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Psychosocial Factors (psychosocial + factor)
Kinds of Psychosocial Factors Selected AbstractsExpanding the Andersen Model: The Role of Psychosocial Factors in Long-Term Care UseHEALTH SERVICES RESEARCH, Issue 5 2002Elizabeth H Bradley Objective. To examine a prevailing conceptual model of health services use (Andersen 1995) and to suggest modifications that may enhance its explanatory power when applied to empirical studies of race/ethnicity and long-term care. Study Setting. Twelve focus groups of African-American (five groups) and white (seven groups) individuals, aged 65 and older, residing in Connecticut during 2000. Study Design. Using qualitative analysis, data were coded and analyzed in NUD-IST 4 software to facilitate the reporting of recurrent themes, supporting quotations, and links among the themes for developing the conceptual framework. Specific analysis was conducted to assess distinctions in common themes between African-American and white focus groups. Data Collection. Data were collected using a standardized discussion guide, augmented by prompts for clarification. Audio taped sessions were transcribed and independently coded by investigators and crosschecked to enhance coding validity. An audit trail was maintained to document analytic decisions during data analysis and interpretation. Principal Findings. Psychosocial factors (e.g., attitudes and knowledge, social norms, and perceived control) are identified as determinants of service use, thereby expanding the Andersen model (1995). African-American and white focus group members differed in their reported accessibility of information about long-term care, social norms concerning caregiving expectations and burden, and concerns of privacy and self-determination. Conclusions. More comprehensive identification of psychosocial factors may enhance our understanding of the complex role of race/ethnicity in long-term care use as well as the effectiveness of policies and programs designed to address disparities in long-term care service use among minority and nonminority groups. [source] Psychosocial Factors Associated With Stage of Change for Contraceptive Use Among Women at Increased Risk for HIV and STDsJOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 5 2004Rebecca J. Cabral This study assessed the psychosocial factors associated with contraceptive use among inner-city women at risk for HIV/STDs by using the transtheoretical model of behavior change. The five-city study group of women aged 15 to 34 years was recruited from neighborhoods, social service agencies and shelters (n= 998). We measured stages of change for contraceptive use and assessed theoretically proposed factors associated with being at a higher stage. Variables such as perceived advantages of contraceptive use and normative support for use were very important at early stages, but less important in later stages. However, self-efficacy was important in both early (OR =1.5) and later (OR = 1.6) stages, suggesting that women's confidence in their ability to initiate and sustain contraceptive use is crucial. [source] Psychosocial Factors Affecting Adults With Intellectual Disabilities With Psychiatric Disorders in Cali, ColombiaJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 3 2009Miguel Ángel Verdugo Abstract Increases in life expectancy have heightened concerns for people with intellectual disability (ID) who are growing old and who have be designated as "dually diagnosed",that is, who have, apart from their ID, a psychiatric disorder, and who because of this conjoint condition, are subjected to social exclusion due to three factors: old age, cognitive limitation, and mental illness. The objective of this study was to describe the psychosocial factors associated with the comorbidity between ID and psychiatric disorder of adults in the city of Cali, Colombia. Subjects were 50 dyads consisting of a carer and a person with ID. The Caregivers Questionnaire and the Integral Quality of Life Scale were adapted for use in the study. The analysis of information was based on three factors: person, family, and society. In the case of the personal factor, an adequate level of physical well-being and a good level of self-care were found in more than 60% of the adults with dual diagnosis, good adherence to treatment in 82%, and medium satisfaction in the individual-context relationship in 54%. With regard to the family factor, a high level of satisfaction of needs (84%) was found. Good family functioning was observed in 86%, while family participation in rehabilitation was reported to be between moderate and deficient in 60% of the cases. With respect to the social factor, cases of support between moderate and deficient were found in 68%, and a regular inclusion was observed in 48%. The authors conclude that the family functioning aspect appeared as the major protective factor, while the inclusion and social support were shown as the main risk factors. [source] Prebirth Psychosocial Factors as Predictors of Consistency in Contraceptive Use Among Taiwanese Adolescent Mothers at 6 Months PostpartumPUBLIC HEALTH NURSING, Issue 4 2005Ruey-Hsia Wang Abstract,Objective: To assess contraceptive behavior and whether pre-birth psychosocial factors could predict consistency in contraceptive use among adolescent mothers at six-month postpartum. Design: Prospective study. Sample: 104 Taiwanese adolescent mothers. Measurements: Participants completed a contraception questionnaire in their third trimester and a postpartum contraception questionnaire at six-month postpartum. Results: Prior to giving birth, the adolescent mothers most commonly answered that condom use (39.8%) was the contraceptive method they planned to use after delivery. It was also more commonly reported in the postpartum to be the method they actually were using (54.3%). Stepwise logistic regression analysis further showed that a more positive contraceptive attitude (odds ratio = 1.104) and a higher self-efficacy (odds ratio = 1.068) in contraceptive use in the pre-birth period increased the probability that a participant would report that she always used contraceptives in the postpartum period. Nevertheless, a higher score in the pre-birth period in the area of subjective contraceptive norms (odds ratio = 0.978) decreased this probability. The final regression model could correctly classify 81.7% of the participants. Conclusions: Health care professionals should provide adolescent mothers with the information they need to improve their attitude and self-efficacy toward contraception before they enter the postpartum period. [source] The Reserve Capacity Model as a Framework for Understanding Psychosocial Factors in Health DisparitiesAPPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 1 2009Linda C. Gallo Substantial research has identified a robust, linear association between socioeconomic status (SES) and health, across many different populations and outcomes. Among myriad influences, psychosocial factors may contribute to SES-related gradients in health. In the current manuscript, we describe the Reserve Capacity Model (Gallo & Matthews, 2003) as a potential framework through which to examine psychosocial pathways in health disparities. The model posits that SES is connected to health, in part through associations with stress and concomitant negative emotions, and their subsequent links with bio-behavioral functioning. In addition, low SES may predict enhanced emotional and physiological reactivity to stress due to a deficiency in resilient psychosocial resources (i.e. "reserve capacity") and limited opportunities to replenish resource reserves. In addition, resources might represent a direct mediational pathway from SES to health. We describe several studies in which we have examined various tenets of the Reserve Capacity Model, and comment on future research directions to better understand the roles of psychosocial variables in health disparities. [source] Race and religion: differential prediction of anxiety symptoms by religious coping in African American and European American young adults,DEPRESSION AND ANXIETY, Issue 3 2010L. Kevin Chapman Ph.D. Abstract Background: Psychosocial factors, including religious coping, consistently have been implicated in the expression of anxiety disorders. This study sought to investigate the relationship between religious coping on anxiety symptoms among a nonclinical sample of African American and European American young adults. Methods: One hundred twenty-one European American and 100 African American young adults completed measures of anxiety and religious coping. Results: As predicted, results differed according to race. African Americans reported significantly more positive religious coping, less negative religious coping, and experienced fewer anxiety symptoms than European Americans. European Americans demonstrated a significant, positive relationship between negative religious coping and anxiety symptoms, and an opposite trend related to anxiety and positive religious coping. However, no such relationships emerged among the African American sample. Conclusions: Implications and suggestions for future research are discussed. Depression and Anxiety, 2010. © 2008 Wiley-Liss, Inc. [source] Psychosocial factors are independent risk factors for the development of Type 2 diabetes in Japanese workers with impaired fasting glucose and/or impaired glucose tolerance,DIABETIC MEDICINE, Issue 10 2008M. Toshihiro Abstract Aims, We prospectively studied Japanese workers with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) and analysed possible risk factors for diabetes, including psychosocial factors such as stress. Methods, The participants were 128 male Japanese company employees (mean age, 49.3 ± 5.9 years) with IFG and/or IGT diagnosed by oral glucose tolerance test (OGTT). Participants were prospectively studied for 5 years with annual OGTTs. The Kaplan,Meier method and Cox's proportional hazard model were used to analyse the incidence of diabetes and the factors affecting glucose tolerance, including anthropometric, biochemical and social,psychological factors. Results, Of 128 participants, 36 (28.1%) developed diabetes and 39 (30.5%) returned to normal glucose tolerance (NGT) during a mean follow-up of 3.2 years. Independent risk factors for diabetes were night duty [hazard ratio (HR) = 5.48, P = 0.002], higher fasting plasma glucose (FPG) levels within 6.1,6.9 mmol/l (HR = 1.05, P = 0.031), stress (HR = 3.81, P = 0.037) and administrative position (HR = 12.70, P = 0.045), while independent factors associated with recovery were lower FPG levels (HR = 0.94, P = 0.017), being a white-collar worker (HR = 0.34, P = 0.033), non-smoking (HR = 0.31, P = 0.040) and lower serum alanine aminotransferase (ALT) levels (HR = 0.97, P = 0.042). Conclusions, In addition to FPG levels at baseline, psychosocial factors (night duty, stress and administrative position) are risk factors for Type 2 diabetes, while being a white-collar worker, a non-smoker and lower serum ALT levels are factors associated with return to NGT in Japanese workers with IFG and/or IGT. [source] Psychosocial factors involved in delayed consultation by patients with head and neck cancerHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2005Olivier Rozniatowski DESS Abstract Background. In the north of France, a delay in primary consultation has been noted among patients with head and neck cancer. This group is often correlated with lower socioeconomic status and a lack of medical information. Therefore, the choice to seek consultation is often influenced by symptoms such as pain and change in the size of tumors in the neck. We studied this delay in seeking consultation, focusing on psychosocial variables such as professional and social background, the involvement of a spouse/partner, and the presence of anxiety and depression. Methods. Two rating scales were administered to 50 patients with large tumors (T3/T4) and 50 patients with small tumors (T1/T2), and the results were compared. These rating scales were as follows: (1) a 17-item questionnaire assessing sociodemographic data, presenting symptoms, factors generating the consultation, and reasons for delay; and (2) the Hospital Anxiety and Depression Scale (HADS). Results. Both groups were predominantly male and working-class. Significant differences were observed in time since symptom onset and in conscious delay in seeking medical attention. The group with large tumors was characterized by lower involvement of a spouse/partner, conscious delay before first consultation, greater social isolation, fewer medical visits, and lower HADS anxiety scores. The group with small tumors sought consultation sooner and was characterized by greater involvement of a spouse/partner, correlated with significant anxiety. Depression was not a factor influencing delay within either group. Conclusions. The interpersonal relationship with a spouse/partner seemed to be essential in the dynamics surrounding consultation. Anxiety, rather than socioeconomics status, was a discriminating factor in the delay in seeking consultation. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Expanding the Andersen Model: The Role of Psychosocial Factors in Long-Term Care UseHEALTH SERVICES RESEARCH, Issue 5 2002Elizabeth H Bradley Objective. To examine a prevailing conceptual model of health services use (Andersen 1995) and to suggest modifications that may enhance its explanatory power when applied to empirical studies of race/ethnicity and long-term care. Study Setting. Twelve focus groups of African-American (five groups) and white (seven groups) individuals, aged 65 and older, residing in Connecticut during 2000. Study Design. Using qualitative analysis, data were coded and analyzed in NUD-IST 4 software to facilitate the reporting of recurrent themes, supporting quotations, and links among the themes for developing the conceptual framework. Specific analysis was conducted to assess distinctions in common themes between African-American and white focus groups. Data Collection. Data were collected using a standardized discussion guide, augmented by prompts for clarification. Audio taped sessions were transcribed and independently coded by investigators and crosschecked to enhance coding validity. An audit trail was maintained to document analytic decisions during data analysis and interpretation. Principal Findings. Psychosocial factors (e.g., attitudes and knowledge, social norms, and perceived control) are identified as determinants of service use, thereby expanding the Andersen model (1995). African-American and white focus group members differed in their reported accessibility of information about long-term care, social norms concerning caregiving expectations and burden, and concerns of privacy and self-determination. Conclusions. More comprehensive identification of psychosocial factors may enhance our understanding of the complex role of race/ethnicity in long-term care use as well as the effectiveness of policies and programs designed to address disparities in long-term care service use among minority and nonminority groups. [source] Determinants of adherence to highly active antiretroviral therapy (HAART) in Chinese HIV/AIDS patientsHIV MEDICINE, Issue 2 2003OW Fong Objective Drug adherence is crucial to the success of highly active antiretroviral therapy (HAART) in the treatment of HIV disease. Adherence to HAART and its determinants may, however, differ across HIV/AIDS populations. Methods We retrospectively studied drug adherence by self-report in HIV-1 infected Chinese patients who have been on HAART for at least 1 year as at the end of year 2000. HAART is defined as three or more antiretrovirals with at least one protease inhibitor or non-nucleoside analogue reverse transcriptase inhibitor. Results The last drug adherence level assessed by self-report in 161 Chinese patients were: grade A (100%) , 130, 80.7%; grade B (95,99%) , 25, 15.5%; grade C (90,94%) , three, 1.9% and grade D (< 90%) , three, 1.9%. Patients with full adherence were more likely to have undetectable (< 500 copies/mL) plasma virus level (adjusted OR, 4.22; 95% CI, 1.75,12.33). Patients' demographics, HIV disease status and antiretroviral regimen did not affect adherence. Partial drug adherence was, however, independently associated with the psychosocial factors of missing clinic appointments (adjusted OR, 3.13; 95% CI, 1.23,8.33), forgetfulness (adjusted OR, 4.55; 95% CI, 1.64,12.5) and a busy work life (adjusted OR, 6.67; 95% CI, 1.75,25). Conclusion There were similarities and differences in determinants affecting HAART adherence in Chinese compared with other patients. Psychosocial factors rather than HIV disease or treatment were more important factors in our Chinese patients. The relevance of patient populations and care setting for adherence to HAART shall be further studied. [source] Temperament and character profile of patients with psoriasisJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2008Abstract Background, Psychosocial factors have been implicated as being important in the onset and/or exacerbation of psoriasis.1 The aim of this study is to examine both the personality factors of patients with psoriasis and the correlations between temperament and character dimensions. Material and methods, A total number of 105 psoriasis patients and 109 healthy individuals were enrolled in the study. Questionnaires including Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Temperament and Character Inventory (TCI) were administered individually. Both groups were evaluated in terms of depression, anxiety and characteristic features by using these psychological tests and compared statistically. The relationship between psoriasis area and severity index (PASI) score and the BDI, BAI and TCI scales were also evaluated. Results, The mean BDI score of the psoriasis group were significantly higher than the control group. The psoriasis group had significantly higher scores of harm avoidance and lower scores of being self-directedness than the control group. The duration of psoriasis and the PASI scores were not correlated with BDI and BAI scores. Conclusion, The current study shows that psoriasis patients have distinctive temperament and character dimensions when compared with the control group. We suggest that evaluation and treatment of psoriasis should also include psychosomatic approaches in clinical practice. [source] Psychosocial factors and shoulder symptom development among workersAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2009Caroline K. Smith MPH Abstract Background Shoulder injuries are a common cause of pain and discomfort. Many work-related factors have been associated with the onset of shoulder symptoms. The psychosocial concepts in the demand,control model have been studied in association with musculoskeletal symptoms but with heterogeneous findings. The purpose of this study was to assess the relationship between the psychosocial concepts of the demand,control model and the incidence of shoulder symptoms in a working population. Methods After following 424 subjects for approximately 1 year, 85 incident cases were identified from self-reported data. Cox proportional hazards modeling was used to assess the associations between shoulder symptoms and demand,control model quadrants. Results Cases were more likely to be female and report other upper extremity symptoms at baseline (P,<,0.05). From the hazard models, being in either a passive or high strain job quadrant was associated with the incidence of shoulder symptoms. Hazard ratios were 2.17, 95% CI 1.02,4.66 and 2.19, 95% CI 1.08,4.42, respectively. Conclusions Using self-reporting to determine demand,control quadrants was successful in identifying subjects at risk of developing work-related shoulder symptoms. Research is needed to determine if this relationship holds with clinically diagnosed shoulder and other upper extremity musculoskeletal disorders. This may be part of a simple tool for assessing risk of developing these UEMSDs. Am. J. Ind. Med. 52:57,68, 2009. © 2008 Wiley-Liss, Inc. [source] Development and validation of the psychosomatic scale for atopic dermatitis in adultsTHE JOURNAL OF DERMATOLOGY, Issue 7 2006Tetsuya ANDO ABSTRACT Psychosocial factors play an important role in the course of adult atopic dermatitis (AD). Nevertheless, AD patients are rarely treated for their psychosomatic concerns. The purpose of the present study was to develop and validate a brief self-rating scale for adult AD in order to aid dermatologists in evaluating psychosocial factors during the course of AD. A preliminary scale assessing stress-induced exacerbation, the secondary psychosocial burden, and attitude toward treatment was developed and administered to 187 AD patients (82 male, 105 female, aged 28.4 ± 7.8, 13,61). Severity of skin lesions and improvement with standard dermatological treatment were assessed by both the dermatologist and the participant. Measures of anxiety and depression were also determined. In addition, psychosomatic evaluations were made according to the Psychosomatic Diagnostic Criteria for AD. Factor analysis resulted in the development of a 12-item scale (The Psychosomatic Scale for Atopic Dermatitis; PSS-AD) consisting of three factors: (i) exacerbation triggered by stress; (ii) disturbances due to AD; and (iii) ineffective control. Internal consistency indicated by Cronbach's alpha coefficient was 0.86 for the entire measure, 0.82 for (i), 0.81 for (ii), and 0.77 for (iii), verifying the acceptable reliability of PSS-AD. Patients with psychosomatic problems had higher PSS-AD scores than those without. PSS-AD scores were positively associated with the severity of the skin lesions, anxiety and depression. The scores were negatively associated with improvement during dermatological treatments. In conclusion, PSS-AD is a simple and reliable measure of the psychosomatic pathology of adult AD patients. It may be useful in dermatological practice for screening patients who would benefit from psychological or psychiatric interventions. [source] Psychosocial factors and interleukin-6 among women with advanced ovarian cancerCANCER, Issue 2 2005Erin S. Costanzo M.A. Abstract BACKGROUND Relations among psychological stress, depression, social support, and interleukin-6 (IL-6, a proinflammatory cytokine) have been documented in humans and animals. Because elevated IL-6 is associated with a poorer prognosis among ovarian cancer patients and has been implicated in the metastasis of ovarian cancer, the current study examined relations between psychosocial factors and IL-6 among women with advanced-stage ovarian cancer. METHODS Sixty-one ovarian cancer patients completed assessments of social support, distressed mood, and quality of life before surgery. Peripheral blood was drawn preoperatively, and the plasma was assayed for IL-6. Ascites samples were also assayed for IL-6 for a subset of patients. RESULTS Both IL-6 levels and distressed mood were elevated among patients. After statistically adjusting effects of age and disease stage, social attachment was associated with lower levels of IL-6 in peripheral blood (P = 0.03), whereas poorer health-related quality of life was associated with higher IL-6 (P values ranged from 0.01 to 0.03 on different measures). This pattern of relations was also found in the ascites. Moreover, IL-6 levels in peripheral blood plasma correlated significantly with IL-6 in the ascites (P < 0.001), suggesting that peripheral IL-6 reflects IL-6 levels at the site of the tumor. CONCLUSIONS Results suggest that social support may play a protective role with respect to IL-6 elevations, and IL-6 may be an independent marker of health-related quality of life among ovarian cancer patients. Processes involving IL-6 represent possible pathways by which behavioral factors may contribute to disease outcomes among women with ovarian cancer. Cancer 2005. © 2005 American Cancer Society. [source] Is negative affectivity associated with oral quality of life?COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 6 2001Nancy R. Kressin Abstract ,Objectives: The personality trait of negative affectivity (NA) is associated with reports of worse physical health, more symptoms and worse health-related quality of life but its associations with oral quality of life (OQOL) are unexplored. In this study we examined the association of NA with OQOL. Methods: We drew on data from two samples of older men: The VA Dental Longitudinal Study (DLS; n=177) and the Veterans Health Study (VHS; n=514), which included three measures of oral quality of life: the Oral Health-Related Quality of Life Measure (OHQOL), the Oral Health Impact Profile (OHIP), and the Geriatric Oral Health Assessment Instrument (GOHAI). For each OQOL measure, and the GOHAI and OHIP subscales, two regression models were estimated to examine the marginal change in variance due to NA: the first model included age, number of teeth, and self-rated oral health, and the second added NA. Results: In both bivariate and multivariate analyses, higher NA was consistently associated with worse scores on the OQOL measures. In the regression analyses, NA explained an additional .01 to 18% of the variance in OQOL, explaining the most variance in the OHIP and the least in the OHQOL. The addition of NA explained more variance in the more subjective, psychologically oriented GOHAI and OHIP subscales than it did in the more objective, physical function oriented subscales. Conclusions: Psychosocial factors such as personality are significantly associated with quality of life ratings. Such associations should be taken into account when OQOL measurements are used and interpreted. [source] Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist?: A review of the epidemiological literatureAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2002Paulien M. Bongers PhD Abstract Background In 1993, an extensive review on the role of psychosocial factors in the development of musculoskeletal problems was published by Bongers et al (1993). Since then, additional reviews on this topic have been published; however, none of these focussed on upper limb problems. Methods In this systematic review, the methodological quality of all studies was assessed and levels of evidence were apriori defined. Results The large majority of the studies reported an association between at least one work-related psychosocial factor and adverse upper extremity symptoms or signs. High-perceived job stress was consistently associated with all upper extremity problems (UEP) in high and lower quality studies. Although not often studied, non-work-related stress was also consistently associated with UEP. In addition, there was some evidence for a relationship between high job demands and UEP, although the results did not meet the pre-set criterion for consistency. Conclusions High job stress and non-work-related stress reactions are consistently associated with UEP. In addition, high job demands is also in most studies associated with these disorders. Firm conclusions on the role of these factors in the etiology of UEP are not possible due to the cross-sectional nature of most studies. Am. J. Ind. Med. 41:315,342, 2002. © 2002 Wiley-Liss, Inc. [source] Mediating Pathways Explaining Psychosocial Functioning and Revictimization as Sequelae of Parental Violence Among Adolescent MothersAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2009Taryn Lindhorst PhD Adolescent mothers are at high risk for negative life events, such as previous childhood physical abuse, impaired psychosocial functioning, and young adulthood revictimization. However, little is known about the potential pathways in these events; hence, little is known about opportunities for intervention. This study used structural equation modeling to investigate mediators of the effects of parental child abuse on later psychosocial functioning and revictimization (in the form of intimate partner violence and sexual violence) among adolescent mothers, with longitudinal data spanning 2.4 years. On psychological distress in the final time period, parental physical child abuse had an early and then maintained effect but also effects mediated by earlier psychological distress and revictimization. Psychological distress rather than substance use appeared as the primary psychosocial factor mediating the effects of parental violence on both future distress and revictimization. For prevention of further psychosocial impairment and revictimization, these findings indicate the need for early intervention with adolescent mothers who come from abusive families and who display higher levels of psychological distress. [source] Psychopathic traits in adolescent offenders: an evaluation of criminal history, clinical, and psychosocial correlates,BEHAVIORAL SCIENCES & THE LAW, Issue 1 2004Mary Ann Campbell Ph.D. Although a large body of research has established the relevance of psychopathy to adult offenders, its relevance to adolescent offenders is far less clear. The current study evaluated the clinical, psychosocial and criminal correlates of psychopathic traits in a sample of 226 male and female incarcerated adolescent offenders. According to an 18-item version of the Psychopathy Checklist,Youth Version (PCL-YV; Forth, Kosson, & Hare, 2003), only 9.4% exhibited a high level of psychopathic traits (PCL-YV,25). Consistent with past research, higher PCL-YV scores were positively associated with self-reported delinquency and aggressive behavior and were unrelated to emotional difficulties. Although higher PCL-YV scores were associated with the experience of physical abuse, the only psychosocial factor to predict PCL-YV scores was a history of non-parental living arrangements (e.g. foster care). In terms of criminality, a violent/versatile criminal history was positively associated with psychopathic traits. However, PCL-YV scores were unrelated to participants' official criminal records for total, non-violent, violent, and technical violation convictions. In conclusion, the data partially support the construct validity of psychopathy with adolescent offenders, but some inconsistencies with prior adult and adolescent psychopathy research were evident. These issues are discussed. Copyright © 2004 John Wiley & Sons, Ltd. [source] Psychosocial factors are independent risk factors for the development of Type 2 diabetes in Japanese workers with impaired fasting glucose and/or impaired glucose tolerance,DIABETIC MEDICINE, Issue 10 2008M. Toshihiro Abstract Aims, We prospectively studied Japanese workers with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) and analysed possible risk factors for diabetes, including psychosocial factors such as stress. Methods, The participants were 128 male Japanese company employees (mean age, 49.3 ± 5.9 years) with IFG and/or IGT diagnosed by oral glucose tolerance test (OGTT). Participants were prospectively studied for 5 years with annual OGTTs. The Kaplan,Meier method and Cox's proportional hazard model were used to analyse the incidence of diabetes and the factors affecting glucose tolerance, including anthropometric, biochemical and social,psychological factors. Results, Of 128 participants, 36 (28.1%) developed diabetes and 39 (30.5%) returned to normal glucose tolerance (NGT) during a mean follow-up of 3.2 years. Independent risk factors for diabetes were night duty [hazard ratio (HR) = 5.48, P = 0.002], higher fasting plasma glucose (FPG) levels within 6.1,6.9 mmol/l (HR = 1.05, P = 0.031), stress (HR = 3.81, P = 0.037) and administrative position (HR = 12.70, P = 0.045), while independent factors associated with recovery were lower FPG levels (HR = 0.94, P = 0.017), being a white-collar worker (HR = 0.34, P = 0.033), non-smoking (HR = 0.31, P = 0.040) and lower serum alanine aminotransferase (ALT) levels (HR = 0.97, P = 0.042). Conclusions, In addition to FPG levels at baseline, psychosocial factors (night duty, stress and administrative position) are risk factors for Type 2 diabetes, while being a white-collar worker, a non-smoker and lower serum ALT levels are factors associated with return to NGT in Japanese workers with IFG and/or IGT. [source] Alcohol consumption patterns and risk factors among childhood cancer survivors compared to siblings and general population peersADDICTION, Issue 7 2008E. Anne Lown ABSTRACT Aims This study describes alcohol consumption among adult survivors of pediatric cancer compared to sibling controls and a national sample of healthy peers. Risk factors for heavy drinking among survivors are described. Design, setting and participants Cross-sectional data were utilized from the Childhood Cancer Survivor Study including adult survivors of pediatric cancer (n = 10 398) and a sibling cohort (n = 3034). Comparison data were drawn from the National Alcohol Survey (n = 4774). Measurement Alcohol consumption, demographic, cancer diagnosis, treatment and psychosocial factors were measured. Findings Compared to peers, survivors were slightly less likely to be risky [adjusted odds ratio (ORadj) = 0.9; confidence interval (CI) 0.8,1.0] and heavy drinkers (ORadj = 0.8; CI 0.7,0.9) and more likely to be current drinkers. Compared to siblings, survivors were less likely to be current, risky and heavy drinkers. Risk factors for survivors' heavy drinking included being age 18,21 years (ORadj = 2.0; 95% CI 1.5,2.6), male (ORadj = 2.1; 95% CI 1.8,2.6), having high school education or less (ORadj = 3.4; 95% CI 2.7,4.4) and drinking initiation before age 14 (ORadj = 6.9; 95% CI 4.4,10.8). Among survivors, symptoms of depression, anxiety or somatization, fair or poor self-assessed health, activity limitations and anxiety about cancer were associated with heavy drinking. Cognitively compromising treatment, brain tumors and older age at diagnosis were protective. Conclusions Adult survivors of childhood cancer show only a modest reduction in alcohol consumption compared to peers despite their more vulnerable health status. Distress and poorer health are associated with survivor heavy drinking. Screening for alcohol consumption should be instituted in long-term follow-up care and interventions among survivors and siblings should be established to reduce risk for early drinking. [source] Psychosocial effects in long-term head and neck cancer survivorsHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2005Richard L. Holloway PhD Abstract Background. To identify and rate the importance of several psychosocial and physiologic influences on quality of life (QOL) among a cohort of 5-year head and neck cancer survivors, we conducted a cross-sectional study of a convenience sample that used both questionnaires and physiologic evaluations. Methods. QOL was assessed by the Functional Assessment of Cancer Therapy (FACT) and the FACT Head and Neck additional concerns (FACT-H&N) questionnaires. Psychosocial characteristics (or risk factors) potentially influencing QOL were measured by the Millon Behavioral Health Inventory (MBHI) and the Social Support Questionnaire (SSQSR). Physiologic risk factors were measured in examinations that included shoulder and neck range of motion, whole and stimulated saliva measurements, and oropharyngeal swallowing efficiency. We evaluated the association of selected QOL measures with three groups of potential risk factors: psychosocial factors, consisting of selected MBHI and SSQSR scales; physiologic factors, consisting of selected physical ability measures; and a combination of psychosocial/physiologic factors. Results. The entire study population of 105 subjects completed the FACT and FACT-H&N questionnaires; 86 of these completed the physiologic tests as well. Combined psychosocial/physiologic models best predicted all QOL measures considered. Psychosocial models alone, compared with physiologic models alone, better predicted FACT physical and social/family well-being measures. Physiologic models alone, compared with psychosocial models alone, better predicted FACT-H&N additional concerns measures. Premorbid pessimism (MBHI) was consistently the best predictor of QOL measures. Conclusions. Both psychosocial and physiologic factors influence QOL in patients with head and neck cancer, but many QOL measures are most strongly influenced by psychosocial considerations. Physicians and surgeons caring for long-term head and neck cancer survivors should be cognizant of the importance of psychosocial risk factors in the QOL of their patients. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] The Prevalence of Headache and Its Association With Socioeconomic Status Among Schoolchildren in Istanbul, TurkeyHEADACHE, Issue 5 2009Objective., The etiology and pathogenesis of migraine and other types of headache are still under discussion. An interaction of organic, psychological, and psychosocial factors is operative. In this study, we aimed to determine the prevalence of headache and its association with socioeconomic status among schoolchildren. Study Design., A cross-sectional study was performed on 2669 schoolchildren via a parental questionnaire. Socioeconomic status was determined according to the Turkish socioeconomic status scale. Results., The mean age of the students was 8.2 ± 2.4 years. The headache prevalence was 46.2% (95% CI: 44.3-48.1). The prevalence of migraine was 3.4% (95% CI: 2.8-4.1), the prevalence of probable migraine was 8.7% (95% CI: 7.6-9.8), and that of non-migraine headache was 34.1% (95% CI: 32.3-35.9). Multivariate analysis revealed that older age, being a girl, having a family history of headache, and exposure to passive smoking at home were independently associated with headache. There was an inverse association between socioeconomic status and all 3 types of headaches after adjusting for age, sex, family history of headache, and presence of passive smoking. When the group with the lowest socioeconomic status was taken as the reference category, the odds ratios for the highest socioeconomic group were 0.33 (95% CI: 0.16-0.69, P = .003) for the migraine, 0.30 (95% CI: 0.11-0.89, P = .029) for the probable migraine, and 0.34 (95% CI: 0.16-0.72, P = 0.005) for the non-migraine headache. Conclusion., Headache is more common among children with lower socioeconomic groups. Social causation can play a role in the pathogenesis of headache. [source] Primary Headache in Italian Early Adolescents: The Role of Perceived Teacher UnfairnessHEADACHE, Issue 3 2009Massimo Santinello BA Background., The impact of perceived teacher unfairness on headache incidence has previously been insufficiently investigated. Objective., The aims of the study are to analyze the prevalence of headache among Italian early adolescents as well as to examine the role of perceived teacher unfairness and classmate social support in predicting this health outcome. Methods., Data were taken from the "Health Behaviour in School Aged Children," a cross-sectional survey investigating health behaviors among early adolescents in selected European countries. Headache, perceived teacher unfairness, and classmate social support were measured through a self-administered questionnaire filled out by a representative sample of 4386 (48.4% males) Italian students (11, 13, and 15 years old). Covariates included demographic characteristics (age, gender) and socioeconomic status (parental educational attainment), and other confounding psychological factors (eg, family empowerment, bullying). Results., Prevalence of frequent headaches (at least once a week) was about 40%. Girls were more likely to report frequent headaches compared with boys. Prevalence of frequent headaches increased with age. After adjusting for age and gender, teacher unfairness showed a significant association with frequent headache (P < .001). This relationship remained significant even after additional adjustment for several psychosocial factors. Classmate social support seems to act as a protective factor, but not as a buffering mechanism against the negative effects of teacher unfairness. Conclusions., Italian early adolescents show a quite high prevalence of frequent headache. Results show that characteristics of the school setting, such as teacher unfairness and classmate social support, can be significant predictors of frequent headache among early adolescents. Longitudinal research is needed to delineate causal relationships between school factors and recurrent headache. [source] The Influence of Gender and Sex Steroids on Craniofacial NociceptionHEADACHE, Issue 2 2007Brian E. Cairns PhD Several pain conditions localized to the craniofacial region show a remarkable sex-related difference in their prevalence. These conditions include temporomandibular disorders and burning mouth syndrome as well as tension-type, migraine, and cluster headaches. The mechanisms that underlie sex-related differences in the prevalence of these craniofacial pain conditions remain obscure and likely involve both physiological and psychosocial factors. In terms of physiological factors relevant to the development of headache, direct evidence of sex-related differences in the properties of dural afferent fibers or durally activated second-order trigeminal sensory neurons has yet to be provided. There is, however, evidence for sex-related differences in the response properties of afferent fibers and second-order trigeminal sensory neurons that convey nociceptive input from other craniofacial tissues associated with sex-related differences in chronic pain conditions, such as those that innervate the masseter muscle and temporomandibular joint. Further, modulation of craniofacial nociceptive input by opioidergic receptor mechanisms appears to be dependent on biological sex. Research into mechanisms that may contribute to sex-related differences in trigeminal nociceptive processing has primarily focused on effect of the female sex hormone estrogen, which appears to alter the excitability of trigeminal afferent fibers and sensory neurons to noxious stimulation of craniofacial tissues. This article discusses current knowledge of potential physiological mechanisms that could contribute to sex-related differences in certain craniofacial pain conditions. [source] Psychosocial Impact of Headache and Comorbidity with Other Pains among Swedish School AdolescentsHEADACHE, Issue 8 2002Åsa Fichtel MSc Background.,The psychosocial impact of headache combined with other pains has previously been insufficiently investigated. Objective., The present study examined the prevalence of headache, its comorbidity with other pains and psychosocial impact among adolescents. Methods., 793 adolescents in a sample recruited from 8 schools in the middle of Sweden were assessed. Results.,Forty-five percent of the adolescents reported ongoing pain during assessment and more than half of the adolescents reported at least one frequent pain during the previous 6 months. The most common pain among girls was headache (42%), but for boys muscle pain (32%) was most prevalent. Number of pains and perceived pain disability were also higher among girls than boys. One-third of the headache sufferers had headache only, while one-third reported one other frequent pain and the others had at least two other frequent pains. Overall, adolescents with frequent headaches had higher levels of anxiety or depressive symptoms, in addition to functional disability and usage of analgesic medication. Frequent headache sufferers reported more problems in everyday life areas than those with infrequent headaches. Conclusions.,It is recommended that adolescents suffering from recurrent headaches routinely should be asked about the presence of other pains, anxiety and depressive symptoms, medication usage, in addition to psychosocial consequences in their everyday life activities. Longitudinal research is also needed to delineate causal relationships between psychosocial factors and recurrent pains, in particular regarding possible sex differences. [source] Expanding the Andersen Model: The Role of Psychosocial Factors in Long-Term Care UseHEALTH SERVICES RESEARCH, Issue 5 2002Elizabeth H Bradley Objective. To examine a prevailing conceptual model of health services use (Andersen 1995) and to suggest modifications that may enhance its explanatory power when applied to empirical studies of race/ethnicity and long-term care. Study Setting. Twelve focus groups of African-American (five groups) and white (seven groups) individuals, aged 65 and older, residing in Connecticut during 2000. Study Design. Using qualitative analysis, data were coded and analyzed in NUD-IST 4 software to facilitate the reporting of recurrent themes, supporting quotations, and links among the themes for developing the conceptual framework. Specific analysis was conducted to assess distinctions in common themes between African-American and white focus groups. Data Collection. Data were collected using a standardized discussion guide, augmented by prompts for clarification. Audio taped sessions were transcribed and independently coded by investigators and crosschecked to enhance coding validity. An audit trail was maintained to document analytic decisions during data analysis and interpretation. Principal Findings. Psychosocial factors (e.g., attitudes and knowledge, social norms, and perceived control) are identified as determinants of service use, thereby expanding the Andersen model (1995). African-American and white focus group members differed in their reported accessibility of information about long-term care, social norms concerning caregiving expectations and burden, and concerns of privacy and self-determination. Conclusions. More comprehensive identification of psychosocial factors may enhance our understanding of the complex role of race/ethnicity in long-term care use as well as the effectiveness of policies and programs designed to address disparities in long-term care service use among minority and nonminority groups. [source] Determinants of adherence to highly active antiretroviral therapy (HAART) in Chinese HIV/AIDS patientsHIV MEDICINE, Issue 2 2003OW Fong Objective Drug adherence is crucial to the success of highly active antiretroviral therapy (HAART) in the treatment of HIV disease. Adherence to HAART and its determinants may, however, differ across HIV/AIDS populations. Methods We retrospectively studied drug adherence by self-report in HIV-1 infected Chinese patients who have been on HAART for at least 1 year as at the end of year 2000. HAART is defined as three or more antiretrovirals with at least one protease inhibitor or non-nucleoside analogue reverse transcriptase inhibitor. Results The last drug adherence level assessed by self-report in 161 Chinese patients were: grade A (100%) , 130, 80.7%; grade B (95,99%) , 25, 15.5%; grade C (90,94%) , three, 1.9% and grade D (< 90%) , three, 1.9%. Patients with full adherence were more likely to have undetectable (< 500 copies/mL) plasma virus level (adjusted OR, 4.22; 95% CI, 1.75,12.33). Patients' demographics, HIV disease status and antiretroviral regimen did not affect adherence. Partial drug adherence was, however, independently associated with the psychosocial factors of missing clinic appointments (adjusted OR, 3.13; 95% CI, 1.23,8.33), forgetfulness (adjusted OR, 4.55; 95% CI, 1.64,12.5) and a busy work life (adjusted OR, 6.67; 95% CI, 1.75,25). Conclusion There were similarities and differences in determinants affecting HAART adherence in Chinese compared with other patients. Psychosocial factors rather than HIV disease or treatment were more important factors in our Chinese patients. The relevance of patient populations and care setting for adherence to HAART shall be further studied. [source] Caffeine levels in saliva: associations with psychosocial factors and behavioural effectsHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2001Carolyn Brice Abstract The present study had two main aims. The first was to examine associations between psychosocial factors, health-related behaviours, regular level of caffeine consumption, time of day and levels of caffeine in saliva following acute caffeine challenges. The second aim was to determine whether individual differences in changes in performance following ingestion of caffeine were related to levels of caffeine in saliva. One hundred and forty-four young adults participated in the study. Questionnaires were administered prior to the study to measure psychosocial characteristics, health-related behaviours and habitual levels of caffeine consumption. Two double-blind acute caffeine challenges were then carried out 1 week apart. Volunteers were given either placebo or 1.5 or 3,mg/kg of caffeine on each occasion. The challenges were carried out at 8,:,00, 11,:,00, 14,:,00 or 18,:,00,h so that the impact of time of day could be assessed. In the week between the two challenges the volunteers consumed either caffeinated or decaffeinated products. This allowed investigation of the effects of caffeine withdrawal on caffeine metabolism. Prior to each caffeine challenge volunteers performed a range of tasks, and a baseline saliva sample was taken. The tasks were repeated 1,h after ingestion of the caffeine, with saliva samples being taken at the start and end of the 1,h test battery. The results showed that the level of caffeine in the saliva was a good indicator of the dose of caffeine consumed and of compliance with the withdrawal manipulation. Caffeine levels were not influenced by time of day, habitual caffeine consumption, psychosocial factors or health-related behaviours. Individual differences in caffeine levels in saliva were not related to the individual variation in the effects of caffeine on performance. Copyright © 2001 John Wiley & Sons, Ltd. [source] Suicidal ideation among elderly homecare patientsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2007Patrick J. Raue Abstract Objectives To identify the prevalence, correlates, and one-year naturalistic course of suicidal ideation in a representative sample of elderly adults newly admitted to visiting nurse homecare. Method Five hundred and thirty-nine participants (aged ,65), newly initiating homecare for skilled nursing services, were interviewed with the Structured Clinical Interview for DSM-IV (SCID-IV) and measures of depression severity, medical comorbidity, functional status, and social support. Participants were classified as having no suicidal ideation in the past month, passive ideation, active ideation, or active ideation with poor impulse control or suicide plan. Results Fifty-seven participants (10.6%) reported passive and six (1.2%) reported active suicidal ideation. Higher depression severity, greater medical comorbidity, and lower subjective social support were independently associated with the presence of any level of suicidal ideation. At one year, suicidal ideation persisted for 36.7% of those with ideation at baseline, and the incidence of suicide ideation was 5.4% Conclusions The high prevalence, persistence, and incidence of suicidal ideation in medically ill home healthcare patients underscore the relevance of this population for suicide prevention efforts. The clinical and psychosocial factors associated with suicidal ideation in this underserved, high-risk population are potentially modifiable, and thus useful targets for suicide prevention interventions. Copyright © 2006 John Wiley & Sons, Ltd. [source] Improving methods of assessing natural killer cell cytotoxicityINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2006Sandra E. Sephton Abstract Natural killer (NK) cells are a class of lymphocytes important in immune resistance to viral and other serious diseases. The cytotoxic function, or ,killing activity' of NK cells has become important in studies of the effects of stress and other psychosocial factors on physical health. Unfortunately, research on NK cell function has been plagued by discrepancies in the methods of interpreting NK cytotoxicity data. We briefly review some of the variations in measuring NK cell activity and present a new model for interpreting these results, introducing maximal target cell lysis (A) and the slope of the cytolytic curve (k) as parameters that attempt to make full use of the information and the statistical power in NK cell cytotoxicity data. Examples of these interpretation methods are presented using NK cytotoxicity data from a group of metastatic breast cancer patients. This approach will be useful in applications of NK cell measurement in psychoneuroimmunology research. 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