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PubMed1991

Transfer between psychiatric hospitals: symptom, social function and patient attitude changes in long-term patients.

This study followed up a ward group of long-term, mainly schizophrenic patients after transfer from Bexley Hospital, a large institution in South East London, to small purpose built rehabilitation unit in a distant hospital, and used a matched control group of patients remaining in Bexley Hospital for comparison. There was no pattern of symptomatic improvement or deterioration with time in either group, but social functioning and behaviour did improve in those transferred. The patients transferred were well informed about the process, became more favourable about the medical advice offered to them but remained sure, as did patients in the control group, that they wanted to leave hospital eventually. We suggest that the successful transfer of patients between hospitals must involve clear information to prepare patients and relatives, the consent of patients, staff enthusiasm, the provision of a full range of services after transfer, including occupational therapy, and staff continuity.

Adult↗
PubMed1996

Social function after cervical hip fracture. A comparison of hook-pins and total hip replacement in 47 patients.

47 patients with a cervical hip fracture Garden 3 or 4 and fully ambulatory before the fracture, were randomized to either fixation with Hansson hook-pins (24 patients, median age 79 years) or to a Charnley hip replacement (23 patients, median age 80 years). The patients were followed for 2 years. Social function was evaluated using a standard questionnaire. There were no postoperative deaths and no significant differences in hospital stay. 9/24 patients treated with hook-pins developed healing complications and 2 dislocations occurred in the THR group. After 1 and 2 years, fewer patients treated with hip replacement used outdoor walking aids; they were also more likely to do their own shopping. Hip replacement is a good choice when treating healthy older people with displaced cervical hip fractures, when primary mortality is expected to be low and the risk of healing complications after nailing is high.

Activities of Daily Living↗
PubMed1985

Parental affective style and the treatment of schizophrenia. Predicting course of illness and social functioning.

In a randomized controlled study, the affective style (AS) of parents of schizophrenics in clinic-based individual treatment groups and home-based family treatment groups was compared prior to treatment and again three months after treatment had begun. Affective style is an index reflecting the quality of the family emotional climate, measured from face-to-face discussion. Pretherapy and posttherapy measures of negative AS were significantly predictive of relapse within the nine-month treatment period for patients in individual treatment. In addition, for both treatment groups, a negative AS pattern at the posttherapy reassessment was significantly associated with decreased patient social functioning, reduced ability of the family to absorb the family intervention, and lower capacity of the family to cope with everyday family stresses. The results suggest that AS is an important intrafamilial attribute, with implications for treatment strategy and planning.

Adolescent↗
PubMed2000

Conceptual structure and social functions of behavior explanations: beyond person--situation attributions.

The traditional approach to studying behavior explanations involves treating them as either person causes or situation causes and assessing them by using rating scales. An analysis of people's free-response behavior explanations reveals, however, that the conceptual distinctions people use in their explanations are more complex and sophisticated than the person-situation dichotomy suggests. The authors, therefore, introduce a model of the conceptual structure of folk behavior explanations (the network of concepts and assumptions on which explanations are based) and test it in 4 studies. The modes and features of behavior explanations within this conceptual structure also have specific social functions. In 2 additional studies, the authors demonstrate that people alter distinct features of their explanations when pursuing particular impression-management goals and that listeners make inferences about explainers' goals on the basis of these features.

Adult↗
PubMed2006

The EQ-5D in alcohol dependent patients: relationships among health-related quality of life, psychopathology and social functioning.

OBJECTIVE: The EQ-5D, a short generic health-related quality of life (HRQOL) questionnaire, can derive preference-based index scores (e.g. EQ VAS, British and German EQ-5D indices) for economic evaluation. This study examined if the EQ-5D could be a valid measure describing and valuing HRQOL in alcohol dependent individuals. METHODS: In a sample of 103 individuals diagnosed with alcohol dependence (ICD-10 F10.2), we compared the EQ-5D against a quality of life measure (WHOQoL-BREF), a utility scale (TTO), measures of psychopathology (SCL-90R, CGI-S) and measures of social functioning (GAF, GARF, SOFAS, HoNOS). RESULTS: The response rate to EQ-5D dimensions was > 98%. Twelve percent of the individuals indicated "extreme problems" in at least one dimension. Different response levels in the dimension "anxiety/depression" were associated with largest effect sizes (absolute value(d)) of differences in mean scores of the WHOQoL-BREF domain "mental" (absolute value(d) = 1.17), the SCL-90R scales "obsessive-compulsive" (absolute value(d) = 1.15), "depression" (absolute value(d) = 1.16), "anxiety" (absolute value(d) = 1.10) and "GSI" (absolute value(d) = 1.09) indicating a similarity between the underlying constructs; concerning the dimensions "self-care", "usual activities", "pain/discomfort" and "mobility" effect sizes were generally lower (0.74 < absolute value(d) < 1.07) or insignificant. The EQ-5D VAS score (mean 58.0), the British EQ-5D index (mean 0.74) and the German EQ-5D index (mean 0.85) showed moderate correlations with other scales (0.28 < r < 0.60). CONCLUSION: Seventeen out of 30 hypothesized relationships between similar constructs of the EQ-5D and measures used for comparison were confirmed, possibly favoring EQ-5D's validity. However, the EQ-5D showed a moderate ceiling effect. Further confirmatory research is needed to support the EQ-5D suitability for economic evaluation in alcohol dependent populations.

Activities of Daily Living↗
PubMed2005

Electrophysiological indices associated with social functioning outcome in schizophrenia: a 5-year follow-up study.

We previously demonstrated that event-related potentials (ERPs), such as N1/N2b amplitudes in an auditory selective attention task, were significantly associated with communication skills of schizophrenia. The present study investigated the relationship between N1/N2b amplitudes and the quality of life (QOL) 5 years after ERP measurement. QOL of 15 patients with schizophrenia was assessed using the quality of life scale (QLS). Correlational analyses revealed a significant relationship between N2b, but not N1, amplitude and specific domains of QOL. N2b amplitude, an electrophysiological index of orienting response, may be associated with longitudinal social functioning outcome in schizophrenia.

Acoustic Stimulation↗
PubMed1997

Treating depressed primary care patients improves their physical, mental, and social functioning.

BACKGROUND: This study describes the functioning of primary care patients with major depressive disorder, the relationship of medical comorbidity to functional status, and the effects of depression-specific treatment on functional status after 8 months. METHODS: Patients were randomized to a protocol intervention (nortriptyline hydrochloride or interpersonal psychotherapy) or to usual care with the patient's physician in a clinical trial of primary care treatments of depression. Their functional status was evaluated using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and the Global Assessment Scale. Medical comorbidity was assessed with the Duke Severity of Illness Checklist. The Hamilton Rating Scale for Depression and Beck Depression Inventory were used to measure depressive severity. Assessments were conducted at baseline and at 1, 2, 4, and 8 months after randomization. RESULTS: At baseline, patients reported substantial impairments in the functional domains as assessed by the SF-36 and Global Assessment Scale. Severity of general medical illness and depression were not correlated. Greater medical comorbidity was associated with diminished physical, but not psychological, functioning. Mean scores on SF-36 scales and the Global Assessment Scale improved significantly during the 8 months of follow-up. Patients assigned to protocol treatments showed greater improvement, compared with those assigned to usual care, on the SF-36 mental summary scale and most individual scales but not on the SF-36 physical summary scale. However, patients who completed protocol treatment also experienced significant improvement on the physical summary scale. Medical comorbidity was only a weak predictor of outcome. CONCLUSIONS: Primary care patients with major depressive disorder report substantial impairments in physical, psychological, and social functioning on initial assessment. Severity of baseline medical comorbidity did not correlate with severity of depression and only weakly correlated with functional status at 8 months. Functional impairments improve with time, but standardized depression-specific treatment is associated with greater improvement in more domains of functioning than is a physician's usual care.

Adolescent↗
PubMed2006

Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders.

Research has paradoxically linked awareness of illness to both better function outcomes and lesser hope and self-esteem. One possible explanation for these findings is that acceptance of having schizophrenia may impact outcomes differently depending on the meanings the person attaches to this acceptance, particularly whether he or she accepts stigmatizing beliefs about mental illness. To explore this possibility we performed a cluster analysis of 75 persons with schizophrenia spectrum disorders based on single measures of insight using the Positive and Negative Syndrome Scale, internalized stigma using the Internalized Stigma of Mental Illness Scale, and compared groups on concurrent assessments of hope and self-esteem. Three groups were produced by the cluster analyses: low in sight/mild stigma (n = 23), high insight/minimal stigma (n = 25), and high insight/moderate stigma (n = 27). As predicted, analysis of variance-comparing groups revealed that the high insight/moderate stigma group had significantly the lowest levels of hope on the Beck Hopelessness Scale and self-esteem using the Multidimensional Self-esteem Inventory. As predicted, the high insight/minimal stigma group also had significantly less impaired social function than the other groups. Implications for assisting persons to come to cope with awareness of illness and stigma are discussed.

Adaptation, Psychological↗
PubMed2006

Intimate partner violence and women's physical, mental, and social functioning.

OBJECTIVE: To describe the relationship between women's health and the timing, type, and duration of intimate partner violence (IPV) exposure. METHODS: A telephone interview was completed by 3429 women aged 18 to 64 randomly selected from a large health plan, to assess IPV exposure and heath status (response rate 56.4%). Questions from the Behavioral Risk Factor Surveillance System and the Women's Experience with Battering scale were used to construct IPV exposures: (1) recent (past 5 years) and remote (before past 5 years only) IPV exposure of any type (physical, sexual, or non-physical); (2) recent (past 5 years) IPV exposure to physical and/or sexual or non-physical only; and (3) IPV duration (0 to 2 years, 3 to 10 years, and >10 years). Health outcomes were measured using the Short Form-36 survey (SF-36), the Center for Epidemiologic Studies Depression scale, and the National Institute of Mental Health Presence of Symptoms survey. RESULTS: In adjusted models, compared to women with no IPV in their adult lifetime, more-pronounced adverse health effects were observed for women with recent (vs remote) IPV; for physical and/or sexual (vs non-physical) IPV; and for longer IPV exposure. Compared to women who never experienced IPV, women with any recent IPV (physical, sexual, or non-physical) had higher rates of severe (prevalence ratio [PR]=2.6; 95% confidence interval [CI]=1.9-3.6) and minor depressive symptoms (PR=2.3; 95% CI=1.9-2.8); higher number of physical symptoms (mean, 1.0; 95% CI=0.7-1.2); and lower SF-36 mental and social functioning scores (range, 4.3-5.5 points lower across subscales). Women with recent physical and/or sexual IPV were 2.8 times as likely to report fair/poor health, and had SF-36 scores that ranged from 5.3 to 7.8 points lower, increased risk of depressive symptoms (PR=2.6) and severe depressive symptoms (PR=4.0), and more than one additional symptom. Longer duration of IPV was associated with incrementally worse health. CONCLUSIONS: Women's health was adversely affected by the proximity, type, and duration of IPV exposure.

Adolescent↗
PubMed1994

Family functioning, social support and depression after traumatic brain injury.

Functional outcome after traumatic brain injury (TBI) is thought to be dependent upon effective social support and avoidance of depressive episodes. Research indicates that post-injury changes often occur in the family's functioning, hence impacting the family's ability to provide the needed social support. Social support, in turn, has been hypothesized to work as a buffer between significant life event and levels of depressive symptoms. Thus poor social support after a TBI, due to changes in family functioning, could result in depressive episodes for the person with a TBI. This paper empirically examines this question by investigating whether social support is predictive of depression in persons who have sustained a TBI. Thirty-nine persons who had sustained TBI were interviewed to assess their family functioning, perceived social support, and current depressive symptomatology. The results showed that the effective use of problem-solving and behavioural coping strategies by the family in response to TBI was significantly related to lower levels of depression in the person who sustained the TBI. However, perceived social support was not predictive of depression.

Adaptation, Psychological↗
PubMedDate not supplied

Autonomy and adolescent social functioning: the moderating effect of risk.

This study examined the moderating effect of risk on the relation between autonomy processes and family and adolescent functioning. The present sample comprised 131 adolescents from either a low-risk or high-risk social context, their mothers, and their peers. Observational ratings of autonomy processes within the mother-adolescent dyad were obtained, along with adolescent reports of the quality of the mother-adolescent relationship, and both adolescent and peer reports of the adolescent's functioning. Consistent with past research, in low-risk families, behavior undermining autonomy was negatively related to relationship quality, and adolescents' expressions of autonomy were linked with positive indices of social functioning. In high-risk families, however, undermining of autonomy was positively linked with mother-adolescent relationship quality, and adolescents' expressions of autonomy were linked with negative indices of social functioning. Results are interpreted as demonstrating the ways in which the developmental task of attaining autonomy in adolescence is systematically altered depending on the level of risk and challenge in the adolescent's social context.

Adaptation, Psychological↗
PubMedDate not supplied

Influence of HIV-infection on the Karnofsky score and general social functioning in patients with hemophilia.

Quality of live, defined by different models, has become a major focus of research in chronic disorders. Patients with hemophilia have been found to suffer seriously from the impact of HIV infection. To compare the impact of HIV infection on HIV-positive and HIV-negative patients, we evaluated a group of 60 patients, 30 being positive and 30 negative, suffering from hemophilia, using the Karnofsky index of functioning besides more general social and clinical data. Most patients (n = 53) suffered from hemophilia A. The mean Karnofsky score decreased from 65.22 to 63.43 in the HIV-infected group between 1988 and 1991, but increased from 77.7 to 82.2 in the HIV-negative group; differences were not significant, though differences were significant between the HIV-infected and HIV-negative groups. The Karnofsky score remained constant or increased in 26 (86.6%) of the HIV-negative patients, in contrast to 50% in the infected group. Seven patients, all from the infected group, had died in 1991. The initial Karnofsky score was not a prognosticator of survival. The group as a whole was socially well integrated. Consequently, the Karnofsky score can be a useful instrument in evaluating the global quality of live in HIV-infected patients, though a careful evaluation of results is necessary and a low initial score does not predict survival.

Adolescent↗
PubMed2002

Improving social functioning in schizophrenia by playing the train game.

Social impairments have long been recognized as a core feature of schizophrenia. Poor social, self-care, and vocational functioning are criteria for a diagnosis of schizophrenia in most diagnostic systems. Consequently, improving the social behaviors of persons with schizophrenia has been a key target of psychiatric rehabilitation techniques. One such technique, social skills training, has demonstrated effectiveness in yielding skill acquisition, durability, and generalization (1) and has been recognized as a psychosocial treatment of choice for schizophrenia (2). Nevertheless, a number of limitations to the benefits that may be achieved through skills training have been described. For example, the cognitive impairments of persons with schizophrenia, such as poor sustained attention and verbal memory deficits, have been shown to limit the acquisition of social skills (3). Moreover, one study showed that patients with negative symptoms, such as apathy, anhedonia, and amotivation, have an impaired capacity to benefit from social skills training (4). However, the results of a more recent study suggest that only persons with primary, deficit-type negative symptoms-not those with negative symptoms secondary to positive psychotic symptoms, depression, or extrapyramidal side effects-are unable to benefit from conventional social skills training (5). Recognizing these obstacles to implementing a social skills training program for persons with schizophrenia, Torres and his colleagues have created a board game called El Tren (The Train). Several characteristics of El Tren make it ideal for use with this population. First, the game is behaviorally oriented and has an emphasis on positive reinforcement and shaping. Second, it is sensitive to the cognitive limitations of the participants, emphasizing repetition and procedural learning. Third, it is designed to overcome participants' negative symptoms by being entertaining and fun. In this month's column, these authors describe El Tren and present the results of a randomized controlled study of its efficacy.

Analysis of Variance↗
PubMed2005

Social functioning and personality of subjects at familial risk for affective disorder.

BACKGROUND: Particular patterns of personality (e.g., neuroticism, obsessionality) and difficulties in various social roles have been found to be associated with unipolar depression. Interpersonal and instrumental difficulties of depressives can be understood either as a risk factor, or as a consequence caused by the disorder itself. Concerning patients with bipolar disorder, there is some evidence that their premorbid level of occupational and educational achievement is often superior when compared to the premorbid functioning of patients with unipolar depression. METHODS: Personality features and the level of social functioning of 114 high-risk subjects (healthy first-degree relatives of patients suffering from an affective disorder) have been investigated using self- and expert-ratings. Sixty-three subjects without a personal and family history of psychiatric disorder served as the reference group. RESULTS: Relatives of melancholic depressives described themselves as more neurotic than controls but proved to be inconspicuous regarding their role functioning. Relatives of bipolar I patients were more strongly oriented toward social norms, and their instrumental role functioning was superior to that of controls. Neuroticism was strongly associated with depressive symptoms. LIMITATION: The statistical power of our data is sufficient to detect medium effect sizes but is insufficient for identifying small group differences. CONCLUSION: Whether these discriminating personality features and other variables (not characterising the high-risk group (HRG) as a whole) act as true vulnerability factor have to be clarified by a follow-up investigation.

Adolescent↗
PubMed2006

Diversity in in-group bias: structural factors, situational features, and social functions.

Four experiments addressed the different forms and functions of in-group bias in different contexts. The authors proposed 2 functions: an identity-expressive function and an instrumental function (or promotion of positive social change). The authors manipulated status differentials, the stability of these differences, and the communication context (intra- vs. intergroup) and measured in-group bias and both functions. As predicted, identity expression via in-group bias on symbolic measures was most important for stable, high-status groups. By contrast, material in-group bias for instrumental motives was most prevalent in unstable, low-status groups but only when communicating with in-group members. This latter effect illustrates the strategic adaptation of group behavior to audience (i.e., displaying in-group bias may provoke the out-group and be counterproductive in instrumental terms). Stable, low-status groups displayed more extreme forms of in-group bias for instrumental reasons regardless of communication context (i.e., they had nothing to lose). Results are discussed in terms of a contextual-functional approach to in-group bias.

Adult↗
PubMedDate not supplied

Family education seminars and social functioning of adults with chronic aphasia.

UNLABELLED: Aphasia affects functional activities and participation in social roles years after onset. Some group and individual programs have reported success in improving social activities and perceived wellness. These programs typically last several weeks or months. A short, 2-day seminar style program designed for adults with chronic aphasia and their families is described in this report. Six-month follow-up data from participant pairs demonstrates a significant improvement in functional activity level, improved knowledge of aphasia, and improved family relationships. Nonparticipant pairs did not demonstrate any changes over the same period. These findings replicate and extend those of a previous study on the same 2-day seminar [Top. Stroke Rehabil. 2 (1995) 53.]. The results of this study demonstrate the important outcomes of even a very brief program designed to address the long-term psychosocial needs of adults living with aphasia and their families. EDUCATIONAL OBJECTIVES: As a result of this activity, the participant will be able to: (1) describe a brief family education seminar for adults with chronic aphasia; (2) discuss outcomes in family adjustment, community reintegration, and activities of daily living associated with participation in a family education seminar; and (3) evaluate areas of programming and outcomes that should be addressed in future research.

Aphasia↗
PubMed2006

Girls' and mothers' social anxiety, social skills, and loneliness: associations after accounting for depressive symptoms.

This study examined, in 102 mother-daughter dyads, whether (a) girls' social skills and loneliness are related to girls' social anxiety, after adjusting for girls' depressive symptoms, and (b) mothers' social functioning (social anxiety, social skills, and loneliness) is related to girls' social anxiety, after accounting for girls' social functioning (social skills and loneliness) and mothers' and girls' depressive symptoms. After accounting for girls' depression, girls' loneliness (and not social skills) was related to girls' self-reported social anxiety and girls' social skills (and not loneliness) were related to mothers' reports of girls' social anxiety. Mothers' social functioning accounted for significant variance in girls' social anxiety, beyond that accounted for by girls' social functioning and mothers' and girls' depression. Mothers' loneliness and fear of negative evaluation showed significant relations to girls' social anxiety when variance attributable to other variables was partialed out, whereas mothers' social skills and social avoidance and distress did not. Directions for future research on social anxiety are highlighted.

Adult↗
PubMedDate not supplied

Changes in cognitive and social functioning of diabetic patients following initiation of insulin infusion therapy.

Functional health outcomes resulting from intensive insulin regimens may differ depending upon the age of the diabetic patient. This study tested the hypothesis that health functioning is poorer for younger insulin-dependent diabetic (IDDM) patients following a change to the insulin infusion pump regimen, with progressive improvements occurring in functional health status at higher age levels. Thirty IDDM patients aged 10-47 years were administered health status instruments prior to changing to the new regimen, and again six months later. The instruments assessed physical, cognitive, psychological, and social health functioning. When compared at six months to an age-matched control group on conventional insulin therapy, declines in social activities were found for younger insulin pump patients, with improvements occurring linearly as age increased. Lower performance levels were also found for the younger patients in Conceptual Quotient (CQ), an indicator of cognitive functional status, with progressive improvements with age through the early 30s. However, corresponding declines in function occurred at the oldest age levels. Adaptation to an intensive diabetes regimen appears to be more difficult at younger and older age levels.

Activities of Daily Living↗