Social Adjustment Scale-Self Report Research Articles

Exploring the performance of during-treatment substance use outcome measures in predicting longer-term psychosocial functioning and post-treatment abstinence

BackgroundThe selection of appropriate efficacy endpoints in clinical trials has been a long-standing challenge for the substance use disorder field. Using data from a large, multi-site National Drug Abuse Treatment Clinical Trials Network trial (CTN-0044; n=474), this secondary data analysis aimed to explore whether specific proximal (during-treatment) substance use outcome measures predict longer-term improvements in psychosocial functioning and post-treatment abstinence, and whether predictions vary depending on the specific substance (cannabis, cocaine/stimulants, opioids, and alcohol). MethodsGeneralized linear mixed models examined associations between six during-treatment substance use outcome measures and social functioning impairment (Social Adjustment Scale Self-Report) and severity of psychiatric symptoms (Brief Symptom Inventory-18) at end-of-treatment, and 3- and 6-months after treatment as well as post-treatment abstinence. ResultsMaximum days of consecutive abstinence, proportion of days abstinent, ≥3 weeks of continuous abstinence, and the proportion of urine specimens negative for the primary substance were associated with post-treatment psychiatric and social functioning improvement and abstinence. However, only the effects of abstinence during the last 4 weeks of the treatment period on all three post-treatment outcomes was stable over time and did not differ between primary substance groups. In contrast, complete abstinence during the 12-week treatment period was not consistently associated with functioning improvements. ConclusionsSubstance use outcome measures capturing the duration of primary substance abstinence during treatment are suitable predictors of post-treatment abstinence and longer-term psychosocial functioning improvement. Binary outcomes, such as end-of-treatment abstinence, may be particularly stable predictors and attractive given their ease of computation and straightforward clinical interpretability.

COMPARATIVE STUDY OF QUALITY OF LIFE AND SOCIAL ADJUSTMENT AMONG PATIENTS WITH SCHIZOPHRENIAAND BPAD

Background: People with schizophrenia and bipolar disorder have to face many challenges. They struggle with the symptoms and disabilities that occur due to the disorder. An important consequence of improve social adjustment would be to improve the quality of life of people who have psychiatric illnesses.Aim:To assess and compare the quality of life and social adjustment among the schizophrenia and BPAD patients.Methods: The study has been conducted at the outpatient department (OPD) of CIIMHANS, Dewada, Rajnandgoan. The total sample size was 60 patients of schizophrenia and bipolar affective disorders through purposively sampling technique in accordance of inclusion and exclusion criteria. Sociodemographic and clinical details of the entire patients were assessed through socio-demographic datasheet and clinical datasheet, Quality of life was assessed by The World Health Organization Quality of Life and Social adjustment was assessed by Social Adjustment Scale Self-Report.Results: The result shows that more quality of life and social adjustment among patients with BPAD as compared patients with schizophrenia and there was significant difference in overall qua lity of lif e and soc i a l adjustment be twe en both groups.Conclusion: People with psychiatric disorders frequently felt that their social adjustment and quality of life were inadequate. These people confront social adjustment challenges, employment prospects that are limited, and discrimination on a global scale. It was connected to their standard of living.

Spiritually oriented therapy approach applying in complex rehabilitation of patients with mental disorders

IntroductionNumerous studies point to a high effectiveness of psychosocial rehabilitation using psychopharmacological treatment, psychosocial methods and spiritually oriented care technologies.ObjectivesDescription of the experience of using a spiritually oriented approach in complex rehabilitation of patients with mental disorders.MethodsClinical, pathopsychological, statistic. The study involved two groups of patients with illness (ICD-10 F 20.04 – F 20.05, F25.х, F21.3-21.4, F 33.4, F31.7, F32.2 – 18 patients) and comorbid addictive disorders (ICD-10 F10.2х1- F10.2х2 - 17 patients). “The Social Adjustment Scale–Self-Report SAS-SR” (М. Weissman, S. Bothwell, 1976); “Medical Outcomes Study 36-item short form health survey” (SF-36, John E.Ware, 1992); “Methodology of the severity of anti-drug potential” (Kopeyko G.I. et al, 2018); “The Scale of Religiosity” (Kaz’mina O.Y., 2000) were used to assess the effectiveness.ResultsAll patients received psychopharmacological treatment and participated in rehabilitation work in patient community organizations using psychosocial and spiritually oriented therapy. The rehabilitation program included psychoeducation, skills training, group and individual psychotherapy, social activity. Spiritually oriented assistance was realized in the tradition of dialogical approach (Florenskaya T.A., 1992) and included conversations on Evangelical topics, work in therapeutic groups on the principles of a religious community. Longer remission times, a social functioning improvement, a tendency to change lifestyle based on the values of religious worldview, anti-drug potential increase and a higher understanding of religious life with an orientation towards internal religiosity were revealed among the participants of complex rehabilitation program.ConclusionsPerspective of using biopsychosociospiritual approach in psychiatry in work with patients with schizophrenia and patients with comorbid addictive disorders was shown.DisclosureNo significant relationships.

Domain-Based Functional Improvements in Bipolar Disorder After Interpersonal and Social Rhythm Therapy.

BackgroundStudies typically report overall change in function when assessing bipolar disorder (BD) interventions, but individual domains are not analyzed. Which aspects of functioning are impacted is clearly important and may differ between treatments.MethodsData were analyzed from two previous clinical trials of Interpersonal and Social Rhythm Therapy (IPSRT) for BD patients. Change in total and subscale scores on the Social Adjustment Scale Self-Report (SAS-SR) from 0 to 78 weeks, were analyzed.Results152 BD patients took part in randomized controlled trials of IPSRT (n = 38) vs. Specialist Supportive Care (SSC) (n = 43), and of IPSRT (n = 41) vs. treatment as usual (TAU) which was discharge to primary care (n = 30). IPSRT was superior to TAU on change in the social and leisure activities and extended family subscales, and SAS-SR total score over 18 months.LimitationsStudies were not designed to be pooled. Patients in study 1 were younger and symptomatic at baseline. Patients assigned to TAU were more likely to drop-out. Patients did not respond to subscales that were not personally applicable (work, marital, children).ConclusionIPSRT had a positive impact on two SAS-SR subscales compared to TAU over 18 months. Other subscales were limited by the lack of respondents due to individual applicability. Different psychotherapy may have differential effects on different domains of function. Measures of function and research into functioning in BD should include domain-based measures, and report the numbers of participants who respond to questions in each domain.

The efficacy of short-term individual interpersonal psychotherapy in augmentation with pharmacotherapy in major depressive disorder

Background The high prevalence rates and persistently increasing burden of depression indicate that there are still many unmet needs in the management of depression. Interpersonal psychotherapy (IPT) is one of the main evidence-based psychotherapeutic interventions for depression.Aim To evaluate the efficacy of short-term individual IPT in combination with pharmacotherapy, compared with pharmacotherapy alone, in the treatment of depression and assess its role in improving social functioning.Setting and design This study was conducted in Mansoura University hospitals and was an interventional randomized controlled trial.Patients and methods A total of 40 patients were recruited and randomized into either the interventional group or the control group. The interventional group received IPT in combination with selective serotonin reuptake inhibitor. IPT was in the form of once weekly session for 12 weeks. Patients in the control group received treatment with an selective serotonin reuptake inhibitor with appointments once every 2 weeks. Patients from both groups were assessed by the Montgomery–Asberg Depression Rating Scale and the Social Adjustment Scale Self-Report at the beginning and after 12 weeks.Statistical analysis IBM SPSS Statistics version 20.0 was used for statistical analysis.Results There were highly statistically significant improvements in depressive symptoms and in social functioning between the baseline assessments and after 12 weeks on the used scales in both groups. There was a trend for better improvement in the interventional group (IPT+pharmacotherapy) in depressive symptoms and in overall and specific domains of social functioning when compared with the control group. The interventional group showed statistically significant better improvements in social functioning when compared with the control group.Conclusions Combined IPT and pharmacotherapy shows clear benefits over pharmacotherapy alone, in both alleviating depressive symptoms and improvement of social functioning.

Effect of 3 Forms of Early Intervention for Young People With Borderline Personality Disorder

Clinical trials have neither focused on early intervention for psychosocial impairment nor on the contribution of components of borderline personality disorder (BPD) treatment beyond individual psychotherapy. To evaluate the effectiveness of 3 early interventions for BPD of differing complexity. This single-blinded randomized clinical trial recruited young people between March 17, 2011, and September 30, 2015, into parallel groups. The study took place at 2 government-funded mental health services for young people in Melbourne, Australia. Inclusion criteria were age 15 to 25 years (inclusive), recent DSM-IV-TR BPD diagnosis, and never receiving evidence-based BPD treatment. A total of 139 participants were randomized (pool of 876; 70 declined, 667 excluded), balanced for sex, age, and depressive symptomatology. Data analysis completed May 2020. (1) The Helping Young People Early (HYPE) dedicated BPD service model for young people, combined with weekly cognitive analytic therapy (CAT); (2) HYPE combined with a weekly befriending psychotherapy control condition; and (3) a general youth mental health service (YMHS) model, combined with befriending. Therefore, the 3 treatment arms were HYPE + CAT, HYPE + befriending, and YMHS + befriending. Participants were randomly assigned both to 1 treatment arm (in a 1:1:1 ratio) and to a clinician. Psychosocial functioning, measured with the Inventory of Interpersonal Problems Circumplex Version and the Social Adjustment Scale Self-report. One hundred twenty-eight participants (104 [81.3%] were female; mean [SD] age, 19.1 [2.8] years; HYPE + CAT: 40 [31.3%]; HYPE + befriending: 45 [35.2%]; YMHS + befriending: 43 [33.6%]) who provided postbaseline data were included in the intent-to-treat analysis. Regardless of group, from baseline to 12 months, there was a mean of 19.3% to 23.8% improvement in the primary outcomes and 40.7% to 52.7% for all secondary outcomes, except severity of substance use and client satisfaction. The latter remained high across all time points. Planned comparisons (YMHS + befriending vs HYPE; HYPE + CAT vs befriending) showed that neither the service model nor the psychotherapy intervention was associated with a superior rate of change in psychosocial functioning by the 12-month primary end point. The HYPE service model was superior to YMHS + befriending for treatment attendance (median [IQR], 22 [19] vs 3 [16] contacts; median duration, 200 [139.5] vs 94 [125] days) and treatment completion (44 of 92 [47.8%] vs 9 of 47 [19.2%]). HYPE + CAT was superior to befriending for treatment attendance (median [IQR], 12 [16.5] vs 3 [9.8] sessions) and treatment completion (24 of 46 [52.2%] vs 29 of 93 [31.2%]). In this randomized clinical trial of 3 interventions for young people with BPD, effective early intervention was not reliant on availability of specialist psychotherapy but did require youth-oriented clinical case management and psychiatric care. A dedicated early intervention BPD service model (HYPE), with or without individual psychotherapy, achieved greater treatment attendance and completion, making it more likely to meet service user, family, and community expectations of care. anzctr.org.au Identifier: ACTRN12610000100099.

HCN1 Ion Channel in the Hippocampal CA1 Region Was Involved in Ketamine-Induced Antidepressant Action and Increased BDNF Levels in Mice

Bilateral subthalamic nucleus deep brain stimulation improves motor symptoms and treatment-related complications in patients with Parkinson’s disease. However, some patients have trouble adjusting socially after successful neurosurgery, in part because of “unrealistic” expectations and psychiatric disorders. Preoperative psychological interventions focusing on these aspects could be beneficial for such patients.We compared the outcomes of 2 psychosocial approaches—1 based on cognitive restructuration and 1 consisting of 2 interviews—with those of a control group without preoperative preparation. All patients underwent a psychometric evaluation 2 months before surgery (M−2) and again at 3 (M+3) and 6 months (M+6) after surgery. The psychometric evaluation focused on social adjustment using the social adjustment scale–self-report. The psychiatric profile of the patients was also assessed.Of 73 patients initially enrolled, 62 performed the initial inclusion visit (M−2) and the 2 postoperative visits (M+3, M+6). For these 62 patients (52% male), the overall mean age was 59 ± 6.13 years, and the mean disease duration was 9.44 ± 3.62 years. No specific differences were observed for social adjustment between the groups or visits (M−2, M+3, M+6); however, an interaction was found in the cognitive restructuration group at M+6 for the family dimension of the social adjustment scale–self-report.Our results suggest that even if no overall increase in the social adjustment score was observed, patients with Parkinson’s disease eligible for neurosurgery should undergo preoperative psychosocial therapy to define their expectations and help them in their psychological restructuration. This type of therapy, complementary to psychoeducation, could represent an opportunity to prevent postoperative deception and social maladjustment.

The impact of lifetime interpersonal and intentional trauma on cognition and vulnerability to psychosis in bipolar disorder

Background Studies have shown that over half of individuals with bipolar disorder experience early-life trauma, which may influence clinical outcomes, including suicidality and presence of psychotic features. However, studies report inconsistent findings regarding the effect of trauma on cognitive outcomes in bipolar disorder. Aims Our study explores the effect of lifetime trauma on the level of vulnerability to psychosis and cognitive performance in participants with bipolar disorder. Method We evaluated lifetime trauma history in 236 participants with a diagnosis of bipolar disorder type 1 or 2, using the Structured Clinical Interview for DSM-IV and the Childhood Trauma Questionnaire. We classified trauma types based on the Substance Abuse and Mental Health Services Administration's concept of trauma, which characterises the type of experienced trauma (e.g. interpersonal and intentional, accidental or naturally occurring). Our primary outcome measures of interest were vulnerability to psychosis (Schizotypal Personality Questionnaire), cognitive performance (MATRICS Consensus Cognitive Battery) and social functioning (Social Adjustment Scale Self-Report). Results Multivariate analysis of covariance showed a significant effect of trauma type on the Schizotypal Personality Questionnaire cognitive–perceptual domain (F(3) = 6.7, P < 0.001). The no-trauma group had lower cognitive–perceptual schizotypal features compared with the accidental and intentional trauma (P < 0.001) and interpersonal and intentional trauma (P = 0.01) groups. Conclusions Our results highlight the need for careful trauma inquiry in patients with bipolar disorder, and consideration of how trauma-focused or -informed treatments may be an integral part of treatment planning to improve outcomes in bipolar disorder.

Major depression, temperament, and social support as psychosocial mechanisms of the intergenerational transmission of parenting styles.

In this three-generation longitudinal study of familial depression, we investigated the continuity of parenting styles, and major depressive disorder (MDD), temperament, and social support during childrearing as potential mechanisms. Each generation independently completed the Parental Bonding Instrument (PBI), measuring individuals' experiences of care and overprotection received from parents during childhood. MDD was assessed prospectively, up to 38 years, using the semi-structured Schedule for Affective Disorders and Schizophrenia (SADS). Social support and temperament were assessed using the Social Adjustment Scale - Self-Report (SAS-SR) and Dimensions of Temperament Scales - Revised, respectively. We first assessed transmission of parenting styles in the generation 1 to generation 2 cycle (G1→G2), including 133 G1 and their 229 G2 children (367 pairs), and found continuity of both care and overprotection. G1 MDD accounted for the association between G1→G2 experiences of care, and G1 social support and temperament moderated the transmission of overprotection. The findings were largely similar when examining these psychosocial mechanisms in 111 G2 and their spouses (G2+S) and their 136 children (G3) (a total of 223 pairs). Finally, in a subsample of families with three successive generations (G1→G2→G3), G2 experiences of overprotection accounted for the association between G1→G3 experiences of overprotection. The results of this study highlight the roles of MDD, temperament, and social support in the intergenerational continuity of parenting, which should be considered in interventions to "break the cycle" of poor parenting practices across generations.

Impact of Psychotherapy on Psychosocial Functioning in Borderline Personality Disorder Patients.

Borderline Personality Disorder (BPD) significantly impairs functioning. Fortunately, effective treatments are available for borderline symptoms but their effect on functioning should be assessed. The objective of this meta-analysis is to assess the effect of specifically-designed versus non-specifically designed psychotherapies on function in adult patients with BPD. The reference list of Cristea et al. 2017 was used to identify the randomized controlled trials (RCTs) assessing the BPD-specifically-designed psychotherapy versus non-specific psychotherapies in adult BPD patients. Among those, RCTs assessing post-treatment functioning using the Global Assessment of Functioning, Social Adjustment Scale–Self-Report and Inventory of Interpersonal Problems were included. Ten trials (880 participants) were included. Summary effect size was calculated using the measured Hedge’s g. The results indicate the BPD patients in the intervention group had a significantly higher (g = 0.41; 95% CI, 0.09–0.73) level of psychosocial functioning after receiving the specifically-designed psychotherapies in comparison with BPD patients in control groups after receiving non-specific psychotherapies. Specifically-designed psychotherapies can improve psychosocial functioning although improvement in measurement of function (i.e., more objective and universal tools) and improvement in psychotherapies (i.e., more focused on general functioning) will be helpful.

Mobilizing self through short-term dynamic interpersonal psychotherapy: a preliminary report

Background: The key features of short-term dynamic interpersonal psychotherapy (STDIP) are outlined along with the background of its development. Preliminary data demonstrating functional improvement in a small case series of patients is presented.Methods: Nineteen patients were evaluated at commencement and end of therapy in a pilot study. Instruments used were the Childhood Trauma Questionnaire (CTQ); Beck Depression Inventory (BDI); Brief Symptom Inventory (BSI); COPE (Coping Style Questionnaire); Relationship Styles Questionnaire (RSQ) and Social Adjustment Scale-Self Report (SAS-SR).Results: This cohort had significantly elevated scores on the CTQ. They demonstrated substantial improvement on measures including the BDI, and several subscales of BSI, COPE, RSQ and SAS-SR.Conclusions: The small numbers and naturalistic design preclude firm conclusions however the results suggest that STDIP can be used to successfully treat patients, notwithstanding a history of childhood trauma.

Quality of Life as Predictor of Psychological Well-being, Self-care and Psychosocial Adjustment in Patients with Type II Diabetes after Initial Unilateral Minor Amputation

OBJECTIVE: The present research investigated the role of perceived quality of life as significant predictor of psychological well-being, self-care and psychosocial adjustment among patients with type II diabetes initially after minor unilateral amputation. HYPOTHESIS: The quality of life is likely to predict the psychological well-being, psychosocial adjustment and self-care in patients with type II diabetes, gone through initial unilateral minor amputation. RESEARCH DESIGN: Cross Sectional descriptive. METHODOLOGY: A sample of 200 patients with type II diabetes was taken; 100 with minor amputation and 100 without amputation. The age ranged between 40 to 60 years. A written informed consent was taken in addition to departmental permission to collect the data from indoor and outdoor units of three main hospitals of Lahore including Jinnah Hospital, Arif Diabetics and Mayo hospital, Lahore. The study was carried between Sep, 2015 to December, 2015. The major study constructs were measured by using Urdu translated measures including Diabetes Related Quality of Life Scale, Psychological Well-being Scale and Social Adjustment Scale- self report (SAS-SR); and Self-care Inventory. Regression analysis was carried out to assess the role of quality of life as significant predictor. RESULTS: The results revealed that quality of life emerged as significant positive predictor of psychological well-being, self-care and psychosocial adjustment in patients with diabetes who have gone through minor amputation. CONCLUSION: Quality of life is significant positive predictor and by enhancing the Perceived quality of life of patients with diabetes and minor amputation through psycho-education and counseling, the psychological well-being, psychosocial adjustment and self-case behaviors can be improved.

Adult Attachment, Social Adjustment, and Well-Being in Drug-Addicted Inpatients.

In recent years, attachment studies have gathered overwhelming evidence for a relation between insecure attachment and drug addiction. The existing literature predominantly addresses attachment styles and little attention is given to attachment-pattern-oriented studies. The current study explored how attachment, social adjustment, and well-being interact in 40 (28 men, 12 women; ages 20-52 years, M = 32.3, SD = 9.4) inpatients with drug addiction. The Adult Attachment Projective Picture System (AAP), the Social Adjustment Scale-Self-report (SAS-SR), and the General Health Questionnaire-28 (GHQ-28) were administered. Descriptive statistics were computed as well as differences between patterns of attachment in all variables were measured. None of the inpatients showed a secure attachment pattern: 7 scored as dismissing (18%), 5 preoccupied (12%) and 28 unresolved (70%). AAP stories were mainly connected with themes of danger, lack of protection, and helplessness. Inpatients classified as unresolved reported significantly higher maladjustment on the SAS-SR and GHQ-28 than those with resolved attachment patterns. Implications for clinicians and researchers are presented.

Aspects of quality of life in depression

IntroductionThe quality of life in patients with depression may be a measure of the efficiency of its management. Although quality of life is a subjective concept, difficult to assess, it may be reflected by the degree of social adaptation and the individual's level of functioning.ObjectiveThe study evaluates the time evolution of depressive symptoms and of some parameters attesting the quality of life in patients diagnosed with depression who are on antidepressant treatment.AimsHighlighting the evolution in time of depressive symptoms and patients’ perceptions on some aspects of quality of life.MethodsThere were included 23 patients who met the criteria of depressive episode, single or within recurrent depressive disorder, according to the International Classification of Diseases (ICD-10-AM), requiring antidepressant treatment. Subjects were evaluated at baseline and after 12 weeks of treatment using the Hamilton Rating Scale for Depression (HAMD), Sheehan disability scale (SDS), Social Adjustment Scale – Self-report (SASS).ResultsStatistically significant decrease in mean HAMD scores was observed in the second administration. There were registered statistically significant differences of scores obtained in the two administrations for the 17 items of the SASS scale. Correlations with statistical significance between HAMD scores and some of the SDS areas were observed.ConclusionsResults showed a favorable course of depressive symptoms while under treatment and differences in time of subjects’ perception on several aspects evaluated on SASS for the group studied. Correlations with statistical significance between HAMD scores and some SDS areas were observed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Do Personality Traits Predict Functional Impairment and Quality of Life in Adult ADHD? A Controlled Study

Objective: To examine the association of personality traits and characteristics on quality of life and functioning in adults with ADHD. Method: Participants were adults with (n = 206) and without ADHD (n = 123) who completed the Temperament and Character Inventory (TCI), the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), and the Social Adjustment Scale–Self-Report (SAS-SR). Participants also provided information on academic, motor vehicle operation, legal, social, familial, and occupational functioning. Outcomes were examined using stepwise linear regression, logistic regression (for binary outcomes), and negative binomial regression (for count outcomes) controlling for ADHD symptoms, psychiatric comorbidity, and executive dysfunction. Results: Adults with ADHD significantly differed from controls across nearly all TCI personality domains. On average, adults with ADHD endorsed more novelty seeking, harm avoidance, and self-transcendence, and less reward dependence, persistence, self-directedness, and cooperativeness. Personality traits and characteristics, especially self-directedness, significantly predicted functional impairments even after controlling for ADHD symptoms, executive function deficits, and current psychiatric comorbidities. Conclusion: In adults with ADHD, personality traits exert unique associations on quality of life and functional impairment across major life domains, beyond the relations expected of and associated with ADHD symptoms and other associated psychiatric conditions and cognitive vulnerabilities. Addressing personality traits in adults with ADHD may lead to improvements in quality of life and reductions in functional impairment.

Psychosocial distress and functioning of Greek youth with cystic fibrosis: a cross-sectional study.

BackgroundTo assess psychosocial functioning and distress of children and adolescents with cystic fibrosis compared to healthy controls.MethodsThirty-six patients with cystic fibrosis aged 8–18 years (24 boys, mean age ± SD: 11.5 ± 2.6 years) and 31 sex- and age-matched healthy control subjects (18 boys, mean age ± SD: 12 ± 2.5 years) were enrolled in the study. In order to assess the self-esteem, social adjustment, and family functioning of these young people, the Culture-free Self-esteem Inventory, the Social Adjustment Scale–Self-Report, and the Family Assessment Device were administered. Emotional/ behavioral problems were assessed through the Youth Self Report and the Child Behavior Checklist given to both the subjects and their parents.ResultsNo significant differences were found for self-esteem between the two study groups. Regarding social adjustment, children with cystic fibrosis reported significantly worse friendship and overall adjustment (P < 0.05). Moreover, no difference was found in the levels of family functioning between the two groups. No significant differences between the groups were found in emotional/ behavioral problems from the self-reports. On the contrary, parents of children with cystic fibrosis reported significantly higher levels of withdrawal/ depression, thought problems, and delinquent behavior (P ≤ 0.01) as compared to controls.ConclusionsChildren and adolescents with cystic fibrosis appear to be a psychosocially vulnerable group. A biopsychosocial approach should emphasize the assessment and treatment of the psychosocial distress of these patients alongside multiple somatic treatments.

Borderline Personality Disorder, Exposure to Interpersonal Trauma, and Psychiatric Comorbidity in Urban Primary Care Patients

Objective: Few data are available on interpersonal trauma as a risk factor for borderline personality disorder (BPD) and its psychiatric comorbidity in ethnic minority primary care populations. This study aimed to examine the relation between trauma exposure and BPD in low-income, predominantly Hispanic primary care patients. Method: Logistic regression was used to analyze data from structured clinical interviews and self-report measures (n = 474). BPD was assessed with the McLean screening scale. Trauma exposure was assessed with the Life Events Checklist (LEC); posttraumatic stress disorder (PTSD) was assessed with the Lifetime Composite International Diagnostic Interview, other psychiatric disorders with the SCID-I, and functional impairment with items from the Sheehan Disability Scale and Social Adjustment Scale Self-Report (SAS-SR). Results: Of the 57 (14%) patients screening positive for BPD, 83% reported a history of interpersonally traumatic events such as sexual and physical assault or abuse. While interpersonal trauma experienced during adulthood was as strongly associated with BPD as interpersonal trauma experienced during childhood, noninterpersonal trauma was associated with BPD only if it had occurred during childhood. The majority (91%) of patients screening positive for BPD met criteria for at least one current DSM-IV Axis I diagnosis and exhibited significant levels of functional impairment. Conclusion: Increased awareness of BPD in minority patients attending primary care clinics, high rates of exposure to interpersonal trauma, and elevated risk for psychiatric comorbidity in this population may enhance physicians' understanding, treatment, and referral of BPD patients.

The efficacy of interpersonal psychotherapy for depression among economically disadvantaged mothers.

A randomized clinical trial was conducted to evaluate the efficacy of interpersonal psychotherapy (IPT) for ethnically and racially diverse, economically disadvantaged women with major depressive disorder. Non-treatment-seeking urban women (N = 128; M age = 25.40, SD = 4.98) with infants were recruited from the community. Participants were at or below the poverty level: 59.4% were Black and 21.1% were Hispanic. Women were screened for depressive symptoms using the Center for Epidemiologic Studies Depression Scale; the Diagnostic Interview Schedule was used to confirm major depressive disorder diagnosis. Participants were randomized to individual IPT or enhanced community standard. Depressive symptoms were assessed before, after, and 8 months posttreatment with the Beck Depression Inventory-II and the Revised Hamilton Rating Scale for Depression. The Social Support Behaviors Scale, the Social Adjustment Scale-Self-Report, and the Perceived Stress Scale were administered to examine mediators of outcome at follow-up. Treatment effects were evaluated with a growth mixture model for randomized trials using complier-average causal effect estimation. Depressive symptoms trajectories from baseline through postintervention to follow-up showed significant decreases among the IPT group compared to the enhanced community standard group. Changes on the Perceived Stress Scale and the Social Support Behaviors Scale mediated sustained treatment outcome.

Towards the development of a gender‐sensitive measure of women's mental health

To develop a gender-sensitive measure of women's mental health and to evaluate the measure's psychometric properties. Mental health problems are a leading global burden of disease, and gender differences in the prevalence of these problems are well documented. Improving mental health is as important as resolving mental health problems. Although many mental health scales have been developed, few measure women's positive mental health from a gender perspective. Instrument development and psychometric evaluation were used. First, a new mental health scale (Women's Mental Health Scale) grounded in women's subjective experiences was formulated from the narratives of four female focus groups (n = 23). The new scale was evaluated using principal component analysis and internal consistency reliability in a sample of female participants (n = 106). Next, the Women's Mental Health Scale, the Chinese version of Beck Depression Inventory-II and Social Adjustment Scale Self-Report were used in a survey of female undergraduate students (n = 163) for examining the concurrent criterion-related validity. Finally, gender differences were examined by assessing the discriminated validity of the Women's Mental Health Scale in a sample of male and female undergraduate students (n = 357). All participants were recruited from communities and universities in middle and south Taiwan. A 50-item Women's Mental Health Scale with four concepts of self, interpersonal, family and social domains was developed. It revealed that the Women's Mental Health Scale had acceptable psychometric properties. There was a significant negative correlation between scores of the Women's Mental Health Scale and the Chinese version of Beck Depression Inventory-II and a significant positive correlation between scores of the Women's Mental Health Scale and Social Adjustment Scale Self-Report. There were significant gender differences in the family domain and social domain. Women reported greater mental health in the family domain and social domain than men. The Women's Mental Health Scale is a promising gender-sensitive tool to measure women's mental health. The Women's Mental Health Scale appears to be a gender-sensitive measure to assess the positive mental health potentials among women population.

Recognition of emotion from body language among patients with unipolar depression

Major depression may be associated with abnormal perception of emotions and impairment in social adaptation. Emotion recognition from body language and its possible implications to social adjustment have not been examined in patients with depression. Three groups of participants (51 with depression; 68 with history of depression in remission; and 69 never depressed healthy volunteers) were compared on static and dynamic tasks of emotion recognition from body language. Psychosocial adjustment was assessed using the Social Adjustment Scale Self-Report (SAS-SR). Participants with current depression showed reduced recognition accuracy for happy stimuli across tasks relative to remission and comparison participants. Participants with depression tended to show poorer psychosocial adaptation relative to remission and comparison groups. Correlations between perception accuracy of happiness and scores on the SAS-SR were largely not significant. These results indicate that depression is associated with reduced ability to appraise positive stimuli of emotional body language but emotion recognition performance is not tied to social adjustment. These alterations do not appear to be present in participants in remission suggesting state-like qualities.