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Psychosocial Variables (psychosocial + variable)
Selected AbstractsPretreatment Psychosocial Variables as Predictors of Outcomes Following Lumbar Surgery and Spinal Cord Stimulation: A Systematic Review and Literature SynthesisPAIN MEDICINE, Issue 4 2009James Celestin MD ABSTRACT Background., In the multimodal treatment approach to chronic back pain, interventional back procedures are often reserved for those who do not improve after more conservative management. Psychological screening prior to lumbar surgery or spinal cord stimulation (SCS) has been widely recommended to help identify suitable candidates and to predict possible complications or poor outcome from treatment. However, it remains unclear which, if any, variables are most predictive of pain-related treatment outcomes. Objective., The intent of this article is to perform a systematic review to examine the relationship between presurgical predictor variables and treatment outcomes, to review the existing evidence for the benefit of psychological screening prior to lumbar surgery or SCS, and to make treatment recommendations for the use of psychological screening. Results., Out of 753 study titles, 25 studies were identified, of which none were randomized controlled trials and only four SCS studies met inclusion criteria. The methodological quality of the studies varied and some important shortcomings were identified. A positive relationship was found between one or more psychological factors and poor treatment outcome in 92.0% of the studies reviewed. In particular, presurgical somatization, depression, anxiety, and poor coping were most useful in helping to predict poor response (i.e., less treatment-related benefit) to lumbar surgery and SCS. Older age and longer pain duration were also predictive of poorer outcome in some studies, while pretreatment physical findings, activity interference, and presurgical pain intensity were minimally predictive. Conclusions., At present, while there is insufficient empirical evidence that psychological screening before surgery or device implantation helps to improve treatment outcomes, the current literature suggests that psychological factors such as somatization, depression, anxiety, and poor coping, are important predictors of poor outcome. More research is needed to show if early identification and treatment of these factors through psychological screening will enhance treatment outcome. [source] Behavioral and Psychiatric Comorbidities in Pediatric Epilepsy: Toward an Integrative ModelEPILEPSIA, Issue 9 2007Joan K. Austin Summary:, It is well recognized that children with epilepsy are at heightened risk for developing behavior problems and psychiatric disorders. Studies identifying factors associated with child behavior were reviewed and findings were placed into two broad categories for review and critique: illness-related variables and psychosocial variables. Illness-related variables were seizure frequency and seizure control, type of epilepsy, age of onset, duration of illness, and antiepileptic drugs. Psychosocial variables were reviewed using a family stress framework: stressors, perceptions, adaptive resources, coping, and family adjustment. After the literature on each category is reviewed, an integrated heuristic model that includes key illness-related and psychosocial variables is presented. [source] Self-Esteem and Socioeconomic Disparities in Self-Perceived Oral HealthJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2009David Locker Abstract Objective: To determine if psychosocial factors explain the socioeconomic disparities in self-perceived oral health that persist after controlling for oral status variables. Methods: Data came from the participants in the Canadian Community Health Survey 2003 who were residents in the city of Toronto. Oral health variables included self-rated oral health, a 13-item oral health scale, denture wearing, and having a tooth extracted in the previous year. The last two measures were regarded as proxy indicators of tooth loss. Psychosocial variables included a self-esteem scale, a depression scale, and single items measuring life satisfaction, life stress, and sense of cohesion. Socioeconomic status was assessed using total annual household income. Results: Interviews were completed with 2,754 dentate persons aged 20 years and over. Bivariate analyses confirmed that there were income gradients in self-rated oral health and scores on the oral health scale. Linear regression analyses confirmed that these persisted after controlling for age, gender, denture wearing, and having a tooth extracted in the previous year. In the model predicting self-rated oral health self-esteem, life satisfaction, stress, a sense of cohesion, and depression also contributed to the model, increased its explanatory power, and reduced the strength of but did not eliminate the association between income and self-rated oral health. Broadly, similar results were obtained when the oral health scale score was used as the dependent variable. In both analyses and all models, denture wearing had the strongest and most enduring effect. Conclusion: Psychosocial factors partly but do not wholly explain the socioeconomic disparities in self-perceived oral health in this population after controlling for tooth loss and denture wearing. Other variables need to be added to the models to increase their explanatory power. [source] Psychosocial variables in children and teens of extended families identified through bipolar affective disorder probandsBIPOLAR DISORDERS, Issue 2 2004Theodore Petti Objectives:, This multi-site study investigated the frequency of risk-related variables for developing an affective disorder using a within-pedigree control group. We wished to determine the effect of life events, social relationships, self-perceived competence, and aspects of home environment for youngsters from extended families with loading for bipolar disorder. Using a within-family contrast group, we address the following two issues: (1) Do offspring or their parents from families who do and do not have an affected parent report differences (i) in home environment? (ii) in frequency and type of offspring life events? and (iii) in social relations and self-perception? and (2) Do children or their parents who do or do not have an affective disorder report differently on these areas? Methods:, Juvenile offspring (n = 50) and their parents from 14 bipolar pedigrees were assessed. Structured interviews and self- or parent-reported instruments were used to compare offspring with an affected first-degree relative to those without and to compare offspring with or without an affective disorder. Results:, Only one significant psychosocial difference was found between offspring with or without a parent with an affective disorder but several were found between offspring who themselves did or did not have an affective disorder. These differences are in the areas of the need for discipline, social support, and dependent negative life events. Conclusions:, The findings identify potential early psychosocial markers for affective disorder in high risk offspring. [source] Incidence of social phobia and identification of its risk indicators: a model for preventionACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009C. Acarturk Objective:, This study seeks to examine the incidence of social phobia in the general population and to establish a number of risk indicators. Method:, Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population based prospective study (n = 7076). A sample of adults aged 18,64 years (n = 5618) were re-interviewed 1 year later using Composite International Diagnostic Interview (CIDI). Results:, The 12-month incidence of DSM-III-R social phobia was 1.0%. Low education, low mastery, low self-esteem, emotional neglect in childhood and ongoing difficulties were found to be risk indicators. After including other mental disorders as risk indicators in the model, the incidence was found to be more common among those with low mastery, major depression, subthreshold social phobia, emotional neglect, negative life events, and low education. Conclusion:, The incidence of social phobia can be predicted relatively well with psychosocial variables and comorbidity. [source] Behavioral and Psychiatric Comorbidities in Pediatric Epilepsy: Toward an Integrative ModelEPILEPSIA, Issue 9 2007Joan K. Austin Summary:, It is well recognized that children with epilepsy are at heightened risk for developing behavior problems and psychiatric disorders. Studies identifying factors associated with child behavior were reviewed and findings were placed into two broad categories for review and critique: illness-related variables and psychosocial variables. Illness-related variables were seizure frequency and seizure control, type of epilepsy, age of onset, duration of illness, and antiepileptic drugs. Psychosocial variables were reviewed using a family stress framework: stressors, perceptions, adaptive resources, coping, and family adjustment. After the literature on each category is reviewed, an integrated heuristic model that includes key illness-related and psychosocial variables is presented. [source] Social Functioning, Psychological Functioning, and Quality of Life in EpilepsyEPILEPSIA, Issue 9 2001Theo P. B. M. Suurmeijer Summary: ,Purpose: Part of our research intended to explain "Quality of Life" (QoL) differences between people with epilepsy. To this end, a series of already existing generic and disease-specific health status measures were used. In this study, they were considered as determinants of people's QoL, whereas QoL itself was conceived as a general "value judgment" about one's life. Methods: From the records of four outpatient clinics, 210 persons with epilepsy were randomly selected. During their visit to the outpatient clinic, they completed a questionnaire assessing, among other things, health perceptions and social and psychological functioning. Additional information about their medical and psychosocial status was gathered from the patient files. Data were analysed by using a hierarchical regression analysis. Results: In decreasing order of importance, "psychological distress,""loneliness,""adjustment and coping," and "stigma perception" appeared to contribute most significantly to the outcome QoL as judged by the patients themselves, regardless of their physical status. In the final model, none of the clinical variables (onset, seizure frequency, side effects of antiepileptic drugs) contributed significantly anymore to the patients' "quality-of-life judgement." Apparently the effect of other variables such as seizure frequency and health perceptions, medication and side effects, life fulfilment, self-esteem, and mastery is mediated by these variables. Conclusions: Because all of the variance in QoL of the patients was explained by the psychosocial variables included in this study, health professionals should be aware of the significance of the psychosocial functioning of the patients and the role it plays in the achievement of a good QoL. Both informal and professional support may be an adjunct to conventional treatment. In future research, this issue should be given high priority. [source] Child Weight Status and Young Adult Quality of Life: Is There a Reason for Concern?FAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 1 2008Holly S. Kihm The purpose of the study was to examine the relationship between child weight status and young adult quality of life. One hundred sixty-four college students participated in the study. Students completed four questionnaires that were used to assess physical and psychosocial variables. Several statistical analyses, including correlations and hierarchal regression models, were employed to test the study's hypotheses. Results from the study showed that child weight status was negatively associated with adult quality of life, and child self-concept was a mediating variable within the relationship. Recognizing the relationship between child weight status and young adult quality of life stresses the importance of addressing psychosocial concerns related to weight status during childhood in efforts to achieve a greater quality of life in adulthood. [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] Factors Influencing Migraineur-Consulting Behavior in a University PopulationHEADACHE, Issue 5 2006Monica L. Skomo PharmD Objective.,The purpose of this study was to identify factors that contribute to treatment-seeking behavior in migraineurs in a large employer population. Specifically, the impact of psychographic variables, such as social support, attitudes toward medication, locus of control, and migraine-associated disability, are considered concomitantly with demographic and disease severity variables. Background.,Migraine remains an underconsulted condition. Previous explorations of demographic factors and headache characteristics have not adequately predicted migraineur physician-consulting behavior. Methods.,University employees and students experiencing headaches were interviewed by pharmacists to determine whether they suffer from migraine using the International Headache Society (IHS) criteria for migraine. Identified migraineurs were categorized into 3 groups: (1) never-consulter, (2) lapsed-consulter, and (3) current-consulter. Each group was asked to complete an instrument that assesses perceived social support (Headache Social Support Questionnaire), medication attitudes (Beliefs about Medicines Questionnaire), locus of control (Headache-Specific Locus of Control Scale), and migraine-associated disability (Migraine Disability Assessment Questionnaire). Univariate (ANOVA) and multivariate (logistic regression) approaches were used to identify factors associated with migraineur-consulting behavior. Results.,A total of 100 subjects participated in the study. Eighty-two participants met IHS criteria for migraine, of whom 22 were never-consulters, 20 were lapsed-consulters, and 40 were current-consulters. The consulter groups differed on scores acquired from the Social Support Active Involvement subscale (P= .04) and the Healthcare Professional Locus of Control subscale (P= .010). The logistic regression procedures confirmed the contributions of social support and healthcare locus of control in predicting migraineur-consulting behavior. Conclusion.,Results suggest that attitudes concerning the role of healthcare professionals and the presence of a supportive social network have greater influence on migraineur-consulting behavior than do patient demographic characteristics, beliefs about medications, and migraine frequency and severity. With an understanding of the link between psychosocial variables and consulting behavior, healthcare professionals may be able to positively impact migraineur physician consultation rates, drug therapy, and quality of life. [source] Population-based controlled study of social support, self-perceived stress, activity and work issues, and access to health care in inflammatory bowel diseaseINFLAMMATORY BOWEL DISEASES, Issue 4 2008Linda Rogala RN Abstract Background: The Manitoba IBD Cohort Study is a longitudinal, population-based study of multiple determinants of health outcomes in persons with inflammatory bowel disease (IBD) diagnosed within 7 years at enrollment. In this cross-sectional substudy we compared IBD participants' levels of social support, self-perceived stress, disability, and access to healthcare with those of a matched community sample. Methods: IBD participants (n = 388) were interviewed using the Canadian Community Health Surveys (CCHS) 1.1 and 1.2 to assess psychosocial variables. The national CCHS data were accessed to extract a community comparison group, matched on age, sex, and geographic residence. Results: Compared to the community sample, IBD participants received more tangible, affective, or emotional support in the past year and were more likely to have experienced a positive social interaction. Those with IBD were as likely to be employed as those in the community sample, although they reported greater rates of reduced activity and days missed. Work was not identified as a significant source of stress, but physical health was more likely to be identified as a main stressor by those with active IBD compared to the non-IBD sample. Individuals with IBD were twice as likely to report unmet healthcare needs than the community sample; however, there was agreement across both groups regarding common barriers, including long waits and availability. Conclusions: While the disease may contribute to greater interference with work quality and daily activities, IBD patients have similar levels of stress and appear to have enhanced social supports relative to those in the community without IBD. (Inflamm Bowel Dis 2008) [source] The effects of antidepressant medication adherence as well as psychosocial and clinical factors on depression outcome among older adultsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2008Hayden B. Bosworth Abstract Objective To examine the contribution of medication adherence to 12-month depression scores in the context of other psychosocial and clinical predictors of depression in a sample of older adults treated for depression. Methods Secondary analysis of a prospective cohort study involving 241 older patients undergoing depression treatment using a standardized algorithm. Depression was measured at baseline and 12-months post-baseline. Baseline predictor variables included antidepressant adherence, barriers to antidepressant adherence, four domains of social support, basic and instrumental activities of daily living (BADLs and IADLs), and clinical factors including past history of depression and medical comorbidities. Results Nearly 28% of patients reported being nonadherent with their antidepressant medication. In bivariate analyses, greater antidepressant medication nonadherence, more medication barriers, poorer subjective social support, less non-family interaction, greater BADL and IADL limitations, poor self-rated health, higher baseline depression scores, and not having diabetes were related to higher 12-month depression scores. In multivariable analyses, greater medication nonadherence, not having diabetes, poorer subjective social support, greater BADL limitations, and higher baseline depression scores were related to higher 12-month depression scores. Conclusion Interventions should be directed toward improving antidepressant adherence and modifiable psychosocial variables. Copyright © 2007 John Wiley & Sons, Ltd. [source] Effects of clinical factors on psychosocial variables in renal transplant recipientsJOURNAL OF ADVANCED NURSING, Issue 12 2009Hongxia Liu Abstract Title.,Effects of clinical factors on psychosocial variables in renal transplant recipients. Aim., This paper is a report of a study investigating the effects of clinical factors (side effects of immunosuppressive medications, transplant-related hospitalizations, donor type, duration of dialysis before transplantation and time post-transplant) on cognitive appraisal of health, perceived self-efficacy, perceived social support, coping and health-related quality of life after renal transplantation. Background., Some clinical factors such as hospitalizations, side effects of medications, donor type and dialysis, which influence the health-related quality of life of renal transplant recipients, have been investigated. However, the effects of these clinical factors on psychosocial variables after renal transplantation have not been well documented. Method., Using a descriptive cross-sectional design, a convenience sample of 160 renal transplant recipients was recruited (N = 55 < 1 year post-transplant; N = 105 1,3 years post-transplant) from May, 2005 to January, 2006. Standardized instruments were used to measure the key constructs. Multivariate analysis of variance was used to examine the effects of clinical factors on the psychosocial outcome measures. Results., Participants reporting more (>17) immunosuppressive medication-associated side effects appraised their health more negatively, used more disengagement coping, had lower degrees of perceived self-efficacy, and reported lower physical and mental health-related quality of life than those with fewer symptoms (,17). Participants less than 1 year post-transplant used more engagement coping, reported higher degrees of perceived self-efficacy and perceived social support than participants in the later period post-transplant. Conclusion., Interventions aimed at alleviating bothersome medication side effects are needed to help these patients cope with transplantation and improve their health-related quality of life. [source] Screening for Abuse and Neglect of People with DementiaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2010Aileen Wiglesworth PhD OBJECTIVE: To investigate characteristics of people with dementia and their caregivers (CGs) that are associated with mistreatment in order to inform clinicians about screening for mistreatment. DESIGN: A convenience sample of CG,care recipient (CR) dyads were assessed for literature-supported factors associated with mistreatment, and evidence of mistreatment for the prior year was collected. An expert panel considered the evidence and decided on occurrences of psychological abuse, physical abuse, and neglect based on criteria adopted before data collection. SETTING: Participants' homes. PARTICIPANTS: One hundred twenty-nine persons with dementia and their CGs. MEASUREMENTS: CG and CR characteristics (demographic, health, and psychosocial variables), relationship characteristics, and three elder abuse and neglect detection instruments. RESULTS: Mistreatment was detected in 47.3%. Variables associated with different kinds and combinations of mistreatment types included the CG's anxiety, depressive symptoms, social contacts, perceived burden, emotional status, and role limitations due to emotional problems and the CR's psychological aggression and physical assault behaviors. The combination of CR's physical assault and psychological aggression provided the best sensitivity (75.4%) and specificity (70.6%) for elder mistreatment as defined by the expert panel. This finding has potential to be useful as a clinical screen for detecting mistreatment. CONCLUSIONS: The findings suggest important characteristics of older adults with dementia and their CGs that have potential for use in a clinical screening tool for elder mistreatment. Potential screening questions to be asked of CGs of people with dementia are suggested. [source] A predictive model for psychological reactions to crime in Italy: an analysis of fear of crime and concern about crime as a social problemJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 1 2005Piero Amerio Abstract In this study a model for predicting fear of crime (FC) and concern about crime as a social problem (CC) in Italy has been built, using three sets of independent variables concerning: (a) the sociodemographic and criminal victimization domain; (b) the psychosocial domain; and (c) the mass media. A secondary analysis on data gathered by the Observatory of the North-West (N,=,3262, a mail panel that is representative of the Italian population over 18) has been performed. Results showed that FC and CC are related yet distinct constructs: FC is less widespread than CC, and has different predictors. FC predictors are sociodemographic, psychosocial and, above all, victimization variables; whereas mass media and psychosocial variables predict CC. Results were compared with the literature on the topic. Implications, limitations, and future directions are discussed. Copyright © 2004 John Wiley & Sons, Ltd. [source] Expanding the traditional user versus non-user dichotomy amongst ecstasy usersJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 1 2003Brian McMillan Abstract Differences in the drug use characteristics and psychosocial variables in the use and non-use of ecstasy within 845 16,25 year-olds in the UK was examined. Based on levels of ecstasy use and intentions, two groups of non-users (resistant and vulnerable), three groups of users (light, moderate and heavy) and an ex-user group were identified. It was found that there is predictive utility in this way of expanding the widely employed ,user versus non-user' dichotomy. Resistant non-users were more likely to be younger, female, and were characterized by lower levels of use of four other drugs (amphetamine, cannabis, cocaine and LSD). Those ,at risk' of using ecstasy reported more frequent use of amphetamine, LSD, and cannabis than resistant non-users. Heavy user groups reported using amphetamine, cocaine and LSD more frequently than all the other groups. Having ecstasy using friends increased the odds of being an ,at risk' non-user or an ecstasy user. Normative influence also differentiated between the three user groups (light, moderate, and heavy). Beliefs about ecstasy use being immoral, ecstasy offers being difficult to resist, ecstasy use making one feel guilty and ecstasy being readily available differentiated between user and non-user groups. These factors could usefully inform the content of health education materials designed to change ecstasy use. Copyright © 2003 John Wiley & Sons, Ltd. [source] Influences on HIV testing among young African-American men who have sex with men and the moderating effect of the geographic settingJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 1 2004Andrew J. Mashburn This study examined the influence of demographic characteristics, risk behaviors, knowledge, and psychosocial variables on HIV testing among a sample (n = 551) of young African-American men who have sex with men (MSM) from three cities,Atlanta (n = 241), Birmingham (n = 174), and Chicago (n = 136). Among the entire sample of young men, age, knowledge of HIV treatments, knowledge of a comfortable place for an HIV test, and social support were related positively to rates of HIV testing. Furthermore, men who had sex with both main male partner(s) and non-main male partner(s) during the past year had significantly higher rates of HIV testing than men who had non-main male partner(s) only. Geographic setting moderated the effect on HIV testing behavior. In particular, social support, peer norms about condom use, and knowledge of HIV treatments were not associated with HIV testing in Atlanta, but were associated positively with HIV testing in either Birmingham, Chicago, or both. The strongest influence on HIV testing across all three settings was knowledge of a comfortable place for an HIV test. Implications of these findings for designing interventions to increase HIV testing are discussed. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 45,60, 2004. [source] Ethnic identity in urban African American youth: Exploring links with self-worth, aggression, and other psychosocial variablesJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 4 2002Susan D. McMahon This study represents an attempt to examine the relative influences of ethnic identity and global self-worth on aggression, coping, and adjustment among urban African American adolescents. Findings suggest that ethnic identity was associated with a range of positive feelings about oneself and health-related outcomes. When taking into account global self-worth, youth with a greater sense of ethnic/racial identity reported more active coping strategies, fewer beliefs supporting aggression, and fewer aggressive behaviors. A strong positive sense of global self-worth was significantly related to lower levels of anxiety and depression, and greater beliefs supporting aggressive behavior, when taking into account ethnic identity. Examining these constructs in combination can yield insight into the processes involved in competence and adjustment among at-risk youth. This study suggests that ethnic identity is an important component of development, and that we should consider examining and strengthening ethnoracial and political consciousness among youth in preventive interventions. © 2002 Wiley Periodicals, Inc. [source] Psychological aspects of hair diseaseJOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2005Ramon Grimalt Summary Balding men are viewed as less desirable in a physical, personal, and social sense. Given the stereotype, it is not surprising that some men with androgenetic alopecia (AGA) appear to have a lower self-image, depression resulting in increased introversion, and increased feelings of unattractiveness. Ours is a culture that places a premium on physical appearance. In this context, appearance-altering conditions can be psychosocially insidious, especially conditions such as AGA with an uncertain course and a negative social meaning. To date, little or no data have been available regarding the psychosocial and quality-of-life aspects of AGA in a representative sample of community men. It is unknown whether AGA is a causal factor in the development of low self-esteem, depression, introversion, and feeling of unattractiveness, or whether there are underlying problems in certain patients prior to hair loss. Longitudinal studies will be important to investigate the temporal relationships between the degree of hair loss and psychosocial variables associated with AGA. A patient with male pattern baldness will be better treated and consequently more satisfied (better quality of life) if he receives effective anti-alopecia agents and simultaneously is evaluated and treated, if needed, for his psychological disorder. [source] Temporomandibular disorder subtypes according to self-reported physical and psychosocial variables in female patients: a re-evaluationJOURNAL OF ORAL REHABILITATION, Issue 3 2005T. I. SUVINEN summary, Several studies support the relevance of psychological and psychosocial factors in the assessment and management of chronic musculoskeletal pain disorders, including temporomandibular pain disorders (TMDs). The aim of this study was to re-evaluate subtyping approach used in an earlier study (TI Suvinen, KR Hanes, JA Gerschman, PC Reade. J Orofac Pain 1997;11:200) and to compare perceived physical symptoms, psychological, coping and psychosocial variables between subtypes of patients who seek treatment for their temporomandibular pain and dysfunction. A total of 41 consecutive female patients were assessed multiaxially for physical symptoms, coping style and effectiveness and illness behaviour by a previously validated Temporomandibular Pain Dysfunction Questionnaire (TI Suvinen, KR Hanes, JA Gerschman, PC Reade. J Orofac Pain 1997;11:200). Additional measures of psychosocial variables included the global scores of the Beck Depression and Anxiety Inventory and Part I of the Multidimensional Pain Inventory. Subtypes were generated using an iterative partitioning method, k-means cluster analysis. Three clusters were identified and termed as Simple (22%), Intermediate (41%) and Complex (37%) temporomandibular disorders subtypes. Significant differences (P < 0·05) were found between clusters in psychological (coping style and effectiveness, disease conviction and affective disturbance) and in psychosocial variables (daily interference and social, work and family satisfaction), but not between physical variables. The results support previous studies that have shown differences in psychosocial variables in the presentation and subtyping of TMDs and the biopsychosocial orientation in assessment. The findings need to be reverified in a larger sample along specific physical diagnoses, but it is tentatively proposed how the three subtypes could be used in the classification of temporomandibular pain patients to guide management, based on the constellation of predominant psychological and psychosocial illness impact variables. [source] Consequences of an Adolescent Onset and Persistent Course of Alcohol Dependence in Men: Adolescent Risk Factors and Adult OutcomesALCOHOLISM, Issue 5 2010Brian M. Hicks Background:, While there is an extensive literature on the correlates of alcohol use disorders (AUD; alcohol abuse and dependence), there are relatively few prospective studies of representative birth cohorts that have examined the unique effects of an adolescent onset and persistent course of AUD on a wide range of psychosocial variables. Methods:, A longitudinal, community-based sample of 530 men was used to examine the impact of an adolescent onset (AUD+ at age 17) and persistent course (AUD+ at age 29) of AUD on adolescent and adult functioning including substance use, antisocial behavior, mental health problems, overall psychosocial functioning, environmental risk and protective factors, and social outcomes such as peer and romantic relationships, marriage, educational and occupational attainment, and parenthood. Results:, An adolescent onset of AUD (n = 57) was associated with severe deficits across multiple domains of psychosocial functioning in adolescence. Measures of behavioral disinhibition in adolescence were strong predictors of a persistent course of AUD (n = 93). Nearly 40% of men with an adolescent onset were able to desist by age 29, and were similar, but not identical to men who never experienced an AUD in terms of adult functioning. Men with an adolescent onset and persistent course of AUD exhibited the most severe deficits in functioning. Conclusion:, Results emphasize the importance of examining developmental course to understand the etiology of AUD. Our findings are optimistic in that individuals who desist from AUD are able to achieve high levels of psychosocial functioning. Our findings suggest that future research on the persistence of AUD into adulthood should focus on the contributions of behavioral disinhibition and social environment variables including peer and romantic relationships. [source] Alcohol Consumption, Lung Function, and Quality of Life in PneumoconiosisALCOHOLISM, Issue 7 2005Wai Kwong Tang Background: To our knowledge, there are no previous data on drinking problems in patients with pneumoconiosis. The aim of this study was to examine drinking patterns and the impact of drinking on lung function and health-related quality of life (HRQOL) in Chinese patients with pneumoconiosis. Methods: Three hundred patients with pneumoconiosis were recruited from a community-based case registry. The HRQOL was measured with the St. George's Respiratory Questionnaire (SGRQ). Pulmonary function, comorbidity, and psychosocial variables were also assessed. The alcohol use of the patients was evaluated with the Alcohol Use Disorders Identification questionnaire. Results: Of the 300 patients, 72.3% (217) reported that they had not consumed any alcohol during the past year, whereas 83 patients (27.7%) did report drinking alcohol. In the drinking group, 88.0% (73) consumed <7 standard drinks per week, and none of them exceeded the safety limit of 21 standard drinks per week. The drinking group (n= 83) was younger, had less concurrent medical diseases, and lower (i.e., better) unadjusted SGRQ symptom, activity, impact, and total scores than the nondrinking group (n= 217). The SGRQ scores, which were adjusted for age, duration of occupation, concurrent medical diseases, smoking status, and forced expiratory volume in 1 sec predicted tests (FEV1%), remained significantly lower for the drinking group. Although the drinking group had a higher unadjusted FEV1% predicted, the difference between the FEV1% of the two groups, after adjustment for covariates, was of borderline significance only. Conclusions: Most Chinese patients with pneumoconiosis in this study did not consume alcohol, and among those who did, the level of alcohol consumption was low. This low level of alcohol consumption was associated with a better HRQOL and possibly with better lung function. [source] Chronic Pain and Violent Ideation: Testing a Model of Patient ViolencePAIN MEDICINE, Issue 3 2007Daniel Bruns PsyD ABSTRACT Objective., Physicians are at risk of patient-perpetrated violence. The objective of this study was to test a clinical model of patient violence, which had been developed previously by Fishbain and colleagues. The developers of this model believed that it would be associated with increased risk of violence in pain patients. Design., Hypotheses generated by the model were tested using manova and chi-square procedures. Setting., A total of 527 subjects for this study were patients obtained from 90 medical facilities in 30 U.S. states. Patients., All subjects were patients being treated for injury and nonmalignant pain. All of the subjects were adults, ranging in age from 18 to 65 years, and were able to read at the sixth-grade level. The demographics of the sample approximated U.S. Census data for race, education, age, and gender. Results., The results included findings that violent ideation was associated with higher levels of physical difficulties, including pain (P = 0.01), problems with functioning (P = 0.0003), and somatic complaints (P = 0.0001). Significant psychosocial variables included hostility (P < 0.0001), dependency (P < 0.0001), substance abuse (P < 0.0001), litigation (P < 0.001), and a lack of trust in the physician (P < 0.001). Conclusions., Using the Battery for Health Improvement 2 as a measure, the findings of this study consistently supported the Fishbain Model of violence risk, and also reinforced the need for psychological assessment and management when working with chronic pain patients. Suggestions for intervention were also offered, but further research will be necessary to see whether these interventions are effective in decreasing patient violence. [source] Associates of school absenteeism in adolescents with sickle cell diseasePEDIATRIC BLOOD & CANCER, Issue 1 2009Lisa A. Schwartz PhD Abstract Background Despite high rates of school absenteeism in adolescents with sickle cell disease (SCD), the issue remains understudied. Potential associates of school absenteeism in adolescents with SCD include demographic (age, income), psychosocial (IQ, self-efficacy, competence, internalizing symptoms, negative thinking), and health-related (hemoglobin, health-care utilization, pain, disease knowledge). Procedure Forty participants ages 12,18 completed measures of psychosocial functioning, IQ, and pain. Medical chart reviews identified other health-related variables. A subsample also completed an assessment of goals. Using school records, absenteeism was the percent of school days missed in the previous year. Correlations tested associates of absenteeism and linear regression tested a model of absenteeism. Results Participants missed an average of 12% of the school year and more than 35% missed at least 1 month of school. Health-related and psychosocial variables, but not demographic variables, correlated with absenteeism. Attendance at clinic appointments and parent-reported teen pain frequency were significant associates of absenteeism in the regression model. For those who completed goal assessment, over 40% of goals identified were academically focused. Absenteeism was positively related to current academic goals and health-related hindrance of academic goals, and negatively related to future-oriented academic goals. Conclusions School absenteeism is a significant problem for adolescents with SCD despite the presence of academic goals. Collaboration between schools, parents, patients, and providers to understand and manage the impact of SCD on school attendance is recommended. Pediatr Blood Cancer 2009;52:92,96. © 2008 Wiley-Liss, Inc. [source] Predictors of Homicidal Ideation and Intent in Schizophrenia: An Empirical StudyAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 3 2001Robert C. Schwartz Ph.D. Correlations of age, gender, and psychosocial variables with ratings of current homicidal ideation and intent were investigated among psychiatric facility clients with schizophrenia. Multiple regression analyses revealed, irrespective of age or gender, significantly positive correlations of three psychosocial variables , manic symptoms, psychotic symptoms, and impaired global functioning , with homicidal ideation and intent. Implications for research are discussed. [source] Where is help sought for depression or suicidal ideation in an elderly population living in a rural area of Japan?PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2004SHINJI SAKAMOTO phd Abstract, Although suicide is increasingly becoming a social problem in Japan, especially among the elderly, little early intervention or suicide prevention is done. A project was begun which, since 1999, has aimed to detect depression at an early stage as a suicide prevention measure in a model area of Town A, which had a high suicide rate. In order to promote early intervention and prevention in a community, it is important to know where residents seek help if they become depressed or have suicidal ideation. Therefore, in the present study, help-seeking behavior using case vignettes was investigated. Data from 230 residents (82 men, 148 women) in the model area of Town A, aged 65 or over, were analyzed in the present study. If participants were unable to answer by themselves due to physical condition, public health nurses read out each item and wrote in their answers. The relationship between help-seeking behavior and demographic variables, psychosocial variables, depressive symptoms and so forth, were examined. The results show that participation in mental health workshops facilitated consultation with specialists (e.g. primary care doctors and nurses). The expected effects of psychoeducation on the general public and specialists were considered. [source] Antecedents of domain-specific quality of life after colorectal cancerPSYCHO-ONCOLOGY, Issue 2 2009Suzanne K. Steginga Abstract Objective: The present study prospectively assessed the influence of medical, socio-demographic, psychological, and lifestyle variables on physical, social/family, emotional, functional well-being and colorectal cancer-specific concerns in a population-based sample of colorectal cancer survivors. Methods: Participants (n=1822) were assessed at 6 and 24 months post-diagnosis. Predictor variables assessed at 6 months included socio-demographic and medical variables, symptoms/side-effects, body mass index, physical activity, optimism, social support, and cancer threat appraisal. Quality of life (QOL) was assessed at 6 and 24 months post-diagnosis using the Functional Assessment of Cancer Therapy - Colorectal (FACT-C). Results: For each QOL subscale and for the overall FACT-C scale, 6 month scores were the strongest predictor of QOL scores at 24 months post-diagnosis (e.g. ,=0.447, p < 0.001 for overall QOL). Socio-demographic, medical, and psychosocial variables, but not lifestyle variables, differentially predicted domain specific QOL. Only cancer threat appraisal was associated with all five QOL domains. Conclusion: Cancer threat appraisal presents as a potentially modifiable variable for interventions seeking to improve QOL. Symptom management and lifestyle strategies to ameliorate the effects of co-morbidities, disease stage and troublesome symptoms such as faecal incontinence on QOL should also be included. Copyright © 2008 John Wiley & Sons, Ltd. [source] The relative importance of specific risk factors for insomnia in women treated for early-stage breast cancerPSYCHO-ONCOLOGY, Issue 1 2008Wayne A. Bardwell Abstract Background: Many individual risk factors for insomnia have been identified for women with a history of breast cancer. We assessed the relative importance of a wide range of risk factors for insomnia in this population. Methods: Two thousand six hundred and forty-five women ,4 years post-treatment for Stage I (,1 cm),IIIA breast cancer provided data on cancer-related variables, personal characteristics, health behaviors, physical health/symptoms, psychosocial variables, and the Women's Health Initiative-Insomnia Rating Scale (WHI-IRS; scores ,9 indicate clinically significant insomnia). Results: Thirty-nine per cent had elevated WHI-IRS scores. In binary logistic regression, the variance in high/low insomnia group status accounted for by each risk factor category was: cancer-specific variables, 0.4% (n.s.); personal characteristics, 0.9% (n.s.); health behaviors, 0.6% (n.s.); physical health/symptoms, 13.4% (p<0.001); and, psychosocial factors, 11.4% (p<0.001). Insomnia was associated with worse depressive (OR = 1.32) and vasomotor symptoms (particularly night sweats) (OR = 1.57). Conclusion: Various cancer-specific, demographic, health behavior, physical health, and psychosocial factors have been previously reported as risk factors for insomnia in breast cancer. In our study (which was powered for simultaneous examination of a variety of variables), cancer-specific, health behavior, and other patient variables were not significant risk factors when in the presence of physical health and psychosocial variables. Only worse depressive and vasomotor symptoms were meaningful predictors. Copyright © 2007 John Wiley & Sons, Ltd. [source] Quality of life among long-term survivors of breast cancer: different types of antecedents predict different classes of outcomesPSYCHO-ONCOLOGY, Issue 9 2006Charles S. Carver Abstract Quality of life (QOL) has many aspects, both in the short-term and in the long-term. Different aspects of QOL may have different types of precursors: demographic, medical, and psychosocial. We examined this possibility in a group of long-term breast cancer survivors. Early-stage breast cancer patients (N=163) who had provided information about medical, demographic, and psychosocial variables during the year after surgery completed a multidimensional measure of QOL 5,13 years later. Initial chemotherapy and higher stage predicted greater financial problems and greater worry about appearance at follow-up. Being partnered at diagnosis predicted many psychosocial benefits at follow-up. Hispanic women reported greater distress and social avoidance at follow-up. Initial trait optimism predicted diverse aspects of better psychosocial QOL at follow-up, but not other aspects of QOL. Thus, different aspects of QOL at long-term follow-up had different antecedents. Overall, psychological outcomes were predicted by psychosocial variables, presence of a partner at diagnosis, and ethnicity. Financial outcomes, in contrast, were predicted by medical variables, which otherwise predicted little about long-term QOL. This divergence among aspects of QOL should receive closer attention in future work. Copyright © 2005 John Wiley & Sons, Ltd. [source] Dimensions of quality of life and psychosocial variables most salient to colorectal cancer patientsPSYCHO-ONCOLOGY, Issue 1 2006Jeff Dunn Abstract Colorectal cancer is one of the most common invasive cancers, and is responsible for considerable physical and psychosocial morbidity. Understanding the quality of life experienced by colorectal cancer patients is essential for evaluating the full impact of the disease on individuals, their families and their communities. Patient perspective is essential in establishing a proper understanding of the quality of life of colorectal cancer patients. Despite this, few studies have employed a qualitative methodology to explore quality of life issues for colorectal cancer patients. A review of the literature identified only seven qualitative studies pertaining to quality of life issues for colorectal cancer patients, a surprising finding given the prevalence of this cancer. Accordingly, this study sought to build on the findings of previous qualitative research by providing descriptive data on the quality of life and psychosocial variables most salient to colorectal cancer patients. Six core themes emerged from interview and focus group data: Satisfaction with diagnosis and treatment; support (including information provision); quality of life; benefits of diagnosis; making sense of the cancer experience; and coping strategies. The information derived from this study will help inform the development of supportive care services to address the needs of the increasing number of people diagnosed with colorectal cancer. Copyright © 2005 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||