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PubMed2002

Role of social disadvantage in crime, joblessness, and homelessness among persons with serious mental illness.

Research on mental illness in relation to social problems such as crime, unemployment, and homelessness often ignores the broader social context in which mental illness is embedded. Policy, research, and practice will be improved if greater attention is given to social context. The authors critically analyze the approach used in much of the psychiatric services literature to infer links between mental illness and social problems. They compare these studies with studies that have been more validly conceptualized to account for social context. With this broader perspective, the impact of mental illness on crime, unemployment, and homelessness appears to be much smaller than that implied by much of the psychiatric services literature. Poverty moderates the relationship between serious mental illness and social problems. Factors related to poverty include lack of education, problems with employment, substance abuse, and a low likelihood of prosocial attachments. This relationship is often complicated and is not amenable to simple explanations. Research and policy that take this complexity into account may lead to greater effectiveness in interventions for persons with serious mental illness.

Adaptation, Psychological↗
PubMed1994

Psychologic adjustment of human immunodeficiency virus-infected school-age children.

We investigated the psychosocial adjustment of school-aged, human immunodeficiency virus-positive children and factors associated with level of adjustment. Participants were primarily transfusion-infected children living in middle-class families. We administered measures of depression, anxiety, and self-concept to children, and measures of behavior problems, social functioning, personality characteristics, and life events to parents. An index of disease stage was also collected. Children reported experiencing low levels of depressive and anxious affect and generally felt positively about themselves. By contrast, parents saw their children as more anxious and less socially active than respective standardization samples. A greater than expected proportion of these children, as reported by their parents, scored in the maladaptive range on measures of social functioning, anxiety, and conduct problems. Experience of adversive life events and progression of the disease were associated with more behavioral and social problems. Findings are discussed in terms of their generalizability and implications for future research.

Adaptation, Psychological↗
PubMed2004

Relation of adolescent mothers' history of antisocial behavior to child conduct problems and social competence.

We examined the extent to which maternal antisocial behavior (ASB) is directly related to child conduct problems and social competence and assessed the potential mediating role of negative parenting. The sample included 93 adolescent mothers and their children (44 boys, 49 girls). Mothers retrospectively reported about their ASB since the child's birth, through Grade 2. Negative parenting was coded during a parent-child interaction task (PCIT) at Grade 2. Teachers assessed child outcomes at Grade 3. Maternal ASB during the child's life was directly related to parenting and both child outcomes. In the overall sample, negative parenting partially mediated the relation between maternal ASB and child conduct problems. However, the pattern of relations differed by sex. For boys, maternal ASB was directly related to conduct problems, independent of parenting. For girls, maternal ASB was strongly related to parenting but not conduct problems. Negative parenting did not mediate the relation between maternal ASB and child social competence. Implications for intervention and future research are discussed.

Adolescent↗
PubMed1998

Social problem-solving deficits and hopelessness, depression, and suicidal risk in college students and psychiatric inpatients.

The Social Problem-Solving Inventory-Revised was used to examine the relations between problem-solving abilities and hopelessness, depression, and suicidal risk in three different samples: undergraduate college students, general psychiatric inpatients, and suicidal psychiatric inpatients. A similar pattern of results was found in both college students and psychiatric patients: a negative problem orientation was most highly correlated with all three criterion variables, followed by either a positive problem orientation or an avoidance problem-solving style. Rational problem-solving skills emerged as an important predictor variable in the suicidal psychiatric sample. Support was found for a prediction model of suicidal risk that includes problem-solving deficits and hopelessness, with partial support being found for including depression in the model as well.

Adolescent↗
PubMed1999

[Early diagnosis and early treatment of cognitive disorders: a study of geriatric screening of an unselected patient population in general practice].

To investigate the feasibility of early assessment of preventable disabilities in primary care, we developed a geriatric preventive screening examination with various indicators of physical, emotional, and social functions as well as laboratory exams. Cognitive impairment was measured by the modified MMSE. Severe cases of dementia, who would deserve home visits were excluded. Results of the assessment procedure in 446 patients aged 70 and over (71.5% females) were compared to ratings of general practitioners (n = 67). In these patients we found 4250 medical, 374 psychiatric, and 528 social problems. 45.4% of medical, 61.8% of psychiatric, and 56.8% of social problems where hitherto unknown to the GPs. The prevalence of cognitive impairment was 4.6% according to GPs diagnosis and 21% according to the MMSE. The sensitivity of GPs diagnosis was 14%, the specificity 98%, and the overall agreement measured by kappa was 0.17. There were significant (p < 0.05) associations of cognitive impairment with poor health, vascular disease, syncope, weight loss, previous hospitalization, depression, and ADL and IADL-items. Hypertension, or pathological thyroid function, occurred more frequently in the cognitively impaired (p > 0.05). Only 19.5% of dementia cases had severe functional loss, which substantiates our hypothesis that mild dementia was studied. Of all cases with newly identified cognitive impairment (n = 83 of 446 patients), three (3.6%) had reversible disorder such as depression (n = 1), drug toxicity (n = 2) 3 (3.6%) received counseling, and 5 (6%) further diagnostic assessment or treatment. One (1.2%) patient did not accept any treatment. In the remainder of 71 patients (85.5%), the GPs adopted a wait and see strategy with no intervention. In conclusion, memory deficits seem to be underdiagnosed in general practice despite much treatable comorbidity or social problems, and some reversible conditions such as depression and drug adverse effects.

Activities of Daily Living↗
PubMed1997

Primary mental health care in a rural community: patient and illness profiles, treatment and referral.

The objective of this study was to determine the extent and nature of psychosocial morbidity and patterns of treatment and referral in rural general practice in a West Australian community. The research design was a survey based on structured questionnaires completed by the general practitioners about patients consulting with mental health problems in Bunbury in the rural south west region of Western Australia. Twenty-two general practitioners from five surgeries collected information on 428 patients, pertaining to socio-demographic characteristics, reasons for encounter, diagnoses, social problems, chronicity, counselling, medication and use of referral services. The positive stereotype of patients (i.e. most likely to be identified) consisted of a female preponderance in a ratio of 3:1, a high prevalence in the middle years (35-54), an overrepresentation of the divorced and separated, unemployed men and housewives. Neurosis was the most prevalent diagnosis at 68.5%, chronicity at 55%, and the most frequent social problems reported to the GPs related to relationship difficulties with partner, and being physically ill. Only a quarter of the patients were referred to other counselling services and social problems were an important reason for referral. Particular attention needs to be given to the negative stereotype in general practice of young people under the age of 25. With the bulk of psychosocial disorder concentrated in general practice, with the evident association of mental illness with physical illness and social problems, and with the lack of specialist resources in rural areas, innovative ways of support from other mental health professionals need to be addressed.

Adolescent↗
PubMed2003

The missing link.

Current TB services fail to reflect the changing epidemiology of the disease. Patients present with multiple and complex health and social problems. Services concentrate on providing a microbiological cure but ignore underlying social problems.

Community Networks↗
PubMed1988

Socioeconomic accompaniments of severe epilepsy.

Limited quantitative research has been undertaken on the social accompaniments of severe epilepsy. In this study we present new data from 92 patients with uncontrolled seizures necessitating admission to a special assessment unit in the United Kingdom. Comprehensive information on the medical, educational, and social history of each subject was obtained; moreover, they completed the Social Problems Questionnaire, which examines the respondent's level of satisfaction with various aspects of living including employment, finances, housing, etc. Thirty-nine percent of the sample reported moderate or severe dissatisfaction in four problem areas. The most frequently reported problems were with social contacts (73%) and employment (71%). The significance of these findings is discussed and some remedial strategies outlined.

Adolescent↗
PubMed1994

Governmental and nongovernmental youth welfare in the new German Länder.

Demands on youth welfare are growing, social problems are increasing, and right-wing extremism and unemployment among the youth are causing long-term social problems. In addition, social budgets are being cut, while establishment of youth welfare departments in the eastern part of Germany has not been completed. The results of this investigation clearly show that in light of these problems, effective youth welfare is impossible.

Adolescent↗
PubMed2005

The social skills problems of victims of bullying: self, peer and teacher perceptions.

BACKGROUND: A small number of prior studies have found that victims of school bullying tend to exhibit poor social skills. Few of these have examined this issue from multiple perspectives, and there has been a focus on a restricted range of social skills. AIMS: To determine the extent to which self, peers, and teachers regard victims as having poorer social skills than non-victims across 20 behaviours/competencies. SAMPLE: A convenience sample of 330 pupils aged between 9 and 11 years (162 girls and 168 boys) provided self-report and peer-report data. They were drawn from 12 classes from 6 junior schools in the UK. Additionally, 11 of the class teachers provided data. METHOD: Three separate methods were employed and in each case, participants were provided with 20 short statements that described a different social skill: (1) participants who were classified as either 'victims' or 'non-victims' (using peer nominations) rated themselves on a 3-point scale in terms of how like them each description was, (2) participants were asked to think of a victim and a non-victim in their class and to rate both of these people on each description, and (3) teachers were asked to rate a previously identified victim and a non-victim from their class on each description. RESULTS: Using a direct discriminant function analysis of the self-ratings, six of the social skills items were found to discriminate between victims and non-victims, and the discriminant function was able to correctly classify 80% of the participants. For 18 of the items, peer ratings indicated significantly more pronounced social skills problems for victims than for non-victims. Teacher ratings were significant for eight of the social skill items, and in each case, victims were rated as having greater problems. CONCLUSION: The finding that victims are perceived by three different sources to have poor social skills has important implications for interventions to support victims of bullying.

Aggression↗