Taste and smell complaints in HIV-infected patients

OBJECTIVES: To define the scope of taste and smell (chemosensory) complaints amongst HIV-infected persons in the study population; to evaluate the clinical factors associated with chemosensory complaints; and to determine the impact of chemosensory complaints on quality of life. DESIGN: Cross-sectional survey. SETTING: Tertiary care university medical center clinic. PARTICIPANTS: A total of 207 HIV-infected patients. MAIN OUTCOME MEASURES: Chemosensory complaint score from taste and smell questionnaire and quality of life scores from the Medical Outcomes Study HIV Health Survey (MOS-HIV). RESULTS: A total of 144 patients (70%) reported chemosensory complaints, 91 (44%) reported both taste and smell complaints, 47 (23%) reported only taste complaints, and six (3%) reported only smell complaints. Many patients complained that drugs interfered with their sense of taste, or that medications tasted bad. Higher chemosensory complaint scores were associated with a greater number of medications taken, tobacco use, and hay fever. Patients with chemosensory complaints had significantly lower scores in all domains of the MOS-HIV than those without complaints. Quality of life as measured by the MOS-HIV was lower in patients with chemosensory complaints even after controlling for number of AIDS diagnoses, number of medications, CD4 cell count, and HIV-1 viral load. CONCLUSIONS: Chemosensory complaints were common in the patient population and were associated with a poor quality of life. Medications played an important role in chemosensory complaints. Measures to optimize taste and smell function may improve quality of life and medication adherence, and prevent complications such as inadequate oral intake, malnutrition, weight loss, and ultimately wasting.     

The Family Health Project: Psychosocial adjustment of children whose mothers are HIV infected.

The psychosocial adjustment of 87 inner-city African American children 6–11 years old whose mothers were HIV infected was compared with that of 149 children from a similar sociodemographic background whose mothers did not report being HIV infected. Children were not identified as being HIV infected. Mother reports, child reports, and standardized reading achievement scores were used to assess 4 domains of adjustment: externalizing problems, internalizing problems, cognitive competence, and prosocial competence. The results indicated that, on average, children from both groups had elevated levels of behavior problem scores and low reading achievement scores when compared with national averages. Relative to children whose mothers were not infected, those whose mothers were HIV infected were reported to have more difficulties in all domains of psychosocial adjustment. Potential family processes that may explain the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The value of different sources of information in evaluating psychiatric disorders in adolescence--a comparison of parental judgment and self-assessment by adolescents

Data from the national representative epidemiologic survey (PAK-KID-study) assessed by the German versions of Achenbach'S Child Behavior Checklist and Youth Self-Report of N = 1757 parents and their children aged 11 to 18 years are compared by using the corresponding Cross-Informant-Scales. On all problem scales adolescents report more problems than parents. For some scales the differences between girls and their parents are higher than between boys and their parents (social withdrawal, somatic complaints, anxious/depressed, attention problems, internalizing and total score). Averaged Pearson correlations of the eight subscales are in a moderate rage (r < 0.50). For all problem scales an agreement of 30% in the area of high problems (> PR95) is found. If one informant scores above PR95 the Relative Risk of the other one scoring in this range too is significantly higher than one for nearly all scales.     

Lack of synchronized seasonal variation in the intensity of psychological problems.

Temporal variation in the subjective intensity of psychological problems identified by 40 psychotherapy clients (most diagnosed as depressed) was investigated longitudinally. Each client rated the intensity of 10 individualized problems 3 times per week (on Tuesdays, Thursdays, and Sundays) for an average of 6 mo. Ratings from all clients were spread over 3 yrs. When scores were statistically adjusted for client differences and average rate of improvement, no significant variation among months was found, regardless of problem content or client gender. Standard assessment measures administered 4 times to each client also failed to show systematic seasonal variation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized trial of social rehabilitation and integrated health care for older people with severe mental illness.

Objective: The Helping Older People Experience Success (HOPES) program was developed to improve psychosocial functioning and reduce long-term medical burden in older people with severe mental illness (SMI) living in the community. HOPES includes 1 year of intensive skills training and health management, followed by a 1-year maintenance phase. Method: To evaluate effects of HOPES on social skills and psychosocial functioning, we conducted a randomized controlled trial with 183 older adults with SMI (58% schizophrenia spectrum) age 50 and older at 3 sites who were assigned to HOPES or treatment as usual with blinded follow-up assessments at baseline and 1- and 2-year follow-up. Results: Retention in the HOPES program was high (80%). Intent-to-treat analyses showed significant improvements for older adults assigned to HOPES compared to treatment as usual in performance measures of social skill, psychosocial and community functioning, negative symptoms, and self-efficacy, with effect sizes in the moderate (.37–.63) range. Exploratory analyses indicated that men improved more than women in the HOPES program, whereas benefit from the program was not related to psychiatric diagnosis, age, or baseline levels of cognitive functioning, psychosocial functioning, or social skill. Conclusions: The results support the feasibility of engaging older adults with SMI in the HOPES program, an intensive psychiatric rehabilitation intervention that incorporates skills training and medical case management, and improves psychosocial functioning in this population. Further research is needed to better understand gender differences in benefit from the HOPES program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The factor structure of the SF-36 Health Survey in 10 countries: results from the IQOLA Project. International Quality of Life Assessment

Studies of the factor structure of the SF-36 Health Survey are an important step in its construct validation. Its structure is also the psychometric basis for scoring physical and mental health summary scales, which are proving useful in simplifying and interpreting statistical analyses. To test the generalizability of the SF-36 factor structure, product-moment correlations among the eight SF-36 Health Survey scales were estimated for representative samples of general populations in each of 10 countries. Matrices were independently factor analyzed using identical methods to test for hypothesized physical and mental health components, and results were compared with those published for the United States. Following simple orthogonal rotation of two principal components, they were easily interpreted as dimensions of physical and mental health in all countries. These components accounted for 76% to 85% of the reliable variance in scale scores across nine European countries, in comparison with 82% in the United States. Similar patterns of correlations between the eight scales and the components were observed across all countries and across age and gender subgroups within each country. Correlations with the physical component were highest (0.64 to 0.86) for the Physical Functioning, Role Physical, and Bodily Pain scales, whereas the Mental Health, Role Emotional, and Social Functioning scales correlated highest (0.62 to 0.91) with the mental component. Secondary correlations for both clusters of scales were much lower. Scales measuring General Health and Vitality correlated moderately with both physical and mental health components. These results support the construct validity of the SF-36 translations and the scoring of physical and mental health components in all countries studied.     

Problem-behavior factor correlates of Personality Inventory for Children profile scales.

Investigated the relationships between empirically determined dimensions of problem behaviors and the profile scales of the Personality Inventory for Children, a multidimensional objective personality inventory. Behavior problems and family characteristics of 430 children and adolescents (ages 2–17 yrs) tapping a variety of content areas were obtained on a 100-item checklist. Responses on the checklist were submitted to a principle components factor analysis with varimax rotation. Factor scores were generated for each S on the 16 interpretable factors. T scores of the 16 profile scales were correlated with the problem-behavior factor scores separately for male children, male adolescents, female children, and female adolescents. The resulting correlation matrices allowed identification of scale to correlates and their variation by age or sex and facilitated the estimate of generalizability of the data analysis. Results provide substantial evidence of scale convergent and discriminant validity and suggest the potential utility of this instrument. Further research is necessary to determine specific correlates suggested by scale elevation, setting, age-specific or sex-specific correlates, and development of profile classification rules. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contemporary militant extremism: A linguistic approach to scale development.

In this article, the authors describe procedures used in the development of a new scale of militant extremist mindset. A 2-step approach consisted of (a) linguistic analysis of the texts produced by known terrorist organizations and selection of statements from these texts that reflect the mindset of those belonging to these organizations and (b) analyses of the structural properties of the scales based on 132 selected statements. Factor analysis of militant extremist statements with participants (N = 452) from Australia, Serbia, and the United States produced 3 dimensions: (a) justification and advocacy of violence (War factor), (b) violence in the name of God (God factor), and (c) blaming Western nations for the problems in the world today (West factor). We also report the distributions of scores for the 3 subscales, mean differences among the 3 national samples, and correlations with a measure of dogmatism (M. Rokeach, 1956). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interconversion of stroke scales. Implications for therapeutic trials

BACKGROUND AND PURPOSE: Stroke scales are intended to measure stroke severity for the purpose of clinical trials. Scores have been used to determine trial entry, to compare patient groups within or between trials, or as a secondary end point. The use of scores as an end point in meta-analysis has not been validated, but such analyses have nevertheless been performed when equivocal results have been obtained using the main outcome measure. The different scale designs suggest that conversion of scores may not be possible. We sought to determine whether scores on different scales could be interconverted. METHODS: A single observer scored 433 consecutive admissions to an acute stroke unit on the Canadian Neurological Scale, the middle cerebral artery Neurological Score (or Orgogozo scale), and the National Institutes of Health stroke scale. Data were separated into training and test sets, and linear regression was used to model conversion between scales. Prediction errors were calculated. Strokes were subdivided according to the Oxfordshire Community Stroke Project classification, and coefficients of determination were calculated for different subtypes. RESULTS: Conversion between Canadian and middle cerebral artery Neurological scales was satisfactory (R2 = 94.7%), and prediction errors were acceptable (absolute prediction error, 5.0 +/- 5). Conversion from the National Institutes of Health scale was worse (R2 = 87.5% to Canadian and 89.0% to Neurological Score), and prediction errors were significantly greater (Neurological Score error, 8.7 +/- 7; Canadian Neurological Scale error, 8.5 +/- 7.3; P < .005 for both). Coefficients of determination for interconversion were significantly worse for dysphasic patients with total anterior circulation strokes than for other stroke types (P < .01). Reweighting the motor component of the National Institutes of Health scale improved coefficients of determination and reduced prediction errors, but prediction error for conversion to the Canadian scale remained significantly greater than other conversions (P = .001). CONCLUSIONS: The Canadian Neurological Scale and the middle cerebral artery Neurological Score may reliably be converted. The National Institutes of Health scale cannot be used to predict these scores reliably, even with reweighting of the motor score. Interconversion is poorest for patients with dysphasia and total anterior circulation strokes. These results suggest that there will be more general difficulty in interconverting scales that use different test items and weighting. Meta-analysis using sequential changes in averaged scores from various stroke scales is not valid.     

Measurement of attribution of causality in counselor behavior.

Describes a set of process scales (Locus of Control Content Scales, Locus of Control Counselor Style Scale, and Problem Solving Scale) developed for use in the study of group counseling. Three of the process scales were designed to rate counselors' references to locus of control, and a 4th scale recorded frequency of problem-solving statements. The locus of control scales differentiated between conveying attitudes about causality through the content of a counselor's statements vs through the style in which he or she interacted with the group. Results of 6 high school counselors working with 96 students indicate that counselors are not consistent in their use of style and content in expressing ideas about causality. Counselor statements tended to imply that students had the resources to solve their own problems (internal content) but provided the students with solutions rather than allowing them to decide on a course of action (external style). Appropriate reliability coefficients and suggestions for designing research using these process scales are given. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Swedish SF-36 Health Survey III. Evaluation of criterion-based validity: results from normative population

Assumptions of the variation in SF-36 scale scores were tested in relation to external criteria in 8930 respondents comprising the Swedish norming population. Physical health scales were strongly associated with age, while small differences were found for the Mental Health scale across age groups. Females reported poorer health than males, particularly in ages between 30-40 and over 70. Worse health profiles were associated with social risk factors (unemployment, divorce, etc.). The disability pension rate was strongly related to reduced Physical Functioning and increased Bodily Pain. The use of medical care was reflected in general health scores (i.e., the lower the scale score, the higher the care consumption). Self-reported physical and psychological symptoms were selectively related to SF-36 scales. All SF-36 scales, except Mental Health, were more strongly related to ratings of health satisfaction than to global quality of life. Combinations of the SF-36 well-being scales explained a substantial part of the variance of these ratings. In conclusion, the performed criterion-validity tests support the cross-cultural stability of the SF-36.     

Individual differences in memory for mathematical story problems: Memory span and problem perception.

The purpose of this study was to investigate individual differences in the recall of propositional units from algebra story problems as a function of memory span and problem perception. Consistent with predictions derived from a processing efficiency view of short-term memory, memory span was inversely related to the recall of extraneous information, positively related to the recall of relational statements, and unrelated to the recall of assignment statements and questions. As predicted by the schema hypothesis, problem perception was inversely related to the recall of extraneous information; however, this relationship was not statistically significant when memory span scores were partialed out. It was concluded that the elementary cognitive processes underlying memory span are important sources of individual differences in problem perception, the ability to eliminate extraneous information from the mental representation of mathematical story problems, and the ability to integrate relational information into a problem representation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral expectation scales: Effects of developmental procedures and formats.

Compared differences in developmental procedures and formats for behavioral expectation scales for effects on interrater reliability, leniency error, rating variability across dimensions, and discriminability. Two different sets of scales were developed using critical incidents that were placed on one dimension category either 50-60% of the time or 80% or greater of the time. In one procedure, Ss first placed each incident into a dimension category and then rated the desirability of each incident in the context of that category on a scale from 1 to 7. In another procedure, Ss placed incidents into categories and another group of Ss rated their desirability. Ratings were made on either continuous or noncontinuous 7-point scales, scales with or without definition-clarification statements, and were scored by either a summary rating procedure or a method which required the rescaling of new incidents. Results from a series of studies involving 258 raters and 81 ratees indicate that there are optimal developmental procedures and formats for behavioral expectation scales. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivations and risk factors for tobacco use in new members of non-smoking youth clubs

OBJECTIVE: This study evaluated neonatal pain scales during procedures commonly performed in a neonatal intensive care unit. DESIGN: Evaluated were the Neonatal Infant Pain Scale (NIPS), the Comfort scale, and a new scale known as the Scale for Use in Newborns (SUN). Four procedures were scored: intubation, intravenous catheter insertion, endotracheal tube suctioning, and diaper changes. Scoring was done before, during, and after each procedure. Thirty-three patients were tested during 68 procedures with 1,428 scale scores. RESULTS: All scales demonstrated significant changes. In before-versus-during for each procedure, the increase in pain scale score was significant for the NIPS, Comfort scale, and SUN. All three scales also demonstrated a return to baseline (before-vs.-after) for the four procedures, except for the Comfort scale, which remained elevated (p < .05) following diaper change. The NIPS had a significantly larger coefficient of variation (CV, 188% +/- 99%), whereas the Comfort scale and SUN had small CVs (27% +/- 5% and 33% +/- 8%, respectively). In evaluating potential confounding influences, it was found that infants > 2.5 kg on sedative or analgesic medications appeared to have procedure-related accentuation and sustained elevation in scale scores, whereas swaddling seemed to provide little added benefit. CONCLUSIONS: The pain scale scores identify changes in an infant's behavior/physiologic state. It is unclear whether these changes are totally "pain specific." In comparing the three scales, the SUN overall was a preferable tool because of its ease of use, scale symmetry, and scoring consistency.     

The Child Behavior Profile: II. Boys aged 12–16 and girls aged 6–11 and 12–16.

Based on the overall rationale and methodology described previously by the 1st author (see record 1979-12316-001), the present article reports the construction of editions of the Child Behavior Profile for boys aged 12–26 and girls aged 6–21 and 12–26 yrs. Scored from the Child Behavior Checklist, the profile consists of social competence and behavior problem scales derived from factor analysis of the checklists filled out by parents of 450 children of each sex and age group referred for mental health services. Second-order factor analyses showed that the behavior problem scales for each sample could be divided into broad-band groupings called "internalizing" and "externalizing." Normalized T scores for the social competence scales, behavior problem scales, internalizing, and externalizing were derived from nonclinical samples. Comparison of clinical and nonclinical samples showed significant differences on all social competence and behavior problem scores. Test–retest (1 wk) correlations averaged .87, and interparent correlations averaged .67. Comparison with findings for boys aged 6–11 yrs are reported. Computerized and hand-scored versions of the profile can be used to display item and scale scores for individual children. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Militant extremist mind-set: Proviolence, Vile World, and Divine Power.

In the present article, the authors report on the development of a scale for the measurement of the militant extremist mind-set. A previous pilot study identified 56 statements selected from writings of various terrorist groups as well as from psychological, historical, and political texts on terrorism. These statements, together with measures of personality, social attitudes, values, and social cynicism, were administered to participants from 9 countries (N = 2,424). A series of exploratory factor analyses of 56 statements produced 3 factors: Proviolence, Vile World, and Divine Power. Correlations of these factors with external variables indicate that Divine Power is a traditional religiosity scale, whereas Proviolence and Vile World scales cannot be accounted for by the existing psychological constructs. The distribution of scores on the Proviolence scale is skewed, indicating that the majority of participants disapprove of this attitude. The authors also present means for the countries included in the analysis. Participants from Malaysia endorse Vile World and Divine Power statements stronger than participants from other countries. The 3 Asian countries (China, Korea, and Malaysia) endorse Proviolence more strongly than countries from other parts of the world. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics of psychiatric programs and their effects on patients' adjustment.

Considers that measuring characteristics of psychiatric programs is an important 1st step in identifying ingredients related to treatment efficiency and effectiveness. Perception of ward (POW) scales were developed using repeated factor analyses of 1,141 male psychiatric patients' perceptions. Program dimensions identified by POW scales are evaluated. The serious problem of response variability in measuring the milieu characteristics of a ward through patient perceptions is examined. POW scores for 353 patients on 3 wards and ratings of later community adjustment revealed that staff receptivity positively affects the posthospital adjustment of certain patient subgroups. (32 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)