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Symptom Levels (symptom + level)
Kinds of Symptom Levels Selected AbstractsStability and individual change in depressive symptoms among mothers raising young children with ASD: maternal and child correlates,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2009Alice S. Carter Abstract Mothers raising children with Autism Spectrum Disorders (ASD) evidence elevated depressive symptoms, but symptom stability has not been examined. Mothers (N=143) of toddlers with ASD (77% boys) were enrolled and assessed when their children were 18 to 33 months old and followed annually for 2 years. Multilevel modeling revealed no significant change in group depressive symptom level, which was in the moderately elevated range (Intercept=13.67; SE=.96). In contrast, there was significant individual variation in change over time. Child problem behaviors and delayed competence, maternal anxiety symptoms and angry/hostile mood, low parenting efficacy and social supports, and coping styles were associated with depression severity. Only maternal anxiety and parenting efficacy predicted individual change. Many mothers do not appear to adapt, supporting the need for early intervention for maternal well-being. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1,11, 2009. [source] Psychotherapeutic case conceptualization using plan analysis for bipolar affective disorder,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2009Ueli Kramer Abstract Valid individualized case conceptualization methodologies, such as plan analysis, are rarely used for the psychotherapeutic treatment conceptualization and planning of bipolar affective disorder (BD), even if data do exist showing that psychotherapy interventions might be enhanced by applying such analyses for treatment planning for several groups of patients. We applied plan analysis as a research tool (Caspar, 1995) to N=30 inpatients presenting BD, who were interviewed twice. Our study aimed at producing a prototypical plan structure encompassing the most relevant data from the 30 individual case conceptualizations. Special focus was given to links with emotions and coping plans. Inter-rater reliability of these plan analyses was considered sufficient. Results suggest the presence of two subtypes based on plananalytic principles: emotion control and relationship control, along with a mixed form. These subtypes are discussed with regard to inherent plananalytic conflicts, specific emotions and coping plans, as well as symptom level and type. Finally, conclusions are drawn for enhancing psychotherapeutic practice with BD patients, based on the motive-oriented therapeutic relationship. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1,16, 2009. [source] Musculoskeletal problems of the neck, shoulder, and back and functional consequences in nursesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2002Alison M. Trinkoff ScD Abstract Background Though musculoskeletal disorders (MSDs) are highly prevalent among registered nurses (RNs), little is known about functional consequences of MSDs in nurses. Methods Data on neck, shoulder, and back MSD problems were analyzed in 1,163 working nurses (response rate,=,74%). Cases had relevant symptoms lasting at least 1 week or occurring at least monthly in the past year, with at least moderate pain intensity, on average. MSD problems with a frequency, duration, or pain intensity below the level needed to meet the case definition were defined as MSD symptoms. Those who did not meet symptom or case criteria at any body site were defined as asymptomatic. Odds of consequences (e.g., saw a doctor/provider, missed work, reduced/modified work, non-work activities, or recreation, medication use, inadequate sleep) were estimated for cases versus those with symptoms. Results We found 45.8, 35.1, and 47.0% of nurses had neck, shoulder, or back MSD problems (either at the case or symptom level), respectively, within the past year. Cases were far more likely to have seen a provider versus those with symptoms (adjusted odds ratio, aOR Neck: 4.33, 95% CI: 2.85,6.56; aOR Shoulder: 4.83, 95% CI: 3.00,7.77; aOR Back: 3.69, 95% CI: 2.47,5.49). Cases also were more likely to experience all other functional consequences. Conclusions MSD consequences are substantial and suggest opportunities for intervention. Future research will examine the impact of work organization and physical demands on MSDs. Am. J. Ind. Med. 41:170,178, 2002. © 2002 Wiley-Liss, Inc. [source] Predictors of Depressive Symptoms in Chinese American College Students: Parent and Peer Attachment, College Challenges and Sense of CoherenceAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2007Yu-Wen Ying PhD Based on Antonovsky's salutogenic model, the authors hypothesized that sense of coherence would mediate the effects of parent and peer attachment and college challenges on depressive symptoms as well as moderate the relationship between college challenges and depressive symptoms in Chinese Americans. To test our hypotheses, 353 Chinese American college students completed paper-pencil measures. Supporting our hypotheses, sense of coherence fully mediated the effects of parent and peer attachment on depressive symptom level and served as a partial mediator and moderator of the effect of college challenges on depressive symptoms. Implications of the study findings for promoting the mental health of Chinese American students are discussed. [source] A prospective test of anxiety sensitivity as a moderator of the relation between gender and posttraumatic symptom maintenance among high anxiety sensitive young adultsDEPRESSION AND ANXIETY, Issue 3 2008Matthew T. Feldner M.D. Abstract The primary aim of this study was to evaluate the individual and combined influence of anxiety sensitivity (AS) and gender on the longitudinal prediction of posttraumatic symptoms. A large nonclinical sample of young adults (n=404) was prospectively followed over approximately 18 months. The primary findings indicated that gender and AS were uniquely associated with posttraumatic symptom levels during the follow-up period. Moreover, AS appeared more strongly (positively) related to posttraumatic stress symptoms during the follow-up period among females than males. These data provide novel prospective evidence regarding the interplay of relatively well-established risk factors implicated in the maintenance of posttraumatic stress symptoms. Depression and Anxiety 0:1,10, 2007. Published 2007 Wiley-Liss, Inc. [source] Tests of causal linkages between cannabis use and psychotic symptomsADDICTION, Issue 3 2005David M. Fergusson ABSTRACT Aim To examine possible causal linkages between cannabis use and psychosis using data gathered over the course of a 25-year longitudinal study. Design A 25-year longitudinal study of the health, development and adjustment of a birth cohort of 1265 New Zealand children (635 males, 630 females). Setting The Christchurch Health and Development Study, a general community sample. Participants A total of 1055 participants from the Christchurch Health and Development Study (CHDS) cohort for whom data on cannabis use and psychotic symptoms were available on at least one occasion from 18, 21 and 25 years. Measurements As part of this study, data were gathered on frequency of cannabis use and psychotic symptoms at ages 18, 21 and 25 years. Findings Regression models adjusting for observed and non-observed confounding suggested that daily users of cannabis had rates of psychotic symptoms that were between 1.6 and 1.8 times higher (P < 0.001) than non-users of cannabis. Structural equation modelling suggested that these associations reflected the effects of cannabis use on symptom levels rather than the effects of symptom levels on cannabis use. Conclusions The results of the present study add to a growing body of evidence suggesting that regular cannabis use may increase risks of psychosis. The present study suggests that: (a) the association between cannabis use and psychotic symptoms is unlikely to be due to confounding factors; and (b) the direction of causality is from cannabis use to psychotic symptoms. [source] A Dyadic Examination of Daily Health Symptoms and Emotional Well-Being in Late-Life Couples,FAMILY RELATIONS, Issue 5 2006Jeremy B. Yorgason Abstract: This study investigated the link between daily health symptoms and spousal emotional well-being in a sample of 96 older dyads. Higher negative mood and lower positive mood were associated with spousal symptoms in couples wherein husbands or wives reported higher average levels of symptoms. For wives, partner effects were moderated by husbands' marital satisfaction and illness severity. Specifically, higher husband marital satisfaction and illness severity were associated with higher negative mood and lower positive mood for wives on days where husbands reported higher symptom levels. In their work with later-life families, practitioners and educators should address long-term and daily health-related relationship stressors. [source] Onset of Depression in Elderly Persons After Hip Fracture: Implications for Prevention and Early Intervention of Late-Life DepressionJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2007Eric J. Lenze MD OBJECTIVES: To identify predictors of onset of major depressive disorder (MDD) and of depressive symptoms in subjects who suffered a hip fracture. DESIGN: Prospective naturalistic study. SETTING: University of Pittsburgh Medical Center,Shadyside, a large urban hospital in Pittsburgh, Pennsylvannia. PARTICIPANTS: One hundred twenty-six elderly patients who received surgical fixation for hip fracture and who were not experiencing a major depressive episode at the time of the fracture; severely cognitively impaired persons were excluded. MEASUREMENTS: Subjects were evaluated at the time of hospital discharge using a battery of clinical measures (including apathy measured using the Apathy Evaluation Scale (AES), delirium, cognitive measures, social support, and disability level). Depression was assessed at the end of the surgical stay, 2 weeks later, and then monthly for 6 months, using the Hamilton Rating Scale for Depression (Ham-D) to evaluate symptomatology and the Primary Care Evaluation of Mental Disorders to evaluate diagnosis of MDD. RESULTS: Eighteen of 126 subjects (14.3%) developed MDD after hip fracture. Of these, 11 developed MDD by the end of the hospitalization, and seven developed MDD between 2 and 10 weeks later. Logistic regression showed that baseline apathy score, as measured using the AES, was the only clinical measure associated with the development of MDD (odds ratio=1.09, 95% confidence interval=1.03,1.16, P=.003); 46.2% of those with high AES scores developed MDD, versus 10.9% of those with lower scores. In contrast, cognitive variables, delirium, disability after hip fracture, and other factors related to the fracture (e.g., fracture type) were not associated with MDD. A repeated-measures analysis with Ham-D over time as a dependent variable generally confirmed these findings; depressive symptoms were highest immediately after the fracture, and apathy and delirium scores were associated with higher depressive symptom levels. CONCLUSION: The onset of MDD is common after hip fracture, and the greatest period of risk is immediately after the fracture. Individuals with clinical evidence of apathy are at high risk for developing MDD, and evaluation and close follow-up of such individuals is warranted. However, further research is needed to examine other candidate variables (e.g., clinical measures or biomarkers) to model adequately the risk for MDD after hip fracture and other disabling medical events. [source] Meditation with yoga, group therapy with hypnosis, and psychoeducation for long-term depressed mood: a randomized pilot trialJOURNAL OF CLINICAL PSYCHOLOGY, Issue 7 2008Lisa D. Butler Abstract This randomized pilot study investigated the effects of meditation with yoga (and psychoeducation) versus group therapy with hypnosis (and psychoeducation) versus psychoeducation alone on diagnostic status and symptom levels among 46 individuals with long-term depressive disorders. Results indicate that significantly more meditation group participants experienced a remission than did controls at 9-month follow-up. Eight hypnosis group participants also experienced a remission, but the difference from controls was not statistically significant. Three control participants, but no meditation or hypnosis participants, developed a new depressive episode during the study, though this difference did not reach statistical significance in any case. Although all groups reported some reduction in symptom levels, they did not differ significantly in that outcome. Overall, these results suggest that these two interventions show promise for treating low- to moderate-level depression. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64(7): 1,15, 2008. [source] A Multilevel Analysis of Gender Differences in Psychological Distress Over TimeJOURNAL OF RESEARCH ON ADOLESCENCE, Issue 2 2009Amanda L. Botticello Females have higher rates of depression than males, a disparity that emerges in adolescence and persists into adulthood. This study uses hierarchical linear modeling to assess the effects of school context on gender differences in depressive symptoms among adolescents based on two waves of data from the National Longitudinal Study of Adolescent Health (N=9,709 teens, 127 schools). Analysis indicates significant school-level variation in both overall symptom levels and the average gender gap in depression net of prior symptoms and individual-level covariates. Aggregate levels of depressive symptomatology were positively associated with contextual-level socioeconomic status (SES) disadvantage. A cross-level contingency emerged for the relationship between gender and depressive symptoms with school SES and aggregate perceived community safety such that the gender "gap" was most apparent in contexts characterized by low SES disadvantage and high levels of perceived safety. These results highlight the importance of context to understanding the development of mental health disparities. [source] The Relation of Patterns of Coping of Inner,City Youth to Psychopathology SymptomsJOURNAL OF RESEARCH ON ADOLESCENCE, Issue 4 2002Patrick H. Tolan This study provides empirical verification that variations in patterns of coping can explain current and future functioning of youth. The study evaluated the methods and styles of coping of inner,city youth and their relation to age, gender, ethnicity, stress levels, and internalizing and externalizing symptom levels. Three hundred seventy,two 12, to 16,year,old adolescents from inner,city schools (67.0% African American, 24.4% Hispanic; 53.41% males) participated. One hundred forty,nine were also included in a follow,up evaluation of the prospective relation of coping to functioning. A seven,factor model of coping methods was identified and found to be applicable across age groups, genders, and ethnic groups. The model was robust over time. Coping methods were categorized through cluster analysis into five styles. Styles were found to relate somewhat to demographic characteristics and stress levels. Controlling for demographic characteristics and stress levels, coping style related concurrently and prospectively to internalizing and externalizing symptom levels. Except in one instance, age, ethnicity, and gender did not interact with coping in predicting symptoms. Implications for further coping research and risk and intervention design are discussed. [source] A longitudinal study of posttraumatic stress disorder, depression, and generalized anxiety disorder in Israeli civilians exposed to war traumaJOURNAL OF TRAUMATIC STRESS, Issue 3 2010Yuval Neria This 3-wave longitudinal study examined the mental health consequences of the Israel,Gaza 2008,2009 war among young Israeli civilians. Data on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD), and their predictors were collected during the war, and 2 and 4 months after ceasefire. Results showed a sharp decline in symptom levels of PTSD, MDD, and GAD over time. Perceived social support during the war moderated the effects of immediate emotional response on subsequent levels of PTSD, MDD, and GAD. These findings underscore the importance of social support and immediate emotional response to trauma in predicting trauma-related psychopathology, and highlight the potential need for providing early care to exposed individuals exhibiting immediate and severe emotional responses. [source] Psychological consequences of forced evacuation on children: Risk and protective factorsJOURNAL OF TRAUMATIC STRESS, Issue 4 2009Michelle Slone Children's psychological distress and symptoms after forced evacuation from the Gaza Strip in Israel were studied. Fifty families living in temporary residences 2 weeks postevacuation were assessed for general political and evacuation life events exposure as risk factors and family support and hardiness as protective factors. The hypothesis predicting a positive correlation between forced evacuation events and political life events and symptom levels was confirmed. Perceived family support served as a significant predictor of symptomatology, but not family hardiness, substantiating parents' role in aiding children's coping. [source] Use of mental health treatment among veterans filing claims for posttraumatic stress disorderJOURNAL OF TRAUMATIC STRESS, Issue 1 2007Nina A. Sayer This study examines predictors of current mental health service use in a sample of 154 veterans filing claims for Veterans Affairs (VA) disability benefits based on Posttraumatic Stress Disorder (PTSD). Our conceptual framework was the behavioral model that classifies predictors of service utilization into predisposing (background), enabling (e.g., insurance) and need (e.g., symptoms) factors. Slightly more than half of the PTSD claimants were receiving mental health treatment at the time of claim initiation. Mean symptom levels were clinically significant in both users and nonusers of mental health treatment. In a multivariate logistic regression analysis, mental health treatment use was associated with younger age, marriage, and dependence on public insurance. Implications for future research are discussed. [source] Patterns of treatment response in chronic posttraumatic stress disorder: An application of latent growth mixture modelingJOURNAL OF TRAUMATIC STRESS, Issue 4 2005Peter Elliott This study attempts to differentiate groups of individuals who exhibit different patterns of recovery following treatment for chronic posttraumatic stress disorder (PTSD) and describes these groups in terms of relevant characteristics at program intake. A sample of 2,219 Vietnam veterans who had completed a 12-week treatment program was followed up at 6, 12, and 24 months post admission using self-report measures. With change in PTSD symptoms over time as the focus, latent growth mixture modeling was used to assign individual veterans to subgroups. A three-group solution provided the best account of the data. Two groups showed moderate and consistent improvement over time although the larger group (n = 1,380) began treatment with more PTSD symptoms and improved more quickly over time. The smallest group (n = 87) showed a substantially different trajectory, with almost no net change in symptom levels over the 24-month period. The groups also varied significantly in terms of their characteristics, with symptom severity and improvements over time reflecting greater comorbidity and younger age. The results have both research and clinical implications. [source] The Effects of Pain and Depression on Physical Functioning in Elderly Residents of a Continuing Care Retirement CommunityPAIN MEDICINE, Issue 4 2000Jana M. Mossey PhD Objective., Explore the relationships between pain, depression, and functional disability in elderly persons. Design.,A cross-sectional, observational study of 228 independently living retirement community residents. Methods., Self-report measures of pain (adaptation of McGill Pain Questionnaire), depression (Geriatric Depression Scale [GDS]) and physical functioning (Physical performance difficulties, activities of daily living [ADL], independent activities of daily living [IADL], and 3-meter walking speed) were employed. Outcome Measures.,Physical functioning variables were dichotomized. Individuals in the lowest quartiles of functional performance and of walking speed were contrasted to all others; for ADL and IADL, those needing some help were compared with those independent in activities. Results., Pain and depression levels were strongly related to physical performance; depression levels were related to ADL and walking speed. In multivariate analyses, an interaction effect was observed where the effects of pain were a function of level of depression. Individuals reporting activity-limiting pain and slightly elevated depressive symptom levels, sub-threshold depression, or major depression were significantly more likely (AOR 7.8; 95% CI, 3.07,20.03) than non-depressed persons to be in the lowest quartile of self-reported physical performance. Conclusions., While both pain and depression level affect physical performance, depressive symptoms rather than pain appear the more influential factor. When seeing elderly patients, identifying, evaluating, and treating both pain complaints and depressive symptoms and disorders may reduce functional impairment. [source] Psychosocial Interventions for School Refusal Behavior in Children and AdolescentsCHILD DEVELOPMENT PERSPECTIVES, Issue 1 2009Armando A. Pina ABSTRACT,This article reviews empirical evidence for the efficacy of psychosocial interventions for school refusal behavior. Data corresponding to 8 experimental single-case and 7 group-design studies are presented. Across studies, behavioral and cognitive-behavioral treatments emerged as promising lines of intervention. These interventions produced improvements in school attendance and youths' symptom levels (e.g., anxiety, fear, depression, anger) based on this study's examination of effect sizes. The article concludes with suggestions for interventionists, researchers, and policy makers attempting to deal with the problem of school refusal. [source] An evaluation of a supervised self-help programme for bulimic disordersCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 4 2001Lorraine Bell Self-help programmes are recommended as cost-effective initial interventions for the treatment of bulimic disorders. This is a report of the effectiveness of such a programme in routine clinical practice. Twenty-one patients completed the programme and both pre- and post- measures. Patients were treated in a secondary mental health setting over an 11-month period from July 1998 to June 1999. Outcome was assessed using standardized measures and records of symptom levels and drop-out rates. Significant improvements in depression, bulimic symptom and severity were observed. Multi-impulsive clients (as indicated by clinically significant scores on bingeing and two other areas of impulsivity) had similar levels of bulimia but higher depression scores pre-treatment. They made significant gains in most areas but, despite reduction in depression scores, remained significantly depressed. They also made less improvement in disordered attitudes than non-impulsive clients. A global measure of motivation did not predict drop-out or outcome though numbers were small. Patients who used Getting Better Bit(e) by Bit(e) and received motivational enhancement sessions made a greater reduction in fasting behaviour and were less likely to drop out than those who used a more standard CBT programme, but these results could be due to other factors. Copyright © 2001 John Wiley & Sons, Ltd. [source] A Multidimensional Meta-Analysis of Psychotherapy for Bulimia NervosaCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 3 2003Heather Thompson-Brenner We report a multidimensional meta-analysis of psychotherapy trials for bulimia nervosa published between 1980 and 2000, including multiple variables in addition to effect size such as inclusion and exclusion, recovery, and sustained recovery rates. The data point to four conclusions. First, psychotherapy leads to large improvements from baseline. Approximately 40% of patients who complete treatment recover completely, although 60% maintain clinically significant posttreatment symptoms. Second, individual therapy shows substantially better effects than group therapy for the therapies tested. Third, additional approaches or treatment parameters (e.g., number of sessions) need to be tested for the substantial number of patients who enter treatment and do not recover. Finally, the utility of meta-analyses can be augmented by including a wider range of outcome metrics, such as recovery rates and posttreatment symptom levels. [source] Gender Differences in the Across-Time Associations of the Job Demands-Control-Support Model and Depressive Symptoms: A Three-Wave StudyAPPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 1 2010Galit Armon We used a full-panel longitudinal design to investigate, separately for women and men, the hypotheses that changes in the components of the Job Demands-Control-Support (JDC-S) model predict changes in depression symptoms levels over time and that the reversed prediction would also be found. Our study was conducted on a multi-occupational sample of apparently healthy employees (N = 692, 68% men) using three waves of data gathering, replicating our tests on two time lags of 18 months and 3 years on average. We controlled for neuroticism and other potential confounding variables. For both time lags, support for our hypotheses was found for the men only. We did not find systematic differences between the time lags, nor did we find a predominance of one of the unidirectional effects examined. We outline the theoretical and practical implications of our findings, including their relevance for efforts to combat depressive symptoms by changing job characteristics. [source] | |||||||||||||||||||||||||