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PubMed1994

Worrying, social problem-solving abilities, and social problem-solving confidence.

This study investigated the relationship between worrying and two features of social problem solving: problem-solving ability and confidence. However, while levels of worrying were significantly related to both poor problem-solving confidence and poor perceived control over the problem-solving process, worrying was unrelated to problem-solving ability per se. The failure to find a relationship between worrying and social problem-solving skills was found separately at both low and high levels of worrying, and also when levels of trait anxiety had been controlled for. These results provide no support for the hypothesis that chronic worrying results from poor social problem-solving abilities, but the results are consistent with the belief that worrying is primarily an anxiety-related phenomenon with any problem-solving deficits occurring at the level of solution implementation rather than solution generation.

Adult↗
PubMed1994

Cancer prevention through health promotion. Defining the role of physicians in public health.

In recent years a major focus in the delivery of cancer prevention services has been on the actions of physicians in ambulatory care practice. Whereas delivery of these services has increased markedly, it is likely that physician actions overall are not producing expected measurable benefits to whole populations. The level and quality of prevention services will be increased through greater local consensus regarding cancer prevention goals, better organization to provide these services more efficiently, and improved health education in clinics. But the greatest challenge is to increase access for all Americans to these services. Access to health services is not only a medical problem. Social problems of unemployment, poverty, and limited education significantly influence access to services and good health in poorly understood ways. While encouraging direct approaches to addressing social problems in the medical community, the agenda for the future in cancer prevention must be concerned with facilitating a public health community responsibility attitude among physicians and with fostering development of hospital/community/physician partnerships in which community organizations have significant ownership. Overall public health indices in cancer can improve only with greater attention to access and the broad societal issues of preventive medicine.

Health Promotion↗
PubMed2005

Mental health in immigrant children in the Netherlands.

BACKGROUND: Background In the past decades, the ethnic diversity of the population in the Netherlands has rapidly grown. At present, approximately 10% of all people in the Netherlands belong to immigrant families that originate from a very large variety of non-Western nations. Although it is often assumed that migration has a stress-inducing effect, leading to heightened levels of mental health problems in both immigrant children and their parents, research into this group of children is very scarce in Europe. In this paper, we want to report on the mental health of immigrant children originating from non-Western countries enrolled in a large cohort study in the Netherlands. METHOD: A large sample of 11-year-old children in the Netherlands (n=2230) participated in the TRacking Adolescents' Individual Lives Survey (TRAILS). Approximately 10% of these children (n=230) belong to immigrant families originating from non-Western countries. Mental health problems were assessed using self-report measures (Youth Self-Report), using parent-report measures (Child Behaviour Check List) and using teacher report (Teacher Checklist for Psychopathology). In this paper, we report on the mental health problems of these children from all three perspectives (child, parent, teacher). In analysing the impact of immigrant status, the effect of gender and of socio-economic inequality was taken into account. RESULTS: According to self-report measures, mean level of mental health problems in immigrant children is comparable to that in non-immigrant children. Immigrant parents report higher problem rates for their daughters, in particular for internalising problem behaviours, social problems and attention problems, but not for their sons. In contrast, teachers perceive higher levels of externalising problem behaviour, but lower levels of anxious/depressed problems, social problems and thought problems in immigrant children. This last effect is most strongly found with respect to boys: teachers perceive less withdrawn/depressed problems, social problems, thought problems and attention problems in immigrant boys. CONCLUSIONS: Children from immigrant families do not appear to experience more problems than their non-immigrant peers. However, parents from immigrant families do report more problems in their daughters than non-immigrant parents, in contrast to teachers who perceive lower levels of internalising, social and thought problems in particular in boys, and higher levels of externalising problems in both immigrant boys and girls. In describing problem behaviour in immigrant children, the effect of diverging social contexts for and multiple perspectives on immigrant youth has to be taken into account.

Acculturation↗
PubMed1999

Association of sexual problems with social, psychological, and physical problems in men and women: a cross sectional population survey.

STUDY OBJECTIVE: To investigate the association of sexual problems with social, physical, and psychological problems. DESIGN: An anonymous postal questionnaire survey. SETTING: Four general practices in England. PARTICIPANTS: 789 men and 979 women responding to a questionnaire sent to a stratified random sample of the adult general population (n = 4000). MAIN RESULTS: Strong physical, social, and psychological associations were found with sexual problems. In men, erectile problems and premature ejaculation were associated with increasing age. Erectile problems were most strongly associated with prostate trouble, with an age adjusted odds ratio of 2.6 (95% confidence intervals 1.4, 4.7), but hypertension and diabetes were also associated. Premature ejaculation was predominantly associated with anxiety (age adjusted odds ratio 3.1 (95% confidence intervals 1.7, 5.6)). In women, the predominant association with arousal, orgasmic, and enjoyment problems was martial difficulties, all with odds ratios greater than five. All female sexual problems were associated with anxiety and depression. Vaginal dryness was found to increase with age, whereas dyspareunia decreased with age. CONCLUSIONS: This study indicates that sexual problems cluster with self reported physical problems in men, and with psychological and social problems in women. This has potentially important consequences for the planning of treatment for sexual problems, and implies that effective therapy could have a broad impact on health in the adult population.

Adolescent↗
PubMed1982

Explanation and social policy: 'the' problem of social inequalities in health.

Inequalities in rates of sickness and mortality between social groups has long been a matter of concern and of inquiry in Britain. Disciplinary differentiation has resulted in the problem now being treated within what have become three distinct intellectual traditions. These are social administration, epidemiology, and sociology, and the accounts they provide differ significantly from each other. This is partly because 'the' problem is somewhat differently defined in each; and partly because of their different orientations to theory and to practical amelioration. This article explores the strengths and weaknesses of each approach, and raises the possibility of a more adequate explanation than any one discipline provides. The implications for study of social administration are considered.

Epidemiology↗
PubMed1987

Classifying family/household problems.

To investigate how family/household problems could be classified 186 problems recorded in 55 families by 14 Israeli family physicians were studied. Four major categories were used which included health problems in one family member affecting others in the household, relationship problems, social problems and health problems in more than one family member. Over half of the 186 problems were psychological or physical problems in the individual which affected other household members. Specific diagnostic titles from the International Classification of Health Problems in Primary Care (ICHPPC-2-Defined) were suitable to classify virtually all identified family/household problems. More problems were identified in mothers than in fathers or children and mothers were perceived as being affected most by social and relationship problems. Additional studies are suggested.

Adult↗
PubMed1994

Hospitalization in a pediatric ward of adolescent suicide attempters admitted to general hospitals.

PURPOSE: Considering the growing interest of pediatricians in the adolescent patient, one might hypothesize that adolescent suicide attempters might receive superior treatment in a pediatric unit than in other in-patient settings. METHODS: In order to examine this hypothesis, we compared sociodemographic and psychosocial characteristics of patients admitted to pediatric wards (n = 174) with those admitted to other departments (n = 251), based on data from a survey of 430 adolescents aged 13-19 years hospitalized following a suicide attempt. RESULTS: Patients admitted to pediatric units tended to be younger and were more often described as manifesting depression and sleep disturbances. However, no differences were found between the two groups for the other factors investigated (sex, socio-professional category of parents, academic level, family situation, psychiatric problems, social problems, etc.). We then examined differences between the two groups with respect to hospital care (length of stay, psychiatric consultations) and follow-up course (coordination with the family doctor and/or social services, recommended after-care). Our findings showed that for a similar psychosocial profile, pediatric units contact the family doctors more often and proposed a more extensive follow-up. The role in patient management of depression, family, social and school problems is also discussed. CONCLUSION: Compared with other departments to which adolescent suicide attempters could be admitted, pediatric wards appear to show better performance.

Adolescent↗
PubMed2004

Is obesity a risk factor for psychopathology among adolescents?

BACKGROUND: Although several studies have documented the existence of psychopathology in obese adolescents, disagreement remains regarding the extent and nature of this psychopathology. The aim of the present study was to explore the type and frequency of psychopathology in a clinical as well as a non-clinical sample of obese adolescents, and in a normal weight control group. METHODS: The study sample consisted of a clinical study group of 30 obese adolescents, a non-clinical obese group of 30 obese adolescents, and a control group of 30 normal weight adolescents. Psychological assessment was performed using a non-structured psychiatric interview, the Child Behavior Checklist (CBCL), Children Depression Inventory (CDI), Rosenberg Self-esteem scale (SES) and the Eating Attitude Test (EAT). RESULTS: More than half of the clinical obese adolescents (16/30) had a DSM-IV diagnosis, often involving major depressive disorder (n = 10). The mean scores of anxiety-depression, social problems, social withdrawal and total problem in the CBCL scale of the clinical obese group were significantly higher than the non-clinical obese group and the normal weight control group. The mean total scores of the SES and the CDI of the clinical obese group were higher than the normal weight control group. The mean total score of EAT of the clinical obese group was significantly higher than the normal weight control group, and the mean score of EAT of the non-clinical obese group was significantly higher than the normal weight control group. CONCLUSIONS: The results support previously published reports which show a higher ratio of psychopathology (depression, behavioral problems, low-esteem) among clinical obese adolescents than among non-clinical obese adolescents. Findings provided evidence for a psychosocial at-risk population in a subgroup of obese adolescents.

Adolescent↗
PubMed1998

Early detection of social interaction problems: development of a social interaction instrument in young children.

Children with developmental or psychiatric disorders often have problems with social interaction. This study reports on the development of the Ghuman-Folstein Screen for Social Interaction (SSI), a parent/caregiver questionnaire designed to measure the capacity for basic social interaction skills across a variety of contexts in preschool children. The SSI was administered to 51 clinically referred children with a high probability of deficits in social interaction and 60 healthy control subjects to establish reliability and validity. The children were 24 to 61 months of age, with diverse ethnic and socioeconomic backgrounds. Strong internal consistency, significant correlation for test/retest reliability, moderate correlation for interrater reliability and support for external validity of the SSI was established. The SSI scores differentiated between the clinically referred subjects and healthy control subjects and between children with pervasive developmental disorder (PDD) of the autistic type and other non-PDD developmental disorders. The SSI is a relatively simple, efficient, reliable, and valid measure for the capacity for basic social interaction skills in children 24 months to 5 years of age. The SSI has a potential to be useful in primary health care settings to identify children at risk who may need tracking and/or further evaluation and treatment services.

Child Behavior↗
PubMed1999

[Applicability of the Child Behavior Checklist in developmentally delayed children].

OBJECTIVES: The Child Behavior Checklist is used to assess behavioral problems in a large unselected sample of children. In the present study we assess the usefulness of the CBCL in the evaluation of the typical behavioral problems usually reported in children with developmental disorders. METHODS: We examined two groups of children which both had language or communication problems. The first group consisted of 34 children with infantile autism, the second group consisted of 34 age-, sex- and IQ-matched children with a specific developmental speech and language disorder. The CBCL was filled out by the parents in both groups as part of the routine diagnostic procedures. RESULTS: Half of the language-impaired children have Total Behavioral Problem scores within the clinical range. Problems are mainly reported on the scales: "Attention Problems", "Social Problems" and "Withdrawn". Two-thirds of the autistic children have deviant scores on the syndrome scales mentioned above. 32 out of 34 autistic children score within the clinical range on the scale "Thought Problems", whereas only one language-impaired child does so. Single item analysis shows a high prevalence of developmental problems (speech problems, enuresis ...) in both groups. CONCLUSION: The CBCL records characteristic behavioral problems in children with developmental disorders. The problematic behaviors are shown on the syndrome scale level as well as on the single item level. Children with developmental disorders and high scores on the "Thought Problems" scale of the CBCL should be evaluated for the presence of a possible pervasive developmental disorder.

Adolescent↗
PubMed2006

Psychopathological profile in children with chronic tic disorder and co-existing ADHD: additive effects.

The nature of the co-occurrence of chronic tic disorders (CTD) and attention deficit hyperactivity disorder (ADHD) is unclear. Especially in the field of psychopathology, the relationship of CTD and ADHD remains to be clarified. Thus, the aim of the present chart review study was to specify the contribution of CTD and/or ADHD to the psychopathological profile of the comorbid group (CTD+ADHD). The psychopathological profiles of four large groups (CTD-only (n=112), CTD+ADHD (n=82), ADHD-only (n=129), controls (n=144)) were measured by the eight subscales of the Child Behavior Checklist (CBCL) and analyzed by a 2x2 factorial design followed by contrasts. There were main effects of ADHD diagnosis on all but one subscale of the CBCL (Somatic Complaints). For CTD diagnosis, main effects were found for Attention Problems, Anxious/Depressed, Thought Problems, Social Problems and Somatic Complaints. The only interaction effect was seen for Somatic Complaints. While CTD and ADHD were both related to internalizing psychopathology of children in the CTD+ADHD group, ADHD had the largest effect on externalizing psychopathology in the comorbid group. At the level of psychopathology, an additive model for the co-occurrence of CTD and ADHD is strongly supported. In the comorbid group (CTD+ADHD), the ADHD diagnosis shows the strongest relation to externalizing psychopathology.

Aggression↗
PubMed1998

Revision and restandardization of the Conners Teacher Rating Scale (CTRS-R): factor structure, reliability, and criterion validity.

The Conners Teacher Rating Scale (CTRS) is a commonly used research and clinical tool for assessing children's behavior in the classroom. The present study introduces the revised CTRS (CTRS-R) which improves on the original CTRS by (1) establishing normative data from a large, representative North American sample, (2) deriving a factor structure using advanced statistical techniques, and (3) updating the item content to reflect current conceptualizations of childhood disorders. Using confirmatory factor analysis, a six-factor structure was found which includes Hyperactivity-Impulsivity, Perfectionism, Inattention/Cognitive Problems, Social Problems, Oppositionality, and Anxious/Shy factors. The reliability of the scale, as measured by test-retest correlations and internal consistency, is generally satisfactory. Using all of the scale factors to discriminate between attention deficit hyperactivity disordered and normal children, 85 percent of children were correctly classified, supporting the validity of the scale and indicating excellent clinical utility. Similarities and differences between the original CTRS factor structure and the CTRS-R factor structure are discussed.

Attention Deficit Disorder with Hyperactivity↗
PubMed1992

Alcohol and attempted suicide.

This study investigates the prevalence of excessive drinking and alcohol-related problems amongst suicide attempts. It also compares the characteristics of attempted suicide by alcohol consumption group. Drinking histories were taken on 250 consecutive attempted suicides admitted to the West Midlands Poisons Unit. Fifty-one per cent of the men and 31% of the women drank more than the weekly limits recommended by the Health Education Council. Of the men, 22.5% drank more than 50 units of alcohol a week and 9.5% of the women drank more than 35 units of alcohol a week. Alcohol-related problems (social problems, alcohol dependence or physical illness) were present in 34% of men and 15.5% of women. These results show a greater incidence of alcohol misuse than previous studies on attempted suicide. This is probably because detailed alcohol histories were taken on all patients. Alcohol misuse is best treated before major alcohol-related problems develop. Those responsible for assessing cases of attempted suicide should be adept at detecting alcohol misuse and instituting appropriate management.

Adult↗
PubMedDate not supplied

Patterns of parent-reported problems indicative in autism.

Parental report Child Behavior Checklists (CBCL) of 77 male and female subjects aged 4-18 years were analyzed in this study. Individuals had been given diagnoses of autistic disorder using the Autism Diagnostic-Interview-Revised (ADI-R) within a research project on the genetics of autism. A feature of behavior problems independent of sex but influenced by age and IQ level could be identified for the autistic sample with highest relative scores on the scales measuring attention problems, social problems and thought problems and low scores on the scale for somatic complaints.

Adolescent↗
PubMed2003

Behaviour in children with language development disorders.

OBJECTIVE: The objective of the study was to explore the univariate and multivariate differences in behavioural problems among children with disorders in expressive or mixed receptive-expressive language development and children with unimpaired language development. METHOD: Ninety-four children with language development disorders (LDD) between the ages of 4 and 6 years and 94 children (matched by age and sex) without disorders of language development were compared concerning behavioural problems, as measured by the German version of the Child Behavior Checklist/4-18. RESULTS: Thirty-two children (34%) with LDD showed behavioural problems in the clinical range, whereas only 6 control subjects (6%) had scores in this range. Univariate group comparisons between patients and control subjects showed significant differences in all 8 syndromes and the scale "other problems," with patients having higher scores. Multivariate stepwise discriminant analysis showed a significant discriminant function by the scales "other problems," "social problems," "anxious-depressed," "thought problems," "attention problems," and "delinquent problems." CONCLUSIONS: In general, our results agree with several studies that report that children with speech and language disorders are at special risk for developing behavioural problems. Neurodevelopmental immaturity may be one factor underlying both the disorder in language development and the behavioural problems.

Age Factors↗
PubMed1985

Day treatment: suitability and referral procedure.

In a prospective screening of emergency admissions of patients suffering from neurosis, personality disorder or adjustment reaction, 100 were assessed as suitable for early transfer to day hospital treatment, 101 as unsuitable, and 39 as not requiring further intervention. Of the unsuitable patients, 39 were grossly disturbed; the remainder did not differ in severity from those thought suitable, but there was a specific reason against day treatment in all but 13 of the 62--most commonly alcohol abuse, physical problems, social problems or aggression. Patients' attitudes were also important. Recruitment of patients had to be active, with regular visits to the wards by day hospital staff.

Adjustment Disorders↗
PubMed2000

Behavioral and emotional problems in Chinese children: teacher reports for ages 6 to 11.

This study examined the applicability of the Chinese Version of Teacher's Report Form (TRF-CV) and estimated the prevalence of behavioral problems in a general population sample of 2,936 children aged 6 through 11 years in the Shandong Province of China. Teachers completed the TRF-CV and the Conners Hyperkinesis Index (CHI). The TRF-CV total scale showed satisfactory 2-week test-retest reliability (r = .83) and internal consistency (Cronbach's alpha = .94). The TRF-CV Total Problems, Attention Problems, Delinquent Behavior, and Aggressive Behavior had acceptable concurrent validity with the CHI (mean r = .62). With the TRF-CV Total Problems score of 26 as a cutoff, an overall correct classification rate of 90% for clinical sample and nonreferral required children was obtained. Exploratory factor analysis yielded six syndromes: Aggressive/Delinquent Behavior, Withdrawn/Depressed, Somatic Complaints, Attention Problems, Social Problems, and Thought Problems, with significant correlations with corresponding American cross-informant syndromes (mean r = .84). The overall prevalence rate of behavioral problems was 15.5% (95% CI = 14.2-16.8%), with a boy-to-girl ratio of 2.0:1 (chi2 = 59.70, p < .001). Younger boys exhibited more externalizing problems. These findings indicate that the TRF-CV is applicable for Chinese children, and the prevalence of behavioral problems shown by it among Chinese children seems comparable to that found in other countries. Although most of the American syndromes were well replicated, the differences in the present subjects, when submitted to principal components analysis, from American samples from whom the original syndromes were derived, could have prevented the study from replicating distinctions between aggressive vs. delinquent and depressed vs. withdrawn syndromes.

Affect↗
PubMed1997

A comparison of children affected by prenatal alcohol exposure and attention deficit, hyperactivity disorder.

Behavioral deficits are often noted in children with fetal alcohol syndrome (FAS) and other individuals with prenatal alcohol exposure, including mental retardation, learning problems, social problems, and deficits in attention. Because attention deficit, hyperactivity disorder (ADHD) has been diagnosed so frequently in children with FAS and other alcohol related birth defects, there has been speculation that alcohol is an etiological factor in ADHD. To examine the relationship between behavior characteristics of children with fetal alcohol exposure and those seen in children with a diagnosis of ADHD, 149 low socioeconomic status (SES), African-American children (mean age = 7.63 years) were given a battery of neuropsychological and behavioral tests. One hundred and twenty-two were a sub-sample from a longitudinal study of prenatal alcohol exposure, whereas twenty-seven were identified in an ADHD Clinic. Children were given two sets of tests: (1) "traditional model" of conventional behavioral and psychiatric measures of ADHD and externalizing behavior; and (2) measures of neurocognitive functioning reflecting a four-factor model of the neurological basis of the components of attention (Mirsky AF, in Integrated Theory and Practice in Clinical Neuropsychology, Hillsdale, NJ, Lawrence Erlbaum Associates, 1989). Results indicated that children with the physical characteristics associated with prenatal alcohol exposure and those with a diagnosis of ADHD had equivalent intellectual abilities with both clinical groups performing more poorly than contrast children from the same SES and ethnic groups. However, there were clear distinctions on behavioral and neurocognitive measures between the two clinical groups with those with ADHD performing more poorly on conventional tests sensitive to attentional problems and conduct disorder. When these two groups were compared on measures designed to measure the model of the four factors of attention by Mirsky, they were noted to have distinct patterns of deficits. These results suggested that the alcohol-affected children did not have the same neurocognitive and behavioral characteristics as children with a primary diagnosis of ADHD.

Black or African American↗