Poor Psychological Functioning Research Articles

Widespread pain is associated with greater perceived pain and disability, but not with psychological features in patients with cervical radiculopathy

Purpose: People with cervical radiculopathy (CR) present with varying pain extent indicative of an interplay of differing pain mechanisms. A widespread distribution of perceived pain may reflect central sensitisation and could be associated with poorer psychological functioning as seen in other conditions such as individuals with whiplash associated disorders (WAD). No studies have evaluated the relation of pain extent to perceived pain and disability, general health and psychological status in individuals with CR.

Psychological wellbeing and physical activity in children and adolescents with inflammatory bowel disease compared to healthy controls

BackgroundChildren and adolescents with inflammatory bowel disease (IBD) report impairments in daily activities, social interactions and coping. Findings regarding psychological functioning are inconsistent, while limited information is available on objectively assessed physical activity (PA). The aims of the present study were therefore to compare anthropometric dimensions, blood values, psychological functioning and PA of children and adolescents with IBD with healthy controls.MethodsForty-seven children and adolescents took part in the study. Of these, 23 were diagnosed with IBD (mean age: 13.88 years, 44% females). The IBD group was divided into a medically well adjusted “remission-group” (n = 14; IBD-RE) and a group with an “active state” of disease (n = 8; IBD-AD). Healthy controls (n = 24; HC) were age- and gender-matched. Participants’ anthropometric data, blood values and objective PA were assessed. Further, participants completed questionnaires covering socio-demographic data and psychological functioning.ResultsParticipants with IBD-AD showed higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) values, haemoglobin, and leukocyte values. IBD-AD had poorer psychological functioning and lower PA (average steps per day) compared to IBD-RE and HC. No mean differences were found between IBD-RE and HC.ConclusionsThe pattern of results suggests that effective medical treatment of IBD in children and adolescents is associated with favorable physiological parameters, psychological dimensions and PA. Psychological counselling of children and adolescents in an active state of IBD seem to be advised in addition to standard treatment schedules.Trial registrationNCT NCT02264275; Registered 8 October 2014.

Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States

It is the position of the Academy of Nutrition and Dietetics that systematic and sustained action is needed to achieve food and nutrition security in the United States. To achieve food security, effective interventions are needed, along with adequate funding for, and increased utilization of, food and nutrition assistance programs; inclusion of nutrition education in such programs; strategies to support individual and household economic stability; and research to measure impact on food insecurity- and health-related outcomes. Millions of individuals living in the United States experience food insecurity. Negative nutritional and non-nutritional outcomes are associated with food insecurity across the lifespan, including substandard academic achievement, inadequate intake of key nutrients, increased risk for chronic disease, and poor psychological and cognitive functioning. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, play key roles in addressing food insecurity and are uniquely positioned to make valuable contributions through competent and collaborative practice, provision of comprehensive food and nutrition education and training, innovative research related to all aspects of food insecurity, and advocacy efforts at the local, state, regional, and national levels.

Aerobic exercise training in children and adolescents with inflammatory bowel disease: Influence on psychological functioning, sleep and physical performance – An exploratory trial

People with Inflammatory Bowel Disease (IBD) are at risk for mental health issues, poor sleep quality and limited engagement in physical activity (PA). Standard treatment consists of immune modulating pharmaceuticals though evidence is growing that aerobic exercise training (AET) could serve as an adjuvant option to reduce disease symptoms and improve mental health. The aim of the present exploratory trial was to investigate possible AET effects on psychological functioning, symptoms of depression, sleep and physical activity in paediatric patients with IBD.Twenty-one paediatric patients with IBD and 23 gender- and age-matched healthy controls (HC) were assessed. The IBD group was further split into a “remission-group” (IBD-RE; n = 14) and an “active disease group” (IBD-AD; n = 7). All participants completed an 8-week AET exergame intervention reaching 60–80% of maximum heart rate for 5 days per week. At baseline and after 8 weeks, psychological functioning, depressive symptoms, objective sleep EEG, subjective sleep and objective and subjective PA were assessed.AET improved the exercise capacity of all participants. Self-reported fitness and daily physical activity increased in IBD-AD, but not in IBD-RE and HC. No improvements were observed for psychological functioning, depressive symptoms or subjective sleep. Objective sleep improved, deep sleep increased, light sleep decreased, and in the IBD-AD group the number of arousals after sleep onset decreased. Descriptively, the IBD-AD group reported lower psychological functioning and poorer subjective sleep quality.Among paediatric patients with IBD and healthy controls, an exergaming intervention has the potential to improve exercise capacity, self-reported fitness, daily physical activity, and aspects of objective sleep. Results suggest that children and adolescents in an active state of IBD are at increased risk of poor psychological functioning and poor sleep quality.

Early predictors of psychosocial functioning 5 years after paediatric stroke.

Little is known about psychological and social outcomes after paediatric stroke. This study aimed to evaluate psychosocial outcomes in children 5 years after paediatric stroke and explore the contribution of early presenting factors. Thirty-one children (19 males, 12 females) with arterial ischemic stroke were involved in this prospective, longitudinal study. Children underwent intellectual assessment at 12 months poststroke and parents completed questionnaires rating their own mental health and their child's functioning at 12 months and 5 years poststroke. At 5-year follow-up, psychological and social function were significantly poorer than normative expectations. Exploration of early predictive factors showed poorer cognitive and psychological function at 12 months poststroke and older age at stroke onset was associated with poorer psychosocial function at 5 years. Larger lesion size was also associated with poorer psychological function at 5 years poststroke. These early predictors of poorer psychosocial outcome suggest that screening children within the first year after stroke may identify children most at risk of later problems and facilitate early intervention.

In Individuals Following Aneurysmal Subarachnoid Haemorrhage, Hair Cortisol Concentrations Are Higher and More Strongly Associated with Psychological Functioning and Sleep Complaints than in Healthy Controls

Background: Following an aneurysmal subarachnoid haemorrhage (aSAH), many patients report persistent deficits in psychological functioning, characterised by high levels of stress and symptoms of depression, low life satisfaction, along with poor sleep. Such deficits have been associated with altered saliva and serum cortisol levels due to a dysregulation of hypothalamic-pituitary-adrenal axis activity (HPA-AA). However, hair cortisol concentrations (HCCs) have not been assessed in this population, although this method allows a long-term insight into cortisol values. Therefore, the objective of this study was to compare HCCs in aSAH patients and healthy controls and to examine how HCCs are associated with perceived stress, psychological functioning, and sleep complaints. Methods: In this cross-sectional study, data on depressive symptoms, hypochondriacal beliefs, life satisfaction, and sleep complaints were gathered in 15 aSAH patients and 17 healthy controls. HCCs of the previous 3 months were assessed. Results: aSAH patients had significantly higher HCCs than healthy controls. In aSAH patients, higher HCCs were significantly associated with increased depressive symptoms, hypochondriacal beliefs, lower life satisfaction, and increased sleep complaints. Such significant associations were not found in healthy controls. Conclusions: Our findings indicate that a dysregulation of HPA-AA is associated with some of the long-term impairments in psychological functioning and sleep in aSAH survivors. While the direction of association remained unclear, a dysregulated HPA-AA may be causally linked with the maintenance of poor psychological functioning and poor sleep. The overall findings should be considered in the planning of long-term treatment aimed at improving psychological functioning and sleep in aSAH patients.

Early maladaptive schemas of emotional deprivation, social isolation, shame and abandonment are related to a history of suicide attempts among patients with major depressive disorders

BackgroundPatients with psychiatric disorders have an exceptionally high risk of completed or attempted suicide. This holds particularly true for patients with major depressive disorders. The aim of the present study was to explore whether patients with major depressive disorders (MDD) and a history of suicide attempts differed in their early maladaptive schemas from patients with MDD but without such a history or from healthy controls. MethodNinety participants took part in the study. Of these, 30 were patients with MDD who had made a recent suicide attempt; 30 were patients with MDD but no suicide attempts, and 30 were gender- and age-matched healthy controls. Participants completed questionnaires covering socio-demographic characteristics and the Young Schema Questionnaire (YSQ- RE2R) to assess early maladaptive schemas. Experts rated patients' MDD with the Montgomery–Asberg Depression Rating Scale. ResultsPatients did not differ in experts' ratings of symptoms of depression. Compared to healthy controls, patients with MDD recorded higher scores on maladaptive schemas such as recognition seeking, negativity/pessimism, and insufficient self-control. Compared to patients without suicide attempts and healthy controls, those who had made a suicide attempt had higher scores on dimensions such as failure, mistrust, emotional inhibition, social isolation, and abandonment/instability. ConclusionCompared to healthy controls, patients with MDD had more pronounced maladaptive schemas, but this was more marked in patients with a history of suicide attempts. The results suggest that suicide attempts and poorer psychological functioning are related.

Illness-related parenting stress among parents of adolescents and young adults with inflammatory bowel diseases

ABSTRACTIllness-related parenting stress in parents of adolescents/young adults (AYA) with inflammatory bowel diseases (n = 51) was compared with parents of younger youth (n = 48), using the Pediatric Inventory for Parents. Parents and AYA self-reported psychological functioning. Physicians rated disease activity. Parents of AYA and younger youth experienced comparable levels and types of parenting stress. Parents most commonly endorsed items within the emotional distress domain. Poorer parent psychological functioning explained additional variance in parenting stress beyond that of AYA disease activity and psychological functioning. Parents of AYA with greater disease activity and parents with poorer psychological functioning may benefit from behavioral health involvement.

Validation of the German version of the short form of the dysfunctional beliefs and attitudes about sleep scale (DBAS-16).

Research shows that dysfunctional sleep-related cognitions play an important role in the development, maintenance and exacerbation of insomnia. This study examines the factorial validity, psychometric properties and both concurrent and predictive validity of the German version of the 16-item DBAS (dysfunctional beliefs and attitudes about sleep) scale. Data was collected in 864 vocational students from the German-speaking part of Switzerland (43% females, M age=17.9years). Data collection took place twice within a 10-month interval. The students completed a German translation of the DBAS-16, the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), and provided information about their psychological functioning. Descriptive statistics, factorial validity, internal consistency, gender differences, concurrent, and predictive validity were examined. Confirmatory factor analysis supported the 4-factor structure of the DBAS-16. All factors (consequences, worry/helplessness, expectations, medication) were positively correlated and had acceptable psychometric properties. Females reported higher scores across all DBAS measures. Weak-to-moderate correlations were found between dysfunctional sleep-related beliefs, insomnia and poor sleep quality. Dysfunctional sleep-related beliefs were also associated with decreased psychological functioning, and consistently predicted insomnia and poor psychological functioning at follow-up, even after controlling for socio-demographic background and baseline levels. The present study provides support for the validity and psychometric properties of the German version of the DBAS-16. Most importantly, it corroborates the relevance of cognitive-emotional factors in the onset and maintenance of insomnia and psychological symptoms among young people.

Promoting Strengths and Resilience in Single-Mother Families.

Mothering can be particularly demanding for single women who are more vulnerable to a variety of risks ranging from economic hardship to poor psychological functioning. These risks place their children at higher risk of experiencing maladjustment. Examining factors that contribute to the well-being of single mothers and, in turn, their parenting may be one of the most effective ways of contributing to children's adjustment. This article highlights two factors, perceived social support and specific internal resources, that (a) substantially contribute to single mothers' well-being, (b) are linked to positive parenting behaviors, and (c) are amenable to change. The authors highlight the current research in these focus areas and explore how these two particular risk modifiers have potential to be changed via behavioral interventions.

A population-based study of quantitative sensory testing in adolescents with and without chronic pain.

Quantitative sensory testing (QST) has been used to characterize pain sensitivity in individuals with and without pain conditions. Research remains limited in pediatric populations, hindering the ability to expand the utility of QST toward its potential application in clinical settings and clinical predictive value. The aims of this study were to examine pain sensitivity using QST in adolescents with chronic pain compared to adolescents without chronic pain and identify predictors of pain sensitivity. A population-based study conducted from 2010 to 2011 provided data on 941 adolescents, 197 were classified as having chronic pain and 744 were classified without chronic pain. Self-reported data on pain characteristics, psychological functioning, and QST responses were examined. The findings revealed lower pressure pain threshold and tolerance on the trapezius (P's = 0.03) in adolescents with chronic pain compared to adolescents without chronic pain, but no differences on heat or cold-pressor pain tasks. Female sex (P's = 0.02) and poorer psychological functioning (P's = 0.02) emerged as significant predictors of greater pain sensitivity across all pain modalities. Exploratory analyses revealed several associations between clinical pain characteristics and QST responses within the chronic pain cohort. Findings from this large pediatric sample provide comprehensive data that could serve as normative data on QST responses in adolescents with and without chronic pain. These findings lay the groundwork toward developing future QST research and study protocols in pediatric populations, taking into consideration sex and psychological distress.

The impact of appraisals on intrusive memories

Background and objectivesIntrusive memories are a core feature of posttraumatic stress disorder (PTSD). Cognitive models posit that PTSD symptoms are stimulated by maladaptive appraisals about symptoms. This study aimed to test the causal pathway of maladaptive appraisals about the meaning of intrusions on subsequent intrusive memories. MethodsForty-five healthy participants were presented with a traumatic film, and were subsequently told either (a) intrusions are indicative of poor psychological functioning, (b) intrusions are not indicative of psychological functioning, or (c) no instructions. Participants subsequently completed a measure of cognitive performance to index potential interference by intrusions, as well as a scale of intrusive memories. ResultsParticipants who were told that intrusions are indicative of negative psychological state subsequently reported more intrusive memories than those who were told that intrusions have no particular significance. LimitationsInferences are reduced by lack of group differences in appraisals reported by participants. A stronger index of intrusions would have been achieved through diary keeping in the period after the experimental session. ConclusionsThis finding provides initial causal evidence that appraising intrusions as maladaptive may directly enhance the occurrence of intrusions following encoding of an aversive event, and in this sense is supportive of cognitive models of PTSD.

Development and preliminary effectiveness of an innovative treatment for binge eating in racially diverse adolescent girls

IntroductionBinge and loss of control (LOC) eating are significant concerns among many adolescents and are associated with poor physical, social, and psychological functioning. Black girls appear to be particularly vulnerable to binge and LOC eating. Yet, empirically validated, culturally sensitive treatments for these disordered eating behaviors are not well established. This investigation examined satisfaction, feasibility, and preliminary outcomes of a binge eating intervention for ethnically diverse adolescent girls. MethodsParticipants were 45 girls (age 13–17years; 44.4% white, 42.2% black) randomized into a dialectical behavior therapy (DBT)-based intervention (Linking Individuals Being Emotionally Real, LIBER8) or a weight management group (2BFit). Following each meeting, participants completed satisfaction measures, and therapists assessed intervention feasibility. Participants also completed assessments of eating behavior and related psychological constructs at baseline, immediately following the intervention, and at 3-month follow-up. ResultsDescriptive statistics indicated that LIBER8 was feasible, and participants were highly satisfied with this intervention. Significant reductions in eating disorder cognitions, dietary restraint, and eating in response to negative affect were observed for participants in both groups, with no differences between LIBER8 and 2BFit. DiscussionThe acceptability and feasibility of LIBER8 and associated reductions in emotional eating show promise in ameliorating binge eating and provide insight into multiple options for treating this challenging eating concern.

Psychological functioning among vertically infected HIV-positive children and their primary caregivers

ABSTRACTThe current study sought to explore the association between primary caregiver depressive symptoms and the psychological functioning in children vertically infected with human immunodeficiency virus (HIV) living in Eastern Cape, South Africa. A cross-sectional data were collected using the Beck Depression Inventory and Strength and Difficulties Questionnaire in a sample of 152 caregiver/child dyads. The results revealed that poorer psychological functioning in children was significantly associated with depressive symptoms in caregivers. This relationship existed whether or not the child was raised by a biological or non-biological caregiver as well as for both genders. Younger children's psychological functioning was more negatively influenced than that of older children raised by a caregiver with depressive symptoms. In the context of a large treatment gap for common mental disorders in South Africa, there is a need for interventions to address maternal mental health in families infected and affected by the HIV/AIDS pandemic as a mental health promotion strategy given that HIV-infected children are a particularly vulnerable population for poor mental and behavioural health outcomes.

Positive Psychological Functioning and the Biology of Health

AbstractMost research considers both psychological and physical health with a disease perspective by focusing on poor psychological functioning or disease outcomes. However, identifying attributes that support adaptive functioning may inform approaches to achieving health beyond what we learn from studying risk factors that accelerate deterioration. Recent evidence suggests that positive psychological functioning contributes to attaining optimal physical health. We evaluate the current state of knowledge on the relationship between positive psychological functioning and physical health, defining health beyond solely the absence of disease. We further consider when positive psychological functioning begins to exert effects on health, whether it has direct effects on biological processes or serves primarily to buffer the effects of stress, and whether it is associated with health outcomes and biological processes beyond those that reflect the absence of deterioration and disease. We propose some key directions for future research including the assessment of positive psychological functioning, positive biological functioning, and optimal health, the value of multi‐system measures, and the potential of “omics” to provide novel insights into biological mechanisms underlying associations between positive psychological functioning and physical health.

Health-related quality of life and psychological functioning in patients with primary malignant brain tumors: a systematic review of clinical, demographic and mental health factors

The impact of primary malignant brain tumors on patient quality of life and psychological functioning is poorly understood, limiting the development of an evidence base for supportive interventions. We conducted a thorough systematic review and quality appraisal of the relevant literature to identify correlates of health-related quality of life (HRQoL) and psychological functioning (depression, anxiety and distress) in adults with primary malignant brain tumors. Twenty-three articles met predefined inclusion criteria from a pool of peer-reviewed literature published between January 1984 and July 2015 (N = 2407). Methodological quality of included studies was assessed using an adapted version of the Newcastle-Ottawa Scale. The overall methodological quality of the literature was moderate. Factors relating consistently with HRQoL and/or psychological functioning were cognitive impairment, corticosteroid use, current or previous mental health difficulties, fatigue, functional impairment, performance status and motor impairment. Practitioners should remain alert to the presence of these factors as they may indicate patients at greater risk of poor HRQoL and psychological functioning. Attention should be directed towards improving patients' psychological functioning and maximizing functional independence to promote HRQoL. We outline several areas of future research with emphasis on improved methodological rigor.

Child behaviour problems mediate the association between coping and perceived stress in caregivers of children with autism

Coping and child behaviour problems (CBP) predict psychological distress in caregivers of children with autism. Whether CBP mediate the relationship between coping and caregivers’ psychological functioning has yet to be determined. This was the aim of the current study. A sample of 56 caregivers of children with autism completed an electronic survey assessing perceived stress, disengaged and problem focused coping, and CBP. Disengaged and problem focused coping predicted both CBP and perceived stress, albeit in different directions. CBP was also predictive of perceived stress. Data revealed an indirect effect of both disengaged and problem focused coping on perceived stress through CBP. In conclusion, caregivers who use more disengaged coping might be less effective at managing the problematic behaviours of the child with autism, thus resulting in poorer psychological functioning. Conversely, caregivers who use more problem focused strategies might, due to fewer CBP, be relatively protected against the psychological sequelae associated with the caregiving experience. Whether interventions that enhance problem focused coping have adaptive effects for caregivers’ psychological functioning, and whether these effects are mediated by fewer CBP might be the focus of subsequent research.

Who Are the Gatekeepers? Predictors of Maternal Gatekeeping

SYNOPSISObjective. The goal of this study was to identify determinants of maternal gatekeeping at the transition to parenthood. Design. Participants included 182 different-gender dual-earner couples. During pregnancy, expectant parents completed questionnaires regarding their psychological functioning, attitudes, and expectations, and at 3 months postpartum questionnaires regarding maternal gatekeeping behavior and gate-closing attitudes. Results. Structural equation modeling analyses revealed that mothers were more likely to close the gate to fathers when mothers held greater perfectionistic expectations for fathers’ parenting, had poorer psychological functioning, perceived their romantic relationship as less stable, and had higher levels of parenting self-efficacy. In contrast, fathers with lower parenting self-efficacy appeared to elicit greater maternal gate-closing behavior. Mothers who engaged in greater gate-opening behavior were more religious. Conclusions. Maternal gatekeeping may be more strongly associated with maternal expectations and psychological functioning than with maternal traditional gender attitudes. Fathers’ characteristics are less predictive of maternal gatekeeping than mothers’ characteristics.

Frequent Use of Social Networking Sites Is Associated with Poor Psychological Functioning Among Children and Adolescents.

Social networking sites (SNSs) have gained substantial popularity among youth in recent years. However, the relationship between the use of these Web-based platforms and mental health problems in children and adolescents is unclear. This study investigated the association between time spent on SNSs and unmet need for mental health support, poor self-rated mental health, and reports of psychological distress and suicidal ideation in a representative sample of middle and high school children in Ottawa, Canada. Data for this study were based on 753 students (55% female; Mage=14.1 years) in grades 7-12 derived from the 2013 Ontario Student Drug Use and Health Survey. Multinomial logistic regression was used to examine the associations between mental health variables and time spent using SNSs. Overall, 25.2% of students reported using SNSs for more than 2 hours every day, 54.3% reported using SNSs for 2 hours or less every day, and 20.5% reported infrequent or no use of SNSs. Students who reported unmet need for mental health support were more likely to report using SNSs for more than 2 hours every day than those with no identified unmet need for mental health support. Daily SNS use of more than 2 hours was also independently associated with poor self-rating of mental health and experiences of high levels of psychological distress and suicidal ideation. The findings suggest that students with poor mental health may be greater users of SNSs. These results indicate an opportunity to enhance the presence of health service providers on SNSs in order to provide support to youth.

Relationship between sleep problems and psychological outcomes in adolescent and young adult cancer survivors and controls.

How cancer history and distress relate to sleep outcomes of adolescents and young adults (AYAs) is unclear. The current study compares AYA cancer survivors to controls on indicators of sleep and fatigue; examines the concurrent association between psychological status, sleep, and fatigue; and investigates the lagged relationship between sleep and fatigue problems with psychological functioning. AYA cancer survivors (n = 167) and controls (n = 170), ages 16 to 30, completed measures at a survivorship clinic/primary care visit (time 1) and 2 months later (time 2). Participants completed questions about sleep quality, quantity, sleep medication use, self-reports of sleep problems, and fatigue in addition to measures of depression, anxiety, and posttraumatic stress symptoms (PTSS). There were no differences in sleep quantity or quality between survivors and controls, but survivors reported significantly more fatigue. Within groups, AYAs with self-reported sleep and fatigue problems reported significantly higher depression, anxiety, and PTS symptoms. Controlling for baseline depression, sleep, and fatigue problems at time 1 significantly predicted depression at time 2 in survivors but not in controls. This study offers important insight into the psychological functioning of childhood cancer survivors and prospectively describes sleep and fatigue as risk factors for poor psychological functioning in survivors. These findings support screening for sleep problems in AYA survivors as these difficulties are closely related to mental health functioning.