Students’ Perceptions of School Climate During the Middle School Years: Associations with Trajectories of Psychological and Behavioral Adjustment

A cross-domain latent growth curve model was used to examine the trajectories of change in student perceptions of four critical dimensions of school climate (i.e., teacher support, peer support, student autonomy in the classroom, and clarity and consistency in school rules and regulations) among 1,451 early adolescents from the beginning of sixth through the end of eighth grade; and the effects of such trajectories on the rate of change in psychological and behavioral adjustment. Findings indicated that all of the dimensions of perceived school climate declined over the 3 years of middle school. Furthermore, declines in each of the dimensions of perceived school climate were associated with declines over time in psychological and behavioral adjustment. Moreover, the direction of effects between each dimension of perceived school climate and psychological or behavioral adjustment were often unidirectional rather than bi-directional, underscoring the role of perceived school climate in the psychological and behavioral health of early adolescents. Gender and socioeconomic class differences in these patterns are noted.     

Validity evidence of the Health-Related Quality of Life for Drug Abusers Test based on the Biaxial Model of Addiction

The aim of this work is to show evidence of the validity of the Health-Related Quality of Life for Drug Abusers Test (HRQoLDA Test). This test was developed to measure specific HRQoL for drugs abusers, within the theoretical addiction framework of the biaxial model. The sample comprised 138 patients diagnosed with opiate drug dependence. In this study, the following constructs and variables of the biaxial model were measured: severity of dependence, physical health status, psychological adjustment and substance consumption. Results indicate that the HRQoLDA Test scores are related to dependency and consumption-related problems. Multiple regression analysis reveals that HRQoL can be predicted from drug dependence, physical health status and psychological adjustment. These results contribute empirical evidence of the theoretical relationships established between HRQoL and the biaxial model, and they support the interpretation of the HRQoLDA Test to measure HRQoL in drug abusers, thus providing a test to measure this specific construct in this population.     

Determination of Weights for Health Related Quality of Life Indicators among Kidney Patients: A Fuzzy Decision Making Method

Health-Related Quality of Life (HRQoL) is one of the significant current discussions in the health fraternity. It encompasses multidimensional indicators and serves the purpose of evaluating health quality among patients. Patients’ perceptions of the impact of disease and treatment and the indicators such as physical, psychological, social function and well being are normally investigated. However there is no clear suggestion of which indicators contributed more than others. The arbitrary nature of HRQoL paves the way for fuzzy theory in evaluation of indicators. This paper describes the application of a fuzzy decision making method in ranking indicators of HRQoL among kidney patients. Four experts in health fraternity were selected as decision makers to elicit information regarding health related status of chronic kidney disease patients over eight HRQoL indicators. The decision makers were required to rate the regularity of experiencing health-related problems in linguistic judgment among the patients. The five linguistics variables were used as input data to a modified version of Fuzzy Simple Additive Weight decision making model. The modified six-step method was possible to tap the extent of decision makers’ opinions on the severity of HRQoL experienced by the patients. It is shown that the indicator of role-physical recorded the lowest problematic level while the indicator of mental health recorded the highest problematic level experienced by the patients. The ranking signifies the impact of the indicators to health quality specifically the chronic kidney disease patients.     

Depression Moderates the Relationship between Body Image and Health-Related Quality of Life in Adolescent Girls

Body image can predict health-related quality of life (HRQoL) in adolescent girls through self-esteem and psychological well-being. Additionally, depression is a significant predictor of adolescents’ HRQoL and is associated with body image. Therefore, we investigated whether the relationship between body image and HRQoL in adolescent girls is moderated by depression. In this cross-sectional study, adolescent girls’ body image, depression, and HRQoL (n?=?385, age: 12–15 years) were measured through self-report questionnaires. Multiple regression and simple slope analyses were conducted to examine the moderating effect of depression. Body image was positively correlated with HRQoL, whereas depression was negatively correlated with body image and HRQoL. Body image, depression, and their interaction explained 44.9% of the variance in HRQoL. Simple slope analysis showed that a more positive body image was associated with higher HRQoL among adolescent girls without depressive symptoms, but was not significantly related to HRQoL for adolescents with depressive symptoms. The moderating effect of depression was confirmed. In conclusion, screening for depression is recommended for adolescent girls prior to implementing body image interventions in schools and the community that are aimed at improving HRQoL. Furthermore, health care providers in schools and the community should provide psychological support for depression along with body image interventions to improve the HRQoL of girls in schools and the community. In particular, for girls with depressive symptoms, depression management should be conducted beforehand.     

Social support as a multifaceted concept: Examination of important dimensions for adjustment

Four commonly used operationalizations of the social support concept: network contact frequency, satisfaction with support (including nine dimensions), perceived availability of support, and use of support, were related to two measures of psychological adjustment (Beck Depression Inventory and Symptom Checklist-90) and to one measure of physical adjustment (Cornell Medical Index). Subjects were 68 45- to 85-year-old, highly stressed care-givers to spouses with Alzheimer's disease. Results indicate that of the four operationalizations, Satisfaction with Support was the only significant predictor of depression and general psychopathology. The set of four support variables showed the strongest relationship to depression level, next strongest to general psychopathology, and least to physical health. The satisfaction with nine social support dimensions related differentially to the types of adjustment. Results suggest the importance of specificity (sample, support operationalization, dimensions, adjustment measures) in social support research.     

L’enfance et l’adolescence in situ : facteurs environnementaux facilitateurs et inhibiteurs de troubles cognitifs et comportementaux

The definition of mental health associates three fundamental variables: biological variables, psychological variables and environmental variables. In this article, we will focus on environmental variables that inhibit and facilitate cognitive and behavioural disorders in childhood and adolescence. Environmental psychology considers the interrelations between human and environment in its spatial, social and chronological dimensions and considers it as a characterized and undissociated system. We will bring to mind social and physical environmental variables with which children and adolescents interact frequently and, through a literature review, we will enlighten environmental variables that are susceptible to induce behavioural disorders and psychological variables that modulate children's and adolescent's relations to environment. We then suggest possible outcomes of this approach in clinical practice as well as in terms of therapeutic applications in child psychology and psychiatry. Finally, we evoke the necessity of taking in account neurobiological fields in order to outline a model of human development integrating the three variables that define mental health.     

Treating Primary Insomnia: Clinical Effectiveness and Predictors of Outcomes on Sleep,Daytime Function and Health-Related Quality of Life

Primary insomnia, as defined by DSM-IV-TR, refers to a persistent sleep disturbance which is not connected to a current psychiatric or physical condition, but significantly impairs social and occupational functioning. This study explored the impact of Cognitive Behavioral Therapy for Insomnia (CBT-i) on sleep, daytime functioning and health-related quality of life (HRQoL). Next, we investigated which factors predicted positive treatment outcome by examining demographics, insomnia characteristics, baseline levels of daytime function, HRQoL, sleep-disruptive beliefs and psychological health on post-treatment sleep quality, daytime function and HRQoL. 138 consecutive primary insomnia patients completed questionnaires pre- and post-treatment and at 6 months follow-up. After CBT-i, robust clinical improvements were observed in sleep, daytime function and HRQoL, regardless of age, gender, type or duration of the complaint. Patients with pre-treatment severe insomnia, pronounced daytime impairment and low psychological well-being benefited most.     

Family Cohesion and Health-Related Quality of Life of Children with Type 1 Diabetes: The Mediating Role of Parental Adjustment

Despite the increasing number of studies on the health-related quality of life (HRQOL) of children with type 1 diabetes (T1D), little is known about the influence of family and parental factors on this outcome. This study aimed to explore whether family cohesion and children’s HRQOL were connected through three indicators of parental psychological adjustment (parenting stress, depressive symptoms, and anxious symptoms) as well as whether these links varied according to the child’s age. Levels of family cohesion, parenting stress, and depression/anxiety symptoms of parents of children with T1D and parents of healthy children were compared. The sample included 88 child–parent dyads composed of children/adolescents (8–18 years old) with T1D and one of their parents and 121 dyads composed of healthy children/adolescents and one of their parents. The parents completed self-report measures of family cohesion, parenting stress, and emotional adjustment, and the children completed measures of HRQOL. Testing of the hypothesized moderated mediational model showed that higher HRQOL ratings in children were associated with higher levels of cohesion through lower levels of parental stress, regardless of the child’s age. Parents of children with T1D perceived less cohesion and felt more anxiety and stress about parenting tasks compared to parents of healthy children. Our findings suggest that parents of children with T1D are at an increased risk of psychological maladjustment. Moreover, this study highlights the interrelation between family/parental functioning and child adjustment and makes an innovative contribution by identifying a mechanism that may account for the link between family and child variables.     

Justification of violence beliefs and social problem-solving as mediators between maltreatment and behavior problems in adolescents

This study examined whether justification of violence beliefs and social problem solving mediated between maltreatment experiences and aggressive and delinquent behavior in adolescents. Data were collected on 191 maltreated and 546 nonmaltreated adolescents (ages 14 to 17 years), who completed measures of justification of violence beliefs, social problem-solving dimensions (problem orientation, and impulsivity/carelessness style), and psychological problems. Findings indicated that maltreated adolescents' higher levels of delinquent and aggressive behavior were partially accounted for by justification of violence beliefs, and that their higher levels of depressive symptoms were partially mediated by a more negative orientation to social problem-solving. Comparisons between boys and girls indicated that the model linking maltreatment, cognitive variables, and psychological problems was invariant.     

Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy white women.

This preliminary study compared the associations between objective and subjective socioeconomic status (SES) with psychological and physical variables among 157 healthy White women, 59 of whom subsequently participated in a laboratory stress study. Compared with objective indicators, subjective social status was more consistently and strongly related to psychological functioning and health-related factors (self-rated health, heart rate, sleep latency, body fat distribution, and cortisol habituation to repeated stress). Most associations remained significant even after controlling for objective social status and negative affectivity. Results suggest that, in this sample with a moderately restricted range on SES and health, psychological perceptions of social status may be contributing to the SES-health gradient.     

Body image of children and adolescents with cancer: A systematic review

We report a systematic literature review to identify (1) differences in body image (BI) between children and adolescents with cancer and healthy controls; (2) relationships between BI and demographic or medical variables; (3) implications of BI for psychological adjustment; and (4) relationship between BI and social support. Thirty-two studies were identified from computerized databases including BNI (1985-March, 2008), CINAHL (1982-March, 2008), MEDLINE (1950-March, 2008), PsychInfo (1806-March, 2008), and PubMed (1950-March, 2008). There was no consistent evidence regarding BI differences between children and adolescents with cancer and healthy controls. Relations between BI and gender, disease characteristics, and psychological adjustment were found. Changes in BI have adverse implications for self-esteem and adjustment, but can be moderated by social support. Future research should also adopt broader definitions of BI, and cancer-specific age-appropriate BI measures are needed to increase sensitivity of this work.     

Optimism,appraisals, and coping in the adjustment of mothers and their children with spina bifida

Families of children with physical disabilities show substantial differences in the levels of adjustment of both the children and their parents. These differences result, in part, from the complex interplay of family and child adaptation resources, such as coping and social support. In order to identify factors which may differentiate levels of adjustment among families with children with physical disabilities, this study examined relationships among optimism, primary and secondary appraisals of and coping with child-related stressors, maternal psychological adjustment, and child adjustment in 29 families with a child with spina bifida without mental retardation and 28 comparison families with a nondisabled child. For the spina bifida group, primary appraisals were related to the use of avoidant coping strategies, and these coping strategies were related to maternal psychological adjustment and child internalizing behavior problems. No significant differences between the groups in terms of the nature of the relationships or in the levels of the variables were found with the exception that mothers of children with spina bifida were less optimistic than comparison mothers. These data support the importance of coping in understanding the psychological adjustment of mothers faced with a chronic stressor in the family.     

Individual and parental factors related to meaning in life among Hungarian minority adolescents from Romania

Understanding how adolescents achieve meaning in life has important implications for their psychological development. A social cognitive model of meaning development was tested by assessing psychological (self‐efficacy, self‐regulation and social comparison) and parental (parental responsiveness, demandingness, and social support) variables in a sample of 1944 adolescents (aged 15–19 years; 47.8% males) from secondary schools of the Middle Transylvanian Region, Romania. Both psychological and parental factors were significantly related to meaning in life. For both boys and girls, self‐efficacy, self‐regulation, and maternal responsiveness related positively with meaning in life, and paternal demandingness related inversely to meaning in life. However, social comparison related positively to meaning only among boys, and paternal responsiveness related positively to meaning only among girls. Results point to a possible meaning‐supporting role played by social cognitive variables, as well as parental autonomy support. The gender differences observed here suggest that existing theories of meaning development may need to be elaborated to include family of origin and gender.     

Predictors of Health-Related Quality of Life over Time Among Adolescents and Young Adults with Sickle Cell Disease

Little is known about what factors affect the health-related quality of life (HRQoL) of adolescents and young adults (AYAs) with sickle cell disease (SCD), and how their HRQoL changes over time. This retrospective study included 87 AYAs attending a SCD Adolescent Clinic who completed a measure of HRQoL at each visit over the course of approximately 1.3 years. Results suggested that the following were associated with poorer physical HRQoL: being female, more healthcare utilization events, and presence of internalizing symptoms. Internalizing and externalizing symptoms were the only factors correlated with poorer psychosocial HRQoL. Generalized linear mixed models indicated that physical and psychosocial HRQoL improved among all participants during the assessment period, and those with externalizing behaviors reported faster improvement in physical HRQoL over time. AYAs with SCD may benefit from early mental health screening and intervention to optimize clinical care.     

Diabetes mellitus as a model of psychosomatic and somatopsychic interrelationships

The article reviews research on the problem of interrelationship between different physical and psychosocial factors in type 1 diabetes mellitus (DM1). The authors consider methodological principles of health-related quality of life (HRQoL) assessment in DM1 patients and stress the need for an integrated biopsychosocial approach to the management of the disease. DM1 is a chronic metabolic disease with an absolute requirement for insulin replacement therapy. The stress-inducing nature of DM1 is associated with its unexpected and dramatic manifestation in juvenile years, life-threatening nature of severe hypo-/hyperglycaemias and long-term complications, with the burden of diabetes self-management, threat of work disability, employment and career problems etc. These features of DM1 increase the likelihood of the development of anxiety and depressive disorders, which, in turn, may negatively influence the course of diabetes and in particular, diabetes self-care. This necessitates early diagnosis of emotional and behavioral disturbances in DM1 using self-report instruments as well as clinical assessment. Evidence suggests that active problem-focused coping behavior and adequate social support promote adherence to diabetes regimes and may act as a buffer against negative effects of the disease on HRQoL in DM1 patients. The core element in the HRQoL structure is personal disease picture (as opposed by objective clinical picture)--the cognitive-affective-behavioral complex reflecting the patient's personal perception of the disease. Examination of the personal disease picture and attitude towards the ailment in DM1 patients may help to improve understanding of the mechanisms of poor adjustment. Problems in disease adjustment can be detected also by diabetes-specific HRQoL assessment. The measures of HRQoL can be applied as screening instruments useful in increasing the effectiveness of patient-provider interactions and diabetes care.     

Speech and Language Difficulties Along with Other Child and Family Factors Associated with Health Related Quality of Life of Australian Children

Speech and/or language difficulties (SaLD) can potentially compromise a child’s health-related quality-of-life (HRQoL). Very few studies have examined associations between SaLD, other child and family factors and HRQoL and none have been undertaken in Australia. We explore these associations using data from a nationally representative Australian sample of 4–5 year old children, extracted from the Longitudinal Study of Australian Children (LSAC) (n?=?4386). The Disability-Stress-Coping Model informed variable selection. Three domains of HRQoL were examined, and assessed on physical, emotional and social functioning subscales of the Pediatric Quality of Life Inventory (PedsQL). SaLD measures included parent concern about speech/language (Parents’ Evaluation of Developmental Status) and receptive vocabulary ability (adapted Peabody Picture Vocabulary Test-III). Multiple regression analyses revealed that various child and family factors representing all constructs from the Disability-Stress-Coping Model were significantly associated with HRQoL. Specifically, HRQoL was positively associated with parental warmth and child’s general health and negatively associated with parent speech/language concerns and maternal depression across all domains. Parents with concerns about their pre-school child’s speech and language rate the quality of their child’s health more poorly across physical, emotional and social domains. Associations between parent speech/language concerns and HRQoL were notable for being apparent in a (non-clinical) population sample and for persisting independent of factors such as maternal depression, parenting style and the child’s general health.     

Psychosocial Factors Associated with Quality of Life Among Individuals Attending Genetic Counseling for Hereditary Cancer

The aim of this multicenter study was to explore associations between psychosocial factors (general self-efficacy, perceived availability of social support, cancer-related distress) and health-related quality of life, among individuals at risk for hereditary cancer. One-hundred and twenty one participants with a family history of breast-cancer or colorectal cancer answered a questionnaire 2-4 weeks prior to genetic counseling. The two dimensions of the health-related quality of life measure, mental and physical health were both used as outcome variables. Multiple regression (linear) analyses revealed that increasing degrees of cancer-related distress was related to decreasing degrees of mental health whereas increasing degrees of self-efficacy and social support were related to increasing degrees of this outcome variable. Self-efficacy, self-esteem support and tangible aid seemed to moderate the relationship between cancer-related distress and mental health. These results suggest that self-efficacy and certain resources of social support buffer the negative association between cancer-related distress and mental health, and might be suitable for interventional efforts. Implications for genetic counseling practice are discussed.     

Cross-sectional and longitudinal relations among peer-reported trustworthiness, social relationships, and psychological adjustment in children and early adolescents from the United Kingdom and Canada

Trustworthiness was examined in children and early adolescents from two countries. In Study 1,505 children in the fifth and sixth school years in the United Kingdom (mean age = 9 years 7 months) were tested across an 8-month period. In Study 2,350 sixth- through eighth-grade Canadian children and early adolescents (mean age = 12 years 11 months) were tested across a 1-year period. Participants completed measures assessing trustworthiness (ratings of promise and secret keeping by peer group and also by best friend in Study 1), assertiveness (Study 1), prosocial behavior (Study 2), social relationships (friendships and peer preference), and psychological adjustment (self-esteem, depressive symptoms, and loneliness). Peer-reported trustworthiness was positively associated with, and predicted changes across time in, the number of friendships. The observed relations were found to be statistically independent of peer preference and peer-reported assertiveness or prosocial behavior. Trustworthiness was found to be positively associated with peer preference (Study 1 and Study 2) and psychological adjustment (Study 1).     

The relationship between anxiety sensitivity and latent symptoms of emotional problems: A structural equation modeling approach

A large body of research suggests that common and specific psychopathology dimensions underlie the symptoms that occur within mood and anxiety disorders. As of yet, it is unclear precisely how the facets of Anxiety Sensitivity (AS), or fear of the symptoms of fear and anxiety, relate to these latent factors. Using data from 606 adolescents participating in the baseline phase of a longitudinal study on risk factors for emotional disorders, we modeled the facets of AS as measured by the Anxiety Sensitivity Index-Expanded Form (ASI-X) and related these facets to a hierarchical model of latent symptoms of psychological distress. Results suggest that one facet of AS is associated with a broad General Distress factor underlying symptoms of most emotional disorders while others relate to intermediate-level and conceptually-meaningful narrow factors representing aspects of psychological distress specific to particular emotional disorders.     

Predictors of Psychological Well-Being of Adolescents’ Parents

Informed by theories about processes in families with adolescent children, this study examined the contribution of self-perceived decline in physical and cognitive functioning related to midlife, marital satisfaction, and parent–child conflict to psychological well-being of parents of young adolescents. Parental well-being was conceptualized within Ryff’s multidimensional model, which encompasses six dimensions: Autonomy, Self-Acceptance, Environmental Mastery, Positive Relationships with Others, Personal Growth, and Purpose in Life. In examining relationships between parental well-being and supposed predictors, sociodemographic variables (parental age and education), perceived general life stress, and perceived available social support were controlled for. Participants were Croatian mothers (N?=?356) and fathers (N?=?328) whose oldest child was transitioning to adolescence. Overall, the patterns of associations between the studied predictors and well-being dimensions were similar for mothers and fathers. The main finding of the study was that individual differences in the psychological well-being of adolescents’ parents may be more attributable to self-perceived midlife changes (particularly for mothers) and marital satisfaction (particularly for fathers) than to perceived level of parent–adolescent conflict.