Indicators Of Adjustment Research Articles

Coping with Prostate Cancer: A Meta-Analytic Review

The present meta-analytic review assessed the relations between coping categories and indices of adjustment in men with prostate cancer. Relevant methodological and statistical information was extracted from 33 target studies (n = 3,133 men with prostate cancer). Men with prostate cancer who used approach, problem-focused, and emotion-focused coping were healthier both psychologically and physically, although the effect sizes for problem-focused coping and emotion-focused coping were more modest. For approach coping these effect sizes were particularly strong for measures of self-esteem, positive affect, depression, and anxiety. Conversely, men with prostate cancer who used avoidance coping experienced heightened negative psychological adjustment and physical health, and particularly for measures of positive mood and physical functioning. The findings of this study suggest that active approaches to coping with prostate cancer are beneficial psychologically, physically, and are positively associated with a return to pre-cancer activities.

Govt. Agency Defends Accuracy Of Geography-Based Cost Criteria

Back to table of contents Previous article Next article Government NewsFull AccessGovt. Agency Defends Accuracy Of Geography-Based Cost CriteriaMark MoranMark MoranSearch for more papers by this authorPublished Online:6 May 2005https://doi.org/10.1176/pn.40.9.00400025bThe components of the Medicare physician payment formula designed to account for practice-cost differences between geographic areas of the country appear to be “valid in their fundamental design,” according to a report by the U.S. Government Accountability Office (GAO).But the GAO did make some recommendations for refining the methods by which the indices are determined.The report, titled, “Geographic Adjustment Indices Are Valid in Design, but Data Methods Need Refinement,” was released in March.The geographic practice-cost indices (GPCI) for physician work, practice expense, and malpractice expense as implemented “appropriately reflect broad patterns of geographic differences in the costs of running a medical practice,” according to the GAO.In a letter to Congress, the GAO noted that the geographic-adjustment indices have been criticized by groups representing rural physicians because the indices adjust fees downward when an area's costs and expenses are lower than the national average. Those groups also contend that disparities in Medicare payment related to the GPCIs are affecting the supply of physicians in rural areas.For instance, the American Academy of Family Physicians has stated that“ the formulas used by the Medicare program to reimburse physicians and health care providers for beneficiaries' medical care are not accurately measuring the cost of providing services and are reimbursing physicians and other health care providers in a manner that favors urban providers over rural providers.”The GAO, however, did not agree. “In addition to adjusting for cost differences, the physician-work GPCI is valid in that it also reflects a goal of protecting physician fees in low-cost areas from dropping to levels that could be considered unfair relative to fees in high-cost areas,” the GAO said.The GAO also found that GPCIs appear to have a negligible effect on physicians' decisions to locate in rural areas. “Our interviews with physician-recruitment experts and published studies indicate that income is only one of many factors affecting physicians' decisions to locate in rural areas and in employers' successful efforts to recruit and retain physicians,” the GAO wrote in the letter to Congress. “Given GPCIs' limited effect on physician income and income's secondary effect on physician supply, GPCIs are not important factors in physician location, recruitment, and retention.”However, the GAO did find that problems with data and methodology underlying the GPCIs may detract from their accuracy as measures of cost differences. “For example, the wage data used in the work and practice expense GPCIs are not current, and the data used in the malpractice GPCI are not complete,” the GAO told Congress.To address these concerns, the GAO recommended that CMS use data for wages and earnings from the American Community Survey, collect malpractice data from all 50 states, collect data from insurers that account for at least 50 percent of malpractice business in a state, and standardize collection of malpractice premium data.The GAO report is posted online at<www.gao.gov/new.items/d05119.pdf>.▪ ISSUES NewArchived

Étude de validation de la version française du Body Shape Questionnaire

Resume Le but de l’etude est l’adaptation, en langue francaise, d’un questionnaire anglosaxon d’insatisfaction corporelle : Body Shape Questionnaire (BSQ, Cooper et al., 1987) et de tester sa fidelite et sa validite concourante sur un echantillon de 242 etudiantes. Les relations entre les categories de poids et l’insatisfaction corporelle et les facteurs issus de l’analyse factorielle ont ete explorees.Nous avons procede au calcul des coefficients alpha, a un test de fiabilite test-retest et a une analyse factorielle. La validite concourante du BSQ a ete evaluee a partir de la comparaison avec un autre test : l’Eating Disorder Inventory (EDI, Garner et Olmsted, 1984). Enfin, des analyses statistiques inferentielles (Anova) ont ete realisees.Les coefficients alpha relatifs au test/retest du BSQ sont eleves (0,95/0,94) ainsi que ceux pour le test/retest de l’EDI (0,85/0,84). Ces resultats mettent en evidence une tres bonne consistance interne des 2 instruments. L’analyse factorielle en composantes principales suggere une solution a 4 facteurs : evitement et honte sociale de l’exposition du corps, insatisfaction corporelle par rapport aux parties inferieures du corps, usage de laxatifs et de vomissements pour reduire l’insatisfaction corporelle, cognitions et comportements inadaptes afin de controler le poids. Ces 4 facteurs expliquent 55,2 % de la variance totale. Les analyses statistiques inferentielles ont mis en evidence une relation significative entre la categorie de poids et le score total au BSQ et entre la categorie de poids et le score sous les facteurs 1, 2 et 4.La version francaise du BSQ se presente comme un instrument ayant de bonnes qualites metrologiques. Il permettrait d’explorer le role d’une preoccupation excessive de l’apparence du corps dans le developpement, le maintien et le traitement des troubles du comportement alimentaire.

An empirical typology of narcissism and mental health in late adolescence

A two-step cluster analytic strategy was used in two studies to identify an empirically derived typology of narcissism in late adolescence. In Study 1, late adolescents ( N = 204 ) responded to the profile of narcissistic dispositions and measures of grandiosity (“superiority”) and idealization (“goal instability”) inspired by Kohut's theory, along with several College Adjustment Scales and a measure of pathology of separation-individuation. Cluster analysis revealed three clusters: covert narcissists ( N = 71 ), moderate narcissists ( N = 55 ) and overt narcissists ( N = 74 ). Moderate narcissists had significantly lower means scores on indices of anxiety, relationship problem, depression, esteem- and family problems and pathology of separation-individuation. The overt and covert clusters showed comparable levels of dysfunction on most indices of adjustment. This general pattern was replicated in Study 2 ( N = 210 ). Moderate narcissists showed a uniform profile of good adjustment, whereas covert and overt narcissist clusters showed a pervasive pattern of dysfunction. Results support the claim that narcissism has “two faces” and that a moderate degree of narcissism is associated with fewer adjustment problems or psychological symptoms. Directions for future research are discussed.

Labour Market Efficiency Over the Transitional Period: The Case of Romania

Romania started the transition process by adopting a gradualist strategy for implementing its economic reforms, most of which being carried out independently and not through a concrete and cohesive policy package. The dynamics of restructuring on the labor market is analyzed by the Index of Employment Restructuring, the Rate of Unemployment Absorption and the Net Rate of Private Sector Expansion. These indices show that the capacity of Romanian economy to absorb the unemployment is very modest because the private activities are insufficiently developed due to a major delay in market reforms aimed to effectively stimulate the private initiative. With respect to efficiency, the Index of Labor Efficiency shows that the private sector loses continuously its efficiency because the privatization of public enterprises induced the phenomenon of sharing the inefficiency (the speed of restructuring the privatized firms is lower than the speed of privatization). The Index of Employment Adjustment indicates that this process is far from being completed in the Romanian economy, while the Index of Output Adjustment confirms that the private sector - despite its increasing share in overall activity - remains insufficiently developed in terms of productivity and economic efficiency.

Markers of Resilience and Risk: Adult Lives in a Vulnerable Population

In this report, we drew on data from an ongoing longitudinal study that began in 1978 (Hauser, Powers, Noam, Jacobson, Weiss, & Folansbee, 1984). Focusing on late, young-adult life among individuals who were psychiatrically hospitalized during adolescence, we examined markers of resilience empirically defined in terms of adult success and well-being. The study includes a demographically similar group recruited from a public high school. Major goals were to (a) develop preliminary models of adaptive functioning among adults in their 30s, (b) examine the extent to which adults with histories of serious mental disorders can be characterized by these models, and (c) explore predictors of successful adult lives from indicators of individuals' psychosocial adjustment at age 25. Results showed significant cohort effects on indexes of adaptive functioning, especially for men. Findings suggest that social relations as well as self-views of competence and relatedness play important roles in characterizing adjustment during the adult years. In addition, indexes of psychosocial adjustment as well as symptoms of psychiatric distress and hard drug use at age 25 made a difference in adult social functioning and well-being, providing hints of possible mechanisms likely to facilitate the ability to "bounce back" after a difficult adolescence.

Religious Orientation and the Experience of Eid‐ul‐Azha Among Pakistani Muslims

Measures of religious orientation were used to predict the experience of Pakistani Muslims during Eid‐ul‐Azha, a celebration that marks the end of the Haj. Participants displayed varying degrees of correlation of the intrinsic, extrinsic‐personal, and extrinsic‐social orientations with interest, affect, and work‐related responsibility variables during the Eid holiday. Gender differences appeared in that religious orientations were more predictive of the male Eid‐ul‐Azha experience, but these measures usefully clarified the religious commitments of women as well. As expected, the intrinsic orientation proved to be an especially noteworthy index of religious adjustment, and the extrinsic‐social orientation was significantly lower than the other two motivations. These data demonstrated once again that religious orientation constructs developed in the West might serve as a useful point of departure for understanding the psychology of Muslim religion.

Cardiac vagal regulation across the preschool period: Stability, continuity, and implications for childhood adjustment

Stability and continuity of vagal regulation of the heart, operationalized as suppression of respiratory sinus arrhythmia (RSA) during challenge, was examined in a longitudinal study of preschoolers. A sample of 154 two-year-old children was recruited for participation in a study of the effects of emotional and behavioral challenge on cardiac activity and behavioral indices of adjustment and self-regulation. A total of 122 of these children were assessed again at age 4.5 years. At both ages, the children were assessed in a series of laboratory procedures that were intended to be emotionally and behaviorally challenging, during which time heart rate was recorded. To assess vagal regulation, resting measures of RSA and RSA suppression to the challenge task were derived from these procedures. To assess childhood adjustment and self-regulation, a number of parent-report measures were administered when the children were 4.5 years of age. Results indicated that there was high stability in RSA suppression across the challenge tasks within both ages, modest cross-age stability in RSA suppression, and a significant decrease in the magnitude of RSA suppression across age. Second, children who displayed a pattern of stable and high suppression across the preschool period were less emotionally negative, and had fewer behavior problems and better social skills than other children.

Subgroups of physically abusive parents based on cluster analysis of parenting behavior and affect.

Cluster analysis of observed parenting and self-reported discipline was used to categorize 83 abusive parents into subgroups. A 2-cluster solution received support for validity. Cluster 1 parents were relatively warm, positive, sensitive, and engaged during interactions with their children, whereas Cluster 2 parents were relatively negative, disengaged or intrusive, and insensitive. Further, clusters differed in emotional health, parenting stress, perceptions of children, and problem solving. Children of parents in the 2 clusters differed on several indexes of social adjustment. Cluster 1 parents were similar to nonabusive parents (n = 66) on parenting and related constructs, but Cluster 2 parents differed from nonabusive parents on all clustering variables and many validation variables. Results highlight clinically relevant diversity in parenting practices and functioning among abusive parents.

Differentiation of Self, Personal Adjustment, Problem Solving, and Ethnic Group Belonging Among Persons of Color

This study focused on examining the cross‐cultural validity of Bowen family systems theory (M. Bowen, 1978), namely differentiation of self for individuals of color. Ethnic minority men and women completed measures of differentiation of self, ethnic group belonging, and 3 indices of personal adjustment. Initial support for the cross‐cultural utility of Bowen family systems theory was observed. Higher levels of differentiation of self predicted better psychological adjustment, social problem‐solving skills, and greater ethnic group belonging among persons of color. Limitations regarding the cross‐cultural utility of differentiation of self, directions for further research, and implications for counseling are discussed.

War‐Zone Exposure and Long‐Term General Life Adjustment Among Vietnam Veterans: Findings From Two Perspectives1

This two‐part investigation examined associations between service in Vietnam and indices of long‐term general life adjustment using a national sample of male and female members of the Vietnam generation. In Study 1, we documented reasonably high levels of satisfaction and attainment among Vietnam veterans, levels that differed minimally, on average, from those who served elsewhere and those who never served in the military. In Study 2, dimensions of war‐zone stressor exposure were only marginally related to satisfaction and attainment, in contrast with research documenting strong relationships with psychopathol‐ogy. These findings support the importance of expanding our thinking about dimensions of mental illness and mental health.

The Predictive Nature of Humor, Authoritative Parenting Style, and Academic Achievement on Indices of Initial Adjustment and Commitment to College among College Freshmen

Through the administration of self-report surveys, this study examined the relationships among a) parenting styles, b) family structure, c) academic achievement, d) birth order, e) gender, and f) humor on the initial personal-emotional, social, academic, and commitment to college adjustment among 257 first-quarter college freshmen. Multiple regression models demonstrated that humor, academic achievement, and authoritative parenting were positively related to students' college adjustment. Implications were drawn for post-secondary educational institutions as well as parents.

Does gender identity influence children's psychological well-being?

This study examined influences of gender identity on change in preadolescents' adjustment over time. In each of two successive years, three measures of gender identity (felt gender typicality, contentment with gender assignment, and felt pressure for gender conformity) and four measures of adjustment (self-esteem, internalizing symptoms, externalizing symptoms, and acceptance by peers) were collected. Low gender typicality, low gender contentedness, and high felt pressure all foreshadowed deterioration on one or more indexes of adjustment. The combination of low gender typicality with high felt pressure was especially conducive to internalizing problems, underscoring the importance of the cognitive organization of the gender identity variables. The advantages of a multidimensional perspective on gender identity are discussed.

MEANING CONSTRUCTS AS PREDICTORS OF BEREAVEMENT ADJUSTMENT: A REPORT FROM THE SCOTT & WHITE GRIEF STUDY

Nine unique meaning constructs were derived from a content analysis of free essays written by 85 mourners in response to the question, “What does the death of your loved one mean to you?” These constructs were then treated as predictor variables in a quantitative analysis of several indices of bereavement adjustment including (a) risk factors of grief pathogenesis and psychometric measures of negative grief affect and (b) indicators and correlates of personal growth. Mourners who expressed one or more constructs connoting positive themes of hope and recovery in their narrative essays fared better on several indicators of bereavement adjustment than those expressing solely themes of pain and suffering. As a single meaning category, Focusing on Negativity carried the strongest statistical relation to outcome measures and correlated with poorer adjustment. Implications for combining qualitative and quantitative data are discussed together with potential applications to clinical practice.

Adolescent adjustment in a nationally collected sample: identifying group differences by adoption status, adoption subtype, developmental stage and gender*1

The current study investigated group differences in adolescent adjustment by adoption status and adoption subtype in a national sample, in contrast to group differences based on developmental stage or gender. Secondary analyses of the National Longitudinal Study of Adolescent Health were performed to describe group differences in a broad range of adjustment measures (a) between adoptees and non-adoptees, (b) between different-race adoptees and same-race adoptees and, (c) across adolescent developmental stage and gender groups. Based upon a developmental deviance hypothesis, the current study hypothesized that early adolescent different-race adoptees would fair better across measures of academic performance, familial relationships, psychological adjustment, and physical health than their middle and late adolescent counterparts. Group comparisons revealed little evidence of increased maladjustment among adopted adolescents compared to non-adopted study participants. In addition, group comparisons revealed few differences across indices of adolescent adjustment by adoption subtype (i.e. by the degree of racial congruence adopted child and adoptive parent). However, significant group differences in adolescent adjustment were found based on participants’ developmental stage and gender. The implications of the findings are discussed.

Adolescent adjustment in a nationally collected sample: identifying group differences by adoption status, adoption subtype, developmental stage and gender

The current study investigated group differences in adolescent adjustment by adoption status and adoption subtype in a national sample, in contrast to group differences based on developmental stage or gender. Secondary analyses of the National Longitudinal Study of Adolescent Health were performed to describe group differences in a broad range of adjustment measures (a) between adoptees and non-adoptees, (b) between different-race adoptees and same-race adoptees and, (c) across adolescent developmental stage and gender groups. Based upon a developmental deviance hypothesis, the current study hypothesized that early adolescent different-race adoptees would fair better across measures of academic performance, familial relationships, psychological adjustment, and physical health than their middle and late adolescent counterparts. Group comparisons revealed little evidence of increased maladjustment among adopted adolescents compared to non-adopted study participants. In addition, group comparisons revealed few differences across indices of adolescent adjustment by adoption subtype (i.e. by the degree of racial congruence adopted child and adoptive parent). However, significant group differences in adolescent adjustment were found based on participants’ developmental stage and gender. The implications of the findings are discussed.

An Empirical Typology of Perfectionism in Gifted Adolescents

We document a typology of perfectionism in a sample of academically talented adolescents and directly examine its relationship to indices of psychiatric symptomatology, adjustment, self-esteem, and coping. Adolescents enrolled in a state-funded residential academy for academically gifted high school students ( N = 141) responded to the Multidimensional Perfectionism Scale (Frost, Marten, Lahart, &amp; Rosenblate, 1990), the Hopkins Symptom Checklist, the Mastery Coping and Superior Adjustment scales from the Self-Image Questionnaire for Young Adolescents, the Perception of Personal Security and Academic Competence scales from the Self-Esteem Index, and the Coping Inventory (COPE). A 2-step cluster analysis of perfectionism scores revealed four clusters: Mixed-Adaptive ( n = 51), Mixed-Maladaptive ( n = 20), Pervasive ( n = 30), and Self-Assured Nonperfectionist ( n = 39). The Pervasive and Mixed-Maladaptive clusters showed a uniformly poor profile of mental health, adjustment, and coping relative to Mixed-Adaptive and Nonperfectionists. The Mixed-Adaptive cluster reported greater academic competence and superior adjustment than did the Nonperfectionist cluster, although these cluster groups were statistically similar on other dimensions of mental health and adjustment. These results suggest that maladaptive perfectionism takes two forms: pervasive and mixed. Implications for intervention and directions for future research are discussed.

The Failure to Restructure and Improve Efficiency on the Romanian Labor Market

Romania started the transition process by adopting a gradualist strategy for implementing its economic reforms, most of which being carried out independently and not through a concrete and cohesive policy package. The dynamics of restructuring on the labor market is analyzed by the Index of Employment Restructuring, the Rate of Unemployment Absorption and the Net Rate of Private Sector Expansion. These indices show that the capacity of Romanian economy to absorb the unemployment is very modest because the private activities are insufficiently developed due to a major delay in market reforms aimed to effectively stimulate the private initiative. With respect to efficiency, the Index of Labor Efficiency shows that the private sector loses continuously its efficiency because the privatization of public enterprises induced the phenomenon of sharing the inefficiency (the speed of restructuring the privatized firms is lower than the speed of privatization). The Index of Employment Adjustment indicates that this process is far from being completed in the Romanian economy, while the Index of Output Adjustment confirms that the private sector - despite its increasing share in overall activity - remains insufficiently developed in terms of productivity and economic efficiency.

The influence of cultural and racial identification on the psychosocial adjustment of inner-city African American children in school.

The purpose of this study was to examine the relationship and combined influence of racial identity and Africentric values on African American children's psychosocial adjustment. Participants were 104 (53 males, 51 females) African American fourth-grade students attending an inner-city public school in a northeastern city. Child and teacher ratings were used to assess the relationship between racial identity, Africentric values, and several indices of child psychosocial adjustment, including child behavior control, school interest, and teacher perceptions of child strengths and problems in the classroom. Child self-esteem and the effects of gender and cohort were used as covariates in several analyses in the study. Overall, findings from the study supported the usefulness of combining racial identity and Africentric values into a single model of ethnic identification for African American children. Implications for risk prevention and enhancement of psychosocial functioning among African American children are discussed.

Popularity, Friendship Quantity, and Friendship Quality: Interactive Influences on Children's Loneliness and Depression

A mediational model positing that the effects of popularity on children's loneliness and depression are passed through indexes of friendship experiences was tested using structural equation modeling. Children (193 3rd through 6th graders) completed a battery of sociometric and self-report questionnaires from which measures of popularity, multiple friendship dimensions (i.e., quantity and quality of best and good friendships), and loneliness and depression were derived. Confirmation of a slightly modified model supported the mediational hypothesis. Although popularity exerted no direct impact on the adjustment indexes, it strongly influenced friendship, which, in turn, affected depression through its strong association with loneliness. It appears that popularity is important for setting the stage for relationship development, but that it is dyadic friendship experiences that most directly influence feelings of loneliness and depression.