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PubMed1997

Hostility, social support, and perceptions of work.

The aim of this study was to determine whether hostility and perceived availability of social support are related to perceptions of the work environment. The W.W. Cook and D.M. Medley (1954) Hostility (Ho) scale; the Interpersonal Support Evaluation List (S. Cohen, R. Mermelstein, T. Kamarck, & H. Hoberman, 1985); and measures of collegiality, time pressure, and job dissatisfaction were completed by 204 attorneys (159 men and 45 women). After controlling for age, gender, and other job characteristics, high Ho scores were related to lower perceived supportive collegiality at work. Low perceived availability of social support was related to greater job dissatisfaction. Neither hostility nor social support was associated with perceptions of time pressure at work. These findings suggest that hostility and availability of social support may be an important pathway linking certain job characteristics to cardiovascular disease and other illnesses.

Adaptation, Psychological↗
PubMed1995

Perceived family stress as a predictor of health-related outcomes.

OBJECTIVE: To measure the predictive effect of patient-perceived family stress for health-related outcomes. DESIGN: Prospective study of patients whose social stress and support were measured by self-report at baseline with the Duke Social Support and Stress Scale and used as predictors of outcomes during an 18-month follow-up period. SETTING: Rural primary care community health clinic. PATIENTS: Convenience sample of ambulatory adults. INTERVENTION: None. MAIN OUTCOME MEASURES: Follow-up (one or more follow-up visits), frequent follow-up (more than six visits), referral and/or hospitalization (one or more), high follow-up severity of illness (upper-tertile mean Duke Severity of Illness Checklist scores), and high follow-up total charges (> or = $268). RESULTS: There were 413 patients with a mean age of 40.4 years. Of these, 58.6% were women; 47.2%, African American; 52.8%, white; 56.7%, married; 77.2%, wage earners or housekeepers; and 52.3% had more than one health problem. At baseline, patients with high self-reported family stress (upper-tertile Duke Social Support and Stress Scale scores) had lower quality of life, functional health, and social support scores and higher dysfunctional health and social stress scores than other patients. High baseline family stress scores (scale of 0 to 100) predicted follow-up (odds ratio [OR] = 1.014), frequent follow-up (OR = 1.021), referral and/or hospitalization (OR = 1.018), high severity of illness at follow-up (OR = 1.016), and high follow-up charges (OR = 1.018) after controlling for the effects of social support, age, gender, and race. Family stress scores were stronger predictors of these outcomes than the other social stress and support variables. CONCLUSION: The finding of patient-perceived family stress as a risk factor for unfavorable health-related outcomes suggests the need for early detection and treatment of family stress by family physicians.

Adult↗
PubMed2004

Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior.

BACKGROUND: Deficits in social cognition and neurocognition are believed to underlie schizophrenia disability. Attempts at rehabilitation have had circumscribed effects on cognition, without concurrent improvement in broad aspects of behavior and adjustment. OBJECTIVE: To determine the differential effects of cognitive enhancement therapy (a recovery-phase intervention) on cognition and behavior compared with state-of-the-art enriched supportive therapy. DESIGN: A 2-year, randomized controlled trial with neuropsychological and behavioral assessments completed at baseline and at 12 and 24 months. SETTING: An outpatient research clinic housed in a medical center's comprehensive care service for patients with severe mental illness. PATIENTS: A total of 121 symptomatically stable, non-substance-abusing but cognitively disabled and chronically ill patients with schizophrenia or schizoaffective disorder. INTERVENTIONS: Cognitive enhancement therapy is a multidimensional, developmental approach that integrates computer-assisted training in neurocognition with social cognitive group exercises. Enriched supportive therapy fosters illness management through applied coping strategies and education. MAIN OUTCOME MEASURES: Six highly reliable summary measures--Processing Speed, Neurocognition, Cognitive Style, Social Cognition, Social Adjustment and Symptoms--were tested using analysis of covariance and linear trend analysis. RESULTS: At 12 months, robust cognitive enhancement therapy effects were observed on the Neurocognition and Processing Speed composites (P<.003), with marginal effects observed on the behavioral composites. By 24 months, differential cognitive enhancement therapy effects were again observed for the 2 neuropsychological composites and for Cognitive Style (P=.001), Social Cognition (P=.001), and Social Adjustment (P=.01). As expected, no differences were observed on the residual Symptoms composite. Effects were unrelated to the type of antipsychotic medication received. Enriched supportive therapy also demonstrated statistically significant within-group effect sizes, suggesting that supportive psychotherapy can also have positive, although more modest, effects on cognitive deficits. CONCLUSION: Many cognitive deficits and related behaviors of patients with stable schizophrenia are improved when sufficient exposure to relevant rehabilitation is provided.

Adult↗
PubMed1990

A public hospital closes. Impact on patients' access to care and health status.

We studied the impact of the closing of a public hospital on patients' access to care and health status. We surveyed individuals who had been medical inpatients at Shasta General Hospital, Redding, Calif, in the year prior to its closing and compared them with those in a second county, San Luis Obispo, whose public hospital did not close. Surveys were administered after the closing of Shasta General Hospital and 1 year later. We assessed outcomes using the Medical Outcomes Study Short Form and a series of transition questions that asked about changes in health over time. Data were available for 88% of patients at 1 year: 219 from Shasta County and 195 from San Luis Obispo County. At follow-up, the percentage of patients from Shasta County who reported no regular provider increased from 14.0 to 27.7 and the percentage who reported they were denied care rose from 10.8 to 16.9. Meanwhile, patients in San Luis Obispo County reported improved access to a regular provider and the level of denied care was unchanged. Patients in Shasta County had significant declines on the Medical Outcomes Study Short Form in health perception, social and role function, and increases in pain as compared with those patients in San Luis Obispo County. The closing of a public hospital had a significant effect on access to health care and was associated with a decline in health status.

California↗
PubMed1997

Nonverbal support giving induces nonverbal support seeking in depressed patients.

Nonverbal support seeking behavior of 11 mildly depressed patients was studied in relation to the nonverbal support giving behavior of a female interviewer. The patients were interviewed for 20 minutes during which the interviewer gave high and low nonverbal support for 10 minutes in a cross-over design. Different behavioral elements of the patients and of the interviewer were pooled into behavioral factors. Support seeking behavior (Speaking Effort) was significantly higher when high nonverbal support giving behavior (Encouragement) was displayed (p = .05). Also, a positive relationship between Encouragement and patients' Speech was observed (p = .04). The causal relationship between depressed patients' nonverbal support seeking behavior and an interviewer's nonverbal support giving behavior underscores an interpersonal approach of depression.

Cross-Over Studies↗
PubMed1997

Cultural pathways toward Antonovsky's sense of coherence.

This study empirically validated Antonovsky's suggestion that differing cultural pathways exist in the development of a Sense of Coherence Differences were found in the ways in which essentially identical levels of a Sense of Coherence were developed in Native Americans and Anglo-Americans. Native Americans' families appear to emphasize moral and religious values while Anglo-American families appear to emphasize achievement and independence.

Achievement↗
PubMed1998

Getting the right kind of support: functional differences in the types of social support on depression for Chinese adolescents.

The present study adopted a prospective design to explore relationships among various types of social support and depression. Four types of social support, namely network support, instrumental enacted support, socio-emotional enacted support, and perceived support, were assessed in a sample of Chinese adolescents. Results revealed that perceived support was related to a reduction of subsequent depression for both male and female adolescents. In addition, instrumental enacted support was a significant predictor of subsequent depression for male adolescents, whereas socioemotional enacted support was a significant predictor of subsequent depression for female adolescents. Functional differences in the types of social support for Chinese male and female adolescents, as well as implications for clinical intervention, are discussed.

Adolescent↗
PubMed1997

Social anxiety (phobia) and east Asian culture.

Since the introduction of the concept of social anxiety (or phobia) to the American nosological system in DSM-III (1980), it has become increasingly apparent that the condition is also prevalent in other cultures. In Japan, for example, the condition, called taijinkyofusho (usually abbreviated as TKS in English), is widespread and has been extensively discussed since the turn of the century, a fact not well known in the English-speaking psychiatric community. In comparing social phobia in Japanese society (and in other East Asian societies) with North American societies, two questions stand out. First, if TKS is social phobia, why is it so different from the American form of social phobia? In particular, why do typical TKS patients fear the possibility of distressing, and even harming, others, whereas their American counterparts feel anxious at the possibility of being embarrassed by others? In other words, why is TKS other-oriented (allocentric), whereas social phobia is self-oriented (egocentric)? Second, is TKS specific to Japanese culture? In this paper, I suggest that the allocentric nature of TKS reflects those elements of Japanese culture that are common to East Asian societies as seen in their pattern of child-rearing practices, language, and social ideals. In short, TKS is an East Asian cultural patterning of social anxiety (phobia).

Adult↗
PubMed1993

Social support and social cognitive problem-solving in children with newly diagnosed cancer.

Children newly diagnosed with cancer have been documented to be at increased risk for difficulties in their return to school and ongoing positive social experiences. This article reviews the critical role of social support in helping children adjust to their illness and treatment. Social skills training for newly diagnosed children is presented as an important intervention strategy for increasing positive social interactions and overall psychosocial adjustment. A randomized, clinical research trial currently in progress that will evaluate the impact of social skills training on newly diagnosed children 5-13 years of age is delineated. The potentially positive impact of social skills training on the prevention of emotional problems and increased biologic survival are discussed.

Adolescent↗
PubMed1975

Clinical and sign prediction: the draw-a-person and female homosexuality.

The validity of predicting female homosexuality from empirical signs from the Draw-A-Person (DAP) was compared to the validity of psychologists' "blind" predictions from the same DAP protocols. Four specific DAP signs significantly predicted homosexual drawings from those of heterosexual controls; patterns derived from these signs were even better predictors. Two of four clinicians predicted sexual orientation greater than chance; one predicted as well as the optimal sign pattern. In view of the expected shrinkage involved in cross-validating the empirical signs and patterns, clinical prediction probably would equal or surpass the accuracy of statistical prediction. Individual differences in clinical prediction and the process of clinical prediction were discussed.

Adolescent↗
PubMed1991

The difficult temperament in adolescence: associations with substance use, family support, and problem behaviors.

This study investigated interrelations between the number of difficult temperament factors (e.g., arrhythmicity, inflexibility, high distractibility) and substance use, perceived family support, and problem behaviors for a sample of 297 adolescents (M age = 15.7 years). The number of adolescent difficult temperament factors was associated significantly with more childhood behavior problems (e.g., hyperactivity, conduct disordered symptoms), which suggests some continuity of disordered behavior from childhood to adolescence. Number of adolescent difficult temperament factors also was associated with a higher percentage of substance users (for cigarettes, alcohol, marijuana, hard drugs), lower perceived family support, higher levels of depressive symptoms, and more delinquent activity. Number of difficult temperament factors was not associated significantly with gender or age of respondents.

Adolescent↗
PubMed1995

Psychometric properties of the MSPSS and NOS in psychiatric outpatients.

Prior research has demonstrated the utility of the Multidimensional Scale of Perceived Social Support (MSPSS) and the Network Orientation Scale (NOS) as measures of perceived social support among nonpsychiatric samples. The primary objective of this study was to determine whether these two scales can be used reliably among psychiatric outpatients, in particular those with schizophrenia or a major affective disorder. Subjects were 144 outpatients, aged 21 to 67 years, who completed the MSPSS and NOS. Results demonstrated high internal consistency for the MSPSS and adequate internal consistency for the NOS. In addition, convergent validity was demonstrated. Scores on both scales for these psychiatric outpatients were found to be lower as compared to "normals."

Adult↗
PubMed1979

Communication and abnormal behaviour.

In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential).

Communication↗
PubMed2005

Autism severity and temporal lobe functional abnormalities.

Two independent studies have described bilateral temporal hypoperfusion in autistic children. Temporal regions are implicated in social perception, language, and "theory-of-mind," abilities that are impaired in autism. We investigated a putative relationship between cerebral blood flow (rCBF) measured at rest and clinical profile of 45 autistic children (Autism Diagnostic Interview-Revised [ADI-R] scores). A whole-brain covariance analysis was performed. Significant negative correlation was observed between rCBF and ADI-R score in the left superior temporal gyrus. The more severe the autistic syndrome, the more rCBF is low in this region, suggesting that left superior temporal hypoperfusion is related to autistic behavior severity.

Autistic Disorder↗