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1.
PLoS One ; 16(11): e0260033, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34767617

RESUMO

Medical leaders have warned of the potential public health burden of a "parallel pandemic" faced by healthcare workers during the COVID-19 pandemic. These individuals may have experienced scenarios in which their moral code was violated resulting in potentially morally injurious events (PMIEs). In the present study, hierarchical linear modeling was utilized to examine the role of PMIEs on COVID-19 pandemic-related difficulties in psychosocial functioning among 211 healthcare providers (83% female, 89% White, and an average of 11.30 years in their healthcare profession [9.31]) over a 10-month span (May 2020 -March 2021). Reported exposure to PMIEs was associated with statistically significant poorer self-reported psychosocial functioning at baseline and over the course of 10-months of data collection. Within exploratory examinations of PMIE type, perceptions of transgressions by self or others (e.g., "I acted in ways that violated my own moral code or values"), but not perceived betrayal (e.g., "I feel betrayed by leaders who I once trusted"), was associated with poorer COVID-19 related psychosocial functioning (e.g., feeling connected to others, relationship with spouse or partner). Findings from this study speak to the importance of investing in intervention and prevention efforts to mitigate the consequences of exposure to PMIEs among healthcare providers. Interventions for healthcare providers targeting psychosocial functioning in the context of moral injury is an important area for future research.


Assuntos
COVID-19/psicologia , Pessoal de Saúde/psicologia , Pandemias , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Militares/psicologia , Funcionamento Psicossocial , Saúde Pública , SARS-CoV-2/patogenicidade , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-34769656

RESUMO

Caregivers have a key role in protecting children's wellbeing, and, with appropriate skills, can prevent a multitude of negative social outcomes, particularly in challenged or humanitarian settings. Accordingly, the Strong Families programme was designed as a light touch family skills programme, with a focus of supporting caregiving during stressful situations. To evaluate the short-term impact of the Strong Families programme, we performed a time-convenience, randomized, controlled trial in Iran. A total of 292 families (63% from Iranian decent, 39% from Afghan decent, and 1% other), with children aged eight to twelve years, were recruited through ten centers in Iran and allocated to an intervention (n = 199) or waitlist/control group (n = 93). The two groups did not differ demographically at baseline. We assessed families prospectively, through three scales, PAFAS (parenting and family adjustment scales), SDQ (strengths and difficulties questionnaire), and CYRM-R (child and youth resilience measure). Caregivers in the intervention group improved (highly) statistically significantly on all but one PAFAS subscales (parental consistency, coercive parenting, positive encouragement, parental adjustment, family relationships, and parental teamwork), which was not noted in the waitlist group. On the SDQ, there were (highly) significant positive changes in scores in the intervention group on all sub-scales and the "total difficulty scale", whereas the waitlist/control group also improved on three (prosocial, conduct problems, and hyperactivity) of the five SDQ subscales. Children originating from Afghanistan improved significantly on the overall resilience scale of the CYRM-R in the intervention group, but not in the waitlist/control group. Overall, all our stratified results of the different scales reflect an accentuated improvement in families with higher levels of problems at baseline. Our comparative results indicated a strong alignment of the strong families programme with its intended short-term impact, per its logical frame on parenting practices and family management skills, children behaviour, caregivers and children mental health, and capacity to cope with stress. We postulate that the potential nudging or diffusion of knowledge (cross-contamination between intervention and waitlist/control group) at the community level could explain improvements in the waitlist/control group on some indicators, however, further research on this is recommend.


Assuntos
Poder Familiar , Funcionamento Psicossocial , Adolescente , Cuidadores , Criança , Educação Infantil , Humanos , Irã (Geográfico)
3.
Asian J Psychiatr ; 66: 102883, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34700179

RESUMO

OBJECTIVE: Major depressive disorder is the leading cause of non-fatal burden, and disability in adulthood. Even though depression is well-treated in the acute term,psychosocial functioning does not get back to the premorbid level most of the time. In this present study, it is aimed to evaluate the outcome of the acute term treatment of major depressive disorder in terms of psychosocial functioning. METHODS: The study is an open-label, observational, multi-center follow-up study for four months of patients with major depressive disorder according to DSM-5. Patients were evaluated with Montgomery Asberg Depression Rating Scale (MADRS), Sheehan Disability Scale (SDS) and Short Form-36 (SF-36) at the beginning, and at the 2., 4., 8., 12. and 16.weeks. RESULTS: 100 patients were invited to the study and 56 patients completed the study.As a result of the treatment, the mean MADRS and SDS scores decreased significantly. All domains of SF-36 were improved significantly with the treatment. Unfortunately patients suffering from MDD could not reach the normative data,especially on the domains of social functioning, role emotional, pain, and general health perception. Treatment outcomes show that SNRI users presented higher scores on the domains of pain and physical functioning. However SSRI users showed better outcomes on the domains of mental health and vitality. CONCLUSION: Our research corroborated that even patients gain symptomatic remission in MDD treatment, psychosocial dysfunction persists. It is also concluded that different antidepressant options may act differently on treatment outcomes.


Assuntos
Transtorno Depressivo Maior , Adulto , Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Método Duplo-Cego , Seguimentos , Humanos , Funcionamento Psicossocial , Resultado do Tratamento
4.
J Dev Behav Pediatr ; 42(7): 532-539, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34518496

RESUMO

OBJECTIVE: To evaluate how sociodemographic characteristics and various aspects of parent well-being, family functioning, parent-child relationship, and child characteristics are related to psychological functioning in children aged 9 to 12 years during the COVID-19 lockdown. METHOD: Participants included 144 children aged 9 to 12 years and their parents who lived in the province of Quebec, Canada, during the COVID-19 mandatory lockdown. Parents and children were administered a phone-based survey in which various child, parent, parent-child, and family characteristics were assessed. RESULTS: Results showed that higher internalizing problems in children were related to greater depressive symptoms in parents, lower attachment security to parents, and greater aversion to aloneness in children. Results on externalizing behavior problems showed that more problems were associated with more family dysfunction and chaos and lower attachment security to parents. Finally, results on children's anxiety toward COVID-19 showed that more anxiety was associated with greater parental anxiety toward COVID-19 and more child aversion to aloneness. CONCLUSION: Our findings showed that even during an unusual and stressful context such as a pandemic, proximal variables such as the attachment relationship that have been known to be closely associated with adaptation are significantly related to child psychological functioning. Such observations are important because they highlight factors that may accentuate child vulnerability in times of a pandemic and shed light on potential intervention targets.


Assuntos
Sintomas Comportamentais/psicologia , COVID-19 , Comportamento Infantil/psicologia , Relações Pais-Filho , Pais/psicologia , Funcionamento Psicossocial , COVID-19/prevenção & controle , Criança , Feminino , Humanos , Masculino , Apego ao Objeto , Quebeque
5.
J Pak Med Assoc ; 71(8): 2080-2082, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34418035

RESUMO

Whiplash is a soft tissue injury of the cervical spine that is generally caused by trauma from a motor vehicle accident or gunshot. It is associated with a wide range of clinical symptoms, including neck pain and stiffness, pain and restricted movement in the upper arms. We report the manifestations of this trauma within the beliefs and psychological functioning based on a comprehensive psychological assessment that include a review of hospital records, clinical examinations, a structured clinical interview, an inventory of psychosocial function, and a post-traumatic maladaptive belief scale. The results show that the patient's traumatic cervical syndrome manifested as moderate impairment in friendships and romantic relationships which reveal severe daily impairment in work, parenting, and self-care activities. The study further suggests that the injury is associated with maladaptive beliefs and significant impairment in psychosocial functioning.


Assuntos
Traumatismos em Chicotada , Vértebras Cervicais , Humanos , Cervicalgia/etiologia , Funcionamento Psicossocial , Medula Espinal , Traumatismos em Chicotada/complicações
6.
Artigo em Inglês | MEDLINE | ID: mdl-34444502

RESUMO

This work studied self-reports from adolescents on how the COVID-19 pandemic has changed their behaviors, relationships, mood, and victimization. Data collection was conducted between September 2020 and February 2021 in five countries (Sweden, the USA, Serbia, Morocco, and Vietnam). In total, 5114 high school students (aged 15 to 19 years, 61.8% females) responded to our electronic survey. A substantial proportion of students reported decreased time being outside (41.7%), meeting friends in real life (59.4%), and school performance (30.7%), while reporting increased time to do things they did not have time for before (49.3%) and using social media to stay connected (44.9%). One third of the adolescents increased exercise and felt that they have more control over their life. Only a small proportion of adolescents reported substance use, norm-breaking behaviors, or victimization. The overall COVID-19 impact on adolescent life was gender-specific: we found a stronger negative impact on female students. The results indicated that the majority of adolescents could adapt to the dramatic changes in their environment. However, healthcare institutions, municipalities, schools, and social services could benefit from the findings of this study in their work to meet the needs of those young people who signaled worsened psychosocial functioning, increased stress, and victimization.


Assuntos
COVID-19 , Vítimas de Crime , Adolescente , Feminino , Humanos , Masculino , Pandemias , Funcionamento Psicossocial , SARS-CoV-2
7.
J Psychiatr Res ; 143: 60-67, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34455193

RESUMO

BACKGROUND: Functional impairment is a major target in the treatment of bipolar disorder (BD), but the magnitude and type of functional difficulties differ across patients. Findings on predictors of overall functioning and specific functional areas are inconsistent. We aimed to characterize functional difficulties and identify factors associated with global functioning and individual domains in euthymic patients. METHODS: The Functional Assessment Short Test (FAST) was used to assess overall psychosocial functioning and specific functional domains in 80 euthymic participants with BD. Participants also completed a clinical interview and a cognitive assessment. Model selection with elastic net regression was performed to identify predictors of global functioning. We then examined the association of these predictors with individual functional domains using correlation. RESULTS: FAST scores indicated moderate or severe impairment for 54% of the sample, with occupational functioning showing the highest impairment rate. Elastic net regression selected a model with three variables (higher residual depressive symptoms, lower executive functioning, more perceived cognitive deficits) as predictors of overall functioning. No significant associations were found between these predictors. Depressive symptoms were associated with interpersonal relationships and leisure time, executive skills with occupational functioning, and perceived deficits with cognitive functioning. CONCLUSIONS: Residual depressive symptoms were the strongest predictor of overall functioning which highlights the importance of assessing and targeting subthreshold symptoms for recovery. Executive difficulties were associated with functioning, particularly occupational skills, independently of depressive symptoms. Interventions targeting these difficulties, such as cognitive and functional remediation, may be key treatment options towards facilitating functional recovery.


Assuntos
Transtorno Bipolar , Transtornos Cognitivos , Cognição , Humanos , Testes Neuropsicológicos , Funcionamento Psicossocial
8.
Int J Behav Nutr Phys Act ; 18(1): 110, 2021 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-34433476

RESUMO

BACKGROUND: A recent paradigm shift has highlighted the importance of considering how sleep, physical activity and sedentary behaviour work together to influence health, rather than examining each behaviour individually. We aimed to determine how adherence to 24-h movement behavior guidelines from infancy to the preschool years influences mental health and self-regulation at 5 years of age. METHODS: Twenty-four hour movement behaviors were measured by 7-day actigraphy (physical activity, sleep) or questionnaires (screen time) in 528 children at 1, 2, 3.5, and 5 years of age and compared to mental health (anxiety, depression), adaptive skills (resilience), self-regulation (attentional problems, hyperactivity, emotional self-control, executive functioning), and inhibitory control (Statue, Head-Toes-Knees-Shoulders task) outcomes at 5 years of age. Adjusted standardised mean differences (95% CI) were determined between those who did and did not achieve guidelines at each age. RESULTS: Children who met physical activity guidelines at 1 year of age (38.7%) had lower depression (mean difference [MD]: -0.28; 95% CI: -0.51, -0.06) and anxiety (MD: -0.23; 95% CI: -0.47, 0.00) scores than those who did not. At the same age, sleeping for 11-14 h or having consistent wake and sleep times was associated with lower anxiety (MD: -0.34; 95% CI: -0.66, -0.02) and higher resilience (MD: 0.35; 95% CI: 0.03, 0.68) scores respectively. No significant relationships were observed at any other age or for any measure of self-regulation. Children who consistently met screen time guidelines had lower anxiety (MD: -0.43; 95% CI: -0.68, -0.18) and depression (MD: -0.36; 95% CI: -0.62, -0.09) scores at 5. However, few significant relationships were observed for adherence to all three guidelines; anxiety scores were lower (MD: -0.42; 95% CI: -0.72, -0.12) in the 20.2% who adhered at 1 year of age, and depression scores were lower (MD: -0.25; 95% CI: -0.48, -0.02) in the 36.7% who adhered at 5 years of age compared with children who did not meet all three guidelines. CONCLUSIONS: Although adherence to some individual movement guidelines at certain ages throughout early childhood was associated with improved mental health and wellbeing at 5 years of age, particularly reduced anxiety and depression scores, there was little consistency in these relationships. Future work should consider a compositional approach to 24-h time use and how it may influence mental wellbeing. TRIAL REGISTRATION: ClinicalTrials.gov number NCT00892983.


Assuntos
Exercício Físico , Fidelidade a Diretrizes , Saúde Mental , Funcionamento Psicossocial , Comportamento Sedentário , Sono/fisiologia , Criança , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Tempo de Tela , Inquéritos e Questionários
9.
Rev. Eugenio Espejo ; 15(3): 4-15, 20210830.
Artigo em Espanhol | LILACS | ID: biblio-1337752

RESUMO

La presente investigación tuvo como objetivo determinar la relación existente entre las dimensiones de apego, autoestima y funcionamiento familiar en estudiantes de bachillerato de los cantones Riobamba y Guano, provincia de Chimborazo, Ecuador; mediante un estudio con enfoque cuantitativo, de tipo no experimental, correlacional y de corte transversal. En este participa-ron 341 estudiantes de bachillerato pertenecientes a unidades educativas mencionadas, en los que se aplicaron los instrumentos: Cuestionario de apego Camir-R y los test de autoestima de Rosenberg y el de funcionamiento familiar FF-SIL. Los resultados mostraron un predominio del género femenino (277) y que la seguridad fue la dimensión mejor punteada (= 30,19). Se establecieron diferencias significativas entre las tipologías preocupado y evitativo (p<0,05). La auto-estima valorada como alta predominó entre las mujeres (51,53%), también predominó la tipología de moderadamente funcional en la población estudiada (56,7% en las mujeres y 71,9 % en los hombres). Los niveles de correlación entre las variables y dimensiones y el sentido de esta resultaron diversos. Las conclusiones establecidas apoyan la importancia del apego para el desarrollo adecuado de la autoestima y el funcionamiento familiar.


This research aimed to determine the relationship among the dimensions of attachment, selfesteem and family functioning in high school students from the cities of Riobamba and Guano, Chimborazo province, Ecuador. The study considered a quantitative approach, non-experimental, correlational, and cross-sectional. 341 high school students from the aforementioned educa-tional units participated in this study, in which the following instruments were applied: the Camir-R attachment questionnaire, the Rosenberg selfesteem test and the FF-SIL family functioning test. The results showed a predominance of the female gender (277), and that safety was the best scored dimension (=30.19). Significant differences were established between the worried and avoidant typologies (p<0.05). Selfesteem valued as high prevailed among women (51.53%), the moderately functional typology also predominated in the studied population (56.7% in women and 71.9% in men). The levels of correlation between the variables and dimensions and their meaning were diverse. The established conclusions support the importance of attachment for the proper development of selfesteem and family functioning.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Desenvolvimento da Personalidade , Autoimagem , Família , Estudantes , Inquéritos e Questionários , Funcionamento Psicossocial
10.
J Pediatr Psychol ; 46(10): 1238-1248, 2021 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-34363683

RESUMO

OBJECTIVE: To inform efforts to better support caregivers of children with cancer during the transition from treatment to survivorship, this study sought to characterize caregiver mental health-related quality of life (HRQOL) and anxiety, and examine the influence of family psychosocial risk and caregiver problem-solving on these outcomes. METHOD: Participants included 124 caregivers (child age M = 10.05 years; SD = 4.78), 12-19 months from the conclusion of cancer-directed treatment. Participants' self-reported mental HRQOL, anxiety, and problem-solving were compared with community norms using t-tests. Correlations and hierarchical multiple regressions examined the influence of psychosocial risk and problem-solving on caregiver mental HRQOL and anxiety. RESULTS: Overall, caregivers reported HRQOL and anxiety within normal limits. Caregivers also reported more adaptive patterns of problem-solving than community norms. Subsets of caregivers reported clinical levels of psychosocial risk (11%) and at-risk levels of mental HRQOL (2.5%) and anxiety (5.7%). Females reported greater anxiety than males. Psychosocial risk and negative problem orientation (NPO) were both related to poorer mental HRQOL and greater anxiety (r = .40-.51, p's < .001). Positive problem orientation related to better mental HRQOL and lower anxiety (r = .18-.21, p's < .05). Impulsivity/carelessness and avoidance were associated with greater anxiety (r = .19-.25, p's < .05). Only NPO accounted for additional variance in mental HRQOL and anxiety, over and above psychosocial risk and demographic characteristics. CONCLUSIONS: The majority of caregivers appear to be resilient and experience limited distress during the off therapy period. Targeting negative cognitive appraisals (NPO) through cognitive-behavioral therapy or problem-solving skills training may further improve caregiver psychosocial functioning.


Assuntos
Sobreviventes de Câncer , Neoplasias , Cuidadores , Criança , Feminino , Humanos , Masculino , Neoplasias/terapia , Funcionamento Psicossocial , Qualidade de Vida
12.
Sch Psychol ; 36(5): 285-292, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34292037

RESUMO

Despite recognition of the potential impact of the COVID-19 pandemic on secondary schooling experiences, little empirical evidence has captured adolescents' perspectives on the extent of academic and social disruption resulting from the pandemic. The present study examined adolescents' academic worries amid the COVID-19 pandemic and their perspectives on pandemic-related changes in teacher and peer relations. Participants were 452 adolescents (55% female) between the ages of 11 and 17, who completed online surveys asking them about their worries about their schoolwork and educational futures, perceived support from teachers, and perceptions of electronic (cyber) bullying during the pandemic. Results indicated that COVID-related academic worries pertaining to motivation to focus on and complete schoolwork were most frequent. High school students and female students reported heightened academic worries compared to middle school students and male students. In addition, the majority of adolescents indicated decreased support from teachers during the COVID-19 pandemic, including more than two-thirds (69%) who reported reduced communication with teachers. Adolescents perceived relative consistency in electronic (cyber) bullying throughout the pandemic, and a third of students indicated that cyberbullying has become more of a problem and increased in frequency during this time period. Perceived changes in cyberbullying were consistent across grade level and gender. Findings emphasize the psychosocial implications of the COVID-19 pandemic on adolescents' secondary schooling experiences and underscore the importance of bolstering social resources to minimize the short- and long-term impact of the pandemic on students' academic functioning. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Cyberbullying/psicologia , Relações Interpessoais , Grupo Associado , Funcionamento Psicossocial , Professores Escolares , Apoio Social , Estudantes/psicologia , Adolescente , COVID-19 , Criança , Feminino , Humanos , Masculino , Instituições Acadêmicas
13.
Brain Behav ; 11(8): e02197, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34216110

RESUMO

The COVID-19 pandemic has had a profound impact on the lives of individuals, families, and communities around the world with constraints on multiple aspects of daily life. The purpose of the present study was to identify specific profiles of pandemic-related experiences and their relation to psychosocial functioning using the 92-item Epidemic-Pandemic Impacts Inventory (EPII). Data were collected as part of a cross-sectional, online survey of adults (18+) residing in the Northeast region of the United States (N = 652) and recruited via online advertisements. Person-centered latent class analysis (LCA) was applied to 38 pandemic-related experiences that showed a significant bivariate correlation with perceived stress. Measures of psychosocial risk were also obtained. Results revealed five unique profiles of respondents based on patterns of pandemic-related experiences. Three profiles representing about 64% of the sample were characterized by moderate to high exposure to adverse experiences during the pandemic and were more likely to screen positive for depression, anxiety, and posttraumatic stress. These profiles were differentiated by sociodemographic differences, including age, caregiving, and employment status. Two profiles differentiated by age and caregiver status represented about 36% of the sample and were characterized by relatively low exposure to adverse experiences and lower risk for psychosocial impairment. Findings support the EPII as an instrument for measuring tangible and meaningful experiences in the context of an unprecedented pandemic disaster. This research may serve to identify high-risk subpopulations toward developing public health strategies for supporting families and communities in the context of public health emergencies such as the COVID-19 pandemic.


Assuntos
COVID-19 , Pandemias , Adulto , Estudos Transversais , Humanos , Funcionamento Psicossocial , SARS-CoV-2 , Estados Unidos/epidemiologia
14.
J Psychiatr Res ; 142: 40-47, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34314993

RESUMO

Co-occurring posttraumatic stress disorder and alcohol use disorder (PTSD/AUD) is associated with poorer psychosocial functioning than either disorder alone; however, it is unclear if psychosocial functioning improves in treatment for PTSD/AUD. This study examined if psychosocial functioning improved in integrated treatments for PTSD/AUD, and if changes in PTSD severity and percentage heavy drinking days (PHDD) during treatment were associated with functioning outcomes. 119 veterans with PTSD/AUD randomized to receive either Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure or Seeking Safety completed measures of functioning (Medical Outcomes Survey SF-36), PTSD (Clinician Administered PTSD Scale for DSM-5), and alcohol use (Timeline Follow-Back) at baseline, posttreatment, 3- and 6-month follow-ups. Our findings suggest that psychosocial functioning improved to a statistically significant degree with no significant differences between conditions. Reductions in PTSD severity during treatment were associated with psychosocial functioning improvements, whereas reductions in PHDD were associated with improvement in role impairment at posttreatment. Although psychosocial functioning improves to a statistically significant degree in interventions designed to treat PTSD/AUD, these improvements do not represent clinically meaningful improvements in patients' abilities to navigate important roles. Findings underscore the need to study how to best treat psychosocial functioning impairment in PTSD/AUD.


Assuntos
Alcoolismo , Transtornos de Estresse Pós-Traumáticos , Transtornos Relacionados ao Uso de Substâncias , Veteranos , Alcoolismo/complicações , Alcoolismo/epidemiologia , Alcoolismo/terapia , Comorbidade , Humanos , Funcionamento Psicossocial , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia
15.
Sci Rep ; 11(1): 15024, 2021 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-34294809

RESUMO

People have a strong and reliable tendency to infer the character traits of strangers based solely on facial appearance. In five highly powered and pre-registered experiments, we investigate the relative merits of learning and nativist accounts of the origins of these first impressions. First, we test whether brief periods of training can establish consistent first impressions de novo. Using a novel paradigm with Greebles-a class of synthetic object with inter-exemplar variation that approximates that seen between individual faces-we show that participants quickly learn to associate appearance cues with trustworthiness (Experiments 1 and 2). In a further experiment, we show that participants easily learn a two-dimensional structure in which individuals are presented as simultaneously varying in both trustworthiness and competence (Experiment 3). Crucially, in the final two experiments (Experiments 4 and 5) we show that, once learned, these first impressions occur following very brief exposure (100 ms). These results demonstrate that first impressions can be rapidly learned and, once learned, take on features previously thought to hold only for innate first impressions (rapid availability). Taken together, these results highlight the plausibility of learning accounts of first impressions.


Assuntos
Percepção , Funcionamento Psicossocial , Adolescente , Adulto , Análise de Variância , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Confiança/psicologia , Adulto Jovem
16.
Depress Anxiety ; 38(10): 1007-1017, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34293236

RESUMO

INTRODUCTION: Little is known about the relationship between moral distress and mental health problems. We examined moral distress in 2579 frontline healthcare workers (FHCWs) caring for coronavirus disease 2019 (COVID-19) patients during the height of the spring 2020 pandemic surge in New York City. The goals of the study were to identify common dimensions of COVID-19 moral distress; and to examine the relationship between moral distress, and positive screen for COVID-19-related posttraumatic stress disorder (PTSD) symptoms, burnout, and work and interpersonal functional difficulties. METHOD: Data were collected in spring 2020, through an anonymous survey delivered to a purposively-selected sample of 6026 FHCWs at Mount Sinai Hospital; 2579 endorsed treating COVID-19 patients and provided complete survey responses. Physicians, house staff, nurses, physician assistants, social workers, chaplains, and clinical dietitians comprised the sample. RESULTS: The majority of the sample (52.7%-87.8%) endorsed moral distress. Factor analyses revealed three dimensions of COVID-19 moral distress: negative impact on family, fear of infecting others, and work-related concerns. All three factors were significantly associated with severity and positive screen for COVID-19-related PTSD symptoms, burnout, and work and interpersonal difficulties. Relative importance analyses revealed that concerns about work competencies and personal relationships were most strongly related to all outcomes. CONCLUSION: Moral distress is prevalent in FHCWs and includes family-, infection-, and work-related concerns. Prevention and treatment efforts to address moral distress during the acute phase of potentially morally injurious events may help mitigate risk for PTSD, burnout, and functional difficulties.


Assuntos
Esgotamento Profissional , COVID-19 , Transtornos de Estresse Pós-Traumáticos , Esgotamento Profissional/epidemiologia , Pessoal de Saúde , Humanos , Princípios Morais , Pandemias , Funcionamento Psicossocial , SARS-CoV-2 , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estados Unidos/epidemiologia
17.
Epilepsy Behav ; 121(Pt A): 108077, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34087680

RESUMO

PURPOSE: Frontal lobe resection (FLR) is the second most common epilepsy surgery procedure in adults. Few studies address neuropsychological consequences after FLR. The aim of this study was to explore patients' and relatives' experiences of cognitive, emotional and social cognitive functioning after frontal lobe epilepsy surgery. METHODS: Semi-structured interviews were held with 14 patients having gone through FLR as adults during the years 2000-2016 and 12 of their relatives. Interviews were audio-recorded, transcribed and analyzed with inductive qualitative content analysis. RESULTS: Positive as well as negative consequences were described both by patients and relatives. Feelings of relief and an increased capacity to experience emotions of well-being were mainly experienced as related to seizure freedom. A newfound autonomy and a more grown-up identity as opposed to a self-image based on epilepsy was also highlighted. However, results also showed that even for seizure free patients, FLR could give rise to negative experiences, the most prominent of which were mental fatigue, lowered mood and social withdrawal. Coping strategies included planning ahead to avoid mental exhaustion. Over all, respondents considered that the epilepsy surgery had been a risk well worth taking and that positive consequences outweighed the negative ones. CONCLUSIONS: This study shows a range of positive as well as negative outcomes after FLR for epilepsy. The findings indicate that lowered mood and mental fatigue could affect the life situation in a negative way, regardless of seizure outcome. This is important to consider in the preoperative counselling of patients and their families, as well as in the postsurgical follow-up. It is also crucial that the epilepsy surgery team has the possibility to offer rehabilitation and support to families regarding these aspects after surgery.


Assuntos
Epilepsia do Lobo Frontal , Funcionamento Psicossocial , Adulto , Emoções , Epilepsia do Lobo Frontal/cirurgia , Lobo Frontal , Humanos , Resultado do Tratamento
18.
Neuron ; 109(12): 2025-2040.e7, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34019810

RESUMO

Decision-making is a cognitive process of central importance for the quality of our lives. Here, we ask whether a common factor underpins our diverse decision-making abilities. We obtained 32 decision-making measures from 830 young people and identified a common factor that we call "decision acuity," which was distinct from IQ and reflected a generic decision-making ability. Decision acuity was decreased in those with aberrant thinking and low general social functioning. Crucially, decision acuity and IQ had dissociable brain signatures, in terms of their associated neural networks of resting-state functional connectivity. Decision acuity was reliably measured, and its relationship with functional connectivity was also stable when measured in the same individuals 18 months later. Thus, our behavioral and brain data identify a new cognitive construct that underpins decision-making ability across multiple domains. This construct may be important for understanding mental health, particularly regarding poor social function and aberrant thought patterns.


Assuntos
Encéfalo/diagnóstico por imagem , Cognição/fisiologia , Tomada de Decisões/fisiologia , Funcionamento Psicossocial , Interação Social , Adolescente , Afeto , Transtorno da Personalidade Antissocial/fisiopatologia , Ansiedade/fisiopatologia , Encéfalo/fisiologia , Depressão/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Análise Fatorial , Feminino , Neuroimagem Funcional , Humanos , Testes de Inteligência , Imageamento por Ressonância Magnética , Masculino , Vias Neurais , Testes Neuropsicológicos , Autoimagem , Adulto Jovem
19.
J Clin Psychiatry ; 82(3)2021 04 13.
Artigo em Inglês | MEDLINE | ID: mdl-34000130

RESUMO

OBJECTIVE: The aim of this report was to evaluate the psychometric properties of the Pain Frequency, Intensity, and Burden Scale (P-FIBS), a brief measure of pain, as well as the association of pain with irritability and depression and how these symptoms relate to functional impairments. METHODS: Participants of 2 randomized controlled trials (Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care [EMBARC; n = 251 with DSM-IV diagnosis of major depressive disorder; study duration: August 2011-December 2015] and STimulant Reduction Intervention Using Dosed Exercise [STRIDE; n = 302 with DSM-IV diagnosis of stimulant abuse or dependence; study-duration: July 2010-February 2013]) and treatment-seeking patients in primary care clinics from an ongoing quality-improvement project (VitalSign6; n = 4,370; project duration: August 2014-July 2019) were included. Psychometric properties of the P-FIBS were evaluated with confirmatory factor and item response theory analyses in EMBARC and VitalSign6. The approach of Baron and Kenny was used to assess whether irritability accounted for the effect of pain on depression. RESULTS: Cronbach α (0.84-0.89) and model fits for single-factor structure of P-FIBS were acceptable. Pain was positively correlated with irritability (r = 0.22-0.29) and depression (r = 0.10-0.33). Irritability accounted for 40.7%-65.5% of the effect of pain on depression. Higher irritability and depression were associated with poorer social functioning, quality of life, and productivity in work- and non-work-related activities. Pain was associated with non-work-related activity impairments even after controlling for irritability and depression. CONCLUSIONS: The P-FIBS is a brief and reliable measure of pain. Irritability is associated with pain and accounts for a large proportion of the effect of pain on depression. Symptoms of pain, irritability, and depression are associated with functional impairments. TRIAL REGISTRATION: ClinicalTrials.gov identifiers: NCT01407094 (EMBARC), NCT01141608 (STRIDE).


Assuntos
Depressão/fisiopatologia , Humor Irritável/fisiologia , Medição da Dor/normas , Dor/diagnóstico , Dor/fisiopatologia , Psicometria/normas , Funcionamento Psicossocial , Índice de Gravidade de Doença , Adulto , Antidepressivos/farmacologia , Estimulantes do Sistema Nervoso Central/efeitos adversos , Estudos Transversais , Depressão/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/fisiopatologia , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Psicometria/instrumentação , Melhoria de Qualidade , Qualidade de Vida , Reprodutibilidade dos Testes , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Adulto Jovem
20.
Rehabil Psychol ; 66(3): 286-299, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34043409

RESUMO

Objective: Past research suggests that certain sociodemographic factors may put youth with spina bifida (SB) at risk for poor outcomes. The aims of this study were to examine (a) associations between ten sociodemographic factors and health-related, neuropsychological, and psychosocial functioning among youth with SB,(b) cumulative sociodemographic risk as a predictor of youth outcomes as moderated by age, and (c) SB-related family stress as a mediator of longitudinal associations between cumulative sociodemographic risk and youth outcomes. Method: Participants were youth with SB (N = 140 at Time 1; Mage at Time 1 = 11.43, 53.6% female) recruited as part of a larger, longitudinal study. The study included questionnaire (parent-, teacher-, and youth-report), neuropsychological testing, and medical chart data across three time points, spaced 2 years apart. Results: A subset of the sociodemographic factors and their cumulative risk were associated with study outcomes. Specifically, youth characterized by sociodemographic risk had greater pain and lower academic achievement, but also fewer urinary tract infections and fewer attention and executive function problems. Age did not moderate the association between cumulative risk and outcomes. Cumulative risk predicted lower SB-related family stress, which, in turn, predicted several outcomes. Conclusions: Examining a range of sociodemographic factors is warranted. Sociodemographic risk is linked to poorer outcomes for some risk indicators but similar or better outcomes for others. Results have implications for delivering evidence-based, diversity-sensitive clinical care to youth with SB. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Funcionamento Psicossocial , Disrafismo Espinal , Adolescente , Ansiedade , Feminino , Humanos , Estudos Longitudinais , Masculino , Pais , Disrafismo Espinal/complicações
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