Interbacterial binding among strains of pathogenic and commensal oral bacterial species

OBJECTIVE: Family resources and coping skills are important to adaptation to pediatric chronic illness. Psychological and educational interventions have been found to enhance the coping skills of children with juvenile rheumatic disease (JRD) and their families. We examined the efficacy of a 3-day family retreat as a multidisciplinary, comprehensive treatment. METHODS: Children with JRD and their caregivers completed questionnaires assessing the children's behavioral and emotional functioning, pain, strain on caregivers' work and leisure activities, and caregivers' psychological distress before and 6 months after the family retreat. Principal caregivers were both parents for 16 children, mothers only for 10 children, and an aunt for 1 child. RESULTS: Improvements were found in children's emotional functioning, strain on caregivers' work, and strain on caregivers' leisure activities. Reductions in reported pain were not consistently revealed. CONCLUSIONS: Family retreats are an efficacious, multidisciplinary approach to helping families of children with JRD cope with the disease and its manifestations. Importantly, retreats offer a comprehensive intervention package that might not be available to families on an individual basis.     

The role of neuroticism and mastery in spouse caregivers' assessment of and response to a contextual stressor

Data from more than 300 spousal caregivers and their care recipients were analyzed to demonstrate the effects of caregivers' personality attributes--neuroticism and mastery--on their assessment of a contextual stressor (the care recipient's behavioral and functional impairment) and on their experience of distress associated with that stressor. Caregivers who were high in neuroticism and/or low in mastery reported higher levels of behavioral and functional impairment in their disabled spouse and experienced more strain and depressive symptoms associated with caregiving relative to caregivers with lower neuroticism or higher mastery scores. We further showed that the widely reported association between caregiver-assessed impairment of the care recipient and caregiver outcomes can in part be explained by caregivers' personality attributes, such as neuroticism and mastery. Our findings that caregivers' personality variables are related to their assessment of a given objective stressor and their response to a given level of stress have implications for interventions targeting caregivers and for the use of caregivers as proxy informants.     

Impact of close family members on older adults' early response to depression treatment.

This study of 130 depressed older adults and their spouses or adult children examined the impact of caregiver burden specific to patients' depressive symptoms on patients' response to antidepressant treatment. Primary care patients completed medical, psychiatric, and neuropsychological assessments prior to treatment, and interviews were conducted with their identified family member. As hypothesized, caregivers' depression-specific burden predicted greater depression severity for the patient at the 6th week of treatment after accounting for patients' pretreatment characteristics, caregivers' depressive symptoms, and caregivers' relationship satisfaction. Future research may identify family attitudes and behaviors that stem from burden and compromise older adults' ability to recover from depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Structural equation modeling of the relationship between caregiver psychosocial variables and functioning of individuals with stroke.

Purpose/Objective: Stroke is a leading cause of disability worldwide. Informal caregivers are essential in the survival of most individuals with stroke and may even aid in their recovery. Yet caregivers experience high levels of burnout, depression, burden, and physical illness. Research Method/Design: With structural equation modeling and canonical correlation analysis, links were identified between caregiver psychosocial variables and specific aspects of the functioning of individuals with stroke in 135 care recipient-caregiver dyads. Results: Initial analyses uncovered a medium-sized correlation between caregiver variables and care recipients' functioning. Follow-up analyses pinpointed specific links between caregivers' sense of coherence and care recipients' basic engagement with life and between caregivers' levels of burden and depression and care recipients' cognitive deficits and depression. Conclusions/Implications: On the basis of these findings, the authors propose a feedback loop wherein caregivers' psychosocial functioning, their quality of caregiving, and stroke severity and recovery are causally interconnected. Findings are consistent with the use of cognitive-behavioral interventions for caregivers, which may improve caregivers' sense of coherence, reducing their levels of burden and depression and leading to improved informal care and better recovery from stroke. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reciprocal influences in children's and families' adaptation to early childhood wheezing.

Objective: The objective of the present study was to demonstrate the reciprocal relationships between family adaptation to illness and children's medication use over time among children who presented with wheezing illness in infancy but have varying illness outcomes by age 4. Design: A longitudinal design and latent growth curve models (LGM) were used to predict change in family and caregiver adaptation to illness and children's medication use over three years among 140 infants with wheezing, among families from low socioeconomic, multi-ethnic backgrounds. Main Outcome Measures: One LGM predicted level and change (slope) of family adaptation to illness from children's baseline medication use. The second LGM predicted level and change (slope) of children's medication use from baseline family adjustment to illness. In both models, illness severity, caregivers' psychological resources, and emergency department use were covaried with the independent variable. Results: Two latent growth models were found to adequately fit the data and demonstrate full reciprocal relations between family adaptation to illness and children's medication use while accounting for baseline variables. Baseline measures of caregiver psychological functioning and illness severity were also significant predictors of family adaptation and children's medication use over time. The two models were not statistically different for children with and without active asthma at 4 years of age. Conclusion: Findings support the reciprocal effects model of child and family influences on pediatric illness and underscore the importance of early indicators of individual and family functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A quantitative study of the emotional outcome of people caring for stroke survivors

BACKGROUND AND PURPOSE: Although the physical and, to a lesser extent, emotional outcome of stroke survivors has been well documented, there are far fewer data relating to the outcomes of those who care for them. We aimed to describe the outcome of those caring for stroke patients and to identify both patient and caregiver factors that are associated with poor caregiver outcomes. METHODS: As part of a randomized trial to evaluate a stroke family care worker, we identified 417 patients (67% of all referrals to our institution). We followed up 376 survivors of whom 246 identified a caregiver at a 6-month follow-up interview. The patients and caregivers were asked to complete 2 measures of emotional distress ( 30-item General Health Questionnaire [GHQ-30] and Hospital Anxiety and Depression [HAD] Scale). A regression analysis was used to identify factors that were independently associated with poor caregiver outcomes. RESULTS: Fifty-five percent of responding caregivers scored more than 4 on the GHQ-30, indicating that emotional distress is common in this group. Caregivers were more likely to be depressed if the patients were severely dependent (P<0.01) or emotionally distressed themselves (P<0.01). Female caregivers reported more anxiety (median HAD=8) than male caregivers (median HAD=5; P<0.01) but caregivers' levels of anxiety were not so clearly related to the patients' degree of physical disability as their levels of depression. Caregivers suffered more emotional distress if the patients had been dependent before their strokes. CONCLUSIONS: These data may help to identify those caregivers at greatest risk of poor emotional outcomes and thus help in the planning of trials and delivery of interventions aimed at preventing or treating distress among caregivers.     

Temperament, activity, and expectations for later personality development.

Temperament is assumed to be the biologically based, emotional core of personality. Adult personality is presumed to emerge developmentally from temperament. One mechanism that may link temperament to subsequent personality development involves caregiver expectancies. Stability in personality may be associated with caregiver expectancies about the meaning of temperament-based behavior. The expectancies, in combination with implicit theories of personality development, support stability and patterned change. This multimethod study examined the relations among motor activity differences, temperament, and expectations about future personality characteristics in preschool children. It was hypothesized that motor activity and temperament differences would be linked to teachers' expectations about later personality development. The hypothesis that expectations about such links would be moderated by the sex of the child was also examined. Outcomes generally corroborated hypotheses. Results are discussed in terms of personality development and age-related adaptations to social contexts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Five-factor personality traits and subjective health among caregivers: The role of caregiver strain and self-efficacy.

This study examined the association among caregivers' five-factor personality traits and subjective health with particular emphasis on the role of two theoretically implicated mediators: multi-domain self-efficacy and caregiver strain. The sample comprised 536 informal caregivers (mean age = 62.9 years, SD = 19.9, 72% female, 98% White) of community-dwelling older adults with multiple functional impairments. Both physical health and mental health were negatively associated with neuroticism and positively associated with extraversion and conscientiousness. Agreeableness and openness were associated with better subjective mental health and physical health, respectively. Multiple mediation analyses indicated that self-efficacy mediated all observed associations between personality and subjective health, whereas caregiver strain selectively mediated the associations of neuroticism and agreeableness with mental health. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Bulimia and binge eating in college women: A comparison of personality and behavioral characteristics.

Assessed 9 behavioral and personality characteristics—restraint, binge eating, high self-expectations, demand for approval, body attitude, assertion, dating, self-esteem, and depression—that have been implicated in studying the onset of bulimia. Ss were 30 women who fulfilled an operationalized definition of the DSM-III criteria for bulimia (bulimics), 22 women who reported binge eating 8 or more times per month but did not fulfill the criteria for bulimia (binge eaters), and 28 women who did not binge eat (controls). Ss completed measures that included the Beck Depression Inventory, a self-esteem index, and the short form of the Personality Attributes Questionnaire. In comparison to controls, bulimics were more depressed and had lower self-esteem, poorer body image, higher self-expectations, higher need for approval, greater restraint, and higher binge-eating scores. Binge eaters exhibited higher restraint and binge-eating scores than controls. Bulimics and binge eaters differed significantly on all but a few variables. Results suggest that treatment for bulimics should extend beyond the disturbed eating pattern and that the distinction between binge eating and bulimia is an important one. Some empirical support for the DSM-III definition of bulimia was found. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-esteem, need for approval, and cheating behavior in children.

We investigated the effects of personality and situational variables on children's cheating behavior. Two hundred twenty-eight 10- to 12-year-old boys and girls completed the Children's Social Desirability Questionnaire and the Coopersmith Self-Esteem Inventory and were given unsolvable problems at which they could "succeed" only by cheating. One group was offered a tangible prize for success, the second group was told that its performance would be made public, and the third group served as a control group. The children with high self-esteem and low need for approval cheated significantly less than the children with high self-esteem and high need for approval, who behaved similarly to the children with low self-esteem. In addition, boys cheated more than girls, and all children cheated most when they expected a tangible prize. We discuss two kinds of high self-esteem: "true" high self-esteem and defensive high-esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family Caregivers of Stroke Survivors: Characteristics of Caregivers at Risk for Depression.

Objective: To examine characteristics that best predict family caregivers of stroke survivors at risk for depression. Survivor and caregiver demographic variables and caregiver general health, problem-solving skills, social support, satisfaction with rehabilitation health care services, preparedness, and burden were examined. Design: A correlational design. Participants: Seventy-four family caregivers of individuals receiving inpatient stroke rehabilitation were interviewed 1-2 days prior to their relative's discharge. Main Outcome Measure: The Center for Epidemiologic Studies Depression Scale (L. S. Radloff. 1977). Results: Caregivers at risk for depression had a negative orientation toward solving problems, a lack of caregiver preparedness, and impaired social functioning secondary to their own health. Conclusions: Rehabilitation psychologists should be aware that these variables are important in predicting family caregivers of stroke survivors at risk for depression. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Family functioning and social support in the adaptation of caregivers of children with sickle cell syndromes

OBJECTIVE: To examine moderating effects of family functioning and social support on the relationship of child-related stressors to caregivers' psychological adaptation in a sample of caregivers of children with a chronic illness. METHOD: Participants were 67 caregivers of children and adolescents with sickle cell syndromes. We conducted MANOVAs and subsequent effect size calculations to determine if family functioning would buffer the effects of caring for difficult-to-manage children with this illness. RESULTS: Findings supported a moderator effect of family functioning on the association of children's externalizing behavioral problems to caregivers' symptoms of hostility. Greater levels of cohesive and adaptive family functioning buffered the potential detrimental effects of caring for children perceived as hard to manage. No significant associations were obtained between measures of caregivers' psychological adaptation and the severity of their children's disease. CONCLUSIONS: We make recommendations for family systems interventions, particularly for caregivers of children with behavior problems.     

Personality and self-efficacy as predictors of coping with abortion.

Explored the relationships among dispositional optimism, self-esteem, chronic perceptions of control, depression, and self-efficacy in predicting psychological adjustment among women undergoing an abortion. Self-efficacy was found to be a strong, proximal predictor of adjustment, both immediately after the abortion and 3 wks later. Optimism, perceptions of personal control, and high self-esteem were all related to better postabortion adjustment (mainly through the mediator of increased self-efficacy for coping). In addition, the effects of these 3 personality variables were found to overlap considerably. Finally, preabortion depression had both direct and indirect (through self-efficacy) effects on adjustment. These effects did not overlap completely with the effects attributable to personality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association of level and stability of self-esteem and depressive symptoms in the acute inpatient stroke rehabilitation setting.

Purpose: Explore the relationship of level and stability of self-esteem with self-reported depressive symptoms during acute inpatient stroke rehabilitation. Research Method: A consecutive sample of 79 participants was administered measures of state self-esteem and mood twice a day for 4 consecutive days. The Geriatric Depression Scale (GDS) was administered at the end of the 4 days. Self-esteem level was calculated by averaging the total self-esteem scores across the assessments, and self-esteem stability was operationalized as the standard deviation of self-esteem total scores. Mood level and stability were calculated likewise. Results: Regression analysis indicated that self-esteem stability moderated self-esteem level in predicting GDS scores, with stable lower self-esteem level associated with the most reported depressive symptoms. Unstable higher self-esteem levels were associated with more depressive symptoms than stable higher self-esteem. This interaction was demonstrated after controlling for mood level and stability, suggesting the independence of self-esteem stability from mood characteristics. Conclusion: Self-esteem stability may be an important variable in identifying individuals at risk for emotional disturbance following stroke. Further exploration of self-esteem stability correlates in this setting is warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A French-Canadian scale for suicide ideation for use with adolescents.

Extended the Scale for Suicide Ideation (SSI) and evaluated whether the adaptation of the SSI by A. F. De Man et al (see record 1987-30114-001) that had been validated for use with adults could also be used with adolescents. 110 French-Canadian adolescents (aged 11–18 yrs) participated in an analysis of the reliability and validity of a French version of the SSI. Item analysis and coefficient alpha results suggested good reliability. Correlations with selected personality variables were obtained. Associations were found between suicide ideation and measures of self-esteem, multi-dimensional locus of control, life stress, depression, anomie, and age. (French abstract) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Over-the-counter medications. Do parents give what they intend to give?

OBJECTIVE: To evaluate caregiver (parent or guardian) use of over-the-counter medications (OTCs) as related to the accuracy and correctness of dosing for children seen at a pediatric emergency department with nonemergent concerns. DESIGN: Prospective patient series. SETTING: A tertiary care pediatric emergency center. PARTICIPANTS: A representative sample of children with nonemergent chief complaints. INTERVENTIONS: A questionnaire about general demographic characteristics, recent OTC use, and medical history of the patients was given to each caregiver. A mock scenario was then presented that required the caregivers to determine and measure a correct dose of acetaminophen for their child. A dose of 9 to 16.5 mg/kg was considered correct. Accuracy of measuring was considered within +/-20% of the caregivers' stated intended dose for their child. RESULTS: One hundred caregivers were enrolled in the study. Mean caregivers' age was 29 years, with 82% having at least a high school education. Seventy-seven percent of their children used OTCs within the previous 2 months, and Tylenol (acetaminophen) was the most commonly used. While 66% of the caregivers reported Tylenol use, only 8% reported the use of acetaminophen. During the dosing scenario, only 40% of the caregivers stated an appropriate dose for their child and only 67% accurately measured the amount of acetaminophen they intended. Forty-three percent measured out a correct amount of acetaminophen for their child. However, almost one third of these occurred strictly by accident because they inaccurately measured an improper intended dose. Combining these results, only 30% of the caregivers were able to demonstrate both an accurately measured and correct dose for their child. CONCLUSIONS: Although a large number of caregivers administer OTCs, knowledge of these medications, and accuracy and correctness of dosing remain a marked concern. Improved caregiver education on the accuracy and correctness of dosing OTCs is necessary.     

Demand characteristics and inferential processes in psychotherapeutic change.

Assigned 87 19–54 yr old unassertive Ss to 4 types of imaginary role playing: (a) roles based on personality attributes presenting demand characteristics for changing self-concepts, (b) social skills training, (c) exposure to stressful social situations, and (d) a neutral social situation control group. Pre- and post-role-playing scores on a self-concept instrument were determined. ANOVAs showed that Ss who participated in condition (a) increased significantly in assertiveness and self-esteem and decreased significantly in social discomfort compared to the control Ss. It is suggested that general therapeutic factors involve demand variables that cue Ss to alter their self-concepts. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of the professional profile of family and community medicine tutors on residents'' training

This cross-sectional study aimed at assessing the relationship of feeling of personal responsibility for miscarriage and personal coping resources (self-esteem and self-efficacy), with symptoms of anxiety and depression in 138 women at 19 to 400 days following the diagnosis of a missed abortion. Multiple regression analyses controlling for demographic and obstetric variables demonstrated that higher feelings of personal responsibility, and lower personal resources were significantly associated with anxiety and depression. Self-esteem had the most salient effect on women's level of affective psychopathology; higher levels of self-esteem were associated with lower anxiety and depression. Women with high levels of self-esteem also reported significantly lower feelings of personal responsibility for miscarriage than those with low levels of self-esteem. Interventions aimed at enhancing feelings of self-worth, and at altering exaggerated feelings of personal responsibility for miscarriage, could lessen the potential negative emotional impact of pregnancy loss on women.