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PubMed2004

Gender differences in the relation between social support, problems in parent-offspring communication, and depression and anxiety.

Gender differences in the buffer-effect of social support in the relation between stressful circumstances and the development of depression and anxiety disorders are widely assumed, but few studies address this three-way interaction between gender, stress, and support. Data in the present study came from the baseline assessment of the Adolescents at Risk for Anxiety and Depression (ARIADNE) study in 502 adolescent and young-adult children of 356 parents in the Netherlands with a depression, panic disorder and/or obsessive-compulsive disorder. Results indicate that the daughters benefit more from social support than the sons when problems in parent-offspring communication are high, but that this effect holds only for depression symptoms and particularly in relation to problems in father-offspring communication. Social support does not seem to play a role in the development of anxiety.

Adolescent↗
PubMed1989

Severity of precipitated opiate withdrawal predicts drug dependence by DSM-III-R criteria.

Drug diagnoses in DSM-III-R are based on the dependence syndrome concept which hypothesizes that dependence on drugs is defined by behavioral and physiological changes but is separate from the social problems related to drug use. Previous studies provide support for the dependence syndrome in drug use; however, no study has examined whether biological indications of addiction are related to the dependence syndrome. The present study tests this relationship in 52 opiate addicts who were administered the Naloxone Challenge Test. The severity of withdrawal was correlated positively with the opiate dependence score, derived from the number of DSM-III-R criteria met. We also found that opiate withdrawal was inversely related to cocaine dependence and unrelated to any other drug use. Opiate withdrawal was not correlated with a global measure of social problems or to frequency or length of drug use. Our results support the validity of the dependence syndrome in opiate addiction because dependence is correlated with severity of withdrawal, is fairly specific to the drug, and is not related to social problems.

Adult↗
PubMed1990

The escalating health care cost of AIDS: who will pay?

AIDS is a crisis that has been imposed on an imperfect healthcare system. The flaws are easy to recognize but difficult to treat. Difficult choices about who pays for the medical care for AIDS patients will be made by upper-class and upper middle-class policymakers who are influenced by their own sense of vulnerability and by an aroused public. Social prejudice and moral judgment must be set aside. While the public ethic speaks the language of social justice, public activity often speaks the language of market justice. Beauchamp (1984) cites the philosophy of Anthony Downs when he states that solving social problems "requires painful losses, the restructuring of society and the acceptance of new burdens by the most powerful and the most numerous on behalf of the least powerful or the least numerous" (p. 306). It is characteristic of the public to attend to social problems until "it becomes clear that solving these problems requires painful costs that the dominant interests in society are unwilling to pay" (p. 306). The problem of AIDS care will require painful costs; but unlike many social problems, it will refuse to be hidden, refuse to be contained, refuse to be silenced, and refuse to be equitable in the marketplace and in the social system.

Acquired Immunodeficiency Syndrome↗
PubMed2002

[Recent psychophysical deterioration in the elderly patient: a potentially severe medical emergency. Assessment and attitudes].

An atypical presentation of diseases is common in the elderly patient. Also, a number of conditions in the elderly are commonly associated with deterioration of the functional status, that is, the independence level for daily life activities. This loss of autonomy occasionally calls the physicians attention, masking other symptoms. On the other hand, the high prevalence of social problems in the elderly adds a distorting element to the clinical evaluation of the patient. Four patients with a main complaint of recent physical and psychical deterioration are here reported. The complementary tests were inconclusive and patients were classified as social problems, thus posing the problem of home discharge. All patients were later demonstrated to have potentially severe conditions amenable to hospital admission (hypothyroidism, meningitis, arrhythmia, which prompted the implantation of a pacemaker, and digital intoxication). The recent loss of autonomy should be considered as a potentially severe medical emergency among the elderly. Failure to identify this problem may lead to minimizing the symptoms and overestimating the social problems, thus leading to inappropriate hospital discharges.

Aged↗
PubMed2004

Mental health problems of deaf Dutch children as indicated by parents' responses to the child behavior checklist.

Emotional/behavioral problems of 238 deaf Dutch children ages 4-18 years were studied. Parental reports indicated that 41% had emotional/behavioral problems, a rate nearly 2.6 times higher than the 16% reported by parents of a Dutch normative sample. Mental health problems seemed most prevalent in families with poor parent-child communication. Deaf children ages 12-18 showed more problems with anxiety and depression and more social problems than those ages 4-11. Deaf children with relatively low intelligence showed more social problems, thought problems, and attention problems than those with relatively high intelligence. The authors stress the need to get information on deaf children's mental health functioning not just from parents but from other informants such as teachers and the children themselves. An expansion assessment of deaf children, and of special services and treatments for deaf children and adolescents with emotional/behavioral problems, is recommended.

Adolescent↗
PubMed2005

Patterns of psychological problems in Parkinson's disease.

OBJECTIVE: To identify patterns of psychological problems in Parkinson's disease (PD). METHOD: A sample of 3075 patients was surveyed to determine frequencies of psychological problems and cross-validated cluster analyses were computed to identify patterns of these problems. RESULTS: An increase of symptoms during arousal was reported by 68%, sleep disturbances by 32% of the sample, and sexual problems by 57% of men and 22% of women. Less frequently reported were difficulties in communicating (27%), needing help of others (38%), and depressive moods (20%). Four patterns of psychological problems were identified: general low stress, general high stress, sexual and social problems, and non-social problems. CONCLUSION: The study confirms the clinical observation that PD patients differ not only in degree, but also in structure of psychological stress. Social and non-social stress constitute principal types of stress experienced in PD. This distinction should be taken into account for any approach to support people with PD.

Adult↗
PubMed1999

Stress-buffering factors related to adolescent coping: a path analysis.

To uncover those factors that buffer the impact of stressful negative experiences on adolescent adjustment, a theoretical model of adolescent stress and coping, with social support and social problem solving proposed as moderators, was investigated using path analysis. The study was conducted with 122 ninth-and tenth-grade nonreferred high school students. Using the LISREL statistical package (Jöreskog & Sörbom, 1986), it was found that a recursive loop leading from stress outcomes back to negative stressors did not allow for a successful solution to the model. However, the effects of stressful events on adjustment were mediated by coping resources, which included a combination of problem-solving abilities and social support. Overall, the findings replicated previous investigations that have demonstrated direct relationships among stressful life events, social support, problem solving, and adolescent adjustment. While a successful fit to the theoretical model was not attained, it was concluded that a refined model may provide a more acceptable solution.

Adaptation, Psychological↗
PubMedDate not supplied

Problems related to the diagnosis and treatment of adolescents with leukemia.

This descriptive study investigated the problems related to the diagnosis and treatment of adolescents diagnosed with leukemia. Subjects were 8 females and 22 males diagnosed with leukemia for at least one year and who received outpatient treatment. The study found that the information needs of the adolescents related more to the treatment and the prognosis of the disease than to the etiology. All subjects reported that they experienced physical problems relevant to the disease and the treatment, and 50% reported that they experienced social problems. Also, their social problems decreased as the time period after the diagnosis increased and subjects were in the remission stage. Adolescents also have fears and concerns related to the side effects of treatment and prognosis. Especially in the recurrence stage, their fears and concerns about death are increased. Friends and family relationships of the adolescents changed, and their future life plans were disrupted after the disease.

Activities of Daily Living↗
PubMed1986

Emergency care. Identification of psychosocial problems.

Psychosocial problems are common among emergency department visitors, and can remain undetected if not focused upon. In the present study the magnitude of these problems was analysed by a social worker through telephone interviews 3-5 days after patients emergency department visit. This survey revealed not only those patients recognized by the regular staff as in need of help because of social problems (5%) but also an additional 33% of patients whose problems went undetected. Fifteen percent of the visitors found contact with a social worker to be helpful and six percent requested such help. A follow-up investigation five months after the visit revealed that assistance had been given to 83% of those patients.

Emergency Service, Hospital↗
PubMed1999

Pubertal maturation and the development of behavioural and emotional problems in early adolescence.

Development of problem behaviour in early adolescence was predicted from change in pubertal stage and timing of pubertal development. Parent-reported (Child Behavior Checklist) and self-reported (Youth Self-Report) problem behaviour, pubertal stage and life events were assessed twice from a community sample of nearly 1300 Dutch children, aged 10-12 years at T1 and 12-14 years at T2. Pubertal change was a significant predictor of development in most parent-reported problems. Once initial differences in problems had been accounted for, the slower the progress in pubertal development, the higher the problem score at T2. Development of self-reported problems was independent of pubertal change. Pubertal timing predicted development of two parent-reported and three self-reported problem scales. Of the parent-reported problems, early maturation was associated with a decrease in boys' social problems and attention problems. Late maturing increased girls' social problems. Of the self-reported problems, early maturation was associated with an increase in girls' withdrawn and delinquent behaviour. Late maturing increased boys' attention problems. We conclude that pubertal development has small but significant effects on the development of problem behaviour in early adolescence.

Adolescent↗
PubMed1978

Evaluation of a social work service for self-poisoning patients.

Four hundred patients aged at least 17 who came to Casualty in one year after deliberately poisoning themselves were randomly assigned between an Experimental social work service (task-centered casework) and a Control (routine) follow-up service. 139 patients were excluded from the trial, most of whom were already in continuing psychiatric treatment. After one year there was no difference in the proportions of E and C patients who repeated self-poisoning (about 14 per cent), but significantly more of the excluded group had repeated (36 per cent). A random half of the trial patients were re-interviewed four months after admission. Both E and C groups had improved to a significant extent on measures of depressed mood and of social problems. E patients showed more change in social problems and were more satisfied with the service they had received.

Adolescent↗
PubMedDate not supplied

Fetal alcohol syndrome: the origins of a moral panic.

Since its discovery almost 30 years ago, the fetal alcohol syndrome (FAS) has been characterized in the USA, as a major threat to public health. In part because FAS resonated with broader social concerns in the 1970s and 1980s about alcohol's deleterious effect on American society and about a perceived increase in child abuse and neglect, it quickly achieved prominence as a social problem. In this paper, we demonstrate that, as concern about this social problem escalated beyond the level warranted by the existing evidence, FAS took on the status of a moral panic. Through examples taken from both the biomedical literature and the media about drinking during pregnancy, we illustrate the evolution of this development, and we describe its implications, particularly how it has contributed to a vapid public policy response.

Female↗
PubMed2000

Neurocognitive and social functioning in schizophrenia: a 2.5 year follow-up study.

In our previous study we demonstrated that, in 80 schizophrenia subjects, verbal ability, verbal memory and executive functioning were significantly associated with social problem solving. The objective of this present study was to assess the longitudinal stability of the relationship between social and neurocognitive functioning in schizophrenia. This 2.5 year longitudinal cohort study re-assessed community functioning, social problem solving and symptoms in 65 of the 80 original subjects to determine the predictive ability of neurocognitive functioning. Neurocognition was not re-assessed at this follow-up. Positive and negative symptoms were assessed with the Positive and Negative Syndrome Scale. Social functioning was assessed using the Social Functioning Scale, the Quality of Life Scale, and the Assessment of Interpersonal Problem-Solving Skills (AIPSS). Verbal ability, verbal memory and vigilance were significant predictors of social problem solving as assessed by the AIPSS. Results suggest that the association between neurocognition and social functioning remains consistent over time.

Adult↗
PubMed1989

Psychotropic drug prescription in general practice in Italy: a two-week prevalence study.

A study on psychotropic drug monitoring was carried out in Verona over a 2-week period using information obtained during consultation with 3 GPs. Psychotropic drugs accounted for 23.4% and 24.3% of all prescriptions in men and women respectively. Benzodiazepines were the most frequently prescribed: 76% and 72% of all psychotropic prescriptions respectively in women and in men. No significant association between psychotropic drug prescription and age, sex, marital status and occupation was found in the present survey. In men only, those patients with higher educational level were more likely to receive a prescription for psychotropic drugs than those with a lower educational level. About 70% of men and 60.4% of women diagnosed by the GP as having a psychiatric problem were prescribed a psychotropic drug. However, the probability of a psychotropic being prescribed, when a psychiatric problem is identified by the GP, was significantly higher (p less than 0.05) in men than in women: odds ratio 39.37 and 16.33 respectively. Psychotropic drugs were prescribed in 35% of men and in about 48% of women in which a social problem was identified by the GP. Women were about 5 times more likely to receive a prescription than men: odds ratio 12 and 2.75 respectively. A significant influence of physical ill-health and educational level on psychotropic prescription emerged: both effects were independent of sex, psychiatric morbidity and social problems. Using a logistic regression analysis, an interactive effect between sex and conspicuous psychiatric morbidity and between sex and social problems was also found.

Adult↗
PubMed2001

Predictors of recidivism in Australian juvenile sex offenders: implications for treatment.

Juvenile sex offenders charged with their first sexual offense were compared with recidivist juvenile sex offenders who had been charged with more than one sexual offense on a number of factors related to sexual offending. Participants were 70 male juvenile sex offenders, aged 13-21 years who were awaiting court disposition. Negative family history, negative family characteristics, school and learning problems, social skill deficits, deviant sexual experiences, deviant sexual fantasies, and cognitive distortions were assessed for their direct and mediating roles in recidivism. Path analysis indicated that poor social skills, learning problems, and deviant sexual experiences were causally related to recidivism of sexual offending. Poor social skills were directly related to recidivism, whereas cognitive distortions and deviant sexual fantasies mediated the role of learning problems and deviant sexual experiences. There was a significant association between deviant sexual experience and learning problems. The findings support the role of cognitive distortions and deviant sexual fantasies in recidivist sexual offending for this sample. The causal role identified for poor social skills and learning problems in recidivism for sexual offending has implications for treatment and therefore deserves further attention.

Adolescent↗