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Psychological Problems (psychological + problem)
Selected AbstractsPathways to help-seeking in bulimia nervosa and binge eating problems: A concept mapping approachINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 6 2007Natasha Hepworth PhD Abstract Objective: To conduct an in-depth study, using concept mapping, of three factors related to help-seeking for bulimia nervosa and binge eating: problem recognition, barriers to help-seeking, and prompts to help-seeking. Method: Semistructured interviews were conducted to elicit information about help-seeking with 63 women (18,62 years) with past or present bulimic behaviors. Results: Using Leximancer software, factors identified as associated with problem recognition were Changes in Behavior, Interference with Life Roles, Comments about Changes and Psychological Problems. Salient barriers to help-seeking were Fear of Stigma, Low Mental Health Literacy/Perception of Need, Shame, Fear of Change and Cost. Prompts to help-seeking were increased Symptom Severity, Psychological Distress, Interference with Life Roles, Health Problems, and Desire to Get Better. Conclusion: Results highlighted the need for awareness campaigns to reduce both self and perceived stigma by others towards bulimic behaviors, and the need to enhance awareness of available interventions for people ready to engage in treatment, to increase help-seeking. © 2007 by Wiley Periodicals, Inc. [source] The Stigma of Psychological Problems in a Work Environment: Evidence From the Screening of Service Members Returning From Bosnia,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 8 2000Thomas W. Britt The present research examined the stigma associated with psychological problems among service members returning from the United States peacekeeping mission to Bosnia. The results show that admitting a psychological problem in the military is perceived as muchmore stigmatizing than admitting a medical problem. Service members had more concerns about stigmatization and felt more uncomfortable discussing psychological problems than medical problems, and these feelings were magnified when service members were being screened with their units rather than alone. Service members also reported a lesser likelihood of following through with a psychological referral than with a medical referral. However, participants who discussed psychological issues with a therapist felt the screening was more beneficial than those who did not discuss their responses. The results address the neglected topic of the stigma associated with psychological problems in the workplace. [source] Psychological problems of partnership and profit or: who has the higher population impact?ADDICTION, Issue 9 2000Ulrich John First page of article [source] Significant psychological morbidity occurs in irritable bowel syndrome: a case-control study using a pharmacy reimbursement databaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2009J. B. CANAVAN Summary Background, Psychological problems are associated with IBS but the strength of this association is unclear. Aim, To assess co-prescribing of antispasmodic and CNS-acting drugs through a nested case-control study. Methods, A national dispensing database identified patients who were first dispensed antispasmodic medicines for a continuous 3-month period or more during 2006, using 2005 as a run-in period. Each patient was matched with four control patients and excluded if they received drugs indicated for IBD. Results, Four hundred and seven patients commenced antispasmodic drugs during 2006. These patients were matched with 1628 controls. In 2005, patients subsequently prescribed antispasmodics were 2,3 times more likely to receive CNS-acting drugs than controls. In the year following commencement of IBS therapy, patients were 2,4 times more likely than controls to be prescribed CNS-acting drugs including antidepressants (35.4% vs. 9.3%), anxiolytics (27.8% vs. 8.8%), antipsychotics (9.8% vs. 3.3%) and hypno-sedatives (32.7% vs. 11.3%; P < 0.0001). The adjusted OR (95% CI) for antidepressant, anxiolytic, hypnosedative and antipsychotic prescribing in IBS patients were 3.81 (2.79,5.20), 2.84 (2.12,3.81), 2.62 (1.91,3.60) and 2.58 (1.80,3.66), respectively. Conclusions, Patients prescribed ongoing therapy for presumed IBS are 2,4 times more likely to be prescribed CNS-acting drugs than controls, providing evidence of psychological comorbidity in IBS. [source] Test,re-test reliability of DSM-IV adopted criteria for 3,4-methylenedioxymethamphetamine (MDMA) abuse and dependence: a cross-national studyADDICTION, Issue 10 2009Linda B. Cottler ABSTRACT Aims This study evaluated the prevalence and reliability of DSM-IV adopted criteria for 3,4-methylenedioxymethamphetamine (MDMA) abuse and dependence with a purpose to determine whether it is best conceptualized within the category of hallucinogens, amphetamines or its own category. Design Test,re-test study. Participants MDMA users (life-time use >5 times) were recruited in St Louis, Miami and Sydney (n = 593). The median life-time MDMA consumption was 50 pills at the baseline. Measurements The computerized Substance Abuse Module for Club Drug (CD-SAM) was used to assess MDMA abuse and dependence. The Discrepancy Interview Protocol (DIP) was used to determine the reasons for the discrepant responses between the two interviews. Reliability of diagnoses, individual diagnostic criteria and withdrawal symptoms was examined using the kappa coefficient (,). Findings For baseline data, 15% and 59% met MDMA abuse and dependence, respectively. Substantial test,re-test reliability of the diagnoses was observed consistently across cities (, = 0.69). ,Continued use despite knowledge of physical/psychological problems' (87%) and ,withdrawal' (68%) were the two most prevalent dependence criteria. ,Physically hazardous use' was the most prevalent abuse criterion. Six dependence criteria and all abuse criteria were reported reliably across cities (,: 0.53,0.77). Seventeen of 19 withdrawal symptoms showed consistency in the reliability across cities. The most commonly reported reason for discrepant responses was ,interpretation of question changed'. Only a small proportion of the total discrepancies were attributed to lying or social desirability. Conclusion The adopted DSM-IV diagnostic classification for MDMA abuse and dependence was moderately reliable across cities. Findings on MDMA withdrawal support the argument that MDMA should be separated from other hallucinogens in DSM. [source] The Stigma of Psychological Problems in a Work Environment: Evidence From the Screening of Service Members Returning From Bosnia,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 8 2000Thomas W. Britt The present research examined the stigma associated with psychological problems among service members returning from the United States peacekeeping mission to Bosnia. The results show that admitting a psychological problem in the military is perceived as muchmore stigmatizing than admitting a medical problem. Service members had more concerns about stigmatization and felt more uncomfortable discussing psychological problems than medical problems, and these feelings were magnified when service members were being screened with their units rather than alone. Service members also reported a lesser likelihood of following through with a psychological referral than with a medical referral. However, participants who discussed psychological issues with a therapist felt the screening was more beneficial than those who did not discuss their responses. The results address the neglected topic of the stigma associated with psychological problems in the workplace. [source] Neurological presentations of conversion disorders in a group of Singapore childrenPEDIATRICS INTERNATIONAL, Issue 4 2008Wan-yee Teo Abstract Background: Neurological presentations of conversion disorders in children are not uncommon. Conversion disorders mimicking neurological conditions constitute a group of underdiagnosed conditions. Methods: This was a retrospective study of 13 children with neurological presentations of conversion disorders who were admitted to hospital. Patients were followed for 1,4 years. Results: Paralysis was the most common neurological symptom, patients presented with multiple, complex conversion symptoms and other neurological symptoms such as seizures and headache. The affected children underwent complete physical, neurological examination and psychological evaluation. Investigations included blood tests, cranial imaging and electroencephalography. Most common external environmental factors detected were school stress and change in family situation. Five of 13 patients had family members who were reported to have medical conditions with presentations similar to patients' neurological and psychological problem. All the patients were admitted, five patients required multiple admissions. Ten patients eventually had good outcome in terms of academic grades and social functioning. Conclusion: Diagnosis of conversion disorders mimicking neurological conditions can be challenging. There is a need to heighten awareness of this entity for early recognition and diagnosis. Awareness of this entity coupled with a high index of suspicion can facilitate accurate and earlier diagnosis. [source] Practitioner Review: Psychological Management of Anxiety Disorders in ChildhoodTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 8 2001Mark R. Dadds Many anxiety problems begin in childhood and are a common form of psychological problem that can be highly distressing and associated with a range of social impairments. Thus, skills for conceptualising, assessing, and treating childhood anxiety problems should be in the repertoire of all child mental health specialists. This paper reviews psychosocial treatments for the most common anxiety disorders in children and adolescents. Developmental models of anxiety disorders emphasise maximum risk in children with shy or inhibited temperaments who are exposed to high family anxiety and avoidance, and/or acutely distressing experiences. As children mature these temperamental and environmental experiences are internalised to low self-competence and high threat expectancy. Both individual or group-based interventions utilising cognitive-behavioural strategies to address multiple risk factors are highly efficacious and family involvement can contribute to positive outcomes. Guidelines for assessment and treatment are presented, and suggestions are made for effectively managing clinical process. [source] Joint liaison psychiatry,diabetes clinic: a new specialist serviceDIABETIC MEDICINE, Issue 6 2000C. Mitchell Summary Aims Specialist diabetes clinics have an established role in prevention and management of complications. As psychological problems are usually treated separately from diabetes centres, the role of a specialist psychiatrist within a teaching hospital was assessed. The aims of the study were to describe referral patterns, specific psychiatric conditions and treatments offered. Results During weekly outpatient sessions over a 12-month period, 31 patients were referred with a wide range of psychiatric diagnoses. One-third of patients were seen on the day and two-thirds within 2 weeks of referral. Treatments included anti-depressant medication, counselling and cognitive behaviour therapy. Successful discharge was obtained in 10 subjects and eight were undergoing continued treatment. Conclusions The range of specific diagnoses requiring psychiatric supervision supported the role of specifically trained personnel as seen in a joint liaison psychiatry,diabetes service. Keywords diabetes mellitus, joint clinic, liaison psychiatry [source] Injecting and non-injecting cocaine use in Sydney, Australia: physical and psychological morbidityDRUG AND ALCOHOL REVIEW, Issue 4 2004SHARLENE KAYE Abstract This study aimed to examine the physical and psychological harms of cocaine use and investigate the role of injecting versus non-injecting routes of administration in the severity of such harms. Two hundred and twelve cocaine users from inner-city and southwestern Sydney were administered a structured interview containing sections on demographics, drug treatment history, drug use history, cocaine use patterns, cocaine dependence and physical and psychological problems associated with cocaine use. Serious physical and psychological symptoms were prevalent among both injecting and non-injecting cocaine users. The prevalence and extent of symptoms was greater among injecting cocaine users, however route of administration did not prove to be a significant independent predictor of harm when other factors, such as frequency of use and level of dependence, were taken into account. While the level of physical and psychological harm was greater among cocaine injectors, it would appear that factors engendered by injecting, such as more frequent use and higher levels of dependence, result in higher levels of harm, rather than the route of administration per se. Physical and psychological problems were also reported among infrequent users, suggesting that cocaine can cause harm irrespective of frequency or method of use. Harm reduction initiatives should be targeted towards all cocaine users, not just those who seek treatment for dependence or present with acute medical complications. [source] Young people at risk of psychosis: a user-led exploration of interpersonal relationships and communication of psychological difficultiesEARLY INTERVENTION IN PSYCHIATRY, Issue 2 2010Rory Byrne Abstract Aim: The aim of the present study was to qualitatively explore experiences and perceptions of interpersonal relationships and interpersonal communication among young people at risk of psychosis. Method: Semi-structured interviews were conducted using a qualitative grounded theory approach. Participants had entered into a service providing psychological interventions for young people assessed to be at a high risk of developing psychosis (Northwest UK). Our sample comprised one female and seven male participants (n = 8), ranging in age from 16 to 28 years, with a mean age of 22.4 years. Results: Analyses identified three central themes: difficulty with interpersonal relationships and reduced opportunities for helpful communication, difficulty talking to others about psychological problems, and experiences of talking to others about psychological problems. Conclusions: Individuals at risk of psychosis may have experienced significant difficulties with interpersonal relationships. Such difficulties may contribute directly to the development of unusual psychological experiences, and to an inability or reluctance to communicate these to others. In addition, commonly held stigmatizing ideas associated with unusual psychological experiences may contribute to a fear among at-risk individuals that they are ,going mad', and this may lead to concealment of their difficulties, and to delayed help-seeking. For at-risk individuals, helpful communication of psychological distress offers significant benefits, including improved psychological and emotional well-being and reduced risk of psychosis. Thus, while concealment of distress may directly impact on the development of unusual psychological difficulties, communication of such difficulties may be central to recovery. [source] Genetic and environmental influences on cannabis use initiation and problematic use: a meta-analysis of twin studiesADDICTION, Issue 3 2010Karin J. H. Verweij ABSTRACT Background Because cannabis use is associated with social, physical and psychological problems, it is important to know what causes some individuals to initiate cannabis use and a subset of those to become problematic users. Previous twin studies found evidence for both genetic and environmental influences on vulnerability, but due to considerable variation in the results it is difficult to draw clear conclusions regarding the relative magnitude of these influences. Methods A systematic literature search identified 28 twin studies on cannabis use initiation and 24 studies on problematic cannabis use. The proportion of total variance accounted for by genes (A), shared environment (C) and unshared environment (E) in (i) initiation of cannabis use and (ii) problematic cannabis use was calculated by averaging corresponding A, C and E estimates across studies from independent cohorts and weighting by sample size. Results For cannabis use initiation, A, C and E estimates were 48%, 25% and 27% in males and 40%, 39% and 21% in females. For problematic cannabis use A, C and E estimates were 51%, 20% and 29% for males and 59%, 15% and 26% for females. Confidence intervals of these estimates are considerably narrower than those in the source studies. Conclusions Our results indicate that vulnerability to both cannabis use initiation and problematic use was influenced significantly by A, C and E. There was a trend for a greater C and lesser A component for cannabis use initiation compared to problematic use for females. [source] Phenotypic Comparison of Two Scottish Families with Mutations in Different Genes Causing Autosomal Dominant Nocturnal Frontal Lobe EpilepsyEPILEPSIA, Issue 4 2003Ailsa McLellan Summary: ,Purpose: Mutations in genes coding for the ,4 and ,2 subunits of the neuronal nicotinic acetylcholine receptor receptor (CHRN) are known to cause autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE). Here we examined the phenotypes in two families, from the same ethnic and geographic backgrounds, with ADNFLE as a result of mutations in these two different subunits of CHRN. Methods: All affected family members underwent a detailed clinical evaluation and review of available EEG, neuroimaging, and videotapes of seizures. The molecular study of family D is reported here; family S has a previously reported mutation in the ,2 subunit of CHRN. Results: A total of 16 individuals with ADNFLE were identified in the two families. In both families, seizure semiology, age at seizure onset, and the natural history of the seizure disorder was similar. Intrafamilial variation in terms of severity of epilepsy syndrome was present in both families. A significant number of individuals from each family had a history of psychological problems. The molecular study of family D revealed a Ser248Phe mutation in the ,4 subunit of CHRN. Conclusions: The epilepsy phenotype is not distinguishable in the two families who have ADNFLE as a result of mutations in genes coding for different CHRN subunits. This is likely to be due to the similar functional consequences of each mutation on the CHRN receptor. [source] Living with anorexia nervosa: the experience of a cohort of sufferers from anorexia nervosa 7.5 years after initial presentation to a specialized eating disorders serviceEUROPEAN EATING DISORDERS REVIEW, Issue 2 2001Eric J. Button Abstract Objective The main aim of the present study was to further understand how sufferers from anorexia nervosa view the disorder, how it affects their lives and how they experience treatment and help. Method A cohort of anorectic patients were followed up 7.5 years after presentation at a specialist locally-based eating disorders service for adults. All subjects were invited to take part in a semi-structured interview and complete a series of questionnaires. Results Thirty-six subjects were interviewed and the group as a whole showed marked improvement compared with initial presentation, but only 14 per cent were judged to be free of the disorder and about one-quarter remained entrenched in the world of anorexia nervosa. The main results focus on common themes which emerged from the interview and extensive quotes from subjects are used for illustrative purposes. Although each person expressed a very individual experience of the disorder, a common theme was of it emerging as a response to a sense of loss of control in one or more areas of their lives, often centering on their self-image and problems in relationships with others. Although the disorder was commonly experienced as having a devastating effect on their lives, the focus on weight and eating at least offered them some semblance of control. A wide range of experiences of treatment were reported, but there was considerable consensus regarding the importance of individual psychotherapy/counselling and of the quality of relationship with a therapist. Discussion This study confirms the often long-term psychological problems experienced by sufferers from anorexia nervosa and helps to illuminate the client's perspective on the disorder and other people's attempts to help. The individual views of the sufferer are an important consideration for those involved in the planning and delivery of services for these vulnerable people. Copyright © 2001 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Results of a multi-componential psychosocial intervention programme for women with early-stage breast cancer in Spain: quality of life and mental adjustmentEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2009D. MANOS phd, psychologist-psychotherapist The effectiveness of a structured psychosocial intervention for women with breast cancer was studied in relation to a control group. The study was conducted in a hospital setting in Spain, and the aim of the intervention programme was to foster a higher quality of life and a more positive mental adjustment to the cancer. Three measures were used: baseline, post-treatment and 6-month follow-up for both groups. The dependent variables examined were quality of life and mental adjustment. The independent variable was the psychosocial intervention programme. Subjects were 188 women who had been operated for breast cancer and who satisfied a series of medical criteria, had no history of psychological problems and were between 25 and 65 years old. The results have shown that the psychosocial intervention programme was highly effective in improving the patients' quality of life, as compared with baseline measures, as well as compared with the control group. Additionally, the intervention increased the patients' fighting spirit and hopefulness/optimism, and reduced their anxious preoccupation as coping styles. These changes persevered at the 6-month follow-up. [source] A consultation leaflet to improve an older patient's involvement in general practice care: a randomized trialHEALTH EXPECTATIONS, Issue 4 2005Raymond Wetzels MD Abstract Objective, To evaluate the effects of a programme to enhance the involvement of older patients in their consultations in general practice. Design, Cluster randomized trial, in which data was collected from different cohorts. Setting and participants, Twenty-five general practices in the south-east part of the Netherlands and their patients aged 70 years and over. Intervention, Patients in the intervention group received a leaflet to help them prepare for the consultation. General practitioners (GPs) received an outreach visit to optimize older patients' involvement when visiting their GP. Patients in the control group received usual care. Main outcome measures, Questionnaires measuring involvement (COMRADE), enablement (Patient Enablement Index) and satisfaction with their care (EUROPEP). Results, Pre-intervention 315 patients and post-intervention 263 patients were included. Subjects were satisfied with their involvement and the GP's behaviour during the consultation. No differences in effect as a result of the leaflet on involvement, enablement or satisfaction were found between the intervention and the control group. Of 318 patients who received the leaflet and visited their GP in the intervention period, 47 patients used the leaflet. These users were more accustomed to prepare themselves for consultations. Users reported more psychological problems than non-users. Conclusions, No relevant effects of the implementation programme on involvement, enablement or satisfaction were found. Other strategies are needed to enhance involvement of older patients in their care. Alternatively, older patients may perceive themselves sufficiently involved. [source] Psychogastroenterology: a call for psychological input in Australian gastroenterology clinicsINTERNAL MEDICINE JOURNAL, Issue 2 2009A. Mikocka-Walus Abstract Gastroenterologists should be able to refer patients directly to psychologists with full Medicare reimbursement. Psychological comorbidities are frequently seen in patients with gastrointestinal conditions. However, time pressure and lack of expertise in non-medical therapies of psychological problems prevent gastroenterologists from initiating psychological treatment although such treatment may improve patients' outcomes and reduce health-care utilization. Psychologists are needed as part of the multidisciplinary team in gastroenterology clinics in Australia to take the leading role in the psychological management of those patients by contributing to screening, faster diagnosis and treatment of depression and anxiety disorders in particular. [source] Developmental pathways of eating problems in adolescentsINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 8 2008Annie Aimé PhD Abstract Objective: To examine the developmental eating trajectories of adolescents and identify psychological correlates and risk factors associated with those trajectories. Method: Seven hundred thirty-nine adolescents completed self-reported measures of eating problems, internalizing and externalizing behaviors, alcohol and drug use, peer victimization, and depression. Results: Five eating trajectories were obtained. The proportions of males and females were the same in the increasing eating problems trajectory. For both genders, internalizing and externalizing problems were identified as associated risk factors of an eating pathology and reporting at least some eating problems was associated with an increased likelihood of psychological problems. Other risk factors found only in boys were frequency of drug use, victimization, and depressive symptoms. Conclusion: Externalizing problems in girls and internalizing behaviors in boys with disordered eating should not be overlooked. Atypical eating behaviors in boys are of particular concern since it increases their risk of cooccurring psychopathology. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [source] The needs of older people with dementia in residential careINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2006Geraldine A. Hancock Abstract Background People with dementia often move into care homes as their needs become too complex or expensive for them to remain in their own homes. Little is known about how well their needs are met within care homes. Method The aim of this study was to identify the unmet needs of people with dementia in care and the characteristics associated with high levels of needs. Two hundred and thirty-eight people with dementia were recruited from residential care homes nationally. Needs were identified using the Camberwell Assessment of Needs for the Elderly (CANE). Results Residents with dementia had a mean of 4.4 (SD 2.6) unmet and 12.1 (SD 2.6) met needs. Environmental and physical health needs were usually met. However, sensory or physical disability (including mobility problems and incontinence) needs, mental health needs, and social needs, such as company and daytime activities, were often unmet. Unmet needs were associated with psychological problems, such as anxiety and depression, but not with severity of dementia or level of dependency. Conclusion Mental health services and residential home staff need to be aware that many needs remain unmet and much can be done to improve the quality of life of the residents with dementia. Copyright © 2005 John Wiley & Sons, Ltd. [source] Treatment of adult female epispadias without exstrophy in the presence of rhabdosphincter functionINTERNATIONAL JOURNAL OF UROLOGY, Issue 3 2006ALEXANDRE E. PELZER Abstract, Female epispadias without exstrophy is a very rare entity. Symptoms of female epispadias are primary urinary incontinence and anatomical abnormal features. A 24-year-old married women with two children presented with primary urinary incontinence. Due to previous failure of correct diagnosis and ineffective medical treatment, the patient developed psychological problems (anxiety and depression). In the presence of minimal rhabdosphincter function we could achieve socially acceptable urinary continence by bladder neck plication and a Burch colposuspension. The patient did not consent to a major reconstruction. [source] Life experiences after stroke among Iranian stroke survivorsINTERNATIONAL NURSING REVIEW, Issue 2 2010A. Dalvandi phd DALVANDI A., HEIKKILÄ K., MADDAH S.S.B., KHANKEH H.R. & EKMAN S.L. (2010) Life experiences after stroke among Iranian stroke survivors. International Nursing Review57, 247,253 Background:, Stroke is a major cause of disability worldwide. It is a life-threatening and life-altering event, which leaves many physical and mental disabilities, thus creating major social and economic burdens. Experiencing a stroke and its aftermath can be devastating for patients and their families. In Iran, many services are not available for those who lack property; this may result in many difficulties and long-term problems for stroke survivors and their family members who are usually the main caregivers in Iranian cultural. Despite its effect on their lives, little is known about how the survivors perceive stroke in the Iranian context, therefore, knowing more about this process may enhance problem identification and problem solving. Aim:, To illuminate how stroke survivors experience and perceive life after stroke. Method:, A grounded theory approach was recruited using semi-structured interviews with 10 stroke survivors. Findings:, The survivors perceived that inadequate social and financial support, lack of an educational plan, lack of access to rehabilitative services, physical and psychological problems led them to functional disturbances, poor socio-economical situation and life disintegration. The core concept of life after stroke was functional disturbances. Conclusions:, The study shows the need to support the stroke survivors in their coping process with their new situation by providing appropriate discharge plans, social and financial support, social insurances and training programmes for the stroke survivors and their families. [source] Emotional outcome after intensive care: literature reviewJOURNAL OF ADVANCED NURSING, Issue 1 2008Janice E. Rattray Abstract Title., Emotional outcome after intensive care: literature review. Aim., This paper is a report of a literature review to identify (a) the prevalence of emotional and psychological problems after intensive care, (b) associated factors and (c) interventions that might improve this aspect of recovery. Background., Being a patient in intensive care has been linked to both short- and long-term emotional and psychological consequences. Data sources., The literature search was conducted during 2006. Relevant journals and databases were searched, i.e. Medline and CINAHL, between the years 1995 and 2006. Review methods., The search terms were ,anxiety', ,depression', posttraumatic stress', ,posttraumatic stress disorder' and ,intensive care'. Results., Fifteen papers were reviewed representing research studies of anxiety, depression and posttraumatic stress, and seven that represented intensive care follow-up clinics and patient diaries. Being in intensive care can result in significant emotional and psychological problems for a number of patients. For the majority of patients, symptoms of distress will decrease over time but for a number these will endure for some years. Current evidence indicates that emotional problems after intensive care are related to both subjective and objective indicators of a patient's intensive care experience. Evidence suggests some benefit in an early rehabilitation programme, daily sedation withdrawal and the use of patient diaries. However, additional research is required to support such findings. Conclusion., Our understanding of the consequences of intensive care is improving. Psychological care for intensive care patients has lagged behind care for physical problems. We now need to focus on developing and evaluating appropriate interventions to improve psychological outcome in this patient group. [source] Bathing Disability in Community-Living Older Persons: Common, Consequential, and ComplexJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2004Aanand D. Naik MD Objectives: To identify the specific bathing subtasks that are affected in community-living-older persons with bathing disability and to determine the self-reported reasons for bathing disability. Design: Cross-sectional study. Setting: General community of greater New Haven, Connecticut. Participants: A total of 626 community-living persons, aged 73 and older, who completed a comprehensive assessment, including a detailed evaluation of bathing disability. Measurements: Trained research nurses assessed bathing disability (defined as requiring personal assistance or having difficulty washing and drying the whole body), the specific bathing subtasks that were affected, and the main reasons (up to three) for bathing disability. Results: Disability in bathing was present in 195 (31%) participants; of these, 97 required personal assistance (i.e., dependence), and 98 had difficulty bathing. Participants with bathing disability reported a mean±standard deviation of 4.0±2.4 affected subtasks. The prevalence rate of disability for the eight prespecified bathing subtasks ranged from 25% for taking off clothes to 75% for leaving the bathing position. The majority of participants (59%) provided more than one reason for bathing disability. The most common reasons cited by participants for their bathing disability were balance problems (28%), arthritic complaints (26%), and fall or fear of falling (23%). Conclusion: For community-living older persons, disability in bathing is common, involves multiple subtasks, and is attributable to an array of physical and psychological problems. Preventive and restorative interventions for bathing disability will need to account for the inherent complexity of this essential activity of daily living. [source] The Stigma of Psychological Problems in a Work Environment: Evidence From the Screening of Service Members Returning From Bosnia,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 8 2000Thomas W. Britt The present research examined the stigma associated with psychological problems among service members returning from the United States peacekeeping mission to Bosnia. The results show that admitting a psychological problem in the military is perceived as muchmore stigmatizing than admitting a medical problem. Service members had more concerns about stigmatization and felt more uncomfortable discussing psychological problems than medical problems, and these feelings were magnified when service members were being screened with their units rather than alone. Service members also reported a lesser likelihood of following through with a psychological referral than with a medical referral. However, participants who discussed psychological issues with a therapist felt the screening was more beneficial than those who did not discuss their responses. The results address the neglected topic of the stigma associated with psychological problems in the workplace. [source] Identifying and screening for psychological and comorbid medical and psychological disorders in medical settings,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 3 2009Rodger Kessler Abstract There is increased attention to the medical and economic consequences of psychological problems comorbid with medical issues. There is also a clear awareness that most psychological problems are assessed and responded to in nonpsychiatric medical settings. This has furthered interest and attention in implementing screening procedures to better identify psychological, behavioral, and substance abuse problems in medical settings. Such interest is taking the form of recommendations from federal government task forces, and the funding of large projects to include screening in medical settings. At the same time there has been further attention to brief, valid, and reliable measures with which to capture psychological comorbidities. However, there have been multiple concerns raised about a variety of issues concerning the utility and effectiveness of such screening procedures and the identification of multiple issues to be considered in screening design. The author outlines and reviews the rationale and concerns about screening, identifies the issues that need to be considered in screening program development, and describes the efforts to develop a screening capacity in a rural family practice. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65:1,15, 2009. [source] Multiple sclerosis: Empirical literature for the clinical health psychologistJOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2001David C. Mohr This article reviews the empirical literature related to clinical health psychology in multiple sclerosis (MS). MS is a disease in which the immune system attacks the central nervous system. As such, the interactions between medical and psychological variables are complex, and potentially of considerable importance to patients. Common neuropsychological and psychological problems associated with MS and their etiologies are reviewed. The effects of stress and depression on MS exacerbation are discussed, including clinical, immune, endocrine, and neuroimaging findings. The types of coping common in MS and their effects on adjustment are discussed. The empirical literature on psychological and neuropsychological intervention is reviewed. The small literature on caregiving in MS is also summarized. © 2001 John Wiley & Sons, Inc. J Clin Psychol 57: 479,499, 2001 [source] Community perceptions of mental disorders: a Greek perspectiveJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 2 2006Anastasia Zissi Abstract The present cross-sectional study examines the perceptions of residents of a rural community in Greece pertaining to the interpretation, explanation, treatment and prognosis of various psychological problems. In all, 100 community residents took part. A series of vignettes in combination with both qualitative and quantitative data collection procedures was employed. The findings indicate a variation in the endorsement of interpretations and causal attributions as a function of the type of symptomatology presented. The overt psychotic cases of schizophrenia were more likely to be understood within a genetic explanatory framework while the less overt symptoms of mental disorders were perceived as being indicative of emotional problems triggered by personality and social environmental factors. A preference for psychological methods of treatment was expressed. Copyright © 2006 John Wiley & Sons, Ltd. [source] Stress and well-being in the aftermath of the World Trade Center attack: The continuing effects of a communitywide disasterJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2005Richard E. Adams In this study, we examine the relationship between exposure to the World Trade Center disaster (WTCD) and the well-being of adults living in New York City (NYC) at the time of the attacks by using a stress process model. One year after the attacks, we conducted a telephone survey of a cross-sectional random sample of city residents with an oversample of residents who had received mental health treatment since the attacks (N = 2,368). The survey gathered information about respondents' demographic characteristics, exposure to the WTCD, other stressful events, and social psychological resources. The dependent variable (health status) was measured by using the Short Form-12 (SF-12) mental health and physical health scales. Overall, the greater the exposure to the events surrounding the WTCD, the poorer the person's psychological well-being, even after controlling for demographic characteristics, other stressors, and social psychological resources. Exposure was only weakly related to physical well-being, once other factors were taken into account. The findings clearly show that individuals who experienced greater exposure to the WTCD have more psychological problems than those who had less exposure 1 year after the attacks. Exposure did not seem to have such severe consequences for physical well-being. Thus, our study supports the continuation of mental health services to survivors of a community disaster well beyond the first year post disaster. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 175,190, 2005. [source] Teasing, rejection, and violence: Case studies of the school shootingsAGGRESSIVE BEHAVIOR, Issue 3 2003Mark R. Leary Abstract Media commentators have suggested that recent school shootings were precipitated by social rejection, but no empirical research has examined this claim. Case studies were conducted of 15 school shootings between 1995 and 2001 to examine the possible role of social rejection in school violence. Acute or chronic rejection,in the form of ostracism, bullying, and/or romantic rejection,was present in all but two of the incidents. In addition, the shooters tended to be characterized by one or more of three other risk factors,an interest in firearms or bombs, a fascination with death or Satanism, or psychological problems involving depression, impulse control, or sadistic tendencies. Implications for understanding and preventing school violence are discussed. Aggr. Behav. 29:202,214, 2003. © 2003 Wiley-Liss, Inc. [source] Thyroid dysfunction , weight problems and the psyche: the patients' perspectiveJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2000B. O'Malley Objective To establish the extent to which individuals with thyroid dysfunction consider weight as a problem and the relevance of psychological factors. Design Cross-sectional study of individuals with thyroid dysfunction. Participants Members of the British Thyroid Foundation. Main outcome measures Two self-administered questionnaires, tailored for hypothyroid and hyperthyroid patients, respectively, and circulated to all members of the British Thyroid Foundation. These questionnaires specifically targeted views on weight and the experiencing of psychological symptoms. Results Twenty-five per cent of hypothyroid individuals regained normal body weight on adequate treatment with Thyroxine but 75% did not. Only 19% of subjects had received dietary advice from their doctor. Eighty-seven per cent of hypothyroid individuals felt depressed prediagnosis and 80% remained so on adequate treatment. Thirty-nine per cent felt weight was a contributing factor. Fifty-five per cent of thyrotoxic subjects reported a weight problem on or after treatment, 69% exceeding their pretoxic weight. Only 28% had received dietary advice from their doctor. Seventy-eight per cent of thyrotoxic individuals reported mood problems when the thyroid was over active and of these 77% improved with therapy. Twenty-three per cent did not. In excess of 60% of individuals had persistent symptoms after treatment. Thirty-four per cent of these blamed a weight problem. Conclusion Weight is a major concern to the majority of patients with thyroid dysfunction, sometimes contributing to significant mood disturbance. All patients with thyroid dysfunction, particularly if over weight, should receive dietary advice. This must emphasize that thyroid hormone manipulation does not always solve the problem. Furthermore, the associated psychological problems of thyroid disease do not always settle with treatment to euthyroidism and may require therapy in their own right. [source] | |||||||||||||||||||||||||||||||