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The relationship of clinical factors and environmental opportunities to social functioning in young adults with schizophrenia.

This study used data from the long-term experimental evaluation of the Program of Assertive Community Treatment (PACT) to examine the clinical and situational contributors to social functioning in people with schizophrenia. Subjects were 87 young adults with schizophrenia spectrum disorders. Data from two time points, 6 months apart, were used to test models predicting five social outcomes (network size, network reciprocity, sociosexual contact, satisfaction with social relationships, and loneliness) from positive symptoms, work involvement, living situation, and residential mobility. Results indicated that (1) work involvement was associated with larger network sizes over a 6-month period; (2) experiencing an increase in positive symptoms over a 6-month period was associated with the loss of reciprocal network ties, a lessening of satisfaction with social relationships, and an increase in loneliness; and (3) neither living situation nor moving frequently was associated with later social outcomes. These findings suggest strong support for the role of short-term changes in positive symptoms and modest support for the role of work involvement in social outcome.

Adolescent↗

Omissions in assessment of work roles: implications for evaluating social functioning and mental illness.

An analysis of data from a longitudinal study of individuals during and after psychiatric hospitalization found that multiple work roles often remain unconsidered in assessments of social functioning and psychiatric status. The inclusion of such multiple roles was found to be important for adequate measurement of productive functioning and to illuminate their interaction with individuals' psychopathology.

Activities of Daily Living↗

Effects of labelling on income, work and social function among hypertensive employees.

Two hundred and thirty hypertensive Canadian steelworkers were followed for 5 years after screening and referral. Data on income, absenteeism and measures of work and social function were collected on these men and on a matched group of 230 normotensive employees. In the fifth year after screening, hypertensive employees earned an average of Can. $1093 less than normotensive employees despite similar incomes in the year before screening. This adverse effect on income was observed regardless of awareness of hypertension at the time of screening or compliance with treatment. Illness-related absenteeism among hypertensives rose in the year following screening and remained elevated for 4 years after screening. Normotensive and hypertensive employees reported similar levels of physical ability and psychological well-being. These findings need verification in other settings before inclusion in cost-effectiveness analyses of the management of hypertension.

Absenteeism↗

Children's asthma, internalizing problems, and social functioning: an urban perspective.

PROBLEM: Asthma may serve as a risk factor for higher levels of psychosocial problems in urban school-aged children. METHOD: Interview data were collected from 48 children (27 with asthma and 21 without asthma) and their mothers. FINDINGS: Asthma did not function as a risk factor for psychosocial problems in this sample. Children with more symptoms of depression and anxiety experienced poorer social functioning, regardless of their health status. CONCLUSION: These results highlight the importance of examining co-occurring difficulties in psychosocial development among urban children in order to design interventions that minimize the impact of such challenges.

Anxiety↗

Social functioning and general well-being in patients treated with clean intermittent catheterization.

Social role function, health perceptions and general well-being were studied longitudinally over 1 yr in 149 males and 153 females performing clean intermittent catheterization (CIC). The evaluation included urological assessments and self-rating instruments (Revised Physical Battery, General Health Questionnaire--28 items, State Anxiety Inventory and CIC Pain and Discomfort Scale). Twenty-six percent reported major improvement in their overall quality of life, while 7% reported a wish to be dead and away from it all. Females with infranuclear lesions and detrusor myopathies scored higher on unpleasant health perceptions, state anxiety and physical discomfort by performing CIC than males. In males, the social role function 1 yr later was predicted by initial anxiety and urinary tract infections, whereas in females by initial anxiety only. Discomfort by CIC was predicted by initial infection in males, and by none or moderate medical comorbidity, initial depression and infection in females.

Adaptation, Psychological↗

Cognitive and social functioning across adulthood: age or student status differences?

Younger adult students between 19 and 24 years of age (M = 21.3 years), older adult students between 61 and 76 years of age (M = 67.9 years), and older adult nonstudents between 62 and 76 years of age (M = 68.5 years) were assessed for health (self-ratings of physical and mental health), social functioning (self-ratings of physical and mental activity, perceived role activity level, perceived roles, locus of control, and age-norm expectations), and cognitive functioning (Wechsler Adult Intelligence Scale-Revised vocabulary and block design, and paired associate memory). Age differences were observed in self-ratings of health, social roles, intellectual performance, and memory. No student status differences were observed. The results are discussed in terms of plasticity of intellectual function and characteristics of student status in later adulthood.

Adult↗

Social functioning and residual symptomatology among outpatients who responded to treatment and recovered from major depression.

It is unclear whether depressed patients who respond to treatment, and subsequently recover, manifest a significant degree of residual symptomatology and enduring psychosocial impairment. The purpose of this study was to compare the social functioning and symptoms of depressed outpatients who responded to acute treatment, and had a sustained recovery from major depression for 6 months, with psychiatrically normal community samples. The sample (n = 48) was drawn from the NIMH Treatment of Depression Collaborative Research Program. The Social Adjustment Scale scores and the Symptom Check List of recovered patients were clinically indistinguishable from the community sample scores. These data suggest that patients who benefit from acute treatment and recover from major depression can expect to achieve a normal level of functioning and symptomatology.

Adult↗

[Social functioning of schizophrenic patients after 15 years from the first hospitalization (Part II -- the evaluation of needs for community care)].

The description of the studied group was given in the first part of the paper. Some of the factors having been present at the first hospitalization were found to be important for the patients' functioning 15 years later. On the basis of the collected regarding data 85 patients, significant coincidence has been found between more intensive use of extramural services, more frequent and longer hospitalizations, and worse social functioning during 15 years' period in individual cases. The conclusion has been assumed that there exists obvious need for more intensive community care for such patients. On the basis of 0.15% morbidity index the number of schizophrenics needing social support, sheltered accommodation and sheltered working conditions were estimated. According to the Mental Health Care Act of 1994 such services have to be organized within social care system.

Adult↗

Effects of sulthiame upon intellectual, neuropsychological, and social functioning abilities among adult epileptics: comparison with diphenylhydantoin.

This report presented results of psychological studies done during a double-blind study which compared sulthiame with diphenylhydantoin as primary agents in the treatment of uncontrolled epileptics. Assessments of intellectual, neuropsychological, and social functioning abilities were made with 22 adult epileptic patients. The results showed significantly less impairment with treatment by diphenylhydantoin than by sulthiame, and substantial differences were revealed on intellectual tasks, on tasks calling for sustained concentration and attention, and on psychomotor problem-solving tasks. The results could not be explained on the basis of increased tonic-clonic seizures while on sulthiame. However, an increase in other types of seizures was noted, as was an increase in EEG epileptiform discharges. Possible mechanisms for the decrement in performance were discussed, and the value of an objective assessment of the psychological effects of anticonvulsant agents was noted.

Adult↗

Children's symptom and social functioning self-report scales. Comparison of mothers' and children's reports.

This paper reports on the testing of self-report scales, in a pilot study of 28 children with a psychiatrically ill parent. We examined the relationship between children's responses about themselves and mothers' responses about their children, on symptom and social functioning scales. The self-report scales administered to the children included the Center for Epidemiologic Studies Depression Scale, the Children's Depression Inventory, and the Social Adjustment Scale. The mothers completed the Achenbach Child Behavior Checklist, the Conners Parent Questionnaire, and the Center for Epidemiologic Studies Depression Scale about their children. Agreement between mothers and children on the assessment of the child was poor. Agreement was good across the scales used when the information was derived from the same informant. The implication of these results for epidemiological studies, particularly concerning dual informants, is discussed.

Adolescent↗

Emotion processing and its relationship to social functioning in schizophrenia patients.

Schizophrenia patients have demonstrated deficits in affect recognition. Whether this deficit is part of a general difficulty in face perception or a specific problem in affect recognition is debatable. However, there is little research investigating the functional consequences of difficulties in identifying emotion in schizophrenia patients. We tested 20 chronic, medicated schizophrenia patients and 27 normal control participants on a battery of face recognition and affect recognition tasks. A subset of 14 patients was rated on the Social Dysfunction Index. Results demonstrated that schizophrenia patients were less accurate than normal control participants on face recognition, facial affect recognition and vocal affect recognition tasks, but among schizophrenia patients, only affect recognition performance was related to social functioning. These results suggest that schizophrenia patients have general face processing deficits, but affect recognition deficits may lead to more problems in social behavior.

Adult↗

Relating emotional abilities to social functioning: a comparison of self-report and performance measures of emotional intelligence.

Three studies used J. D. Mayer and P. Salovey's (1997) theory of emotional intelligence (EI) as a framework to examine the role of emotional abilities (assessed with both self-report and performance measures) in social functioning. Self-ratings were assessed in ways that mapped onto the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), a validated performance measure of EI. In Study 1, self-ratings and MSCEIT scores were not strongly correlated. In Study 2, men's MSCEIT scores, but not self-ratings, correlated with perceived social competence after personality measures were held constant. In Study 3, only the MSCEIT predicted real-time social competence, again, just for men. Implications for analyzing how emotional abilities contribute to social behavior are discussed, as is the importance of incorporating gender into theoretical frameworks and study designs.

Adolescent↗

Tourette syndrome and social functioning in a Canadian population.

Two hundred and ten patients with Tourette Syndrome (TS) and/or their parents completed a survey, answering questions about the frequency and disruptiveness of vocal and motor tics, behaviour problems and sleep disturbances. Respondents also rated the impact of TS symptoms on social relationships and level of personal and social functioning. Motor tics were reported to be more problematic than were vocal tics. Disruptive behavioural problems included obsessive-compulsive rituals, hyperactivity, anxiety, temper tantrums, mood swings, aggressiveness and coprolalia. Respondents also reported problems getting to sleep, bad dreams, somnambulism and enuresis. More than 40% of respondents reported problems in dating, and problems in making and keeping friends. Family members, friends and physicians were reported to be the most understanding and tolerant of TS symptoms; employers were rated as being the least understanding. More than 30% of respondents reported some problems in coping, but more than 50% of respondents also rated their mental health as good or excellent.

Adolescent↗

Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning.

We designed a study to assess the specific contribution of cognitive dysfunction to multiple sclerosis patients' problems in daily living. Based on the results of a comprehensive neuropsychological test battery, we classified 100 MS patients as either cognitively intact (N = 52) or cognitively impaired (N = 48). In addition to a neurologic examination, MS patients completed questionnaires on mood and social functioning, underwent a comprehensive in-home occupational therapy evaluation, and were rated by a close relative or friend regarding specific personality characteristics. While there were no significant differences between the two groups on measures of physical disability and illness duration, patients in the cognitively impaired group were less likely to be working, engaged in fewer social and avocational activities, reported more sexual dysfunction, experienced greater difficulty in performing routine household tasks, and exhibited more psychopathology than cognitively intact patients. These findings suggest that cognitive dysfunction is a major factor in determining the quality of life of patients with MS.

Activities of Daily Living↗

Anxiety and impaired social function in the elderly.

The effect of anxiety on impairment in activities of daily living was examined among elderly individuals residing in a long-term care setting. Eighty one subjects received complete assessments of psychiatric symptoms, cognitive impairment, and ability to perform daily living tasks. A multivariate analysis was conducted to determine the relative influence of anxiety, cognitive status, and depressive symptoms on daily living skills. The presence of anxiety was significantly associated with reduced functional status in performing activities of daily living. This relationship remained significant even after controlling for the presence of concurrent depressive symptoms as well as cognitive impairment. Anxiety is a significant source of morbidity among elderly individuals and substantially impairs social function over and above the effects of depression and cognitive decline. Current interventions for anxiety such as benzodiazepines may have adverse cognitive effects, hence more specific intervention strategies for anxiety may be very important for this population.

Activities of Daily Living↗

The effects of ritanserin on mood, sleep, vigilance, clinical impression, and social functioning in alcohol-dependent individuals. Ritanserin in Alcoholism Work Group.

In an international double-blind placebo-controlled trial with 493 detoxified alcohol-dependent individuals, ritanserin, a specific 5-hydroxytryptamine, antagonist, was tested in three different dosages (2.5, 5, and 10 mg/day) against placebo over a period of 6 months. Data on changes in mood state, sleep quality, morning vigilance, clinical impression, and social functioning were analysed. None of the three dosages of ritanserin given revealed any significant effect against placebo on the above-mentioned parameters either at the end of treatment or upon relapse. Therefore, we conclude that patients suffering from alcohol dependence without concomitant psychiatric disorders do not benefit from additional treatment with (2.5, 5, or 10 mg/day) ritanserin.

Adult↗

Effect of incest on self and social functioning: a developmental psychopathology perspective.

The effects of child sexual abuse have become a leading concern of mental health service providers. Despite an explosion of studies, one major difficulty in this research is the lack of a developmentally sensitive model for conceptualizing short- and long-term effects and continuity and discontinuity of effects over time. This article proposes a model based in the perspective of developmental psychopathology. It is argued that incest has its unique negative effects in the domains of self and social functioning, specifically in jeopardizing self-definition and integration, self-regulatory processes, and a sense of security and trust in relationships. Studies with clinical samples indicate that diagnostic conditions associated uniquely with a history of incest reflect serious self- and social impairments. A review of the developmental literature on self and social development summarizes each major developmental transition from infancy to middle adulthood, and the implications for the negative effects of incest on development are discussed. Finally, implications for developmentally sensitive research are discussed.

Adolescent↗

The contribution of the cerebellum to mental and social functions in developmental age.

Here are present the data concerning the intellectual, language and frontal performances of 24 children who had undergone surgery because of cerebellar hemispheric or vermis tumors and one girl with viral cerebellitis. The children with right cerebellar tumors presented auditory sequential memory and language processing disturbances; those with left cerebellar tumors showed deficits in spatial tests and visual sequential memory. The girl with cerebellitis showed a complex neuropsychological picture with impairment in processing language and in general sequential functions. Lesions of the vermis lead to two pictures: 1) a postsurgical mutism that could be subdivided into speech disorders (even to the extent of anarthria) and true language disturbances similar to frontal aphasia; and 2) behavioral disturbances ranging from irritability to a truly autistic response. These data seem to support the recently attributed role of the cerebellum as a modulator of the superior mental and social functions.

Adolescent↗