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PubMed2007

Life stress and depression in a tribal area of Pakistan.

BACKGROUND: Depression is common in Pakistan but no research on this subject has been reported from the North West Frontier Province (NWFP), host to numerous Afghan refugees. AIMS: To measure depressive symptoms and associated features in a population-based sample. METHOD: A Pushto translation of the Self Reporting Questionnaire (SRQ) was administered to 471 adults living in a village in one of the federally administered tribal areas. Respondents were also assessed with a life events checklist for social problems, a social support questionnaire and the Brief Disability Questionnaire. RESULTS: Sixty per cent (95/158) of women and 45% (140/313) of men scored 9 or more on the SRQ. High SRQ score was associated with few years of education, higher social problem score, less social support and greater disability. High social problem score was the strongest correlate. CONCLUSIONS: This population reports more depressive symptoms than other communities in Pakistan and this probably reflects the very high degree of social stress experienced in the NWFP, which has been affected by years of turmoilin neighbouring Afghanistan.

Adolescent↗
PubMed1979

Some psycho-social consequences of multiple sclerosis: problems of social interaction and group identity.

The study was concerned with the psycho-social consequences for married couples of multiple sclerosis being contracted by one of the partners. In particular, problems of social interaction and group identity were explored. In determining their mode of interaction with healthy people such couples can choose between normalizing, i.e. endeavouring to carry on their relationships with other people according to their pre-illness pattern, or of disassociating, i.e. turning away from former associates and seeking a new peer group among others with like affliction. In nearly every case husband and wife agreed on the choice of stratagem, a majority of the couples forming the sample opting for disassociation. Membership of the Multiple Sclerosis Society was much more usual among the disassociating couples than among those 'normalizing'. The variables of age, sex, social class and severity of illness were not found to affect the mode of interaction, whereas place of residence and medical interest in them, as perceived by patients and their spouses, were influencing factors.

Adult↗
PubMed1982

Social skills problems in neurotic outpatients. Social skills training with and without cognitive modification.

Twenty-two "socially dysfunctional" outpatients had 12 1 1/2-hour sessions of social skills training either alone or combined with cognitive modification (each, n = 11). Two raters who were blind to the treatment regimen significantly differentiated the two treatments, as judged from audiotapes of treatment sessions. Measurement was by an independent assessor in a structured interview, by self-monitoring of several activities and of anxiety felt during them, and by self-rated questionnaires. In each treatment regimen, patients' conditions improved significantly and equally on reported behavioral and cognitive measures both during and after treatment, and at six-month follow-up. Outcome did not differ significantly between the two treatment conditions at any time on any measure. Patients reported increased levels of social activities and less anxiety during these, less isolation, better relations with their colleagues at work, less depression, and loss of many irrational social beliefs. During multiple baseline monitoring for up to nine weeks, no improvement occurred. Performance of each social task or "target" increased significantly after training was begun for it, and subjective anxiety decreased similarly during social performance. Untreated targets improved much less, and more slowly. Social skills training was followed by lasting and worthwhile improvement that was not enhanced by the addition of cognitive modification.

Adult↗
PubMed2002

Cognitive functioning and social problem-solving skills in schizophrenia.

INTRODUCTION: This study examined the relationships between symptoms, cognitive functioning, and social skill deficits in schizophrenia. Few studies have incorporated measures of cognitive functioning and symptoms in predictive models for social problem solving. METHOD: For our study, 44 participants were recruited from consecutive outpatient admissions. Neuropsychological tests were given to assess cognitive function, and social problem solving was assessed using structured vignettes designed to evoke the participant's ability to generate, evaluate, and apply solutions to social problems. A sequential model-fitting method of analysis was used to incorporate social problem solving, symptom presentation, and cognitive impairment into linear regression models. Predictor variables were drawn from demographic, cognitive, and symptom domains. Because this method of analysis was exploratory and not intended as hierarchical modelling, no a priori hypotheses were proposed. RESULTS: Participants with higher scores on tests of cognitive flexibility were better able to generate accurate, appropriate, and relevant responses to the social problem-solving vignettes. CONCLUSIONS: The results suggest that cognitive flexibility is a potentially important mediating factor in social problem-solving competence. While other factors are related to social problem-solving skill, this study supports the importance of cognition and understanding how it relates to the complex and multifaceted nature of social functioning.

Journal Article↗
PubMed2002

Rumination and social problem-solving in depression.

We tested the hypothesis that impaired social problem solving in depression is a consequence of state-oriented rumination, which can be ameliorated by improving awareness of mental processes. 32 currently depressed, 26 recovered depressed, and 26 never depressed participants completed the Means Ends Problem Solving Test while randomly allocated to no questions, state-oriented ruminative questions, (e.g. focusing on why you have a problem) or process-focused questions (e.g. focusing on how you decide to solve a problem). In the no question condition, the currently depressed group was significantly impaired at problem solving compared to the never depressed and recovered depressed groups, which did not differ from each other. As predicted, the process-focused questions significantly improved social problem solving in depressed patients, compared to no questions and state-oriented questions, which did not differ from each other. As predicted, compared to the process-focused questions, the state-oriented questions significantly impaired social problem solving in the recovered depressed group. These results are consistent with recent theories and treatment developments which suggest that increased awareness of mental processes can shift people away from ruminative thinking, thereby, reducing depressive relapse.

Adolescent↗
PubMed1994

Evaluating care of patients reporting pain in fundholding practices.

OBJECTIVE: To compare quality of care between 1990 and 1992 in patients with self diagnosed joint pain. DESIGN: Questionnaire and record based study. SUBJECTS: Patients identified at consecutive consultations during two weeks in 1990, 1991, and 1992. SETTING: Six practice groups in pilot fundholding scheme in Scotland. MAIN OUTCOME MEASURES: Length of consultation; numbers referred or investigated or prescribed drugs; responses to questions about enablement and satisfaction. RESULTS: About 15% of patients consulted with joint pain each year. 25% (316) of them had social problems in 1990 and 37% (370) in 1992; about a fifth wanted to discuss their social problems. Social problems were associated with a raised general health questionnaire score. The mean length of consultation for patients with pain was 7.6 min in 1990 and 7.7 min in 1992. Patients wishing to discuss social problems received longer consultations (8.5 min 1990; 10.4 min 1992); but other patients with social problems received shorter consultations (7.4 min; 7.2 min). The level of prescribing was stable but the proportion of patients having investigations or attending hospital fell significantly from 1990 to 1992 (31% to 24%; 31% to 13% respectively). Fewer patients responded "much better" to six questions about enablement in 1992 than in 1990. Enablement was better after longer than shorter consultations for patients with social problems. CONCLUSIONS: Quality of care for patients with pain has been broadly maintained in terms of consultation times. The effects of lower rates of investigation and referral need to be investigated further.

Drug Prescriptions↗
PubMed2005

Behavioral profiles of children with infantile nephropathic cystinosis.

Children with infantile nephropathic cystinosis have evidence of visuospatial and arithmetic deficits on a background of normal intellectual and verbal skills. This study aimed to define further their behavioral phenotype. The Achenbach Child Behavior Checklist was completed by parents of: 64 children and adolescents with cystinosis (33 females, 31 males; mean age 8 y 8 mo, range 4 to 16y, SD 2 y 11 mo); 101 healthy controls (47 females, 54 males; mean age 8 y 4 mo, range 4 to 16 y, SD 2 y 11 mo); 21 children and adolescents with cystic fibrosis (CF), termed chronic-disease controls (9 females, 12 males; mean age 11 y 3 mo, age range 4 to 17 y, SD 3 y 5 mo). Compared with healthy controls, individuals with cystinosis had evidence of a significantly higher incidence of behavioral problems, including social problems, somatic complaints, and attention problems. Compared with the chronic-disease control group, the cystinosis group differed only on the Social Problems scale, with 22% of participants with cystinosis scoring in the 'at risk' range whereas no participant with CF received an elevated score on this scale. We conclude that children and adolescents with cystinosis have evidence of a significant incidence of social difficulties compared with individuals with another chronic illness and healthy participants. The combination of visuospatial problems, difficulty with arithmetic, attention problems, and social difficulties seen in the cystinosis group constitutes a behavioral phenotype of this genetic disorder. This cluster of cognitive and behavioral symptoms is also seen in the nonverbal learning disabilities syndrome, and suggests a possible early difference in brain development in children with cystinosis compared with children who do not share this genetic disorder.

Chi-Square Distribution↗
PubMed2004

Classifying psychiatric disorders after traumatic brain injury and orthopaedic injury in children: adequacy of K-SADS versus CBCL.

PRIMARY OBJECTIVE: [corrected] To evaluate the convergence between the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) for the diagnosis of psychiatric disorders and the Child Behavior Checklist (CBCL). RESEARCH DESIGN: Cross-sectional psychiatric study of 72 children with traumatic brain injuries or orthopaedic injuries aged 5-14. METHODS AND PROCEDURES: Sensitivity, specificity, total predictive value and odds ratio were calculated to evaluate the association between CBCL summary scores and K-SADS diagnosis of at least one psychiatric disorder (K-SADS-1), and of CBCL subscales and K-SADS diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD). Lowered cut-off scores of t > or = 60 were used. MAIN OUTCOMES AND RESULTS: Convergence between the CBCL total problem scale and K-SADS-1 was poor. Convergence between 'at least one elevated CBCL subscale' and K-SADS-1, and between CBCL attention problems and social problems scales and K-SADS diagnosis of ADHD was excellent. CONCLUSIONS: Caution is needed when using the total problem scale of CBCL in predicting global psychological impairment because underestimation of problems is likely. The attention and social problems scales of CBCL can be used to estimate ADHD.

Adolescent↗
PubMed2002

Multidimensional latent-construct analysis of children's social information processing patterns: correlations with aggressive behavior problems.

Social information processing (SIP) patterns were conceptualized in orthogonal domains of process and context and measured through responses to hypothetical vignettes in a stratified sample of 387 children (50% boys; 49% minority) from 4 geographical sites followed from kindergarten through 3rd grade. Multidimensional, latent-construct, confirmatory factor analyses supported the within-construct internal consistency, cross-construct discrimination, and multidimensionality of SIP patterns. Contrasts among nested structural equation models indicated that SIP constructs significantly predicted children's aggressive behavior problems as measured by later teacher reports. The findings support the multidimensional construct validity of children's social cognitive patterns and the relevance of SIP patterns in children's aggressive behavior problems.

Aggression↗
PubMedDate not supplied

Social phobia viewed as a problem in social functioning: a pilot study of group behavioral treatment.

Available treatments of social phobia reduce anxiety and avoidance of social situations. Social functioning however, remains relatively unaffected. This study piloted a behavioral group treatment that aimed at improving patients' individual difficulties in social functioning. Five patients fulfilling DSM-IV criteria for social phobia were selected for treatment by a 16-session behavioral group treatment focusing on improving interpersonal functioning both in specific phobic situations as well as in different spheres of social life in general. Four out of 5 patients completed treatment and showed individual patterns of clinically significant improvement. Their individual test-score results and case-histories are presented. Three patients no longer fulfilled to the diagnostic criteria at the end of treatment; the fourth--at 6 month follow-up. This was maintained at a 2 year follow-up.

Adult↗
PubMed2000

Social phobia treated as a problem in social functioning: a controlled comparison of two behavioural group approaches.

OBJECTIVE: Treatments for social phobia result typically in significant anxiety and avoidance reduction; the repercussions in terms of social functioning, however, are not clear. This controlled study compared two approaches designed to improve the social functioning of social phobics. METHOD: Sixty-eight socially phobic patients were randomly assigned to two treatments focused on improving interpersonal relationships either with or without social skills training or a waiting list; 60 completed treatment and 59 a 1-year follow-up. Treatment was administered in small groups, 14 sessions altogether. RESULTS: No clinically meaningful change was observed during the waiting period. A statistically significant and equivalent improvement obtained in both treatment conditions. CONCLUSION: Both treatments resulted in reduced anxiety, avoidance, general psychopathology and better social functioning that maintained over follow-up. Continuing improvement in remission rates was noted; fully 60% of the patients no longer fulfilled criteria for social phobia at the end of 1-year follow-up.

Adult↗
PubMed2005

The Chinese version of the social problem-solving inventory: some initial results on reliability and validity.

The development of an instrument that measures social problem solving of Chinese adolescents is reported. The Social Problem-Solving Inventory Revised (SPSI-R) was translated to Chinese, and content validity, cultural relevance, and reading level of the translated measure were reviewed by panels of experts. The Chinese version of the scale (C-SPSI-R) was then administered to a sample of 352 junior secondary-school students. Exploratory factor analyses revealed a 5-factor structure that was largely consistent with the structure of the original English-language SPSI-R. The C-SPSI-R and its subscales were found to be internally consistent and temporally stable over time. The scores of the subscales were also correlated with depression scores, a correlation that supported the convergent validity of the subscales. Adolescents with high and low Chinese Beck Depression Inventory scores had significant differences in four out of five subscales of the C-SPSI-R (except Rational Problem-Solving). On the whole, the results supported that the C-SPSI-R is a reliable and valid instrument in the assessment of social problem solving in Chinese adolescents.

Adolescent↗
PubMed1977

Pregnancy in Swedish teenagers. Perinatal problems and social situation.

Teenage pregnancies are considered a major problem, socially and medically, in the USA. In the present study, the scope of the problem in a Swedish population was investigated. Primiparas age 17 or less constituted 2% of all 8945 women delivered of babies at the University Hospital in Linköping, 1969-72. The most common obstetrical complications and operations did not occur more often in this age group. The incidence of deliveries before the 36th gestational week was increased 3-fold but no significant differences in intra-uterine growth retardation, asphyxia or perinatal mortality were found. One to two years after the delivery, 70% of the young mothers lived in ordinary nuclear families. Their economic position was worse than in a control group of women 21-29 years old. Barely 10% reached the median income of the control group. This disadvantageous situation was not thought to be caused by their early pregnancies, but rather considered part of the life pattern of an underprivileged group otherwise characterized by a low occupational status of their own fathers, a low educational level and a high frequency of teenage pregnancy among their own mothers.

Adolescent↗
PubMed1990

Social problem-solving skills of young physically abused children.

The ability of physically abused children to resolve hypothetical social problems was compared to the social problem-solving skills of a comparison group of nonabused children. Analyses indicated that the abused children generated a more narrow range of solutions and were more likely to perserverate on negative solutions. Implications for intervention and future research are made.

Child Abuse↗
PubMedDate not supplied

Frontal lobe dysfunction and everyday problem-solving: social and non-social contributions.

Everyday problem-solving involves both non-social executive processes, social and emotional processes, and draws upon social and practical knowledge. A series of studies including both adult-acquired lesions and neurodevelopmental disorders is reviewed examining problem-solving on a real-life-type task that involves generating a range of solutions to brief problem scenarios and selecting preferred solutions to solve the problems. Impairments in problem-solving are described in groups of participants with left anterior frontal lobe lesions, Tourette's syndrome and Asperger's syndrome. By contrast, healthy older people did not show problem-solving deficits on the same task. The possible contributions of non-social executive skills, social and emotional skills, and knowledge acquired from experience are each considered in relation to everyday performance. Multiple cognitive/emotional routes to the development of everyday life difficulties pose a complex challenge both in understanding the nature of the relevant processes and in developing adequate methods for management and rehabilitation.

Adolescent↗