Katz Adjustment Scale Research Articles

Cognitive rehabilitation versus day treatment in head-injured adults: Is there an impact on emotional and psychosocial adjustment?

Emotional and psychosocial adjustments are typically the most challenging problems faced by the head injured, but there exists a paucity in research as to how affective problems are best ameliorated. In the present analysis, emotional and psychosocial adjustment were evaluated as part of a study comparing the efficacy of cognitive remediation versus day treatment. Out of 24 head-injured patients, half were randomly assigned into either treatment condition, each conducted 4 days a week over an 8-week span. A more favourable outcome for emotional adjustment was postulated for the day-treatment programme, since it was far more nurturing compared with cognitive remediation, which was thought to be more challenging if not confronting. However, our differential hypothesis for the two treatments was not confirmed, because in both groups there was a lessening of depression as measured by the Katz Adjustment Scale. The need is discussed for providing ongoing structured activities for the head injured in order to facilitate their emotional and psychosocial adjustment.

The structure of head-injured patients' neurobehavioural complaints: A preliminary study

Psychological functioning in 55 severely head-injured individuals was investigated in order to extend findings on the long-term nature of psychological sequelae after closed head injury. Results showed that head-injured subjects reported numerous psychological deficits many years post-injury, were psychologically distressed by their own report (Brief Symptom Inventory) and that of care-giving relatives (Katz Adjustment Scale--Relatives Version), and also exhibited a different pattern of coping from that of a normative group. A three-factor model of residual psychological complaints that contained a 'General Complaints' factor, a 'Somatization' factor and a 'Severity' factor was identified; this showed some similarity to a model proposed by van Zomeren and van den Burg (1985). Results indicate support for the 'coping hypothesis' of post-injury psychological deficits, although effects consistent with a 'gradations of severity' hypothesis were also present.

Reliability of parental reports using the Katz Adjustment Scales: before and after hospital admission for schizophrenia.

We examined the interrater and test-retest reliability of the KATZ Adjustment Scale (Relative rated or R form) longitudinally in a sample of schizophrenic patients, assessing their function before hospital admission, as well as at 1 and 9 mo. after discharge. Changes in mean scores over those assessments suggested sensitivity to change while mothers and fathers both completed the measure with moderate consistency over time. Interrater reliability was moderate at best and quite poor at initial testing, when the subjects were most disturbed clinically, suggesting that the scales may be acceptable when the individual is stable but that ratings may be unreliable when there is an exacerbation in clinical state.

Quality of life in patients 2 to 4 years after closed head injury.

This study evaluated quality of life in 78 patients with closed head injury (CHI) 2 to 4 years postinjury. Using both interview data and mean data from the Sickness Impact Profile questionnaire, impaired quality of life was observed in the areas of psychosocial functioning, social role functioning, leisure activities, and, to a lesser extent, physical functioning, during chronic phases of recovery. Relatives and close friends reported by means of the Katz Adjustment Scale that the CHI patients showed a series of negative behavioral symptoms 2 to 4 years postinjury. These data suggest that CHI patients may experience impaired quality of life in a number of domains well beyond the acute postinjury phases. An attempt was also made to compare patients' and relatives' reports of patient quality of life. Preliminary analyses indicated modest correspondence between relatives' and patients' ratings of some areas of postinjury dysfunction, including cognitive and behavioral slowing and social withdrawal.

Predictors and indicators of quality of life in patients with closed-head injury.

This study examined predictors and indicators of quality of life in 71 patients with closed-head injury (CHI), 2-4 years postinjury. Predictors included premorbid characteristics and acute injury-related data. Indicators included follow-up data, e.g., neuropsychological functioning. Exploratory canonical correlation analyses demonstrated that the combination of the predictor variable, initial Glasgow Coma Scale score, and indicator variables of neuropsychological data in the areas of motor functioning, memory, and constructional ability were related most strongly to quality of life as reported by the patients. Severity of head injury and motor disability also related strongly to quality of life, based on reports by relatives (n = 68) on the Katz Adjustment Scale (Relatives' Form). These findings suggest that quality of life is adversely affected by increased severity of head injury and greater residual motor deficits. Implications of these findings for treatment and recovery are discussed.

Social adjustment and interaction after severe head injury.

The social adjustment of 11 severely head injured patients was assessed using the KATZ adjustment scale. The result suggested that the group had poor social adjustment, and on many dimensions was similar to a psychiatric population. The head-injured patients also had social interaction difficulties as assessed by a range of observational and self-report measures. When compared to an out-patient and non-clinical group they had poor social performance, high social anxiety and low self-esteem. The implications of this for rehabilitation are discussed.

Enhanced emotional reactions in chronic head trauma patients.

The emotional characteristics of head injury patients referred for neuropsychological testing were examined as a function of the time since injury. Patients referred more than 6 months from injury were more emotionally distressed on the MMPI and Katz Adjustment Scale (relatives form) compared to those tested 6 months or earlier. The more chronic head trauma patients were more anxious and depressed, more confused in their thinking, and more socially withdrawn compared to the acute patient group. These differences in emotional functioning appeared to be independent of level of neuropsychological impairment and the initial length of coma. Premorbid personality and increased awareness of impaired functioning with the passage of time are discussed as possible mediators of enhanced emotional distress in some chronic head injury patients.

Behavioural changes following gastric surgery for morbid obesity: a prospective, controlled study.

The authors present results of a prospective, controlled longterm follow-up study of patients undergoing a gastric procedure for morbid obesity. Pre-operatively the gastric surgery group (GS) was compared with a group of normal weighted (NC) and obese (OC) individuals participating in self-help weight reduction groups. The GS group was assessed at 3-months, 6-months and one year or more post-operatively. All groups were examined by a structured self-rating schedule reflecting personal characteristics and family history, current attitudes and experiences related to personal weight, and an extensive exploration of eating habits. Moreover, the groups completed the Minnesota Multiphasic Personality Inventory (MMPI), the Katz Adjustment Scale and the Zung Self-rating Depression Scale. The results demonstrated major differences between the GS and the NC and OC groups initially, and at follow-up; the GS demonstrated major weight loss without major psychopathologic reactions. The GS did not show, however, major alterations in eating habits, but clearly showed behavioural change subsequent to weight loss.

Sex Differences in Alcoholics: A Comparison of Male and Female Alcoholics' Self and Spouse Perceptions

Self-perceptions of male and female alcoholics and the perception of them by their respective spouses were investigated in an attempt to study sex differences in alcoholics. The subjects were 20 male and 20 female hospitalized alcoholics and their spouses. Subjects were administered a modified Katz Adjustment Scale and the NIMH Mood Scale applied both to states of sobriety and intoxication. The results indicated that the female alcoholic is more likely to characterized by her spouse as guilty and depressed both in states of sobriety and intoxication than is the male alcoholic. The therapeutic implications of these and other findings are discussed.

Validity of Family Informants' Ratings of Psychiatric Patients: General Validity

149 psychiatric patients were rated by members of their families, using the Katz Adjustment Scale. The validity of these ratings was assessed against entrance diagnosis, global ratings of pathology by patient, nurse, and psychiatric resident, and standard ward- and self-ratings. The family ratings had validity levels comparable to ward- and self-ratings.

Measuring behavior and adjustment in the community: A factor analytic study of the katz adjustment scale (form R1)

Measuring behavior and adjustment in the community: A factor analytic study of the katz adjustment scale (form R1)