Home About us Contact
|
Home About us Contact | ||
|
|
||
Subscales
Kinds of Subscales Terms modified by Subscales Selected AbstractsThe clinically related predictors of dental fear in Taiwanese childrenINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2008CHEN-YI LEE Background. Dental fear has been singled out as one of the most troublesome problems facing paediatric dentistry today. Children with dental fear may avoid visiting dentists; therefore, their oral health protection is often compromised. However, the aetiology of dental fear is still not entirely understood. Objective. This study investigated the dental visiting habit, the previous dental experiences, the conditioning pathway, and the clinically related predictors of dental fear in children. Design., The dental history of 247 children (2,10 years old) was obtained when they came to a dental clinic for treatment. The level of dental fear in these children was assessed using the Children's Fear Survey Schedule,Dental Subscale (CFSS-DS). Observers rated the clinically anxious responses and uncooperative behaviour towards dental treatment in these children. Three stepwise regression analyses were performed to determine significant predictors of CFSS-DS score, clinically anxious responses, and uncooperative behaviour of children, respectively. Results. We found that the CFSS-DS score and clinical anxiety have different predictors, but age , 3.99 years old and cooperativeness in the first dental visit were important predictors for both the CFSS-DS score and the clinical anxiety. Furthermore, the other predictors of the CFSS-DS score were maternal dental fear, unbearable pain during the first dental visit, and visiting dentists in a regular dental clinic; the other predictors of clinical anxiety were first-born, regular dentist, and CFSS-DS score. Finally, the only significant predictor for uncooperative behaviour was clinical anxiety. Conclusion. Children's dental fear and their anxious response during dental treatment were dynamic processes that consisted of many different factors. The direct conditioning of subjective experience of pain was more important than the objective pathway of child dental fear, and the indirect conditioning does not seem influential in this study sample. [source] A study to assess the validity of clinical judgement in determining paediatric dental anxiety and related outcomes of managementINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2005R. D. HOLMES Summary. Objective. The aim of the present study was to determine the validity of subjective anxiety assessment and the outcomes of management of children receiving operative dental treatment. Setting., The study was conducted at the Departments of Sedation and Child Dental Health, Newcastle Dental Hospital, Newcastle upon Tyne, UK. Subjects and methods., One hundred children and adolescents aged between 8 and 15 years participated in the study. Clinicians subjectively allocated 50 children for treatment with local analgesia alone (low anxiety), and identified 50 children who had the potential to benefit from nitrous oxide and oxygen sedation (high anxiety). Participants then completed the State-Trait Anxiety Inventory for Children (STAIC), the Venham Picture Test (VPT) and the Child Fear Survey Schedule , Dental Subscale (CFSS-DS). A global rating scale classified behaviour during dental treatment. Results., State anxiety and dental fear prior to treatment were significantly higher in children allocated to receive inhalation sedation (P = 0·004 and P = 0·005, respectively). There was no significant difference in trait anxiety or post-treatment state anxiety between the two groups (P = 0·69 and P = 0·06, respectively). Only 11% displayed ,negative' behaviour during treatment: 82% of this group represented those allocated to receive sedation. Conclusion., Children receiving inhalation sedation were significantly more anxious prior to treatment than children receiving treatment with local analgesia alone. The findings support the subjective assessment of anxiety in children; however, objective anxiety measures may assist clinicians in identifying specific fears, which may ultimately aid patient management. [source] Concurrent validity of the Yale,Brown Obsessive,Compulsive Scale,Symptom checklist,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2008Michael L. Sulkowski Abstract Despite the frequent use of the Yale,Brown Obsessive,Compulsive Scale,Symptom Checklist (Y-BOCS-SC; Goodman et al., 1989a) and the Obsessive,Compulsive Inventory-Revised (OCI-R; Foa et al., 2002), there are limited data on the psychometric properties of the two instruments. In the present research, clinician ratings on the Y-BOCS-SC for 112 patients with obsessive,compulsive disorder (OCD) were compared to their self-report ratings on the OCI-R. In addition, Y-BOCS-SC and OCI-R scores were compared to measures of OCD symptom severity and self-report measures of anxiety (State,Trait Anxiety Inventory,Trait Subscale [STAI-T]; Spielberger, Gorusch, & Lushene, 1970) and depression (Beck Depression Inventory-II [BDI-II]; Beck, Steer, & Brown, 1996). The six symptom scales of the OCI-R had good internal consistency reliabilities (,s). For the Y-BOCS-SC, three of five scales had good reliabilities (,s >.80), but ,s for symmetry/ordering and sexual/religious symptom scales were inadequate. Total scores for the two instruments were strongly correlated with their corresponding "checking" scales, but no individual symptoms scales were identified as indices of overall OCD symptom presence. Scales assessing washing/contamination, symmetry/ordering, and hoarding from the two OCD instruments correlated well, but lower correlations for the other scales suggested differences in symptom coverage by the two instruments. Most symptom scales from the Y-BOCS-SC and OCI-R had low correlations with the BDI-II and STAI-T, but the OCI-R obsessing scale was well correlated (r=.54) with the STAI-T. These findings reveal some of the strengths and weaknesses of these two OCD instruments, and the results provide guidance for selecting scales that are suitable for measuring OCD symptoms. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64:1,14, 2008. [source] Subjective Overachievement: Individual Differences in Self-Doubt and Concern With PerformanceJOURNAL OF PERSONALITY, Issue 3 2000Kathryn C. Oleson We discuss the construct of doubt about one's competence and suggest that doubt can have myriad consequences (e.g., self-handicapping, defensive pessimism). We focus on the effect of self-doubt when it is combined with a concern with performance and assert that this combination leads to the phenomenon of subjective overachievement. In two studies, we present a new 17-item Subjective Overachievement Scale (SOS), which includes two independent subscales measuring individual differences in self-doubt and concern with performance. The first study, consisting of two large samples (Ns = 2,311 and 1,703), provides evidence that the scale has high internal consistency and a clear two-factor structure. Additionally, the subscales have adequate test-retest reliability (Ns = 67 and 115). A second study reveals that the SOS has good convergent and discriminant validity. Both subscales are unrelated to social desirability but exhibit the predicted patterns of associations with other related constructs. The Concern with Performance Subscale is correlated with achievement motivation, whereas the Self-Doubt Subscale is correlated with scales assessing negative affectivity (e.g., self-esteem, social anxiety) and other self-related strategies associated with concerns about one's competence (e.g., self-handicapping, defensive pessimism, impostor phenomenon). The SOS, which combines the two subscales, appears to tap a unique strategy that individuals may use to deal with doubts about their own competence. [source] Atraumatic Restorative Treatment and Dental Anxiety in Outpatients Attending Public Oral Health Clinics in South AfricaJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 3 2007Steffen Mickenautsch BDS Abstract Objectives: This study was undertaken to test the hypotheses that using the atraumatic restorative treatment (ART) approach results in lower patient anxiety and that lower anxiety leads to higher restoration/extraction ratios. Methods: The test group of dental operators (n=9) was trained in ART. The control group (n=11) was not, and did not apply ART. The Short Form of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-SF) and Corah's Dental Anxiety Scale (DAS) were used to assess patient anxiety after ART (test group) and after traditional restorations (control group). The restoration/extraction ratio calculated for primary (children) and permanent dentitions (adults) per operator was based on 12-month treatment statistics. Dental anxiety assessments were analysed using ANOVA. Differences were compared using the t -test and corrected for confounding factors (ANCOVA). The Pearson correlation coefficient was used to measure the correlation between dental anxiety levels and restoration/extraction ratios. Results: The mean CFSS-SF score for test-group children was statistically significantly lower than for the control-group children. The mean DAS score for test-group adults was statistically significant lower than the control. No significant correlation was observed between dental anxiety level and restoration/extraction ratio per operator for both dentitions in both groups. Conclusion: The first hypothesis was accepted; the second, rejected. Although dental anxiety scores were lower both in child and in adult patients treated by ART than in those who received traditional restorative treatments, this positive effect had not resulted in higher restoration/extraction ratios. [source] Elementary Students' Sleep Habits and Teacher Observations of Sleep-Related ProblemsJOURNAL OF SCHOOL HEALTH, Issue 2 2005Denise H. Amschler PhD Professor ABSTRACT: Sleep affects the health and well-being of children and plays a key role in preventing disease and injury, stability of mood, and ability to learn. Unfortunately, children often do not get adequate sleep on a regular basis. This study surveyed 199 fifth-grade students regarding their sleep habits using the Sleep Self-Report (SSR) instrument (child's form), the Morningness/Eveningness (M/E) Scale, and additional demographic questions. Students' teachers also were asked to evaluate their students' behavior using the Teacher's Daytime Sleepiness Questionnaire (TDSQ). Results indicated many students experienced problems with sleep-related behavior. However, correlating the TDSQ scale with the SSR Daytime Sleepiness Subscale produced a weak correlation coefficient, indicating teachers may not be able to accurately identify students with sleep problems. Overall findings indicated these students displayed sleep behavior similar to other US children. However, research involving children's sleep behavior is limited, and more research is needed. Parents should monitor their children's sleep times, and teachers need to be aware how sleep deprivation can affect children's mood, reaction time, and concentration. Health education curricula need to include sleep-related instruction at all grade levels to address this concern. [source] Assessing spiritual growth and spiritual decline following a diagnosis of cancer: reliability and validity of the spiritual transformation scalePSYCHO-ONCOLOGY, Issue 2 2008Brenda S. Cole Abstract This study assessed the factor structure, reliability, and validity of an instrument designed to assess spiritual transformations following a diagnosis of cancer,the Spiritual Transformation Scale (STS). The instrument was administering to 253 people diagnosed with cancer within the previous 2 years. Two underlying factors emerged (spiritual growth (SG) and spiritual decline (SD)) with adequate internal reliability (alpha=0.98 and 0.86, respectively) and test,retest reliability (r=0.85 and 0.73, respectively). Validity was supported by correlations between SG and the Positive and Negative Affect Scale (PANAS) Positive Affect Subscale (r=0.23, p<0.001), the Daily Spiritual Experiences Scale (r=0.57, p<0.001), and the Post-traumatic Growth Inventory (r=0.68, p<0.001). SD was associated with higher scores on the Center for Epidemiological Studies Depression scale (r=0.38, p<0.001) and PANAS-Negative Affect Subscale (r=0.40, p<0.001), and lower scores on the PANAS-Positive Affect Subscale (r=,0.23, p<0.001), and the Daily Spiritual Experiences Scale (r=,0.30, p<0.001). Hierarchical regression analyses indicated that the subscales uniquely predicted adjustment beyond related constructs (intrinsic religiousness, spiritual coping, and general post-traumatic growth). The results indicate that the STS is psychometrically sound, with SG predicting better, and SD predicting poorer, mental and spiritual well-being following a diagnosis of cancer. Copyright © 2007 John Wiley & Sons, Ltd. [source] The stability of AQT processing speed, ADAS-Cog and MMSE during acetylcholinesterase inhibitor treatment in Alzheimer's diseaseACTA NEUROLOGICA SCANDINAVICA, Issue 3 2010E. H. Wiig Wiig EH, Annas P, Basun H, Andreasen N, Lannfelt L, Zetterberg H, Blennow K, Minthon L. The stability of AQT processing speed, ADAS-Cog and MMSE during acetylcholinesterase inhibitor treatment in Alzheimer's disease. Acta Neurol Scand: 2010: 121: 186,193. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, To explore the longitudinal stability of measures of cognition during treatment with acetylcholinesterase inhibitors (AchEI) in patients with Alzheimer's disease (AD). Materials and methods,,, Cognitive status was measured in a cohort of 60 patients at 6 months after initiation of treatment with AchEI (baseline) and after an additional 6 months of treatment (endpoint). A Quick Test of Cognitive Speed (AQT), Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and MMSE were administered concurrently. Results,,, Correlations (,) between age and AQT processing speed were non-significant, but were significant for ADAS-Cog and Mini Mental State Examination (MMSE). AQT and ADAS-Cog means did not differ significantly between baseline and endpoint. There was a small, significant reduction in MMSE point scores. Measures of stability (Spearman's ,) were moderate-to-high for all tests. Means for subgroups did not differ as a function of medication type. Conclusions,,, AQT processing speed, ADAS-Cog, and MMSE measures proved stable during the second 6 months of treatment with AChEI. [source] Conflict resolution and bully prevention: Skills for school successCONFLICT RESOLUTION QUARTERLY, Issue 1 2006Roberta A. Heydenberk In a two-year study, 673 elementary students participated in a bully prevention program that included seven training sessions introducing affective vocabulary, social and emotional literacy, and Conflict resolution skills. Treatment groups showed statistically significant gains on the Conflict resolution subscale of the standardized instrument employed. No gains were found in the comparison groups. A decrease in bullying and an increased sense of safety were indicated from student and staff questionnaire responses. [source] Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorderDEPRESSION AND ANXIETY, Issue 7 2009Yong Woo Kim M.D. Abstract Background: Mindfulness-based cognitive therapy (MBCT) has been widely used to treat patients with depressive disorder to prevent relapse. The objective of this study was to examine the effectiveness of newly developed MBCT program as an adjuvant to pharmacotherapy in the treatment of patients with panic disorder or generalized anxiety disorder. Methods: Forty-six patients with panic disorder or generalized anxiety disorder were assigned to either MBCT or an anxiety disorder education (ADE) program for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Symptom Checklist-90-Revised (SCL-90-R) were used to assess the patients at 0 week and after the two programs had been running for 2, 4, and 8 weeks. Results: The MBCT group demonstrated significantly more improvement than the ADE group according to all anxiety (HAM-A, p<0.01; BAI, p<0.01; anxiety subscale of SCL-90-R, p=0.01) and depression (HAM-D, p<0.01; BDI, p<0.01; depression subscale of SCL-90-R, p<0.01) scale scores. The obsessive-compulsive and phobic subscales of the SCL-90-R also showed significantly more improvement in the MBCT group. However, no significant improvement was observed in the MBCT group versus the ADE group in terms of the somatization, interpersonal sensitivity, paranoid ideation, or psychoticism subscale scores of the SCL-90-R. Conclusions: MBCT may be effective at relieving anxiety and depressive symptoms in patients with panic disorder or generalized anxiety disorder. However, well-designed, randomized controlled trials are needed. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source] Striatal dopamine D2 receptor availability in OCD with and without comorbid social anxiety disorder: preliminary findings,DEPRESSION AND ANXIETY, Issue 1 2008Franklin R. Schneier M.D. Abstract Dopamine D2 receptor availability in the striatum has been reported to be low in generalized social anxiety disorder (GSAD) and obsessive,compulsive disorder (OCD), but it has not been studied in persons with comorbid OCD and GSAD (OCD+GSAD). D2 receptor availability was assessed in 7 subjects with OCD+GSAD, 8 with OCD, and 7 matched healthy comparison (HC) subjects, all unmedicated adults. D2 receptor availability was assessed with single-photon emission computerized tomography (SPECT) to measure binding potential (BP) of the D2 receptor radiotracer [123I] iodobenzamide ([123I]IBZM). Mean striatal [123I]IBZM BP was significantly lower in the OCD+GSAD group (72.58 mL/g, SD=18.17) than in the HC group (118.41 mL/g, SD=45.40; P=.025). Mean BP in the OCD group (93.08 mL/g, SD=36.90) did not differ significantly from the HC group (P=.247). Trait detachment, as measured by the Detachment subscale of the Karolinska Scales of Personality, was negatively correlated with D2 availability across all subjects (rs=,.55, P=.013). Comorbid GSAD and OCD may be associated with decreased availability of D2 receptors in the striatum, consistent with prior findings in GSAD. Prior findings of decreased D2 receptor availability in noncomorbid OCD were not confirmed. Decreased D2 receptor availability was also associated with trait detachment, supporting prior findings in samples of healthy subjects. Depression and Anxiety 0:1,7, 2007. Published 2007 Wiley-Liss, Inc. [source] Screening for depression and anxiety disorders in primary care patientsDEPRESSION AND ANXIETY, Issue 7 2007Adomas Bunevicius B.S. Abstract Mood and anxiety disorders are highly prevalent in primary health care. In this study we assessed performance of the Hospital Anxiety and Depression Scale (HADS) for screening of depression and anxiety disorders in a population of primary care patients. A total of 503 primary care patients consecutively admitted to the primary care medical center in Kaunas, Lithuania, completed the study. We found that the HADS subscale of depression (HADS-D) at a cutoff score of 6 or more showed the best performance screening for a major depressive episode diagnosed by means of the Mini International Neuropsychiatric Interview (MINI), with a sensitivity of 80%, specificity of 69%, positive predictive value of 80%, negative predictive value of 92%, and area under the receiver operating characteristic (ROC) curve of 0.75. Performance of the HADS-D against MINI diagnosis of dysthymia was weak. The HADS subscale of anxiety (HADS-A) at a cutoff score of 9 or more showed the best performance screening for MINI diagnosis of overall anxiety disorders, with a sensitivity of 77%, specificity of 75%, positive predictive value of 53%, negative predictive value of 90%, and area under the ROC curve of 0.76. These results suggest that in primary care patients HADS is an adequate screening instrument for the MINI diagnoses of major depressive episode, but not for dysthymia at a cutoff score of 6, and for anxiety disorders at a cutoff score of 9. Depression and Anxiety 24:455,460, 2007. © 2006 Wiley-Liss, Inc. [source] Prevalence and relationship to delusions and hallucinations of anxiety disorders in schizophreniaDEPRESSION AND ANXIETY, Issue 2 2003F.R.C.P.C., Philip Tibbo M.D. Abstract We investigated the prevalence of anxiety disorders in a sample of individuals with chronic schizophrenia, controlling for anxiety symptoms that may be related to delusions and hallucinations, and the possible differences in clinical variables between the groups. Individuals with a diagnosis of schizophrenia and able to give informed consent were recruited from the community. The Mini International Neuropsychiatric Interview (MINI) was administered to both confirm the DSM-IV diagnosis of schizophrenia and screen for comorbid anxiety disorders. If a comorbid anxiety disorder was found, its relation to the individual's delusions and hallucinations was examined. Clinical rating scales for schizophrenia were administered as well as rating scales for specific anxiety disorders where appropriate. Overall, anxiety disorders ranged from 0% [ for Post Traumatic Stress Disorder (PTSD)] to 26.7% [ for generalized anxiety disorder (GAD) and agoraphobia without panic] with lower rates when controlled for anxiety symptoms related to delusions and hallucinations. In investigating clinical variables, the cohort was initially divided into schizophrenics with no anxiety disorders and those with an anxiety disorder; with further analyses including schizophrenics with anxiety disorders related to delusions and hallucinations and those with anxiety disorders not related to delusions and hallucinations. The most consistent difference between all the groups was on the PANSS-G subscale. No significant differences were found on the remaining clinical variables. Comorbid anxiety disorders in schizophrenia can be related to the individual's delusions and hallucinations, though anxiety disorders can occur exclusive of these positive symptoms. Clinicians must be aware that this comorbidity exists in order to optimize an individual's treatment. Depression and Anxiety 17:65,72, 2003. © 2003 Wiley-Liss, Inc. [source] Factorial validity of the Childhood Trauma Questionnaire in men and womenDEPRESSION AND ANXIETY, Issue 4 2001Kristi D. Wright B.A. Abstract In an effort to confirm the factorial validity of the Childhood Trauma Questionnaire (CTQ) across sex, the items from the CTQ for 916 university students were subjected to confirmatory factor analysis. Results indicated that the factor structure for the CTQ was significantly different for men and women. For women, the items from the Physical Abuse subscale did not create a stable factor and thus appear not to be conceptually valid. Conversely, for men, the five-factor model provided a relatively good fit to the data. This investigation provides important information regarding sex differences in the factorial validity of the CTQ. Implications and future research directions are discussed. Depression and Anxiety 13:179,183, 2001. © 2001 Wiley-Liss, Inc. [source] Brain functional changes during placebo lead-in and changes in specific symptoms during pharmacotherapy for major depressionACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2009A. M. Hunter Objective:, Brain functional changes during placebo lead-in have been associated with antidepressant response in clinical trials for major depressive disorder (MDD); however, the relationship between such non-pharmacodynamic changes in brain function and changes in specific symptoms is unknown. Method:, Fifty-eight adults with MDD completed a 1-week single-blind placebo lead-in preceding 8 weeks of double-blind randomized treatment with fluoxetine or venlafaxine (n = 30) or placebo (n = 28). Brain functional change during lead-in was assessed using quantitative electroencephalographic (qEEG) prefrontal theta-band cordance. Symptoms were assessed using the Symptom Checklist-90-Revised (SCL-90-R). Results:, The multiple regression model examining the qEEG parameter in relation to SCL-90-R subscales was significant [F(9,9) = 4.27, P = 0.021, R2 = 0.81] in females, with a significant association for the interpersonal sensitivity subscale (beta coefficient = 1.94, P = 0.001). Conclusion:, Prefrontal neurophysiologic change during placebo lead-in may indicate subsequent antidepressant-related improvement in symptoms of interpersonal sensitivity. [source] A placebo-controlled trial of mirtazapine for the management of methamphetamine withdrawalDRUG AND ALCOHOL REVIEW, Issue 3 2008CHRISTOPHER C. CRUICKSHANK Abstract Introduction and Aims. As an antidepressant with sedative and anxiolytic properties, mirtazapine may be an appropriate pharmacotherapy for methamphetamine withdrawal. This study sought to examine whether mirtazapine improves retention and alleviates methamphetamine withdrawal symptoms in an out-patient setting. Design and Methods. An out-patient double-blind, randomised placebo-controlled trial of mirtazapine for the treatment of methamphetamine withdrawal was conducted (15 mg nocte for 2 days, 30 mg nocte for 12 days). Both groups were offered narrative therapy counselling. Measures recorded on days 0, 3, 7, 14 and 35 included: treatment retention, Amphetamine Cessation Symptoms Assessment, the Athens Insomnia Scale, the Brief Symptom Inventory, the Depression,Anxiety,Stress Scale (DASS), Severity of Dependence scale and the Opiate Treatment Index Drug Use subscale. Results. Thirty-one participants were recruited (18 placebo, 13 mirtazapine) and 52% completed the 2-week medication phase. No significant differences between the mirtazapine and placebo groups in retention, or any symptom measure were observed, except greater DASS,anxiety and longer sleep duration were measured at baseline among the mirtazapine group. Discussion and Conclusions. Results suggest that mirtazapine does not facilitate retention or recruitment in out-patient methamphetamine withdrawal treatment, although recruitment may have been insufficient to identify a significant treatment effect. The potential role of narrative therapy for methamphetamine dependent patients deserves further exploration. [source] Improving detection of first-episode psychosis by mental health-care services using a self-report questionnaireEARLY INTERVENTION IN PSYCHIATRY, Issue 4 2009Nynke Boonstra Abstract Objective: To examine the utility of the Community Assessment of Psychic Experiences (CAPE)-42, a self-report questionnaire, to improve detection of first-episode psychosis in new referrals to mental health services. Method: At first contact with mental health-care services patients were asked to complete the CAPE-42 and were then routinely diagnosed by a clinician. Standard diagnoses were obtained by means of the mini-Schedule for Clinical Assessment in Neuropsychiatry. Results: Of the 246 included patients, 26 (10.6%) were diagnosed with psychosis according to the mini-Schedule for Clinical Assessment in Neuropsychiatry. Only 10 of them were recognized by clinical routine, and 16 psychotic patients were not properly identified. Using an optimal cut-off of 50 on the frequency or distress dimension of the positive subscale of the CAPE-42 detected 14 of these misdiagnosed patients. The sensitivity of the CAPE-42 at this cut-off point was 77.5 and the specificity 70.5. Conclusion: Systematic screening of patients using a self-report questionnaire for psychotic symptoms improves routine detection of psychotic patients when they first come into contact with mental health services. [source] Family members of relatives with alcohol, drug and gambling problems: a set of standardized questionnaires for assessing stress, coping and strainADDICTION, Issue 11 2005Jim Orford ABSTRACT Aims To describe a set of standard questionnaire measures for the assessment of the needs of family members of relatives with alcohol, drug or gambling problems, and to present evidence of their reliability and validity from a series of related studies. Design Includes cross-sectional and repeated-measurement studies. Setting and participants Family members affected by and concerned about the problem drinking or drug-taking of close relatives in treatment and non-treatment samples in the United Kingdom (white and Sikh) and Mexico City; family members of untreated heavy drinkers; and family members of problem gamblers. Measurements Four measures derived from a stress,strain,coping,support model of alcohol, drugs and gambling problems and the family: Family Member Impact scale (FMI), Symptom Rating Test (SRT), Coping Questionnaire (CQ), and Hopefulness,Hopelessness scale (HOPE). FMI, SRT and CQ assess stress, strain and coping, respectively. The exact role of HOPE in the model remains to be determined. The support component remains unmeasured. Findings Results from a number of studies support the internal reliability, discriminant and construct validity and sensitivity to change of the SRT and its two constituent scales (psychological and physical symptoms) and at least two subscales of the CQ (engaged and tolerant,inactive coping). Although showing evidence of satisfactory reliability and some evidence of discriminant validity, further work may be required on the CQ withdrawal coping subscale. Evidence suggests that the FMI is reliable and valid and may have a factor structure that will support future research (distinguishing worrying behaviour from active disturbance). HOPE is a new measure showing promising characteristics. Conclusions A set of standard measures is available for helping to assess the needs of concerned and affected family members, derived from an explicit model of the family in relation to excessive drinking, drug taking or gambling. It may have a role to play in correcting the current neglect of the needs of such family members, estimated to be in the region of nearly a million adults in Britain alone. [source] Psychosocial outcomes in children two years after epilepsy surgery: Has anything changed?EPILEPSIA, Issue 4 2008Irene M. Elliott Summary Purpose: We prospectively explored psychosocial outcomes in children (7,18 years) 2 years after epilepsy surgery. This study built on our previous one that examined these children 1 year after surgery. Methods: Twenty children were studied using the Child Behavior Checklist (CBCL; a parent report instrument of potential behavioral and social problems) preoperatively, 1 year and 2 years after surgery. A comparison group of 12 children with medically refractory seizures was examined at comparable times. We conducted mixed factorial ANOVAs to determine group, time, and interaction effects, and regression analyses to assess factors driving significant (p , 0.05) interactions. We also investigated the proportion of children scoring in the abnormal range over time. Results: Significant main effects of time were observed on total behavior, externalizing, aggression, and delinquent behavior scales, with both groups reporting improvement. Main effects of group were observed for withdrawn and total competence scales, with the surgical group demonstrating favorable scores. Significant group × time interactions were observed on the social and social problems subscales. On both subscales, the surgical group demonstrated improvement over time, whereas the nonsurgical group experienced decline. Fifty percent of the surgical group remained seizure-free. Seizure status and number of antiepileptic medications predicted changes in social scores. We did not observe a significant regression model for the social problems subscale. Discussion: These findings suggest that change in social function may take time to develop after surgery. Prospective studies designed for longer periods are required to determine if improvements in other psychosocial domains are seen over time. [source] Interictal Psychoses in Comparison with Schizophrenia,A Prospective StudyEPILEPSIA, Issue 12 2007Yukari Tadokoro Summary Purpose: To prospectively investigate the incidence of interictal psychoses of epilepsy patients, and make a comparison between those with interictal psychoses and patients with schizophrenia in respect to their responses to antipsychotic drugs, as well as psychotic states. Methods: We undertook a two-part prospective investigation. In Part I, the psychotic episodes of 619 epilepsy patients were investigated, while 182 patients with psychotic syndromes were followed in Part II, of whom 59 were diagnosed with schizophrenia and 13 with epilepsy with interictal psychoses. The Positive and Negative Syndrome Scale was used for efficacy assessment. Results: The average annual incidence of interictal psychosis was 0.42% during the 56-month study period. A significant difference was found between patients with schizophrenia and epilepsy patients with interictal psychoses in respect to results on the negative subscale of the PANSS at the initial examination (mean scores of 18.1 and 13.2, respectively, p = 0.004). The response rates one year later for these groups were 27.1% and 53.8%, respectively, which showed a trend of better response to the antipsychotic medication by the epilepsy group (p = 0.098). Initial and maximum doses of antipsychotic drugs used for epilepsy patients with interictal psychoses were significantly lower than those used for patients with schizophrenia (p = 0.008 and p = 0.006, respectively). Conclusions: Schizophrenia and epileptic psychosis showed different symptom profiles. On average, epilepsy patients with interictal psychoses achieved higher remission rates with lower doses of antipsychotic drugs as compared to patients with schizophrenia in the present 1-year follow-up study. [source] Pergolide mesylate can improve sexual dysfunction in patients with Parkinson's disease: the results of an open, prospective, 6-month follow-upEUROPEAN JOURNAL OF NEUROLOGY, Issue 7 2004M. Pohanka One of the most disabling problems in males suffering from advanced Parkinson's disease (PD) is complex sexual dysfunction. The effect of dopamine replacement or dopaminergic stimulation on sexual dysfunction has been recently examined and described in patients treated by L-DOPA or apomorphine. Pergolide mesylate is another dopamine agonist with a known high affinity to hD(2S) subtype and a lower affinity to hD(2L) subtype of D2 dopaminergic receptors. It has been repeatedly shown to be a highly effective treatment of the complicated and advanced stages of PD. The current study has been designed to assess its efficacy in the treatment of sexual dysfunction, which frequently accompanies the complicated stage of PD in males. Fourteen male patients suffering from PD, each of whom had been treated with L-DOPA, and in whom additional treatment with peroral dopaminergic agonist (DA) was needed, were followed for a 6-month period. Pergolide mesylate (Permax) was given to each patient, and titrated to a total daily dose of 3 mg. All of the patients were taking L-DOPA. The assessments performed before the start of pergolide treatment consisted of a neurological examination, including Unified Parkinson's Disease Rating Scale (UPDRS) III and IV subscales scoring, Mini Mental State Examination (MMSE) scoring, the neuropsychological examination including Zung scale scoring to exclude depression, biochemical and haematological examinations including the examination of prolactine serum levels; and a sexological examination during which the patients filled-in the International Index of Erectile Function (IIEF) questionnaire. These examinations were repeated during the control assessments at months 1, 3 and 6. To compare the examination results, anova, Friedmann's anova (non-parametric) and Tukey post hoc tests were used. There were statistically significant differences between the values of UPDRS III motor subscale, UPDRS IV (complications of therapy) subscale and all subscales of IIEF when months 0 and 1 were compared with the results obtained at months 3 and 6. The differences between months 0 and 1 and months 3 and 6 (in these items) were virtually insignificant. In conclusion, pergolide substantially improved sexual function in the younger male patients who were still interested in sexual activities. In such cases, the introduction of pergolide might be a better choice than treatment with sildenafile, which usually meets several contraindications in common PD male population. [source] Changes in TMIG-Index of Competence by subscale in Japanese urban and rural community older populations: Six years prospective studyGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2003Yoshinori Fujiwara Objective: To examine the longitudinal changes in higher-level functional capacity in Japanese urban and rural community older populations. Design: Population-based cross-sectional, and prospective cohort studies. Setting: Koganei city in a suburb of Tokyo, and Nangai village, Akita Prefecture, Japan. Participants: One thousand, five hundred and six older persons (793 in Koganei and 713 in Nangai) aged 65,83 years living at home. Main outcome measures: Disability in Instrumental Self-Maintenance (IADL), Intellectual Activity or Social Role, measured by the Tokyo Metropolitan Institute of Gerontology Index of Competence. Results: At baseline, older men and women in the rural area, Nangai, had higher prevalence of disability in Intellectual Activity compared with respective counterparts in the urban area, Koganei. By contrast, disability in Social Role was more prevalent among elderly people in Koganei than in Nangai. In both areas older men and women had lowest prevalence of disability in IADL among three subscales. The six-year longitudinal survey on older persons who had initially no disability in all three subscales demonstrated that in urban Koganei older persons were most likely to be disabled in Social Role with advancing age, followed in turn by Intellectual Activity and IADL. By contrast, elderly people in rural Nangai were most likely to be disabled in Intellectual Activity, followed by Social Role and instrumental ADL. The Cox-proportional hazard model analysis for those who had no IADL disability at baseline revealed that the baseline level of Intellectual Activity or Social Role predicted significantly future onset of IADL disability in both areas even after controlling for sex, age, and chronic medical conditions. Conclusions: In both urban and rural community older populations, disability in Social Role and Intellectual Activity preceded IADL disability, and predicted significantly the future onset of IADL disability. [source] Impact of history or onset of chronic medical conditions on higher-level functional capacity among older community-dwelling Japanese adultsGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2003Yoshinori Fujiwara Background: Many studies have examined the impact of chronic medical conditions on the age-related decline in basic activities of daily living (BADL) and the instrumental activities of daily living (IADL), but less is known concerning the influence of chronic disease on physical, cognitive, social, and economic aspects of higher-level functional capacity. Methods: Subjects comprised 793 and 725 persons aged 65,84 years, living in an urban and a rural Japanese community, respectively. A baseline interview established any history of chronic medical conditions. Four years later, a second interview again assessed chronic disease, and higher-level functional capacity was evaluated using the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence. Results: Multiple logistic regression analysis revealed that declines in total score and/or any of three subscales of the TMIG Index of Competence were significantly associated with a history of chronic disease, the onset of visual impairment and the development of hearing impairment, even after controlling for the subject's age, gender, educational attainment, and baseline TMIG Index of Competence. Episodes of stroke were significantly associated with declines in IADL. Hypertension, diabetes mellitus, and heart disease were also significantly associated with a decrease in functional competence, although each affected a different subscale of the TMIG Index of Competence. Conclusions: The present results underline the importance of controlling chronic medical conditions through a physically active lifestyle and an appropriate medical regimen in order to limit the age-related decline in functional capacity. [source] Development and preliminary testing of a Paediatric Version of the Haemophilia Activities List (pedhal)HAEMOPHILIA, Issue 2 2010W. G. GROEN Summary., Worldwide, children with haemophilia suffer from limitations in performing activities of daily living. To measure such limitations in adults a disease-specific instrument, the Haemophilia Activities List (HAL), was created in 2004. The aim of this study was to adapt the HAL for children with haemophilia and to assess its psychometric properties. The structure and the main content were derived from the HAL. Additionally, items of the Childhood Health Assessment Questionnaire and the Activity Scale for Kids were considered for inclusion. This version was evaluated by health professionals (n = 6), patients (n = 4), and parents (n = 3). A pilot test in a sample of 32 Dutch children was performed to assess score distribution, construct validity (Spearman's rho) and reproducibility. Administration of the pedhal was feasible for children from the age of 4 years onwards. The pedhal scores of the Dutch children were in the high end of the scale, reflecting a good functional status. Most subscales showed moderate associations with the joint examination (rho = 0.42,0.63) and moderate-to-good associations with the physical function subscale of the CHQ-50 (rho = 0.48,0.74). No significant associations were found for the pedhal and the subscales mental health and behaviour, except for the subscales leisure and sport and mental health (rho = 0.47). Test,retest agreement was good. The pedhal is a promising tool, but further testing in populations with a higher level of disability is warranted to study the full range of its psychometric properties. [source] Asking fathers: a study of psychosocial adaptationHAEMOPHILIA, Issue 5 2004E. K. Herrick Summary., Although few contemporary studies specifically address paternal adaptation, the theme of paternal estrangement from medical care and from family relationships is pervasive in the psychosocial literature on haemophilia. This estrangement has been shown to have a negative effect on fathers' psychological well-being, marital relationships and the adaptive outcome of their sons who have haemophilia. The goals of this study were to provide contemporary data on the psychosocial adaptation of fathers of boys with haemophilia and to examine specific variables that might influence their adjustment. Eighty-three eligible fathers returned a survey instrument that collected demographic and medical information, as well as scores on self-measures of adaptation in marital and parenting roles. Statistically significant direct correlations (P < 0.01) were found between fathers' scores on the Marital Adjustment Test and the Parenting Sense of Competence subscales (parenting efficacy and satisfaction). Variables specific to rearing a son with haemophilia that negatively affected fathers' marital adjustment scores included: feeling left out of medical decision making by their wives or partners, worry about their sons' having limited activity, and the presence of a secondary diagnosis in the affected child. Scores on the parenting efficacy subscale of the PSOC were statistically significantly reduced (i.e. fathers felt less effective in the parenting role) in men who ,rarely' or ,never' infused their sons (42/80, 53%). Variables that negatively affected scores on the parenting satisfaction subscale included frustrating interactions with medical staff and concern about their sons' potential to contract an infection or secondary diagnosis. This paper presents a model to examine the interrelationships among the data and discusses the clinical implications. [source] Efficacy of Eletriptan in Migraine-Related Functional Impairment: Functional and Work Productivity OutcomesHEADACHE, Issue 5 2007Stephen D. Silberstein MD Objective.,To provide a multidimensional assessment of the extent of functional impairment during an acute migraine attack, and of the improvement in functioning in response to treatment, using 4 concurrently administered scales: the 7-item work productivity questionnaire (PQ-7), the functional assessment in migraine (FAIM) activities and participation (FAIM-A&P) subscale, the FAIM-impact of migraine on mental functioning (FAIM-IMMF) subscale, and the traditional 4-point global functional impairment scale (FIS). Methods.,Outpatients with an International Classification of Headache Disorders diagnosis of migraine were randomized to double-blind treatment of a single attack with either oral eletriptan 20 mg (n = 192) once-daily, eletriptan 40 mg (N = 213) once-daily, or placebo (n = 208). Patients were encouraged to take study medication as soon as they were sure they were experiencing a typical migraine headache, after the aura phase (if present) had ended. Patients with moderate-to-severe functional impairment were identified on each of the 4 disability scales, and 2-hour functional response was compared between treatments. Results.,At baseline, the PQ-7 and FAIM-IMMF items that assessed ability to perform tasks requiring concentration, sustained work or attention, and ability to think quickly or spontaneously, were especially sensitive to the effects of mild headache pain, with 27% to 48% of patients (n = 92-112) reporting moderate-to-severe impairment. Only 11.3% of patients (n = 112) reported this level of impairment due to mild pain on the FIS. Functional response at 2 hours was significantly higher on eletriptan 40 mg versus placebo on the FAIM-A&P (63% vs 36%; n = 218; P < .0001); on the PQ-7 (56% vs 34%; n = 116; P= .0052); and on the FAIM-IMMF (50% vs 34%; n = 215; P= .017). These rates were all lower than the functional response rates on the FIS for eletriptan 40 mg (75%) and eletriptan 20 mg (70%) versus placebo (45%; P < .001). Conclusions.,In this exploratory analysis, use of multidimensional scales was found to provide a sensitive measure of headache-related functional impairment, especially for detecting clinically meaningful cognitive effects, and for detecting drug versus placebo differences. [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] Factors Associated With Burden of Primary Headache in a Specialty ClinicHEADACHE, Issue 6 2003Eugene M. Cassidy MRCPsych Objective.,To examine factors associated with social, occupational, and psychological burden of common primary headache (migraine and tension-type headache). Background.,The personal and social burden of primary headache is high. Health, occupational, social, and psychological factors contributing to burden in people with disabling headache have not been fully unravelled. Methods.,One hundred eighty consecutive patients with either migraine or tension-type headache attending a specialty headache outpatient clinic for the first time were evaluated over a 9-month period. Headache subtype was operationally defined according to International Headache Society criteria. Headache frequency, duration, and severity were recorded. Occupational and social disability were quantified using the Migraine Disability Assessment questionnaire. Psychological burden was quantified using the 28-item General Health Questionnaire, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. Premorbid vulnerability to life stress was quantified using the neuroticism subscale of the Eysenck Personality Inventory. Results.,Patients with frequent (chronic) headache scored higher on the Migraine Disability Assessment questionnaire and had higher Beck Depression Inventory and General Health Questionnaire depression scores than those with less frequent (episodic) headache. Frequency of headache, but not pain severity, duration, or diagnosis, predicted both Migraine Disability Assessment total disability and General Health Questionnaire/Beck Depression Inventory depression. Neuroticism was predictive of depression but not disability. Patients with chronic migraine had the highest depression and disability scores. Conclusion.,The number of days per month with headache is a key determinant of headache-related burden in those attending specialty clinics. Frequent (chronic) headache is associated with significantly higher psychopathology scores and general social impairment, but the direction of this relationship is not clear. Those with migraine and chronicity are the most impaired. [source] A Self-Report Measure of Clinicians' Orientation toward Integrative MedicineHEALTH SERVICES RESEARCH, Issue 5p1 2005An-Fu Hsiao Objective. Patients in the U.S. often turn to complementary and alternative medicine (CAM) and may use it concurrently with conventional medicine to treat illness and promote wellness. However, clinicians vary in their openness to the merging of treatment paradigms. Because integration of CAM with conventional medicine can have important implications for health care, we developed a survey instrument to assess clinicians' orientation toward integrative medicine. Study Setting. A convenience sample of 294 acupuncturists, chiropractors, primary care physicians, and physician acupuncturists in academic and community settings in California. Data Collection Methods. We used a qualitative analysis of structured interviews to develop a conceptual model of integrative medicine at the provider level. Based on this conceptual model, we developed a 30-item survey (IM-30) to assess five domains of clinicians' orientation toward integrative medicine: openness, readiness to refer, learning from alternate paradigms, patient-centered care, and safety of integration. Principal Findings. Two hundred and two clinicians (69 percent response rate) returned the survey. The internal consistency reliability for the 30-item total scale and the five subscales ranged from 0.71 to 0.90. Item-scale correlations for the five subscales were higher for the hypothesized subscale than other subscales 75 percent or more of the time. Construct validity was supported by the association of the IM-30 total scale score (0,100 possible range, with a higher score indicative of greater orientation toward integrative medicine) with hypothesized constructs: physician acupuncturists scored higher than physicians (71 versus 50, p<.001), dual-trained practitioners scored higher than single-trained practitioners (71 versus 62, p<.001), and practitioners' self-perceived "integrativeness" was significantly correlated (r=0.60, p<.001) with the IM-30 total score. Conclusion. This study provides support for the reliability and validity of the IM-30 as a measure of clinicians' orientation toward integrative medicine. The IM-30 survey, which we estimate as requiring 5 minutes to complete, can be administered to both conventional and CAM clinicians. [source] Efficacy and safety of quetiapine for depressive symptoms in patients with schizophreniaHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 6 2009Kyoung-Uk Lee Abstract Objective To investigate the efficacy and safety of quetiapine for depressive symptoms in patients with schizophrenia. Method Thirty-nine patients fulfilling DSM-IV-TR diagnostic criteria for schizophrenia and had depressive symptoms were studied in a prospective 6-week open-label design using quetiapine monotherapy. The brief psychiatric rating scale (BPRS), 17-item Hamilton depression rating scale (HAMD-17), Simpson,Angus rating scale, and the Barnes Akathisia rating scale (BARS) were used to assess patients at baseline, week 1, 2, 4, and 6. Results Thirty patients (76.9%) completed this study. The dose of quetiapine at endpoint was 583 (±235 SD),mg/day. Treatment with Quetiapine was associated with significantly reduced depressive symptoms (HAMD-17 total score and BPRS depression/anxiety subscale) from the first week of treatment. Changes of mean score from baseline to endpoint were 7.8,±,6.2 for HAMD-17 total score and 3.4,±,3.6 for BPRS depression/anxiety subscale (LOCF, n,=,39, p,<,0.001). Quetiapine was well tolerated, with minimal extrapyramidal symptoms and non-significant increase in body weight (mean increase of 0.8,kg). Conclusions While the interpretation of findings from the open-label design of this study warrants appropriate caution, the results suggest that quetiapine may be an effective and tolerable treatment for depression in patients with schizophrenia. Copyright © 2009 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||||||||||||||