ABSTRACT
Individuals with schizophrenia or schizoaffective disorder (SZ) experience more violent victimization and noninterpersonal traumatic experiences than the general population. Earlier studies, however, have generally excluded one or grouped together victimization and trauma experiences into single outcome variables, which may obscure their contributory role to SZ symptoms. This issue is important because there is some evidence that intentionally induced violence produces higher rates of psychopathology than nonintentional traumatic experiences. We examined the independent contribution of both types of victimization experiences on SZ patients' symptomatology. We were also interested in determining whether SZ patients' pattern of acute symptom presentation could discriminate between SZ patients with and without posttraumatic stress disorder (PTSD) comorbidity. SZ inpatients (n = 70) were assessed for the presence of comorbid PTSD diagnosis, violent victimization, and noninterpersonal traumatic experiences. Patients were also rated on SZ symptom severity and general psychopathology measures. Past violent victimization experiences predicted severity of dysphoria and anxiety in SZ. Past traumatic experiences, however, predicted severity of psychosis. Victimization predicted severity of patients' autistic/cognitive symptoms. SZ patients with comorbid PTSD presented with significantly more anxiety and dysphoria symptoms and SZ illness chronicity than their non-PTSD counterparts. Discriminant function analysis revealed that the severity of positive, dysphoric, autistic/cognitive, and anxiety symptoms differentiated comorbid PTSD patients from their non-PTSD counterparts, with an overall 72.9% classification rate. Past traumatic and victimization experiences are significantly associated with SZ patients' symptom severity and illness course in partially overlapping domains. Use of common assessment strategies may be employed to increase detection of PTSD in SZ patients presenting for acute treatment.
Subject(s)
Crime Victims/psychology , Life Change Events , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Schizophrenia/diagnosis , Schizophrenic Psychology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Violence/psychology , Adult , Anxiety Disorders/diagnosis , Anxiety Disorders/psychology , Autistic Disorder/diagnosis , Autistic Disorder/psychology , Cognition Disorders/diagnosis , Cognition Disorders/psychology , Comorbidity , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Risk FactorsABSTRACT
OBJECTIVE: This quality-improvement study, following the PDCA methodology, compared the effectiveness of teaching mental imagery (MI) for pain management versus conducting a detailed inquiry (DI) about pain-related experiences with acutely injured PICU patients. METHODS: Participants included 44 hospitalized children and adolescents assigned to one of two intervention groups, MI (N = 24) or DI (N = 20). Pain was assessed pre- and post-intervention using the Wong-Baker Faces Pain Rating Scale and a 0-10 Likert pain rating scale, and the Pediatric Trauma Score was utilized to assess the severity of each child's injuries. RESULTS: Boys in the MI condition exhibited a significant decrease in average pain ratings [t(38) = 3.41, p = .0015]. Girls in the MI condition exhibited a non-significant decrease in average pain ratings. CONCLUSIONS: Teaching children the use of MI for pain management in an intensive-care setting was supported; the use of DI with boys was not supported.
Subject(s)
Imagery, Psychotherapy/methods , Intensive Care Units, Pediatric , Pain Management , Self Care , Accidents, Traffic , Adolescent , Analysis of Variance , Child , Female , Humans , Male , Pain/psychology , Pain Measurement/psychology , Sex Factors , Total Quality Management , Treatment OutcomeABSTRACT
This paper reviews the research on youth empowerment in seven child welfare programmatic areas. A lack of studies specifically focused on the empowerment of youth in foster care was found. Conceptual perspectives and existing data, however, suggest that the empowerment of youth in and transitioning out of care is essential and should be overtly facilitated through policy and program development.
Subject(s)
Child Abuse/rehabilitation , Community Health Services , Foster Home Care , Power, Psychological , Social Support , Adolescent , Child , Education , Humans , Mentors , Public Housing , United States , Vocational GuidanceABSTRACT
Studies of sustained attention using the Continuous Performance Test (CPT) often incorporate effortful processing conditions and different response measures. Difficulty of attentional effort and interrelationships among response measures, however, have not been well established particularly with normal populations. This study investigated three CPT tasks which varied in interstimulus interval and target frequency in 107 nonpatient adults. This report also examined five response measures (d', a measure of discriminability; In(beta), a measure of response bias; reaction time; and omission and commission errors). Findings indicated that a high target frequency condition was more effortful than a short interstimulus interval condition on all response measures. Further, d', omission errors, and commission errors differentiated the short interstimulus interval condition from baseline, but reaction time and In(beta) did not. Participants with faster reaction times in the high target frequency condition had fewer omission errors but more commission errors; these relationships may have been mediated by response bias. This suggested that response measures were interrelated but nonredundant, and that these relationships were influenced by attentional effort and response bias.
Subject(s)
Attention , Periodicity , Psychomotor Performance , Reaction Time , Adult , Female , Humans , Male , Prospective StudiesABSTRACT
This study examined two areas of premorbid adjustment (attentional functioning and social adaptation) and three areas of adult neuropsychological performance (executive functions, learning/memory, and motor functions) in a clinically stable outpatient sample of schizophrenics (n=61). The study examined three components of premorbid attentional functioning (concentration, hyperactivity, and requiring supervision for organizing activities or tasks) and three components of premorbid social adaptation (socialization skills, disciplinary problems, and antisocial behavior) in relation to the neuropsychological variables assessed in adulthood. Findings indicated that premorbid difficulties in all three attentional functioning areas and two of the three social functioning areas were related to adult neuropsychological performance. Childhood concentration deficits were not as significant an influence as distractibility on adult neuropsychological functioning, nor was excessive premorbid activity level as important as inhibiting impulsivity. Premorbid socialization deficits were related to motor dysfluency in adulthood. A history of disciplinary problems but not antisocial behavior in childhood had an adverse influence on adult neuropsychological deficits. This study demonstrated selective influences of premorbid attentional and social adjustment impairments on a broad range of cognitive abilities in adult schizophrenia.
