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PubMed2006

Cognitive predictors of skill acquisition on social problem solving in patients with schizophrenia.

The aim of the study was to evaluate the relationship between social problem solving ability, clinical features and cognitive functions, and determine the predictors of benefit from social problem solving training in 63 patients with schizophrenia. We administered Brief Psychiatric Rating Scale (BPRS), Wisconsin Card Sorting Test (WCST), Digit Span Test, Continuous Performance Test (CPT) and the Assessment of Interpersonal Problem Solving Skills (AIPSS). Only BPRS-positive symptoms subscale was negatively related to AIPSS on linear regression analysis. After the completion of the pretest, the patients were randomized to either problem solving training (n = 32) or control groups (n = 31). Patients in training group received 6 weeks problem solving training in-group modality, and those in control group were treated as usual. We readministered AIPSS at the end of 6 weeks. There were significant changes from pretest to posttest on AIPSS-total, AIPSS-receiving skills, and AIPSS-processing skills score in training group but not in control group. The number of correct answers in WCST and CPT hit rate were the predictors of post-training AIPSS scores in training group. Our findings suggest that skill acquisition on social problem solving is related with cognitive flexibility and sustained attention.

Adolescent↗
PubMed2004

The criminogenic, clinical, and social problems of forensic and civil psychiatric patients.

Forensic psychiatric patients consume an increasing proportion of mental health resources in Canada and the United States. To inform mental health policy and practice, we compared the criminogenic, clinical, and social problems of forensic patients to those of civilly committed psychiatric patients in two Canadian studies. We predicted that forensic patients would score higher on criminogenic problems and lower on clinical and social problems than civil patients in two studies: one comparing 83 forensic and 189 civil inpatients on a clinician-completed form, the Resident Assessment Instrument--Mental Health, at an urban mental health center, and the second comparing 423 forensic and 178 civil patients assessed at different times using the Patient Problem Survey. The two studies were quite similar in their findings, despite differences in their samples, measures, and data collection methods. In both studies, forensic patients were similar to or lower than civil psychiatric patients in all criminogenic, clinical, and social problems. We conclude that forensic mental health services would benefit greatly by drawing from knowledge accumulated in the general psychiatric literature. This finding also supports the idea that many forensic patients can be appropriately diverted to nonforensic mental health services.

Adult↗
PubMed2004

Clinical holistic medicine: social problems disguised as illness.

Many of the diseases seen in the clinic are actually symptoms of social problems. It is often easier for the physician to treat the symptoms than to be a coach and help the patient to assume responsibility in order to improve quality of life, social situation, and relations. If the physician ignores the signs of the disease as a symptom of social problems, and treats the patient with pharmaceuticals, he can give the patient the best justification in the world not to do anything about the situation. It is very important that the physician is not tricked by the games the socially troubled patient, more or less unconsciously, is playing. A firm and wise attitude that confronts the patient with his or her lack of responsibility for solving social problems seems to be a constructive way out. The physician can give holding and support, but the responsibility must remain with the patient. Often it is better for the patient that the physician abstains from giving drugs that can remedy the symptoms and takes the role of a coach instead. Suffering is not necessarily bad, suffering is actually highly motivating and often the most efficient source of learning. Coaching can help the patient canalize his motivation into highly constructive considerations and behavior. A holistic approach thus gives the patient learning and helps him rehabilitate his social reality. Concerning children with recurrent or chronic pain, we have observed an overuse of painkillers, where we believe part is of a psychosomatic nature due to poor thriving in the family. Here the physician has an important job helping the parents to develop as persons, teaching them the basic holding of awareness, respect, care, acknowledgment and acceptance of their child. Most of the chronic pain and discomfort with children can be improved if the physician understands how to use the holistic medical toolbox.

Holistic Health↗
PubMed2000

The measurement of alcohol-related social problems in Sweden.

During the first decades following the end of World War II, registers were the predominant data source in Sweden for studying alcohol-related problems and, before the abolition of the rationing system, also for mapping drinking habits. This was possible due to the strict individual control system of alcohol that dominated in Sweden for many decades. With the gradual shift from individual control to general control in the 1960s, and 1970s, the possibility of using registry data was reduced, and for the past 20 years or so they have almost never been used to study the relationship between drinking and social problems. Instead, not only drinking levels and drinking patterns, but also social problems associated with alcohol, have slowly but to an increasing extent been measured by self-reported questions in general population surveys. This paper discusses experiences gained from working with self-reported survey data on alcohol-related social problems in Sweden for the past few years and describes discrepancies between register- and survey-based analyses. Swedish examples suggest that it is unlikely that survey data can be used successfully to estimate the prevalence of serious alcohol-related social problems in society. Survey data may be more suitable for estimating risks associated with different drinking levels and drinking patterns in the general population on an ordinal level. However, there is still much room for improvement in the Swedish alcohol surveys that include questions on alcohol problems.

Adolescent↗
PubMed2001

A classification system of social problems: concepts and influence on GPs' registration of problems.

OBJECTIVES: (1) To test lists of problems in the three axes of well-being (physical, mental, and social) with the GPs' collaboration (2) To place the resulting classification in the context of other ones aiming at collecting data about psycho-social aspects of life (assessment, index and classification systems). (3) To test if GPs would be induced to record psychological and social problems more often in their everyday practice, after having been trained to look more closely at them, inter allia with the use of classification and codes. METHOD: The lists of problems have been initiated by the WHO Department of Mental Health and discussed at an international symposium; they were then tested on the field, first at an international level, then in Belgium. After discussion by 4 Belgian GPs' Teaching Units, they were then improved. In all surveys concerned, general practitioners were asked to collaborate in three ways: opening their usual medical records and collaborating to prospective phases, including one "test phase," i.e., a training session, recording problems with the use of coding lists, and looking for the proper code. Retrospective and prospective approaches were used both before and after this test phase. RESULTS: (1) The original lists of problems have been improved on the basis of the findings in medical files and in the survey. (2) A conceptual framework is presented for recording social problems, either in everyday practice (i.e., in health records) or in research settings, e.g., for social surveys. It is biaxial: domains and types of problem. (3) Training GPs for using such a coding system drastically increases the number of psycho-social problems, but only during the prospective phases. In the long run older habits prevail again; only the overall number of contacts mentioning a reason increases, together with the number of "other" reasons for encounter (requests, ...). CONTENTS: (1) Main concepts (section 1). (2) Various tools for measuring psychosocial problems and well-being (section 2). (3) New conceptual fanmework for a classification of psychosocial problems ( 2.2.3). (4) Using the lists: influence on MDs' recording propensity (section 3).

Belgium↗
PubMed1994

Evaluation of social problem solving in schizophrenia.

We examined social problem solving in schizophrenia. Twenty-seven schizophrenic patients in an acute hospital, 19 patients with bipolar disease, and 17 demographically matched nonpatient controls were tested on an empirically developed problem-solving battery that assessed the ability to generate solutions to problems, the ability to evaluate the effectiveness of solutions, and the ability to implement solutions in a role-playing format. Schizophrenic Ss were impaired on all 3 problem-solving domains compared with the nonpatient controls, but bipolar Ss were equally impaired. Several alternative explanations for these findings were considered. The most compelling hypothesis is that the deficits resulted from different factors: cognitive impairment for schizophrenic Ss and acute illness for bipolar Ss. However, longitudinal studies are required to determine whether problem-solving deficits in schizophrenic patients persist during periods of remission. Implications for rehabilitation strategies are discussed.

Adult↗
PubMedDate not supplied

Detecting social problems in cancer patients.

Diagnosis of and treatment for cancer may not only create physical and emotional difficulties for patients but may also have an impact on social aspects of patients' lives. Screening for social problems has not become part of routine oncology practice. This may be due to lack of a suitable questionnaire. This paper presents a psychometric analysis of the Problems Checklist with a view to assessing its usefulness as a screening tool for social problems in oncology. Evaluation was undertaken using data from an earlier study of 505 patients who completed the checklist. Frequency of endorsement, missing values, factor analysis and reliability and validity analysis of the summated scales were carried out. Missing data rates ranged from 4 to 18% over the 16 items. Fourteen items were well endorsed. Factor analysis produced a four-factor structure with components labelled daily living, relationships, economics and emotions. Reliability and validity tests endorsed the factor structure with the components on economics and emotions being particularly credible. Difficulties with relationships are harder to measure and results from the analysis suggest that this is an area that warrants further investigation. The checklist is a useful tool for highlighting problems. As a tool for screening for social problems it has some limitations.

Adaptation, Psychological↗
PubMed1986

Impact of a preventive social problem solving intervention on children's coping with middle-school stressors.

Children receiving 1 year or 1/2 year of a preventive social problem solving program in elementary school were compared with each other and with a no-treatment group upon entry into middle school. One year of training was significantly related to reductions in the severity of a variety of middle-school stressors. Most importantly, a clear mediating role for social problem solving (SPS) skills was found. Children lacking in SPS skills were more likely to experience intense stressors; however, possessing the skills was not necessarily predictive of adjustment to stressors. The results are discussed in terms of the implications of this asymmetry and the strong support given to the value of social problem solving as a preventive intervention for children.

Adaptation, Psychological↗
PubMedDate not supplied

Social problems of infertile women in India.

Female partners of 200 consecutively seen infertile couples attending our infertility clinic were interviewed on a structured, precoded form for the social problems faced by the childless women. One or more social problems were present in 34% couples, of whom 53% faced abandonment. Sixteen percent of the women had a strained relationship with their husbands. Social problems increased with duration of marriage and infertility, while these decreased with increase in age, education, and income of the husband. Similarly, the problems decreased with women's education and income. Only seven couples had requested AID.

Adolescent↗
PubMed2005

Variations in the prevalence of psychiatric disorders and social problems across Canadian provinces.

OBJECTIVE: To determine provincial 12-month prevalence rates for selected psychiatric disorders and to assess the association between these and the Canadian Social Problem Index (SPI). METHOD: Psychiatric data for depression, mania, panic disorder, social phobia, and agoraphobia were derived from the results of the 2002 Canadian Community Health Survey: Mental Health and Well-Being. The Canadian SPI was updated for 2002, and correlations were calculated between the SPI and the 5 diagnostic prevalence values across provinces. RESULTS: The results showed that the SPI had maintained its tendency to increase from east to west in Canada, a trend reflected by depression and mania. The psychiatric disorders did not show strong correlations with the SPI in 2002, but depression and mania did show relatively strong associations with index values from earlier years. High-to-low ratios across provinces for individual social problems averaged over 5, and the results were essentially of the same magnitude for the ranges of particular psychiatric diagnoses. CONCLUSIONS: The differences in need found here suggest that per capita allocation of funding for mental health and social programs may not be appropriate. The mixed findings on the association between mental disorders and social problem behaviour across provinces leads to more research questions than research answers.

Adolescent↗
PubMed1989

Teenage pregnancy: a theoretical analysis of a social problem.

This paper begins by contrasting the two basic ways of defining a social problem (i.e., as a "problem" in society or of society). The implications of these two definitions are discussed within the context of the various approaches which have emerged from each. A typology is then developed which allows these divergent approaches to be synthesized into three broad categories (Social Disorganizational, Social Definitional, and Social Organizational). This typology helps to further clarify the implications of isolating certain noxious conditions (whether personal or social) and conceptualizing them as social problems. These implications for the emergence, scope, and possible solution to the problem of teenage pregnancy are discussed. The paper concludes with a theoretical critique that leaves little room for optimism about the piecemeal solutions to teenage pregnancy offered by either the social disorganizational or the social definitional approaches, yet it recognizes the unlikely prospects that the holistic solution is likely to be adopted soon. The paper thus concludes that this problem is likely to be with us for some time to come, and the best that we can hope to do is to treat the symptoms.

Adolescent↗
PubMed2003

[Torture as a medico-psychological and social problem].

AIM: To investigate and define the consequences of the torture in civilian survivors of state sponsored violence in Bosnia and Herzegovina and to point out that torture is not solely medical and psychological problem but also a social problem requiring various interventions of the society at large. METHODS: The study included 50 subjects who were survivors of torture. For registration of psychopathological symptoms, the Multidimensional Instrument for Symptoms Assessment SCL 90-R comprising 90 items divided in 9 subscales, (L.R. Derogates 1986) was used. The Mississippi Questionnaire containing 35 items, (Kean. et al. 1988) for the registration of the symptoms of the posttraumatic stress disorders, was used and Sociodemographic questionnaire for the registration of the sociodemographic characteristics of the subjects, was used. RESULTS: Our research indicates statistically significant decline in social position of the survivors of the torture compared with their life situation before surviving the atrocities of the war their economic position is weaker, unemployment rate in this population reaches 82% compared with the rate of 24% before the war. They also survived the loss of a great number of family members. The subjects also presented with a variety of somatic and psychological symptoms. CONCLUSIONS: Torture survivors comprise the most vulnerable group in the society after the war and they require multidisciplinary program for their psychosocial rehabilitation. This, comprehensive approach includes social and legal guarantees in order to protect their rights and interests.

Adolescent↗
PubMed2000

Social problem solving in children with acquired brain injuries.

OBJECTIVES: To assess the performance of children with acquired brain injuries (ABIs) on a measure of social problem solving and to examine the relationships between participant characteristics and performance on the Social Knowledge Interview (SKI) and between parent-reported child behavior and performance on the SKI. DESIGN: Between-group comparisons using correlational analyses, matched pairs t-tests, and analysis of covariance (ANCOVA). PARTICIPANTS: Thirty-one children 6-12 years old with ABI and 31 control participants, matched on age and sex. MAIN OUTCOME MEASURE: The SKI, a measure of social problem-solving skills. RESULTS: Using matched pairs t-tests and ANCOVA, groups were compared on several SKI measures, including the number of unique responses generated for each problem scenario, the quality of those responses, and the ability to select the best response from a set of alternatives. When equated for socioeconomic status (SES), ABI and control participants performed similarly on the SKI; however, a trend for children with ABI to generate more assertive responses was observed. Performance on the SKI was positively correlated with IQ and related to parent-reported adaptive behavior. In children with ABI, performance was also related to primary lesion location and treatment regimen. CONCLUSIONS: Children with ABI are as capable of judging the appropriateness of behavior and generating response options on an analog measure of social problem solving as were their typically developing peers. However, those individual children with ABI who are more likely to have social problems may be identified by the qualitative aspects of their responses on analog tasks. These findings have implications for the identification of children with social skills deficits following ABI and for the development of effective rehabilitation strategies.

Brain Injuries↗
PubMed2004

[A set of questionnaires for the assessment (screening) of psychological disorders and social problems in cardiac rehabilitation patients].

A set of questionnaires for the assessment (screening) of psychological and social problems in cardiac rehabilitation patients is analyzed for its psychometric properties. The test battery had before been consented by a task force of the German Association for the Prevention and Rehabilitation of Cardiovascular Disease, DGPR. It integrates generally approved and well-tried assessments for depression/anxiety, social isolation (vocational) stress, and subjective vocational disability. The questionnaire was administered to a convenience sample of 426 patients undergoing inpatient cardiac rehabilitation. Results on the psychometric properties, a comparison of the cardiac sample to the general population, as well as distributions of quartile ranges are reported. Also, a preliminary appraisal of the need for further assessment or treatment is made. The results confirm that the short test battery is suited for assessing psychological and social problems in cardiac rehabilitation patients.

Adult↗
PubMed1995

Adolescent health and social problems. A method for detection and early management. The Dartmouth Primary Care Cooperative Information Project (COOP).

OBJECTIVE: To develop and test a method for identification and early management of the health and social problems of adolescents, many of which go undetected and untreated. METHODS: Picture-and-word charts for the measurement of health and social problems formed the core of a brief, self-teaching lesson. Other sections of the lesson were designed to help teenagers interpret, invent solutions for, and communicate concerns about these problems. We examined the impact of the lesson on teenagers' understanding of themselves, their feelings, and their actions. Two hundred ninety-one adolescents served as subjects for this research. RESULTS: Less than 5% of the respondents found the chart-based lesson difficult or bothersome in the way it probed personal topics. Ninety percent reported that the lesson would have some positive impact on their actions or feelings. Three to six weeks after completing the lesson, their opinion of its impact remained high, and 36% of the students reported that they had shown it to others outside the school. CONCLUSION: A chart-based lesson is well accepted by adolescents and can be used to overcome obstacles for the detection and early management of adolescents' health and social problems.

Adolescent↗
PubMed1984

Inclusion of social problem categories in disease registers.

The reliability of a disease register as a record of the number and type of social problems was investigated in one practice of approximately 12,000 patients. A comparison with a randomly selected sample of the practice population, matched for age and sex, indicated that some social problems were not included. The types of problem concerned, and the reasons why they were not included, are discussed.

England↗
PubMed2001

Enhancing social problem solving in children with autism and normal children through computer-assisted instruction.

Children with autism have difficulty in solving social problems and in generating multiple solutions to problems. They are, however, relatively skilled in responding to visual cues such as pictures and animations. Eight distinct social problems were presented on a computer, along with a choice of possible solutions, and an option to produce alternative solutions. Eight preschool children with autism and eight matched normal children went through 10 training sessions interleaved with 6 probe sessions. Children were asked to provide solutions to animated problem scenes in all the sessions. Unlike the probe sessions, in the training sessions problem solutions were first explained thoroughly by the trainer. Subsequently these explanations were illustrated using dynamic animations of the solutions. Although children with autism produced significantly fewer alternative solutions compared to their normal peers, a steady increase across probe sessions was observed for the autistic group. The frequency of new ideas was directly predicted by the diagnostic category of autism. Results suggest young children with autism and their normal peers can be taught problem-solving strategies with the aid of computer interfaces. More research is required to establish whether such computer-assisted instruction will generalize to nontrained problem situations in real-life contexts.

Autistic Disorder↗
PubMed1993

[Acceptability, reliability and validity of the Corney and Clare social problems questionnaire].

OBJECTIVE: To evaluate the acceptability, reliability and concurrent validity of the CORNEY and CLARE self-administered social problems questionnaire. DESIGN: Reliability was studied by a test-retest (24 hours). Validity (concordance) was studied through comparison with a standard social adaptation interview. SETTING: Primary Health Care. PATIENTS: Consecutive patients attached to a long-treatment nursing station and 4 medical clinics. MEASUREMENTS AND MAIN RESULTS: The questionnaire consisted of 33 items and evaluated 9 areas of social functioning. In each area, the items covered 2 types of evaluation: problems in objective circumstances or in functioning and level of satisfaction. There were no significant difficulties in the questionnaire's administration. In the test-retest evaluation, there was adequate concordance of the average scores of the items evaluating difficulties and problems. This was not the case for the average scores of the items which evaluated satisfaction. The validity of 28 of the questionnaire's 33 items was examined. A moderate concordance level was found for 11 items on the questionnaire. An average score taken from these items provided a sufficient measurement of tendency regarding the overall seriousness of the subjects' social problems. CONCLUSIONS: The results do not favour the use of this questionnaire as a substitute for standard interviews in the evaluation of specific social problems, but do support the use of part of it in order to obtain a valid tendency measurement.

Adolescent↗