摘要:

The authors proposed and tested a model of social functioning in schizophrenia. The model consisted of five indicators: social competence, quality of relations, satisfaction, symmetry of relationships, and the number of close friends. The model combines proximal and distal, quality and quantity, and self-report and observer ratings of social functioning. It was designed to have ecological validity in that it reflects real-world social functioning, and the data are all gathered in reference to naturally occurring social contexts. Two independent community samples of individuals diagnosed with schizophrenia or schizoaffective disorder (N= 172;N= 166) were used to test the structure of the measurement model and its invariance across samples. Additional measures of social functioning, prognosis, and intrapsychic deficits were used to further assess the validity of the proposed social functioning construct. A single-factor model had acceptable fit with the data from sample 1. The single-factor model was found to be invariant across the two independent samples. Correlations with other measures in both samples provided additional evidence for the construct validity of the proposed measurement model of social functioning. Implications for research and practice are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Object relations deficits are commonly found in schizophrenia samples from the United States, but it is unknown whether these deficits are a reliable finding in other cultures. The Bell Object Relations Inventory was translated into Brazilian Portuguese and administered to 61 stable outpatients with schizophrenia from Sao Paolo, Brazil. Their scores were compared with a Brazilian normal sample and with a matched U.S. schizophrenia sample. The Brazilian normal sample showed a pattern of scores within the normal range when compared with U.S. norms. The Brazilian schizophrenia sample had significantly greater pathology than the Brazilian normal sample on Alienation, Egocentricity, and Social Incompetence. Their mean scores on Alienation were similar to the matched U.S. schizophrenia sample, and they had significantly greater pathology on Insecure Attachment, Egocentricity, and Social Incompetence with 85.6% showing some type of object relations deficit. Findings support the cross-cultural validity of the Bell Object Relations Inventory and the ubiquity of object relations deficits in schizophrenia. The most common profiles for both schizophrenia samples were the Psychotically Egocentric and the Socially Withdrawn object relations types.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Knowledge of the subjective experience of patients has important implications for the understanding and treatment of schizophrenia. However, previous studies examining the clinical correlates of subjective experiences have yielded inconclusive results. The present study of Japanese inpatients with chronic schizophrenia aimed to reveal the factorial structure of patients’ subjective experiences and to examine the relationships between identified factors and demographic and clinical variables. A systematic assessment was carried out of objective psychopathology and subjective experiences in 129 inpatients. A factor analysis of the data of patients’ subjective experiences identified five factors. Delusions/hallucinations, as clinical variables, were significantly associated with three of these factors. Negative symptoms, extrapyramidal side effects, and female gender each had significant associations with only one of the factors. The first factor, which accounted for the highest percentage, did not correlate significantly with any of the clinical or demographic variables. Subjective experiences in chronic schizophrenia appear to have a heterogeneous structure and fall into two groups, one relatively independent of objective psychopathology and the other reflecting the clinical variable delusions/hallucinations.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

This study investigates the association between childhood depression and the protective qualities of adult religiousness. Subjects were 146 (65 female and 81 male) adults with a history of childhood depression and 123 (61 female and 62 male) adults without a history of childhood depression interviewed as part of a long-term follow-up study (mean years of follow-up, 11.2; SD = 1.4). Depression in childhood and adulthood was assessed by blind and independent clinical interviews by using the Schedule for Affective Disorders for School Aged Children and the Schedule for Affective Disorders Life-time Version, respectively. Religiousness was assessed by report on the personal importance of religion, frequency of attendance of religious services, religious denomination, and child-adult concordance of report. Findings showed adult personal importance of religion to be associated with a decreased risk for depression in women without a history of childhood depression but an increased risk for depression in women with a history of childhood depression. Adult Catholicism as compared with Protestantism was associated with a decreased risk for depression in male childhood depressives, but this association was not found in men without childhood depression. The findings potentially suggest a reciprocal-influence process between childhood pathology and the development of religiousness.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Many Asian-Americans are unfamiliar with depression and its treatment. When depressed, they generally seek treatment from their primary care physicians and complain about their physical symptoms, resulting in under-recognition and under-treatment of depression. This study evaluates the effectiveness of the Chinese version of the Beck Depression Inventory (CBDI) for screening depression among Chinese-Americans in primary care. A total of 503 Chinese-Americans in the primary care clinic of a community health center were administered the CBDI for depression screening. Patients who screened positive (CBDI ≥ 16) were interviewed by a psychiatrist using the Structured Clinical Interview for DSM-III-R, patient version (SCID-I/P) for confirmation of the diagnosis. Patients who screened negative (CBDI < 16) were randomly selected to be interviewed using the depression module of the SCID-I/P. The results of the SCID-I/P interview were used as the standard for evaluating the sensitivity and specificity of the CBDI. A total of 815 Chinese-Americans in a primary care clinic were approached, and 503 completed the CBDI. Seventy-six (15%) screened positive (CBDI ≥ 16), and the prevalence of major depression was 19.6% by using extrapolated results from SCID-I/P interviews. When administered by a native-speaking research assistant, the CBDI has good sensitivity (.79), specificity (.91), positive predictive value (.79), and negative predictive value (.91). Despite the commonly believed tendency to focus on physical symptoms rather than depressed mood, Chinese-Americans are able to report symptoms of depression in response to a questionnaire. The CBDI, when administered by research assistants, has good sensitivity and specificity in recognizing major depression in this population. Lack of interest among Chinese-American patients in using the CBDI as a self-rating instrument has limited its use for depression screening in primary care settings.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

As the literature on co-occurring substance abuse in persons with severe mental illnesses has evolved, emphasis on biologic and pharmacologic factors has diverted attention from important psychosocial issues. The authors review recent research showing that a) psychosocial risk factors may explain consistently high rates of substance abuse by these persons, b) substance abuse is for most clients a socio-environmental phenomenon embedded in interpersonal activities, and c) both natural recovery processes and effective treatments rely on developing new relationships, activities, coping strategies, and identities. Thus, psychosocial issues are critical in our attempts to understand and address substance abuse in this population.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Research on family caregivers of mentally ill relatives has historically focused on negative aspects of caregiving, often described as caregiver burden. The authors document caregivers’ perspectives on both the negative and positive aspects of caregiving. A qualitative approach was used. Data collection involved 20 in-depth, audiotaped, semistructured interviews focusing on caregivers’ positive and negative personal experiences with caregiving to a relative with mental illness. Caregivers reported common negative impacts but also beneficial effects, such as feelings of gratification, love, and pride. Main themes included stigma, systems issues, life lessons learned, and love and caring for the ill relative. This study counterbalances the predominantly negative consequences previously reported and adds to the emerging literature on positive aspects of caregiving. Mental health professionals need to help caregiving families make choices to improve their challenging situations and identify the rewards of caregiving, and to advocate for increased systemic supports to ease caregiver burden.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID