Tomonori

    2013-01-01

    The psychosocial outcomes of individuals with high-functioning autism spectrum disorder (HFASD) appear to be diverse and are often poor relative to their intellectual or language level. To identify predictive variables that are potentially ameliorable by therapeutic intervention, this study investigated self-reported psychosocial quality of life…

  12. Dose-Effect of Children's Psychosocial Rehabilitation on the Daily Functioning of Youth with Serious Emotional Disturbance

    ERIC Educational Resources Information Center

    Williams, Nathaniel J.

    2009-01-01

    Children's psychosocial rehabilitation (CPSR) is a promising but under-evaluated home- and community-based treatment for children with serious emotional disturbance (SED). CPSR addresses the functional impairments of children with SED through an asset-based, skill-building approach that involves multiple systems in the child's life. The present…

  13. Father Involvement, Nurturant Fathering, and Young Adult Psychosocial Functioning: Differences among Adoptive, Adoptive Stepfather, and Nonadoptive Stepfamilies

    ERIC Educational Resources Information Center

    Schwartz, Seth J.; Finley, Gordon E.

    2006-01-01

    The present study was conducted to investigate differences in nurturant fathering, father involvement, and young adult psychosocial functioning among small samples of three nontraditional family forms. A total of 168 young-adult university students from three family forms (27 adoptive, 22 adoptive stepfather, 119 nonadoptive stepfather) completed…

  14. Bidirectional Associations between Sleep (Quality and Duration) and Psychosocial Functioning across the University Years

    ERIC Educational Resources Information Center

    Tavernier, Royette; Willoughby, Teena

    2014-01-01

    Despite extensive research on sleep and psychosocial functioning, an important gap within the literature is the lack of inquiry into the direction of effects between these 2 constructs. The purpose of the present 3-year longitudinal study was to examine bidirectional associations between sleep (quality and duration) and 3 indices of psychosocial…

  15. Sociodemographic, Delinquency-Abuse History, and Psychosocial Functioning Differences among Juvenile Offenders of Various Ages.

    ERIC Educational Resources Information Center

    Dembo, Richard; Schmeidler, James; Nini-Gough, Banni; Manning, Darrell

    1998-01-01

    Sociodemographic characteristics, delinquency and dependency referral histories, and psychosocial functioning were compared for three groups of youth (N=9,583) at a juvenile assessment center. Findings indicate that eight- to twelve- year olds tend to be ethnic minorities, live in mother-headed households of low economic status, and have a…

  16. Mexican-Origin Adolescent Mothers' Stressors and Psychosocial Functioning: Examining Ethnic Identity Affirmation and Familism as Moderators

    ERIC Educational Resources Information Center

    Umana-Taylor, Adriana J.; Updegraff, Kimberly A.; Gonzales-Backen, Melinda A.

    2011-01-01

    Mexican-origin adolescent mothers are at increased risk for poor psychosocial functioning as a result of various stressors with which they must contend; however, existing theory suggests that cultural strengths may help mitigate the negative effects of stress. As such, the current study examined the associations between cultural and economic…

  17. Open-Trial Pilot Study of a Comprehensive Outpatient Psychosocial Treatment for Children with High-Functioning Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Lopata, Christopher; Lipinski, Alanna M.; Thomeer, Marcus L.; Rodgers, Jonathan D.; Donnelly, James P.; McDonald, Christin A.; Volker, Martin A.

    2017-01-01

    This study examined the feasibility and initial outcomes of a comprehensive outpatient psychosocial treatment (MAXout) for children aged 7-12 years with high-functioning autism spectrum disorder. The 18-week treatment, two 90-minute sessions per week, included instruction and therapeutic activities targeting social/social communication skills,…

  18. The Effectiveness of a Multidisciplinary Group Rehabilitation Program on the Psychosocial Functioning of Elderly People Who Are Visually Impaired

    ERIC Educational Resources Information Center

    Alma, Manna A.; Groothoff, Johan W.; Melis-Dankers, Bart J. M.; Suurmeijer, Theo P. B. M.; van der Mei, Sijrike F.

    2013-01-01

    Introduction: The pilot study reported here determined the effectiveness of a multidisciplinary group rehabilitation program, Visually Impaired Elderly Persons Participating (VIPP), on psychosocial functioning. Methods: The single-group pretest-posttest pilot study included 29 persons with visual impairments (aged 55 and older) who were referred…

  19. Effects of Psychosocial Stress on Subsequent Hemorrhagic Shock and Resuscitation in Male Mice.

    PubMed

    Langgartner, Dominik; Wachter, Ulrich; Hartmann, Clair; Gröger, Michael; Vogt, Josef; Merz, Tamara; McCook, Oscar; Fink, Marina; Kress, Sandra; Georgieff, Michael; Kunze, Julia F; Radermacher, Peter L; Reber, Stefan O; Wepler, Martin

    2018-06-08

    Hypoxemia and tissue ischemia during hemorrhage as well as formation of oxygen and nitrogen radicals during resuscitation promote hyperinflammation and, consequently, trigger severe multiple-organ-failure (MOF). Individuals diagnosed with stress-related disorders or reporting a life history of psychosocial stress are characterized by chronic low-grade inflammation and a reduced glucocorticoid (GC) signaling. We hypothesized that exposure to chronic psychosocial stress during adulthood prior to hemorrhagic shock increases oxidative/nitrosative stress and therefore the risk of developing MOF in mice. To induce chronic psychosocial stress linked to mild immune activation and reduced GC signaling in male mice, the chronic subordinate colony housing (CSC) paradigm was employed. Single-housed (SHC) mice were used as controls. Subsequently, CSC and SHC mice were exposed to hemorrhagic shock following resuscitation to investigate the effects of prior psychosocial stress load on survival, organ function, metabolism, oxidative/nitrosative stress, and inflammatory readouts. An increased adrenal weight in CSC mice indicates that the stress paradigm reliably worked. However, no effect of prior psychosocial stress on outcome after subsequent hemorrhage and resuscitation could be detected. Chronic psychosocial stress during adulthood is not sufficient to promote hemodynamic complications, organ dysfunction, metabolic disturbances and did not increase the risk of MOF after subsequent hemorrhage and resuscitation. Intravenous norepinephrine to keep target hemodynamics might have led to a certain level of oxidative stress in both groups and, therefore, disguised potential effects of chronic psychosocial stress on organ function after hemorrhagic shock in the present murine trauma model.

  20. The psychosocial impacts of implantation on the dental aesthetics of missing anterior teeth patients.

    PubMed

    Chen, P; Yu, S; Zhu, G

    2012-12-01

    The aim of the current study was to investigate the psychosocial impact of dental aesthetics among patients who received anterior implant-supported prostheses. The current study is a cross-sectional evaluation involving 115 individuals who had gone through treatment at the dental clinics of general hospitals. Participants completed the Chinese version of the psychosocial impact of dental aesthetics questionnaire (PIDAQ) before implantation and six months after crown restoration. Basic demographic information was recorded. Six months after implant crown restoration, participants were asked to self-assess their own oral aesthetics compared to before implantation. A total of 106 patients completed the study. PIDAQ scores correlated significantly with the self-assessment of the degree of oral aesthetics. Six months after crown restoration, the two factors (social impact and aesthetic attitude) decreased and the dental self-confidence score increased significantly compared to pre-implantation scores. Gender and education level significantly affected PIDAQ. Anterior implant-supported prostheses significantly affected the patients' psychosocial perception. Implantation of missing anterior teeth can significantly improve patients' negative psychosocial impact of dental aesthetics. Gender and education level are correlated with the degree of improvement. The PIDAQ can be used in assessing the psychosocial effects of implantation in missing anterior teeth.

  1. Associations between past bullying experiences and psychosocial and academic functioning among college students.

    PubMed

    Holt, Melissa K; Greif Green, Jennifer; Reid, Gerald; DiMeo, Amanda; Espelage, Dorothy L; Felix, Erika D; Furlong, Michael J; Poteat, V Paul; Sharkey, Jill D

    2014-01-01

    This study examined whether childhood bullying victimization was associated with psychosocial and academic functioning at college. The sample consisted of 413 first-year students from a large northeastern university. Students completed an online survey in February 2012 that included items assessing past bullying involvement, current psychosocial and academic functioning, and victimization experiences since arriving at college. Regression analyses indicated that reports of past bullying and other peer victimization were associated with lower mental health functioning and perceptions of physical and mental health, but were not associated with perceptions of social life at college, overall college experience, or academic performance. Childhood bullying victimization is associated with poorer mental and physical health among first-year college students. Colleges should consider assessing histories of bullying victimization, along with other past victimization exposures, in their service provision to students.

  2. Correlates of Psychosocial Adjustment in Deaf Adolescents with and without Cochlear Implants: A Preliminary Investigation

    ERIC Educational Resources Information Center

    Leigh, Irene W.; Maxwell-McCaw, Deborah; Bat-Chava, Yael; Christiansen, John B.

    2009-01-01

    The number of children who have received cochlear implants (CIs) has increased dramatically in the past two decades. In view of potential concerns about their psychosocial adjustment, our aim was to assess the effect of implants on the adolescents' psychosocial functioning among a group of 57 deaf adolescents with and without CIs, using published…

  3. The Development and Evaluation of an Innovative Internet-Based Breast Cancer Psychosocial Intervention

    DTIC Science & Technology

    2002-10-01

    R. R., et al. (2001). Psychological testing and psychological assessment. A review of evidence and issues. Am Psychol, 56(2), 128-165. Pennebaker, J...shown to improve quality of life and coping responses and to reduce psychological symptoms and pain in breast cancer participants. However, psychosocial...effective intervention which may reduce participants’ psychological symptoms, improve their coping skills, and may improve their adherence to medical regimens

  4. Prevalence and psychosocial correlates of food addiction in persons with obesity seeking weight reduction.

    PubMed

    Chao, Ariana M; Shaw, Jena A; Pearl, Rebecca L; Alamuddin, Naji; Hopkins, Christina M; Bakizada, Zayna M; Berkowitz, Robert I; Wadden, Thomas A

    2017-02-01

    Food addiction is a controversial concept. The potential influence of food addiction on patients' psychosocial functioning and well-being has not been well established. The purpose of this study was to examine the relationships between psychosocial functioning (depressive symptoms and health-related quality of life [HRQOL]) and food addiction as measured by the Yale Food Addiction Scale (YFAS). We also explored whether food addiction contributed additional variance in explaining psychosocial functioning, beyond demographic and clinical factors (e.g., binge eating). The sample included 178 participants (mean age=44.2±11.2years; BMI=40.9±5.9kg/m 2 ; 88.2% female; 70.8% Black) with obesity seeking treatment for weight loss. Participants completed the Medical Outcomes Study 36-Item Short-Form Health Survey, Impact of Weight on Quality of Life-Lite, Patient Health Questionnaire, YFAS, and Questionnaire on Eating and Weight Patterns-5. Twelve (6.7%) participants met criteria for food addiction, with 4 (33.3%) of these participants having co-occurring binge eating disorder. After adjusting for covariates, the number of food addiction symptoms accounted for 6.5% to 16.3% of additional variance in general HRQOL, 5.0% to 21.5% in weight-related HRQOL, and 19.1% in symptoms of depression. In this treatment-seeking sample of participants, we found a low prevalence of food addiction, suggesting that addictive-like eating is unlikely to be a causal mechanism for most people with obesity. However, individuals who met criteria for food addiction had reduced psychosocial functioning compared to those who did not meet criteria. Individuals with addictive-like eating may require additional psychosocial support. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The role of face transplantation in the self-inflicted gunshot wound.

    PubMed

    Kiwanuka, Harriet; Aycart, Mario A; Gitlin, David F; Devine, Elaine; Perry, Bridget J; Win, Thet-Su; Bueno, Ericka M; Alhefzi, Muayyad; Krezdorn, Nicco; Pomahac, Bohdan

    2016-12-01

    Facial self-inflicted gunshot wounds (SIGSWs) cause a devastating midfacial defect and pose a challenging problem to the reconstructive surgeon. Face transplantation (FT) has the potential for near-normal restoration in otherwise non-reconstructible defects. Two out of 7 FT recipients at Brigham and Women's Hospital (BWH) sustained SIGSWs. In this study, we illustrate the role of FT in the management of SIGSWs through an aesthetic, functional, and psychosocial examination of outcomes. We performed a retrospective analysis of individuals with SIGSWs who were screened at BWH between 2008 and 2015. We then collected data of the injuries, modes of conventional reconstruction (CR), and deficits. For the FT recipients, we critically reviewed the psychosocial screening process and post-transplantation aesthetic, functional, and psychosocial outcomes. A total of six individuals post-SIGSWs were screened for FT. All of them had undergone CR, with five receiving loco-regional flaps and free tissue transfers, and one undergoing serial debridement and primary soft-tissue repair. Following CR, all suffered from residual functional and aesthetic deficits. Two underwent partial FT and one is currently undergoing FT screening. We describe the pre-transplant psychosocial screening process and the aesthetic, functional, and psychosocial outcomes of the SIGSW FT recipients. We examined the facial SIGSW injury, outcomes of CR, and the mechanism of FT to offer a potential solution to the shortcomings of CR. More importantly, we highlight the critical nature of the psychosocial component of the multidisciplinary evaluation given the history of mental illness and suicidal behavior in this subset of patients. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. The impact of cognitive impairment, neurological soft signs and subdepressive symptoms on functional outcome in bipolar disorder.

    PubMed

    Baş, Tuba Öcek; Poyraz, Cana Aksoy; Baş, Alper; Poyraz, Burç Çağrı; Tosun, Musa

    2015-03-15

    Cognitive impairments and subsyndromal depressive symptoms are present during euthymic periods of bipolar disorder (BD). Most studies have determined that cognitive impairments and residual depressive symptoms have major impacts on psychosocial functioning. The aim of the present study was to identify the major factor responsible for low psychosocial functioning in a subgroup of patients with BD despite clinical recovery. Sixty patients with bipolar I disorder and 41 healthy subjects were enrolled in this study. Cognitive performance, neurological soft signs (NSSs), psychosocial functioning, residual mood symptoms and illness characteristics were assessed. Using the median value of the Functioning Assessment Short Test (FAST) as the cut-off point, the patients were divided into two groups, high- (n=29) or low-functioning (n=31), and they were compared based on total NSS, residual depressive symptoms, cognitive performance and clinical variables. Performances on the verbal memory tests and social functioning were significantly worse in the euthymic patients with BD. Increased rates of NSS were identified in the patients compared with the normal controls. The low-functioning patients performed significantly worse on verbal memory, and their NSS and residual depressive symptoms were significantly higher compared to high-functioning patients. In the regression analysis, subsyndromal depressive symptoms and verbal learning measures were identified as the best predictors of psychosocial functioning. The patients were artificially separated into two groups based on a FAST score cut-off. In this study, residual depressive symptoms and verbal memory impairments were the most prominent factors associated with the level of functioning. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. The role of psychosocial factors and psychiatric disorders in functional dyspepsia.

    PubMed

    Van Oudenhove, Lukas; Aziz, Qasim

    2013-03-01

    In this Review, after a brief historical introduction, we first provide an overview of epidemiological studies that demonstrate an association between functional dyspepsia and psychological traits, states or psychiatric disorders. These studies suggest an important intrinsic role for psychosocial factors and psychiatric disorders, especially anxiety and depression, in the aetiopathogenesis of functional dyspepsia, in addition to their putative influence on health-care-seeking behaviour. Second, we describe pathophysiological evidence on how psychosocial factors and psychiatric disorders might exert their role in functional dyspepsia. Novel insights from functional brain imaging studies regarding the integration of gut-brain signals, processed in homeostatic-interoceptive brain regions, with input from the exteroceptive system, the reward system and affective and cognitive circuits, help to clarify the important role of psychological processes and psychiatric morbidity. We therefore propose an integrated model of functional dyspepsia as a disorder of gut-brain signalling, supporting a biopsychosocial approach to the diagnosis and management of this disorder.

  8. Does psychosocial competency training for junior physicians working in pediatric medicine improve individual skills and perceived job stress.

    PubMed

    Bernburg, Monika; Baresi, Lisa; Groneberg, David; Mache, Stefanie

    2016-12-01

    Pediatricians' job performance, work engagement, and job satisfaction are essential for both the individual physician and quality of care for their little patients and parents. Therefore, it is important to maintain or possibly augment pediatricians' individual and professional competencies. In this study, we developed and implemented a psychosocial competency training (PCT) teaching different psychosocial competencies and stress coping techniques. We investigated (1) the influence of the PCT on work-related characteristics: stress perception, work engagement, job satisfaction and (2) explored pediatricians' outcomes and satisfaction with PCT. Fifty-four junior physicians working in pediatric hospital departments participated in the training and were randomized in an intervention (n = 26) or a control group (n = 28). In the beginning, at follow-up 1 and 2, both groups answered a self-rated questionnaire on perceived training outcomes and work-related factors. The intervention group showed that their job satisfaction significantly increased while perceived stress scores decreased after taking part in the PCT. No substantial changes were observed with regard to pediatricians' work engagement. Participating physicians evaluated PCT with high scores for training design, content, received outcome, and overall satisfaction with the training. Professional psychosocial competency training could improve junior pediatricians' professional skills, reduce stress perception, increase their job satisfaction, and psychosocial skills. In addition, this study indicates that the PCT is beneficial to be implemented as a group training program for junior pediatricians at work. What is Known: • Junior pediatricians often report experiencing high levels of job strain and little supervisory support. • High levels of job demands make pediatricians vulnerable for mental health problems and decreased work ability. What is New: • Development, implementation, and evaluation of a psychosocial competency training for junior pediatricians working in clinical settings • Psychosocial competency training has the potential to improve pediatricians' psychosocial skills and perceptions of perceived work-related stress and job satisfaction.

  9. Auditory verbal memory and psychosocial symptoms are related in children with idiopathic epilepsy.

    PubMed

    Schaffer, Yael; Ben Zeev, Bruria; Cohen, Roni; Shuper, Avinoam; Geva, Ronny

    2015-07-01

    Idiopathic epilepsies are considered to have relatively good prognoses and normal or near normal developmental outcomes. Nevertheless, accumulating studies demonstrate memory and psychosocial deficits in this population, and the prevalence, severity and relationships between these domains are still not well defined. We aimed to assess memory, psychosocial function, and the relationships between these two domains among children with idiopathic epilepsy syndromes using an extended neuropsychological battery and psychosocial questionnaires. Cognitive abilities, neuropsychological performance, and socioemotional behavior of 33 early adolescent children, diagnosed with idiopathic epilepsy, ages 9-14years, were assessed and compared with 27 age- and education-matched healthy controls. Compared to controls, patients with stabilized idiopathic epilepsy exhibited higher risks for short-term memory deficits (auditory verbal and visual) (p<0.0001), working memory deficits (p<0.003), auditory verbal long-term memory deficits (p<0.0021), and more frequent psychosocial symptoms (p<0.0001). The severity of auditory verbal memory deficits was related to severity of psychosocial symptoms among the children with epilepsy but not in the healthy controls. Results suggest that deficient auditory verbal memory may be compromising psychosocial functioning in children with idiopathic epilepsy, possibly underscoring that cognitive variables, such as auditory verbal memory, should be assessed and treated in this population to prevent secondary symptoms. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Randomised controlled trial of a 12 week yoga intervention on negative affective states, cardiovascular and cognitive function in post-cardiac rehabilitation patients.

    PubMed

    Yeung, Alan; Kiat, Hosen; Denniss, A Robert; Cheema, Birinder S; Bensoussan, Alan; Machliss, Bianca; Colagiuri, Ben; Chang, Dennis

    2014-10-24

    Negative affective states such as anxiety, depression and stress are significant risk factors for cardiovascular disease, particularly in cardiac and post-cardiac rehabilitation populations.Yoga is a balanced practice of physical exercise, breathing control and meditation that can reduce psychosocial symptoms as well as improve cardiovascular and cognitive function. It has the potential to positively affect multiple disease pathways and may prove to be a practical adjunct to cardiac rehabilitation in further reducing cardiac risk factors as well as improving self-efficacy and post-cardiac rehabilitation adherence to healthy lifestyle behaviours. This is a parallel arm, multi-centre, randomised controlled trial that will assess the outcomes of post- phase 2 cardiac rehabilitation patients assigned to a yoga intervention in comparison to a no-treatment wait-list control group. Participants randomised to the yoga group will engage in a 12 week yoga program comprising of two group based sessions and one self-administered home session each week. Group based sessions will be led by an experienced yoga instructor. This will involve teaching beginner students a hatha yoga sequence that incorporates asana (poses and postures), pranayama (breathing control) and meditation. The primary outcomes of this study are negative affective states of anxiety, depression and stress assessed using the Depression Anxiety Stress Scale. Secondary outcomes include measures of quality of life, and cardiovascular and cognitive function. The cardiovascular outcomes will include blood pressure, heart rate, heart rate variability, pulse wave velocity, carotid intima media thickness measurements, lipid/glucose profiles and C-reactive protein assays. Assessments will be conducted prior to (week 0), mid-way through (week 6) and following the intervention period (week 12) as well as at a four week follow-up (week 16). This study will determine the effect of yoga practice on negative affective states, cardiovascular and cognitive function in post-phase 2 cardiac rehabilitation patients. The findings may provide evidence to incorporate yoga into standardised cardiac rehabilitation programs as a practical adjunct to improve the management of psychosocial symptoms associated with cardiovascular events in addition to improving patients' cognitive and cardiovascular functions. ACTRN12612000358842.

  11. Alexithymia, Assertiveness and Psychosocial Functioning in HIV: Implications for Medication Adherence and Disease Severity.

    PubMed

    McIntosh, Roger C; Ironson, Gail; Antoni, Michael; Fletcher, Mary Ann; Schneiderman, Neil

    2016-02-01

    Psychosocial function and adherence to antiretroviral regimen are key factors in human immunodeficiency virus (HIV) disease management. Alexithymia (AL) is a trait deficit in the ability to identify and describe feelings, emotions and bodily sensations. A structural equation model was used to test whether high levels of AL indirectly relate to greater non-adherent behavior and HIV disease severity via psychosocial dysfunction. Blood draws for HIV-1 viral load and CD4 T-lymphocyte, along with psychosocial surveys were collected from 439 HIV positive adults aged 18-73 years. The structural model supports significant paths from: (1) AL to non-active patient involvement, psychological distress, and lower social support, (2) psychological distress and non-active involvement to non-adherent behavior, and (3) non-adherence to greater HIV disease severity (CFI = .97, RMSEA = .04, SRMR = .05). A second model confirmed the intermediary effect of greater patient assertiveness on the path from AL to social support and non-active patient involvement (CFI = .94, RMSEA = .04, SRMR = .05). Altogether, AL is indirectly linked with HIV disease management through it's association with poor psychosocial function, however greater patient assertiveness buffers the negative impact of AL on relationship quality with healthcare providers and members of one's social support network.

  12. Cardiac rehabilitation with a nurse case manager (GoHeart) across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study.

    PubMed

    Hansen, Vibeke Brogaard; Maindal, Helle Terkildsen

    2014-01-01

    In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR). The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM). A one-year follow-up study. A CR programme (GoHeart) was evaluated in a cohort at Lillebaelt Hospital Vejle, DK from 2010 to 2011. Consecutive patients admitted to CR were included. The inclusion criteria were the event of acute myocardial infarction or stable angina and invasive revascularization (left ventricular ejection fraction (LVEF) ≥45%). Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS)) were assessed at admission (phase IIa), at three months at discharge (phase IIb) and at one-year follow-up (phase III). Intention-to-treat and predefined subgroup analysis on sex was performed. Of 241 patients, 183 (75.9%) were included (mean age 63.8 years). At discharge improvements were found in total-cholesterol (p < 0.001), low density lipoprotein (LDL; p < 0.001), functional capacities (metabolic equivalent of tasks (METS), p < 0.01), self-care management (p < 0.001), Health status Short Form 12 version (SF12; physical; p < 0.001 and mental; p < 0.01) and in depression symptoms (p < 0.01). At one-year follow-up these outcomes were maintained; additionally there was improvement in body mass index (BMI; p < 0.05), and high density lipoprotein (HDL; p < 0.05). There were no sex differences. CR shared between local and regional health authorities led by a NCM (GoHeart) improves risk factors, self-care and psychosocial factors. Further improvements in most variables were at one-year follow-up.

  13. Evolving psychosocial, emotional, functional, and support needs of women with advanced breast cancer: Results from the Count Us, Know Us, Join Us and Here & Now surveys.

    PubMed

    Cardoso, Fatima; Harbeck, Nadia; Mertz, Shirley; Fenech, Doris

    2016-08-01

    Although medical advances have marginally improved survival of women with advanced breast cancer, their psychosocial, emotional, and functional needs remain unmet. Two surveys, Count Us, Know Us, Join Us (Count Us) and Here & Now (H&N), were conducted to understand the unique challenges faced by women with advanced breast cancer and to identify ways of addressing these issues. A total of 1577 women with advanced breast cancer (Count Us, N = 1273; H&N, N = 304) participated in the two surveys, which revealed several previously unreported challenges. Nearly half the women felt isolated and worried, and slightly more than half experienced declines in income because of change in employment; 41% of women felt that support from family and friends decreased over time, and many patients believed information about advanced breast cancer was inadequate and difficult to find. Concerted efforts by people who care for and support women with advanced breast cancer are urgently needed to address these issues. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Long term self esteem assessment after height increase by lengthening and then nailing.

    PubMed

    Emara, K; Al Kersh, M A; Emara, A K

    2017-03-01

    The purpose of the study is to assess the long term psychosocial functioning after height increase, using the external fixation then nailing method. Rosenberg Self-esteem scale and a questionnaire to assess social functioning were completed by 28 patients both preoperatively and at a mean follow-up of 7 years. The mean total score of RSE self-esteem for the 28 patients before lengthening was 21.5 (SD 1.03) (20-24). The mean total score of RSE for the patients 1 year after lengthening was 22 (SD 1.17) (20-24) with highly significant difference (p = 0.002).The mean total RSE self-esteem score after 7 years was 21.7 (SD 1.12) (21-25) with no significant difference (p = 0.11) Improvement was an evident in the short term self esteem after 1 year of follow up of the patients with height increase. On the other hand, there was an evident deterioration in the long term psychosocial evaluation during follow up after 7 years of height increase, returning to near pre-operative levels of self esteem.

  15. Behavioral Sleep Medicine Services for Hypersomnia Disorders: A Survey Study.

    PubMed

    Neikrug, Ariel B; Crawford, Megan R; Ong, Jason C

    2017-01-01

    Patients with hypersomnia disorders (HD) suffer from debilitating symptoms that result in reduced functioning, depression, anxiety, and overall worse quality of life. Little is known about the need and desire of this population to utilize behavioral sleep medicine (BSM) interventions that focus on psychosocial functioning and quality of life, and there have been limited attempts to develop such interventions. The purpose of this survey study was to gather patient-centered data on engagement in pharmacological and nonpharmacological interventions, the psychosocial impact of HD symptoms on quality of life and mental health, and potential interest in BSM services, such as cognitive behavioral therapy, mindfulness or yoga, and support groups. We obtained responses from 371 individuals with HD (65.2% narcolepsy and 34.8% idiopathic hypersomnia) to an Internet-based survey. Overall, HD patients reported engagement in pharmacological and nonpharmacological interventions, with narcolepsy patients reporting more perceived effectiveness than those with idiopathic hypersomnia. In addition, HD patients reported a strong negative impact on psychosocial functioning, with elevations in depression and anxiety symptoms along with significant impact on functioning and quality of life. The majority (71.7-85.5%) voiced at least some interest in BSM services. These data suggest that there is substantial interest and need for BSM services that focus on assessment and treatment of psychosocial functioning related to HD.

  16. A Community-Based, Environmental Chronic Disease Prevention Intervention to Improve Healthy Eating Psychosocial Factors and Behaviors in Indigenous Populations in the Canadian Arctic

    ERIC Educational Resources Information Center

    Mead, Erin L.; Gittelsohn, Joel; Roache, Cindy; Corriveau, André; Sharma, Sangita

    2013-01-01

    Diet-related chronic diseases are highly prevalent among indigenous populations in the Canadian Arctic. A community-based, multi-institutional nutritional and lifestyle intervention--Healthy Foods North--was implemented to improve food-related psychosocial factors and behaviors among Inuit and Inuvialuit in four intervention communities (with two…

  17. Mothers, Fathers, and Toddlers: Parental Psychosocial Functioning as a Context for Young Children's Sleep

    ERIC Educational Resources Information Center

    Bernier, Annie; Bélanger, Marie-Ève; Bordeleau, Stéphanie; Carrier, Julie

    2013-01-01

    The aim of this study was to investigate the prospective relations between parental psychosocial functioning and toddlers' sleep consolidation. Investigators met with 85 families 3 times, when children were 15 months (Time 1 [T1]), 18 months (T2), and 2 years of age (T3). Mothers and fathers completed questionnaires pertaining to their parenting…

  18. Investigating the Effects of Asthma Medication on the Cognitive and Psychosocial Functioning of Primary School Children with Asthma

    ERIC Educational Resources Information Center

    Naude, H.; Pretorius, E.

    2003-01-01

    The effects of asthma medication on the cognitive and psychosocial functioning of primary school children with asthma are investigated. A questionnaire survey was conducted in a primary school in Stellenbosch (South Africa) with a population of six hundred and thirty-five students. Among these students, fifty-nine asthmatic children were…

  19. The Relationship of School Breakfast to Psychosocial and Academic Functioning: Cross-Sectional and Longitudinal Observations in an Inner-City School Sample

    ERIC Educational Resources Information Center

    Murphy, J. Michael; Pagano, Maria E.; Nachmani, Joan; Sperling, Peter; Kane, Shirley; Kleinman, Ronald E.

    1998-01-01

    Objective: To determine if a relationship exists between participation in a school breakfast program and measures of psychosocial and academic functioning in school-aged children. Methods: Information on participation in a school breakfast program, school record data, and in-depth interviews with parents and children were collected in 1 public…

  20. Psychosocial Functioning of Bullied Youth Who Adopt versus Deny the Bully-Victim Label

    ERIC Educational Resources Information Center

    Sharkey, Jill D.; Ruderman, Matthew A.; Mayworm, Ashley M.; Green, Jennifer Greif; Furlong, Michael J.; Rivera, Nelly; Purisch, Lindsey

    2015-01-01

    This study addressed a need for research on the association between adopting or denying the label of bully victim and students' psychosocial functioning. Participants were 1,063 students in Grades 5, 7, and 9 in a school district in the northeastern United States. Students were grouped based on their pattern of responses to (a) the California…

  1. The Ethnic Identity, Other-Group Attitudes, and Psychosocial Functioning of Asian American Emerging Adults from Two Contexts

    ERIC Educational Resources Information Center

    Juang, Linda P.; Nguyen, Huong H.; Lin, Yunghui

    2006-01-01

    Drawing from two samples of Asian American emerging adults, one in an ethnically concentrated context (n = 108) and the other in an ethnically-dispersed, mainly White context (n = 153), we examined (a) how ethnic identity and other-group attitudes were related to psychosocial functioning (i.e., depression, self-esteem, and connectedness to…

  2. The Impact of the Developmental Timing of Trauma Exposure on PTSD Symptoms and Psychosocial Functioning among Older Adults

    ERIC Educational Resources Information Center

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2013-01-01

    The present study examined the impact of the developmental timing of trauma exposure on posttraumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (N = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas…

  3. Sticks and Stones May Break My Bones, but Names will Make Me Feel Sick: The Psychosocial, Somatic, and Scholastic Consequences of Peer Harassment

    ERIC Educational Resources Information Center

    Nishina, Adrienne; Juvonen, Jaana; Witkow, Melissa R.

    2005-01-01

    This study examined associations among peer victimization, psychosocial problems, physical symptoms, and school functioning across the 1st year in middle school. An ethnically diverse sample of urban 6th graders (N = 1,526) reported on their perceptions of peer victimization, psychosocial adjustment, and physical symptoms during fall and spring.…

  4. Nursing leadership style and psychosocial work environment.

    PubMed

    Malloy, Terry; Penprase, Barbara

    2010-09-01

    This study examines the relationship between leadership style and the psychosocial work environment of registered nurses. Research consistently supports the positive relationship between transformational leadership style and job satisfaction. There is less evidence, which identifies the relationship between leadership style and psychosocial work environment. The Multifactor Leadership Questionnaire 5× was used to identify the leadership style. The Copenhagen Psychosocial Questionnaire was used to measure psychosocial work environment dimensions. Statistical analysis included Pearson's r correlation between leadership style and psychosocial work environment and anova to analyse group means. There is a significant correlation between leadership style and 22 out of the 37 dimensions of the psychosocial work environment. This correlation was significant ranging from r = 0.88, P < 0.01 to r = 0.18, P < 0.05. Nurses divided into groups based on transformational leadership scores of the immediate supervisor report significant differences in their psychosocial work environment. This study supports the significant correlation between leadership style and psychosocial work environment for registered nurses. The results of this study suggest that there would be an improvement in the nursing psychosocial work environment by implementation of transformational and contingent reward leadership behaviours. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  5. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials

    PubMed Central

    2012-01-01

    Background This study aimed to systematically review the evidence from randomized controlled trials (RCTs) and to conduct a meta-analysis of the effects of yoga on physical and psychosocial outcomes in cancer patients and survivors. Methods A systematic literature search in ten databases was conducted in November 2011. Studies were included if they had an RCT design, focused on cancer patients or survivors, included physical postures in the yoga program, compared yoga with a non-exercise or waitlist control group, and evaluated physical and/or psychosocial outcomes. Two researchers independently rated the quality of the included RCTs, and high quality was defined as >50% of the total possible score. Effect sizes (Cohen’s d) were calculated for outcomes studied in more than three studies among patients with breast cancer using means and standard deviations of post-test scores of the intervention and control groups. Results Sixteen publications of 13 RCTs met the inclusion criteria, of which one included patients with lymphomas and the others focused on patients with breast cancer. The median quality score was 67% (range: 22–89%). The included studies evaluated 23 physical and 20 psychosocial outcomes. Of the outcomes studied in more than three studies among patients with breast cancer, we found large reductions in distress, anxiety, and depression (d = −0.69 to −0.75), moderate reductions in fatigue (d = −0.51), moderate increases in general quality of life, emotional function and social function (d = 0.33 to 0.49), and a small increase in functional well-being (d = 0.31). Effects on physical function and sleep were small and not significant. Conclusion Yoga appeared to be a feasible intervention and beneficial effects on several physical and psychosocial symptoms were reported. In patients with breast cancer, effect size on functional well-being was small, and they were moderate to large for psychosocial outcomes. PMID:23181734

  6. Is cognitive adaptation training (CAT) compensatory, restorative, or both?

    PubMed

    Fredrick, Megan M; Mintz, Jim; Roberts, David L; Maples, Natalie J; Sarkar, Sonali; Li, Xueying; Velligan, Dawn I

    2015-08-01

    Cognitive adaptation training (CAT) is a psychosocial treatment incorporating environmental supports including signs, checklists to bypass the cognitive deficits of schizophrenia. Our objective was to examine the association between CAT, functional outcomes, and cognitive test performance (cognition). The two research questions were as follows: 1) Does cognition mediate the effect of CAT intervention on functional outcome? 2) Does CAT impact cognitive test performance? A total of 120 participants with schizophrenia were randomized to one of three treatments: 1) CAT (weekly for 9months; monthly thereafter), 2) generic environmental supports (given to participants on clinic visits to promote adaptive behavior), or 3) treatment as usual (TAU). Assessments of cognition and functional outcome were conducted at baseline, 9 and 24months. Mediation analyses and mixed effects regression were conducted. Mediation analyses revealed that during the initial 9months, the direct path from treatment group to functional outcome on the primary measure was positive and highly significant. CAT significantly improved functional outcome compared to the other treatments. However, paths involving cognition were negligible. There was no evidence that cognition mediated improvement in functional outcomes. At 24months, cognition improved more in CAT compared to other treatment groups. The test for cognition mediating improvement in functional outcomes was not significant at this time point. However, improvement in functional outcome led to better performance on cognitive testing. We concluded that improvement in cognition is not a necessary condition for improvement in functional outcome and that greater engagement in functional behavior has a positive impact on cognition. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. [Programme for improving emotional and cognitive changes in patients under renal dialysis in Egypt].

    PubMed

    Awadalla, Hala I; El-Ateek, Ahmed M; Elhammady, Mohamed M; Kamel, Magda A

    2008-01-01

    We investigated the effect of chronic renal failure on the emotional status, social and psychological adaptation and the cognitive status of patients and the effect of a programme to improve the psychosocial state of the patients; 40 renal dialysis patients and 40 healthy controls were included. We used the Emotional Status Scale, Psychosocial Adaptation Scale, the Primary Mental Abilities Test and the Memory Processes Scale for assessment of the participants. The controls had better emotional/cognitive status and psychosocial adaptation than the dialysis patients, a statistically significant difference. There were also statistically significant differences between the patients before and after the application of the programme.

  8. Family dynamics and psychosocial functioning in children with SCI/D from Colombia, South America

    PubMed Central

    Nicolais, Christina J.; Perrin, Paul B.; Panyavin, Ivan; Nicholls, Elizabeth G.; Olivera Plaza, Silvia Leonor; Quintero, Lorena Medina; Arango-Lasprilla, Juan Carlos

    2016-01-01

    Objective The purpose of this study was to examine the connections between family dynamics and the psychosocial functioning of children with spinal cord injuries and disorders (SCI/D). Design Cross-sectional. Setting Participants were recruited from communities in Neiva, Colombia. Participants Thirty children with SCI/D and their primary caregiver participated. Children were between 8 and 17 years of age, and had sustained their injury at least six months prior to data collection. Interventions NA. Outcome measures Participating children completed measures assessing their own psychosocial functioning (Children's Depression Inventory, Revised Children's Manifest Anxiety Scale-2, Pediatric Quality of Life Inventory), and their primary caregiver completed measures of family dynamics (Family Adaptability and Cohesion Evaluation Scale- Fourth Edition, Family Communication Scale, Family Assessment Device- General Functioning, Family Satisfaction Scale, Relationship-Focused Coping Scale). Results A correlation matrix showed a number of significant bivariate correlations between child and family variables, and three multiple regressions showed that family satisfaction, empathy, and flexibility significantly explained 27% of the variance in child worry; family satisfaction and communication explained 18% of the variance in child social anxiety; and family cohesion and communication explained 23% of the variance in child emotional functioning. Conclusions These findings highlight the importance of rehabilitation professionals considering the association between family dynamics and the psychosocial functioning of children with SCI/D when working with this population. PMID:25582185

  9. Toward a Broader Role for Occupational Therapy in Supportive Oncology Care.

    PubMed

    Sleight, Alix G; Duker, Leah I Stein

    2016-01-01

    Supportive care in oncology helps people cope with cancer and its psychological, physical, and emotional side effects. However, cancer survivors report dissatisfaction with supportive care and a need for more psychosocial and self-management services. Occupational therapy practitioners represent an integral part of the supportive care team because their scope of practice emphasizes function. Through a focus on function, practitioners address the full spectrum of physical and psychosocial care. Currently, conceptualizations of occupational therapy for cancer survivors often focus solely on physical interventions and, therefore, do not represent the unique involvement of the profession in supportive oncology care. We advocate for a focused framework for occupational therapy practitioners in oncology as experts in function and providers of both physical and psychosocial treatments. Barriers to a focus on function are identified, and strategies are suggested for expanding involvement for the profession in supportive oncology care. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  10. Toward a Broader Role for Occupational Therapy in Supportive Oncology Care

    PubMed Central

    Duker, Leah I. Stein

    2016-01-01

    Supportive care in oncology helps people cope with cancer and its psychological, physical, and emotional side effects. However, cancer survivors report dissatisfaction with supportive care and a need for more psychosocial and self-management services. Occupational therapy practitioners represent an integral part of the supportive care team because their scope of practice emphasizes function. Through a focus on function, practitioners address the full spectrum of physical and psychosocial care. Currently, conceptualizations of occupational therapy for cancer survivors often focus solely on physical interventions and, therefore, do not represent the unique involvement of the profession in supportive oncology care. We advocate for a focused framework for occupational therapy practitioners in oncology as experts in function and providers of both physical and psychosocial treatments. Barriers to a focus on function are identified, and strategies are suggested for expanding involvement for the profession in supportive oncology care. PMID:27295001

  11. Role of affective self-regulatory efficacy in diverse spheres of psychosocial functioning.

    PubMed

    Bandura, Albert; Caprara, Gian Vittorio; Barbaranelli, Claudio; Gerbino, Maria; Pastorelli, Concetta

    2003-01-01

    This prospective study with 464 older adolescents (14 to 19 years at Time 1; 16 to 21 years at Time 2) tested the structural paths of influence through which perceived self-efficacy for affect regulation operates in concert with perceived behavioral efficacy in governing diverse spheres of psychosocial functioning. Self-efficacy to regulate positive and negative affect is accompanied by high efficacy to manage one's academic development, to resist social pressures for antisocial activities, and to engage oneself with empathy in others' emotional experiences. Perceived self-efficacy for affect regulation essentially operated mediationally through the latter behavioral forms of self-efficacy rather than directly on prosocial behavior, delinquent conduct, and depression. Perceived empathic self-efficacy functioned as a generalized contributor to psychosocial functioning. It was accompanied by prosocial behavior and low involvement in delinquency but increased vulnerability to depression in adolescent females.

  12. Cumulative psychosocial risk, parental socialization, and child cognitive functioning: A longitudinal cascade model.

    PubMed

    Wade, Mark; Madigan, Sheri; Plamondon, Andre; Rodrigues, Michelle; Browne, Dillon; Jenkins, Jennifer M

    2018-06-01

    Previous studies have demonstrated that various psychosocial risks are associated with poor cognitive functioning in children, and these risks frequently cluster together. In the current longitudinal study, we tested a model in which it was hypothesized that cumulative psychosocial adversity of mothers would have deleterious effects on children's cognitive functioning by compromising socialization processes within families (i.e., parental competence). A prospective community birth cohort of 501 families was recruited when children were newborns. At this time, mothers reported on their current psychosocial circumstances (socioeconomic status, teen parenthood, depression, etc.), which were summed into a cumulative risk score. Families were followed up at 18 months and 3 years, at which point maternal reflective capacity and cognitive sensitivity were measured, respectively. Child cognition (executive functioning, theory of mind, and language ability) was assessed at age 4.5 using age-appropriate observational and standardized tasks. Analyses controlled for child age, gender, number of children in the home, number of years married, and mothers' history of adversity. The results revealed significant declines in child cognition as well as maternal reflective capacity and cognitive sensitivity as the number of psychosocial risks increased. Moreover, longitudinal path analysis showed significant indirect effects from cumulative risk to all three cognitive outcomes via reflective capacity and cognitive sensitivity. Findings suggest that cumulative risk of mothers may partially account for child cognitive difficulties in various domains by disrupting key parental socialization competencies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Predicting low back pain outcome following rehabilitation for low back pain.

    PubMed

    Roberts, Andrew J; Dew, Angela; Bridger, Robert; Etherington, John; Kilminster, Shaun

    2015-01-01

    Psychosocial factors are known to play a key role in determining the progress of back pain patients. However, it is not known whether these factors are applicable to military personnel, who tend to be fitter than the general population. The aim was to identify physical and psychological predictors in a prospective study of the outcome of back pain rehabilitation over 6 months and a longer follow-up time of between 15 and 32 months. Two hundred and fifty military personnel reporting for a residential rehabilitation programme completed a battery of physical and psychological tests. The physical tests included 800 m run time and the Biering-Sorensen test. The psychological/psychosocial measures included items on fear avoidance, self efficacy, anxiety and depression and occupational psychosocial factors such as job satisfaction. Self efficacy and 800 m run time predicted self-reported functional ability at 6 months and medical discharge/return to full fitness at 15–32 months. Patients with 800 m run times of more than 3 minutes 31 seconds had a four times greater chance of medical discharge from the Armed forces. Eight hundred metre run time and self-efficacy were independent predictors of both self-reported functional ability at 6 months and return to full fitness/medical discharge at 15–32 months. Self-efficacy also predicted 40% of the variance in the intensity of back pain and 10% of other non-back pain. Rehabilitation should include greater emphasis on physical fitness and on improving self-efficacy.

  14. Perceptions About Competing Psychosocial Problems and Treatment Priorities Among Older Adults With Depression

    PubMed Central

    Proctor, Enola K.; Hasche, Leslie; Morrow-Howell, Nancy; Shumway, Martha; Snell, Grace

    2009-01-01

    Objective Depression often co-occurs with other conditions that may pose competing demands to depression care, particularly in later life. This study examined older adults’ perceptions of depression among cooccurring social, medical, and functional problems and compared the priority of depression with that of other problems. Methods The study’s purposeful sample comprised 49 adults age 60 or older with a history of depression and in publicly funded community long-term care. Fourpart, mixed-methods interviews sought to capture participants’ perceptions of life problems as well as the priority they placed on depression. Methods included standardized depression screening, semistructured qualitative interviews, listing of problems, and qualitative and quantitative analysis of problem rankings. Results Most participants identified health, functional, and psychosocial problems co-occurring with depressive symptoms. Depression was ranked low among the co-occurring conditions; 6% ranked depression as the most important of their problems, whereas 45% ranked it last. Relative rank scores for problems were remarkably similar, with the notable exception of depression, which was ranked lowest of all problems. Participants did not see depression as a high priority compared with co-occurring problems, particularly psychosocial ones. Conclusions Effective and durable improvements to mental health care must be shaped by an understanding of client perceptions and priorities. Motivational interviewing, health education, and assessment of treatment priorities may be necessary in helping older adults value and accept depression care. Nonspecialty settings of care may effectively link depression treatment to other services, thereby increasing receptivity to mental health services. PMID:18511588

  15. Rehabilitation of schizophrenic patients.

    PubMed

    Gunatilake, S; Ananth, J; Parameswaran, S; Brown, S; Silva, W

    2004-01-01

    Schizophrenia is a maldevelopmental disorder of the brain that manifests in positive, negative, cognitive and affective symptoms. Currently, the mainstay of treatment involves pharmacotherapy. The limitations of antipsychotic treatment are that they can only control symptoms and cannot cure the illness, and 20% of patients do not respond, thus leading to the requirement of maintenance treatment. Patients that do respond continue to have disabling residual symptoms such as amotivation and isolation, maladaptive behavior, and impaired social functioning. These symptoms prevent patients from attaining educational, occupational, and social roles. Psychosocial interventions and models of quality of life in schizophrenia are based on the notion that increases in psychosocial functioning will be related to improvement in subjective experiences, such as self-esteem and satisfaction with life. The comparative effect of specific treatment methods and the additional benefits of multiple treatments need to be explored. Diversified techniques have also been employed, such as shaping, cognitive process therapy, mastery-oriented skill training, motivation and enhancement. Issues in designing psychosocial interventions and the role of various professionals in providing such interventions need to be carefully considered. Predictor variables and the indications for particular therapies in an individual need to be explored. Generalizability of the gains made by rehabilitation/recovery is also an important consideration. Patients in jail, chronic mental hospitals, private facilities, and the Veterans Administration system are all different in their ability to benefit, their motivations, and the severity of their psychopathology. Therefore, it is very difficult to generalize findings from one setting to another.

  16. Non-pharmacological cognitive intervention for aging and dementia: Current perspectives

    PubMed Central

    Alves, Jorge; Magalhães, Rosana; Machado, Álvaro; Gonçalves, Óscar F; Sampaio, Adriana; Petrosyan, Agavni

    2013-01-01

    In recent years, cognitive difficulties associated with normal aging and dementia have been receiving increased attention from both public and scientific communities. With an increase in overall lifespan, promoting healthy cognition has become a priority and a necessity for minimizing and preventing individual and societal burdens associated with cognitive dysfunctions in the elderly. The general awareness concerning the efficacy of preventive (e.g., lifestyles) and palliative treatment strategies of cognitive impairments, related to either healthy or unhealthy trajectories in cognitive aging, is continuously rising. There are several therapeutic strategies which can be broadly classified as either pharmacological or non-pharmacological/psychosocial. In face of the modest evidence for success of pharmacological treatments, especially for dementia related impairments, psychosocial interventions are progressively considered as a complementary treatment. Despite the relative spread of psychosocial interventions in clinical settings, research in this area is rather scarce with evidence for success of these therapies remaining controversial. In this work we provide an evidence based perspective on cognitive intervention(s) for healthy aging, pre-dementia (mild cognitive impairment), and dementia populations. Current evidence and future directions for improving cognitive functions in the elderly are discussed as well. PMID:24340275

  17. Assessing mental health and psychosocial status in communities exposed to traumatic events: Sri Lanka as an example.

    PubMed

    Fernando, Gaithri A

    2008-04-01

    The purpose of this study was to develop a measure of psychosocial status that could reliably and accurately assess psychosocial functioning in Sinhalese Sri Lankans impacted by traumatic events. A culturally grounded methodology using qualitative data was used to develop and validate the Sri Lankan Index of Psychosocial Status--Adult Version (SLIPSS-A). The SLIPPS-A is a 26-item measure assessing local indicators of distress, with items placed on a frequency scale from 0 (never) to 4 (6-7 days per week). The instrument was administered to 170 Sinhalese Sri Lankans (72% women) between the ages of 21 and 71 years with differing types of trauma exposure. The measure demonstrated excellent reliability (alpha = .92) and was significantly correlated with the Postraumatic Stress Disorder (PTSD) Checklist. Scores on the SLIPSS-A significantly predicted exposure to the tsunami. Factor analysis resulted in the extraction of five factors. The results suggest that the SLIPSS-A could be used as a general measure to assess psychosocial functioning in Sri Lankan rural Sinhalese adults impacted by trauma. Copyright 2008 APA, all rights reserved.

  18. Cognitive and psychosocial effects of oxcarbazepine monotherapy in newly diagnosed partial epilepsy.

    PubMed

    Kim, Daeyoung; Seo, Ji-Hye; Joo, Eun Yeon; Lee, Hyang Woon; Shin, Won Chul; Hong, Seung Bong

    2014-01-01

    The aim of this study was to assess the effects of oxcarbazepine (OXC) on cognition and psychosocial difficulties in patients with new-onset partial epilepsy. Cognitive and psychosocial assessments were performed before and after 6 to 12 months of OXC monotherapy in 52 drug-naive patients (25 women; mean age, 31.1 years; SD, 12.1 years). Cognitive functions were evaluated with well-structured and validated tools. Mood, psychological distress, subjective handicap, and quality of life were also evaluated. Differences between baseline and after-treatment evaluation were compared and adjusted for possible confounders such as age, sex, seizure control, duration of epilepsy, assessment interval, and epileptogenic region. Mean assessment interval was 231.8 (range, 182-348) days, and mean (SD) OXC dose at retest was 693.8 (208.9) mg. The OXC was found to have no significant adverse effect on cognition. Furthermore, OXC monotherapy was not found to affect psychosocial difficulties, including psychological distress and subjective handicap. The results suggest that OXC monotherapy could be used to treat newly diagnosed partial epilepsy without adversely affecting cognitive and psychosocial functions.

  19. Health related quality of life in parents of six to eight year old children with Down syndrome.

    PubMed

    Marchal, Jan Pieter; Maurice-Stam, Heleen; Hatzmann, Janneke; van Trotsenburg, A S Paul; Grootenhuis, Martha A

    2013-11-01

    Raising a child with Down syndrome (DS) has been found to be associated with lowered health related quality of life (HRQoL) in the domains cognitive functioning, social functioning, daily activities and vitality. We aimed to explore which socio-demographics, child functioning and psychosocial variables were related to these HRQoL domains in parents of children with DS. Parents of 98 children with DS completed the TNO-AZL adult quality of life questionnaire (TAAQOL) and a questionnaire assessing socio-demographic, child functioning and psychosocial predictors. Using multiple linear regression analyses for each category of predictors, we selected relevant predictors for the final models. The final multiple linear regression models revealed that cognitive functioning was best predicted by the sleep of the child (β=.29, p<.01) and by the parent having given up a hobby (β=-.29, p<.01), social functioning by the quality of the partner relation (β=.34, p<.001), daily activities by the parent having to care for an ill friend or family member (β=-.31, p<.01), and vitality by the parent having enough personal time (β=.32, p<.01). Overall, psychosocial variables rather than socio-demographics or child functioning showed most consistent and powerful relations to the HRQoL domains of cognitive functioning, social functioning, daily activities and vitality. These psychosocial variables mainly related to social support and time pressure. Systematic screening of parents to detect problems timely, and interventions targeting the supportive network and the demands in time are recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Insight as a social identity process in the evolution of psychosocial functioning in the early phase of psychosis.

    PubMed

    Klaas, H S; Clémence, A; Marion-Veyron, R; Antonietti, J-P; Alameda, L; Golay, P; Conus, P

    2017-03-01

    Awareness of illness (insight) has been found to have contradictory effects for different functional outcomes after the early course of psychosis. Whereas it is related to psychotic symptom reduction and medication adherence, it is also associated with increased depressive symptoms. In this line, the specific effects of insight on the evolution of functioning over time have not been identified, and social indicators, such as socio-occupational functioning have barely been considered. Drawing from social identity theory we investigated the impact of insight on the development of psychosocial outcomes and the interactions of these variables over time. The participants, 240 patients in early phase of psychosis from the Treatment and Early Intervention in Psychosis Program (TIPP) of the University Hospital of Lausanne, Switzerland, were assessed at eight time points over 3 years. Cross-lagged panel analyses and multilevel analyses were conducted on socio-occupational and general functioning [Social and Occupational Functioning Assessment Scale (SOFAS) and Global Assessment of Functioning (GAF)] with insight, time and depressive symptoms as independent variables. Results from multilevel analyses point to an overall positive impact of insight on psychosocial functioning, which increases over time. Yet the cross-lagged panel analysis did not reveal a systematic positive and causal effect of insight on SOFAS and GAF scores. Depressive symptoms seem only to be relevant in the beginning of the treatment process. Our results point to a complex process in which the positive impact of insight on psychosocial functioning increases over time, even when considering depressive symptoms. Future studies and treatment approaches should consider the procedural aspect of insight.

  1. Internet-Based Group Intervention for Ovarian Cancer Survivors: Feasibility and Preliminary Results

    PubMed Central

    Kinner, Ellen M; Armer, Jessica S; McGregor, Bonnie A; Duffecy, Jennifer; Leighton, Susan; Corden, Marya E; Gauthier Mullady, Janine; Penedo, Frank J

    2018-01-01

    Background Development of psychosocial group interventions for ovarian cancer survivors has been limited. Drawing from elements of cognitive-behavioral stress management (CBSM), mindfulness-based stress reduction (MBSR), and acceptance and commitment therapy (ACT), we developed and conducted preliminary testing of an Internet-based group intervention tailored specifically to meet the needs of ovarian cancer survivors. The Internet-based platform facilitated home delivery of the psychosocial intervention to a group of cancer survivors for whom attending face-to-face programs could be difficult given their physical limitations and the small number of ovarian cancer survivors at any one treatment site. Objective The aim of this study was to develop, optimize, and assess the usability, acceptability, feasibility, and preliminary intended effects of an Internet-based group stress management intervention for ovarian cancer survivors delivered via a tablet or laptop. Methods In total, 9 ovarian cancer survivors provided feedback during usability testing. Subsequently, 19 survivors participated in 5 waves of field testing of the 10-week group intervention led by 2 psychologists. The group met weekly for 2 hours via an Internet-based videoconference platform. Structured interviews and weekly evaluations were used to elicit feedback on the website and intervention content. Before and after the intervention, measures of mood, quality of life (QOL), perceived stress, sleep, and social support were administered. Paired t tests were used to examine changes in psychosocial measures over time. Results Usability results indicated that participants (n=9) performed basic tablet functions quickly with no errors and performed website functions easily with a low frequency of errors. In the field trial (n=19), across 5 groups, the 10-week intervention was well attended. Perceived stress (P=.03) and ovarian cancer-specific QOL (P=.01) both improved significantly during the course of the intervention. Trends toward decreased distress (P=.18) and greater physical (P=.05) and functional well-being (P=.06) were also observed. Qualitative interviews revealed that the most common obstacles participants experienced were technical issues and the time commitment for practicing the techniques taught in the program. Participants reported that the intervention helped them to overcome a sense of isolation and that they appreciated the ability to participate at home. Conclusions An Internet-based group intervention tailored specifically for ovarian cancer survivors is highly usable and acceptable with moderate levels of feasibility. Preliminary psychosocial outcomes indicate decreases in perceived stress and improvements in ovarian cancer-specific QOL following the intervention. A randomized clinical trial is needed to demonstrate the efficacy of this promising intervention for ovarian cancer survivors. PMID:29335233

  2. Disease disclosure in individuals with cystic fibrosis: Association with psychosocial and health outcomes.

    PubMed

    Borschuk, Adrienne P; Everhart, Robin S; Eakin, Michelle N; Rand-Giovannetti, Devin; Borrelli, Belinda; Riekert, Kristin A

    2016-09-01

    This study aimed to quantify cystic fibrosis (CF) disclosure and examine associations between disclosure and psychosocial and health outcomes. Participants completed measures assessing disease disclosure and psychosocial outcomes. Data from chart reviews and pharmacy records were obtained. Participants (N=128; ages 16-63) were more likely to disclose to romantic partners (97%) and close friends (94%) than to casual friends (79%), bosses (71%), or co-workers (53%). Participants reported more comfort discussing CF with and doing treatments in front of romantic partners and close friends than other groups. Disclosure was associated with higher social support, social functioning, and medication adherence self-efficacy. Lower lung-function was associated with disclosure to bosses and co-workers. Clinicians should consider discussing disclosure with patients, as limited disclosure may have a negative impact on psychosocial outcomes. Copyright © 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  3. SHARED, NOT UNIQUE, COMPONENTS OF PERSONALITY AND PSYCHOSOCIAL FUNCTIONING PREDICT DEPRESSION SEVERITY AFTER ACUTE-PHASE COGNITIVE THERAPY

    PubMed Central

    Clark, Lee Anna; Vittengl, Jeffrey R.; Kraft, Dolores; Jarrett, Robin B.

    2005-01-01

    In a sample of 100 patients with recurrent major depression, we collected depression severity data early and late in acute-phase cognitive therapy, plus a wide range of psychosocial variables that have been studied extensively in depression research, including measures of interpersonal, cognitive, and social functioning, and personality traits using an inventory that is linked with the Big-Three tradition in personality assessment theory. By assessing this broad range of variables in a single study, we could examine the extent to which relations of these variables with depression were due to (a) a common factor shared across this diverse set of constructs, (b) factors shared among each type of construct (personality vs. psychosocial measures), or (c) specific aspects of the individual measures. Only the most general factor shared across the personality and psychosocial variables predicted later depression. PMID:14632375

  4. Testing a Positive Psychological Intervention for Osteoarthritis.

    PubMed

    Hausmann, Leslie R M; Youk, Ada; Kwoh, C Kent; Ibrahim, Said A; Hannon, Michael J; Weiner, Debra K; Gallagher, Rollin M; Parks, Acacia

    2017-10-01

    Osteoarthritis is a leading cause of disability for which there is no cure. Psychosocial-oriented treatments are underexplored. We developed and tested an intervention to build positive psychological skills (e.g., gratitude) to reduce osteoarthritis symptom severity, including pain and functioning, and to improve psychosocial well-being in patients with knee or hip osteoarthritis. Two-arm randomized design with six-month follow-up. An academic Veterans Affairs Medical Center. Patients aged 50 years or older with knee or hip osteoarthritis and pain ratings of 4 or higher. Patients (N = 42) were randomized to a six-week program containing positive skill-building activities or neutral control activities tailored to the patient population. Adherence was assessed by telephone each week. We assessed osteoarthritis symptom severity (WOMAC Osteoarthritis Index) and measures of well-being (positive affect, negative affect, and life satisfaction) at baseline and by telephone one, three, and six months after the program ended. We used linear mixed models to examine changes over time. The majority (64%) of patients completed more than 80% of their weekly activities. Patients in the positive (vs neutral) program reported significantly more improvement over time in osteoarthritis symptom severity (P = 0.02, Cohen's d = 0.86), negative affect (P = 0.03, Cohen's d = 0.50), and life satisfaction (P = 0.02, Cohen's d = 0.36). The study successfully engaged patients with knee or hip osteoarthritis in a six-week intervention to build positive psychological skills. Improving osteoarthritis symptom severity and measures of psychosocial well-being, the intervention shows promise as a tool for chronic pain management. 2017 American Academy of Pain Medicine. This work is written by US Government employees and is in the public domain in the US.

  5. Effects of a free school breakfast programme on school attendance, achievement, psychosocial function, and nutrition: a stepped wedge cluster randomised trial

    PubMed Central

    2010-01-01

    Background Approximately 55,000 children in New Zealand do not eat breakfast on any given day. Regular breakfast skipping has been associated with poor diets, higher body mass index, and adverse effects on children's behaviour and academic performance. Research suggests that regular breakfast consumption can improve academic performance, nutrition and behaviour. This paper describes the protocol for a stepped wedge cluster randomised trial of a free school breakfast programme. The aim of the trial is to determine the effects of the breakfast intervention on school attendance, achievement, psychosocial function, dietary habits and food security. Methods/Design Sixteen primary schools in the North Island of New Zealand will be randomised in a sequential stepped wedge design to a free before-school breakfast programme consisting of non-sugar coated breakfast cereal, milk products, and/or toast and spreads. Four hundred children aged 5-13 years (approximately 25 per school) will be recruited. Data collection will be undertaken once each school term over the 2010 school year (February to December). The primary trial outcome is school attendance, defined as the proportion of students achieving an attendance rate of 95% or higher. Secondary outcomes are academic achievement (literacy, numeracy, self-reported grades), sense of belonging at school, psychosocial function, dietary habits, and food security. A concurrent process evaluation seeks information on parents', schools' and providers' perspectives of the breakfast programme. Discussion This randomised controlled trial will provide robust evidence of the effects of a school breakfast programme on students' attendance, achievement and nutrition. Furthermore the study provides an excellent example of the feasibility and value of the stepped wedge trial design in evaluating pragmatic public health intervention programmes. Trial Registration Number Australian New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12609000854235 PMID:21114862

  6. Family breakup and adolescents' psychosocial maladjustment: public health implications of family disruptions.

    PubMed

    Roustit, Christelle; Chaix, Basile; Chauvin, Pierre

    2007-10-01

    Recent changes in family structure are associated with an increase in psychosocial maladjustment in adolescents. We examined, from a public health intervention perspective, the association between family breakup and psychosocial maladjustment in adolescents and assessed the mediating role of family-functioning variables. We analyzed data from the Social and Health Survey of Children and Adolescents in Quebec, Montreal, Canada, which was conducted in 1999. Sample-weighted logistic regression analyses were performed to determine the risk of internalizing disorders, externalizing disorders, substance abuse, and alcohol consumption in relation to family breakups and family-functioning variables, after adjusting for socioeconomic factors. All 4 of the indicators of psychosocial maladjustment were significantly associated with family breakup. The association between family breakups and internalizing disorders was mediated by parental psychological distress and low paternal emotional support. Independently, the witnessing of interparental violence was also strongly associated with internalizing disorders. For the other 3 outcomes, that is, externalizing disorders, substance abuse, and alcohol consumption, family breakup and family-functioning variables had independent effects. Family-based interventions and social approaches are complementary support modalities for adolescents experiencing family disruptions.

  7. Stressful life events as predictors of functioning: findings from the Collaborative Longitudinal Personality Disorders Study

    PubMed Central

    Pagano, M. E.; Skodol, A. E.; Stout, R. L.; Shea, M. T.; Yen, S.; Grilo, C. M.; Sanislow, C. A.; Bender, D. S.; McGlashan, T. H.; Zanarini, M. C.; Gunderson, J. G.

    2008-01-01

    Objective Although much attention has been given to the effects of adverse childhood experiences on the development of personality disorders (PDs), we know far less about how recent life events influence the ongoing course of functioning. We examined the extent to which PD subjects differ in rates of life events and the extent to which life events impact psychosocial functioning. Method A total of 633 subjects were drawn from the Collaborative Longitudinal Personality Disorders Study (CLPS), a multi-site study of four personality disorders – schizotypal (STPD), borderline (BPD), avoidant (AVPD), obsessive-compulsive (OCPD) – and a comparison group of major depressive disorders (MDD) without PD. Results Borderline personality disorder subjects reported significantly more total negative life events than other PDs or subjects with MDD. Negative events, especially interpersonal events, predicted decreased psychosocial functioning over time. Conclusion Our findings indicate higher rates of negative events in subjects with more severe PDs and suggest that negative life events adversely impact multiple areas of psychosocial functioning. PMID:15521826

  8. Improving Exercise Adherence and Physical Measures in English-Speaking Latina Women.

    PubMed

    Martin, Lorena; Signorile, Joseph F; Kahn, Barbara E; Perkins, Andrew W; Ahn, Soyeon; Perry, Arlette C

    2015-12-01

    Epidemiological data have established that lack of physical activity increases risk factors for chronic diseases. Data also suggests that physical activity participation is lowest in minority women, particularly Latinas, and that the nature of the exercise and attitudes toward exercise may influence exercise adherence. The purpose of this study was to determine the effect of hypertrophy training (HT) or power training (PT) used concomitantly with evaluative conditioning (EC) or neutral conditioning (NC) on exercise adherence as well as in physical and psychosocial variables in Latina women. EC is a behavioral method using paired stimuli to develop and strengthen new associations in memory. Two hundred thirty-one English-speaking Latina women (mean ± SD, age 36.8 ± 15.9 years) were randomly assigned to standard HT or high-speed circuit PT and then further stratified to receive EC or NC. One hundred forty-two Latina women completed pre- and posttesting. For HT, EC produced significantly greater exercise time across the training period than NC. HT and PT both significantly improved all physical, functional, and psychosocial variables, with exception of leg extension and usual gait speed (p < 0.05). EC can positively impact exercise adherence during HT in Latina women; while body composition, neuromuscular, and functional performances can be increased using HT and PT independent of psychological conditioning.

  9. Using eye-tracking technology for communication in Rett syndrome: perceptions of impact.

    PubMed

    Vessoyan, Kelli; Steckle, Gill; Easton, Barb; Nichols, Megan; Mok Siu, Victoria; McDougall, Janette

    2018-04-27

    Studies have investigated the use of eye-tracking technology to assess cognition in individuals with Rett syndrome, but few have looked at this access method for communication for this group. Loss of speech, decreased hand use, and severe motor apraxia significantly impact functional communication for this population. Eye gaze is one modality that may be used successfully by individuals with Rett syndrome. This multiple case study explored whether using eye-tracking technology, with ongoing support from a team of augmentative and alternative communication (AAC) therapists, could help four participants with Rett syndrome meet individualized communication goals. Two secondary objectives were to examine parents' perspectives on (a) the psychosocial impact of their child's use of the technology, and (b) satisfaction with using the technology. All four participants were rated by the treating therapists to have made improvement on their goals. According to both quantitative findings and descriptive information, eye-tracking technology was viewed by parents as contributing to participants' improved psychosocial functioning. Parents reported being highly satisfied with both the device and the clinical services received. This study provides initial evidence that eye-tracking may be perceived as a worthwhile and potentially satisfactory technology to support individuals with Rett syndrome in communicating. Future, more rigorous research that addresses the limitations of a case study design is required to substantiate study findings.

  10. Adult Congenital Heart Disease-Coping And REsilience (ACHD-CARE): Rationale and methodology of a pilot randomized controlled trial.

    PubMed

    Kovacs, Adrienne H; Bandyopadhyay, Mimi; Grace, Sherry L; Kentner, Amanda C; Nolan, Robert P; Silversides, Candice K; Irvine, M Jane

    2015-11-01

    One-third of North American adults with congenital heart disease (CHD) have diagnosable mood or anxiety disorders and most do not receive mental health treatment. There are no published interventions targeting the psychosocial needs of patients with CHD of any age. We describe the development of a group psychosocial intervention aimed at improving the psychosocial functioning, quality of life, and resilience of adults with CHD and the design of a study protocol to determine the feasibility of a potential full-scale randomized controlled trial (RCT). Drawing upon our quantitative and qualitative research, we developed the Adult CHD-Coping And REsilience (ACHD-CARE) intervention and designed a feasibility study that included a 2-parallel arm non-blinded pilot RCT. Eligible participants (CHD, age ≥ 18 years, no planned surgery, symptoms suggestive of a mood and/or anxiety disorder) were randomized to the ACHD-CARE intervention or Usual Care (1:1 allocation ratio). The group intervention was delivered during eight 90-minute weekly sessions. Feasibility will be assessed in the following domains: (i) process (e.g. recruitment and retention), (ii) resources, (iii) management, (iv) scientific outcomes, and (v) intervention acceptability. This study underscores the importance of carefully developing and testing the feasibility of psychosocial interventions in medical populations before moving to full-scale clinical trials. At study conclusion, we will be poised to make one of three determinations for a full-scale RCT: (1) feasible, (2) feasible with modifications, or (3) not feasible. This study will guide the future evaluation and provision of psychosocial treatment for adults with CHD. Copyright © 2015. Published by Elsevier Inc.

  11. Methods to improve rehabilitation of patients following breast cancer surgery: a review of systematic reviews

    PubMed Central

    Loh, Siew Yim; Musa, Aisya Nadia

    2015-01-01

    Context Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery. Method A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search terms included: ‘breast cancer’, ‘breast carcinoma’, ‘surgery’, ‘mastectomy’, ‘lumpectomy’, ‘breast conservation’, ‘axillary lymph node dissection’, ‘rehabilitation’, ‘therapy’, ‘physiotherapy’, ‘occupational therapy’, ‘psychological’, ‘psychosocial’, ‘psychotherapy’, ‘exercise’, ‘physical activity’, ‘cognitive’, ‘occupational’, ‘alternative’, ‘complementary’, and ‘systematic review’. Study selection Systematic reviews on the effectiveness of rehabilitation methods in improving post-operative physical, and psychological outcomes for breast cancer were selected. Sixteen articles met all the eligibility criteria and were included in the review. Data extraction Included review year, study aim, total number of participants included, and results. Data synthesis Evidence for exercise rehabilitation is predominantly in the improvement of shoulder mobility and limb strength. Inconclusive results exist for a range of rehabilitation methods (physical, psycho-education, nutritional, alternative-complementary methods) for addressing the domains of psychosocial, cognitive, and occupational outcomes. Conclusion There is good evidence for narrowly-focused exercise rehabilitation in improving physical outcome particularly for shoulder mobility and lymphedema. There were inconclusive results for methods to improve psychosocial, cognitive, and occupational outcomes. There were no reviews on broader performance areas and lifestyle factors to enable effective living after treatment. The review suggests that comprehensiveness and effectiveness of post-operative breast cancer rehabilitation should consider patients’ self-management approaches towards lifestyle redesign, and incorporate health promotion aspects, in light of the fact that breast cancer is now taking the form of a chronic illness with longer survivorship years. PMID:25792854

  12. The Combined Burden of Cognitive, Executive Function, and Psychosocial Problems in Children with Epilepsy: A Population-Based Study

    ERIC Educational Resources Information Center

    Hoie, B.; Sommerfelt, K.; Waaler, P. E.; Alsaker, F. D.; Skeidsvoll, H.; Mykletun, A.

    2008-01-01

    The combined burden of psychosocial (Achenbach scales), cognitive (Raven matrices), and executive function (EF) problems was studied in a population-based sample of 6- to 12-year-old children with epilepsy (n = 162; 99 males, 63 females) and in an age- and sex-matched control group (n = 107; 62 males, 45 females). Approximately 35% of the children…

  13. Effects of a Psychosocial Intervention on the Executive Functioning in Children with ADHD

    ERIC Educational Resources Information Center

    Miranda, Ana; Presentacion, M. Jesus; Siegenthaler, Rebeca; Jara, Pilar

    2013-01-01

    The purpose of this study was to analyze the effects of an intensive psychosocial intervention on the executive functioning (EF) in children with ADHD. The treatment was carried out in a coordinated manner over a period of 10 weeks with 27 children with ADHD aged 7 to 10, their parents, and their teachers. A battery of neuropsychological tasks was…

  14. Are primary and secondary provoked vestibulodynia two different entities? A comparison of pain, psychosocial, and sexual characteristics.

    PubMed

    Aerts, Leen; Bergeron, Sophie; Corsini-Munt, Serena; Steben, Marc; Pâquet, Myriam

    2015-06-01

    Provoked vestibulodynia (PVD) is suspected to be the most frequent cause of vulvodynia in premenopausal women. Based on the onset of PVD relative to the start of sexual experience, PVD can be divided into primary (PVD1) and secondary PVD (PVD2). Studies comparing these PVD subgroups are inconclusive as to whether differences exist in sexual and psychosocial functioning. The aim of this study was to compare the pain, sexual and psychosocial functioning of a large clinical and community-based sample of premenopausal women with PVD1 and PVD2. A total of 269 women (n = 94 PVD1; n = 175 PVD2) completed measures on sociodemographics, pain, sexual, and psychosocial functioning. Dependent variables were the 0-10 pain numerical rating scale, McGill-Melzack Pain Questionnaire, Female Sexual Function Index, Global Measure of Sexual Satisfaction, Beck Depression Inventory-II, Painful Intercourse Self-Efficacy Scale, Pain Catastrophizing Scale, State-Trait Anxiety Inventory Trait Subscale, Ambivalence over Emotional Expression Questionnaire, Hurlbert Index of Sexual Assertiveness, Experiences in Close Relationships Scale--Revised, and Dyadic Adjustment Scale-Revised. At first sexual relationship, women with PVD2 were significantly younger than women with PVD1 (P < 0.01). The average relationship duration was significantly longer in women with PVD2 compared with women with PVD1 (P < 0.01). Although women with PVD1 described a significantly longer duration of pain compared with women with PVD2 (P < 0.01), no significant subtype differences were found in pain intensity during intercourse. When controlling for the sociodemographics mentioned earlier, no significant differences were found in sexual, psychological, and relational functioning between the PVD subgroups. Nevertheless, on average, both groups were in the clinical range of sexual dysfunction and reported impaired psychological functioning. The findings show that there are no significant differences in the sexual and psychosocial profiles of women with PVD1 and PVD2. Results suggest that similar psychosocial and sex therapy interventions should be offered to both subgroups of PVD. © 2015 International Society for Sexual Medicine.

  15. Family Functioning in First-Episode and Chronic Psychosis: The Role of Patient's Symptom Severity and Psychosocial Functioning.

    PubMed

    Koutra, Katerina; Triliva, Sofia; Roumeliotaki, Theano; Basta, Maria; Lionis, Christos; Vgontzas, Alexandros N

    2016-08-01

    The aim of the present study was to assess the relationship between illness-related characteristics, such as symptom severity and psychosocial functioning, and specific aspects of family functioning both in patients experiencing their first episode of psychosis (FEP) and chronically ill patients. A total of 50 FEP and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) and their family caregivers participated in the study. Family functioning was evaluated in terms of cohesion and flexibility (FACES IV Package), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Patients' symptom severity (BPRS) and psychosocial functioning (GAS) were assessed by their treating psychiatrist within 2 weeks from the caregivers' assessment. Increased symptom severity was associated with greater dysfunction in terms of family cohesion and flexibility (β coefficient -0.13; 95 % CI -0.23, -0.03), increased caregivers' EE levels on the form of emotional overinvolvement (β coefficient 1.03; 95 % CI 0.02, 2.03), and psychological distress (β coefficient 3.37; 95 % CI 1.29, 5.45). Family burden was found to be significantly related to both symptom severity (β coefficient 3.01; 95 % CI 1.50, 4.51) and patient's functioning (β coefficient -2.04; 95 % CI -3.55, -0.53). No significant interaction effect of chronicity was observed in the afore-mentioned associations. These findings indicate that severe psychopathology and patient's low psychosocial functioning are associated with poor family functioning. It appears that the effect for family function is significant from the early stages of the illness. Thus, early psychoeducational interventions should focus on patients with severe symptomatology and impaired functioning and their families.

  16. Acute stress affects prospective memory functions via associative memory processes.

    PubMed

    Szőllősi, Ágnes; Pajkossy, Péter; Demeter, Gyula; Kéri, Szabolcs; Racsmány, Mihály

    2018-01-01

    Recent findings suggest that acute stress can improve the execution of delayed intentions (prospective memory, PM). However, it is unclear whether this improvement can be explained by altered executive control processes or by altered associative memory functioning. To investigate this issue, we used physical-psychosocial stressors to induce acute stress in laboratory settings. Then participants completed event- and time-based PM tasks requiring the different contribution of control processes and a control task (letter fluency) frequently used to measure executive functions. According to our results, acute stress had no impact on ongoing task performance, time-based PM, and verbal fluency, whereas it enhanced event-based PM as measured by response speed for the prospective cues. Our findings indicate that, here, acute stress did not affect executive control processes. We suggest that stress affected event-based PM via associative memory processes. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies.

    PubMed

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina Del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F; Vieta, Eduard

    2017-08-01

    Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients' psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  18. Social ecology of child soldiers: child, family, and community determinants of mental health, psychosocial well-being, and reintegration in Nepal.

    PubMed

    Kohrt, Brandon A; Jordans, Mark J D; Tol, Wietse A; Perera, Em; Karki, Rohit; Koirala, Suraj; Upadhaya, Nawaraj

    2010-11-01

    This study employed a social ecology framework to evaluate psychosocial well-being in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Disorder Symptom Scale (CPSS), and locally developed measures of functional impairment and reintegration. Hierarchical linear modeling was used to examine the contribution of factors at multiple levels. At the child level, traumatic exposures, especially torture, predicted poor outcomes, while education improved outcomes. At the family level, conflict-related death of a relative, physical abuse in the household, and loss of wealth during the conflict predicted poor outcomes. At the community level, living in high caste Hindu communities predicted lack of reintegration supports. Ultimately, social ecology is well suited to identify intervention foci across ecological levels based on community differences in vulnerability and protective factors.

  19. Alcoholics Anonymous and Reduced Impulsivity: A Novel Mechanism of Change

    PubMed Central

    Blonigen, Daniel M.; Timko, Christine; Moos, Rudolf H.

    2012-01-01

    Reduced impulsivity is a novel, yet plausible, mechanism of change associated with the salutary effects of Alcoholics Anonymous (AA). Here, we review our work on links between AA attendance and reduced impulsivity using a 16-year prospective study of men and women with alcohol use disorders (AUD) who were initially untreated for their drinking problems. Across the study period, there were significant mean-level decreases in impulsivity, and longer AA duration was associated with reductions in impulsivity. In turn, decreases in impulsivity from baseline to Year 1 were associated with fewer legal problems and better drinking and psychosocial outcomes at Year 1, and better psychosocial functioning at Year 8. Decreases in impulsivity mediated associations between longer AA duration and improvements on several Year 1 outcomes, with the indirect effects conditional on participants’ age. Findings are discussed in terms of their potential implications for research on AA and, more broadly, interventions for individuals with AUD. PMID:23327499

  20. Cognitive behavioral therapy for insomnia in posttraumatic stress disorder: a randomized controlled trial.

    PubMed

    Talbot, Lisa S; Maguen, Shira; Metzler, Thomas J; Schmitz, Martha; McCaslin, Shannon E; Richards, Anne; Perlis, Michael L; Posner, Donn A; Weiss, Brandon; Ruoff, Leslie; Varbel, Jonathan; Neylan, Thomas C

    2014-02-01

    Examine whether cognitive behavioral therapy for insomnia (CBT-I) improves sleep in posttraumatic stress disorder (PTSD) as well as nightmares, nonsleep PTSD symptoms, depression symptoms, and psychosocial functioning. RANDOMIZED CONTROLLED TRIAL WITH TWO ARMS: CBT-I and monitor-only waitlist control. Department of Veterans Affairs (VA) Medical Center. Forty-five adults (31 females: [mean age 37 y (22-59 y)] with PTSD meeting research diagnostic criteria for insomnia, randomly assigned to CBT-I (n = 29; 22 females) or monitor-only waitlist control (n = 16; nine females). Eight-session weekly individual CBT-I delivered by a licensed clinical psychologist or a board-certified psychiatrist. Measures included continuous monitoring of sleep with diary and actigraphy; prepolysomnography and postpolysomnography and Clinician-Administered PTSD Scale (CAPS); and pre, mid, and post self-report questionnaires, with follow-up of CBT-I participants 6 mo later. CBT-I was superior to the waitlist control condition in all sleep diary outcomes and in polysomnography-measured total sleep time. Compared to waitlist participants, CBT-I participants reported improved subjective sleep (41% full remission versus 0%), disruptive nocturnal behaviors (based on the Pittsburgh Sleep Quality Index-Addendum), and overall work and interpersonal functioning. These effects were maintained at 6-mo follow-up. Both CBT-I and waitlist control participants reported reductions in PTSD symptoms and CAPS-measured nightmares. Cognitive behavioral therapy for insomnia (CBT-I) improved sleep in individuals with posttraumatic stress disorder, with durable gains at 6 mo. Overall psychosocial functioning improved following CBT-I. The initial evidence regarding CBT-I and nightmares is promising but further research is needed. Results suggest that a comprehensive approach to treatment of posttraumatic stress disorder should include behavioral sleep medicine. TRIAL NAME: Cognitive Behavioral Treatment Of Insomnia In Posttraumatic Stress Disorder. URL: http://clinicaltrials.gov/ct2/show/NCT00881647. NCT00881647.

  1. Adapting the Patient-Centered Medical Home to Address Psychosocial Adversity: Results of a Qualitative Study.

    PubMed

    Vu, Cecilia; Rothman, Emily; Kistin, Caroline J; Barton, Kelly; Bulman, Barb; Budzak-Garza, Ann; Olson-Dorff, Denyse; Bair-Merritt, Megan H

    The patient-centered medical home (PCMH) seeks to improve population health. However, PCMH models often focus on improving treatment of chronic diseases rather than on addressing psychosocial adversity. We sought to gather key stakeholder input about how PCMHs might feasibly and sustainably address psychosocial adversity within their patient populations. We conducted 25 semistructured interviews with key stakeholders, such as physicians, nurses, medical assistants, and patients. The audiorecorded interviews focused on participants' perceptions of the best ways to modify the PCMH to address patients' psychosocial adversity. To facilitate information gathering, a fictional patient case was presented. Analyses were conducted using a 3-stage content-analysis process. Participants identified provider-related and systems-level changes necessary for addressing these psychosocial adversities effectively. On the provider level, participants thought that practitioners should foster trusting relationships with patients and should be emotionally present as patients describe their life experiences. Participants also emphasized that providers need to have sensitive conversations about adversity and resilience. On a systems level, participants discussed that documentation must balance privacy and include relevant information in the medical record. In addition, care should be delivered not by a single provider but by a team that has a longitudinal relationship with the patient; this care team should include behavioral health support. Participants provided practical strategies and highlighted provider and systems level changes to adequately address patients' prior psychosocial adversity. Future studies need to assess the degree to which such a trauma-informed approach improves patient access, outcomes, and care quality, and reduces cost. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  2. Do Savings Mediate Changes in Adolescents' Future Orientation and Health-Related Outcomes? Findings From Randomized Experiment in Uganda.

    PubMed

    Karimli, Leyla; Ssewamala, Fred M

    2015-10-01

    This present study tests the proposition that an economic strengthening intervention for families caring for AIDS-orphaned adolescents would positively affect adolescent future orientation and psychosocial outcomes through increased asset accumulation (in this case, by increasing family savings). Using longitudinal data from the cluster-randomized experiment, we ran generalized estimating equation models with robust standard errors clustering on individual observations. To examine whether family savings mediate the effect of the intervention on adolescents' future orientation and psychosocial outcomes, analyses were conducted in three steps: (1) testing the effect of intervention on mediator; (2) testing the effect of mediator on outcomes, controlling for the intervention; and (3) testing the significance of mediating effect using Sobel-Goodman method. Asymmetric confidence intervals for mediated effect were obtained through bootstrapping-to address the assumption of normal distribution. Results indicate that participation in a matched Child Savings Account (CSA) program improved adolescents' future orientation and psychosocial outcomes by reducing hopelessness, enhancing self-concept, and improving adolescents' confidence about their educational plans. However, the positive intervention effect on adolescent future orientation and psychosocial outcomes was not transmitted through saving. In other words, participation in the matched CSA program improved adolescent future orientation and psychosocial outcomes regardless of its impact on reported savings. Further research is necessary to understand exactly how participation in economic strengthening interventions, for example, those that employ matched CSAs, shape adolescent future orientation and psychosocial outcomes: what, if not savings, transmits the treatment effect and how? Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  3. Do savings mediate changes in adolescents’ future orientation and health-related outcomes? Findings from randomized experiment in Uganda

    PubMed Central

    Karimli, Leyla; Ssewamala, Fred M.

    2015-01-01

    Purpose This present study tests the proposition that an economic strengthening intervention for families caring for AIDS-orphaned adolescents would positively affect adolescent future orientation and psychosocial outcomes through increased asset-accumulation (in this case, by increasing family savings). Methods Using longitudinal data from the cluster-randomized experiment we ran generalized estimating equation (GEE) models with robust standard errors clustering on individual observations. To examine whether family savings mediate the effect of the intervention on adolescents’ future orientation and psychosocial outcomes, analyses were conducted in three steps: (1) testing the effect of intervention on mediator; (2) testing the effect of mediator on outcomes, controlling for the intervention; and (3) testing the significance of mediating effect using Sobel-Goodman method. Asymmetric confidence intervals for mediated effect were obtained through bootstrapping—to address the assumption of normal distribution. Results Results indicate that participation in a matched Child Savings Account program improved adolescents’ future orientation and psychosocial outcomes by reducing hopelessness, enhancing self-concept, and improving adolescents’ confidence about their educational plans. However, the positive intervention effect on adolescent future orientation and psychosocial outcomes was not transmitted through saving. In other words, participation in the matched Child Savings Account program improved adolescent future orientation and psychosocial outcomes regardless of its impact on reported savings. Conclusions Further research is necessary to understand exactly how participation in economic strengthening interventions, for example, those that employ matched Child Savings Accounts, shape adolescent future orientation and psychosocial outcomes: what, if not savings, transmits the treatment effect and how? PMID:26271162

  4. The ward atmosphere important for the psychosocial work environment of nursing staff in psychiatric in-patient care

    PubMed Central

    2011-01-01

    Background The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. Methods 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. Results The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. Conclusions The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways. PMID:21679430

  5. Emerging Treatments for Motor Rehabilitation After Stroke

    PubMed Central

    Krishnan, Chandramouli; Khot, Sandeep P.

    2015-01-01

    Although numerous treatments are available to improve cerebral perfusion after acute stroke and prevent recurrent stroke, few rehabilitation treatments have been conclusively shown to improve neurologic recovery. The majority of stroke survivors with motor impairment do not recover to their functional baseline, and there remains a need for novel neurorehabilitation treatments to minimize long-term disability, maximize quality of life, and optimize psychosocial outcomes. In recent years, several novel therapies have emerged to restore motor function after stroke, and additional investigational treatments have also shown promise. Here, we familiarize the neurohospitalist with emerging treatments for poststroke motor rehabilitation. The rehabilitation treatments covered in this review will include selective serotonin reuptake inhibitor medications, constraint-induced movement therapy, noninvasive brain stimulation, mirror therapy, and motor imagery or mental practice. PMID:25829989

  6. Psychosocial difficulties from the perspective of persons with neuropsychiatric disorders.

    PubMed

    Coenen, Michaela; Cabello, Maria; Umlauf, Silvia; Ayuso-Mateos, José Luis; Anczewska, Marta; Tourunen, Jouni; Leonardi, Matilde; Cieza, Alarcos

    2016-01-01

    The objective of this study is to determine whether persons with neuropsychiatric disorders experience a common set of psychosocial difficulties using qualitative data from focus groups and individual interviews. The study was performed in five European countries (Finland, Italy, Germany, Poland and Spain) using the focus groups and individual interviews with persons with nine neuropsychiatric disorders (dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke and substance dependence). Digitally recorded sessions were analysed using a step-by-step qualitative and quantitative methodology resulting in the compilation of a common set of psychosocial difficulties using the International Classification of Functioning, Disability and Health (ICF) as a framework. Sixty-seven persons participated in the study. Most persons with neuropsychiatric disorders experience difficulties in emotional functions, sleeping, carrying out daily routine, working and interpersonal relationships in common. Sixteen out of 33 psychosocial difficulties made up the common set. This set includes mental functions, pain and issues addressing activities and participation and provides first evidence for the hypothesis of horizontal epidemiology of psychosocial difficulties in neuropsychiatric disorders. This study provides information about psychosocial difficulties that should be covered in the treatment and rehabilitation of persons with neuropsychiatric disorders regardless of clinical diagnoses. Emotional problems, work and sleep problems should be addressed in all the treatments of neuropsychiatric disorders regardless of their specific diagnosis, etiology and severity. Personality issues should be targeted in the treatment for neurological disorders, whereas communication skill training may also be useful for mental disorders. The effects of medication and social environment on patient's daily life should be considered in all the neuropsychiatric conditions.

  7. Psychosocial Approaches in the Treatment of Psychosis: Cognitive Behavior Therapy for Psychosis (CBTp) and Metacognitive Training (MCT).

    PubMed

    Menon, Mahesh; Balzan, Ryan P; Harper, Katy; Kumar, Devavrata; Andersen, Devon; Moritz, Steffen; Woodward, Todd S

    Although antipsychotic medication has been the most widely used and efficacious treatment in ameliorating the symptoms of psychosis, there has been a growing realization that pharmacological treatment has limitations. A significant minority of individuals continue to show "treatment-resistant" symptoms and significant relapse risk, while others show symptom reduction without the corresponding improvement in social and role functioning. Psychotherapy, in combination with medication, can help with symptom reduction, as well as improve functioning and quality of life. In this paper, we focus on two modalities of psychotherapy which have been shown to improve symptomatology and functioning in individuals with psychosis: Cognitive Behavior Therapy for psychosis (CBTp) and Metacognitive Training (MCT). Both treatment approaches focus on increasing the individuals' understanding of the psychological mechanisms associated with delusions and hallucinations, and helping them develop strategies to improve reality testing and belief evaluation. We aim to provide an overview of both treatments, examining not only the theoretical mechanisms and efficacy of each approach, but also the common therapeutic components they share.

  8. A Qualitative Investigation of Health Care Professionals’, Patients’ and Partners’ Views on Psychosocial Issues and Related Interventions for Couples Coping with Cancer

    PubMed Central

    Regan, Tim; Levesque, Janelle V.; Lambert, Sylvie D.; Kelly, Brian

    2015-01-01

    Introduction There is growing evidence that cancer affects couples as an interdependent system and that couple-based psychosocial interventions are efficacious in reducing distress and improving coping skills. However, adoption of a couples-focused approach into cancer care is limited. Previous research has shown that patients and partners hold differing views from health care professionals (HCPs) regarding their psychosocial needs, and HCPs from different disciplines also hold divergent views regarding couples’ psychosocial needs. This study aimed to explore the perspectives of HCPs and couples on the provision of couple-focused psychosocial care in routine cancer services. Methods A qualitative study using semi-structured interviews was undertaken with 20 HCPs (medical oncologists, nurses, psycho-oncology professionals) and 20 couples where one member had been diagnosed with cancer (breast, prostate, head/neck, bowel, multiple myeloma). Interviews were analysed using the framework approach. Results Three core themes were identified: “How Do Couples Cope with Cancer?” emphasised the positive and negative coping strategies used by couples, and highlighted that partners perceived a lack of engagement by HCPs. “What Is Couple-focused Psychosocial Care for People with Cancer?” described varying perspectives regarding the value of couple-focused psychosocial care and variation in the types of support couples need among HCPs and couples. Whereas most couples did not perceive a need for specialist couple-focused support and interventions, most HCPs felt couple-focused psychosocial care was necessary. “How Can Couple-Focused Psychosocial Care be Improved?” described couples’ view of a need for better provision of information, and the importance of their relationship with oncology clinicians. HCPs identified a lack of confidence in responding to the emotional needs of couples, and barriers to providing psychosocial care, including challenges identifying distress (through screening) and referring distressed individuals/couples for specialist assessment. Conclusions The three core themes revealed discrepancies about couple-focused psychosocial care between HCPs and couples, and HCPs from different professional backgrounds, and several barriers to the provision of psychosocial care for couples. Despite HCPs and couples acknowledging that a couple-focused approach to psycho-social support was potentially beneficial, the majority of couples did not feel they needed specific couple-focused interventions. These issues and recommendations for future research are discussed. PMID:26222890

  9. Pharmacotherapy Relapse Prevention in Body Dysmorphic Disorder: A Double-Blind Placebo-Controlled Trial

    PubMed Central

    Phillips, Katharine A.; Keshaviah, Aparna; Dougherty, Darin; Stout, Robert L.; Menard, William; Wilhelm, Sabine

    2016-01-01

    Objective Body dysmorphic disorder (BDD) is common, distressing, and often severely impairing. Serotonin-reuptake inhibitors (SRIs) appear efficacious for BDD, but the few existing pharmacotherapy studies were short-term (≤4 months), and no relapse prevention studies or continuation phase studies have been conducted. We report results from the first BDD relapse prevention study. Method Adults (N=100) with DSM-IV BDD received open-label escitalopram for 14 weeks (Phase 1); 58 responders were then randomized to double-blind continuation treatment with escitalopram versus switch to placebo for six months (Phase 2). Reliable and valid outcome measures were utilized. Results Phase 1: Overall, 67.0% of treated subjects and 81.1% of completers were escitalopram responders (p’s<0.0001). BDD severity, BDD-related insight, depressive symptoms, psychosocial functioning, and quality of life significantly improved from baseline to end of Phase 1 (all p's<0.0001). Phase 2: Time to relapse was significantly longer for subjects receiving escitalopram than those receiving placebo (hazard ratio=2.72, 95% CI [1.01, 8.57], p=0.049). Phase 2 relapse proportions were 18% for escitalopram versus 40% for placebo. In escitalopram-treated subjects, BDD severity significantly decreased over time during the continuation treatment phase (p=0.036); further improvement occurred in 35.7% of the escitalopram group. There were no significant group differences in BDD severity, insight, depressive symptoms, psychosocial functioning, or quality of life. Conclusions Continuation-phase escitalopram delayed time to relapse, and fewer escitalopram-treated subjects relapsed compared with placebo-treated subjects. BDD severity significantly further improved during six additional months of escitalopram treatment following acute response; more than one-third of escitalopram-treated subjects had further improvement during continuation phase treatment. PMID:27056606

  10. Pharmacotherapy Relapse Prevention in Body Dysmorphic Disorder: A Double-Blind, Placebo-Controlled Trial.

    PubMed

    Phillips, Katharine A; Keshaviah, Aparna; Dougherty, Darin D; Stout, Robert L; Menard, William; Wilhelm, Sabine

    2016-09-01

    Body dysmorphic disorder is common, distressing, and often severely impairing. Serotonin reuptake inhibitors appear efficacious, but the few existing pharmacotherapy studies were short term (≤4 months), and no relapse prevention studies or continuation phase studies have been conducted to the authors' knowledge. The authors report results from the first relapse prevention study in body dysmorphic disorder. Adults (N=100) with DSM-IV body dysmorphic disorder received open-label escitalopram for 14 weeks (phase 1); 58 responders were then randomized to double-blind continuation treatment with escitalopram versus switch to placebo for 6 months (phase 2). Reliable and valid outcome measures were utilized. In phase 1, 67.0% of treated subjects and 81.1% of subjects who completed phase 1 responded to escitalopram. Body dysmorphic disorder severity (in both the intent-to-treat and the completer groups) and insight, depressive symptoms, psychosocial functioning, and quality of life significantly improved from baseline to end of phase 1. In phase 2, time to relapse was significantly longer with escitalopram than with placebo treatment (hazard ratio=2.72, 95% CI=1.01-8.57). Phase 2 relapse proportions were 18% for escitalopram and 40% for placebo. Among escitalopram-treated subjects, body dysmorphic disorder severity significantly decreased over time during the continuation phase, with 35.7% of subjects showing further improvement. There were no significant group differences in body dysmorphic disorder severity or insight, depressive symptoms, psychosocial functioning, or quality of life. Continuation-phase escitalopram delayed time to relapse, and fewer escitalopram-treated subjects relapsed than did placebo-treated subjects. Body dysmorphic disorder severity significantly improved during 6 additional months of escitalopram treatment following acute response; more than one-third of escitalopram-treated subjects experienced further improvement.

  11. Course of Quality of Life After Radiation Therapy for Painful Bone Metastases: A Detailed Analysis From the Dutch Bone Metastasis Study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Westhoff, Paulien G., E-mail: p.g.westhoff@umcutrecht.nl; Department of Radiotherapy, Radboud University Medical Center, Nijmegen; Verdam, Mathilde G.E.

    Purpose: To study the course of quality of life (QoL) after radiation therapy for painful bone metastases. Patients and Methods: The Dutch Bone Metastasis Study randomized 1157 patients with painful bone metastases between a single fraction of 8 Gy and 6 fractions of 4 Gy between 1996 and 1998. The study showed a comparable pain response of 74%. Patients filled out weekly questionnaires for 13 weeks, then monthly for 2 years. In these analyses, physical, psychosocial, and functional QoL domain scores and a score of general health were studied. Mixed modeling was used to model the course of QoL and to study the influence ofmore » several characteristics. Results: In general, QoL stabilized after 1 month. Psychosocial QoL improved after treatment. The level of QoL remained stable, steeply deteriorating at the end of life. For most QoL domains, a high pain score and intake of opioids were associated with worse QoL, with small effect sizes (−0.11 to −0.27). A poor performance score was associated with worse functional QoL, with a medium effect size (0.41). There is no difference in QoL between patients receiving a single fraction of 8 Gy and 6 fractions of 4 Gy, except for a temporary worsening of physical QoL after 6 fractions. Conclusion: Although radiation therapy for painful bone metastases leads to a meaningful pain response, most domains of QoL do not improve after treatment. Only psychosocial QoL improves slightly after treatment. The level of QoL is related to the actual survival, with a rather stable course of QoL for most of the remaining survival time and afterward a sharp decrease, starting only a few weeks before the end of life. Six fractions of 4 Gy lead to a temporary worse physical QoL compared with a single fraction of 8 Gy.« less

  12. Psychosocial Functioning of Mothers of Malnourished Children.

    ERIC Educational Resources Information Center

    Kerr, Mary Ann D.; And Others

    1978-01-01

    The relationship between infant malnutrition and maternal psychosocial behavior was explored by comparing mothers of malnourished children with mothers whose children were matched for age and family income but were not malnourished. Journal availability: see EC 111 045. (Author)

  13. Screening for distress, the 6th vital sign: common problems in cancer outpatients over one year in usual care: associations with marital status, sex, and age

    PubMed Central

    2012-01-01

    Background Very few studies examine the longitudinal prevalence of problems and the awareness or use of clinical programs by patients who report these problems. Of the studies that examine age, gender and marital status as predictors of a range of patient outcomes, none examines the interactions between these demographic variables. This study examined the typical trajectory of common practical and psychosocial problems endorsed over 12 months in a usual-care sample of cancer outpatients. Specifically, we examined whether marital status, sex, age, and their interactions predicted these trajectories. We did not actively triage or refer patients in this study in order to examine the natural course of problem reports. Methods Patients completed baseline screening (N = 1196 of 1707 approached) and the sample included more men (N = 696) than women (N = 498), average age 61.1 years. The most common diagnoses were gastrointestinal (27.1%), prostate (19.2%), skin (11.1%) and gynecological (9.2%). Among other measures, patients completed a Common Problem Checklist and Psychosocial Resources Use questions at baseline, 3, 6, and 12 months using paper and pencil surveys. Results Results indicated that patients reported psychosocial problems more often than practical and both decreased significantly over time. Younger single patients reported more practical problems than those in committed relationships. Younger patients and women of all ages reported more psychosocial problems. Among a number of interesting interactions, for practical problems, single older patients improved more; whereas among married people, younger patients improved more. For psychosocial problems we found that older female patients improved more than younger females, but among males, it was younger patients who improved more. Young single men and women reported the most past-and future-use of services. Conclusions Younger women are particularly vulnerable to experiencing practical and psychosocial problems when diagnosed with cancer, but being married protects these younger women. Marriage appeared to buffer reports of both practical and psychosocial problems, and led to less awareness and use of services. Unexpectedly, young men reported the highest use of psychosocial services. This study informs clinical program development with information on these risk groups. PMID:23031647

  14. Institutional capacity to provide psychosocial oncology support services: A report from the Association of Oncology Social Work.

    PubMed

    Zebrack, Brad; Kayser, Karen; Padgett, Lynne; Sundstrom, Laura; Jobin, Chad; Nelson, Krista; Fineberg, Iris C

    2016-06-15

    This study reports cancer-treating institutions' capacity to deliver comprehensive psychosocial support services. Oncology care providers at 60 cancer-treating institutions completed surveys assessing the capacity of their institutions to provide psychosocial care. Capacity was assessed with the Cancer Psychosocial Care Matrix (CPCM) from the National Cancer Institute (NCI). Scores represented individuals' perceptions of their cancer program's performance with respect to 10 fundamental elements of psychosocial care. Among 2134 respondents, 62% reported a mid-level capacity for ≥5 of 10 CPCM items. In comparison with other types of cancer programs (eg, NCI-designated, academic, or comprehensive centers), providers at community cancer programs reported a significantly greater capacity with respect to patient-provider communication, psychosocial needs assessment, and continuity in the delivery of psychosocial care over time. Nurses and primary medical providers reported a significantly lower capacity for linking patients and families with needed psychosocial services within their respective cancer programs. They also reported a significantly higher capacity for conducting follow-up, re-evaluations, and adjustments of psychosocial treatment plans. Cancer programs are performing moderately well in terms of communicating to patients the importance of psychosocial care, identifying patient psychosocial needs, and referring patients and families to psychosocial services. They are doing less well with respect to the provision of that care over time. Findings suggest that gaps in psychosocial service capacity are a function of patient, provider, and system characteristics. These results may be useful in formulating strategies to enhance psychosocial care delivery. Cancer 2016;122:1937-45. © 2016 American Cancer Society. © 2016 American Cancer Society.

  15. The Effects of Attention Problems on Psychosocial Functioning in Childhood Brain Tumor Survivors: A 2-Year Postcraniospinal Irradiation Follow-up.

    PubMed

    Oh, Yunhye; Seo, Hyunjung; Sung, Ki Woong; Joung, Yoo Sook

    2017-03-01

    To examine the psychosocial outcomes and impact of attention problems in survivors of pediatric brain tumor. The survivors' cognitive functioning was measured using the Wechsler Intelligence Scale for Children. The Child Behavior Checklist-Attention Problems scale was used to screen for attention problems, and participants were classified as having attention problems (n=15) or normal attention (n=36). Psychosocial functioning was examined with the Korean Personality Rating scale for Children (K-PRC) at precraniospinal radiation and at 2-year follow-up. The attention problem group showed significantly higher depression and externalizing symptoms (delinquency, hyperactivity) and more significant impairment in family relationships than did the normal attention group at baseline. At follow-up, the attention problem group demonstrated significantly more delinquency and impaired family and social relationships. With the K-PRC scores, except for the somatization, social relationship subscale, there were significant differences between groups, but not in terms of treatment by time interaction or within time. At follow-up, multiple linear regressions showed that age at diagnosis significantly predicted K-PRC somatization (B=-1.7, P=0.004) and social relationships (B=-1.7, P=0.004), baseline full-scale intelligence quotient predicted K-PRC depression (B=-0.4, P=0.032) and somatization (B=-0.3, P=0.015), and attention problems at baseline predicted K-PRC depression (B=-15.2, P=0.036) and social relationships (B=-11.6, P=0.016). Pediatric brain tumor survivors, in particular, patients with attention problems, had worse psychosocial functioning at baseline and follow-up. Attention problems at baseline need to be carefully evaluated in assessing psychosocial functioning of pediatric brain tumor survivors.

  16. Perceived Family Functioning Predicts Baseline Psychosocial Characteristics in U.S. Participants of a Family Focused Grief Therapy Trial.

    PubMed

    Schuler, Tammy A; Zaider, Talia I; Li, Yuelin; Masterson, Melissa; McDonnell, Glynnis A; Hichenberg, Shira; Loeb, Rebecca; Kissane, David W

    2017-07-01

    Screening and baseline data on 170 American families (620 individuals), selected by screening from a palliative care population for inclusion in a randomized controlled trial of family-focused grief therapy, were examined to determine whether family dysfunction conferred higher levels of psychosocial morbidity. We hypothesized that greater family dysfunction would, indeed, be associated with poorer psychosocial outcomes among palliative care patients and their family members. Screened families were classified according to their functioning on the Family Relationships Index (FRI) and consented families completed baseline assessments. Mixed-effects modeling with post hoc tests compared individuals' baseline psychosocial outcomes (psychological distress, social functioning, and family functioning on a different measure) according to the classification of their family on the FRI. Covariates were included in all models as appropriate. For those who completed baseline measures, 191 (30.0%) individuals were in low-communicating families, 313 (50.5%) in uninvolved families, and 116 (18.7%) in conflictual families. Family class was significantly associated (at ps ≤ 0.05) with increased psychological distress (Beck Depression Inventory and Brief Symptom Inventory) and poorer social adjustment (Social Adjustment Scale) for individual family members. The family assessment device supported the concurrent accuracy of the FRI. As predicted, significantly greater levels of individual psychosocial morbidity were present in American families whose functioning as a group was poorer. Support was generated for a clinical approach that screens families to identify those at high risk. Overall, these baseline data point to the importance of a family-centered model of care. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  17. Trauma Collaborative Care Intervention: Effect on Surgeon Confidence in Managing Psychosocial Complications After Orthopaedic Trauma.

    PubMed

    Wegener, Stephen T; Carroll, Eben A; Gary, Joshua L; McKinley, Todd O; OʼToole, Robert V; Sietsema, Debra L; Castillo, Renan C; Frey, Katherine P; Scharfstein, Daniel O; Huang, Yanjie; Collins, Susan C J; MacKenzie, Ellen J

    2017-08-01

    The impact of the Trauma Collaborative Care (TCC) program on surgeon confidence in managing the psychosocial sequelae of orthopaedic trauma was evaluated as part of a larger prospective, multisite, cluster clinical trial. We compared confidence and perceived resource availability among surgeons practicing in trauma centers that implemented the TCC program with orthopaedic trauma surgeons in similar trauma centers that did not implement the TCC. Prospective cohort design. Level-I trauma centers. Attending surgeons and fellows (N = 95 Pre and N = 82 Post). Self-report 10-item measure of surgeon confidence in managing psychosocial issues associated with trauma and perceived availability of support resources. Analyses, performed on the entire sample and repeated on the subset of 52 surgeons who responded to the survey at both times points, found surgeons at intervention sites experienced a significantly greater positive improvement (P < 0.05) in their (1) belief that they have strategies to help orthopaedic trauma patients change their psychosocial situation; (2) confidence in making appropriate referrals for orthopaedic trauma patients with psychosocial problems; and (3) belief that they have access to information to guide the management of psychosocial issues related to recovery. Initial data suggest that the establishment of the TCC program can improve surgeons' perceived availability of resources and their confidence in managing the psychosocial sequelae after injury. Further studies will be required to determine if this translates into beneficial patient effects. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

  18. Parent-training programmes for improving maternal psychosocial health.

    PubMed

    Barlow, J; Coren, E

    2001-01-01

    Mental health problems are common, and there is evidence from a range of studies to suggest that a number of factors relating to maternal psychosocial health can have a significant effect on the mother-infant relationship, and that this can have consequences for both the short and long-term psychological health of the child. The use of parenting programmes is increasing in the UK and evidence of their effectiveness in improving outcomes for mothers is now required. The objective of this review is to address whether group-based parenting programmes are effective in improving maternal psychosocial health including anxiety, depression, and self-esteem. A range of biomedical, social science, educational and general reference electronic databases were searched including MEDLINE, EMBASE CINAHL, PsychLIT, ERIC, ASSIA, Sociofile and the Social Science Citation Index. Other sources of information included the Cochrane Library (SPECTR, CENTRAL), and the National Research Register (NRR). Only randomised controlled trials were included in which participants had been randomly allocated to an experimental and a control group, the latter being either a waiting-list, no-treatment or a placebo control group. Studies had to include at least one group-based parenting programme, and one standardised instrument measuring maternal psychosocial health. A systematic critical appraisal of all included studies was undertaken using a modified version of the Journal of the American Medical Association (JAMA) published criteria. The treatment effect for each outcome in each study was standardised by dividing the mean difference in post-intervention scores for the intervention and treatment group, by the pooled standard deviation, to produce an effect size. Where appropriate the results were then combined in a meta-analysis using a fixed-effect model, and 95% confidence intervals were used to assess the significance of the findings. A total of 23 studies were included in the review but only 17 provided sufficient data to calculate effect sizes. The 17 studies provided a total of 59 assessments of outcome on a range of aspects of psychosocial functioning including depression, anxiety, stress, self-esteem, social competence, social support, guilt, mood, automatic thoughts, dyadic adjustment, psychiatric morbidity, irrationality, anger and aggression, mood, attitude, personality, and beliefs. There was only sufficient data, however, on five outcomes (depression; anxiety/stress; self-esteem; social support; and relationship with spouse/marital adjustment) to combine the results in a meta-analysis. The meta-analyses show statistically significant results favouring the intervention group as regards depression; anxiety/stress; self-esteem; and relationship with spouse/marital adjustment. The meta-analysis of the social support data, however, showed no evidence of effectiveness. These results suggest that parenting programmes, irrespective of the type (or content) of programme, can be effective in improving important aspects of maternal psycho-social functioning. Of the data summarising the effectiveness of the different types of parenting programmes, which it was not possible to combine in a meta-analysis, approximately 22% of the outcomes measured, showed significant differences between the intervention group and the control group. A further 40% showed medium to large non-significant differences favouring the intervention group. Approximately one-third of outcomes showed small non-significant differences or no evidence of effectiveness. A meta-analysis of the follow-up data on three outcomes was also conducted - depression, self-esteem and relationship with spouse/marital adjustment. The results show that there was a continued improvement in self-esteem, depression and marital adjustment at follow-up, although the latter two findings were not statistically significant. It is suggested that parenting programmes can make a significant contribution to short-term psychosocial health in mothers, and that the limited follow-up data available suggest that these are maintained over time. However, the overall paucity of long-term follow-up data points to the need for further evidence concerning the long-term effectiveness of parenting programmes on maternal mental health. Furthermore, it is suggested that some caution should be exercised before the results are generalised to parents irrespective of the level of pathology present, and that further research is still required.

  19. Provision of integrated psychosocial services for cancer survivors post-treatment

    PubMed Central

    Recklitis, Christopher J; Syrjala, Karen L

    2018-01-01

    Meeting the psychosocial needs of patients with cancer has been recognised as a priority within oncology care for several decades. Many approaches that address these needs have been developed and described; however, until recently much of this work had focused on patients during treatment and end-of-life care. With continued improvement in therapies, the population of cancer survivors who can expect to live for 5 or more years after cancer diagnosis has increased dramatically, as have associated concerns about how to meet their medical, psychosocial, and health behaviour needs after treatment. Guidelines and models for general survivorship care routinely address psychosocial needs, and similar guidelines for psychosocial care of patients with cancer are being extended to address the needs of survivors. In this Series paper, we summarise the existing recommendations for the provision of routine psychosocial care to survivors, as well as the challenges present in providing this care. We make specific recommendations for the integration of psychosocial services into survivorship care. PMID:28049576

  20. Disclosure of psychosocial stressors affecting diabetes care among uninsured young adults with Type 1 diabetes.

    PubMed

    Pyatak, E A; Sequeira, P; Peters, A L; Montoya, L; Weigensberg, M J

    2013-09-01

    To determine the disclosure rates of psychosocial issues affecting routine diabetes care. A total of 20 young adults were interviewed regarding the impact of psychosocial stressors on their diabetes care. The interviewer, endocrinologist and case manager reported the prevalence rates of psychosocial stressors. Disclosure rates were compared to determine the prevalence of psychosocial issues and the different patterns of disclosure. Participants reported a high number of psychosocial stressors, which were associated with poorer glycaemic control (r = 0.60, P = 0.005). Approximately half of all disclosed stressors (50.9%) were identified in routine care; other stressors were identified only through intensive case management and/or in-depth interviews. Identifying psychosocial stressors in routine care, and providing referrals to psychological or social services, is a significant unmet need and may improve glycaemic control among certain populations with diabetes. Systematic mechanisms of capturing this information, such as by screening surveys, should be considered. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  1. The psychosocial atmosphere in community-based activity centers for people with psychiatric disabilities: visitor and staff perceptions.

    PubMed

    Jansson, Jan-Åke; Johansson, Håkan; Eklund, Mona

    2013-12-01

    This study investigated how visitors and staff in community-based activity centers in Sweden perceived the psychosocial atmosphere and whether this could be explained by the centers' orientation (work-oriented versus meeting place-oriented centers). Eighty-eight visitors and 37 staff members at three work-oriented and three meeting place-oriented centers participated. The Community-oriented Programs Environmental Scale was used to estimate the psychosocial atmosphere. The result showed that the psychosocial atmosphere at the centers was in accordance with a supportive ward atmosphere profile. Visitors and staff perceived several aspects of the psychosocial atmosphere differently, especially in the meeting place-oriented centers. The visitors in the meeting place-oriented centers did not perceive the psychosocial atmosphere differently from those visiting the work-oriented centers. The results indicated that the psychosocial atmosphere at the centers was in line with what previous research has shown to be beneficial for visitors regarding outcome and favorable for promoting a good therapeutic alliance and a good functioning in daily life.

  2. Intelligence and psychosocial functioning during long-term growth hormone therapy in children born small for gestational age.

    PubMed

    van Pareren, Yvonne K; Duivenvoorden, Hugo J; Slijper, Froukje S M; Koot, Hans M; Hokken-Koelega, Anita C S

    2004-11-01

    Short stature is not the only problem faced by small for gestational age (SGA) children. Being born SGA has also been associated with lowered intelligence, poor academic performance, low social competence, and behavioral problems. Although GH treatment in short children born SGA can result in a normalization of height during childhood, the effect of GH treatment on intelligence and psychosocial functioning remains to be investigated. We show the longitudinal results of a randomized, double-blind, GH-dose response study initiated in 1991 to follow growth, intelligence quotient (IQ), and psychosocial functioning in SGA children during long-term GH treatment. Patients were assigned to one of two treatment groups (1 or 2 mg GH/m(2) body surface.d, or approximately 0.035 or 0.07 mg/kg.d). Intelligence and psychosocial functioning were evaluated at start of GH treatment (n = 74), after 2 yr of GH treatment (n = 76), and in 2001 (n = 53). IQ was assessed by a short-form Wechsler Intelligence Scale for Children-Revised or Wechsler Adult Intelligence Scale (Block-design and Vocabulary subtests). Behavioral problems were measured by the Achenbach Child Behavior Checklist or Young Adult Behavior Checklist, and self-perception was measured by the Harter Self-Perception Profile. Mean (sem) birth length sd score was -3.6 (0.2), mean age and height at start was 7.4 (0.2) yr and -3.0 (0.1) sd score, respectively, mean duration of GH treatment was 8.0 (0.2) yr, and mean age in 2001 was 16.5 (0.3) yr. After 2 yr of GH treatment, 96% of both GH groups showed a height gain sd score of 1 sd from the start of treatment or more, resulting in a normal height (i.e. height >/= -2.0 sd for age and sex) in 70% of the children. In 2001, 48 (91%) of the 53 children participating in this study had reached a normal height. Block-design s-score and the estimated total IQ significantly increased (P < 0.001 and P < 0.001, respectively) from scores significantly lower than Dutch peers at start (P < 0.001 and P < 0.001, respectively) to comparable scores in 2001. The increase over time for the Vocabulary s-score was not significant. Internalizing Behavior sd scores remained comparable to Dutch peers, whereas Externalizing Behavior sd scores and Total Problem Behavior sd scores improved significantly during GH therapy (P < 0.01 and P < 0.05, respectively) to scores comparable to Dutch peers. Self-perception sd scores improved from start of GH treatment until 2001 (P < 0.001) to scores significantly higher than Dutch peers (P < 0.05). No significant differences between the two GH dosage groups were found. Improvement in Externalizing and Total Problem Behavior sd scores over time was significantly related to change in height sd score (P < 0.05 and P < 0.01, respectively), whereas scores over time for Vocabulary, Block-design, Internalizing, or total Harter Self-Perception score were not related to change in height sd scores. In conclusion, parallel to a GH-induced catch-up growth in adolescents born SGA, IQ, behavior, and self-perception showed a significant improvement over time from scores below average to scores comparable to Dutch peers. In addition, children whose height over time became closer to that of their peers showed less problem behavior.

  3. Growing up with an ill parent: An examination of family characteristics and parental illness features.

    PubMed

    Stoeckel, Maggie; Weissbrod, Carol

    2015-12-01

    Existing literature suggests that the children of ill parents are vulnerable to a variety of psychosocial difficulties such as depression and anxiety. The purpose of the current study is to investigate the impact of family characteristics (parental involvement, familial support, stress experienced as a result of parental illness) and parental illness features (severity, duration, recovery status, frequency of symptoms, course) on the psychosocial functioning (depression, anxiety, life satisfaction) of late adolescents who have grown up with an ill parent but no longer live with their parents. Participants were 71 college students with a parent who experienced a chronic medical condition while they were growing up. Participants provided information regarding family characteristics, parental illness features, and the impact of parental illness. Impact of parental illness was assessed using the Impact of Illness Scale. Participants also completed measures of depression, anxiety, and life satisfaction. Participants' reported impact of parent illness was positively correlated with participant depression and anxiety. Several family characteristics and parental illness features were significantly associated with participant psychosocial functioning. In particular, lower parental involvement was correlated with greater participant depression and anxiety, as well as lower life satisfaction. These findings extend our understanding of the impact of parental illness on late adolescents' psychosocial functioning. Results could have clinical applications for psychosocial interventions in children and families coping with chronic illness. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  4. A cognitive behavioral group approach to enhance adherence to hemodialysis fluid restrictions: a randomized controlled trial.

    PubMed

    Sharp, John; Wild, Matt R; Gumley, Andrew I; Deighan, Christopher J

    2005-06-01

    Adhering to fluid restrictions represents one of the most difficult aspects of the hemodialysis treatment regimen. This report describes a randomized controlled trial of a group-based cognitive behavioral intervention aimed at improving fluid-restriction adherence in patients receiving hemodialysis. It was hypothesized that the intervention would improve adherence, measured by means of interdialytic weight gain (IWG), without impacting negatively on psychosocial functioning. Fifty-six participants receiving hemodialysis from 4 renal outpatient settings were randomly assigned to an immediate-treatment group (ITG; n = 29) or deferred-treatment group (DTG; n = 27). Participants were assessed at baseline, posttreatment, and follow-up stages. Treatment consisted of a 4-week intervention using educational, cognitive, and behavioral strategies to enhance effective self-management of fluid consumption. No significant difference in mean IWGs was found between the ITG and DTG during the acute-phase analysis (F(1,54) = 0.03; P > 0.05). However, in longitudinal analysis, there was a significant main effect for mean IWG (F(1.76,96.80) = 9.10; P < 0.001) and a significant difference between baseline and follow-up IWG values (t55 = 3.85; P < 0.001), reflecting improved adherence over time. No adverse effects of treatment were indicated through measures of psychosocial functioning. Some significant changes were evidenced in cognitions thought to be important in mediating behavioral change. The current study provides evidence for the feasibility and effectiveness of applying group-based cognitive behavior therapy to enhance adherence to hemodialysis fluid restrictions. Results are discussed in the context of the study's methodological limitations.

  5. Metacognition-oriented social skills training for individuals with long-term schizophrenia: methodology and clinical illustration.

    PubMed

    Ottavi, Paolo; D'Alia, Daria; Lysaker, Paul; Kent, Jerillyn; Popolo, Raffaele; Salvatore, Giampaolo; Dimaggio, Giancarlo

    2014-01-01

    There is much evidence indicating the presence of social deficits in schizophrenia and the detrimental effect of these deficits on global functioning in this population. As a result, social skills training (SST) has emerged as a legitimate psychosocial treatment, although effectiveness research has revealed small effect sizes and limited generalizability regarding the benefits of this treatment. In light of the strong evidence of metacognitive deficits in schizophrenia and the importance of metacognition to successful social functioning, we propose a novel therapeutic intervention wherein metacognitive remediation is integrated into SST: metacognition-oriented social skills training (MOSST). In the current paper, we present MOSST, an adapted SST programme wherein clients are also encouraged to have mindful contact with their own thoughts and to better consider and understand the mental states of others as well as the connection between mental states and behaviour. We present a case wherein an individual with schizophrenia successfully completed the MOSST programme. We outline directions for future research, starting with the logical next step of empirically testing the efficacy of MOSST. Currently social skills training is considered to be the elected psychosocial treatment for people affected by schizophrenia, although evidence indicates limited benefits. People with schizophrenia have metacognitive deficits, which interfere with proper social functioning. A metacognitive-oriented social skills training (MOSST) intervention has been developed by the authors.A treatment such as MOSST, which integrates social skills training and metacognitive training, promises to improve social skills through improving the metacognition. Copyright © 2013 John Wiley & Sons, Ltd.

  6. [Psychosocial functioning in non-psychiatric acute and chronic inpatients: depression, alexithymia and lack of assertiveness].

    PubMed

    Arancibia, Marcelo; Behar, Rosa; Marín, Sofía; Inzunza, Nicolás; Madrid, Eva

    2016-11-01

    Depression, alexithymia, and lack of assertiveness interfere with individual psychosocial functioning and may result in longer hospitalization stay and poorer therapeutic results. To analyze the psychosocial functioning in acute and chronic patients and its association with psychological, clinical and sociodemographic variables. We performed a cross-sectional study that included 80 inpatients of both sexes with organic pathology, aged between 18 to 70 years old, without any current psychiatric disorder. Clinical and sociodemographic data were collected from a semi-structured interview and hospital records. Beck Depression Inventory-IA, Toronto Alexithymia Scale-20 and Rathus Assertiveness Scale were administered. Fifty five percent of patients had some degree of depression, 33% alexithymia and 34% lack of assertiveness. The levels of depression, alexithymia and lack of assertiveness in chronic patients were significantly higher than those observed in acute patients. Women and participants older than 60 years exhibited the highest degrees of depression. Alexithymia and lack of assertiveness were associated with a lower educational level. A negative significant correlation between alexithymia and assertiveness scores was observed among acute patients. Participants with chronic diseases had a lower psychosocial functioning. Less educated patients showed more alexithymic and less assertive features. We emphasized the need of a better management of these aspects by the health team, since social functioning might interfere with the outcome of physical illnesses.

  7. An Integrated Recovery-oriented Model (IRM) for mental health services: evolution and challenges.

    PubMed

    Frost, Barry G; Tirupati, Srinivasan; Johnston, Suzanne; Turrell, Megan; Lewin, Terry J; Sly, Ketrina A; Conrad, Agatha M

    2017-01-17

    Over past decades, improvements in longer-term clinical and personal outcomes for individuals experiencing serious mental illness (SMI) have been moderate, although recovery has clearly been shown to be possible. Recovery experiences are inherently personal, and recovery can be complex and non-linear; however, there are a broad range of potential recovery contexts and contributors, both non-professional and professional. Ongoing refinement of recovery-oriented models for mental health (MH) services needs to be fostered. This descriptive paper outlines a service-wide Integrated Recovery-oriented Model (IRM) for MH services, designed to enhance personally valued health, wellbeing and social inclusion outcomes by increasing access to evidenced-based psychosocial interventions (EBIs) within a service context that supports recovery as both a process and an outcome. Evolution of the IRM is characterised as a series of five broad challenges, which draw together: relevant recovery perspectives; overall service delivery frameworks; psychiatric and psychosocial rehabilitation approaches and literature; our own clinical and service delivery experience; and implementation, evaluation and review strategies. The model revolves around the person's changing recovery needs, focusing on underlying processes and the service frameworks to support and reinforce hope as a primary catalyst for symptomatic and functional recovery. Within the IRM, clinical rehabilitation (CR) practices, processes and partnerships facilitate access to psychosocial EBIs to promote hope, recovery, self-agency and social inclusion. Core IRM components are detailed (remediation of functioning; collaborative restoration of skills and competencies; and active community reconnection), together with associated phases, processes, evaluation strategies, and an illustrative IRM scenario. The achievement of these goals requires ongoing collaboration with community organisations. Improved outcomes are achievable for people with a SMI. It is anticipated that the IRM will afford MH services an opportunity to validate hope, as a critical element for people with SMI in assuming responsibility and developing skills in self-agency and advocacy. Strengthening recovery-oriented practices and policies within MH services needs to occur in tandem with wide-ranging service evaluation strategies.

  8. Psychosocial Treatment Options for Major Depressive Disorder in Older Adults

    PubMed Central

    Renn, Brenna N.; Areán, Patricia A.

    2017-01-01

    Opinion Statement Late-life depression (LLD) is a public health concern with deleterious effects on overall health, cognition, quality of life, and mortality. Although LLD is relatively common, it is not a normal part of aging and is often under-recognized in older adults. However, psychotherapy is an effective treatment for LLD that aligns with many patients’ preferences and can improve health and functioning. This review synthesized the current literature on evidence-based psychotherapies for the treatment of depression in older adults. Findings suggest that active, skills-based psychotherapies (cognitive behavioral therapy [CBT] and problem-solving therapy [PST]) may be more effective for LLD than non-directive, supportive counseling. PST may be particularly relevant for offsetting skill deficit associated with LLD, such as in instances of cognitive impairment (especially executive dysfunction) and disability. Emerging treatments also consider contextual factors to improve treatment delivery, such as personalized care, access, and poverty. Tele-mental health represents one such exciting new way of improving access and uptake of treatment by older adults. Although these strategies hold promise, further investigation via randomized controlled trials and comparative effectiveness are necessary to advance our treatment of LLD. Priority should be given to recruiting and training the geriatric mental health workforce to deliver evidence-based psychosocial interventions for LLD. PMID:28932652

  9. Acceptance and Commitment Therapy modules: Differential impact on treatment processes and outcomes.

    PubMed

    Villatte, Jennifer L; Vilardaga, Roger; Villatte, Matthieu; Plumb Vilardaga, Jennifer C; Atkins, David C; Hayes, Steven C

    2016-02-01

    A modular, transdiagnostic approach to treatment design and implementation may increase the public health impact of evidence-based psychosocial interventions. Such an approach relies on algorithms for selecting and implementing treatment components intended to have a specific therapeutic effect, yet there is little evidence for how components function independent of their treatment packages when employed in clinical service settings. This study aimed to demonstrate the specificity of treatment effects for two components of Acceptance and Commitment Therapy (ACT), a promising candidate for modularization. A randomized, nonconcurrent, multiple-baseline across participants design was used to examine component effects on treatment processes and outcomes in 15 adults seeking mental health treatment. The ACT OPEN module targeted acceptance and cognitive defusion; the ACT ENGAGED module targeted values-based activation and persistence. According to Tau-U analyses, both modules produced significant improvements in psychiatric symptoms, quality of life, and targeted therapeutic processes. ACT ENGAGED demonstrated greater improvements in quality of life and values-based activation. ACT OPEN showed greater improvements in symptom severity, acceptance, and defusion. Both modules improved awareness and non-reactivity, which were mutually targeted, though using distinct intervention procedures. Both interventions demonstrated high treatment acceptability, completion, and patient satisfaction. Treatment effects were maintained at 3-month follow up. ACT components should be considered for inclusion in a modular approach to implementing evidence-based psychosocial interventions for adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Improving Outcomes for Youth with ADHD: A Conceptual Framework for Combined Neurocognitive and Skill-Based Treatment Approaches

    PubMed Central

    Chacko, Anil; Kofler, Michael; Jarrett, Matthew

    2014-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and chronic mental health condition that often results in substantial impairments throughout life. Although evidence-based pharmacological and psychosocial treatments exist for ADHD, effects of these treatments are acute, do not typically generalize into non-treated settings, rarely sustain over time, and insufficiently affect key areas of functional impairment (i.e., family, social, and academic functioning) and executive functioning. The limitations of current evidence-based treatments may be due to the inability of these treatments to address underlying neurocognitive deficits that are related to the symptoms of ADHD and associated areas of functional impairment. Although efforts have been made to directly target the underlying neurocognitive deficits of ADHD, extant neurocognitive interventions have shown limited efficacy, possibly due to misspecification of training targets and inadequate potency. We argue herein that despite these limitations, next-generation neurocognitive training programs that more precisely and potently target neurocognitive deficits may lead to optimal outcomes when used in combination with specific skill-based psychosocial treatments for ADHD. We discuss the rationale for such a combined treatment approach, prominent examples of this combined treatment approach for other mental health disorders, and potential combined treatment approaches for pediatric ADHD. Finally, we conclude with directions for future research necessary to develop a combined neurocognitive + skill-based treatment for youth with ADHD. PMID:25120200

  11. The Impact of a Comprehensive Microfinance Intervention on Depression Levels of AIDS-Orphaned Children in Uganda. *

    PubMed Central

    Ssewamala, Fred M.; Neilands, Torsten B.; Waldfogel, Jane; Ismayilova, Leyla

    2011-01-01

    Purpose By adversely affecting family functioning and stability, poverty constitutes an important risk factor for children’s poor mental health functioning. This study examines the impact of a comprehensive microfinance intervention, designed to reduce the risk of poverty, on depression among AIDS-orphaned youth. Methods Children from 15 comparable primary schools in Rakai District of Uganda, one of those hardest hit by HIVAIDS in the country, were randomly assigned to control (n=148) or treatment (n=138) conditions. Children in the treatment condition received a comprehensive microfinance intervention comprising of matched savings accounts, financial management workshops, and mentorship. This was in addition to traditional services provided for all school-going orphaned adolescents (counseling and school supplies). Data were collected at wave 1 (baseline), wave 2 (10-months postintervention), and wave 3 (20-months post-intervention). We used multilevel growth models to examine the trajectory of depression in treatment and control conditions, measured using Children’s Depression Inventory (Kovacs). Results Children in the treatment group exhibited a significant decrease in depression whereas their control group counterparts showed no change in depression. Conclusion The findings indicate that over and above traditional psychosocial approaches used to address mental health functioning among orphaned children in sub-Saharan Africa, incorporating poverty alleviation-focused approaches, such as this comprehensive microfinance intervention, has the potential to improve psychosocial functioning of these children. PMID:22443837

  12. The effectiveness of psychosocial interventions for children with a psychiatric disorder and mild intellectual disability to borderline intellectual functioning: A systematic literature review and meta-analysis.

    PubMed

    Kok, Lidwien; van der Waa, Anne; Klip, Helen; Staal, Wouter

    2016-01-01

    Children with intellectual disability frequently have difficulties in adapting to their environment. The extent of the experienced problems does not only depend on cognitive functioning but is influenced by other factors, such as the presence of a psychiatric disorder or other brain disorders, or adverse environmental factors. Several epidemiological studies show that children with intellectual disabilities are at an increased risk to develop psychiatric disorders. This is also true for youth with a mild intellectual disability and even those with borderline intellectual functioning (mild to borderline intellectual disability (MBID)). Psychiatric disorders are often overlooked because behavioral problems are rather attributed to the intellectual disability. Consequently, effective psychiatric interventions, which are needed to improve the level of functioning, are not applied. This review aimed to systematically evaluate the currently available, qualitatively sound research concerning the effectiveness of psychosocial interventions, specifically directed at psychiatric disorders in children with MBID. Assessed for eligibility were 1409 unique reports, and the review ultimately included only 12 reports. Review of the results and meta-analyses showed that the majority of studies suffer from multiple limitations and that methodological variations between studies are extensive. This possibly reflects the high variance of factors that may be involved in MBID. It will be important in future research to address multi-causality. © The Author(s) 2015.

  13. Personality predictors of dimensions of psychosocial adjustment after surgery.

    PubMed

    Weinryb, R M; Gustavsson, J P; Barber, J P

    1997-01-01

    Although many studies have examined the relationship between personality factors and adjustment after surgery, most of them have had very short follow-up periods. The present prospective study examines whether preoperative psychodynamic assessment of personality traits enhances prediction of various areas of psychosocial adjustment assessed at least 1 year after surgery. In 53 patients undergoing pelvic pouch surgery for ulcerative colitis, we examined the relationship between personality traits measured before surgery, and postoperative psychosocial adjustment assessed at a median of 17 months postoperatively, controlling for the effect of surgical functional outcome. Personality traits were assessed with the Karolinska Psychodynamic Profile (KAPP). Surgical functional outcome scales and the Psychosocial Adjustment to Illness Scale (PAIS) were used. Problems with sexual satisfaction, perfectionistic body ideals, lack of alexithymia, and poor frustration tolerance predicted poor postoperative adjustment in various areas, beyond what was predicted by surgical functional outcome alone. Moreover, moderate preoperative levels of alexithymia were beneficial to postoperative adjustment in the area of psychological distress. The findings suggest that the preoperative assessment of the patient's long-term sexual functioning and satisfaction, the importance attached to his or her appearance, level of alexithymia, and general capacity to tolerate frustration and set-backs in life, might alert both the surgeon and the patient to potential risk factors for poor postsurgical adjustment.

  14. Systematic Review of Psychosocial Interventions for People With Spinal Cord Injury During Inpatient Rehabilitation: Implications for Evidence-Based Practice.

    PubMed

    Li, Yan; Bressington, Daniel; Chien, Wai Tong

    2017-12-01

    The bio-psychosocial model of spinal cord injury (SCI) highlights that psychosocial care is of equal importance as physical rehabilitation, and should be offered in the earlier stages of inpatient rehabilitation. This systematic review aimed to identify interventional research regarding psychosocial care for people with SCI during inpatient rehabilitation and synthesize the evidence of the effects and characteristics of these studies. A systematic search of relevant literature published between 1985 to July 2016 was conducted with six databases (Scopus, MEDLINE, CINAHL, Science Citation Index Expanded, PsycINFO, and the China Academic Journal Full-text Database). Reference lists of the identified articles were reviewed to find additional relevant articles. A total of four randomized controlled trials and seven non-randomized controlled trials were included in this review. The interventions focused on specialized types of SCI population with relatively high levels of psychological distress, pain or pressure ulcers. Studies reported some varied or inconsistent improvements in participants' cognitive appraisal, psychosocial adaptation or mental health but there were no significant effects on their coping ability. Due to the heterogeneity of the studies, findings were synthesized narratively without conducting meta-analysis. This review found promising evidence that approaches to psychosocial care for people with SCI can improve their cognitive appraisal and psychosocial adaptation. Significant methodological limitations weakened study findings. Additionally, because studies were conducted in only a few developed countries with subgroups of patients having specific illness characteristics or severity, their generalizability to the wider SCI population is uncertain. Therefore, future research should adopt more robust study designs to test psychosocial interventions for SCI patients with different socio-cultural backgrounds and psychological adjustment conditions in the early stages of rehabilitation. © 2017 Sigma Theta Tau International.

  15. Psychological interventions for cystic fibrosis.

    PubMed

    Glasscoe, C A; Quittner, A L

    2003-01-01

    As survival estimates for cystic fibrosis (CF) steadily increase long-term management has become an important focus for intervention. Psychological interventions are largely concerned with emotional and social adjustments, adherence to treatment and quality of life, however no systematic review of such interventions has been undertaken for this disease. To describe the extent and quality of effectiveness studies utilising psychological interventions for CF and whether these interventions provide significant psychosocial and physical benefits in addition to standard care. Relevant trials were identified from searches of Ovid MEDLINE, the Cochrane trial registers for CF and Depression, Anxiety and Neurosis Groups and PsychINFO; unpublished trials were located through professional networks and Listserves. Most recent search: April 2003. This review included RCTs and quasi-randomised trials. Study participants were children and adults diagnosed with CF, and their immediate family members. Psychological interventions were from a broad range of modalities and outcomes were primarily psychosocial, although physical outcomes and cost effectiveness were also considered. Two reviewers independently selected relevant trials and assessed their methodological quality. For binary and continuous outcomes a pooled estimate of treatment effect was calculated for each outcome. This review is based on the findings of eight studies, representing data from a total of 358 participants. Studies fell into four conceptually similar groups: (1) gene pre-test education counselling for relatives of those with CF (one study); (2) biofeedback, massage and music therapy to assist physiotherapy (three studies); (3) behavioural intervention to improve dietary intake in children up to 12 years (three studies); and (4) self-administration of treatments to improve quality of life in adults (one study). Interventions were largely educational or behavioural, targeted at specific treatment concerns during the chronic phase. No completed studies concentrating on complex treatment approaches were found. There is some evidence that behavioural interventions can improve emotional outcomes in people with CF and their carers. There was no consistent effect on lung function although one small study showed that biofeedback assisted breathing re-training was associated with improvement in some measures of spirometric lung function. Insufficient evidence is available at this point for interventions aimed at other aspects of the disease process. Multicentre approaches are required to increase the sample sizes of studies in the psychosocial field and to enhance the power and precision of the findings. This has consequent implications for funding.

  16. Psychosocial student functioning in comprehensive dental clinic education: A qualitative study.

    PubMed

    Moore, R

    2018-02-17

    The aims were to describe first-year clinical dental students' psychosocial experiences in a known well-functioning comprehensive clinic teaching group (F+Grp) and a known dysfunctional group (Dys-Grp) and, thus, discover and describe phenomena related to psychosocial functioning of students. These groups were compared and contrasted regarding negative stress symptoms, perfectionism and coping with stress. Eight female dental students (mean 26 years old), four in each group, were interviewed after the first clinical year about learning and emotional experiences. The students also rated their perceived stress using a 0-10 scale, where 0 is no stress, and 10 is highest stress. Qualitative analyses involved searching for recurring themes and discovery of categories of clinical and social functioning. All 8 students were revisited as dentists after 8 years and filled out a 15-item survey as longitudinal validation of their first-year clinical experiences and to estimate group consensus and informant accuracy. Both groups suffered from negative stress symptoms attributed to lack of time for clinical tasks, worries about work quality with confusion about their own expectations and worries about how others perceived them. Dys-Grp experienced higher negative stress and maladaptive perfectionism and described crying behaviours, withdrawal and unwillingness to cooperate with others. In contrast, students in F+Grp provided rich content about mutual cooperation related to social networking and positive support. The 8 subjects exhibited high internal consistency (α  =  .98) in their responses to the follow-up survey about their first year of clinic. The comprehensive care teaching clinic environment with students working in groups appeared to provide a possibility for students to support each other for improved stress coping. Unfortunately, the opposite also occurred. Positive, supportive teacher supervision of student challenges related to perfectionism and stress is crucial and requires specific attention. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Epilepsy-related clinical factors and psychosocial functions in pediatric epilepsy.

    PubMed

    Eom, Soyong; Eun, So-Hee; Kang, Hoon-Chul; Eun, Baik-Lin; Nam, Sang Ook; Kim, Sun Jun; Chung, Hee Jung; Kwon, Soon Hak; Lee, Young-Mock; Lee, Joon Soo; Kim, Dong Wook; Oh, Kyung Ja; Kim, Heung Dong

    2014-08-01

    The aim of this study was to identify the different influencing patterns of demographic and epilepsy-related variables on various aspects of psychosocial function in pediatric epilepsy. Five hundred ninety-eight patients with pediatric epilepsy between the ages of 4 and 18 years (boys=360, 60% and girls=238, 40%) and their parents participated in the study. Parents completed the Social Maturity Scale (SMS), the Korean version of the Child Behavior Checklist (K-CBCL), and the Korean version of the Quality of Life in Childhood Epilepsy Questionnaire (K-QOLCE) to assess daily living function, behavior, and quality of life. The Children's Global Assessment Scale (CGAS) was completed by clinicians to assess general adaptive function. Demographic variables, such as age and sex of child, and epilepsy-related clinical variables, including seizure type, seizure frequency, duration of epilepsy, and number of medications, were obtained from medical records. Demographic and epilepsy-related clinical variables had a strong influence (22-32%) on the cognition-related domain such as general adaptive function, school/total competence, and quality of life for cognitive function while a comparatively smaller effect (2-16%) on the more psychological domain including behavioral, emotional, and social variables. Younger age, shorter duration of illness, and smaller number of medications showed a strong positive impact on psychosocial function in pediatric epilepsy, particularly for adaptive function, competence, and quality-of-life aspects. Given the wide range of impact of demographic and clinical variables on various facets of psychosocial functions, more specific understanding of the various aspects of factors and their particular pattern of influence may enable more effective therapeutic approaches that address both the medical and psychological needs in pediatric epilepsy. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. The importance of physical function to people with osteoporosis.

    PubMed

    Kerr, C; Bottomley, C; Shingler, S; Giangregorio, L; de Freitas, H M; Patel, C; Randall, S; Gold, D T

    2017-05-01

    There is increasing need to understand patient outcomes in osteoporosis. This article discusses that fracture in osteoporosis can lead to a cycle of impairment, driven by complex psychosocial factors, having a profound impact on physical function/activity which accumulates over time. More information is required on how treatments impact physical function. There is increasing need to understand patient-centred outcomes in osteoporosis (OP) clinical research and management. This multi-method paper provides insight on the effect of OP on patients' physical function and everyday activity. Data were collected from three sources: (1) targeted literature review on OP and physical function, conducted in MEDLINE, Embase and PsycINFO; (2) secondary thematic analysis of transcripts from patient interviews, conducted to develop a patient-reported outcome instrument. Transcripts were re-coded to focus on OP impact on daily activities and physical function for those with and without fracture history; and (3) discussions of the literature review and secondary qualitative analysis results with three clinical experts to review and interpret the importance and implications of the findings. Results suggest that OP, particularly with fracture, can have profound impacts on physical function/activity. These impacts accumulate over time through a cycle of impairment, as fracture leads to longer term detriments in physical function, including loss of muscle, activity avoidance and reduced physical capacity, which in turn leads to greater risk of fracture and potential for further physical restrictions. The cycle of impairment is complex, as other physical, psychosocial and treatment-related factors, such as comorbidities, fears and beliefs about physical activity and fracture risk influence physical function and everyday activity. More information on how treatments impact physical function would benefit healthcare professionals and persons with OP in making treatment decisions and improving treatment compliance/persistence, as these impacts may be more salient to patients than fracture incidence.

  19. Reciprocal effects of treatment-induced increases in exercise and improved eating, and their psychosocial correlates, in obese adults seeking weight loss: a field-based trial.

    PubMed

    Annesi, James J; Porter, Kandice J

    2013-12-05

    A better understanding of interrelations of exercise and improved eating, and their psychosocial correlates of self-efficacy, mood, and self-regulation, may be useful for the architecture of improved weight loss treatments. Theory-based research within field settings, with samples possessing high probabilities of health risks, might enable rapid application of useful findings. Adult volunteers with severe obesity (body mass index [BMI] 35-50 kg/m²; age = 43.0 ± 9.5 y; 83% female) were randomly assigned to six monthly cognitive-behavioral exercise support sessions paired with either group-based nutrition education (n = 145) or cognitive behavioral methods applied to improved eating (n = 149). After specification of mediation models using a bias-corrected bootstrapping procedure, a series of reciprocal effects analyses assessed: a) the reciprocal effects of changes in exercise and fruit and vegetable intake, resulting from the treatments, b) the reciprocal effects of changes in the three psychosocial variables tested (i.e. self-efficacy, mood, and self-regulation) and fruit and vegetable change, resulting from change in exercise volume, and c) the reciprocal effects of changes in the three psychosocial variables and exercise change, resulting from change in fruit and vegetable intake. Mediation analyses suggested a reciprocal effect between changes in exercise volume and fruit and vegetable intake. After inclusion of psychosocial variables, also found were reciprocal effects between change in fruit and vegetable intake and change in mood, self-efficacy for controlled eating, and self-regulation for eating; and change in exercise volume and change in mood and exercise-related self-regulation. Findings had implications for behavioral weight-loss theory and treatment. Specifically, results suggested that treatments should focus upon, and leverage, the transfer effects from each of the primary weight-loss behaviors (exercise and healthy eating) to the other. Findings on psychosocial correlates of these behavioral processes may also have practical applications.

  20. Physical Activity, Functional Ability, and Obesity in Older Adults: A Gender Difference.

    PubMed

    Gretebeck, Kimberlee A; Sabatini, LeAnn M; Black, David R; Gretebeck, Randall J

    2017-09-01

    Disability, institutionalization, and loss of independence may be directly caused or exacerbated by physical inactivity and obesity. The purpose of the current cross-sectional survey was to explore the impact of gender and obesity on functional ability tasks, physical activity, and psychosocial factors in older adults. Participants comprised 964 University retirees (55% female, mean age = 75.3 years, SD = 6.7 years) with a mean body mass index (BMI) of 26.1 kg/m 2 (SD = 4.7 kg/m 2 ). Results revealed significant gender and BMI interaction effects. Women were less active than men and obese women were most functionally impaired, particularly in activities that target lower extremity function, regardless of weight status. These findings suggest that physical activity interventions for older adults should focus on exercises that improve functional ability and are tailored to meet individual needs while considering weight and gender. Type, intensity, frequency, and duration of exercises should be individualized to limit injuries and improve functional ability and physical activity adherence. [Journal of Gerontological Nursing, 43(9), 38-46.]. Copyright 2017, SLACK Incorporated.

  1. Improving patient emotional functioning and psychological morbidity: evaluation of a consultation skills training program for oncologists.

    PubMed

    Girgis, Afaf; Cockburn, Jill; Butow, Phyllis; Bowman, Deborah; Schofield, Penelope; Stojanovski, Elizabeth; D'Este, Catherine; Tattersall, Martin H N; Doran, Christopher; Turner, Jane

    2009-12-01

    To evaluate whether a consultation skills training (CST) program with oncologists and trainees would improve skills in detecting and responding to patient distress, thereby improving their patients' emotional functioning and reducing psychological distress. Randomized-controlled trial with 29 medical and radiation oncologists from Australia randomized to CST group (n=15) or usual-care group (n=14). The CST consisted of a 1.5-day face-to-face workshop incorporating presentation of principles, a DVD modelling ideal behaviour and role-play practice, and four 1.5h monthly video-conferences. At the CST conclusion, patients of participating doctors were recruited (n=192 in CST group, n=183 in usual-care group), completing telephone surveys at baseline, 1 week and 3 months to assess quality of life, anxiety, depression and unmet psychosocial needs. Despite high patient functioning at baseline, anxiety significantly improved at 1-week follow-up in the CST group, compared to the control group. There were no statistically significant differences in emotional functioning, depression or unmet supportive care need between the groups. Consistent trends for greater improvements were observed in intervention compared to control group patients, suggesting the CST program deserves wider evaluation. Video-conferencing after a short training course may be an effective strategy for delivering CST.

  2. Promoting adaptive emotion regulation and coping in adolescence: a school-based programme.

    PubMed

    Horn, Andrea B; Pössel, Patrick; Hautzinger, Martin

    2011-03-01

    Particularly in adolescence, fostering adaptive emotion regulation is an important aim in health promotion. Expressive writing in combination with psycho-education on emotion regulation seems especially appropriate to serve this aim. In this study, school classes were randomly assigned either to a prevention (N = 208) or to a non-treatment control group (N = 151). The prevention group showed significant improvements regarding negative affect, grades, and days absent compared to the control-group. A combination of expressive writing with elements of psycho-education of emotion regulation might be an effective preventive tool, as it seems to improve psychosocial adjustment by establishing functional emotion regulation strategies.

  3. How does family intervention improve the outcome of people with schizophrenia?

    PubMed

    Girón, Manuel; Nova-Fernández, Francisco; Mañá-Alvarenga, Sonia; Nolasco, Andreu; Molina-Habas, Antonia; Fernández-Yañez, Antonio; Tabarés-Seisdedos, Rafael; Gómez-Beneyto, Manuel

    2015-03-01

    There is strong evidence of the efficacy of family psychosocial interventions for schizophrenia, but evidence of the role played by the attitudes of relatives in the therapeutic process is lacking. To study the effect of a family intervention on family attitudes and to analyse their mediating role in the therapeutic process 50 patients with schizophrenia and their key relatives undergoing a trial on the efficacy of a family psychosocial intervention were studied by means of the Affective Style Coding System, the Scale of Empathy, and the Relational Control Coding System. Specific statistical methods were used to determine the nature of the relationship of the relatives' attitudes to the outcome of family intervention. Family psychosocial intervention was associated with a reduction in relatives' guilt induction and dominance and an improvement in empathy. Empathy and lack of dominance were identified as independent mediators of the effect of family psychosocial intervention. The change in empathy and dominance during the first 9 months of the intervention predicted the outcome in the following 15 months. Relatives' empathy and lack of dominance are mediators of the beneficial effect of family psychosocial intervention on patient's outcome.

  4. [Can sports and physical activity promote young peoples' psychosocial health?].

    PubMed

    Ommundsen, Y

    2000-11-30

    Sport and physical activity is generally believed to be beneficial to young people's psychosocial health, but the scientific evidence seems equivocal. This article gives a narrative review of recent developments in the literature on psychosocial health effects of physical activity and sport among children and adolescents. Based on a narrative review of a selection of metaanalytical and key studies, results in four areas of psychosocial functioning are presented. Findings support an association between involvement in physical activity and sport and well-being. Physical activity is associated with lower levels of mental health problems, and seems to promote self-esteem. Physical activity as a treatment of mental health problems for this age group is underexplored and no firm conclusions can be made. The evidence with respect to effects on cognitive and academic functioning is weak. Further, the evidence that juvenile delinquency and antisocial development could be counteracted is equivocal. There is a paucity of studies that can confirm any causal effects. Future research would benefit particularly from studying the role of sports and physical activity mode as well as the psychological and social context in which it may produce beneficial psychosocial outcomes.

  5. Psychosocial job quality and mental health among young workers: a fixed-effects regression analysis using 13 waves of annual data.

    PubMed

    Milner, Allison; Krnjack, Lauren; LaMontagne, Anthony D

    2017-01-01

    Objectives Entry into employment may be a time when a young person's well-being and mental health is challenged. Specifically, we examined the difference in mental health when a young person was "not in the labor force" (NILF) (ie, non-working activity such as participating in education) compared to being in a job with varying levels of psychosocial quality. Method The data source for this study was the Household Income and Labor Dynamics in Australia (HILDA) study, and the sample included 10 534 young people (aged ≤30 years). We used longitudinal fixed-effects regression to investigate within-person changes in mental health comparing circumstances where individuals were NILF to when they were employed in jobs of varying psychosocial quality. Results Compared to when individuals were not in the labor force, results suggest a statistically significant decline in mental health when young people were employed in jobs with poor psychosocial working conditions and an improvement in mental health when they were employed in jobs with optimal psychosocial working conditions. Our results were robust to various sensitivity tests, including adjustment for life events and the lagged effects of mental health and job stressors. Conclusions If causal, the results suggest that improving the psychosocial quality of work for younger workers will protect and promote their wellbeing, and may reduce the likelihood of mental health problems later on.

  6. Psychosocial assessments for young people: a systematic review examining acceptability, disclosure and engagement, and predictive utility

    PubMed Central

    Bradford, Sally; Rickwood, Debra

    2012-01-01

    Adolescence and young adulthood are often turbulent periods in a person’s life. There are high rates of accidental deaths, suicide, mental health concerns, substance use, and sexual experimentation. Health care professionals need to conduct holistic assessments of clients in these developmental life stages to identify psychosocial risks and provide targeted early intervention and implement prevention strategies. The most useful psychosocial assessments for most health care professionals are those that can provide a complete picture of the young person’s life and circumstances. This article identifies psychosocial assessment instruments that can be used as an initial assessment and engagement tool with the general population of young people presenting for health care. We review the psychometric properties of each of the instruments, determining what type of instrument is most acceptable to young people, whether any can increase disclosure and improve engagement between young people and health professionals, and whether they have predictive utility. The search strategy complied with the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 89 published articles were identified, covering 31 different assessment instruments. Results indicated that those that were self-administered were most acceptable to young people, although it is unclear whether pen-and-paper or computer formats were preferred. Most psychosocial assessments can improve rates of disclosure and enhance engagement between young people and health professionals; however, worryingly, we found evidence that clinicians did not always respond to some of the most serious identified risks. Only for one instrument was there any mention of predictive utility. Future research should employ longitudinal approaches to determine the predictive utility of psychosocial assessments and focus on whether the use of new technologies can improve rates of disclosure. PMID:24600292

  7. The associations between psychosocial working conditions and changes in common mental disorders: a follow-up study.

    PubMed

    Laine, Hanna; Saastamoinen, Peppiina; Lahti, Jouni; Rahkonen, Ossi; Lahelma, Eero

    2014-06-11

    Common mental disorders (CMD) are prevalent in working populations and have adverse consequences for employee well-being and work ability, even leading to early retirement. Several studies report associations between psychosocial working conditions and CMD. However, there is a lack of longitudinal research within a broad framework of psychosocial working conditions and improvement in CMD. The aim of this study was to examine the associations between several psychosocial working conditions and deteriorating and improving CMD among ageing employees over a five-to-six-year follow-up period. The study is based on the Helsinki Health Study baseline survey in 2001-2002 and a follow-up in 2007 (N = 4340, response rate 83%) conducted among 40-60-year-old female and male employees. The General Health Questionnaire (GHQ-12) was used to measure common mental disorders. Psychosocial working conditions were measured in terms of job strain, organisational justice, work-family interface, social support and workplace bullying. The covariates included sociodemographic and health factors. Following adjustment for all the covariates, family-to-work (OR 1.41, 95% Cl 1.04-1.91) and work-to-family conflicts (OR 1.99, 95% Cl 1.42-2.78) and workplace bullying (OR 1.40, 95% Cl 1.09-1.79) were associated with deterioration, and family-to-work conflicts (OR 1.65, 95% Cl 1.66-2.34) and social support (OR 1.47, 95% Cl 1.07-2.00) with improvement in CMD. Adverse psychosocial working conditions contribute to poor mental health among employees. Preventing workplace bullying, promoting social support and achieving a better balance between work and family may help employees to maintain their mental health.

  8. The associations between psychosocial working conditions and changes in common mental disorders: a follow-up study

    PubMed Central

    2014-01-01

    Background Common mental disorders (CMD) are prevalent in working populations and have adverse consequences for employee well-being and work ability, even leading to early retirement. Several studies report associations between psychosocial working conditions and CMD. However, there is a lack of longitudinal research within a broad framework of psychosocial working conditions and improvement in CMD. The aim of this study was to examine the associations between several psychosocial working conditions and deteriorating and improving CMD among ageing employees over a five-to-six-year follow-up period. Methods The study is based on the Helsinki Health Study baseline survey in 2001–2002 and a follow-up in 2007 (N = 4340, response rate 83%) conducted among 40-60-year-old female and male employees. The General Health Questionnaire (GHQ-12) was used to measure common mental disorders. Psychosocial working conditions were measured in terms of job strain, organisational justice, work-family interface, social support and workplace bullying. The covariates included sociodemographic and health factors. Results Following adjustment for all the covariates, family-to-work (OR 1.41, 95% Cl 1.04-1.91) and work-to-family conflicts (OR 1.99, 95% Cl 1.42-2.78) and workplace bullying (OR 1.40, 95% Cl 1.09-1.79) were associated with deterioration, and family-to-work conflicts (OR 1.65, 95% Cl 1.66-2.34) and social support (OR 1.47, 95% Cl 1.07-2.00) with improvement in CMD. Conclusions Adverse psychosocial working conditions contribute to poor mental health among employees. Preventing workplace bullying, promoting social support and achieving a better balance between work and family may help employees to maintain their mental health. PMID:24916716

  9. Association between social contact frequency and negative symptoms, psychosocial functioning and quality of life in patients with schizophrenia.

    PubMed

    Siegrist, Karin; Millier, Aurelie; Amri, Ikbal; Aballéa, Samuel; Toumi, Mondher

    2015-12-30

    The lack of social contacts may be an important element in the presumed vicious circle aggravating, or at least stabilising negative symptoms in patients with schizophrenia. A European 2-year cohort study collected negative symptom scores, psychosocial functioning scores, objective social contact frequency scores and quality of life scores every 6 months. Bivariate analyses, correlation analyses, multivariate regressions and random effects regressions were conducted to describe relations between social contact and outcomes of interest and to gain a better understanding of this relation over time. Using data from 1208 patients with schizophrenia, a link between social contact frequency and negative symptom scores, functioning and quality of life at baseline was established. Regression models confirmed the significant association between social contact and negative symptoms as well as psychosocial functioning. This study aimed at demonstrating the importance of social contact for deficient behavioural aspects of schizophrenia. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  10. Psychosocial versus physiological stress – meta-analyses on deactivations and activations of the neural correlates of stress reactions

    PubMed Central

    Kogler, Lydia; Mueller, Veronika I.; Chang, Amy; Eickhoff, Simon B.; Fox, Peter T.; Gur, Ruben C.; Derntl, Birgit

    2015-01-01

    Stress is present in everyday life in various forms and situations. Two stressors frequently investigated are physiological and psychosocial stress. Besides similar subjective and hormonal responses, it has been suggested that they also share common neural substrates. The current study used activation-likelihood-estimation meta-analysis to test this assumption by integrating results of previous neuroimaging studies on stress processing. Reported results are cluster-level FWE corrected. The inferior frontal gyrus (IFG) and the anterior insula (AI) were the only regions that demonstrated overlapping activation for both stressors. Analysis of physiological stress showed consistent activation of cognitive and affective components of pain processing such as the insula, striatum, or the middle cingulate cortex. Contrarily, analysis across psychosocial stress revealed consistent activation of the right superior temporal gyrus and deactivation of the striatum. Notably, parts of the striatum appeared to be functionally specified: the dorsal striatum was activated in physiological stress, whereas the ventral striatum was deactivated in psychosocial stress. Additional functional connectivity and decoding analyses further characterized this functional heterogeneity and revealed higher associations of the dorsal striatum with motor regions and of the ventral striatum with reward processing. Based on our meta-analytic approach, activation of the IFG and the AI seems to indicate a global neural stress reaction. While physiological stress activates a motoric fight-or-flight reaction, during psychosocial stress attention is shifted towards emotion regulation and goal-directed behavior, and reward processing is reduced. Our results show the significance of differentiating physiological and psychosocial stress in neural engagement. Furthermore, the assessment of deactivations in addition to activations in stress research is highly recommended. PMID:26123376

  11. Sexual quality of life, body image distress, and psychosocial outcomes in colorectal cancer: a longitudinal study.

    PubMed

    Reese, Jennifer Barsky; Handorf, Elizabeth; Haythornthwaite, Jennifer A

    2018-04-20

    The objectives were to assess changes in sexual QOL and body image distress over time and to examine longitudinal associations between sexual QOL and body image variables with psychosocial outcomes in a sample of colorectal cancer patients. Participants (N = 141) completed a mail-based survey assessing sexual QOL [sexual distress (ISS), treatment impact on sexual function (SFQ), sexual function (FSFI; IIEF)], body image distress (BIS), and psychosocial outcomes [relationship quality (DAS-4), depressive symptoms (CESD-SF), and health-related QOL (HRQOL; FACT-C)]; 88 patients completed 6-month follow-up surveys (62%). Gender and cancer subgroups (male vs. female; rectal vs. colon cancer) were compared and longitudinal models examined associations between sexual QOL and body image variables with psychosocial outcomes over time and by subgroup. Impairments in sexual QOL and body image distress were common. Women and patients with rectal cancer reported worse body image distress compared to men (p = .005) and those with colon cancer (p = .03), respectively; compared to patients with colon cancer, those with rectal cancer reported worse treatment impact (p < .001) and marginally worse sexual function and HRQOL (p's = .05). At 6-month follow-up, body image distress decreased (p = .02), while sexual QOL was stable (e.g., 58% classified as dysfunctional at both time points, p = .13). For most sexual and body image predictors, worse impairment was associated with worse psychosocial outcomes over time. Several significant gender and cancer subgroup effects were found. Sexual QOL and body image are compromised after colorectal cancer and tend to remain impaired if unaddressed. Sexual concerns should be addressed early to limit broader-reaching psychosocial effects.

  12. Psychosocial interventions in attention-deficit/hyperactivity disorder: update.

    PubMed

    Antshel, Kevin M

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common reason for referral to child and adolescent psychiatry clinics. Although stimulant medications represent an evidence-based approach to managing ADHD, psychosocial interventions for child/adolescent ADHD target functional impairments as the intervention goal, and rely heavily on behavioral therapy techniques and operant conditioning principles. Evidence-based psychosocial interventions for managing pediatric ADHD include behavioral parent training, school-based interventions relying on behavioral modification, teaching skills, and operant conditioning principles, and intensive summer treatment programs. The use of conjoint psychosocial treatments with ADHD medications may enable lower doses of each form of treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Psychotic Symptoms and Attitudes toward Medication Mediate the Effect of Insight on Personal-Social Functions in Patients with Schizophrenia: One-Year Randomized Controlled Trial and Follow-Up.

    PubMed

    Zheng, Yingjun; Ning, Yuping; She, Shenglin; Deng, Yongjie; Chen, Yuwei; Yi, Wenying; Lu, Xiaodan; Chen, Xinrui; Li, Juanhua; Li, Ruikeng; Zhang, Jie; Xiao, Di; Wu, Haibo; Wu, Chao

    2018-02-14

    This study aimed to investigate the mediating pathway of 3 factors (psychotic symptoms, attitude toward medication, and cognitive processing speed) on the effect of insight on personal-social functioning in patients with schizophrenia. Chinese inpatients with schizophrenia (n = 168; mean age 18 ± 50 years) diagnosed according to the DSM-IV were randomly assigned to treatment with antipsychotic medication alone or combined treatment. Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory (DAI), Assessment of Insight (SAI), and Social-Personal Performance Scale (PSPS) scores were evaluated at baseline and at 3, 6, and 12 months. Cognitive function was assessed at baseline. Multiple mediation analyses were conducted with baseline data, end point data, and changes-in-scale scores between baseline and the end point, respectively. At baseline and at 12 months, only psychotic symptoms mediated the effect of insight on personal-social functioning. For changes-in-scale scores over the 12-month follow-up, in patients receiving treatment with medication alone, the effect of improved insight on improved personal-social function was mediated by psychotic symptoms only; in patients receiving a combined treatment, the effect of improved insight on improved personal-social functioning was mediated by both psychotic symptoms and attitudes toward medication, independently. The link between insight and personal-social functions is mainly mediated by psychotic symptoms. Psychosocial intervention improves the predicting effect of insight on personal-social function by improving both the attitude toward medication and psychotic symptoms independently. © 2018 S. Karger AG, Basel.

  14. Outcome of therapy in the conservative management of temporomandibular pain dysfunction disorder.

    PubMed

    Suvinen, T I; Hanes, K R; Reade, P C

    1997-10-01

    The present study considered predictors of the outcome of treatment for temporomandibular pain dysfunction disorder (TMPD). Thirty-seven patients were assessed with objective and self-report measures of physiological and psychosocial aspects of this disorder at initial assessment and at 6-month follow-up subsequent to conservative physical therapy. Patients were subdivided into slow and rapid responders to conservative physical therapy based on self-reported level of improvement. Measures employed included the Temporomandibular Pain Dysfunction Disorder Questionnaire and the Temporomandibular Pain Dysfunction Disorder Clinical Form. Eighty-one per cent of patients showed a 50% or greater improvement in pain severity at follow-up, with minimal differential changes across the two groups found in the physiological symptoms, while the rapid responding group showed greater improvement in terms of psychosocial factors. These findings indicated that psychosocial factors, particularly coping strategies and illness behaviour, cannot be ignored in the management of TMPD.

  15. Assessing the psychosocial needs and program preferences of adolescents and young adults with cancer.

    PubMed

    Barakat, Lamia P; Galtieri, Liana R; Szalda, Dava; Schwartz, Lisa A

    2016-02-01

    Adolescents and young adults (AYA) are a developmentally distinct cancer group, vulnerable to psychosocial late effects and with a range of unmet psychosocial needs. We sought to better understand psychosocial care needs and program preferences to inform development of more easily accessible and effective AYA psychosocial programs. AYA on and off treatment for cancer (n = 111, ages 12-25 years) were approached during an outpatient clinic visit and completed a survey as part of a quality improvement initiative. The survey comprised an open-ended question on challenges related to cancer and treatment and closed-ended questions on access to and preference for various services and programs. Qualitative analyses were used to summarize themes for most significant challenges, and descriptive statistics were used for closed-ended questions. Most common themes for challenges included treatments and associated physical changes, barriers to pursuit of academic/vocational goals, and social isolation. For preferred program focus, AYA ranked highest increasing strength and endurance/reintegration into sports and dealing with physical changes resulting from treatment. AYA's preferred modalities for program delivery were one-on-one/in person and message boards/Facebook. Most of the sample indicated that lack of awareness prevented their accessing available programs. New information was identified that can be used to address access barriers and to offer AYA psychosocial programs in formats that might improve interest and accessibility. Ongoing evaluation of AYA psychosocial programs is recommended to determine acceptability, feasibility, and effectiveness to meet the evolving needs of AYA patients with cancer.

  16. Enhancing psychosocial and spiritual palliative care: Four-year results of the program of comprehensive care for people with advanced illnesses and their families in Spain.

    PubMed

    Gómez-Batiste, Xavier; Mateo-Ortega, Dolors; Lasmarías, Cristina; Novellas, Anna; Espinosa, Jose; Beas, Elba; Ela, Sara; Barbero, Javier

    2017-02-01

    We aimed to describe the overall quantitative and qualitative results of a "La Caixa" Foundation and World Health Organization Collaborating Center Program entitled "Comprehensive Care for Patients with Advanced Illnesses and their Families" after four years of experience. Qualitative and quantitative methods were employed to assess the program. Quasiexperimental, prospective, multicenter, single-group, and pretest/posttest methods were utilized to assess the quantitative data. The effectiveness of psychosocial interventions was assessed at baseline (visit 1) and after four follow-up visits. The following dimensions were assessed: mood state, discomfort, anxiety, degree of adjustment or adaptation to disease, and suffering. We also assessed the four dimensions of the spiritual pain scale: faith or spiritual beliefs, valuable faith or spiritual beliefs, meaning in life, and peace of mind/forgiveness. Qualitative analyses were performed via surveys to evaluate stakeholder satisfaction. We built 29 psychosocial support teams involving 133 professionals-mainly psychologists and social workers. During the study period, 8,964 patients and 11,810 family members attended. Significant improvements were observed in the psychosocial and spiritual dimensions assessed. Patients, family members, and stakeholders all showed high levels of satisfaction. This model of psychosocial care could serve as an example for other countries that wish to improve psychosocial and spiritual support. Our results confirm that specific psychosocial interventions delivered by well-trained experts can help to ease suffering and discomfort in end-of-life and palliative care patients, particularly those with high levels of pain or emotional distress.

  17. Society of Behavioral Medicine (SBM) position statement: improving access to psychosocial care for individuals with persistent pain: supporting the National Pain Strategy's call for interdisciplinary pain care.

    PubMed

    Janke, E Amy; Cheatle, Martin; Keefe, Francis J; Dhingra, Lara

    2018-03-01

    Policy makers have articulated a need for clear, evidence-based guidance to help inform pain policy. Persistent pain is common, expensive, and debilitating, and requires comprehensive assessment and treatment planning. Recently released opioid prescribing guidelines by the CDC (2016) emphasize the importance of using nonopioid therapies before considering opioid treatment for those without a malignant illness. The National Pain Strategy (2016) underscores the importance of comprehensive, interdisciplinary pain care. Unfortunately, despite persuasive evidence supporting the efficacy of psychosocial approaches, these interventions are inaccessible to the majority of Americans. Psychosocial approaches to pain management should be available for all individuals with persistent pain and in all health care settings and contexts as part of the comprehensive, interdisciplinary approach to pain care as outlined in the National Pain Strategy. To achieve this, we must prioritize reimbursement of evidence-based psychosocial approaches for pain assessment and management and improve provider training and competencies to implement these approaches.

  18. 78 FR 67342 - Proposed Information Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ..., volunteer demographic information and level of psycho-social health and functioning. The survey is designed... relationship between various service activities and potential psycho-social health benefits. Lastly this study... minutes. Estimated Total Burden Hours: 785. Total Burden Cost (capital/startup): None. Total Burden Cost...

  19. PSYCHOSOCIAL PHENOMENA AND BUILDING DESIGN.

    ERIC Educational Resources Information Center

    IZUMI, KIYOSHI

    THE DEPTH OF PSYCHOSOCIAL CONSIDERATION VARIES WITH ARCHITECTURAL FUNCTION. THESE FACTORS INCREASE AS A BUILDING USAGE BECOMES MORE ANTHROPOPHILIC. SITUATIONS RELATING TO AMBIGUOUS DESIGN MUST BE ELIMINATED IN BUILDING DESIGN. PROBLEMS INVOLVING VISUAL PERCEPTION SUCH AS (1) GLASS DOORS, (2) APPARENT INSECURITY OF STRUCTURE, (3) AMBIGUOUS SYMBOLIC…

  20. Bullying among Middle School Children Raised by Grandparents

    ERIC Educational Resources Information Center

    Edwards, Oliver W.

    2016-01-01

    Empirical research investigating the growing population of children raised by grandparents remains sparse. Much of the research examines the grandparents' functioning and suggests that they experience heightened psychosocial distress. Although the children are reported to manifest psychosocial and behavioral difficulty, a dearth of empirical…

  1. Diabetes technology: improving care, improving patient-reported outcomes and preventing complications in young people with Type 1 diabetes.

    PubMed

    Prahalad, P; Tanenbaum, M; Hood, K; Maahs, D M

    2018-04-01

    With the evolution of diabetes technology, those living with Type 1 diabetes are given a wider arsenal of tools with which to achieve glycaemic control and improve patient-reported outcomes. Furthermore, the use of these technologies may help reduce the risk of acute complications, such as severe hypoglycaemia and diabetic ketoacidosis, as well as long-term macro- and microvascular complications. In addition, diabetes technology can have a beneficial impact on psychosocial health by reducing the burden of diabetes. Unfortunately, diabetes goals are often unmet and people with Type 1 diabetes too frequently experience acute and long-term complications of this condition, in addition to often having less than ideal psychosocial outcomes. Increasing realization of the importance of patient-reported outcomes is leading to diabetes care delivery becoming more patient-centred. Diabetes technology in the form of medical devices, digital health and big data analytics have the potential to improve clinical care and psychosocial support, resulting in lower rates of acute and chronic complications, decreased burden of diabetes care, and improved quality of life. © 2018 Diabetes UK.

  2. Stabilization of glycemic control and improved quality of life using a shared medical appointment model in adolescents with type 1 diabetes in suboptimal control.

    PubMed

    Floyd, Baraka D; Block, Jennifer M; Buckingham, Bruce B; Ly, Trang; Foster, Nicole; Wright, Robert; Mueller, Claudia L; Hood, Korey K; Shah, Avni C

    2017-05-01

    Declining glycemic control in type 1 diabetes (T1D) during adolescence persists despite treatment advances. Non-adherence, peer relations, diabetes burnout, risk taking, transition to autonomy, family conflict, and poor quality of life (QOL) are recognized barriers. Shared medical appointments (SMAs) in adolescent T1D may offer benefits, but data are limited. Our objective was to determine whether SMAs, with multi-component interventions utilizing multidisciplinary teams, improve glycemic control and psychosocial outcomes in poorly controlled adolescent T1D. SMAs focused on self-management, communication skills, goal setting, glucose pattern recognition, and peer/diabetes team support. SMAs included: individual history and physical, labs, surveys, multidisciplinary educational ice breakers, group session, and individual wrap up. Outcomes were QOL, adherence, and retrospective and prospective glycemic control. Three to six subjects and families came to 3 SMAs and 1 individual appointment every 3 months over 9 months. A total of 37 English speaking subjects, ages 12-16 yrs, with T1D ≥ 1 year, and hemoglobin A1c (HbA1c) 7.5-11% enrolled. Thirty-two subjects attended 75% of visits, meeting inclusion criteria. HbA1c worsened in the 9 months before study (ΔHbA1c= 0.7 ± 1.2; p < 0.01), but remained stable during study (ΔHbA1c = 0.01 ± 1.2; p > 0.05). There were significant improvements in overall QOL (p = 0.005), school function (p = 0.006), psychosocial function (p = 0.008), barriers (p = 0.02), adherence (p = 0.01), and communication (p = 0.02). Improvements in school function and communication reached clinical significance. SMAs are feasible replacements to individual appointments in adolescent T1D, stabilizing glycemic control and improving QOL. Randomized controlled trials with optimizations are needed to further explore and refine this intervention. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Psychosocial care for children with haemophilia and their parents in the Netherlands.

    PubMed

    Limperg, P F; Haverman, L; Beijlevelt, M; van der Pot, M; Zaal, G; de Boer, W A; Fijnvandraat, K; Peters, M; Grootenhuis, M A

    2017-05-01

    Children growing up with haemophilia are at greater risk for psychosocial problems than their healthy peers. Providing psychosocial care to children with haemophilia and their families is indispensable, since psychosocial factors can have a significant impact on health and health-related quality of life (HRQOL). Our aim was to give a description of psychosocial care provided by the multidisciplinary team of the Hemophilia Comprehensive Care Centre (HCCC) at the Emma Children's Hospital in Amsterdam, the Netherlands. With this overview, other caregivers and hospitals can benefit in organizing their psychosocial care for children with haemophilia. The focus of the psychosocial care provided by the multidisciplinary team is on preventing psychosocial problems and medical-related stress, and supporting and equipping the child with haemophilia and its parents with as many skills as possible to lead an independent life with a high HRQOL. Core elements of the psychosocial care are therefore monitoring and screening of HRQOL (e.g. in daily clinical practice via www.hetklikt.nu), psychoeducation (haemophilia camp, haemophilia school, disease-specific activities, meetings for girls, parent meetings), practical help (Emma at Work, an employment agency for adolescents and young adults; Educational Facility and school visits), psychosocial interventions (the On Track group intervention and the Haemophilia Coping and Perception Test) and individual care (psychological counselling and referrals). By providing this overview of psychosocial support offered and by sharing this knowledge, psychosocial care can become more structured and consistent between HCCCs around the world. Potentially, processes and outcomes of care can be improved. © 2017 John Wiley & Sons Ltd.

  4. The Impact of Teen Court on Rural Adolescents: Improved Social Relationships, Psychological Functioning, and School Experiences.

    PubMed

    Smokowski, Paul R; Rose, Roderick A; Evans, Caroline B R; Barbee, James; Cotter, Katie L; Bower, Meredith

    2017-08-01

    Teen Court is a prevention program aimed at diverting first time juvenile offenders from the traditional juvenile justice system and reintegrating them into the community. Few studies have examined if Teen Court impacts adolescent functioning. We examined how Teen Court participation impacted psychosocial functioning, social relationships, and school experiences in a sample of 392 rural Teen Court participants relative to two comparison samples, one from the same county as Teen Court (n = 4276) and one from a neighboring county (n = 3584). We found that Teen Court has the potential to decrease internalizing symptoms, externalizing behavior, violent behavior, parent-adolescent conflict, and delinquent friends, and increase self-esteem and school satisfaction.

  5. Hope for successful implementation of psychosocial/psychiatric rehabilitation in the forensic mental health setting.

    PubMed

    Brown, Stephanie A; Lewis, Kent

    2015-12-01

    To explore staff perceptions of the successes and barriers to implementation of the psychosocial/psychiatric rehabilitation (PSR) model in the forensic mental health setting and identify staff supports needed for greater implementation. A qualitative descriptive design was used and staff focus group data was analyzed using the constant comparative method. All aspects of PSR are being implemented in the forensic setting. Barriers limiting comprehensive implementation include hospital processes and functions, legal components, client clinical presentation, staff attributes and interactions, and lack of resources. To foster greater implementation, employees require support to improve interprofessional interactions and acquire additional resources and education. Strengthening existing successes and addressing barriers identified will foster greater PSR implementation in the forensic setting. Adjusting the physical environment, streamlining documentation, shifting focus from security to rehabilitation goals, and adapting PSR principles to various levels of illness acuity and stages of treatment would enhance PSR implementation. A management focus on improving staff morale, self-care, peer support, team cohesion, and communication would limit burnout and increase successful implementation of PSR. Additional educational opportunities and ongoing training are suggested to support a unified understanding and sustained approach to PSR implementation in the forensic setting. (c) 2015 APA, all rights reserved).

  6. Psychological treatment of attention deficit hyperactivity disorder in adults: a systematic review.

    PubMed

    Vidal-Estrada, Raquel; Bosch-Munso, Rosa; Nogueira-Morais, Mariana; Casas-Brugue, Miquel; Ramos-Quiroga, Josep A

    2012-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder of childhood onset. The disorder persists into adulthood in most cases, significantly affecting patient function. Although the firstline choice of treatment for ADHD is pharmacological, drug treatments are not always sufficient. All the published studies on the psychological treatment of ADHD were systematically reviewed for the present article. The MEDLINE and PsychINFO electronic databases were searched using the terms psychological treatment OR psychotherapy OR psychosocial treatment AND ADHD. Patient age was restricted to adults (all adult:19+ years). Eighteen published studies met inclusion criteria for the review. Fifteen efficacy studies of psychological treatment were selected (cognitive behavioral therapy, metacognitive therapy, dialectical behavior therapy, coaching, cognitive remediation) and three previous reviews. The results indicate that cognitive behavioral therapy is the most effective psychological treatment for ADHD symptoms in adults and the comorbid symptoms of anxiety and depression, which have an important functional impact on the daily life of patients. However, more research is needed to know the differential effects of each psychological approach in relation to improved ADHD symptoms in adults. Finally, future directions for the psychosocial treatment of ADHD problems of adults are suggested.

  7. IMPACT OF ANTIDEPRESSANT THERAPY ON COGNITIVE ASPECTS OF WORK, CONDOM USE, AND PSYCHOSOCIAL WELL-BEING AMONG HIV CLIENTS IN UGANDA*

    PubMed Central

    WAGNER, GLENN J.; NGO, VICTORIA K.; NAKASUJJA, NOELINE; AKENA, DICKENS; AUNON, FRANCES; MUSISI, SEGGANE

    2017-01-01

    Objective Depression has been found to impede several health outcomes among people living with HIV, but little research has examined whether depression treatment mitigates this influence. We assessed the impact of antidepressant therapy on measures of work, condom use, and psychosocial well-being among depressed HIV clients in Uganda. Methods Paired t-tests and McNemar tests were used to assess change in survey data collected from participants at initiation of antidepressant therapy (baseline) and 6 months later. Result Ninety-five participants completed the 6 month assessment, of whom 82 (86%) responded to treatment (defined as Patient Health Questionnaire-9 score < 5). Among study completers, work functioning improved significantly, as did measures of self-efficacy related to condom use and work (as well as general self efficacy) and internalized HIV stigma declined; however, actual engagement in work activity and consistent condom use did not show significant change. Similar findings were observed among treatment responders. Conclusion Antidepressant treatment benefits functional capacity, psychological well-being, and cognitive intermediary factors that may be essential for behavioral change related to work and condom use, but supplementary therapeutic strategies may be needed to impact more direct behavioral change. PMID:25492710

  8. Impact of antidepressant therapy on cognitive aspects of work, condom use, and psychosocial well-being among HIV clients in Uganda.

    PubMed

    Wagner, Glenn J; Ngo, Victoria K; Nakasujja, Noeline; Akena, Dickens; Aunon, Frances; Musisi, Seggane

    2014-01-01

    Depression has been found to impede several health outcomes among people living with HIV, but little research has examined whether depression treatment mitigates this influence. We assessed the impact of antidepressant therapy on measures of work, condom use, and psychosocial well-being among depressed HIV clients in Uganda. Paired t-tests and McNemar tests were used to assess change in survey data collected from participants at initiation of antidepressant therapy (baseline) and 6 months later. Ninety-five participants completed the 6-month assessment, of whom 82 (86%) responded to treatment (defined as Patient Health Questionnaire-9 score < 5). Among study completers, work functioning improved significantly, as did measures of self-efficacy related to condom use and work (as well as general self-efficacy), and internalized HIV stigma declined; however, actual engagement in work activity and consistent condom use did not show significant change. Similar findings were observed among treatment responders. Antidepressant treatment benefits functional capacity, psychological well-being, and cognitive intermediary factors that may be essential for behavioral change related to work and condom use, but supplementary therapeutic strategies may be needed to impact more direct behavioral change.

  9. Power Wheelchair Use in Persons With Amyotrophic Lateral Sclerosis: Changes Over Time.

    PubMed

    Ward, Amber Lea; Hammond, Sara; Holsten, Scott; Bravver, Elena; Brooks, Benjamin Rix

    2015-01-01

    The objectives of this study were to survey persons with Amyotrophic Lateral Sclerosis (ALS) at 1 and 6 months after receiving power wheelchairs to determine long-term use, comfort, and function as well as the power wheelchair's impact on daily tasks and quality of life. A 33-question survey and Psychosocial Impact of Assistive Devices Scale (PIADS) were sent 1 month after getting a new power wheelchair; a follow-up survey was sent at 6 months. Based on satisfaction and feature use survey results, at 1 month, 81% of users found the power wheelchair overall comfort to be high, 88% found their overall mobility to be improved, and 95% found it easy to use. Their quality of life increased and pain decreased at 1 and 6 months. According to the PIADS, the power wheelchair gave users increased ability to participate and sense of competence. This study has important results for the ALS community, as it is the first to assess power wheelchair users at 1 and 6 months after power wheelchair procurement. The results demonstrate the impact the power wheelchair has on mobility, psychosocial issues, functional abilities, and quality of life for a person with ALS.

  10. Community Based Psychosocial Education Can Improve Mood Disturbance in Breast Cancer Survivors at Various Stages of Their Recovery.

    PubMed

    Kokavec, Anna

    2016-11-01

    Psychosocial distress can contribute to avoidance, refusal, or discontinuation of cancer treatment, which could impact recovery and survival. The aim of the present study was to evaluate the effectiveness of a community based psychosocial program on alleviating mood disturbance in breast cancer survivors at different stages of their breast cancer journey. A total of 37 women participated in an 8-week psychosocial program at their local community centre. The weekly 3-hour program was delivered in a small group format. Program components included health education, behavioural training, cognitive behavioural therapy, art therapy and stress-management. Questionnaires aimed at assessing psychiatric morbidity and mood adjustment were administered at the beginning of the program (Pre) and at the completion of the program (Post). Group data revealed a significant reduction in psychiatric morbidity and improved psychological adjustment. When participants were divided into degree of psychiatric morbidity (mild, moderate, severe, very severe) a significant reduction in the reporting of anxiety symptoms in the mild, moderate, severe and very severe groups was reported; depression symptoms in the severe and very severe groups were noted, and anger, confusion and somatic symptoms in the mild group were noted. The level of activity was also significantly improved in the very severe group. A structured community based psychosocial program is beneficial to women struggling to come to terms with the emotional consequences of breast cancer at all stages of recovery.

  11. The Stress Check Program: a new national policy for monitoring and screening psychosocial stress in the workplace in Japan.

    PubMed

    Kawakami, Norito; Tsutsumi, Akizumi

    2016-01-01

    The Japanese government launched a new occupational health policy called the Stress Check Program. This program mandates that all workplaces with 50 or more employees conduct the Stress Check Program for workers at least once a year. This article gives a brief overview and critical review of the program. We reviewed relevant laws, guidelines, and manuals, as well as the policy development process. The policy and the components of the program were compared using available scientific evidence and trends in the management of psychosocial factors at work according to the policies and guidelines of international bodies and European countries. The process of program policy development was based on a discussion among employer and employee representatives, occupational health professionals, and mental health experts. Scientific evidence shows that mandated components of the program (i.e., feedback of stress survey results and physician's interview) may be ineffective. However, additional components recommended to employers, such as stress management skill provision and work environment improvement, in conjunction with the program may be effective in improving psychosocial stress at work. The Stress Check Program is unique compared with the global trend for psychosocial risk management because it focuses on the assessment of stress among individual workers. The new program may be effective in improving worker mental health by facilitating the psychosocial risk management approach in Japan. Concerns regarding the program include mass leakage of collected information, and possible disadvantages for workers labeled as having high stress.

  12. Examining the broader psychosocial effects of mass conflict on PTSD symptoms and functional impairment amongst West Papuan refugees resettled in Papua New Guinea (PNG).

    PubMed

    Tay, Alvin Kuowei; Rees, Susan; Chan, Jack; Kareth, Moses; Silove, Derrick

    2015-05-01

    Mass conflict and displacement erode the core psychosocial foundations of society, but there is a dearth of quantitative data examining the long-term mental health effects of these macrocosmic changes, particularly in relation to posttraumatic stress disorder (PTSD) symptoms. In 2013, we conducted a cross-sectional community study (n = 230) of West Papuan refugees residing in Port Moresby, Papua New Guinea, testing a moderated-mediation structural equation model of PTSD symptoms in which we examined relationships involving the psychosocial effects of mass conflict and displacement based on the Adaptation and Development after Persecution and Trauma (ADAPT) model, a trauma count (TC) of traumatic events (TEs) related to mass conflict, and a count index of current adversity (AC). A direct and an indirect path via AC led to PTSD symptoms. The ADAPT index exerted two effects on PTSD symptoms, an indirect effect via AC, and a moderating effect on TC. PTSD symptoms were directly associated with functional impairment. Although based on cross-sectional data, our findings provide support for a core prediction of the ADAPT model, that is, that undermining of the core psychosocial foundations of society brought about by mass conflict and displacement exerts an indirect and moderating influence on PTSD symptoms. The path model supports the importance of repairing the psychosocial pillars of society as a foundation for addressing trauma-related symptoms and promoting the functioning of refugees. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Psychosocial functioning among regular cannabis users with and without cannabis use disorder.

    PubMed

    Foster, Katherine T; Arterberry, Brooke J; Iacono, William G; McGue, Matt; Hicks, Brian M

    2017-11-27

    In the United States, cannabis accessibility has continued to rise as the perception of its harmfulness has decreased. Only about 30% of regular cannabis users develop cannabis use disorder (CUD), but it is unclear if individuals who use cannabis regularly without ever developing CUD experience notable psychosocial impairment across the lifespan. Therefore, psychosocial functioning was compared across regular cannabis users with or without CUD and a non-user control group during adolescence (age 17; early risk) and young adulthood (ages 18-25; peak CUD prevalence). Weekly cannabis users with CUD (n = 311), weekly users without CUD (n = 111), and non-users (n = 996) were identified in the Minnesota Twin Family Study. Groups were compared on alcohol and illicit drug use, psychiatric problems, personality, and social functioning at age 17 and from ages 18 to 25. Self-reported cannabis use and problem use were independently verified using co-twin informant report. In both adolescence and young adulthood, non-CUD users reported significantly higher levels of substance use problems and externalizing behaviors than non-users, but lower levels than CUD users. High agreement between self- and co-twin informant reports confirmed the validity of self-reported cannabis use problems. Even in the absence of CUD, regular cannabis use was associated with psychosocial impairment in adolescence and young adulthood. However, regular users with CUD endorsed especially high psychiatric comorbidity and psychosocial impairment. The need for early prevention and intervention - regardless of CUD status - was highlighted by the presence of these patterns in adolescence.

  14. Psychosocial Challenges/Transition to Adulthood.

    PubMed

    Frederick, Carla

    2016-08-01

    Advances in the health care of individuals with cystic fibrosis have resulted in more than half of the population older than the age of 18 living longer, fuller lives. This success brings about the need for new areas of improvement and development including the mastery of transitioning from pediatric to adult health care and attention to psychosocial needs. This article reviews key components of the process of transitioning to adult care and some important psychosocial considerations. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. From trust on intimacy: A new inventory for examining erikson's stages of psychosocial development.

    PubMed

    Rosenthal, D A; Gurney, R M; Moore, S M

    1981-12-01

    A new inventory for examining the first six of Erikson's psychosocial stages is described. The self-report questionnaire, developed in a pilot study of 97 adolescents and tested in a study of 622 adolescents, has 12 items for each subscale. Measures of reliability and validity are reported. It is concluded that the Erikson Psychosocial Stage Inventory (EPSI) is a useful measure for researchers interested in development from early adolescence and in mapping changes as a function of life events.

  16. Psychopathology in methamphetamine-dependent adults 3 years after treatment.

    PubMed

    Glasner-Edwards, Suzette; Mooney, Larissa J; Marinelli-Casey, Patricia; Hillhouse, Maureen; Ang, Alfonso; Rawson, Richard A

    2010-01-01

    Although psychiatric symptoms are frequently observed in methamphetamine (MA) users, little is known about the prevalence of psychiatric disorders in MA-dependent individuals. This is the first study to examine the association of psychiatric disorders with substance use and psychosocial functioning in a large sample of MA users 3 years after treatment. We predicted that psychiatric diagnoses and severity would be associated with substance use and poorer overall functioning over the 3 year post-treatment course. Participants (N = 526) received psychosocial treatment for MA dependence as part of the Methamphetamine Treatment Project and were reassessed for psychosocial functioning and substance use at a mean of 3 years after treatment initiation. DSM-IV psychiatric diagnoses were assessed at follow-up using the Mini-International Neuropsychiatric Interview. Psychosocial functioning was assessed using the Addiction Severity Index. Overall, 48.1% of the sample met criteria for a current or past psychiatric disorder other than a substance use disorder. Consistent with prior reports from clinical samples of cocaine users, this rate was largely accounted for by mood disorders, anxiety disorders and antisocial personality. Those with an Axis I psychiatric disorder evidenced increased MA use and greater functional impairment over time relative to those without a psychiatric disorder. This initial investigation of psychiatric diagnoses in MA users after treatment indicates elevated rates of Axis I and II disorders in this population and underscores the need for integrated psychiatric assessment and intervention in drug abuse treatment settings.

  17. Supporting children facing a parent's cancer diagnosis: a systematic review of children's psychosocial needs and existing interventions.

    PubMed

    Ellis, S J; Wakefield, C E; Antill, G; Burns, M; Patterson, P

    2017-01-01

    This review aimed to (1) summarise the psychosocial needs of children/adolescents (0-18 years) with a parent with cancer across the illness trajectory (diagnosis to bereavement) and (2) evaluate existing interventions for this population. Medline, CINAHL, PsychInfo, EMBASE and Social Work Abstracts were systematically searched for articles published from 1985 to 2015. Of 98 full text articles retrieved, 12 reported on children's psychosocial needs, and 12 intervention studies were identified. Each article was appraised in accordance with the Mixed Method Appraisal Tool. Three factors emerged as critical to consider in future intervention development: (1) Children need age-appropriate information about their parent's cancer; (2) Children require support communicating with parents, family members and health professionals and (3) Children need an environment where they feel comfortable sharing positive/negative emotions and can have their experiences normalised among peers. All intervention studies reported at least one positive outcome, however, only five reported significant improvements in child/family functioning based on validated quantitative measure/s. Variability in study design and quality, combined with considerable heterogeneity in intervention characteristics and outcome variables limited the conclusions, which could be drawn. Therefore, further carefully designed and scientifically evaluated interventions for children facing a parent's cancer diagnosis are clearly warranted. © 2016 John Wiley & Sons Ltd.

  18. Back massage therapy promotes psychological relaxation and an increase in salivary chromogranin A release.

    PubMed

    Noto, Yuka; Kudo, Mihoko; Hirota, Kazuyoshi

    2010-12-01

    Massage therapy promotes psychosocial relaxation, reduces stress and has been reported to improve the immune function. As such, massage therapy is currently used in palliative care for the relief of anxiety and pain. Although psychosocial status has been evaluated using subjective psychological tests, such as State-Trait Anxiety Inventory (STAI), subjective psychological tests are of limited value if the subjects fail to report reliably. Salivary biomarkers have been recently suggested as useful objective markers for assessing psychosocial status. To determine whether salivary biomarkers are useful objective indices for assessing the effects of back massage on the mental status of 25 young healthy female volunteers, we measured heart rate and salivary biomarkers (α-amylase activity, cortisol, and chromogranin A) and assessed the STAI score before and after the back massage. Back massage significantly reduced the heart rate and STAI; however, salivary amylase and cortisol levels did not change. In contrast, the level of salivary chromogranin A significantly increased. We therefore conclude that changes in the salivary biomarkers tested here may not indicate changes in psychological status following massage therapy. However, the increase in chromogranin A release may contribute to the immunologically beneficial effects of massage therapy as chromogranin A has antibacterial and antifungal activity.

  19. Depressive and Anxiety Symptoms Predict Sustained Quality of Life Deficits in HIV-Positive Ugandan Adults Despite Antiretroviral Therapy: A Prospective Cohort Study.

    PubMed

    Ezeamama, Amara E; Woolfork, Makhabele N; Guwatudde, David; Bagenda, Danstan; Manabe, Yukari C; Fawzi, Wafaie W; Smith Fawzi, Mary C

    2016-03-01

    The impact of psychosocial status at onset of antiretroviral therapy on changes in quality of life (QOL) and subjectively rated health (SRH) among adults on highly active antiretroviral therapy (HAART) in resource-limited settings is poorly understood. Therefore, we evaluate the association between stigma, anxiety, depression, and social support and change in QOL and SRH in HIV-infected Ugandan adults during an 18-month period. Psychosocial indicators were assessed at enrollment using structured questionnaires. QOL and SRH measures were assessed at months 0, 6, 12, and 18 using the Medical Outcomes Survey-HIV. Linear mixed models determined risk estimated differences in QOL and SRH in relation to quartiles of each psychosocial status indicator. Repeated measures generalized estimating equations modeling was implemented to assess differences in likelihood of improved versus nonimproved SRH during follow-up.QOL scores and SRH improved significantly for all participants over 18 months (P < 0.0001). The gain in QOL increased dose-dependently as baseline depressive symptoms (time*depression P < 0.001) and anxiety levels (time*anxiety P < 0.001) declined. Lower social support was associated with worse QOL at baseline (P = 0.0005) but QOL improvement during follow-up was not dependent on baseline level of social support (time*social support P = 0.8943) or number of stigmatizing experiences (time*stigma P = 0.8662). Psychosocial determinants did not predict changes in SRH in this study. High levels of depression and anxiety symptoms at HAART initiation predicts lower gains in QOL for HIV-positive patients for as long as 18 months. Long-term QOL improvements in HIV-infected adults may be enhanced by implementation of psychosocial interventions to reduce depression and anxiety in HIV-infected adults.

  20. Prospective Analysis of Primary Breast Augmentation on Body Image Using the BREAST-Q: Results from a Nationwide Study

    PubMed Central

    Pusic, Andrea; Murphy, Diane K.

    2016-01-01

    Background: The Breast Implant Follow-up Study is a large, ongoing observational study of women who received Natrelle round silicone-filled or saline-filled breast implants. This analysis describes patient-reported outcomes in the cohort who underwent breast augmentation. Methods: Subjects prospectively completed two validated scales of the BREAST-Q (satisfaction with breasts and psychosocial well-being) preoperatively and at 1 and 4 years postoperatively. Effect size and z tests were used to compare differences between preoperative versus postoperative scores; multivariate mixed models were used to compare differences in scores between silicone-filled and saline-filled implants. Results: Of 17,899 subjects completing the BREAST-Q preoperatively, 14,514 (81.1 percent) completed the postoperative questionnaire (12,726 received silicone-filled implants and 1788 received saline-filled implants). Overall, satisfaction with breasts and psychosocial well-being increased significantly at postoperative year 1 (p < 0.0001 for both), and the improvement was sustained at year 4 (p < 0.0001 for both). Large effect sizes were observed for satisfaction with breasts (2.0 at year 1; 1.8 at year 4) and psychosocial well-being (1.2 at year 1; 1.0 at year 4). In the multivariate model, silicone-filled implants were associated with significantly greater improvement compared with saline-filled implants for satisfaction with breasts and psychosocial well-being at year 1 (p < 0.0001 for both) and year 4 (p < 0.0001 and p < 0.0019, respectively). Conclusions: Breast implants are effective in improving women’s quality of life. The authors found significant and sustained improvements in satisfaction and psychosocial well-being in women undergoing breast augmentation with Natrelle silicone-filled or saline-filled implants. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. PMID:27219264

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