Psychosocial Study Research Articles

The development of communication and language in deaf preschool children with cochlear implants

The study is an ongoing longitudinal and qualitative psycho-social study of the communicative development in 19 preschool children with cochlear implants, using sign language. The children are video-recorded in natural interactional settings. Analysis of patterns of communication show that 16 of the children use sign language in communication with adults and peers. With regard to oral communication, 13 children were observed to utter single words or speech-like sounds upon an adult's request, but seldom used spoken words spontaneously. Six children used single spoken words in dialogues with adults if the content of the dialogue was about the here and now, and if the topic of reference was clear. None of the children in the study were able to take part in age-adequate play activities with peers when speech was used in communication. The results are discussed in reference to early mother–infant interaction, the development of communication and language, and the significance of early close relationships for children's social and emotional development.

Illness-related support and negative network interactions: effects on HIV-infected men's depressive symptomatology.

Data collected as part of a psychosocial study of gay and bisexual men's experiences of living with HIV infection as a chronic illness were examined to investigate the psychological impact of the perceived availability of illness-related support and negative illness-related network interactions in a sample of men from this population. The sample was comprised of 144 HIV-infected non-Hispanic white, African American, and Puerto Rican Men living in the New York City metropolitan area. Analyses found evidence of a conjoint (interactive) effect between perceived support and negative network interactions. There was no evidence of either perceived availability of illness-related network support buffering or negative illness-related network interactions amplifying the effect of HIV/AIDS-related physical symptomatology on depressive symptomatology.

Depression and life satisfaction in aging polio survivors versus age-matched controls: Relation to postpolio syndrome, family functioning, and attitude toward disability

Objective: To compare depressive symptoms and life satisfaction in aging polio survivors with age-matched controls and to relate these outcomes to scores to psychosocial and disability-related variables. Design: A planned medical, functional, and psychosocial study with multivariate analyses. Setting: A large, urban rehabilitation center. Participants: A volunteer sample of 121 polio survivors and an age-matched control group of 60 people with similar sociodemographic backgrounds. Main Outcomes: Depression as measured by the Geriatric Depression Scale and an 11-item life satisfaction scale. Results: The prevalence of depressive disorders was not significantly different in the two groups, although the postpolio group tended to have more symptomatology and an overall depressive disorder prevalence of 28%. Some life satisfaction scale scores were significantly lower in the postpolio group, especially those concerned with health. People with postpolio syndrome scored significantly higher on depression scales and lower on some life satisfaction scales than people with a history of polio but without postpolio syndrome. Several psychosocial variables, most notably family functioning and attitude toward disability, helped to mediate this effect. Among people with significant depression, there was little evidence of adequate treatment in the community. Conclusions: Postpolio by itself does not relate to higher depression scores or lower life satisfaction. Postpolio syndrome has some relation to depression, but family functioning and attitude toward disability are more important. There is a need for better community-based psychological services.

Conflict in Action: A Psychosocial Study of a Venezuelan Revolutionary

Two focal issues are addressed in this study. First, this is an examination of the life of a young Venezuelan revolutionary and the disparity between his overt behavior and political activities, in contrast to various intrapsychic processes and unconscious conflicts. The second focal area is that of demonstrating the use of projective, psychological instruments [in this instance the Rorschach test]for field research, as an economic tool for delineating data that is not observable by studying behavior alone. This review complements a previous extensive life history that was published earlier and constitutes one segment of a long term project that examined a society in the midst of rapid social change, conducted by an international group of social scientists, sponsored by the Massachusetts Institute of Technology and the Universitas Central de Venezuela.

Psychosocial study of depression in early pregnancy.

The psychosocial correlates of depression during pregnancy were explored. Pregnant women attending the antenatal clinic of a general hospital (n = 1329) received a set of questionnaires including Zung's Self-Rating Depression Score (SDS). SDS high scores (> 49) (the cases: n = 179) were compared with low scores (< 38) (the controls; n = 343). The cases were characterised by: first delivery; more nausea, vomiting, and anorexia; more menstrual pains and premenstrual irritability; early paternal loss; lower maternal care and higher paternal overprotection; higher public self-consciousness score; more smoking and use of medication in pregnancy; unwanted pregnancy; negative psychological response to the pregnancy by the woman and husband; poor intimacy by the husband; and having remarried. Depression in early pregnancy is determined mainly by psychosocial factors.

Review of Suicide--The Ultimate Rejection? A Psycho-Social Study.

Suicide in history and literature defining suicide - psychiatric and substance-abuse factors, other contributory psycho-social factors the dilemma of deliberate self-harm and suicidal behaviour in young adults the sociology of mental-health and suicide an integrated needs-led intervention and treatment model family survivors - hidden casualities? euthanasia - an epilogue for chronic mental illness?

Elevated physical health risk among gay men who conceal their homosexual identity.

This study examined the incidence of infectious and neoplastic diseases among 222 HIV-seronegative gay men who participated in the Natural History of AIDS Psychosocial Study. Those who concealed the expression of their homosexual identity experienced a significantly higher incidence of cancer (odds ratio = 3.18) and several infectious diseases (pneumonia, bronchitis, sinusitis, and tuberculosis; odds ratio = 2.91) over a 5-year follow-up period. These effects could not be attributed to differences in age, ethnicity, socioeconomic status, repressive coping style, health-relevant behavioral patterns (e.g., drug use, exercise), anxiety, depression, or reporting biases (e.g., negative affectivity, social desirability). Results are interpreted in the context of previous data linking concealed homosexual identity to other physical health outcomes (e.g., HIV progression and psychosomatic symptomatology) and theories linking psychological inhibition to physical illness.

Accelerated course of human immunodeficiency virus infection in gay men who conceal their homosexual identity.

Research linking psychological inhibition to physical illness led us to examine whether human immunodeficiency virus (HIV) infection might progress more rapidly among gay men who conceal their homosexual identity than among those who do not. We also sought to determine whether any accelerated course of HIV infection among "closeted" gay men might be attributable to differences in health-relevant behavior (e.g., health practices, sexual behavior) or psychosocial characteristics (e.g., depression, anxiety, social support, repressive coping style). Data came from a longitudinal psychosocial study associated with the Los Angeles site of the Multicenter AIDS Cohort Study. Eighty gay men, HIV-seropositive but otherwise healthy at study entry (CD4 T lymphocytes = 30-60% of total lymphocytes), were examined at 6-month intervals for 9 years. Indicators of HIV progression included time to a critically low CD4 T lymphocyte level (15% of total peripheral blood lymphocytes), time to AIDS diagnosis, and time to AIDS mortality. On all measures, HIV infection advanced more rapidly in a dose-response relationship to the degree participants concealed their homosexual identity. Sample characteristics and statistical controls ruled out explanations based on demographic characteristics, health practices, sexual behavior, and antiretroviral therapy. Mediational analyses indicated that observed effects were not attributable to differences in depression, anxiety, social support, or repressive coping style. HIV infection appears to progress more rapidly in gay men who conceal their homosexual identity. These results are consistent with hypotheses about the health effects of psychological inhibition, but further research is required to definitively identify the psychosocial, behavioral, and physiological mechanisms underlying these findings.

A psychosocial study of individual and family dynamics in IBD: [formula omitted], J. Schonholtz, C.H. Grega, D.R. Barr. Doctoral Program in Clinical Psychology, New York University and Division of Gastroenterology, Mt. Sinai School of Medicine, New York, N.Y.

A psychosocial study of individual and family dynamics in IBD: [formula omitted], J. Schonholtz, C.H. Grega, D.R. Barr. Doctoral Program in Clinical Psychology, New York University and Division of Gastroenterology, Mt. Sinai School of Medicine, New York, N.Y.

Who says yes? Identifying selection biases in a psychosocial intervention study of multiple sclerosis

The purpose of this work is to examine whether patients' sociodemographic and medical characteristics are associated with participation in a randomized controlled trial of two psychosocial interventions. After elimination of basic ineligibles from a registry of multiple sclerosis patients, 325 patients were sent a letter inviting participation in the randomized trial. Among those invited, 29% expressed an interest in participating, 19% scheduled an intake interview and 13% were actually randomized. x 2 and logistic regression analyses were used to determine what factors were associated with successive stages of participation or non-participation in the study. Differential referral and participation rates could be traced in part to physician factors. With respect to patient factors, people were more likely to participate in the successive stages of recruitment if they had a higher median family income, lived a moderate distance from the hospital, and were disabled from working. Multivariate analyses of patient factors revealed that having a higher income and being disabled from work were the strongest predictors of participation, after adjusting for the effects of course of disease, disability status, and other sociodemographic predictors. Implications of these findings are discussed in terms of potential sources of bias in the selection of eligible patients, as well as the role the investigator may play in highlighting or underplaying this selection bias. Suggestions are made to minimize the bias-generating barriers.

Sexual behavior research on a cohort of gay men, 1984-1990: can we predict how men will respond to interventions?

In 1984, over 1000 gay and bisexual men volunteered to participate in both the Chicago Multicenter AIDS Cohort Study (MACS) and a companion psychosocial study, the Coping and Change Study (CCS). Participants in the semiannual Chicago MACS/CCS evaluations comprise the largest cohort of high-risk men under continuous medical, behavioral, and psychosocial observation. Chicago MACS/CCS researchers prospectively chart the sexual behavior change patterns of the cohort and relate those behavioral changes to psychosocial correlates and actual HIV infection risk. This report summarizes the behavioral natural history of the Chicago MACS/CCS cohort from 1984 to 1990, focusing on receptive anal sex practices and use patterns for alcohol and the most frequently used recreational drugs. As these are prospective observational and not controlled intervention studies, psychosocial correlates of sexual behavior change by members of the cohort are suggestive of factors influencing behavior change rather than indicative of causal relationships. However, the voluntary availability to participants in the Chicago MACS/CCS of HIV-1 antibody test results beginning in late 1985 provided the opportunity to examine whether demographic, psychosocial, or behavioral factors were indicators of sexual behavior change following disclosure and counseling about HIV-1 serostatus. Recommendations for promotion and maintenance of safer sexual behavior for the long run, and limitations in the generalizability of these findings to the much more diverse populations of men who have sex with other men conclude this article.

Psychosocial study on Hong Kong Chinese with gynecological cancer.

Psychosocial support and adjustment to cancer in 115 Chinese patients with gynecological malignancies were studied by interviews using semi-structured and structured questionnaires before commencement of treatment. Ninety per cent of patients had emotional support with 72% coming from family members, while 77% of the patients said that they were clearly informed of their diagnosis. The majority of our patients (63%) did not wish to see a counsellor. Psychological outcome of the patients was good, with less than 21% having expression of anxiety or depression. Social adjustment was less favorable; 42% of women had a reduction in leisure activity. The majority of married couples maintained a good marital relationship even though 78% had reduction or cessation of their sexual activity. Good emotional support was associated with fewer neurotic symptoms. Though there was no statistical significance demonstrated, the good psychosocial support and the favorable psychological outcome in this group of patients indicated the likelihood of a positive relationship between the two.

Psychosocial self-prognosis in relation to mortality and morbidity in hemophiliacs with HIV infection.

HIV-infected hemophiliacs participated in a psychosocial prognosis study. The Coping Wheel was filled out 1-2 years after the subjects had been told that they were HIV-infected and between 1 and 7 years after they had become infected. The number of significant signs of disease as well as mortality were recorded during the years following the psychosocial measurements. These measures were related to three measures of anticipated future activities derived from the Coping Wheel, namely 'number of activities for oneself', 'number of activities with others' and a combined measure 'number of activities for oneself in relation to number of activities with others'. The results indicated that the subject's own psychosocial prognosis added to the prediction of mortality. The most important psychosocial factor was the combined measure: those with few anticipated activities for oneself in relation to activities with others had a greater likelihood of dying soon during follow-up. The latter prediction was true even after adjustment for age and condition of the immune system (CD4 count) at the start of follow-up. The conclusion is that the Coping Wheel, applied as in the present examination, may be of help in prognosis and in identifying psychosocial needs in patients with HIV infection.

A Psychosocial Study of Albinism in a Predominately Mulatto Caribbean Community

Psychosocial data collected from 12 albinos in rural and isolated parts of the Dominican Republic suggest a stigma is associated with the absence of skin color. The general population living in the area has a skin pigmentation of dark brown. The purpose of the investigation was to assess whether there were psychosocial problems for albinos with white skin and hair. Prior studies imply albinism is a negative social characteristic associated with prejudice and apartheid in a predominately mulatto community. This researcher recommends that psychologists and health-care providers be familiar with similar sensitive issues among special populations.

Psychosocial rehabilitation of cranial trauma and stroke patients.

This paper presents the results of a longitudinal psychosocial study of 22 cranial trauma patients and 14 stroke patients from the time preceding injury (using retrospective data), through a 4-5 month intensive rehabilitation programme, to a follow-up 1 year after completion of the programme. Although the two groups of patients differed on several demographic and medical characteristics, essentially similar patterns for psychosocial decline following injury and improvement following rehabilitation could be observed. For both groups, the proportion in marital or cohabitational relationships returned to pre-injury levels, and for both groups the proportion requiring assistance in their living situation declined following rehabilitation, as did use of the health services. Virtually all patients in both groups had been in employment or undergoing education at the time of the injury, and although this percentage declined in practice to a small minority of both groups post-injury, there was a significant increase in the proportions working or in education following the rehabilitation programme. Similarly, the pattern of leisure-time activities in both groups declined post-injury and was restored following rehabilitation. Since both groups entered the programme at over 2.5 years post-injury, these generally encouraging results seem less likely to reflect spontaneous recovery than a beneficial effect of the programme itself.

MCMI-diagnosed personality disorders among agoraphobic outpatients: Prevalence and relationship to severity and treatment outcome

The prevalence of personality disorders among 165 agoraphobic outpatients was assessed with the Million Clinical Multiaxial Inventory, Versions I or II. Over 90% of clients met criteria for one or more Axis II diagnoses, the most common of which were avoidant and dependent. Scores on the personality scales were not significantly related to agoraphobic avoidance or panic frequency, but were often related to social phobia and dysphoria. Avoidant, dependent, and histrionic, but not severe personality disorders, were significantly associated with one or more indices of outcome for a sample of 64 clients in a naturalistic psychosocial treatment study, whereas paranoid PD was linked with early termination (< 10 sessions). The most consistent predictor was avoidant personality; clients with this Axis II disorder fared more poorly on agoraphobic and social phobic avoidance and on depression.

Psychosocial, neuropsychological and neurological status in a sample of heart transplant recipients.

The sample for this psychosocial follow-up study was formed using the 71 surviving patients from a total of 100 who underwent heart transplantation up until March 1990 at Kiel University Hospital. Forty of these could be investigated comprehensively. The neurological investigation comprised EEG and auditory and visually evoked potentials. The psychological investigation started with several neuropsychological tests; additionally all patients were interviewed and they completed questionnaires concerning anxiety, depression, ways of coping, personality characteristics and life satisfaction. Within the entire sample, there were few indications for specific psychological impairment. The psychosocial status of the patients was not significantly related to the time which had elapsed since they underwent transplantation. There were few associations between neuropsychological and psychosocial data, and several indicators of early postoperative complications which are described in the literature (e.g., length of stay in the intensive care unit). Clinically relevant subgroups (formed on the basis of neuropsychological test results, anxiety and depression) did not differ in terms of these indicators. Nevertheless, a considerable proportion of the patients (25%) were characterized by having a higher level of affective and neuropsychological impairment. Although based upon retrospective investigations, the results of this follow-up generally correlate with those gained from Anglo-American countries. In interpreting the results one needs to consider the possible influence of premorbid personality characteristics as well as denial which may be typical for patients undergoing heart transplantation.

The pattern of psychiatric morbidity in a Victorian urban aboriginal general practice population.

Victorian Aboriginal people, most of whom live an urban lifestyle, form a distinct cultural group within the wider Victorian community. This paper describes a unique psychosocial study of urban Aboriginal adults attending a general practitioner at the Victorian Aboriginal Health Service in Fitzroy. The frequency and nature of psychiatric disorders among survey respondents is reported, together with a discussion of the association between this morbidity and certain sociodemographic variables.

Can family violence be prevented? A psychosocial study of male batterers and battered wives

This study is based on interviews with 18 male wife-beaters and 49 battered wives. It was designed to establish the importance of such social background factors as violence and alcoholism in the family of origin for the eruption of similar problems in the next generation. The study concludes that battered wives and male batterers have a similar social background and that a vast majority of them have experienced violence in childhood and that half of them came from homes where the father was a heavy consumer of alcohol. As adults, the boys repeat the behaviour of their fathers and the girls repeat the behaviour of their mothers. To prevent wife abuse we must extend the scope from the battered wife to the whole family. Only by focusing on the conditions under which the children of the battered wife grow up can family violence be prevented in the future.

Prediction of Distress in the First Six Months After a Cancer Diagnosis

The article describes a prospective study of the Omega Screening Instrument (OSI) as a tool to predict subsequent emotional distress in newly diagnosed cancer patients in semirural west Texas. The measure of subsequent emotional distress was the Total Mood Disturbance score from the Profile of Mood States. The OSI was predictive of later mood disturbance in the patients, but not as accurately as in Boston, where the OSI was developed. Even though the patient population in west Texas differed in many ways from the population of the original Omega Project, the authors believe that the OSI will be useful in selecting high-risk patients for a psychosocial intervention study.