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PubMed1995

Accumulation of problems in social functioning in young adulthood: a developmental approach.

Using longitudinal data from a sample of 369 Finnish adolescents, the authors examined whether problems in social functioning in young adulthood were interrelated and accumulated, and analyzed processes that may lead to cumulative problems. The log-linear modeling showed that an unstable career line of men at age 26 was related to poor social relations, a poor financial standing, drinking problems, and criminal arrests; for both sexes, drinking problems and criminal arrests were interrelated. At a personal level, the authors analyzed male patterns of problems in social functioning and pathways resulting in patterns of social functioning. The pathway leading to an unstable career, criminal arrests, and drinking problems among men included aggressiveness at age 8 and problems in school adjustment and in the family at age 14.

Achievement↗
PubMed2006

Interpersonal problems in social phobia versus unipolar depression.

In this study we compared interpersonal problems in outpatients with social phobia (n=50) to those with unipolar depressive disorders (n=50). All participants completed the Inventory of Interpersonal Problems. Multivariate analyses of variance revealed significant group differences. Individuals with social phobia had significantly lower scores on the primary dimension of Control and significantly higher values on the Social Avoidance subscale than did individuals with depression. Our results support findings from former analogue studies. They indicate that social phobia is associated with severe social relationship problems that should be considered in treatment.

Adult↗
PubMed1976

[Psychopathological findings and social psychiatry problems in patients with transplanted kidneys].

Chronic haemodialysis and kidney transplantation reveal a great number of psychological and psychiatrical problems and tasks. As there are special psychological problems and many psychoreactive symptoms and the fact that haemodialysis and kidney transplantation are strain situation in themselves, one should examine the question of capability, and often a psychiatric or psychotherapeutic treatment is necessary. Authors examined twelve patients who had undergone kidney transplantation, regarding their psychopathological and social-psychiatrical status. The great improvement in the quality of life in comparison to the time of dialysis treatment is often reduced, however, because of psychological and severe social problems as well as deficient or missing steps of rehabilitation.

Adult↗
PubMed2004

Aggression-related hostility bias and social problem-solving deficits in adult males with mental retardation.

Attributional bias and social problem-solving deficits in two groups of adult males (aggressive vs. nonaggressive) with mild mental retardation were investigated. When presented with vignettes depicting various problem situations, aggressive participants were less accurate in correctly identifying interpersonal intent, characterized by more problem-solving deficits, and generated higher numbers of aggressive solutions to resolve problems as compared to their nonaggressive counterparts. The present results support the applicability of contemporary models of social information processing and adjustment with regard to reactive aggression to men with mental retardation.

Adolescent↗
PubMed1998

Patient race and psychotropic prescribing during medical encounters.

This paper examines how patient race, rating of physical and emotional health, expression of physical, emotional, and social problem symptoms, and physician perceptions of patients' physical health, emotional health, and social problems influence psychotropic prescribing in patients with chronic illness. Data were collected at 11 geographic areas in the United States and Canada. Patient visits were audio-tape recorded and research assistants interviewed each patient after their medical visit. Physicians completed self-administered questionnaires after each visit with a participating patient. Whites were significantly more likely to receive psychotropic prescriptions than non-whites (P < 0.05). Twenty percent of white and 13.5% of black patients received prescriptions for one or more psychotropic medications. Logistic regression techniques were used to predict psychotropic prescribing to white and non-white patients respectively. Patient expression of emotional symptoms and physician perceptions of patient emotional health significantly influenced psychotropic prescribing to white patients, whereas only patient expression of emotional symptoms significantly influenced psychotropic prescribing to non-white patients. Patient expression of physical and social problem symptoms and physician perceptions of patient physical health and social problems did not influence psychotropic prescribing to white or non-white patients. The paper emphasizes the importance of training primary care physicians to probe and to provide patients with an opportunity to discuss their emotional symptoms.

Adult↗
PubMedDate not supplied

[Selected social medicine problems of the diabetic patient].

Corresponding publications above all consider social medical problems of the diabetic, which still is in occupation. As more than the half of all diabetics are recipients of pension, we have to engage in them, too. We examined 1397 diabetics. 72% of them were able to get alone in the consulting hour. The rest (28%) had a significantly longer duration of illness and were disabled workers very often. We refer to the insufficient insulin therapy in old diabetics. We demonstrate possibilities for enforcement of the insulin injection.

Aged↗
PubMed2003

Social problem-solving abilities and distress among family members assuming a caregiving role.

We examined the relation of social problem-solving abilities to distress experienced by family members assuming a caregiving role for a loved one who had recently incurred a severe physical disability. Family members completed measures of problem-solving, depression and health, while their loved one participated in an inpatient rehabilitation programme. Correlational analyses indicated that a negative problem orientation was significantly predictive of caregiver distress, regardless of the degree of physical impairment of the care recipient. Women reported more distress on several measures than men, and disability severity was also associated with depression and impaired social functioning. Family members with a greater negative orientation may be at risk to develop psychological and health problems upon assuming a caregiver role. These results are discussed in light of theoretical models of social problem-solving, and implications are presented for psychological interventions and for health policy concerning family caregivers and their care recipients.

Adult↗
PubMed2003

Factors influencing the length of hospital stay of patients with heart failure.

INTRODUCTION: Heart failure (HF) is characterised by frequent hospital admissions and prolonged length of hospital stay. Admissions for HF have increased over the last decade while length of stay has decreased; the reasons for this change in length of stay are uncertain. This study investigates the effect of patient-related variables, in-hospital progress and complications on length of stay. METHODS: Patients admitted to Auckland Hospital general medical service and randomised into the Auckland Heart Failure Management Programme were included in this study. RESULTS: One hundred and ninety-seven patients were included in this study. Mean age 73 years, mean left ventricular ejection fraction 32%; 52% had one or more previous HF admissions and 75% were New York Heart Association class IV at admission. Median length of hospital stay was 6 days (IQR 4, 9) which is comparable to the national average from New Zealand admission databases. Longer than average length of stay, defined as >6 days, was associated with the presence of peripheral congestion, duration of treatment with intravenous diuretic, the development of renal impairment, other acute medical problems at admission, iatrogenic complications during hospital stay, and social problems requiring intervention. Factors independently associated with length of stay in the top quartile (>10 days) on logistic regression included the presence of oedema at admission (OR 10.5), change in weight during stay (OR 1.3), duration of treatment with iv diuretic (OR 7.5), the development of renal impairment (OR 9.8), concurrent respiratory problems requiring specific treatment (OR 3.8), and social problems requiring intervention (OR 6.8). CONCLUSIONS: Peripheral congestion, concomitant acute medical problems requiring specific treatment, the development of renal impairment and the presence of social problems were related to a longer than average length of hospital stay. Multivariate models only partly explained variance in hospital stay, suggesting the importance of pre-admission and post-discharge factors, including the healthcare environment, the availability of primary and secondary care resources, and the threshold for hospital admission.

Aged↗
PubMed1991

Assessment of children's social problem-solving skills in hypothetical and actual conflict situations.

This study compared the social problem-solving skills of 57 maladjusted and 57 well adjusted first and second graders in a series of hypothetical and actual provocations. All children were asked how they would react to four video-taped provocations involving same-age peers. They were also exposed to three provocations simulated by a peer-confederate; their verbal and nonverbal behaviors were videotaped. Multivariate analyses of variance indicated that, overall, maladjusted subjects displayed less assertiveness and more verbal and nonverbal aggressive responses to the actual provocations. Conversely, hypothetical situations yielded few between-group differences with respect to verbal strategies. The validity of hypothetical situations is questioned; the importance of actual situations for assessment and intervention purposes is stressed.

Aggression↗
PubMed2000

Carbamazepine for cocaine dependence.

BACKGROUND: Cocaine dependence has become a substantial public health problem, developing a significant number of medical, psychological and social problems, including the spread of infectious diseases (e.g. AIDS, hepatitis and tuberculosis), crime, violence and neonatal drug exposure. Although there is no consensus regarding how to treat cocaine dependence, effective pharmacotherapy has a potentially major role to play as part of a broader treatment milieu. The anti-convulsant carbamazepine, a tricyclic medication that is widely used to treat a variety of neurological and psychiatric disorder, has also been used for treatment of cocaine dependence, although its effectiveness has not been established. OBJECTIVES: To determine whether carbamazapine (CBZ) is effective on the treatment of cocaine dependence. SEARCH STRATEGY: Electronic searches of Cochrane Library, EMBASE, MEDLINE, PsycLIT, Biological Abstracts and LILACS; scan of reference list of relevant articles; personal communication; conference abstracts; unpublished trials from pharmaceutical industry; book chapters on treatment of cocaine dependence. SELECTION CRITERIA: The inclusion criteria for all randomised controlled trials were that they should focus on the use of carbamazepine drugs versus placebo on the treatment of cocaine dependence. Trials including patients with additional diagnosis such as opiate dependence were also eligible. DATA COLLECTION AND ANALYSIS: The reviewers extracted the data independently and Odds Ratios, weighted mean difference and number needed to treat were estimated. Qualitative assessments of the methodology of eligible studies were carried out using validated checklists. The reviewers assumed that people who died or dropped out had no improvement and tested the sensitivity of the final results to this assumption. Where possible analysis was carried out according to the "intention to treat" principles. MAIN RESULTS: 5 studies were included in the review, with 455 people randomised. No differences were found regarding positive urine sample for cocaine metabolites. Scores on Spielberg State Anxiety Inventory slightly favoured carbamazepine, but didn't reach statistical significance. Dropouts were high in both groups up to 70% in the placebo group. Less dropout occurred in the Carbamazepine group (RR 0.87 95%CI 0.71-1.06). When no retention in treatment was due to side effects no differences were found. The number of participants presenting at least one side effect, reported in Kranzler (1995), was higher in the carbamazepine group (RR 4.33 95% CI 1.45-12.91). REVIEWER'S CONCLUSIONS: There is no current evidence supporting the clinical use of CBZ in the treatment of cocaine dependence. Larger randomised investigation must be considered taking into account that these time-consuming efforts should be reserved for medications showing more relevant and promising evidence.

Anticonvulsants↗
PubMed1997

[A method of detection psychosocial problems at the family physician's office].

OBJECTIVE: To find the value of the Stressful Vital Events (SVE) scale for detecting patients with psycho-social problems and how these affect family function. DESIGN: A descriptive, crossover study with systematic sampling. SETTING: Almanjayar Health Centre. PATIENTS AND OTHER PARTICIPANTS: 202 patients (138 women and 64 men) who attended for on-demand consultations at two clinics during October and November 1994. They were selected systematically, 1 from every 5, with under-18s eliminated. INTERVENTIONS: The GHQ, SVE and Family APGAR tests were self-administered. The GHQ test was used to detect psycho-social problems, SVE to measure stressful vital events and the APGAR family to find family function. MEASUREMENTS AND MAIN RESULTS: 46% (94) had psycho-social problems; 53% (107), positive scoring in the SVE test; and 21% (42), family dysfunction. The relationship between SVE and GHQ was significant (p < 0.0001), but relationships with the APGAR weren't. CONCLUSIONS: We consider that exploration of SVEs is a good way of detecting psycho-social problems.

Adult↗
PubMed1980

Dimensions underlying a hierarchically based assessment of social problem-solving.

The dimensions underlying a procedure designed to assess nine levels of social problem-solving among EMR learners were explored in relation to IQ and MA. Principal-factor solutions followed by oblimin rotations were performed on data collected from 120 EMR children (ages 9 to 14). Results yielded three hierarchical factors, two that were moderately related to IQ and MA and one that was independent of IQ and MA. Explanation of the findings was based on a consideration of the differences between divergent and convergent production abilities.

Factor Analysis, Statistical↗
PubMedDate not supplied

Social problem-solving partnerships with family caregivers.

The goal of this pilot study was to compare the effectiveness of home and telephone social problem-solving partnerships on primary family caregiver outcomes and to determine whether certain caregiver and stroke survivor characteristics influenced these outcomes. Thirty primary family caregivers were assigned to either a home visit, telephone contact, or control group. A registered nurse trained caregivers in the intervention groups in a series of seven telephone calls or home visits during a 12-week period to use social problem-solving skills in managing caregiving problems. Primary family caregiver outcomes were compared before the intervention, during the intervention (at 2 and 5 weeks after discharge), and after the intervention (at 13 weeks after discharge). Compared to the home and control groups, the telephone group had a significant reduction in depression, more positive problem-solving skills, and greater caregiver preparedness during the intervention, and improved, but nonsignificant depression, problem-solving, and caregiver preparedness scores postintervention. Race, age, and education were significant for selected outcomes.

Adult↗
PubMed1991

Relation between social problem-solving ability and subsequent level of psychological stress in college students.

A prospective design was used to examine the relation between social problem-solving ability and later psychological stress in college students during the first semester of the academic year. A new social problem-solving inventory measured not only general ability, but also more specific components of the problem-solving process (e.g., problem orientation, problem-solving skills; D'Zurilla & Nezu, 1990). The results of a hierarchical multiple regression analysis showed that general problem-solving ability was negatively related to later stress, even after prior stress level and number of life problems were controlled. More specific analyses indicated that subjects' problem orientation was a better predictor of stress than their problem-solving skills. Results are discussed in terms of the possible stress-reducing effects of perceived control and successful problem resolution.

Adaptation, Psychological↗
PubMed1997

[Assessment of problem situations in the family].

Goal of the study is the analysis of the German version of Barkle's Home Situations Questionnaire. The analysis is accomplished in a clinical sample of N = 76 children at the age of six to ten years with the diagnosis of a hyperkinetic disorder according to ICD-10 or an Attention deficit-/hyperactivity disorder according to DSM-III-R and in a representative sample of N = 263 children aged seven to ten years. Parents of hyperkinetic children experience many family situations with their child as very problematic which is essentially more often than parents in the representative sample. Analyses of the factorial structure of the questionnaire yielded no clear and well interpretable solutions. The instrument has a good internal consistency. The HSQ-D scores correlate significantly with other parent questionnaires for the assessment of behaviour problems, the highest correlations were found with scales for the assessment of hyperkinetic behaviour problems and social problems. In the clinical practice the instrument has proven helpful within symptom-specific assessment of children with hyperkinetic and oppositional behavior disorders and for the planning of interventions.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

[The prevalence of chronic drinkers in Mexico: an ecologic analysis].

Alcohol consumption is an important element in the epidemiologic profile of Mexico. This can be confirmed observing the increased per capita consumption of certain alcoholic beverages (like beer and wine), alcohol related medical problems (e.g. liver cirrhosis), social problems (i.e. violence) and by the data provided by household surveys of prevalence of alcohol consumption in Mexico since the 60's. The population's consumption of alcoholic beverages has generated concern, as the Simple Distribution Theory (SDT) predicts that an increment in the per capita alcohol consumption is likely to be accompanied by an increment of heavy drinkers. This increment is, then, related to a theoretical increment in alcohol related damages. In order to partially test the SDT data from a series of surveys done in the country, six surveys of the 70's were used. Those surveys were executed in six cities, the capital of five states and the capital of the Republic, with a comparable methodology and definition of alcohol consumption. We used prevalence data of heavy drinkers in those cities as an independent variable for a series of medical and social problems, in a multiple-group comparison study. In general, the results do not support the SDT in the case of mortality by liver cirrhosis, suicide and traffic deaths, or for alcohol related offenses at the Federal Courts. Nevertheless, the results seem to support the SDT for some groups in Common Court offenses and for the rate of traffic accidents. In a comparison with other independent variables (prevalence of abstainers, per capita bars, illiteracy, unemployment, and population density), the prevalence of heavy drinkers and population density were the best. Both obtained the largest number of statistically significant correlations with the problems studied. For the prevalence of heavy drinkers some of those correlations were in the inverse sense as predicted by the SDT.

Accidents, Traffic↗
PubMed1998

Longitudinal genetic analysis of problem behaviors in biologically related and unrelated adoptees.

The genetic and environmental influences on problem behaviors at two assessment points, three years apart, and their stability were studied in a sample of international adoptees, initially aged 10 to 15 years. Parents of 111 pairs of adopted biological siblings, 221 pairs of adopted nonbiological siblings and 1484 adopted singletons completed the Child Behavior Checklist (75 pairs, 154 pairs and 1080 singletons respectively at second assessment). At first assessment, genetic factors accounted for more than 50% of the variance in the Externalizing, Aggressive Behavior, Attention Problems and Social Problems scales. Shared environmental influences explained 40% of the variance in the Total Problem scale and less for all other scales. Nonshared environmental influences were most important for the Internalizing scale and its subscales, and for the Thought Problems and Delinquent Behavior scales. At the second assessment, genetic factors explained most of the variance in the Total Problem, Externalizing and Aggressive Behavior scales, while nonshared environmental influences explained most of the variance in all other scales. Shared environmental influences explained 33% of the variance in the Internalizing scale and less for the other scales. The stability of the Externalizing scale over time was caused mostly by genetic factors, while nonshared environmental factors mostly caused the stability of the Internalizing scale.

Adolescent↗
PubMed1983

Concurrent validity of the addiction severity index.

The concurrent validity of the Addiction Severity Index (ASI), a new scale for assessing a range of clinical dimensions in drug and alcohol abusers, was evaluated in 204 opiate addicts applying for treatment. This study is the first independent validation study of this measure. The ASI subscales were found to have good concurrent validity with self-report measures in the areas of psychological problems, social adjustment problems, legal problems, and employment problems (r = .55 to .39). Drug abuse problems showed limited concurrent validity and medical problems were not concurrently assessed in our study. Addicts with psychiatric diagnoses beyond opiate abuse were effectively identified by the ASI, and depressed addicts were particularly well screened with a sensitivity of 89 per cent and a specificity of 67 per cent. A cluster analysis demonstrated that the six ASI scales could be used to discriminate depressed addicts, antisocial addicts, and addicts without psychiatric disorders. Thus, the ASI was demonstrated to be a potentially important evaluation instrument for opiate addicts.

Alcoholism↗