Biopsychosocial Factor Research Articles

Individual outcomes after tailored versus generic self-management strategies for persistent fatigue in youth with a fatigue syndrome or rheumatic condition: A multiple single-case study.

To examine individual outcomes after tailored lifestyle (PROfeel) or generic dietary advice as self-management intervention for persistent fatigue in adolescents and young adults with a chronic condition, to compare participants who did and did not benefit and to explore changes to factors in the biopsychosocial model of fatigue after PROfeel. A multiple single-case AB-phase design was embedded in a randomized crossover trial (N = 45). Intensive longitudinal data (ILD) on outcomes 'fatigue severity', 'self-efficacy' and 'quality of life' (QoL) were collected through weekly smartphone measurement for 20 weeks. ILD on biopsychosocial factors were collected through experience sampling methodology for 28 days pre-post first intervention. Baseline characteristics were compared with t-tests and chi-square tests. Permutation distancing tests were used to assess change over time in all ILD. Regarding weekly measurements, nineteen participants (42.22%) showed small to large positive outcomes (drange = .05 to 2.59), mostly after PROfeel. Eleven participants (24.44%) showed small to moderate negative outcomes (drange = -.02 to -2.46), mostly after dietary advice. Fatigue severity improved most, followed by self-efficacy. Participants who benefitted showed higher QoL levels and lower fatigue and pain levels compared with others at baseline (all p < .02). When positive outcomes were observed after PROfeel, typically ≥1 biopsychosocial factor had been targeted successfully. Self-management advice has more potential when tailored to individual characteristics, including the biopsychosocial model of fatigue. PROfeel appears particularly useful as fatigue intervention for individuals with relatively less severe symptoms.

National Trends in the Prevalence of Screen Time and Its Association With Biopsychosocial Risk Factors Among Korean Adolescents, 2008–2021

PurposePrior studies suggested an increase in screen time among adolescents during the COVID-19 pandemic; however, due to limited sample size and a short-term observation period, these associations are inconclusive and inconsistent. Thus, we aimed to compare screen time during the pandemic and the long-term trend through a Korean large-scale and long-term study of one million adolescents. MethodsData from 2008 to 2021 on 913,191 Korean adolescents aged 12–18 years were obtained via a nationwide, large-scale, and serial study. We investigated the change of screen time use over time and the change in trend before and during the pandemic (2008–2019 vs. 2020–2021) by using weighted linear regression model with estimates of β-coefficients and 95% confidence intervals (CIs). Moreover, we analyzed the differences in vulnerability of biopsychosocial factor before and during the pandemic. ResultsA total of 913,191 adolescents were included in this analysis. During the pandemic, the overall screen time of Korean adolescents significantly increased compared to the expected based on the prepandemic period during the pre–COVID-19 period (weighted screen time before the pandemic [133.24 min/day; 95% CI, 132.08–134.40] vs. during the pandemic [303.66 min/day; 95% CI, 300.59–306.73]; βdiff 0.331; 95% CI, 0.311–0.351). Comparing before and during the pandemic, potential risk factors associated with screen exposure included female sex, sadness, suicidal thoughts, alcohol consumption, low educational level of parents, low level of vigorous physical activity, middle school students, and low household income. DiscussionThrough large-scale nationwide study, this study described the 14-year trend of screen time among Korean adolescents. In the era of COVID-19, the prevalence of screen exposure has been increasing more rapidly than before at the population level. Also, the pandemic amplified the differences in screen time across grade, sex, sadness, suicidal thoughts, smoking, alcohol consumption, education level of parents, physical activity, and household income groups.

How to Interpret Effect Sizes for Biopsychosocial Outcomes and Implications for Current Research

Biopsychosocial factors are associated with pain, but they can be difficult to compare. One way of comparing them is to use standardized mean differences. Previously, these effects sizes have been termed as small, medium, or large, if they are bigger than or equal to, respectively, .2, .5, or .8. These cut-offs are arbitrary and recent evidence showed that they need to be reconsidered. We argue it is necessary to determine cut-offs for each biopsychosocial factor. To achieve this, we propose 3 potential approaches: 1) examining, for each factor, how the effect size differs depending upon disease severity; 2) using an existing minimum clinically important difference to anchor the large effect size; and 3) define cut-offs by comparing data from people with and without pain. This is important for pain research, as exploring these methodologies has potential to improve comparability of biopsychosocial factors and lead to more directed treatments. We note assumptions and limitations of these methods that should also be considered. PerspectiveStandardized mean differences can estimate effect sizes between groups and could theoretically allow for comparison of biopsychosocial factors. However, common thresholds to define effect sizes are arbitrary and likely differ based on outcome. We propose methods that could overcome this and be used to derive biopsychosocial outcome-specific effect sizes.

Transcultural Adaptation and Psychometric Validation of the Spanish Version of the Pain Attitudes and Beliefs Scale for Physiotherapists.

Low back pain (LBP) is one of the main musculoskeletal pain conditions, and it affects 23-28% of the global population. Strong evidence supports the absence of a direct relationship between the intensity of pain and tissue damage, with psychosocial factors also playing a crucial role. In this context, the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) is a useful tool for evaluating physiotherapists' treatment orientations and beliefs regarding the management of low back pain (LBP). It helps identify practitioners who may benefit from additional education in modern pain neuroscience. However, there is not a Spanish validation of this scale for physiotherapists. Thus, the aims of this study were to translate and culturally adapt the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) into Spanish and to evaluate its psychometric properties. This validation study used three convenience samples of physiotherapists (PTs) (n = 22 for the pilot study, n = 529 for the validity study and n = 53 for assessing the instrument's responsiveness). The process of translating and adapting the PABS-PT into Spanish followed international guidelines and produced a satisfactory pre-final version of the questionnaire. Factor analysis confirmed the two-factor structure of the original version, with the biomedical (BM) factor explaining 39.4% of the variance and the biopsychosocial (BPS) factor explaining 13.8% of the variance. Cronbach's alpha values were excellent for the BM factor (0.86) and good for the BPS factor (0.77), indicating good internal consistency. Test-retest reliability was excellent for both factors, with intraclass correlation coefficients (ICCs) of 0.84 for BM and 0.82 for BPS. The standard error of measurement (SEM) was acceptable for both factors (3.9 points for BM and 2.4 points for BPS). Concurrent validity was moderate and in the expected direction and had significant correlations with the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and Revised Neurophysiology Pain Questionnaire (R-NPQ). Sensitivity to change was demonstrated by significant improvements in both factors after an educational intervention, with medium-to-large effect sizes. The PABS-PT also showed good discriminative ability, as it was able to distinguish between physiotherapists with and without pain education. Cut-off values for the BM and BPS factors were determined. In conclusion, the translated and adapted Spanish version of the PABS-PT demonstrated good psychometric properties and can be reliably used to assess the attitudes and beliefs of Spanish-speaking physiotherapists regarding LBP. The questionnaire is recommended for use in clinical and educational research in the Spanish language context.

Biopsychosocial factors associated with depression in the elderly: A systematic literature review

Background: One of the most common mental illnesses worldwide and that has significant negative effects on well-being and physical health, is depression. Many factors that affect the occurrence of depression are biopsychosocial. Elderly people have high risk factors for depression. This study aims to review and find a gap in current evidence of biopsychosocial factors affecting depression in the elderly. Methods: We conducted an advanced search on PubMed database between October and November 2021. We screened the bibliographies of the articles from the database search using a set of inclusion criteria: studies with quantitative design; elderly population sample; exploration of at least one biopsychosocial factor; depression as the outcome or dependent variable; written in English; and published between 2011 and 2021. Results: We found 54 studies that met the inclusion criteria. Of these, five papers discussed biopsychosocial factors, 18 discussed biological and psychological/social factors, five discussed psychosocial factors, and the rest of the studies discussed one component of biopsychosocial factors. Biological factors influencing elderly depression include being female, having health problems or low health status, older age, genetics, brain structure, and biomarkers, taking certain drugs, and lack of or inability to carry out daily activities. Psychosocial factors include lack of social support, low education level, financial problems, single/unmarried, lack of contact with family/friends, living alone, low self-perceived health, stressful life events, loneliness, and losing hobbies. From the literature search, it was also found that there are biopsychosocial factors that have not been studied and are expected to be able to make references for future research. From this literature review, we found gaps in the availability of evidence about biopsychosocial factors that require further research. Conclusions: Knowing the biopsychosocial factors that affect them can help to prevent depression in the elderly.

Biopsychosocial factors associated with chronic low back pain-related activity limitations in Burundi.

BackgroundChronic low back pain (CLBP) is an increasing burden worldwide. The biopsychosocial factors associated with CLBP-related activity limitations have not yet been investigated in Burundi.ObjectiveThe aim of our study was to investigate the biopsychosocial factors that influence the CLBP-related activity limitations in a Burundian sample population.MethodWe carried out a cross-sectional study of 58 adults with nonspecific CLBP from Bujumbura city. Univariate and bivariate analyses were used to investigate the association between biopsychosocial factors and CLBP activity limitations. Sequential multiple regression analyses were subsequently used to predict CLBP activity limitations.ResultsFifty-eight individuals with a mean age of 41.3 ± 10.20, 58.6% of female gender, were recruited. The univariate and bivariate analyses demonstrated that educational level, gender, healthcare coverage, profession, height, pain intensity, depression and physical fitness were significantly associated with CLBP-related activity limitations (p range, < 0.001 to < 0.05). The multivariate regression analysis showed that the significant biopsychosocial factors accounted for 49% of the variance in self-reported activity limitations. Predictors of activity limitations were education level (β = −0.369; p = 0.001), abdominal muscle endurance (β = −0.339; p = 0.002) and depression (β = 0.289; p = 0.011).ConclusionsOur study provides evidence of biopsychosocial factor associations with CLBP-related activity limitations in Burundi. Evidence-based management and prevention of CLBP in Burundi should incorporate a biopsychosocial model.Clinical implicationsBiopsychosocial factors should be regularly evaluated in people with chronic low back pain and efforts to improve the burden of chronic low back pain in Burundi should take these factors into account.

What do Health/Mental Health Professionals Have to do With Racial Discrimination?

There is a growing evidence that social determinants of health influence the health outcomes. These non-medical factors, i.e., social determinants of health / mental health, are defined as the conditions in which people are born, grow, live, work and age, including the factors shaping these conditions. They either have direct effects on health and ill health or work as mediators. In this respect, racial discrimination is a fundamental social determinant of ill health / mental health and health inequalities. A strong correlation between reported experiences of racial discrimination and poor general health and poor mental health has been reported. Besides, racial discrimination may lead to risk taking behaviors increasing poor health / mental health especially in vulnerable disadvantaged populations. A leading factor mediating the negative effects of any biopsychosocial factor on mental ill health is the degree of discrimination. Furthermore, racial discrimination is one of the processes explaining and reinforcing racial disparities in health and ill health. From a conceptual point of view, racial discrimination and its effects on ill health could be discussed in the context of the issue of othering and related dehumanization and violence. Psychiatrists and mental health workers have accumulated considerable knowledge and experience on understanding and overcoming some of the consequences of racial discrimination, especially via anti-stigma studies. The unfair and avoidable influences of racial discrimination on mental health are neither fated nor inevitable. As Gramsci had said, we have the pessimism of the intellect and optimism of the will.DisclosureNo significant relationships.

Ginger And Citrus Aromatherapy For Servical Cancer Patients Post Chemotherapy

Nausea and vomiting after chemotherapy is one of the effects that can reduce the patient'sspiritual biopsychosocial factor. The first purpose of this study was to determine the effect of aromatherapy inhalation in ginger and citrus. The second one to compare the value of both citrus and ginger aromatherapy to reduce effect of nausea and vomiting. This research was an experimental study with four solomon group designs. A sample of 68 respondents were divided into four groups by purposive sampling. Ginger aromatherapy showed p 0.002 less than alpha 0.05 and citrus aromatherapy showed p 0.009 less than alpha 0.05. These results indicate that both aromatherapy can reduce nausea and vomiting.The second analysis used the Mann-Whitney statistical test to compare the effect on the intervention group of each inhalation aromatherapy. The results showed that the p-value (0.192) more than alpha (0.05), which means that statistically there is no difference in the average score of nausea and vomiting between the intervention groups of ginger aromatherapy and citrus aromatherapy, but ginger aromatherapy can reduce nausea and vomiting by a difference mean 3.18 greater than citrus aromatherapy. Nurses can use ginger and citrus aromatherapy as an alternative solution to reduce nausea and vomiting in improving the patient's physical condition.

Turkish version of health care providers’ pain and impairment relationship scale: Reliability and validity

PurposeTo develop the Turkish version of the Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS-TR) by conducting the linguistic and cultural adaptation and to examine the psychometric properties and reliability of the adapted version. MethodsA double back-translation procedure was used to translate the questionnaire. Participants received an online survey package with the HC-PAIRS-TR, the Turkish version of Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT-TR), and Turkish Version of the Tampa Scale for Kinesiophobia (TSK-TR). Cronbach's alpha coefficient and item analysis were used to evaluate internal consistency. Intraclass correlation coefficient (ICC) was used to determine the test–retest reliability. Confirmatory factor analysis (CFA) and Rasch Analysis were performed. ResultsThe study was conducted with 153 physiotherapists practicing in Turkey. Cronbach's alpha was 0.81. Test-retest reliability was high (ICC = 0.85, p < 0.001), the standard error of measurement was 4.96 (0.94% of mean), and minimal detectable change was 13.75 (26.06% of mean). HC-PAIRS-TR scores correlated significantly with scores for the biomedical factor of the PABS-PT-TR (r = 0.52, p = 0.00), biopsychosocial factor of PABS-PT-TR (r = 0.32, p = 0.00), and TSK-TR (r = 0.52, p = 0.00). According to CFA and Rasch Analysis, the 12 items version of HC-PAIRS-TR fits the one-factor model excellently. ConclusionThe HC-PAIRS-TR appears to be a reliable and valid questionnaire to measure Turkish physiotherapists’ beliefs and attitudes about the relationship between low back pain and impairment. Future studies might be planned to validate this questionnaire for other health care providers.

Higher Executive Control Network Coherence Buffers Against Puberty-Related Increases in Internalizing Symptoms During the COVID-19 Pandemic

BackgroundEarly pubertal maturation has been posited to be a biopsychosocial risk factor for the onset of internalizing psychopathology in adolescence; further, early-maturing youths exhibit heightened reactivity to stressful events. School closures and enforced social distancing, as well as health and financial uncertainties, during the COVID-19 pandemic are expected to adversely affect mental health in youths, particularly adolescents who are already at risk for experiencing emotional difficulties. The executive control network (ECN) supports cognitive processes required to successfully navigate novel challenges and regulate emotions in stressful contexts. MethodsWe examined whether functional coherence of the ECN, measured using resting-state functional magnetic resonance imaging 5 years before the pandemic (T1), is a neurobiological marker of resilience to increases in the severity of internalizing symptoms during COVID-19 in adolescents who were in more advanced stages of puberty at T1 relative to their same-age peers (N = 85, 49 female). ResultsOn average, participants reported an increase in symptoms from the 3 months before pandemic to the 2 most recent weeks during the pandemic. We found that early-maturing youths exhibited greater increases in internalizing symptoms during the pandemic if their ECN coherence was low; in contrast, relative pubertal stage was not associated with changes in internalizing symptoms in adolescents with higher ECN coherence at T1. ConclusionsThese findings highlight the role of the functional architecture of the brain that supports executive functioning in protecting against risk factors that may exacerbate symptoms of internalizing psychopathology during periods of stress and uncertainty.

Assessment, Quantification, and Management of Fracture Pain: from Animals to the Clinic.

Fractures are painful and disabling injuries that can occur due to trauma, especially when compounded with pathologic conditions, such as osteoporosis in older adults. It is well documented that acute pain management plays an integral role in the treatment of orthopedic patients. There is no current therapy available to completely control post-fracture pain that does not interfere with bone healing or have major adverse effects. In this review, we focus on recent advances in the understanding of pain behaviors post-fracture. We review animal models of bone fracture and the assays that have been developed to assess and quantify spontaneous and evoked pain behaviors, including the two most commonly used assays: dynamic weight bearing and von Frey testing to assess withdrawal from a cutaneous (hindpaw) stimulus. Additionally, we discuss the assessment and quantification of fracture pain in the clinical setting, including the use of numeric pain rating scales, satisfaction with pain relief, and other biopsychosocial factor measurements. We review how pain behaviors in animal models and clinical cases can change with the use of current pain management therapies. We conclude by discussing the use of pain behavioral analyses in assessing potential therapeutic treatment options for addressing acute and chronic fracture pain without compromising fracture healing. There currently is a lack of effective treatment options for fracture pain that reliably relieve pain without potentially interfering with bone healing. Continued development and verification of reliable measurements of fracture pain in both pre-clinical and clinical settings is an essential aspect of continued research into novel analgesic treatments for fracture pain.

An Initial Psychometric Evaluation of the Pain Concepts Questionnaire in a Low-SES Setting

The examination of pain beliefs for chronic pain assessment and treatment has been a growing area of interest. A variety of questionnaires have been developed to assess pain beliefs, however, these questionnaires often require high levels of literacy and education. The pain concepts questionnaire (PCQ) was developed with literacy-adaptations to better evaluate pain beliefs in a low socioeconomic (SES) population. This study is an initial exploratory evaluation of the PCQ in a sample of patients with chronic pain and multiple disparities as part of the learning about my pain (LAMP) trial, a randomized controlled trial comparing literacy-adapted psychosocial treatments for chronic pain. All data were collected at pretreatment. Exploratory factor analysis was performed to examine the underlying factor structure of the PCQ and cross-sectional correlational analyses examined relationships between pain beliefs with sociodemographic factors and chronic pain-related variables. Results suggested a 2-factor solution with a Biopsychosocial factor and Biomedical factor. Consistent with the literature, correlational analyses highlighted racial and SES disparities in pain beliefs and the importance of beliefs in pain- and cognitive/affective-related functioning. The study emphasizes the importance of pain beliefs in chronic pain management and recommends future research to further examine additional psychometric properties of the PCQ. PerspectiveThis study is an initial evaluation of the psychometric properties of a new measure of chronic pain beliefs, the pain concepts questionnaire (PCQ). The PCQ is literacy-adapted and was assessed within a low-SES population. Psychometric proprieties of this measure were promising and could be useful in pain assessment and interventions.

The differences between suicide ideators and suicide attempters: Simple, complicated, or complex?

Suicide ideators and suicide attempters might differ in 3 possible ways. First, they might differ in a simple way such that one or a small set of factors are both necessary and sufficient to distinguish between the 2 groups. Second, ideators and attempters might differ in a complicated way such that a specific combination of a large set of factors is necessary and sufficient for the distinction. Third, complex differences might exist: many possible combinations of a large set of factors may be sufficient to distinguish the 2 groups, but no combination may be necessary. This study empirically examined these possibilities. Across 5 samples (total N = 3,869), univariate logistic regressions were conducted to test for simple differences. To test for complicated and complex differences, machine learning (ML) methods were used to identify the optimized algorithm with all variables. Subsequently, the same methods were repeated after removing the top 5 most important or discriminative variables, and a randomly selected 10% subset of variables. Multiple logistic regressions were conducted with all variables. Results were consistent across samples. Univariate logistic regressions on average yielded chance-level accuracy. ML algorithms with all variables showed good accuracy; substantial deviation from the optimized algorithms through the removal of variables did not result in significantly poorer performance. Multiple logistic regressions produced poor to fair accuracy. Differences between suicide ideators and attempters are complex. Findings suggest that their differences may be better understood on a psychological primitive level than a biopsychosocial factor level. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

(321) Physiotherapists’ Attitudes and Beliefs Towards Chronic Non-Specific Low Back Pain in Saudi Arabia

Chronic non-specific low back pain (CNSLBP) is one of the most widespread conditions affecting the population indiscriminately across the world. It is a considerable health problem and the main causes of disability and pain. It is a complex, multifactorial disorder and one of the most controversial conditions for clinicians, patients, and policy makers. Physiotherapists’ (PTs) attitudes and beliefs towards CNSLBP still unknown in Saudi Arabia (SA). The aim of this study was to identify PTs attitudes and beliefs towards NSLBP in SA. A cross sectional study was conducted using a convenience sample. An online survey was distributed from April to September 2018. Only participants working as physiotherapists in SA whether in clinical or academic settings were included. Data were collected regarding demographics, beliefs and attitudes towards NSLBP using the short form of Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT). The short form of PABS-PT consisted of 19 items on a 6-point scale evaluating ‘biomedical’ and ‘biopsychosocial treatment orientation’ factors. Higher scores indicate a higher level of orientation. The data analysis was performed using IBM SPSS (v.24). A total of 299 PTs participated in this study. The majority of the participants were males (61.5%) and most of them had completed their bachelor's degree (54.5%). Most participants worked as a full time (79.9%) and more than half of them had experience less than 5 years (53.8%). The overall mean score for biomedical factor was 34.4 (SD 7.7) and overall mean score for biopsychosocial factor was 31.7 (SD 5.5). Overall mean score of both factors was mean 66.2 (SD 9.6). Among the 19 items of PABS-PT, the lowest three mean scores items were related to biopsychosocial orientation. Physiotherapists were found to have similar biomedical and biopsychosocial orientations in their attitudes and beliefs but both orientation scores were not high.

Resilience as a Psychopathological Construct for Psychiatric Disorders.

Understanding of the psychopathology of various psychiatric disorders is evolving, with newer avenues of research enlightening us from genetics, epigenetics, functional neurobiology, neural circuits, hormones and social/environmental determinants. We are now aware that neurobiological factors are contributing to the development of psychiatric illnesses coupled with their interaction with psychosocial factors. Resilience is defined as the ability to bounce back after an adversity or life event that was traumatic and life-changing. It is a factor that is a unique psychopathological construct as it is a biopsychosocial factor which determines an individual's response to an illness and recovery from the same. Resilience is a human capacity to adapt swiftly and successfully to stress and to revert to a positive state. There has been now a paradigm shift in the understanding of resilience with respect to stress risk vulnerability and such dimensions of psychopathology. Resilience is a factor that must be evaluated in every patient and that shall help us determine the outcome of psychiatric disorders and will also be a determinant in the occurrence of relapses. Early identification of vulnerable patients shall lead to the implementation of resilience-based interventions in these populations and shall prevent against future occurrence of these disorders. In this chapter, we posit the construct of resilience as a psychopathological construct for mental disorders.

Effect of Play Group and Biopsychosocial Factors on the Independence Development of Preschool Children in Surakarta

Background: The development of children's independence is important for their future competitiveness in the rapidly increasing social changes. Disturbance in the development of children’s independence may have a negative future impact in adult life and children become dependent individuals. Efforts are needed to help children develop optimally. Some play groups have been introduced to meet this need in Surakarta, but no studies have been carried out to evaluate its effectiveness. This study aimed to determine the effect of play group on the independence development of preschool children while controlling for the effect of biopsychosocial factors . Subjects and Method: This was an analytic observational study using case control design. The study was conducted at 3 kindergartens in Surakarta, Central Java, from February to April 2017. A sample of 120 kindergarten pupils were selected for this study by purposive sampling and random sampling. The dependent variable was independence development. The independent variables were play group participation status, parenting style (autoritarian, democratic, and permissive), parental education, and child age. The data were collected by a set of questionnaire and analyzed by path analysis. Results: Maternal education ≥Senior High School (b= 8.77; 95% CI= 1.89 to 15.65; p= 0.012), paternal education ≥Senior High School (b= 9.82; 95% CI = 2.70 to 16.93; p= 0.007), child age ≥5 years old (b= 5.59; 95% CI = 1.50 to 9.68; p= 0.007), participation in play group (b= 9.45; 95% CI = 2.19 to 16.71; p= 0.011), and democratic parenting style (b= 0.12; 95% CI= 0.02 to 0.23; p= 0.018) increased child independence. Autoritarian parenting style (b= -0.15; 95% CI= -0.26 to -0.04; p= 0.006) and permissive parenting style (b= -0.09; 95% CI= -0.20 to 0.01; p= 0.092) decreased child independence. Participation in play group was determined by democratic parenting style (b= 0.01; 95% CI -<0.01 to 0.03; p= 0.080), permissive parenting style (b= -0.03; 95% CI -0.05 to <0.01; p= 0.027), paternal education ≥Senior High School (b= 2.06; 95% CI= 0.88 to 3.24; p= 0.001), and child age ≥5 years old (b= 1.42; 95% CI= 0.63 to 2.21; p <0.001). Conclusion: Maternal education ≥Senior High School, paternal education ≥Senior High School, child age ≥5 years old, participation in play group, and democratic parenting style, positively and directly affect child independence. Autoritarian parenting style and permissive parenting style negatively and directly affect child independence. Keywords: play group, parenting style, biopsychosocial factor, independence, development, preschool children Correspondence: Iin Tri Marlinawati. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta, 57126, Central Java, Indonesia. Email: iin3marlina@gmail.com. Mobile: +6285600252256 Journal of Maternal and Child Health (2017), 2(4): 284-296 https://doi.org/10.26911/thejmch.2017.02.04.01

Association between the 10 item Örebro Musculoskeletal Pain Screening Questionnaire and physiotherapists' perception of the contribution of biopsychosocial factors in patients with musculoskeletal pain

BackgroundContrasting evidence exists on the ability of clinicians to identify biopsychosocial factors in patients with musculoskeletal pain compared to questionnaires. ObjectiveEvaluate associations between two aspects of clinical practice used to assess biopsychosocial factor contribution in patient presentations (physiotherapist perceptions versus shortened 10-item Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-10)). Potential influence of physiotherapists' training, experience and confidence level were assessed. Study designObservational. Methods90 musculoskeletal pain patients completed the ÖMPSQ-10 prior to their initial assessment. Independently, 19 treating physiotherapists provided their perception of contribution of biopsychosocial factors to the patient presentation. Pragmatic comparison of physiotherapist perceptions and the ÖMPSQ-10 was made with Spearman's correlations. ResultsFair correlation existed between physiotherapists' perception of overall contribution of biopsychosocial factors to the patients' presentation and the ÖMPSQ-10 (0.39). There where moderate correlations for the domains of recovery expectancy (0.53), self-perceived ability to work (0.52) and ability to sleep (0.54). There where fair correlations for anxiety (0.33) and depression (0.32), and a poor correlation for fear (0.10). Correlations were influenced by therapist training in psychosocial aspects of pain, experience and confidence. ConclusionsPhysiotherapists' perceptions on biopsychosocial contributing factors to overall presentation of patients with musculoskeletal pain were reasonably correlated with a number of the domains in the ÖMPSQ-10. However, correlations for anxiety, depression and fear were not as good. This may reflect a lack of adequate training and/or the inadequacy of single questionnaire items to capture complex issues such as pain-related fear. Screening questionnaires are recommended as an adjunct to clinician perceptions.

Path Analysis: The Effect of Biopsychosocial and Environmental Exposure on Child Asthma in Surakarta

Background : Asthma is a non-communicable disease with high morbidity in Indonesia.According to David Barker’s fetal origin hypothesis, biopsychosocial as well as environmental exposure during gestational period affect health outcome in later life. This study aimed to determine the effect of bio-psychosocial and environmental exposure factor on the risk of child asthma in Surakarta. Subjects and M ethods : This was an analytical observational study with case control design.This study was conducted at the Center for Community Pulmonary Health (BBKPM), Surakarta. A total of 105 study subjects were selected by fixed disease sampling, consisting of 35 asthmatic patients and 70 healthy children aged 6-15 year old. The exogenous variables were maternal education, current child stress, indoor cigarette smoke exposure and maternal stress during gestational period, current family income, and current indoor cigarette smoke exposure. The endogenous variables were birth weight and child asthma. The data were collected by a set of questionnaire and analyzed using path analysis model. Result s: Current child stress (b = 3.49; 95% CI = 1.18-5.81; p = 0.003), exposure to indoor cigarette smoke (b = 3.44; 95% CI = 1.07-5.80; p = 0.004), indoor air polution (b = 2.43; 95% CI = 0.60-4.27; p = 0.009), had positive, direct, and statistically significant effects on the risk of child asthma. Birth weight ≥2.500 gram (b = -2.01; 95% CI = -3.95 to -0.07; p = 0.041) had negative, direct, and statistically significant effect on the risk of child asthma. Maternal education had positive and statistically significant effect on family income (b=1.57; 95% CI=0.62 to 2.52; p= 0.001). Family income had negative and statistically significant effect on indoor air pollution (b= -2.48; 95% CI=-3.52 to -1.44; p= 0.001). Maternal stress at gestational period had negative and statistically significant effect on birth weight (b=-1.13; 95% CI= -2.18 to -0.08; p=0.035). Conclusion: In line with David Barker’s fetal origin hypothesis, this study supports that biopsychosocial as well as environmental factors have significant effects on child asthma. Keywords : bio-psychosocial, environmental exposure, asthma, children. Correspondence: Ayunita Dwi Hadianti. Masters Program in Public Health, Sebelas Maret University, Surakarta. Email: ayunitadwihadianti@gmail.com. Mobile: +6282314064445. Journal of Maternal and Child Health (2016), 1(2): 62-72 https://doi.org/10.26911/thejmch.2016.01.02.01

A multisite controlled study of risk factors in pediatric psychogenic nonepileptic seizures.

Psychogenic nonepileptic seizures (PNES) in youth are symptoms of a difficult to diagnose and treat conversion disorder. PNES is associated with high medical and psychiatric morbidity, but specific PNES risk factors in the pediatric population are not known. We examined if youth with PNES have a distinct biopsychosocial risk factor profile compared to their siblings and if the interrelationships between these risk factors differentiate the PNES probands from the sibling group. This multisite study included 55 youth with a confirmed diagnosis of PNES (age range 8.6-18.4years) and their 35 sibling controls (age range 8.6-18.1years). A video EEG and psychiatric assessment confirmed the PNES diagnosis. Parents reported on each child's past and present medical/epilepsy, psychiatric, family, and educational history. Each child underwent a structured psychiatric interview, standardized cognitive and academic achievement testing, and completed self-report coping, daily stress, adversities, and parental bonding questionnaires. Compared to their siblings, the PNES probands had significantly more lifetime comorbid medical, neurological (including epilepsy), and psychiatric problems; used more medications and intensive medical services; had more higher anxiety sensitivity, practiced solitary emotional coping, and experienced more lifetime adversities. A principal components analysis of these variables identified a somatopsychiatric, adversity, epilepsy, and cognitive component. The somatopsychiatric and adversity components differentiated the probands from the siblings, and were highly significant predictors of PNES with odds ratios of 15.1 (95% CI [3.4, 67.3], and 9.5 (95% CI [2.0, 45.7]), respectively. The epilepsy and cognitive components did not differentiate between the PNES and sibling groups. These findings highlight the complex biopsychosocial and distinct vulnerability profile of pediatric PNES. They also underscore the need for screening the interrelated risk factors included in the somatopsychiatric and adversity components and subsequent mental health referral for confirmation of the diagnosis and treatment of youth with PNES.

Investigation on the influence of a didactic course in psychiatry on attitudes of mental illness in Chinese college students

With the modernization of Chinese society and increased general levels of education, the stigmatization of mental illness may have declined, especially among advanced students. However, misunderstandings about mental illness may remain and adversely affect service delivery to this population. Educational initiatives in psychiatry may support a more accepting and scientific understanding of these illnesses among college students. Attitudes towards mental illness were compared between 161 medical students who received a basic 48-hour introductory course in psychiatry and 170 college students who had not received such a course using a 43-item questionnaire. Previous factor analysis had shown this questionnaire to address four factors: 1. Personal willingness to socialize with people with mental illness; 2. Support for normalizing relationships and activities of people with mental illness; 3. Rejecting supernatural explanations of mental illness; and 4. Agreeing with a biopsychosocial view of the etiology of mental illness. Analysis of Co-Variance was used to compare the groups on these factors with adjustment for significant differences in age and years of education. The two groups of students scored similarly on the socializing factor (P = 0.252), the rejection of supernatural causes factor (P = 0.248) and the normalizing factor (P = 0.362), but students who had the didactic psychiatry course scored more positively on the biopsychosocial factor (percent difference = 15.06%, P = 0.001). A single formal psychiatry course may improve understanding of the biopsychosocial causes of mental illness but did not affect other attitudinal domains among Chinese college students.