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PubMed1997

Determinants of general practitioner recognition of psychological problems in a multi-ethnic inner-city health district.

BACKGROUND: With few exceptions, evaluation of the capacity of general practitioners (GPs) to recognise psychiatric disorder in their patients has failed to consider the role of ethnic diversity in the consultation process and whether such knowledge can improve understanding of the degree to which psychiatric morbidity is recognised within GP settings. METHODS: This research was completed in five general practices representative of all those within an inner-city health district. Psychiatric morbidity in patients consecutively attending the practices was then assessed using the General Health Questionnaire; in addition, GPs were asked to complete a checklist of current problems identified during each consultation. RESULTS: Analysis suggested that Asian and Black patients were less likely than White patients to have psychological problems identified; that social problems and a psychiatric history facilitated recognition; and that current physical illness hindered recognition. CONCLUSIONS: GP recognition of psychological problems varies according to patient ethnicity but can be substantially masked by both the physical and social circumstances of patients at consultation.

Adolescent↗
PubMed1994

Policy implications of differential health status in East and West Europe. The case of Hungary.

Morbidity and mortality trends in Western and Eastern Europe have differed considerably during the past three decades, although the major unfavourable processes have been essentially the same in each of the Central European countries. The most striking feature has been the decline in average life expectancy and deterioration of age-specific mortality rates for the middle-aged, especially men. The former socialist government took no effective action. Due to the denial of social and environmental problems, social, health and environmental policy were underdeveloped and deformed. Partly inherited from previous historical traditions, wishful thinking, victimization and a patronizing attitude were primary ways of dealing with problems. In these circumstances even the few specially supported health education campaigns were doomed to fail. People depended on the omnipotent central state in vain to solve their problems so that health promotion based on the community and self-empowerment did not develop. During the early nineties, in Eastern and Central Europe no central political strategies were initiated or launched to combat the mortality and morbidity tendences. The economic and social prerequisites of a long-term gradual improvement in the health status are missing in Central and Eastern Europe. A declining standard of living due to recession, growing deprivation, poverty, unemployment and migration are unfavourable to improvements in health. In a time of crisis, with stress but without adequate skills of coping, forced adaptation associated with sudden changes and perceived failure have only made matters worse. There are no short-term 'solutions'.

Attitude to Health↗
PubMed2002

Children's coping strategies: moderators of the effects of peer victimization?

Coping strategies were examined as potential moderators of the effects of peer victimization on children's adjustment. Self-report data on victimization experiences, coping strategies, and loneliness were collected on ethnically diverse 9-10-year-old children (177 girls, 179 boys). Teacher ratings of children's anxious-depressed and social problems and peer nominations of social preference were also obtained. Findings revealed that strategies such as problem solving that were beneficial for nonvictimized children exacerbated difficulties for victimized children. The effects of specific forms of coping were dependent on gender: social support seeking buffered victimized girls from social problems but was associated with lower peer preference for victimized boys. Data also revealed the need to examine the effects of coping on multiple adjustment outcomes.

Adaptation, Psychological↗
PubMed2005

Brief report: psychosocial adjustment in adolescents with inflammatory bowel disease.

BACKGROUND: Inflammatory bowel disease (IBD) is an ideal disease for investigating adolescent adjustment to chronic illness, given its embarrassing, socially limiting, appearance-changing symptoms and adolescent onset. OBJECTIVE: To compare psychosocial adjustment among adolescents with a chronic illness to that of healthy adolescents and examine the role of adolescent disease onset. METHODS: Participants were 50 adolescents with IBD and their parents, and parents of 42 healthy comparison adolescents who completed questionnaires assessing behavioral, emotional, social, and family functioning. RESULTS: Adolescents with IBD were reported to have worse anxious and/or depressed and social problems than healthy adolescents. More adolescents with IBD were reported to have clinically significant social problems. Those diagnosed during adolescence were reported to have significantly worse social competence scores. CONCLUSIONS: Adolescents with a chronic illness such as IBD may be at higher risk for specific psychosocial difficulties than healthy adolescents. Diagnosis of a chronic illness during adolescence may have implications for social functioning.

Adaptation, Psychological↗
PubMed1982

Perceived benefits from controlled drinking for convicted problem drinkers and social drinkers.

Convicted problem drinkers taking park in an educational course on responsible drinking and social drinkers listed perceived benefits accruing from controlled as opposed to uncontrolled drinking. Both groups saw improved financial and health status as major benefits of controlled drinking. For social drinkers others perceived benefits were positive in nature and generally related to the facilitative effect of alcohol in that they tended to be confined to the drinking situation and period. Problem drinkers appeared to expect more general and widespread benefits, either through the avoidance of aversive consequences associated with excessive drinking or by effecting some improvement in their social adjustment.

Adult↗
PubMed2001

Social inhibition and overfriendliness: two-year follow-up and observational validation.

Studied socioemotional functioning in 3 groups (n = 15) of high-inhibited, low-inhibited-overfriendly, and low-inhibited-low-overfriendly children at age 9, who were identified by parental ratings in a sample (N = 392) at age 7. Ratings of social inhibition and overfriendliness were stable over the 2-year period from age 7 to age 9. Validity of rated social inhibition and overfriendliness is established with behavioral observations, both predictively and concurrently. The groups are contrasted along the dimensions of social inhibition and overfriendliness with respect to socioemotional distress, social problem solving, empathic ability, and the disinhibitory phenomena of thrill seeking and hyperactivity. The high-inhibited group shows heightened socioemotional distress. The overfriendly group shows heightened levels of thrill seeking and hyperactivity. Social problem solving and empathy are less well developed in the inhibited and in the overfriendly group as contrasted to the low-inhibited-low-overfriendly group. The results are interpreted in terms of risks for socioemotional problems at both ends of the dimension of social inhibition.

Attention Deficit Disorder with Hyperactivity↗
PubMed1979

Victim-blaming and the "looping" effect of social policy: the cause of physician maldistribution and underserved rural communities.

Ryan's (1971) description of the ideology of "victim-blaming" is briefly reviewed. It is then shown how this strategy for obscuring the causes of a social problem is used against rural, medically underserved communities by health care provider and planning interest groups to "explain" critical shortages of physicians in their areas. In addition to lending further support for the existence of this ideology, a "looping" effect of social policy designed to deal with physician maldistribution is identified. It is argued that this can be viewed as analytically distinct from the ideology itself and that it serves the purpose of further obscuring the larger structural sources of the social problem.

Health Policy↗
PubMedDate not supplied

The Comprehensive assessment and Referral Evaluation (CARE)--rationale, development and reliability.

The Comprehensive Assessment and Referral Evaluation (CARE) is a new assessment technique which is intended to reliably elicit, record, grade and classify information on the health and social problems of the older person. The CARE is basically a semi-structured interview guide and an inventory of defined ratings. It is designated comprehensive because it covers psychiatric, medical, nutritional, economic and social problems rather than the interests of only one professional discipline. The style, scope and scoring of the CARE makes it suitable for use with both patients and non-patients, and a potentially useful aid in determining whether an elderly person should be referred, and to whom, for a health or social service. The CARE can also be employed in evaluating the effectiveness of that service if given.

Aged↗
PubMedDate not supplied

Comprehensive care for people living with HIV/AIDS: issues and problems of social integration in Nigeria.

Acquired Immunodeficiency Syndrome (AIDS) pandemic has become a major global public health problem with rising number of cases and associated deaths. Most of the present activities in developing countries, especially in Africa, are aimed at reducing the transmission of the Human Immunodeficiency Virus (HIV) that causes AIDS. Care for people living with HIV/AIDS (PLWHA) is essential not only to mitigate the impacts of HIV/AIDS among PLWHA but is also an important component of prevention of the disease. There is now a general recognition that comprehensive care across the continuum should be provided to PLWHA through all the stages of infection, with a crucial role for community-home based care activities. In addition, AIDS orphans need to be supported Although, documented evidences abound on the utility of comprehensive care and community-home based care approaches outside Africa and in some African countries, there is little information on them in Nigeria. This paper therefore reviews the recent epidemiology of HIV infection, the many currently developed initiatives to deliver comprehensive care for PLWHA in the hospital, community and at home, and the issue of AIDS orphans. In addition, measures to effectively integrate them into the mainstream of societal activities are discussed.

Comprehensive Health Care↗
PubMed1990

Community psychology into the 1990s: capitalizing opportunity and promoting innovation.

Political and social changes during the last decade and their implications for community psychology research and practice are discussed. Shifting responsibility for social problems, economic considerations, and levels of citizen concern and involvement in community problem solution are considered stimuli for new opportunities for innovation and change. The discipline is challenged to renew efforts in the promotion of innovation and to develop and disseminate interventions that result in modification in the role relationships characterizing the ecology of social problems.

Communication↗
PubMed1999

[Psychosocial adjustment to asthma and juvenile diabetes mellitus in school-age children].

The main purpose of this study was to compare psychological and social problems among chronically ill school-aged children to those observed in a group of healthy children of the same age. On the basis of the data collected, it was also possible to compare self-perception and social functioning problems between the 2 groups of children, as well as to identify the contributing factors explaining the observed differences in psychosocial adaptation between these 2 groups. Three measures were used to assess psychological and social problems. Mental health problems were measured by the Dominique (Valla, Bergeron, Bérubé, Gaudet, & Saint-Georges, 1994). Self-Perception and Social Functioning were assessed by the Self-Perception Profile (Harter, 1985) and the Rating Scale of Child's Actual Behavior (Harter, 1985). Information on characteristics of the child and his or her family was also collected. Sixty children aged 6 to 11 and diagnosed as having juvenile diabetes or asthma, 59 control children, and the children's parents participated in this study. A chi-square test and multivariate analysis of variance were used to compare the 2 groups of children. Results indicate that children with diabetes and asthma do not present more psychological and social problems than other children of the same age. Results also suggest that age is the only variable indicating a higher proportion of mental health problems among chronically ill children. Results are discussed and compared to those of previous studies from which the conceptual frame-work of this study was developed.

Adaptation, Psychological↗
PubMed1996

Adjustment in childhood brain tumor survival: child, mother, and teacher report.

Examined the adjustment of 6- to 18-year-old children and adolescents (n = 38) 2 to 5 years postdiagnosis of brain tumor with respect to standardized measures of anxiety and depression; self-perceptions; and adaptive living skills. Child, mother, and teacher report data were used. Maternal adjustment (anxiety and depression, parenting stress) was also assessed. Children and adolescents surviving brain tumors reported themselves to be generally within the normal range. However, maternal ratings of social problems were higher than normative scores and significantly lower than norms on social problems, scholastic competence, and communication skills. Teacher ratings on the Teacher Rating Form were all within normal limits. Maternal adjustment measures were within the normal range, although the Parent-Child Dysfunctional Interaction subscale of the Parenting Stress index was elevated. No differences in scores were found between children in regular and special education, or between children who had received radiation and those who did not. This sample of survivors of pediatric brain tumors and their mothers had relatively mild problems in adjustment, supporting a competency-based view of the adaptation of pediatric patients and their families.

Adaptation, Psychological↗
PubMed2004

[Prevalence of psychiatric symptoms and comorbid conditions in 3- to 5-year-old children: results of the Braunschweig Kindergarten Study].

OBJECTIVES: To analyze the frequency of behavioral and emotional problems and comorbidity of kindergarten children in Braunschweig as rated by their parents. METHOD: The analysis is part of the Braunschweiger Kindergartenstudie. In a sample of N = 809 children aged three to six the parents rated their children using a modified version of the Child Behavior Checklist/CBCL 4-18. RESULTS: The prevalence rates range from 0.5% to 5.0%. The most frequent behavioral problems in kindergarten children were aggressive behavior and attention problems, followed by social problems. The study also provides bidirectional comorbidity rates. CONCLUSION: Finally the prevalence rates and the implications of the findings for prevention of behavioral problems in children are discussed.

Affective Symptoms↗
PubMed2004

[Values and goals of medicine and health care].

Discussions about the goals of medicine and health care have significantly increased through the last decade of the past century. This was determined by the highly increased extent of health care, scarce health care resources, fundamental changes of health care technologies and well-established market relationships in health care. For a long time medicine attempted to achieve three main goals: to save and prolong life, fight and prevent diseases, reduce pain and sufferings. In the result of development of medicine the previous goals became rather problematic. Technological progress of medicine of the second half of the 20th century has implemented the believing, that medicine is able to prolong the life of human without restrictions. Ageing population has started expecting from medicine not only the saving of life and health enhancement, but also prolonging of life, since the mentioned is tended to be more socioeconomic, not medical, problem. Nowadays discussion about the goals of health care comes from the doubts, if the questions for medicine really have medical background. Often the society tries to escape from number of social problems medicalizing them. Spiritual and social problems of human are often supposed to be as medical ones, thus it is crucial to separate the main goals of medicine, which represent its values and targets, from the secondary ones, related to social or individual welfare, crime, dilemmas of poverty or morality. The aim of the article is to reveal the key values of medicine and health care, which determine the goals of medicine and health care.

Aged↗
PubMed2005

Examination of a conceptual model of child neglect.

This study attempted to provide empirical support for conceptual definitions of child neglect. We identified 12 types of needs, conceptualizing neglect as occurring when children's basic needs are not adequately met. We examined measures administered to 377 children and caregivers at ages 4 and 6 years participating in longitudinal studies on child mal-treatment to identify potential indicators of these needs. Indicators were found for latent constructs, operationalizing three of the basic needs (emotional support and/or affection, protection from family conflict and/or violence, and from community violence). These latent constructs were used in a measurement model; this supported the conceptual definitions of neglect. A structural equation model then assessed whether the latent constructs were associated with child adjustment at age 8 years. Low level of perceived support from mother was associated with internalizing and externalizing behavior problems. Exposure to family conflict was also linked to these problems, and to social difficulties. Finally, children's sense of experiencing little early affection was associated with subsequent externalizing behavior and social problems. The approach of conceptualizing neglect in terms of unmet child needs, developing a measurement model to define latent neglect constructs, and relating these constructs to subsequent adjustment can build our understanding of neglect.

Affect↗
PubMed2005

Brain tumors in children and adolescents: cognitive and psychological disorders at different ages.

Cognitive and psychological disorders are among the most frequently observed sequelae in brain tumor survivors. The goal of this work was to verify the presence of these disorders in a group of children and adolescents diagnosed with brain tumor before age 18 years, differentiate these disorders according to age of assessment, identify correlations between the two types of impairments and define possible associations between these impairments and clinical variables. The study involved 76 patients diagnosed with brain tumor before age 18 years. Three age groups were formed, and all the patients received a standardized battery of age-matched cognitive and psychological tests. According to our findings, all three groups present with cognitive and psychological-behavioral disorders. Their frequency varies according to age of onset and is strongly associated to time since diagnosis. The performance intelligence quotient (PIQ) was more impaired than the verbal intelligence quotient (VIQ). Internalizing problems, withdrawal and social problems were the most frequent psychological disorders. Correlations were found between cognitive impairment and the onset of the main psychological and behavioral disorders. These findings are relevant as they point out the long-term outcome of brain tumor survivors. Hence, the recommendation to diversify psychological interventions and rehabilitation plans according to the patients' age.

Adolescent↗
PubMed1996

The association of maternal psychopathology and family socioeconomic status with psychological problems in obese children.

In an earlier study we found parental psychiatric symptoms to be a better correlate of behavioral problems in obese children than either child or parental obesity. This study sought to extend this research by assessing the association of general maternal distress, specific maternal psychopathology, family socioeconomic status and child obesity with the psychological problems of 152 children seeking treatment for obesity in two cohorts. Child psychological problems were measured using the Child Behavior Checklist/4-18 (CBCL) in each cohort. In sample 1 maternal general psychiatric symptoms were measured using the Cornell Medical Index (psychiatric subscales) and the Inventory of Interpersonal Problems whereas specific psychopathology was assessed with the Beck Depression Inventory and the Bulimia Test. In sample 2 the Symptom Checklist-90 and Binge Eating Scale provided general and specific measures of psychopathology. In the combined sample, 58% percent of the boys and 44% of the girls met criteria on at least one CBCL behavioral problem scale, with Social Problems the most prevalent problem in both boys and girls. For both samples, child obesity did not account for any variance in child psychosocial problems beyond that accounted for by maternal psychopathology and family SES. Family SES accounted for a significant increment in variance in child behavioral problems in only two scales. This study systematically replicates previous research, adding support for a broader conceptualization of factors that influence psychological problems in obese treatment-seeking children than one which focuses on child obesity.

Adult↗