Psychosocial correlates of eczema in a non-treatment-seeking population

Data from the Vietnam Experience Study were used to examine psychosocial correlates of eczema. Based upon the results of dermatologic examinations, three groups of male veterans were identified: (a) subjects with eczema (n = 80), (b) subjects with tinea (n = 282), and (c) subjects with no medical diagnosis (n = 176). These three groups were compared on measures of anxiety, depression, hostility, and social support. The Diagnostic Interview Schedule (Version III-A) was used to determine diagnoses of anxiety and depression and level of social support. MMPI Scales 2 and 7, the Wiggins content scale of Depression, and the Cook-Medley Hostility Scale were used to assess anxiety, depression, and hostility. Eczema subjects did not differ from tinea or no-disease control groups on dependent measures. These results are contrasted with previous studies of treatment-seeking patients, which showed greater prevalence of anxiety and depression among individuals with eczema. Directions for future research are suggested.This paper is taken from the first author's dissertation.     

The impact of defibrillator discharges on psychological functioning of implantable cardioverter defibrillator recipients

A lag exists with respect to our understanding of the psychological demands and rehabilitation needs of individuals who have undergone implantable cardioverter defibrillator (ICD) implantation. The ICD is designed to transmit an electric shock to the heart to treat a potentially life-threatening arrhythmia. This study specifically examined the impact of defibrillator discharges on the psychological functioning of ICD recipients. A questionnaire was self-administered to 33 individuals who have been living with the ICD for at least 6 months. Results revealed that levels of anger and depression were significantly higher in those subjects who reported a lower discharge rate, while sense of well-being was significantly higher in those subjects who reported a greater discharge rate. Possible explanations for our findings were proposed as well as implications for clinical intervention were discussed.     

Social support and psychosocial competence: Explaining the adaptation to college of ethnically diverse students

Examined relationships among social support, psychosocial competence, and adaptation to college in a sample of 357 African American, Asian American, Latino, and white college students. Social support and active coping were significant predictors of adaptation to college, whereas locus of control was not. However, there was an interaction between ethnicity and locus of control indicating that although internal African American, Latino, and white students had higher adaptation-to-college scores than external students, the opposite was true for Asian Americans. The relationships among social support, internality, and active coping were also explored. Satisfaction with social support and internality were positively related to active coping, but locus of control and social support were unrelated. Active coping and internality were significantly related to each other for all groups except for African Americans. Although most relationships were the same across groups, these findings call attention to the role of ethnicity as a moderator of college adjustment processes.     

MEDIATING ROLE OF MATERNAL SENSITIVITY: ENHANCING LANGUAGE DEVELOPMENT IN AT‐RISK FAMILIES

Home‐visiting programs have gained increasing importance in family‐centered prevention and intervention. However, few studies have examined the mechanisms underlying early intervention treatment effects. The goal of this study is to analyze the mediating role of maternal sensitivity in enhancing language development with the home‐visiting program Parents as Teachers (PAT). Data were collected and analyzed within the ongoing, long‐term ZEPPELIN study, a randomized controlled trial with 251 participating at‐risk families. Via longitudinal mediation analysis, we examined whether effects of the PAT on receptive and expressive language outcomes at 24 and 36 months were mediated by maternal sensitivity at 12 months. Within a moderated mediation framework, we investigated whether the level of family psychosocial stress affects this mediation. Results showed that intervention effects on language outcomes are mediated by maternal sensitivity—weakly and through specific pathways. Moderation and moderated mediation analyses indicated that effects of the PAT and also specific mediation effects increase with the level of psychosocial stress. Implications of the results for practice are discussed.     

Life stories managing chronic illness: Young adults’ lived experiences with type 1 diabetes

This study aimed to characterise diabetes management experiences of South African young adults living with well-controlled type 1 diabetes (n = 8, female = 5, male = 3, age range = 20–25). The young adults told life stories managing their type 1 diabetes. Thematic analysis revealed the young adults to construct personal identities as people living with type 1 diabetes, to mostly utilise emotion-focused management strategies and social support for successful living with type 1 diabetes. Behavioural health strategies appear important for living well with this chronic insulin deficiency condition.     

Responding to Disaster-Related Loss and Grief: Recovering From the 2013 Flood in Southern Alberta,Canada

Applying a loss and grief perspective, this article explores lived experiences and perceptions of social workers and human service professionals who provided psychosocial supports and services to children, youth, and families recovering from the 2013 flood in southern Alberta, Canada. Five interrelated themes emerged from the analysis: (a) challenges with providing services while experiencing personal loss; (b) lack of funding for long-term postdisaster psychosocial recovery; (c) parenting in the context of disaster-related loss; (d) children’s and youth’s experiences of disaster-related loss and grief; and (e) the impact of the flood on family socioeconomic status. Recommendations for research, education and practice are discussed.     

Psychosocial Adaptation to Chronic Illness and Disability: A Preliminary Study of its Factorial Structure

This study examined the factorial structure of psychosocial adaptation to chronic illness and disability in a sample of 313 individuals who sustained spinal cord injury (SCI). Three models were examined. The first model tested the hypothesis that psychosocial adaptation is composed of a single, global factor, in which positive (adaptive) and negative (nonadaptive) reactions define two opposing poles of the same dimension. The second model tested the validity of two distinguishable factors, representing adaptive and nonadaptive dimensions. The third model examined the relationship between the 2-factor model and a third dimension, that of denial. The data from the instruments measuring psychosocial adaptation to trauma and disability (the Reactions to Impairment and Disability Inventory and the Purdue Posttraumatic Stress Disorder-Revised) were submitted to a series of confirmatory factor analyses, and the results from the goodness of fit tests and fit indices provided strong support to the validity of the latter two models. The findings indicated that the structure of adaptation to SCI can be best conceptualized as representing two, moderately linked but clearly distinguishable, factors and that the construct of denial of disability further elucidates our understanding of the structure of adaptation to loss of body integrity.

Newborn Screening for Cystic Fibrosis: Parents’ Preferences Regarding Counseling At the Time of Infants’ Sweat Test

Newborn screening (NBS) protocols for cystic fibrosis (CF) are the first regional population-based programs to incorporate DNA analysis into their procedures. Research about these programs can inform policy and practice regarding how best to counsel families with abnormal NBS results. The grounded theory method guided interviews with 33 families whose infants had abnormal CF NBS results. A dimensional analysis of these interviews provided a theoretical framework describing parents’ preferences regarding counseling during their infant's sweat test appointment. This framework describes the contexts and characteristics of the two main dimensions of parents’ preferences: factual information and emotional support. Factual information included learning about the probability of a CF diagnosis, CF disease facts, sweat test procedure, and CF genetics. Social support consisted of offering parents a choice about the timing and amount of CF information, showing empathy for their distress, instilling hope, personalizing counseling, and providing hospitality. This framework also explains the consequences of counseling that matched versus mismatched parental preferences in these domains. Counseling that matched parents preferences reduced parents’ distress while mismatched counseling tended to increase parents’ worry about their infant.     

The Role of Cognitive Deficits in the Development of Eating Disorders

Eating disorders (ED), including anorexia and bulimia nervosa, are chronic illnesses with periods of symptom exacerbation and remission. Because symptoms are usually present from 6 to 24 months before a diagnosis is made, aetiological agents are believed to be active well before symptoms appear. It is proposed that neuropsychological deficits in various cognitive domains preexist and underlie the aetiology of ED. This paper provides a comprehensive review of the literature relevant to neuropsychological deficits in ED patients and explores the relationship between cognitive deficits, psychosocial development, and the development of ED. Although the role of neuropsychological deficits in the evolution of ED requires further research, the proposed association has significant implications for clinical practice.     

The Prophylactic Mastectomy Dilemma: A Support Group for Women at High Genetic Risk for Breast Cancer

The goal of this pilot study was to test the usefulness of a six session psychoeducational support group for women at high genetic risk for breast cancer who were considering prophylactic mastectomy. The themes of the group sessions included overestimation of and anxiety about risk; desire for hard data; the emotional impact of watching a mother die of breast cancer; concerns about spouse reactions; self- and body image; the decision-making process; and confusion over whom to trust in decision making. Both the participants and the multidisciplinary leaders concluded that as a supplement to individual counseling, a support group is a beneficial and cost-effective treatment modality. Recommendations for the optimal format for such a group are described.