Adaptation to juvenile rheumatic disease: a controlled evaluation of functional disability with a one-year follow-up.

Compared the adaptation of 165 patients with juvenile rheumatic disease (JRD) to that of their healthy siblings. Patients were divided into those with mild functional disability and those with moderate/severe disability. Adaptation in several domains was assessed by parents and children on two occasions 1 year apart. The adjustment difficulties of the JRD children were limited primarily to social functioning but appeared also in the psychological and family problems domains. Compared to "mild" patients, "moderate/severe" patients had more adjustment difficulties; in some areas, mild patients functioned as well as their healthy siblings. Some Time 1 differences were replicated at Time 2. The results help to delineate (a) the specific domains in which children with chronic disease have adjustment difficulties and (b) the factors that put children at risk for developing adjustment problems.     

Psychosocial adaptation to spinal cord injury: a dimensional perspective

From 313 individuals who sustained spinal cord injuries self-reported responses were examined on their psychosocial adaptation to disability and perceived quality of life. A multidimensional scaling analysis yielded a 2-dimensional structure of adaptation. The first dimension indicated adaptive versus nonadaptive reactions. The second dimension was suggestive of denial versus realization of the affect related to the medical impairment.     

Psychosocial adaptation in relatives of critically injured patients admitted to an intensive care unit

The aim of this study is to analyze how the length of time a patient spends in an Intensive Care Unit (ICU) affects close relatives, with regard to specific clinical variables of personality, family relationships and fear of death. The study group consisted of 57 relatives of seriously ill patients admitted to the ICU of "Virgen del Rocío" Rehabilitation and Trauma Hospital (Seville, Spain). The instruments applied were: a psychosocial questionnaire, clinical analysis questionnaire, family environment scale and fear of death scale. The relatives of patients admitted to ICU obtained higher scores in hypochondria, suicidal depression, agitation, anxious depression, guilt-resentment, paranoia, psychasthenia, psychological maladjustment and self-expression, and less in fear of their own death, as when compared to interviews with the same relatives 4 years later. The length of time a patient spent in the ICU influenced relatives in some clinical variables of personality, family relationships and fear of death     

Psychosocial outcomes in later life: a multivariate model

A conceptual model was developed to identify developmental self-regulatory pathways to optimal psychosocial outcomes in adulthood. The model delineates influences among age, possible selves, developmental processes (i.e., coping, control), and well-being. Results showed age effects on all constructs except selective control. Three consistently common predictors of well-being (i.e., goal pursuit, goal adjustment, and optimization) emerged. The effects of age on well-being were differentially mediated by developmental processes. Specifically, negative age-related changes in offensive processes (i.e., goal attainment) were offset by positive influences of defensive processes (i.e., goal adjustment), which had the net effect of preserving well-being. The model demonstrates a more optimistic pattern of aging in which gains offset losses leading to positive outcomes and highlights the importance of examining both independent and combined influences of age, self, and developmental processes on psychosocial outcomes.     

Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial

The aim of this study was to investigate the effect of mindfulness-based stress reduction (MBSR) for patients with heterogeneous anxiety disorders. Seventy-six self-referred patients were randomized to MBSR or a waiting-list control condition. Eight participants did not complete the eight-week MBSR intervention. Treatment completers improved significantly on all outcome measures compared to controls. The completer sample showed medium to large effect sizes on measures of anxiety (Cohen’s d = 0.55–0.97), and a large effect size for symptoms of depression (Cohen’s d = 0.97). Intention-to-treat analyses yielded effect sizes in the small to moderate range (Cohen’s d = 0.32–0.76). Gains were maintained at six months follow-up. The percentage of participants reaching recovered status was highest for symptom measures of depression and anxiety, and lower for worry and trait anxiety. Mediation analyses indicated that mindfulness fully mediated changes in acute anxiety symptoms, and partially mediated changes in worry and trait anxiety. However, the present study did not find evidence of temporal precedence for the proposed mediator. In the absence of true mediation and an active control condition, it cannot be ruled out that results are due to non-specific aspects of treatment. Despite these and other limitations, we conclude that MBSR is an effective treatment for anxiety disorders and related symptomatology.     

Infant-mother attachment can be improved through group intervention: a preliminary evaluation in Spain in a non-randomized controlled trial

The quality of infant-mother attachment has been linked to competence in different domains of child development. Research indicates that early intervention can enhance the quality of infant-mother attachment, though its efficacy in a group format has yet to be evaluated. The current study is aimed at examining the usefulness of a group intervention in enhancing infant-mother attachment. An intervention aimed at addressing aspects such as maternal responsivity, sensitivity and childrearing behaviour was developed by the researchers and experienced psychologists. The intervention spanned a period of 14 months starting from the third quarter of pregnancy. The intervention was evaluated among 24 mothers from the Basque region of Spain. The sample consisted of children of both genders in a similar proportion: 45.8% were boys and 54.2% were girls. The children in this sample were full-term born and did not present symptoms of any serious pre- or postnatal complications. The intervention had a statistically non-significant medium effect. Infants whose mothers had received the intervention showed higher rates of secure attachment compared to children from the control group, as assessed by the Strange Situation observation procedure. A potentially significant confounding variable, maternal attachment, was balanced across the intervention and comparison groups. We can tentatively point out that a group intervention may enhance the quality of infant-mother attachment. Nevertheless, because the study design was not randomized, the results of this study remain preliminary and need replication in a full randomized controlled trial designed study.     

Psychosocial forces and neural mechanisms in disease: Defining the question and collecting the evidence

Adapted from the Samuel Novey Lecture in Psychological Medicine, The Johns Hopkins University School of Medicine, November 12, 1981.     

Psychosocial development in adulthood: a 22-year sequential study.

Data supporting the notion of adult personality stability are challenged by the present findings, in which developmental change was demonstrated using the Eriksonian-stage-based Inventory of Psychosocial Development (IPD; Constantinople, 1969). A sequential design over the ages 20-42 was used on 2 cohorts of college students and alumni originally tested in 1966 and 1976-1977 (ns in 1988 = 99 and 83, respectively), and a 3rd cohort of college students in 1988-1989 (n = 292). Results of longitudinal, cross-sectional, and sequential analyses challenged ideas about personality stability, with evidence of increasingly favorable resolutions of the early Eriksonian psychosocial stages up through the oldest age studied. There was evidence of a trend over the past decade toward less favorable resolution of ego integrity versus despair. The findings were interpreted in terms of developmental change processes during the adult years interacting with culturally based environmental effects on psychosocial development.     

Response preparation in Parkinson's disease: automatic vs. controlled processing

Using a finger cuing paradigm, we investigated response preparation in Parkinson's disease (PD). The central question was whether PD individuals are differentially affected by preparatory cues that specify a more automatic response set configuration (that induces within-hand preparation) as opposed to a more controlled one (that induces between-hands preparation). Reaction times (RTs) and error rates were measured in 20 non-demented individuals with PD and 20 healthy control participants with a long and short preparation interval (500 ms and 2000 ms). RT benefits and/or costs were measured for cues indicating a within- and between-hands motor preparatory set. Overall, RTs were significantly longer, and errors more frequent, for PD participants than for control participants. More importantly, in comparison with control subjects, PD individuals showed a significant deficit in between-hands preparation but not in within-hand preparation. Furthermore, longer preparation intervals slowed down cued RTs of the control participants, but not those of the PD individuals. Together, these findings suggest that whereas automatic response preparation processes are spared in PD, controlled response preparation processes operate at a slower rate and/or are delayed in time.     

Redundancy: a similar principle in independent adaptation techniques

The present study examined the similarities between four auditory adaptation techniques to determine whether the effects were correlated. The four adaptation techniques compared were: Simultaneous Dichotic Loudness Balance technique (SDLB; Hood, 1950), Magnitude Estimated Binaural technique (MEB; Botté, Canévet, & Scharf, 1982), Magnitude Estimated Monaural technique, (MEM; Weiler, Sandman, & Pederson, 1981), and the Monaural Reaction Time technique (RT; Davis & Weiler, 1976). Results did not show significant correlations between the four techniques, except (r = 0.39) between MEB and MEM procedures. This correlation was much less than the reliability of the measures would allow (r = 0.98 and r = 0.99, respectively). Thus, it appears that the different methods either produced different adaptation effects or measured different aspects of auditory adaptation. The normal ear apparently shows several forms of adaptation, which reduces the perceptual strength of a continuing stimulus, in favor of an intermittent, less redundant one.     

Keeping juvenile delinquents in school: a prediction model

The purpose of this study was to test an empirically based prediction model of school dropout on a sample of 137 juvenile delinquents, some who have dropped out and some who have remained in school. The specific factors among the many found in previous research that are salient for predicting whether delinquent youths will drop out or remain in school were determined. An important finding of this study is that it required only four factors to yield a high level of prediction: misbehavior in school, disliking school, the negative influence of peers with respect to dropping out and getting into trouble, and a marginal or weak relationship with parents. The four factors identified create a model that is directly applicable to prevention strategies and is extremely parsimonious.     

Alienation: a cause of juvenile delinquency

This research investigated differences in levels of alienation between incarcerated (n = 157) and nonincarcerated (n = 1,318) adolescents. It was hypothesized that incarcerated adolescents would have significantly higher levels of isolation, normlessness, powerlessness, and total alienation than would nonincarcerated adolescents. The Dean Alienation Scale, a global measure of alienation, was administered to all subjects. Results indicated that incarcerated adolescents had significantly higher levels of total alienation, isolation, and powerlessness. Given the high rates of recidivism, these results suggest that the reduction of both alienation and rejection of societal norms should be a major component of rehabilitation programs for incarcerated juvenile delinquents.     

Innovation and adaptation in a Turkish sample: a preliminary study

The aim of this study was to examine the representations of adaptation and innovation among adults in Turkey. Semi-structured interviews were carried out with a sample of 20 Turkish adults (10 men, 10 women) from various occupations. The participants' ages ranged from 21 to 58 years. Results of content analysis showed that the representation of innovation varied with the type of context. Innovation was not preferred within the family and interpersonal relationship contexts, whereas it was relatively more readily welcomed within the contexts of work, science, and technology. This finding may indicate that the concept of innovation that is assimilated in traditional Turkish culture has limits. Contents of the interviews were also analyzed with respect to M. J. Kirton's (1976) subscales of originality, efficiency, and rule-group conformity. The participants favored efficient innovators, whereas they thought that the risk of failure was high in cases of inefficient innovation. The reasons for and indications of the representations of innovativeness among Turkish people are discussed in relation to their social structure and cultural expectations.     

Reversing the Trend: a Psychosocial Intervention on Young Immigrants in Sicily

Intervention projects based on providing support for immigrants can offer a number of benefits with regard to the social inclusion of young immigrants. Therefore, the actions suggested in this proposal may not only create a network between institutions and the private sector capable of supporting the intervention of a host country, but may also help to reduce the risk of crime as well as advocating a sense of otherness and integration. The approach to the project, a psychosocial intervention carried out on four young Africans who reached Sicily after crossing the Sicilian Channel on a dilapidated boat, has chiefly been to provide the four individuals with the chance to revisit their original, harrowing voyage, thus allowing them to view the voyage not only as a source of pain and death but also as a source of well-being and mutual understanding. Positive outcomes from the intervention include the satisfaction of the participants and a greater sensitivity towards each other, an awareness of the importance of rules, free time monitoring through utterances, and finally, photographic images for the resulting awareness raising event. The intervention, the only one carried out in Sicilian territory, culminated in the organization of a social visibility day, an event designed to advocate the involvement of local communities and young people. Further, the public event also aimed to raise awareness among the host community to the needs of immigrants, while contributing to discussion on hostile attitudes and closure towards immigrants.     

Psychosocial approaches to smoking prevention: a review of findings

Twenty-seven school-based studies of psychosocial approaches to smoking prevention are reviewed. Two major approaches are represented: the "social influences" approach and the broader "life/social skills" approaches. The research studies are considered in four "generations": the seminal work by Richard Evans and colleagues at the University of Houston; seven "pilot" studies of improved programs at Stanford, Minnesota, New York, and Washington, with one school or classroom per experimental condition; twelve improved "prototype" studies by these four groups and others, with two or three units randomly assigned to conditions; and six studies in which maximizing internal validity was of prime concern. Reported results were fairly consistent, with each tested program seeming to reduce smoking onset by about 50%. However, none of the pilot or prototype studies considered alone provided easily interpreted results. The major contributions were improved programs and methods. The findings from the fourth generation of studies were more easily interpreted, though only two of them were interpreted with high confidence. It seems that psychosocial approaches to smoking prevention, particularly the social influences approach--fourth generation tests of the broader life/social skills approaches have yet to be reported--are effective, but at this time we know very little about why, for whom, or under what conditions. Suggestions are provided for improved future research.     

Psychosocial enhancement of immunocompetence in a geriatric population

This study assessed the enhancement of immunocompetence by relaxation and social contact in 45 geriatric residents of independent-living facilities. Subjects were randomly assigned to one of three protocols: relaxation training, social contact, or no contact. Subjects in the relaxation and social-contact conditions were seen individually three times a week for a month. Blood samples and self-report data were obtained at baseline, at the end of the intervention, and at a 1-month follow-up. At the end of the intervention, the relaxation group showed a significant increase in natural killer cell activity, and significant decreases in antibody titers to Herpes simplex virus and self-rated distress; the other two groups showed nonsignificant changes. There was a general increase in the T-lymphocyte response to phytohemagglutinin stimulation at the end of the intervention, with greater change at lower mitogen concentrations. These data suggest that cellular immunocompetence may be enhanced by psychosocial interventions.