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Vulnerability Factors (vulnerability + factor)

Distribution by Scientific Domains

Medical Sciences	55%
Psychology	30%
Humanities and Social Sciences	15%

Selected Abstracts

Vulnerability factors in OCD symptoms: cross-cultural comparisons between Turkish and Canadian samples

CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 2 2010
Orçun Yorulmaz
Abstract Recent findings have suggested some potential psychological vulnerability factors for development of obsessive-compulsive (OC) symptoms, including cognitive factors of appraisal and thought control, religiosity, self-esteem and personality characteristics such as neuroticism. Studies demonstrating these associations usually come from Western cultures, but there may be cultural differences relevant to these vulnerability factors and OC symptoms. The present study examined the relationship between putative vulnerability factors and OC symptoms by comparing non-clinical samples from Turkey and Canada, two countries with quite different cultural characteristics. The findings revealed some common correlates such as neuroticism and certain types of metacognition, including appraisals of responsibility/threat estimation and perfectionism/need for certainty, as well as thought,action fusion. However, culture-specific factors were also indicated in the type of thought control participants used. For OC disorder symptoms, Turkish participants were more likely to utilize worry and thought suppression, while Canadian participants tended to use self-punishment more frequently. The association with common factors supports the cross-cultural validity of some factors, whereas unique factors suggest cultural features that may be operative in cognitive processes relevant to OC symptoms.,Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: , Despite cross-cultural validity in the cognitive accounts for OCD, there are some evidences implying the impact of cultural characteristics on some cognitive factors across different cultures. Thus, it is important for clinicians who work with people from different cultural backgrounds to be vigilant for possible variations in the cognitive processes during psychotherapy and psychological assessment. [source]

The Health Sector Gap in the Southern Africa Crisis in 2002/2003

DISASTERS, Issue 4 2004
Andre Griekspoor
The southern Africa crisis represents the first widespread emergency in a region with a mature HIV/AIDS epidemic. It provides a steep learning curve for the international humanitarian system in understanding and responding to the complex interactions between the epidemic and the causes and the effects of this crisis. It also provoked much debate about the severity and causes of this emergency, and the appropriateness of the response by the humanitarian community. The authors argue that the over-emphasis on food aid delivery occurred at the expense of other public health interventions, particularly preventative and curative health services. Health service needs were not sufficiently addressed despite the early recognition that ill-health related to HIV/AIDS was a major vulnerability factor. This neglect occurred because analytical frameworks were too narrowly focused on food security, and large-scale support to health service delivery was seen as a long-term developmental issue that could not easily be dealt with by short-term humanitarian action. Furthermore, there were insufficient countrywide data on acute malnutrition, mortality rates and performance of the public health system to make better-balanced evidence-based decisions. In this crisis, humanitarian organisations providing health services could not assume their traditional roles of short-term assistance in a limited geographical area until the governing authorities resume their responsibilities. However, relegating health service delivery as a long-term developmental issue is not acceptable. Improved multisectoral analytical frameworks that include a multidisciplinary team are needed to ensure all aspects of public health are dealt with in similar future emergencies. Humanitarian organisations must advocate for improved delivery and access to health services in this region. They can target limited geographical areas with high mortality and acute malnutrition rates to deliver their services. Finally, to address the underlying problem of the health sector gap, a long-term strategy to ensure improved and sustainable health sector performance can only be accomplished with truly adequate resources. This will require renewed efforts on part of governments, donors and the international community. Public health interventions, complementing those addressing food insecurity, were and are still needed to reduce the impact of the crisis, and to allow people to re-establish their livelihoods. These will increase the population's resilience to prevent or mitigate future disasters. [source]

Predicting school adjustment from motor abilities in kindergarten

INFANT AND CHILD DEVELOPMENT, Issue 6 2007
Orit Bart
Abstract The present study assessed the relations between basic motor abilities in kindergarten and scholastic, social, and emotional adaptation in the transition to formal schooling. Seventy-one five-year-old kindergarten children were administered a battery of standard assessments of basic motor functions. A year later, children's adjustment to school was assessed via a series of questionnaires completed by the children and their class teachers. The results indicate that in addition to the already documented association between visual,motor integration and academic achievement, other motor functions show significant predictive value to both scholastic adaptation and social and emotional adjustment to school. The results further suggest a better prediction of scholastic adaptation and level of disruptive behaviour in school when using an aggregate measure of children's ability in various motor domains than when using assessments of singular motor functions. It is concluded that good motor ability may serve as a buffer to the normative challenges presented to children in the transition to school. In contrast, poor motor ability emerges as a vulnerability factor in the transition to formal schooling. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Stability of negative self-structures: A longitudinal comparison of depressed, remitted, and nonpsychiatric controls

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2007
David J. A. Dozois
To be considered a vulnerability marker for depression, a variable should, in addition to demonstrating sensitivity and specificity, also show evidence of temporal stability (i.e., remain present in the absence of depressive symptomatology). Although many cognitive factors are associated with depression, the majority of them appear to be episode rather than vulnerability markers. This study examined cognitive organization of positive and negative interpersonal and achievement content in clinically depressed, remitted, and nonpsychiatric controls. At initial assessment, a sample of 54 clinically depressed individuals and 37 never-depressed controls completed self-report measures of positive and negative automatic thoughts and two cognitive organizational tasks. They were retested 6 months later when half of the depressed group no longer met diagnostic criteria for major depression. Negative automatic thoughts decreased and positive automatic thoughts increased significantly in individuals who had improved clinically. The organization of negative interpersonal content remained stable despite symptom amelioration, but negative achievement content was less interconnected at follow-up in those patients who had improved. The structure of relational schemas, in particular, appears to be stable and may be an important cognitive vulnerability factor for depression. © 2007 Wiley Periodicals, Inc. J Clin Psychol 63: 319,338, 2007. [source]

Clinical neurological abnormalities in young adults with Asperger syndrome

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2006
PEKKA TANI md
Abstract, Children with Asperger syndrome (AS), a neurodevelopmental disorder falling in the autism spectrum disorders, have an increased rate of neurological abnormalities, especially in motor coordination. While AS is a lifelong condition, little is known about the persistence of neurological abnormalities in adulthood. Twenty young adults with AS were compared with 10 healthy controls using a structured clinical neurological rating scale. The score for neurological abnormalities was higher in the AS group. In addition, a subscore for neurological soft signs indicating defective functioning of the central nervous system with a non-localizing value was significantly higher in the AS subjects. This preliminary study indicates that neurological abnormalities, soft signs in particular, represent a non-specific vulnerability factor for AS. Consistent with other features of AS, neurological abnormalities seem to persist into adulthood. [source]

Panic disorder: from respiration to the homeostatic brain

ACTA NEUROPSYCHIATRICA, Issue 2 2004
Giampaolo Perna
There is some experimental evidence to support the existence of a connection between panic and respiration. However, only recent studies investigating the complexity of respiratory physiology have revealed consistent irregularities in respiratory pattern, suggesting that these abnormalities might be a vulnerability factor to panic attacks. The source of the high irregularity observed, together with unpleasant respiratory sensations in patients with panic disorder (PD), is still unclear and different underlying mechanisms might be hypothesized. It could be the result of compensatory responses to abnormal respiratory inputs or an intrinsic deranged activity in the brainstem network shaping the respiratory rhythm. Moreover, since basic physiological functions in the organism are strictly interrelated, with reciprocal modulations and abnormalities in cardiac and balance system function having been described in PD, the respiratory findings might arise from perturbations of these other basic systems or a more general dysfunction of the homeostatic brain. Phylogenetically ancient brain circuits process physiological perceptions/sensations linked to homeostatic functions, such as respiration, and the parabrachial nucleus might filter and integrate interoceptive information from the basic homeostatic functions. These physiological processes take place continuously and subconsciously and only occasionally do they pervade the conscious awareness as ,primal emotions'. Panic attacks could be the expression of primal emotion arising from an abnormal modulation of the respiratory/homeostatic functions. [source]

Danger,early maladaptive schemas at work!: the role of early maladaptive schemas in career choice and the development of occupational stress in health workers

CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 2 2008
Martin Bamber
The schema-focused model of occupational stress and work dysfunctions (Bamber & Price, 2006; Bamber, 2006) hypothesizes that individuals with EMS (unconsciously) gravitate toward occupations with similar dynamics and structures to the toxic early environments and relationships that created them. They subsequently re-enact these EMS and their associated maladaptive coping styles in the workplace. For most individuals, this results in ,schema healing', but for some individuals with more rigid and severe EMS, schema healing is not achieved and the structures and relationships of the workplace, together with the utilization of maladaptive coping styles, serve to perpetuate their EMS. The model hypothesizes that it is these individuals who are most vulnerable to developing occupational stress syndromes To date, this model has been subjected to very little empirical investigation, so the main aim of this study was to address this gap in the literature by testing out some of its main assumptions and to provide empirical data, which would either support or reject the model using a population of health workers. Specifically, it was hypothesized that ,occupation-specific' EMS would be found in health workers from a range of different healthcare professions. It was also hypothesized that the presence of higher levels of EMS would be predictive of raised levels of occupational stress, psychiatric caseness and increased sickness absence in those individuals. A cross-sectional study design was employed and a total of 249 staff working within a NHS Trust, belonging to one of five occupational groups (medical doctors, nurses, clinical psychologists, IT staff and managers), participated in the study. All participants completed the Young Schema Questionnaire-Short Form (Young, 1998); the Maslach Burnout Inventory-Human Services Form (Maslach & Jackson, 1981), and the General Health Questionnaire-28-item version (Goldberg, 1978). A demographic questionnaire and sickness absence data was also collected. The results of a between groups analysis of variance and further post hoc statistical analyses identified a number of occupation specific EMS. Also, the results of a series of multiple linear regression analyses indicated the presence of some EMS to be predictive of higher levels of burnout, psychiatric caseness and sickness absence in health workers. In conclusion, the findings of this study provide empirical support for the schema-focused model of occupational stress and work dysfunctions (Bamber & Price, 2006; Bamber, 2006), and it appears that the existence of underlying EMS may constitute a predisposing vulnerability factor to developing occupational stress.,Copyright © 2008 John Wiley & Sons, Ltd. [source]

Neurophysiological and genetic distinctions between pure and comorbid anxiety disorders,

DEPRESSION AND ANXIETY, Issue 5 2008
Mary-Anne Enoch M.D.
Abstract Anxiety disorders are often comorbid with major depression (MD) and alcohol use disorders (AUD). Two common functional polymorphisms in catechol-O-methyltransferase (COMT Val158Met) and brain-derived neurotrophic factor (BDNF Val66Met) genes have been implicated in the neurobiology of anxiety and depression. We hypothesized that attentional response and working memory (auditory P300 event-related potential and Weschler Adult Intelligence Scale, Revised digit symbol scores) as well as genetic vulnerability would differ between pure anxiety disorders and comorbid anxiety. Our study sample comprised 249 community-ascertained men and women with lifetime DSM-III-R diagnoses. We analyzed groups of participants with pure anxiety disorders, pure MD, pure AUD, comorbid anxiety, and no psychiatric disorder. Participants were well at the time of testing; state anxiety and depressed mood measures were at most only mildly elevated. Individuals with pure anxiety disorders had elevated P300 amplitudes (P=0.0004) and higher digit symbol scores (P<0.0001) compared with all the other groups. Individuals with comorbid anxiety had the greatest proportion of COMT Met158 and BDNF Met66 alleles (P=0.009) as well as higher harm avoidance-neuroticism (P<0.0005) than all other groups. Our results suggest that there may be two vulnerability factors for anxiety disorders with differing genetic susceptibility: (a) heightened attention and better working memory with mildly elevated anxiety-neuroticism, a constellation that may be protective against other psychopathology; and (b) poorer attention and working memory with greater anxiety-neuroticism, a constellation that may also increase vulnerability to AUD and MD. This refinement of the anxiety phenotype may have implications for therapeutic interventions. Depression and Anxiety 0:1,10, 2007. Published 2007 Wiley-Liss, Inc. [source]

Genetic aspects of pathological gambling: a complex disorder with shared genetic vulnerabilities

ADDICTION, Issue 9 2009
Daniela S. S. Lobo
ABSTRACT Aims To summarize and discuss findings from genetic studies conducted on pathological gambling (PG). Methods Searches were conducted on PubMed and PsychInfo databases using the keywords: ,gambling and genes', ,gambling and family' and ,gambling and genetics', yielding 18 original research articles investigating the genetics of PG. Results Twin studies using the Vietnam Era Twin Registry have found that: (i) the heritability of PG is estimated to be 50,60%; (ii) PG and subclinical PG are a continuum of the same disorder; (iii) PG shares genetic vulnerability factors with antisocial behaviours, alcohol dependence and major depressive disorder; (iv) genetic factors underlie the association between exposure to traumatic life-events and PG. Molecular genetic investigations on PG are at an early stage and published studies have reported associations with genes involved in the brain's reward and impulse control systems. Conclusions Despite the paucity of studies in this area, published studies have provided considerable evidence of the influence of genetic factors on PG and its complex interaction with other psychiatric disorders and environmental factors. The next step would be to investigate the association and interaction of these variables in larger molecular genetic studies with subphenotypes that underlie PG. Results from family and genetic investigations corroborate further the importance of understanding the biological underpinnings of PG in the development of more specific treatment and prevention strategies. [source]

Older patients and delayed discharge from hospital

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2000
Christina R. Victor BA M Phil PhD Hon MFPHM
Abstract Older people (those aged 65 years and over) are the major users of health care services, especially acute hospital beds. Since the creation of the NHS there has been concern that older people inappropriately occupy acute hospital beds when their needs would be best served by other forms of care. Many factors have been associated with delayed discharge (age, sex, multiple pathology, dependency and administrative inefficiencies). However, many of these factors are interrelated (or confounded) and few studies have taken this into account. Using data from a large study of assessment of older patients upon discharge from hospital in England, this paper examines the extent of delayed discharge, and analyses the factors associated with such delays using a conceptual model of individual and organisational factors. Specifically, this paper evaluates the relative contribution of the following factors to the delayed discharge of older people from hospital: predisposing factors (such as age), enabling factors (availability of a family carer), vulnerability factors (dependency and multiple pathology), and organisational/administrative factors (referral for services, type of team undertaking assessments). The study was a retrospective patient case note review in three hospitals in England and included four hundred and fifty-six patients aged 75 years and over admitted from their own homes, and discharged from specialist elderly care wards. Of the 456 patients in the sample, 27% had a recorded delay in their discharge from hospital of three plus days. Multivariate statistical analysis revealed that three factors independently predicted delay in discharge: absence of a family carer, entry to a nursing/residential home, and discharge assessment team staffing. Delayed discharge was not related to the hypothesised vulnerability factors (multiple dependency and multiple pathology) nor to predisposing factors (such as age or whether the older person lived alone). The delayed discharge of older people from hospital is a topic of considerable policy relevance. Our study indicated that delay was independently related to two organisational issues. First, entry into long-term care entailed lengthy assessment procedures, uncertainty over who pays for this care, and waiting lists. Second, the nature of the team assessing people for discharge was associated with delay (the nurse-coordinated team made the fewest referrals for multidisciplinary assessments and had the longest delays). Additionally, the absence of a family carer was implicated in delay, which underlines the importance of family and friends in providing posthospital care and in maintaining older people in the community. Our study suggests that considerable delay in discharging older people from hospital originates from administrative/organisational issues; these were compounded by social services resource constraints. There is still much to be done therefore to improve coordination of care in order to provide a truly ,seamless service'. [source]

The Effects of Health Sector Market Factors and Vulnerable Group Membership on Access to Alcohol, Drug, and Mental Health Care

HEALTH SERVICES RESEARCH, Issue 3p1 2007
Susan E. Stockdale
Objective. This study adapts Andersen's Behavioral Model to determine if health sector market conditions affect vulnerable subgroups' use of alcohol, drug, and mental health services (ADM) differently than the general population, focusing specifically on community-level predisposing and enabling characteristics. Data Sources. Wave 2 data (2000,2001) from the Health Care for Communities study, supplemented with cases from wave 1 (1997,1998), were merged with area characteristics taken from Census, Area Resource File (ARF), and other data sources. Study Design. The study used four-level hierarchical logistic regression to examine access to ADM care from any provider and specialty ADM access. Interactions between community-level predisposing and enabling vulnerability characteristics with individual race/ethnicity, age, income category, and insurance type were explored. Principal Findings. Nonwhites, the poor, uninsured, and elderly had lower likelihoods of service use, but interactions between race/ethnicity, income, age and insurance status with community-level vulnerability factors were not statistically significant for any service use. For ADM specialty care, those with Medicare, Medicaid, private fully managed, and private partially managed insurance, the likelihood of utilization was higher in areas with higher HMO penetration. However, for those with other insurance or no insurance plan, the likelihood of utilization was lower in areas with higher HMO penetration. Conclusions. Community-level enabling factors explain part of the effect of disadvantaged status but, with the exception of the effect of HMO penetration on the relationship between insurance and specialty care use, do not modify any of the residual individual-level effects of disadvantage. Interventions targeting both structural and individual levels may be necessary to address the problem of health disparities. More research with longitudinal data is necessary to sort out the causal direction of social context and ADM access outcomes, and whether policy interventions to change health sector market conditions can shift ADM treatment utilization. [source]

Development of a computerized assessment for visual masking

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 2 2002
Michael Foster Green
Abstract Visual masking provides a highly informative means of assessing the earliest stages of visual processing. This procedure is frequently used in psychopathology research, most commonly in the study of schizophrenia. Deficits in visual masking tasks appear to reflect vulnerability factors in schizophrenia, as opposed to the symptoms of the illness. Visual masking procedures are typically conducted on a tachistoscope, which limits standardization across sites, as well as the number of variables that can be examined in a testing session. Although visual masking can be administered on a computer, most methods used so far have had poor temporal resolution and yielded a limited range of variables. We describe the development of a computerized visual masking battery. This battery includes a staircase procedure to establish an individual's threshold for target detection, and a relatively dense sampling of masking intervals. It includes both forward and backward masking trials for three different masking conditions that have been used previously in experimental psychopathology (target location, target identification with high-energy mask, and target identification with low-energy mask). Copyright © 2002 Whurr Publishers Ltd. [source]

Aggression towards health care staff in a UK general hospital: variation among professions and departments

JOURNAL OF CLINICAL NURSING, Issue 1 2004
Sue Winstanley BSc
Background., Aggression towards health care staff is an increasing problem and although many studies have examined psychiatric settings, few have considered general hospitals and in particular, variation among professions and locations. In addition, studies often fail to include all forms of aggression such as threatening behaviour and verbal aggression. Methods., This study extends existing research by evaluating physical assault, threatening behaviour and verbal aggression from patients/visitors towards general hospital staff in the context of different professions and departments. Results and conclusions., The survey of staff showed that aggression is widespread. Within the preceding year, 27% of the respondents were assaulted, 23% experienced threatening behaviour from patients and 15.5% experienced threatening behaviour from visitors. Over 68% reported verbal aggression, 25.7% experiencing it more regularly than monthly. By departments, over 42% of the medical department staff, 36% of the surgical staff and over 30% of the Accident and Emergency staff were assaulted. By profession, staff nurses and enrolled nurses reported the most assaults (43.4%) and doctors, the fewest (13.8%). Other nursing grades and health care professions all reported levels of physical assault in excess of 20%. Correspondingly high levels of threatening behaviour and verbal aggression were also reported although the patterns of victimization differed according to the various professions and departments. Independently, significant levels of assault, threatening behaviour and verbal aggression were reported. When aggregated they demonstrate the higher levels of victimization that general hospital staff experienced on a regular basis. Relevance to clinical practice., Institutional averages actually obscure the much higher levels of aggression experienced by the particular professions in particular departments. This study helps to localize the problem and identify those at most risk, but more research is needed into the aetiology of the aggression and of vulnerability factors associated with victimization. [source]

Age at onset in bipolar affective disorders: a review

BIPOLAR DISORDERS, Issue 2 2005
Marion Leboyer
Bipolar affective disorder (BPAD) is a multifactorial disorder with various clinical presentations. Etiologic heterogeneity may partly underlie the phenotypic heterogeneity. Efforts to dissect BPAD have been based on the course of the disorders (BP I versus BP II or rapid cycling), cormorbidity pattern (panic attacks, suicide attempts, addiction or hyperactivity), differences between the sexes, and clinical pattern (cycloid and puerperal psychosis). The present article provides a comprehensive review of the existing data, showing that age at onset (AAO) identifies homogeneous sub-groups of patients with BPAD. Recent work has demonstrated the existence of three , early, intermediate and late , onset bipolar sub-groups based on AAO, following Kendell's criteria for validity (The American Journal of Psychiatry 2003; 160: 999). We will also show how these distinctions may be of use in the search for genetic vulnerability factors and other pathogenic influences. Following Kendell's criteria, we show that AAO of bipolar disorders has been tested with most of the available strategies for establishing the validity of clinical syndromes. We also present data from genetic epidemiologic studies in bipolar disorder, showing that AAO sub-groups may reduce the underlying genetic heterogeneity. No accurate AAO thresholds to define valid sub-groups have been identified precisely. Until recently, studies defined early- and late-onset as corresponding to early or mid-adulthood, not taking into account juvenile-onset bipolar disorder. A recently proposed theoretical model with three AAO sub-groups (onset age 17, 27 and 46) is discussed. [source]

Disabled children, parent,child interaction and attachment

CHILD & FAMILY SOCIAL WORK, Issue 2 2006
David Howe
ABSTRACT Although caregiver factors are generally considered the more potent in determining children's attachment organization, a number of child factors have also been considered. Among these have been temperament and disabilities. The present paper examines the effect of various types of children's disability on parent,child interactions, including how disabilities affect parental sensitivity and communications. A brief outline of attachment theory and patterns of organization is followed by a review of the research evidence that has looked at children with disabilities and insecure attachments. A complex picture emerges in which it is not a child's disability per se that is associated with insecure attachments but rather an interaction between children with disabilities and the caregiver's state of mind with respect to attachment. Transactions between both child and caregiver vulnerability factors affect sensitivity, communications and security of attachment. Practice implications for prevention, advice and support are considered. [source]

Commercial and sexual exploitation of children and young people in the UK,a review

CHILD ABUSE REVIEW, Issue 1 2005
Elaine Chase
Abstract This paper reviews recent information and data relevant to the commercial sexual exploitation of children and young people in the UK. Three main aspects of exploitation are addressed: abuse through prostitution; abuse through pornography; and the trafficking of children and young people to and through the UK for the purposes of commercial sexual exploitation. Most published research in this area relates to young people exploited through prostitution. The review explores the range of vulnerability factors, the processes used to engage young people in prostitution and the types of support strategies for those being exploited. Rather less information is currently available on the scale of child pornography, or the links between the use of pornography and other forms of sexual abuse. The internet as a modern technology for proliferating child pornography is discussed, alongside its role in providing opportunities for paedophiles to access and ,groom' children for sexual purposes. Finally, the review provides a summary of research on trafficking of children to and through the UK for the purposes of commercial sexual exploitation and demonstrates the limited knowledge about this topic. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Self-esteem in children and adolescents with mobility impairment: impact on well-being and coping strategies

ACTA PAEDIATRICA, Issue 3 2009
L Jemtå
Abstract Aim: The first aim was to investigate dimension-specific and global self-esteem in children and adolescents with mobility impairment and to analyse the relation between self-esteem and demographic data and disability characteristics. The second aim was to identify the impact of five self-esteem dimensions on well-being and coping strategies. Methods: A total of 138 children and adolescents aged 7,18 years with mobility impairment took part in a semi-structured interview. Demographic and disability characteristics were recorded and motor function was assessed. Self-esteem was measured by the ,I think I am' inventory. Perceived overall well-being was measured by a nine-grade visual scale, the Snoopy scale, and coping strategies by the Children's Coping Strategies Checklist. Results: Although a majority estimated a relatively high level of dimension-specific and global self-esteem, several demographic and disability factors for lower self-esteem were identified. Those who estimated their ,physical characteristics' lower used the coping strategy ,distraction' more often. Three out of five dimensions of self-esteem were positively associated with perceived overall well-being: ,physical characteristics', ,psychological well-being' and ,relationships with others'. Conclusion: Awareness of vulnerability factors for lower self-esteem in children and adolescents with mobility impairment offer health care professionals specific opportunities to enhance self-esteem in this group. [source]