RESUMO
BACKGROUND: The aim of this study was to evaluate whether women's ages at conception and the ratio of male to female infants are associated with various ovulation patterns. METHODS: An observational clinical study was conducted in private OB/GYN clinics. Infertile women with regular menstrual cycles receiving intrauterine insemination (IUI) and/or in-vitro fertilization (IVF) had their ovulation patterns monitored in three consecutive spontaneous cycles receiving infertility treatment in the third cycle. Ovulation patterns were also observed in women with slight ovulation disorders during IUI and/or IVF in clomiphene citrate stimulated cycles. All the pregnant women's ages at conception and their respective offspring sex ratios were compared to various ovulation patterns. Statistical evaluation was performed using ANOVA, unpaired t test, χ2 test or Fisher's exact test, heterogeneity χ2 test, odds ratios at 95% confidence intervals and logistic regression. RESULTS: Contralateral ovulation (i.e. ovulation jumping from ovary to the other) was more often observed in relatively younger women, who showed a higher probability of having a boy than after ipsilateral ovulation. There was a significantly higher frequency of boys being conceived following three consecutive ovulations with a left-left-right (LLR) ovulation pattern, while three ovulations from the left ovary (LLL) were associated with a higher frequency of girls. We also found two consecutive menstrual cycles the left-right (LR) ovulation pattern showed a similar significant difference compared to the left-left (LL) ovulation. Both the infertile and infertile + fertile women groups showing right-sided ovulation, regardless of age, showed significantly higher offspring sex ratio compared to left-sided ovulation, which was not observed in the group of fertile women alone. CONCLUSIONS: LLR, LR and contralateral ovulation happens more often in younger women and favors male offspring in infertile women. Right-sided ovulation favors male offspring in infertile and infertile + fertile women, which was not observed in the group of fertile women.
It is of interest to evaluate whether ovulation patterns change with women's ages at conception and affect offspring sex ratios. An observational clinical study was conducted in private OB/GYN clinics. Infertile women with regular menstrual cycles receiving intrauterine insemination (IUI) and/or in-vitro fertilization (IVF) had their ovulation patterns monitored in three consecutive spontaneous cycles receiving infertility treatment in the third cycle. Ovulation patterns were also observed in women with slight ovulation disorder during IUI and/or IVF in clomiphene citrate stimulated cycles. Women's ages and offspring sex ratios were compared to various ovulation patterns. The contralateral ovulation was more often observed in relatively younger women, who showed a higher probability of having a boy than following a pregnancy after ipsilateral ovulation. There was a significantly higher frequency of boys being conceived following three consecutive ovulations with after a left-left-right (LLR) ovulation pattern, while three ovulations from the left ovary (LLL) were associated with a higher frequency of girls. Only considering two consecutive menstrual cycles the left-right (LR) ovulation pattern showed a similar significant difference compared to the left-left (LL) ovulation. Both infertile and infertile + fertile women showing right-sided ovulation, regardless of age, showed significantly higher offspring sex ratio compared to left-sided ovulation, which was not observed in the group of fertile women alone. LLR, LR and contralateral ovulation happens more often in younger women and favor male offspring in infertile women. Right-sided ovulation favors male offspring in infertile and infertile + fertile women, which was not observed in the group of fertile women.
Assuntos
Infertilidade Feminina , Clomifeno/uso terapêutico , Feminino , Fertilização in vitro , Humanos , Infertilidade Feminina/tratamento farmacológico , Masculino , Ovulação , Indução da Ovulação , Gravidez , Razão de MasculinidadeRESUMO
OBJECTIVE: (1) To evaluate the feasibility of conducting a randomized controlled trial (RCT) of the Safety, Meaning, Activation and Resilience Training (SMART) intervention vs nondirective supportive psychotherapy (NDSP) in an acutely hospitalized adult survivor of burn injury sample; and (2) to assess the preliminary effect of SMART on acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) symptom reduction as secondary prevention. DESIGN: Proof-of-concept, parallel group RCT design. SETTING: Regional burn center. PARTICIPANTS: Acutely injured, hospitalized adult survivors of burn injury (N=50) were randomly assigned to SMART (n=28) or nondirective supportive psychotherapy (n=22). Due to dropout and missing data, final sample size was 40, SMART (n=21) and nondirective supportive psychotherapy (n=19). INTERVENTIONS: SMART is a manualized, 4-session cognitive behavioral therapy-based psychological intervention targeting ASD, PTSD, and MDD symptoms. NDSP is a manualized, 4-session protocol. MAIN OUTCOME MEASURES: Davidson Trauma Scale ([DTS]; diagnostic proxy for ASD and PTSD; clinical cutoff=40, with higher score=higher severity) and the Patient Health Questionnaire-9 ([PHQ-9]; diagnostic proxy for MDD; clinical cutoff=10, with higher score=higher severity) at pretreatment, immediate posttreatment, and 1 month posttreatment. RESULTS: At baseline, median DTS scores and PHQ-9 scores were above clinical cutoffs and did not differ across groups. At 1 week and 1 month posttreatment, median DTS and PHQ-9 scores were beneath clinical cutoffs in the SMART group; scores remained above clinical cutoffs in the NDSP group at these time points. CONCLUSIONS: It is feasible to conduct an RCT of SMART in hospitalized adult survivors of burn injury. SMART has the potential to yield clinically significant outcomes. Additional studies are needed to replicate and extend these findings.
Assuntos
Queimaduras/psicologia , Transtorno Depressivo Maior/prevenção & controle , Psicoterapia/métodos , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adolescente , Adulto , Transtorno Depressivo Maior/psicologia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Resiliência Psicológica , Índices de Gravidade do Trauma , Adulto JovemRESUMO
PURPOSE: To identify the contributions of medical conditions and psychological distress to well-being within a non-clinical sample, stratified by age. It was predicted that medical conditions and psychological distress would be negatively associated with well-being. It was also predicted that psychological distress and medical conditions would account for significant variance in well-being. It was further predicted that psychological distress would mediate the relationship between medical conditions and well-being across the life span. METHODS: 1,424,307 employees/health plan members that completed an HRA. SEM was used to characterize relationships among medical conditions and psychological distress in predicting well-being (QoL, HRQoL, and impairments in ADLs) in five adult age groups. RESULTS: Medical conditions and psychological distress were negatively associated with well-being. As age increased, psychological distress was less associated with well-being. However, in those >75 years old, psychological distress had the largest association with well-being. All medical conditions, except cancer, were negatively associated with well-being. There were decreasing effects of medical conditions across the life span, with the exception of pulmonary disease which increased. Psychological distress mediated the relationship between medical conditions and well-being, with chronic pain having the greatest mediation across the life span. CONCLUSIONS: The analysis revealed differences in the contribution of psychological distress and medical conditions to well-being by age group. Additionally, the contribution of psychological distress was equitable to that of medical conditions, thus highlighting the importance of addressing psychological distress in medical populations for well-being. Findings suggest the relevance of age in well-being and the need for further longitudinal investigation.
Assuntos
Gerenciamento Clínico , Nível de Saúde , Qualidade de Vida/psicologia , Estresse Psicológico/psicologia , Adulto , Idoso , Doença Crônica/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
Stress due to earthquakes and other natural catastrophic events may result in a decline in the male to female ratio of newborn infants. One reason may be an increased death of male fetuses 3-5â¯months earlier. Another reason may relate to reduced conception of males and/or early male embryo demise 8-10â¯months earlier. Almost all of the earthquakes and natural catastrophic events have caused declines in sex ratios at birth except the Hurricane Katrina which showed a rise in the birth sex ratio. We describe hypothetical immunological cause for the decline in the sex ratio at birth following periods of augmented stress levels.
Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Terremotos/estatística & dados numéricos , Inundações/estatística & dados numéricos , Razão de Masculinidade , Poluição do Ar/estatística & dados numéricos , Coeficiente de Natalidade/tendências , Feminino , Humanos , Recém-Nascido , MasculinoRESUMO
PURPOSE: Programs designed to sustainably improve employee well-being are urgently needed but insufficiently researched. This study evaluates the long-term effectiveness of a commercial well-being intervention in a worksite setting. DESIGN: A pre/postintervention repeated analysis with follow-up at 6, 12, and 18 months. SETTING: Office-based worksites (for-profit, nonprofit, and mixed work-type; n = 8). PARTICIPANTS: One hundred sixty-three employees with a mean age of 47 (11) years (57% female). INTERVENTION: A 2.5-day group-based behavioral program emphasizing vitality and purpose in life (PiL). MEASURES: Rand Medical Outcomes Survey (MOS) 36-Item Short Form (SF-36) with a focus on vitality (primary outcome), Ryff PiL Scale, Center for Epidemiologic Studies Depression Scale, Profile of Mood States, Rand MOS Sleep Scale, physical activity, body weight, blood pressure, and blood measures for glucose and lipids at baseline, 6, 12, and 18 months. ANALYSIS: General linear models with repeated measures for mean values at baseline and follow-up. RESULTS: At 18-month follow-up, sustained improvements were observed for vitality, general health, and mental health domains of SF-36 and PiL (P < .001 for all measures). Sleep, mood, vigor, physical activity, and blood pressure were also improved at 18 months (P < .05 for all measures). CONCLUSIONS: An intensive 2.5-day intervention showed sustained improvement in employee quality of life, PiL, and other measures of well-being over 18 months.
Assuntos
Exercício Físico/fisiologia , Exercício Físico/psicologia , Promoção da Saúde/estatística & dados numéricos , Motivação , Qualidade de Vida/psicologia , Local de Trabalho/psicologia , Local de Trabalho/estatística & dados numéricos , Adulto , Boston , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
PURPOSE: This study tested relationships between health and well-being best practices and 3 types of outcomes. DESIGN: A cross-sectional design used data from the HERO Scorecard Benchmark Database. SETTING: Data were voluntarily provided by employers who submitted web-based survey responses. SAMPLE: Analyses were limited to 812 organizations that completed the HERO Scorecard between January 12, 2015 and October 2, 2017. MEASURES: Independent variables included organizational and leadership support, program comprehensiveness, program integration, and incentives. Dependent variables included participation rates, health and medical cost impact, and perceptions of organizational support. ANALYSIS: Three structural equation models were developed to investigate the relationships among study variables. RESULTS: Model sample size varied based on organizationally reported outcomes. All models fit the data well (comparative fit index > 0.96). Organizational and leadership support was the strongest predictor (P < .05) of participation (n = 276 organizations), impact (n = 160 organizations), and perceived organizational support (n = 143 organizations). Incentives predicted participation in health assessment and biometric screening (P < .05). Program comprehensiveness and program integration were not significant predictors (P > .05) in any of the models. CONCLUSION: Organizational and leadership support practices are essential to produce participation, health and medical cost impact, and perceptions of organizational support. While incentives influence participation, they are likely insufficient to yield downstream outcomes. The overall study design limits the ability to make causal inferences from the data.
Assuntos
Promoção da Saúde/organização & administração , Local de Trabalho , Fatores Etários , Estudos Transversais , Humanos , Liderança , Motivação , Saúde Ocupacional , Participação do Paciente , Características de Residência , Fatores SexuaisRESUMO
OBJECTIVE: To explore the factor structure of the HERO Health and Well-being Best Practices Scorecard in Collaboration with Mercer (HERO Scorecard) to develop a reduced version and examine the reliability and validity of that version. METHODS: A reduced version of the HERO Scorecard was developed through formal statistical analyses on data collected from 845 organizations that completed the original HERO Scorecard. RESULTS: The final factors in the reduced Scorecard represented content pertaining to organizational and leadership support, program comprehensiveness, program integration, and incentives. All four implemented practices were found to have a strong, statistically significant effect on perceived effectiveness. Organizational and leadership support had the strongest effect (ßâ=â0.56), followed by incentives (ßâ=â0.23). CONCLUSION: The condensed version of the HERO Scorecard has the potential to be a promising tool for future research on the extent to which employers are adopting best practices in their health and well-being (HWB) initiatives.
Assuntos
Promoção da Saúde , Saúde Ocupacional , Local de Trabalho , Adulto , Centers for Disease Control and Prevention, U.S. , Humanos , Liderança , Cultura Organizacional , Reprodutibilidade dos Testes , Inquéritos e Questionários , Estados UnidosRESUMO
Left ventricular assist devices (LVADs) have evolved into long-term use as destination therapy for those with severe end-stage heart failure due to other medical risks. Success with LVAD depends on adherence to a complicated mechanical regimen, and acceptance of a life that is far from normal. Patients with LVADs share characteristics with other end-stage cardiac failure patients and those waiting for or receiving heart transplants. Understanding the more thoroughly studied issues of psychiatric disorders, adherence, and behavioral correlates of success in heart failure and transplantation may identify feasible strategies for optimizing care of LVAD patients and suggest directions for future research. Depression and distress complicate post-transplant care. Psychiatric morbidity is associated with poor outcomes, including graft rejection, non-adherence, hospitalizations, infection, and death. With a high risk of embolic neurological events, patients' ability for self-care may be compromised. Psychiatric symptoms are underdiagnosed and undertreated, which may impact overall survival and quality of life.
Assuntos
Depressão/diagnóstico , Depressão/terapia , Insuficiência Cardíaca/psicologia , Transplante de Coração/psicologia , Coração Auxiliar/psicologia , Depressão/etiologia , Insuficiência Cardíaca/terapia , Humanos , Morbidade , Prognóstico , Fatores de Risco , Resultado do TratamentoRESUMO
PURPOSE: Programs focused on employee well-being have gained momentum in recent years, but few have been rigorously evaluated. This study evaluates the effectiveness of an intervention designed to enhance vitality and purpose in life by assessing changes in employee quality of life (QoL) and health-related behaviors. DESIGN: A worksite-based randomized controlled trial. SETTING: Twelve eligible worksites (8 randomized to the intervention group [IG] and 4 to the wait-listed control group [CG]). PARTICIPANTS: Employees (n = 240) at the randomized worksites. INTERVENTION: A 2.5-day group-based behavioral intervention. MEASURES: Rand Medical Outcomes Survey (MOS) 36-item Short-Form (SF-36) vitality and QoL measures, Ryff Purpose in Life Scale, Center for Epidemiologic Studies questionnaire for depression, MOS sleep, body weight, physical activity, diet quality, and blood measures for glucose and lipids (which were used to calculate a cardiometabolic risk score) obtained at baseline and 6 months. ANALYSIS: General linear mixed models were used to compare least squares means or prevalence differences in outcomes between IG and CG participants. RESULTS: As compared to CG, IG had a significantly higher mean 6-month change on the SF-36 vitality scale ( P = .003) and scored in the highest categories for 5 of the remaining 7 SF-36 domains: general health ( P = .014), mental health ( P = .027), absence of role limitations due to physical problems ( P = .026), and social functioning ( P = .007). The IG also had greater improvements in purpose in life ( P < .001) and sleep quality (index I, P = .024; index II, P = .021). No statistically significant changes were observed for weight, diet, physical activity, or cardiometabolic risk factors. CONCLUSION: An intensive 2.5-day intervention showed improvement in employee QoL and well-being over 6 months.
Assuntos
Promoção da Saúde/métodos , Saúde Ocupacional , Educação , Exercício Físico , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Inquéritos e Questionários , Local de TrabalhoRESUMO
BACKGROUND: The compression of morbidity model posits a breakpoint in the adult lifespan that separates an initial period of relative health from a subsequent period of ever increasing morbidity. Researchers often assume that such a breakpoint exists; however, this assumption is hitherto untested. PURPOSE: To test the assumption that a breakpoint exists--which we term a morbidity tipping point--separating a period of relative health from a subsequent deterioration in health status. An analogous tipping point for healthcare costs was also investigated. METHODS: Four years of adults' (N = 55,550) morbidity and costs data were retrospectively analyzed. Data were collected in Pittsburgh, PA between 2006 and 2009; analyses were performed in Rochester, NY and Ann Arbor, MI in 2012 and 2013. Cohort-sequential and hockey stick regression models were used to characterize long-term trajectories and tipping points, respectively, for both morbidity and costs. RESULTS: Morbidity increased exponentially with age (P<.001). A morbidity tipping point was observed at age 45.5 (95% CI, 41.3-49.7). An exponential trajectory was also observed for costs (P<.001), with a costs tipping point occurring at age 39.5 (95% CI, 32.4-46.6). Following their respective tipping points, both morbidity and costs increased substantially (Ps<.001). CONCLUSIONS: Findings support the existence of a morbidity tipping point, confirming an important but untested assumption. This tipping point, however, may occur earlier in the lifespan than is widely assumed. An "avalanche of morbidity" occurred after the morbidity tipping point-an ever increasing rate of morbidity progression. For costs, an analogous tipping point and "avalanche" were observed. The time point at which costs began to increase substantially occurred approximately 6 years before health status began to deteriorate.
Assuntos
Modelos Estatísticos , Morbidade/tendências , Adulto , Estudos de Coortes , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Michigan , Pessoa de Meia-Idade , New York , Estudos Retrospectivos , Adulto JovemAssuntos
Queimaduras/terapia , Manejo da Dor , Analgésicos não Narcóticos/uso terapêutico , Analgésicos Opioides/uso terapêutico , Anestésicos/uso terapêutico , Queimaduras/complicações , Queimaduras/psicologia , Terapia Cognitivo-Comportamental , Humanos , Hipnose Anestésica , Imagens, Psicoterapia , Dor/tratamento farmacológico , Terapia de RelaxamentoRESUMO
The objective of this study was to determine the sustained economic impact of a health promotion/disease prevention program delivered through a large regional health plan. This was a retrospective analysis of health risk, health claims, and cost using a mixed model factorial design for the years 2002-2009 that compared program participants to nonparticipants. All analyses were adjusted for age, sex, morbidity, and baseline health care costs as appropriate. The findings presented herein indicate a positive return on investment (ROI) for each program year with ratios ranging from a low of 1.16:1 to a high of 2.83:1. The average ROI collapsed across all 8 years was 2.02:1. The 2009 ROI approximated over $6 million in total savings. This study demonstrates the sustained economic value of a comprehensive health promotion program.
Assuntos
Redução de Custos , Custos de Cuidados de Saúde , Promoção da Saúde/economia , Prevenção Primária/economia , Adolescente , Adulto , Fatores Etários , Idoso , Análise Custo-Benefício , Feminino , Promoção da Saúde/organização & administração , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevenção Primária/organização & administração , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Fatores Sexuais , Fatores de Tempo , Estados Unidos , Adulto JovemRESUMO
OBJECTIVE: To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures. METHODS: Individual employee health care insurance claims data for 33 organizations completing the HERO Scorecard from 2009 to 2011 were linked to employer responses to the Scorecard. Organizations were dichotomized into "high" versus "low" scoring groups and health care cost trends were compared. A secondary analysis examined the tool's ability to predict health risk trends. RESULTS: "High" scorers experienced significant reductions in inflation-adjusted health care costs (averaging an annual trend of -1.6% over 3 years) compared with "low" scorers whose cost trend remained stable. The risk analysis was inconclusive because of the small number of employers scoring "low." CONCLUSIONS: The HERO Scorecard predicts health care cost trends among employers. More research is needed to determine how well it predicts health risk trends for employees.
Assuntos
Planos de Assistência de Saúde para Empregados/economia , Custos de Cuidados de Saúde/tendências , Gastos em Saúde/tendências , Saúde Ocupacional/economia , Adolescente , Adulto , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Promoção da Saúde/economia , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Serviços de Saúde do Trabalhador/economia , Reprodutibilidade dos Testes , Medição de Risco , Estados Unidos , Adulto JovemRESUMO
This study examined the effect of attachment style on subjective sleep outcomes in a population of service members (N=561 (403 male, 157 female)). Active duty, postdeployment service members completed questionnaires including two measures of adult attachment and two measures of subjective sleep. Results confirmed the central hypothesis: secure attachment style is associated with better sleep, followed by dismissing, fearful, and preoccupied, respectively. Gender differences were also found for prevalence of attachment style patterns. This is the first study incorporating attachment style and sleep outcomes within a military population, and provides the basis for future research in this area.
Assuntos
Militares/psicologia , Apego ao Objeto , Transtornos do Sono-Vigília/epidemiologia , Adulto , Análise de Variância , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Inquéritos e Questionários , Estados Unidos/epidemiologiaRESUMO
Consequences of major burn injuries often include losing the ability to engage in basic life functions such as work or employment. As this is a developing area of importance in burn care, the goal of this study was to perform a systematic review of the burn literature to ascertain a comprehensive view of the literature and identify return to work (RTW) factors where possible. A search was conducted and peer-reviewed studies that investigated predictors and barriers of returning to work of those with burn injuries, published since 1970 and written in English, were examined. From the 216 articles initially identified in the search, 26 studies were determined to meet inclusion criteria. Across studies, the mean age was 33.63 years, the mean TBSA was 18.94%, and the average length of stay was 20 days. After 3.3 years (41 months) postburn, 72.03% of previously employed participants had returned to some form of work. Important factors of RTW were identified as burn location, burn size, treatment variables, age, pain, psychosocial factors, job factors, and barriers. This systematic review suggests multiple conclusions. First, there is a significant need for attention to this area of study given that nearly 28% of all burn survivors never return to any form of employment. Second, the RTW literature is in need of coherent and consistent methodological practices, such as a sound system of measurement. Finally, this review calls for increased attention to interventions designed to assist survivors' ability to function in an employed capacity.
Assuntos
Queimaduras/psicologia , Queimaduras/terapia , Emprego/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Adaptação Psicológica , Adulto , Fatores Etários , Queimaduras/diagnóstico , Avaliação da Deficiência , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Medição da Dor , Psicologia , Recuperação de Função Fisiológica , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Estados Unidos , Adulto JovemRESUMO
The purpose of this study was to perform a systematic review of the existing literature on the incidence of hypertrophic scarring and the psychosocial impact of burn scars. In a comprehensive literature review, the authors identified 48 articles published since 1965 and written in English which reported the incidence and risk factors for hypertrophic scarring or assessed outcomes related to scarring. Most studies had important methodological limitations limiting the generalizability of the findings. In particular, the absence of standardized valid measures of scarring and other outcome variables was a major barrier to drawing strong conclusions. Among studies on hypertrophic scarring, the prevalence rate varied between 32 and 72%. Identified risk factors included dark skin, female gender, young age, burn site on neck and upper limb, multiple surgical procedures, meshed skin graph, time to healing, and burn severity. With regard to psychosocial outcomes, two studies compared pediatric burn survivors with a nonburn comparison group on a body image measure; neither study found differences between groups. Across studies, burn severity and location had a modest relationship with psychosocial outcome variables. Psychosocial variables such as social comfort and perceived stigmatization were more highly associated with body image than burn characteristics. To advance our knowledge of the epidemiology of scars and the burden of scars, future studies need to implement more rigorous methodologies. In particular, standardized valid measures of scarring and other outcomes should be developed. This process could be facilitated by an international collaboration among burn centers.
Assuntos
Imagem Corporal , Queimaduras/complicações , Cicatriz Hipertrófica/epidemiologia , Cicatriz Hipertrófica/etiologia , Qualidade de Vida , Adaptação Psicológica , Distribuição por Idade , Queimaduras/diagnóstico , Queimaduras/terapia , Cicatriz Hipertrófica/psicologia , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Fatores de Risco , Autoimagem , Índice de Gravidade de Doença , Distribuição por Sexo , Ajustamento SocialRESUMO
This study examined the effects of attachment style on self-reported posttraumatic stress disorder (PTSD) symptoms in a population of service members (N=561). Active duty, postdeployment service members completed anonymous questionnaires including 2 measures of adult attachment and the PTSD checklist-military as a measure of PTSD symptoms. Results confirmed the central hypothesis that attachment style was related to reported PTSD symptoms. Secure attachment style was associated with less reported PTSD symptoms and therefore may be involved in mechanisms associated with protection from developing PTSD after experiencing wartime trauma. Results were consistent when tested across continuous and dichotomous assessments that captured diagnostic criteria. This study demonstrates a significant relationship between attachment style and PTSD symptoms within a military population, potentially providing the basis for future research in this area.
Assuntos
Apego ao Objeto , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Feminino , Humanos , Relações Interpessoais , Masculino , Militares , Personalidade , Apoio Social , Inquéritos e Questionários , Adulto JovemRESUMO
This study examined perceptions of stigmatization in a sample of 85 pediatric burn survivors and their parents. Survivors and a parent independently completed the Perceived Stigmatization Questionnaire (PSQ) rating the frequency that the child experienced three types of stigmatizing behaviors: absence of friendly behavior, confused and staring behavior, and hostile behavior. The sample was divided into a high (top 25%) and low (bottom 75%) perceived stigmatization groups. The mean ratings of parents did not significantly differ from that of children reporting low stigmatization. The mean PSQ parent ratings were significantly lower than those of children reporting high stigmatization. Additionally, the concordance on PSQ subscale scores within child-parent dyads was significantly lower in children reporting high stigmatization relative to child-parent dyads of children reporting low stigmatization. Children surviving burns may experience stigmatization that is under-perceived by their parents. Clinicians should be alert to this potential discrepancy.