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PubMed2005

Low adherence with antihypertensives in actual practice: the association with social participation--a multilevel analysis.

BACKGROUND: Low adherence is a key factor in explaining impaired effectiveness and efficiency in the pharmacological treatment of hypertension. However, little is known about which factors determine low adherence in actual practice. The purpose of this study is to examine whether low social participation is associated with low adherence with antihypertensive medication, and if this association is modified by the municipality of residence. METHODS: 1288 users of antihypertensive medication were identified from The Health Survey in Scania 2000, Sweden. The outcome was low adherence with antihypertensives during the last two weeks. Multilevel logistic regression with participants at the first level and municipalities at the second level was used for analyses of the data. RESULTS: Low social participation was associated with low adherence with antihypertensives during the last two weeks (OR = 2.05, 95% CI: 1.05-3.99), independently of low educational level. However, after additional adjustment for poor self-rated health and poor psychological health, the association between low social participation and low adherence with antihypertensives during the last two weeks remained but was not conclusive (OR = 1.80, 95% CI: 0.90-3.61). Furthermore, the association between low social participation and low adherence with antihypertensives during the last two weeks varied among municipalities in Scania (i.e., cross-level interaction). CONCLUSION: Low social participation seems to be associated with low adherence with antihypertensives during the last two weeks, and this association may be modified by the municipality of residence. Future studies aimed at investigating health-related behaviours in general and low adherence with medication in particular might benefit if they consider area of residence.

Adult↗
PubMed1990

Impaired ability of schizophrenics, relative to manics or depressives, to appreciate social knowledge about their culture.

Twenty schizophrenics, 20 manics, and 20 depressives were given two sets of multiple choice questions, one testing the subject's social knowledge of how people tend to act in a social situation and the other tapping their knowledge of events or objects which are relatively free of a social component. Schizophrenics were significantly impaired on the former set of questions relative to manic, and were significantly worse on both than depressives. It is suggested that these results represent an objective measure of the social naïvete of schizophrenics. The significant difference from manics indicates that the results are not merely the general effects of psychosis, particularly because the manics performed worse on an attentional test than the schizophrenics.

Adult↗
PubMed2006

Cultural beliefs and domestic violence.

The role of cultural beliefs in domestic violence is examined within the context of the identification of more culturally viable options for women who are operating within diverse cultural frameworks and experiencing domestic violence worldwide. Domestic violence advocacy efforts are encouraged to incorporate more culturally informed strategies that complement the worldviews and cultural traditions of women from different backgrounds. The need for a more culturally sensitive definition of domestic violence that is inclusive of a range of domestic violence across cultures and also enhances communication among victims is identified. Points of relevant cultural reference are discussed and a cultural cost-benefit analysis is recommended for culturally relevant domestic violence research and program implementation.

Aggression↗
PubMed2006

International perspectives on sexual harassment of college students: the sounds of silence.

The incidence, psychological dimensions, reporting, and impact of sexual harassment of college students throughout the world are reviewed. Special attention is paid to methodological constraints in conducting cross-cultural research in sexual harassment, including difficulty in securing research participants, different methodologies to collect incidence data, use of retrospective data, and varying, definitions of sexual harassment. Recommendations for implementing intervention programs are offered. The strategies suggested deal with the social causes that maintain the harassment, including renegotiating the balance of power between men and women.

Cross-Cultural Comparison↗
PubMed2001

Distress and disease status among patients with rheumatoid arthritis: roles of coping styles and perceived responses from support providers.

Previous research has shown that social support can have a beneficial impact on coping processes and psychological adjustment in patients with rheumatoid arthritis (RA). The association of individual coping styles and perceived responses from others to one's pain episodes with patients 'distress and disease status over time was investigated. The sample consisted of 42 middle-aged patients with RA who were predominantly White (98%), female (64%), and married (88%). Participants completed surveys and their rheumatologist completed clinical assessments of patient disease status at 2 time points over a 9-month period. Although punishing responses from others (e.g., getting irritated or angry when the patient is in pain) were perceived as relatively infrequent, they were associated with a patient coping style of focusing on and venting of negative emotion as well as elevated negative affect (NA). Findings also indicated that those who perceived punishing responses from close others and coped by venting negative emotions reported increased NA over time and were rated by their rheumatologist as having more severe RA disease status over time. Implications for psychosocial intervention and directions for future research are discussed.

Adaptation, Psychological↗
PubMed2002

Social cognitive determinants of physical activity in young adults: a prospective structural equation analysis.

This study used a prospective design to test a model of the relation between social cognitive variables and physical activity in a sample of 277 university students. Social support, self-efficacy, outcome expectations, and self-regulation were measured at baseline and used to predict physical activity 8 weeks later. Results of structural equation modeling indicated a good fit of the social cognitive model to the data. Within the model, self-efficacy had the greatest total effect on physical activity, mediated largely by self-regulation, which directly predicted physical activity. Social support indirectly predicted physical activity through its effect on self-efficacy. Outcome expectations had a small total effect on physical activity, which did not reach significance. The social cognitive model explained 55% of the variance observed in physical activity.

Adolescent↗
PubMed2005

Correlates of physical activity among women with fibromyalgia syndrome.

BACKGROUND: Fibromyalgia (FMS) is a chronic pain syndrome of unknown origin that lacks standardized treatment. However, participation in physical activity (PA) benefits people with FMS. Despite the psychosocial and health benefits that can be gained through PA, the correlates of PA among people with FMS remain poorly understood. PURPOSE: The purpose of this study was to identify and compare the effects of cross-sectional and longitudinal correlates of PA among women with FMS. METHODS: Participants were 187 female members of a HMO with a confirmed diagnosis of FMS. They were administered a battery of questionnaires assessing potential correlates of PA. These correlates were suggested by social cognitive theory and the transtheoretical model, and have been repeatedly associated with PA among the general population. RESULTS: Multivariate analyses indicated that self-efficacy for PA and the behavioral processes of change were the strongest discriminators among PA adopters, maintainers, quitters, and those who were sedentary. Enjoyment of PA, barriers to PA, the impact of FMS, and the environment also significantly discriminated among these groups. Longitudinally, changes in self-efficacy were significantly associated with changes in PA. CONCLUSIONS: These findings suggest that self-efficacy may play a critical role in both the present and long-term PA of women with FMS. They also lend additional support to the role of social cognitive and transtheoretical variables in discriminating among levels of PA.

Aged↗
PubMed2001

A comparison of WAIS-R profiles in adults with high-functioning autism or differing subtypes of learning disability.

To examine cognitive differences among adults with differing developmental disorders, a comparison of Wechsler Adult Intelligence Scale-Revisedprofiles was made with samples of 35 individuals with high-functioning autism (HFA) and 102 individuals with adult learning disability (LD). All participants had Verbal andPerformance IQ scores of 70 or higher. The LD group was divided into 3 subtypes based on relative achievement levels in mechanical reading and arithmetic. The group with HFA had a profile characterized by a high score on Block Design with a low Comprehension score. The HFA group most resembled the LD subtype that had superior achievement in reading relative to arithmetic, with the exception of their poor performance on measures of social perception and judgment. Results are discussed in terms of the substantial differences in cognitive structure between these 2 neurodevelopmental disorders and are considered in the context of the learning deficits reported for Asperger 's Disorder and nonverbal learning disability.

Achievement↗
PubMed1977

Children's beliefs in internal-external control and self-esteem as related to academic achievement.

Previous work has shown high self-esteem to be related to an internal locus of control (LOC) orientation. Both have been shown to be related to academic achievement. It was hypothesized that LOC and self-esteem are each independently related to achievement, and that these relationships may vary according to the sex of the child and the measure of achievement used. Subjects were 113 ten-year-old, fourth grade children, 60 males and 53 females. They were administered questionnaire measures of LOC and self-esteem (Nowicki-Strickland and Piers-Harris). An internal LOC orientation was significantly related to greater academic achievement and high self-esteem. Males' LOC scores were related to grade point averages and not achievement test scores, while the reverse held for females. Differential socialization of females from males might account for the lack of a relationship between grades and LOC.

Achievement↗
PubMed2003

Confirmatory factor analysis of the multidimensional scale of perceived social support in clinically distressed and student samples.

Previous authors (e.g., B. R. Sarason, Shearin, Pierce, & Sarason, 1987) have found that perceived social support can affect the emotional well-being of an individual. Consequently, the effective assessment of social supports is a key issue in both research and clinical practice. The Multidimensional Scale of Perceived Social Support (MSPSS; Zimet, Dahlem, Zimet, & Farley, 1988) divides perceived social support into 3 distinct constructs-that derived from Family members, from Friends, and from Significant Others. This study is the first to assess the MSPSS using confirmatory factor analysis in both a college student (N = 549) and psychiatric outpatient (N = 156) sample. Based on several goodness-of-fit indicators, a 3-factor model for the MSPSS was supported in both samples, as was a single, higher order domain of Global social support. The perceived social support factors of Family and Friends consistently had the strongest associations with symptomatology. These results support the use of the MSPSS as a brief instrument for assessing the hierarchical structure of perceived social support in a variety of samples.

Adolescent↗
PubMed2000

Social functioning and emotional regulation in the attention deficit hyperactivity disorder subtypes.

Compared 16 children with attention deficit hyperactivity disorder (ADHD) combined type (ADHD-C), 14 children with ADHD predominantly inattentive type (ADHD-I), and 17 controls on parent and teacher ratings of social status and performance, self-report of social knowledge and performance, and observations of behavior on an emotional regulation task. Analyses revealed distinct patterns of social dysfunction between ADHD subgroups. Children with ADHD-C were rated as showing more aggressive behavior; furthermore, they displayed emotional dysregulation characterized by high intensity and high levels of both positive and negative behavior. In contrast, children with ADHD-I were perceived as displaying social passivity and showed deficits in social knowledge on the self-report measure but did not evidence problems in emotional regulation. Regression analyses revealed that social performance, emotional regulation, and, to a lesser degree, social knowledge, were predictive of social status. The application of these findings to understanding the nature of the social deficits in the ADHD subtypes and directions for future research are discussed.

Affect↗
PubMed2004

The effects of the fast track program on serious problem outcomes at the end of elementary school.

This study examines the effects of the Fast Track program, which is a multicomponent, intensive intervention for children with early-onset conduct problems and continues from 1st grade through high school. Prior research has shown that Fast Track produces small positive effect sizes on children's social and behavioral outcomes at the end of 1st and 3rd grades in comparison to control children. This study addresses the important question of whether this intervention reduces cases of serious problems that can occur during the 4th- and 5th-grade years. Fast Track did have a significant but modest influence on children's rates of social competence and social cognition problems, problems with involvement with deviant peers, and conduct problems in the home and community, compared to children in the control condition. There was no evidence of intervention impact on children's serious problems in the school setting at Grades 4 and 5. This evaluation indicates that Fast Track has continued to influence certain key areas of children's adjustment throughout the elementary school years, reducing children's likelihood of emerging as cases with problems in their social, peer, or home functioning. The stage is set to examine potential prevention effects on these youths' serious antisocial behaviors during adolescence.

Achievement↗
PubMed2006

The time-varying influences of peer and family support on adolescent daily positive and negative affect.

The time-varying influences of peer and family support on adolescent daily mood were explored among youth transitioning from middle school to high school (8th to 9th grade, N = 268) as compared to youth transitioning from 10th to 11th grade (N = 240). Real-time measures of daily positive and negative affect (ecological momentary assessments) were collected via palmtop computers at baseline, 6 months, and 12 months. Participants rated 12 mood adjectives in response to 5 to 7 random prompts per day for 7 consecutive days. Perceived peer and family support were assessed via self-report. Mixed-effects regression analyses revealed significant grade by time by peer support interactions for positive and negative mood, with the younger cohort showing greater increases in the relation between peer support and affect over time than the older cohort. Family support did not interact with cohort or time.

Adolescent↗
PubMed2005

Home-based video CBT for comorbid geriatric insomnia: a pilot study using secondary data analyses.

Two recent studies showed that cognitive-behavioral treatment (CBT) is efficacious in treating insomnia in older adults with comorbid medical conditions. The authors extended these findings by comparing 12 older adults with comorbid insomnia who received a home-based video CBT program to the authors' previously published data on 24 participants who received classroom CBT or no treatment. All 36 participants were initially randomized within the same protocol, but the video arm was conducted 7 months after completion of the other two study arms. Compared to controls, the video CBT group demonstrated significant changes in five of eight self-report measures of sleep at posttreatment, including sleep latency, time awake after sleep onset, total time in bed, overall sleep quality, and dysfunctional beliefs and attitudes about sleep. Compared to controls, the video CBT group also had posttreatment improvements in daytime functioning, including mood, pain perception, social functioning, and energy-vitality. Although video CBT was not significantly different from classroom CBT on self-report measures, the attrition rate was higher (27% vs. 19%) and the number of participants who achieved clinically significant change was lower (50% vs. 73%). These preliminary findings suggest that delivering CBT in a home-based video format has the potential to serve as a first-line, cost-effective treatment for comorbid insomnia.

Aged↗
PubMed1997

The doctor as businessman: the changing politics of a cultural icon.

From just after the Civil War, when medicine began to professionalize, until the late 1970s, doctors and policy makers believed that clinical judgment should not be influenced by the financial interests of doctors. Physicians were highly entrepreneurial, and organized medicine fought to preserve their entrepreneurial interests, but the moral norm that justified their autonomy from state regulation was a strict separation of clinical judgment and pecuniary interests. Under managed care, the old norm is reversed. A good doctor takes financial considerations into account in making clinical decisions. Theoretically, doctors should consider measures of cost to society, but in practice, the payment systems of managed care plans induce doctors to consider the impact of each clinical decision on their own income. Because doctors share the risks of insuring patients with managed care plans, they have the same incentives as insurers to avoid patients who are expensively sick. The new cultural image of doctors as entrepreneurs masks their considerable loss of clinical autonomy under managed care. It also serves to persuade doctors to accept managed care arrangements and to persuade insurance consumers and patients to accept reduced benefits from employers and the government.

Commerce↗