Predictors Of Social Outcomes Research Articles

Social competence following neonatal and childhood stroke.

Social functioning encompasses a range of important skills that an individual uses to interact with the social world. Previous studies suggest that social functioning (outcomes) may be impaired after childhood stroke, but research is limited. We examined the following: (1) the effect of ischemic stroke upon social outcomes in children; (2) the correlation of cognitive abilities and problem behaviors with social outcomes; and (3) the role of infarct characteristics as predictors of social outcomes. We conducted an observational case-controlled study to compare children with neonatal or childhood onset stroke and controls with chronic asthma. Neurological deficits were measured with the Pediatric Stroke Outcome Measure. Cognitive abilities, problem behavior, adaptive behavior, and social outcomes were assessed with standardized measures. Overall stroke cases were impaired in several areas of adaptive behaviors but not in cognitive ability, problem behaviors, or social outcomes. Children with more severe neurological deficits had impairments in a range of adaptive behaviors, social adjustment, and social participation. Impaired cognitive ability and more problem behaviors correlated with impaired social adjustment, particularly in stroke cases. Larger infarcts correlated with greater neurological impairment, lower IQ, and poorer social participation. Stroke can result in impaired adaptive and social functioning without apparent deficits in IQ or behavior. Infarct size, residual neurological deficits, impaired cognitive ability, and problem behaviors increase the risk for poor social adjustment and participation. These findings can help the clinician anticipate impaired social functioning after pediatric stroke, which is important because age-specific treatments are available.

Emotional Intelligence, Theory of Mind, and Executive Functions as Predictors of Social Outcomes in Young Adults With Asperger Syndrome

Social difficulties are frequently cited as a core deficit of individuals with Asperger syndrome (AS). This deficit is particularly evident when processing of emotional information is required in social situations. Deficits in theory of mind and executive functions are the two explanatory hypotheses for social deficits in AS that are predominant in the literature; however, each of these explanations has limitations. Emotional intelligence (EI) has emerged as a relatively new explanation for social difficulties in typically developing individuals. Recently, researchers also have demonstrated that EI predicted important social outcomes for individuals with AS. In this study, we explored EI as an alternative or additive explanation for the social deficits observed in young adults with AS in light of the two predominant theories accounting for social difficulties. Implications for practice are discussed.

Used for ill; used for good: a century of collecting data on race in South Africa

Data on race have been collected in South African censuses for a century. We examine the role played by the census in solidifying race as a social statistic and show that, in contrast to the majority of situations, operational and legislative factors rendered the census largely unimportant as a vehicle for doing this. Since 1994, race has been entirely self-reported and not subject to state reinterpretation. We examine the implications of this for future data collection exercises and caution against reifying race as a predictor of social outcomes in post-apartheid South Africa, and argue for its gradual phasing out.

Early Language and Behavioral Regulation Skills as Predictors of Social Outcomes

In the present study, the authors examined the prospective associations among early language skills, behavioral regulation skills, and 2 aspects of school-age social functioning (adaptability and social skills). The study sample consisted of children with and without a familial risk for dyslexia. The authors analyzed the relations among children's language (at age 2;6 [years;months] and age 5;0), behavioral regulation skills (at age 5;0), and social functioning (at age 8;0) using structural equation modeling. Subgroups of children with respect to language and behavioral regulation skills (at age 5;0) were identified through the use of mixture modeling. Among at-risk children, behavioral regulation skills mediated the association between early language skills and social outcomes. A subgroup of children with poor regulatory and weak language skills scored lower in adaptability, whereas a subgroup having only poor language skills (with normal behavioral regulation) did not differ from a group with age-appropriate skills. The present findings indicate that behavioral regulation skills play an important role in predicting social outcomes among children at risk for language difficulties. Furthermore, it is suggested that various aspects of social functioning may be influenced differently by self-regulation skills and that predictive relationships vary with the degree of language development deficits and accompanying risks.

Negative symptoms and not cognition predict social functioning among patients with schizophrenia

It is well known that patients with schizophrenia have some degree of cognitive impairment, such as deficits in executive functions. There has been a debate over the influence of cognitive impairment in the outcome of schizophrenia, compared to the influence of positive or negative symptoms. Negative symptoms are more chronic and persistent and less responsive to treatment. They are also associated with poor premorbid adjustment, poor social functioning, greater likelihood of cognitive impairment and brain ventricular enlargement. The aim of this study was to relate psychopathological measures and neurocognitive tests to social outcome, to find out which measure is the best predictor of social outcome in the long run. Forty-nine subjects with a DSM-IV diagnosis of schizophrenia were recruited from inpatient and outpatient units in East Yorkshire, UK. The patients were taking conventional and atypical antipsychotic drugs. Psychopathological measures (Brief Psychiatric Rating Scale [BPRS], total and subscales), neurocognitive tests (the Rivermead Behavioural Memory Test, the Intra/Extra Dimensional Shift Test, the Stockings of Cambridge Test) and social outcome scales (Social Behaviour Scale [SBS] and Independent Living Skills Survey, reduced version) were administered at baseline, 9 months and 18 months. The Social Behaviour Scale was developed by the MRC Social Psychiatry Unit, with chronic institutionalised subjects, whilst the Independent Living Skills Survey was designed to provide an assessment of independent living skills in the community of chronically mentally ill patients living in residential care facilities. A stepwise multivariate regression analysis using psychopathological measures and neurocognitive tests as predictors and social functioning scales as outcome showed that negative symptoms were the strongest predictor of social functioning both at 9 months and 18 months. This is the most important finding of this study. The regression analysis at 9 months, with SBS score as the dependent variable, produced a significant overall model (F = 4.748, p <0.05, with R square = 0.126; adjusted R square = 0.099). The only significant partial contribution was made by the BPRS withdrawal retardation dimension (beta = 0.355; p <0.05). Regression analysis at 18 months with the SBS score as the dependent variable also produced a significant model (F = 9.110, p <0.01, with R square = 0.275; adjusted R square = 0.245) and confirmed that the BPRS withdrawal retardation dimension was the only significant predictor in the model (beta = 0.525, p <0.01). In spite of the limitations of this study (small sample size, use of reduced versions of the Independent Living Skills Survey and use of the withdrawal-retardation dimension of the Brief Psychiatric Rating Scale only as a measure of negative symptoms), these findings point in the direction of the importance of negative symptoms' control in schizophrenia.

Symptoms at index admission as predictor for 1-5 year outcome in schizophrenia.

A total of 107 drug-free schizophrenic patients (76 males and 31 females) were consecutively admitted to an emergency ward and rated for psychotic symptoms by means of 32 items from the Comprehensive Psychopathological Rating Scale (CPRS). They were followed prospectively with ratings of social functioning by use of Strauss-Carpenter's outcome scale at 1, 3 and 5 years after index admission with the aim of determining possible early symptoms that are predictors of social outcome. In total, 59 of the patients were first admissions and had never been treated. At index admission, no difference was found in total CPRS scores between first-admission patients and chronic readmitted patients, or between male and female subjects. When subscales for positive symptoms (flights of ideas, feeling controlled, disrupted thoughts, auditory hallucinations, ideas of persecution) and negative symptoms (indecision, withdrawal, reduced speech, lack of appropriate emotions, slowness of movements) from the CPRS were applied, no relationship between the two subscales and outcome scores was found. However, in patients with a duration of the disorder of less than 24 months before index admission, high scores on both negative and positive subscales were significantly correlated with a poor 5-year outcome. No correlation was found in the group with a duration of illness of more than 24 months before index admission. It is concluded that symptoms at index admission have a predictive value for outcome in schizophrenic patients. Negative symptoms measured by use of a subscale of the CPRS have a predictive value for outcome up to 5 years after index admission, but high scores on both positive and negative symptoms are more strongly associated with a poor outcome. The duration of the symptoms before admission, as well as the kind of neuroleptic treatment given (clozapine vs. classical neuroleptics), seem to be important factors for prediction of outcome. Our data support the view that early negative symptoms in particular have a predictive value for the prognosis in schizophrenia for up to 5 years.

Has the outcome of schizophrenia changed?

Most studies of the course of schizophrenia cannot easily be compared because of differences in diagnostic criteria and measures of outcome. Both major clinical elements, the productive symptoms and the signs of deficit, seem in part to be reactive to the degree of stimulation in the psychosocial environment, though such factors by no means explain all their variability. The negative impairment tends to antedate florid onset and is a better predictor of social outcome than the florid symptoms. There is, however, no firm evidence that deterioration (deficit inevitably increasing with time) occurs. Manfred Bleuler's formulation summarises the overall outcome of a substantial part of what most clinicians who do not include a chronic course as part of the diagnosis call schizophrenia. About 20–25% recover, about 20–25% remain severely impaired throughout, the remainder run a fluctuating course.

Family and environmental variables as predictors of social outcome in chronic schizophrenia

Family and environmental variables as predictors of social outcome in chronic schizophrenia

Family and environmental variables as predictors of social outcome in chronic schizophrenia

Schizophrenia remains a major psychiatric illness without definite etiological treatment, and greater efficacy in the treatment of its target symptoms 6 continues to be sought. Investigations during recent years have shown that these target symptoms are influenced by family and environmental factors and, if known, alteration of these may be beneficial in the optimum treatment of the schizophrenic syndrome. The objective of this study is to find which family and environmental variables predict the social outcome of the illness. It is a general experience 12 that schizophrenic patients with similar diagnoses, symptomatology, and chronicity respond differently to similar treatment. Some improve remarkably, some a little, others seem untouched by the treatment. In this study, variables cover a wide range of theoretical and empirical observations: childhood behavior, social crises in the patients' lives, illness patterns, sociological and sociobiological factors, and the families' attitudes and actions during the current illness and hospitalization.