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At least 1,225 records · Page 68Linked to original sources
PubMed2002

Behaviour/mental health problems in young adults with intellectual disability: the impact on families.

BACKGROUND: The present authors studied the impact of dual diagnosis [i.e. intellectual disability (ID) and mental disorder] in young adults on their mothers' perceived levels of stress and decisions about placement. METHODS: The mothers of 103 young adults with severe ID were interviewed using a 2-3-h in-depth protocol of measures designed to assess their child's adaptive functioning, maladaptive behaviour, mental health problems and negative impact on the family, as well as their own thoughts on out-of-home placement. The Scales of Independent Behavior--Revised Problem Behavior Scale assessed problem behaviours and the Reiss Screen assessed mental disorder. RESULTS: These measures were highly correlated (r = 0.64), but tapped some different domains of maladaptive behaviour and proved to be most predictive when employed together. Behaviour and/or mental health (B/MH) problems significantly predicted the mothers' perceived negative impact of the young adult on the family, even after controlling for other young adult characteristics. These problems also predicted the family's steps toward seeking out-of-home placement, as did better young adult health and the mother's higher educational attainment; stress did not predict additional variance in placement once these variables were accounted for. CONCLUSIONS: The discussion focuses on the implications for service provision to families of young adults with B/MH problems.

Activities of Daily Living↗
PubMed1997

School-based secondary prevention for children with disruptive behavior: initial outcomes.

First through fourth graders from 22 suburban elementary schools were screened for cross-setting disruptive behavior as eligibility criteria for participation in a longitudinal secondary prevention study aimed at reducing the risk for serious externalizing behavioral disorders. Three hundred nine subjects participated in either a multicomponent competence enhancement intervention (MCEI) or an information/attention control (IAC) condition over a 2-year period. Following baseline requirements, initial intervention effects were assessed at the end of intervention Year 1, at the beginning of intervention Year 2 (fall of the next school year), and at the end of intervention Year 2. Multisource assessments were not supportive of the efficacy of the MCEI over the IAC condition. Children in both groups rated themselves as improved over time in terms of increased adaptive skills and decreased school problems and internalizing symptoms. Teacher and parent ratings of externalizing behavior did not yield evidence of positive change, but teachers noted improved problem solving and observers noted a decrease in behavioral interference in both groups over time, possibly as a result of maturation.

Adaptation, Psychological↗
PubMed1996

Children's selective coping after a bus disaster: confronting behavior and perceived support.

Data were obtained from 675 seventh graders grieving the death of 19 and injury of 14 fellow students in a traffic accident. Frequency of confronting behaviors was inversely related to their intensity. Perceived helpfulness of the various support person categories (oneself, parents, siblings, relatives, friends, classmates, classroom teachers, guidance counselors, psychologists) was related to current stress levels, context of the disaster, and prior helping relationships. Personal loss and situational variables affected confronting behavior and stress reaction levels. Specific helpful support persons affected interest in individual and/or group treatment. Findings were consistent with a model of search and selection of helpful support persons in community-wide stressful situations.

Accidents, Traffic↗
PubMed1989

Effects of media violence on children. A review of the literature.

The effects of media violence on the behavior of children are controversial. We examined and reviewed studies addressing this issue and identified many mediating variables. A small but genuine association appears to exist between media violence and aggression. However, many unanswered questions persist, and no interventions are clearly indicated.

Aggression↗
PubMed2004

The relationship between non-cognitive symptoms and functional impairment in Alzheimer's disease.

OBJECTIVE: Cognitive impairment is an important determinant for functional impairment in Alzheimer's disease. The role of non-cognitive symptom is uncertain. The objective of this study was to investigate the role of non-cognitive symptoms as predictive factors for functional outcome in A.D. METHODS: This was a retrospective study. Subjects were recruited from the Memory Clinic in Queen Mary Hospital over a two years period. Patients with diagnosis of probable A.D. by NINCDS-ADRDA were identified. Demographic data, Folstein Mini-Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), Neuropsychiatric inventory (NPI), Barthel activities of daily living (ADL) as well as Lawton's Instrumental activities of daily living (IADL) were retrieved. RESULTS: 100 patients were identified. Univariate analysis identified statistically significant correlation between hallucination and disinhibition score with Barthel Index (r=-0.43, p <0.001; r=-0.30, p=0.002 respectively); hallucination and aberrant motor act score with Lawton's IADL (r=-0.21, p=0.038; r=-0.21, p=0.038). MMSE was statistical significantly correlated with the above two functional scores. NPI was not statistical significantly correlated with any one of the functional measures. Multivariate regression analyses showed that hallucination score was an independent predictive factors for the Barthel index but not for the Lawton's IADL. MMSE score was identified to be independent predictive factor for all functional measures. CONCLUSIONS: Global cognitive impairment and hallucination was an important independent predictive factor for functional outcomes. Screening hallucination during the course of A.D. would be helpful. Further studies are needed to show the benefit of treatment of hallucination on the improvement of functional outcomes.

Activities of Daily Living↗
PubMed2006

Identifiers, or "red flags," of complexity and need for integrated care.

Because complex medical patients are a subgroup of the medical population and because complexity assessment involves extra effort, preselection of these patients through identifiers is necessary. There is no best identifier for complexity, and the one most suitable for the population served should be selected. This article provides a table with potential identifiers and discusses the difference between disease-oriented screening and treatment and a more generic approach such as complexity screening and complexity management.

Decision Support Systems, Clinical↗
PubMed2006

Operationalizing integrated care on a clinical level: the INTERMED project.

During the last 10 years the INTERMED method has been developed as a generic method for the assessment of bio-psychosocial health risks and health needs and for planning of integrated treatment. The INTERMED has been conceptualized to counteract divisions and fragmentation of medical care. Designed to enhance the communication between patients and the health providers as well as between different professions and disciplines, the INTERMED is a visualized, action-oriented decision-support tool. This article presents various aspects of the INTERMED, such as its relevance, description, scoring, the related patient interview and treatment planning, scientific evaluation, implementation, and support for the method.

Decision Support Systems, Clinical↗
PubMed2004

Developmental outcomes after early prefrontal cortex damage.

The neuropsychological bases of cognitive, social, and moral development are minimally understood, with a seemingly wide chasm between developmental theories and brain maturation models. As one approach to bridging ideas in these areas, we review 10 cases of early prefrontal cortex damage from the clinical literature, highlighting overall clinical profiles and real life developmental outcomes. Based on these cases, there is preliminary evidence to support distinctive developmental differences after: (1) dorsolateral, (2) mesial, and (3) orbital-polar prefrontal lesions, for more profound impairments after bilateral damage, and possibly for recovery differences after very early vs. later childhood lesion onset. Further case and group studies are needed to confirm reliable effects of specific lesion locations, the influence of age of lesion onset, and related experiential and treatment variables in determining adult outcomes. Rather than a single underlying deficit associated with early prefrontal cortex damage, we interpret the findings to suggest that it is the altered integration and interplay of cognitive, emotional, self-regulatory, and executive/metacognitive deficits that contribute to diverse developmental frontal lobe syndromes. The findings support the fundamental importance of prefrontal cortex maturation in protracted cognitive, social-emotional, and moral development.

Adolescent↗
PubMed1997

Social phobia, avoidant personality disorder and atypical depression: co-occurrence and clinical implications.

BACKGROUND: Increasing attention has been directed in recent years to the detection and treatment of psychiatric co-morbidity among depressed individuals. The overlap of social phobia (SP) and avoidant personality disorder (APD) has been well recognized and a relationship between these disorders and depression has been suggested. METHODS: The pattern and clinical implications of co-morbidity of SP and APD with major depressive disorder (MDD), diagnosed by DSM-III-R criteria, were studied among 243 out-patients presenting with depression. RESULTS: Overall, 26.7% of adults in our sample with MDD met criteria for SP and 28.4% for APD. Almost two-thirds of depressed adults meeting criteria for social phobia or avoidant personality disorder met criteria for both (SP+APD). Depressed adults who met criteria for both SP+APD exhibited a significantly higher proportion of atypical depression (54.8%) compared with those with neither SP nor APD (31.1%). Among depressed patients, the co-occurrence of SP with APD was also associated with an earlier age of onset of MDD, a greater number of comorbid Axis I diagnoses, and greater impairment of social adjustment and assertiveness. CONCLUSIONS: Results confirm the overlap of SP and APD in a depressed population and the high prevalence of these disorders in MDD. They suggest that depressed individuals with both SP and APD but not SP alone are at particularly high risk for atypical depression and for social dysfunction in excess of that caused by a current major depression.

Adult↗