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PubMed2006

Social-cognitive functioning and schizotypal characteristics.

The authors examined the relationship between social cognition and a feature of schizotypal personality referred to as magical ideation, defined broadly as the presence and intensity of illogical beliefs about causality and the nature of reality. The measures of social cognition used in this study were the Character Intention Task (CIT) and the adult version of the Reading the Mind in the Eyes Test. Regression analyses indicated that understanding of character intentions, as measured by CIT scores, and ability to identify emotions on the Eyes test were related to non-realistic beliefs. Principal components analysis of the Magical Ideation Scale generated 3 factors: Occult Beliefs, Non-Realism, and New Age Ideas. Results indicated that impaired understanding of character intentions and ability to identify emotions on the Eyes test were related to non-realistic beliefs. Understanding the cognitive impairments associated with schizotypal characteristics can facilitate development of more targeted therapeutic interventions.

Adolescent↗
PubMed2006

Impact of early lifetime trauma in later life: depression among Holocaust survivors 60 years after the liberation of Auschwitz.

RATIONALE: Holocaust survivors, who experienced trauma 60 years ago, provide an opportunity to explore the impact of early lifetime trauma in later life and, in particular, the interplay of depression and posttraumatic stress disorder (PTSD). In this study, the authors contrast depressed Holocaust survivors (HD), nondepressed Holocaust survivors (HND), and older depressed persons (CD). METHODS: The sample consisted of 36 consecutive Holocaust survivors (mean age: 79 years) treated in a primary care practice, among whom 20 (56%) were diagnosed as having a major depressive disorder and 16 as nondepressed; 18 depressed non-Holocaust Jewish primary care patients served as controls (mean age: 84 years). The authors examined nine clinical and social variables. The Kruskal-Wallis, Mann-Whitney U, and chi(2) tests were used to contrast the groups. The authors used a conservative significance level of .01. RESULTS: In contrast to the CD group, the HD group was significantly older, more likely to report PTSD and guilt symptoms, to have higher Beck Anxiety Inventory (BAI) and Brief Psychiatric Rating Scale (BPRS) scores, and to have more impaired social functioning. In contrast to the HND group, the HD group was significantly more likely to report PTSD and guilt feelings, to have higher Hamilton Depression Scale (HAM-D), BAI, and BPRS scores, and to have more impaired social functioning. In contrast to the CD group, the HND group was significantly more likely to have PTSD symptoms and to have lower HAM-D and BPRS scores. CONCLUSIONS: The prevalence of depression and PTSD symptoms were very high among survivors. Depressed survivors had significantly worse psychologic and social functioning than depressed controls. Depressed survivors had more PTSD symptoms than nondepressed survivors, although it is unclear as to the causal direction of the relationship between depression and PTSD.

Aged↗
PubMed1983

Relationship of scales of schizophrenia proneness and premorbid adjustment to thinking deficits in schizophrenia.

Scales of premorbid adjustment, which generally rely very heavily upon assessment of premorbid social functioning, long have been known to predict some forms of thinking disorder in schizophrenia. Several scales theorized to detect schizophrenia proneness were compared to the Phillips Scale of Premorbid Adjustment to determine whether the characteristics measured by the proneness scales might underlie the predictive power of premorbid social functioning. In a sample of 48 schizophrenics, only the Phillips Scale predicted performance on the Gorham's Proverb Test. These data give no evidence that anhedonia, ambivalence, or perceptual aberration underlie defective schizophrenic social functioning. Cautions and other uses for the schizophrenia proneness scales are discussed.

Adult↗
PubMed2005

Opioid receptor function in social attachment in young domestic fowl.

Opioid systems are implicated in social attachment processes. This research sought to determine the functional contribution of each opioid receptor in modulating social attachment/separation distress. Following ICV administration of opiate probes, 7-day-old cockerels were isolated from conspecifics for a 3 min test period under either a mirror or no-mirror condition. Vocalizations served as the measure of separation-stress. Opioid receptor probes included: the mu agonist DAMGO (0.02, 0.19, 1.95 nmol), the mu antagonist CTOP (0.009, 0.09, 0.9 nmol), the delta agonist SNC80 (0.3, 1.0, 3.0 micromol), the delta antagonist naltrindole (0.2, 2.2, 22.2 nmol), the kappa agonist U50, 488 (1, 30, 100 nmol), the kappa antagonist norBNI (1.3, 13.6, 136.1 nmol), the NOP agonist N/OFQ (0.01, 0.1, 1.0 nmol), and the NOP antagonist UFP-101 (0.1, 1.0, 10.0 nmol). DAMGO attenuated separation distress vocalizations. No other drug probe enhanced or attenuated distress vocalizations. Further, the non-selective opiate antagonist naloxone (0.3, 8.3, 27.5 nmol) did not exacerbate distress vocalizations. These results suggest that only the mu receptor modulates social attachment in young domestic fowl.

Analgesics, Opioid↗
PubMed2002

Quality of life in multiple sclerosis: influence of interferon-beta1 a (Avonex) treatment.

BACKGROUND: Numerous data argue for initiating treatment with interferon-beta (IFN-beta) at an early stage in multiple sderosis (MS). The consequences of its use may negatively influence the MS patient's quality of life (QoL). OBJECTIVE: To evaluate the QoL of MS patients before and after a one-year period of treatment with IFN-beta1a (Avonex). PATIENTS AND METHODS: QoL was assessed using the SF-36 in 121 relapsing-remitting MS patients. We compared QoL before and after treatment and with data from a normal population. We also studied the possible influence of disease progression on the SF-36 scores. RESULTS: One hundred six patients completed the study (87%). Compared to a normal population, patients were, at baseline, worse off for all QoL scales, varying from a minimum decrease of 0.73 SD in mental health, to a maximum decrease of 1.55 SD in general health. After treatment, we found no significant changes in any of the QoL scores, except for physical function, where we noted a slight but significant decrease (p = 0.03). Furthermore, there was no significant change either in the physical component summary (PCS) or mental component summary (MCS). The 'reported health transition' item was significantly improved compared to baseline (p = 0.001). At indusion, significant correlations were found between EDSS scores and scores of physical function (p < 0.001), role - physical (p < 0.01), general health and social function (both p < 0.01), and with the PCS (p < 0.01). Patients with dinical relapses and/or disability progression had a more significant decease in physical function (p < 0.05) and also in social function (p < 0.05). CONCLUSION: The QoL, assessed by the SF-36 scale, is correlated with disability in MS. IFN-beta1a treatment (Avonex) has no negative effect on MS patient's QoL.

Adjuvants, Immunologic↗
PubMed2004

Health-related quality of life in end-stage renal disease patients: the effects of renal rehabilitation.

Health-related quality of life (HRQoL) consists of a number of components like functional status, psychological and social functioning, cognition and disease and treatment-related symptoms. End-stage renal disease (ESRD) patients display emotional disturbances, as well as non-adherence to treatment and fluid and food intake, depression, anxiety, social withdrawal and cardiovascular and other co-existing disease morbidity. They have very low functional capacity and physical limitations in their daily activities that affect their mortality and morbidity. Exercise training in ESRD patients is effective in increasing work related activities and important components of their daily life and improving physical functioning. A physical rehabilitation program also leads to a reduction in depression and improvement in family and social interactions. Therefore, renal rehabilitation should be considered as an important therapeutic method for improving physical fitness, social function, well-being and thus health-adjusted quality of life in ESRD patients.

Activities of Daily Living↗
PubMed1997

Quality of life and social production functions: a framework for understanding health effects.

Quality of life (QofL) has emerged as a new outcome paradigm. It is now the endpoint in various taxonomies of patient outcomes, in which relationships are modeled amongst biological abnormalities, symptom status, functional status, disability, health perceptions and quality of life. Although current models and taxonomies point at important determinants of QofL, they do not provide a heuristic that guides the conceptualization of QofL and the systematic development of an explanatory theory of how ill health affects QofL. General mechanisms linking ill health, behavior, and QofL are lacking. In this paper we propose social production function (SPF) theory as providing such a heuristic, relating the effects of ill health, the activities that patients engage in to maintain QofL, and QofL itself. This theory basically asserts that people produce their own well-being by trying to optimize achievement of universal human goals via six instrumental goals within the environmental and functional limitations they are facing. Three important notions of SPF theory are: (1) the linkages between goals, needs, and well-being; (2) the distinction between universal needs and instrumental goals; and (3) substitution among instrumental goals, activities and endowments according to cost-benefit considerations, whereby costs refer to scarce resources such as functional capacity, time, effort and money. We will argue that SPF theory meaningfully relates the "biomedical model"-with its focus on pathological processes and biological, physiological and clinical outcomes-to the "quality of life" model, with its focus on functioning and well-being. We describe SPF theory and how SPF theory can be used to: (1) operationally define and measure QofL; (2) clarify persistent measurement problems; and (3) develop an explanatory framework of the effects of disease on QofL. In the discussion section, we address the limitations of the SPF approach of QofL and its relationship with personality.

Activities of Daily Living↗
PubMed2006

Predictive validity of proposed remission criteria in first-episode schizophrenic patients responding to antipsychotics.

The objective of this study was to examine the predictive validity of the remission criteria proposed by Andreasen et al in first-episode patients responding to antipsychotics. Antipsychotic responsive patients with first-episode schizophrenia showing symptom remission (n = 60) were compared with patients who did not fulfill the proposed criteria (n = 65). Outcome in terms of symptom severity, social functioning, and quality of life was assessed after 18 months. Patients in the remission group showed a significantly better outcome during follow-up on all Positive and Negative Syndrome Scale subscale scores (positive, negative, and general symptom subscales) and a significantly higher level of social functioning. Quality of life did not differ between groups. The proposed multidimensional criteria for symptomatic remission convey significant information when applied to first-episode patients who responded to antipsychotics, predicting outcome on the domains of both psychopathology and social functioning. The criteria represent a practicable benchmark with clinical relevance. Their implementation should be promoted in research settings, clinical practice, and routine outcome assessment procedures.

Acute Disease↗
PubMed1986

Social skills training for schizophrenic individuals at risk for relapse.

Two studies were conducted to evaluate the clinical efficacy of intensive social skills training in medicated schizophrenic inpatients at risk for relapse. In study 1, three patients were treated; two showed reductions in psychopathology and rehospitalization and improved social functioning 9 months following discharge. In study 2, social skills training was compared with holistic health treatment in 28 patients. Both groups showed reduced psychopathology 2 years after discharge; patients treated with social skills training had better social functioning, spent less time hospitalized, and had fewer symptomatic relapses. The results support the utility of social skills training as a psychosocial treatment for schizophrenia.

Adult↗
PubMed2006

Health-related quality of life among 3--4-year-old children born with very low birthweight.

AIM: This paper reports a study comparing health-related quality of life at 3-4 years of age among children born with very low birthweight (<or=1500 g) to a group of non-very low birthweight controls, and to examine biological, environmental, demographic and health factors associated with quality of life of children born with very low birthweight. BACKGROUND: Advances in modern medicine have increased the survival of infants with very low birthweight, but its impact on quality of life of children during preschool years has been less studied. METHODS: The study sample included 118 children born with very low birthweight and 170 non-very low birthweight controls in Taiwan. Primary caregivers of the study children completed structured questionnaires during the period November 2002 to April 2003. Health-related quality of life was measured using the Mandarin version of the TZO-AZL Preschool Children Quality of Life instrument. This tool has four dimensions: physical, emotional, cognitive and social functions. Higher scores indicate better quality of life. FINDINGS: Children born with very low birthweight had statistically significantly lower mean quality of life scores in all the four dimensions compared with controls. Among the former, those who had current physical health problems scored lower in all dimensions of quality of life. Primary caregivers with higher educational levels and increased ages of the children were associated with improved scores in the emotional and social functions. Birth gestational age was negatively associated with cognitive function. Length of stay in the neonatal intensive care unit was negatively associated with scores for the social function aspect of quality of life. CONCLUSION: Regular monitoring of the quality of life among very low birthweight children is needed. Nurses need to assess the child's current health state, birth gestational age, and the primary caregiver's educational level in order to identify those who are at risk for low quality of life and intervene early.

Case-Control Studies↗
PubMed1991

Stress in caregivers of elderly patients: the effect of an admission to a rehabilitation unit.

OBJECT: to study stress in caregivers of elderly dependent persons after admission to a geriatric assessment and rehabilitation unit. METHOD: in 1986-7 we studied patients admitted to a geriatric assessment and rehabilitation unit in Dunedin to establish the relationship between caregiver stress, their psychological health and social functioning, and patient variables such as physical dependency. RESULTS: of the 64 patients who were admitted from the community and who had a caregiver, 42 were discharged back to the community, and 30 remained there until six weeks. On admission caregiver stress was increased by problems perceived in social function (lack of companionship, excessive responsibilities and financial problems) and decreased when the caregiver had a high sense of psychological wellbeing. It was not associated with high patient dependency or the level of social support. Caregiver stress one week after discharge was lower among those with high emotional support and those with an internal locus of control. If caregiver stress one week after discharge was high there was an increased rate of readmission. CONCLUSION: rehabilitation should include interventions directed towards the psychological health and social function of the caregiver as well as the physical independence of the patient. Improved financial support and the provision of companionship through community support groups may result in reduced caregiver stress, which should help dependent elderly people to continue to live in the community.

Activities of Daily Living↗
PubMed2000

Health related quality of life among persons with HIV after the use of protease inhibitors.

OBJECTIVE: This study was conducted to determine the effect of the use of HIV protease inhibitors on the quality of life among persons infected with HIV. METHODS: Subjects were participants in the British Columbia Centre for Excellence in HIV/AIDS Drug Treatment Program who had completed two annual participant surveys, one prior to initiating therapy with a protease inhibitor and one after. Quality of life was measured using the Medical Outcomes Study Short Form Health Survey (MOS-SF). Statistical analyses were conducted using parametric and multivariate methods. RESULTS: Our analysis was based on 179 HIV-positive individuals. Compared to quality of life at baseline, we found no statistically significant changes in the health perception, pain, physical, role and social functioning MOS-SF subscale scores at follow-up. The measure of mental health was the only component to decline significantly over time. Subanalyses found significant increases in the measures of health perception (p = 0.004), physical (p = 0.037), role (p < 0.001) and social functioning (p = 0.053) for individuals with a low baseline quality of life. For those with a higher quality of life before starting a protease inhibitor containing regimen we observed a significant decline in the subscales of mental health (p = 0.001), physical (p = 0.007), role (p = 0.021) and social functioning (p = 0.003) over the study period. CONCLUSIONS: Our findings indicate that despite strict dosage requirements and adverse side effects associated with protease inhibitor use patients are on the whole maintaining their quality of life after starting on a protease inhibitor containing regimen. Continued follow-up of this cohort will be required to determine the long term implications of these observations.

Adult↗
PubMedDate not supplied

Profile of a large sample of patients with social phobia: comparison between generalized and specific social phobia.

This study examines a large cohort of subjects with social phobia, as part of a larger naturalistic and longitudinal study of 711 subjects with anxiety disorders. We focused on 176 subjects who were in an episode of social phobia at intake. We were particularly interested in evaluating the diagnostic distinction between generalized and specific social phobia. We compared these two groups along demographic characteristics, comorbidities, psychosocial functioning (health, role functioning, social functioning, and emotional functioning) and global assessment scores. We found that generalized social phobics tended to have an earlier age of onset as compared to the specific group; however, this is not a statistically significant difference at this level of analysis. The two groups did not differ for the current comorbidities examined. We observed no differences in the treatment received by the two types of social phobia subjects, and the two groups functioned equally well in terms of health and fulfilling social roles. In addition, we examined adverse childhood events (i.e., death of a parent, childhood abuse) and found no evidence for any differential impact these events might have on the type of social phobia. Although we did observe significantly greater fear of public speaking among the specific compared to the generalized group, which may indicate a qualitative difference between the subtypes, our results suggest that for most parameters, generalized and specific social phobia represent a continuum of similar and overlapping entities.

Adult↗
PubMed1982

Measurement of functional activities in older adults in the community.

Two measures of social function designed for community studies of normal aging and mild senile dementia were evaluated in 195 older adults who underwent neurological, cognitive, and affective assessment. An examining and a reviewing neurologist and a neurologically trained nurse independently rated each on a Scale of Functional Capacity. Interrater reliability was high (examining vs. reviewing neurologist, r = .97; examining neurologist vs. nurse, tau b = .802; p less than .001 for both comparisons). Estimates correlated well with an established measure of social function and with results of cognitive tests. Alternate informants evaluated participants on the Functional Activities Questionnaire and the Instrumental Activities of Daily Living Scale. The Functional Activities Questionnaire was superior to the Instrumental Activities of Daily scores. Used alone as a diagnostic tool, the Functional Activities Questionnaire was more sensitive than distinguishing between normal and demented individuals.

Activities of Daily Living↗
PubMed2000

Children with congenital diaphragmatic hernia are at risk for lower levels of cognitive functioning and increased emotional and behavioral problems.

The physical, psychological, and social functioning of 11 children aged 8 to 12 years with Congenital Diaphragmatic Hernia (CDH) was assessed with several standardized assessment procedures. Physically, most children functioned well at follow-up with half of the children showing minor physical problems such as bronchial hyperreactivity. The mean IQ of the children was 15 points (1 SD) below the norm of 100. Only 6 children were at expected school level. The children showed more emotional and behavioral problems than in the general population as reported by parents and teachers. The children themselves reported more depressive problems, but not a lower self-esteem than children in the general population. These results were confirmed by the results of interviews with parents and children concerning psychosocial functioning. It is concluded that children with CDH show more cognitive and learning problems and increased rates of emotional and behavioral problems compared to children in the general population. Since no children treated with Extra Corporeal Membrane Oxygenation (ECMO) were involved in this study, the earlier reports that lower cognitive functioning is limited to children with CDH treated with ECMO can not be confirmed by this study. Considering the results of this study, there is a need for further follow-up studies concerning the long-term psychological and social functioning of children with CDH.

Child↗
PubMed2006

Attentional dysfunction, social perception, and social competence: what is the nature of the relationship?

The aim of this study was to examine the nature of the relationship between attentional dysfunction and social competence deficits in patients with schizophrenia. Attentional functioning, social perception, and social competence were assessed in 56 inpatients. Measures of vigilance and span of apprehension were administered to assess attentional functioning. Social perception was assessed with an audiovisual measure of affect recognition. Social competence was rated from a role-play task. Span of apprehension and auditory vigilance emerged as specific predictors of social competence. Affect recognition was tested as a mediator and a moderator of the relationship between attentional dysfunction and social competence. Affect recognition was found to moderate the relationship between span of apprehension and social competence.

Adult↗
PubMed1999

Health-related quality of life in chronic hepatitis C: impact of disease and treatment response. The Interventional Therapy Group.

Hepatitis C infects nearly 4 million Americans. Most have chronic hepatitis C (CHC), which progresses to cirrhosis in about 20% of patients. Interferon treatment leads to transient responses in about 40% of patients and apparent eradication of infection in 7% to 40% of patients. In this report, we document the impact of CHC on health-related quality of life (HQL), and changes in HQL among treatment responders. Three hundred twenty-four CHC patients from 10 countries who had relapsed after responding to interferon-alfa therapy were randomized to monotherapy (IFN alfa-2b + placebo) or combination therapy (IFN alfa-2b + ribavirin), treated for 24 weeks, and followed up for 24 weeks. HQL was assessed using the Hepatitis Quality of Life Questionnaire (HQLQ), containing the generic SF-36 Health Survey, three additional generic scales, and two hepatitis-specific scales. Before treatment, CHC patients were impaired in 5 of 8 SF-36 concepts (physical functioning, role-physical, general health, vitality, and social functioning) in comparison with matched population norms. Sustained virological response (SVR) to treatment yielded improvements on three generic scales (vitality, social functioning, and health distress) and the CHC-specific health distress scale. Overall response to treatment (SVR plus histological improvement) yielded the same pattern of improvements with additional gains in generic general health and CHC-specific limitations. Successful treatment of CHC improved HQL as measured by both CHC-specific and generic measures of functional health and well being.

Female↗
PubMed2003

Adult scoliosis: a health assessment analysis by SF-36.

STUDY DESIGN: A prospective self-assessment analysis of a consecutive series of adult patients diagnosed with adult scoliosis of adolescent onset or de novo degenerative scoliosis. PURPOSE: To analyze the impact that scoliosis has on patient health perceptions. SUMMARY OF BACKGROUND DATA: There exists little data studying the effect scoliosis has on an adult's self-perception of health. METHODS: Inclusion criteria were: age > or =18 years, Cobb angle greater than 10 degrees, degenerative or idiopathic deformity, no prior surgery (spine), and complete records. Each patient completed the standard Short Form-36 (SF-36) questionnaire. For each patient, radiographic and clinical data were evaluated. After all data were collected, the mean, standard deviation (SD), and true N values of the Cobb angle were calculated. This study population was then divided into two groups: patients with a Cobb angle greater than 10 degrees and patients with a Cobb angle greater than 20 degrees. Comparison of the SF-36 data for adult scoliosis patients with the United States general population, the United States general population ages 55-64, and patients with hypertension and low back pain was undertaken. RESULTS: The mean age for the patients in this study was 63 years of age; 22 patients were diagnosed as having adult scoliosis of adolescent onset and 27 patients had de novo degenerative scoliosis. The Cobb angle in this study group was found to be greater than 20 degrees in 41 patients; of these patients, 19 patients had a diagnosis of adult scoliosis of adolescent onset and 22 patients had a diagnosis of de novo degenerative scoliosis. Taken as a whole, the patients in this study averaged scores much lower than the norms for both the general U.S. population in all 8 categories and the U.S. population for ages 55 to 64 in 7 out of 8 categories of the SF-36 questionnaire. Additionally, patients with scoliosis also showed lower scores compared to that of the norms found of patients with comorbid conditions: back pain/sciatica with hypertension in seven of the eight categories: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. Of the radiographic parameters analyzed, loss of lumbar lordosis revealed a significant correlation with social function: P = 0.018; role emotional: P = 0.038; and overall general health: P = 0.05. The other radiographic parameters did not reveal statistically significant correlation to the calculated SF-36 scores. CONCLUSION: Our data clearly demonstrate the impact that adult scoliosis has on a patient's perception of health. The severity of this impact is strikingly apparent in the SF-36 scores when compared to benchmark data on patients with comorbid conditions such as back pain and hypertension. It is our conclusion that adult scoliosis is becoming a medical condition of significant impact, affecting the fastest growing section of our society to a previously unrecognized degree.

Adolescent↗