Neighborhood deterioration, religious coping, and changes in health during late life

Research indicates that older adults who reside in deteriorated neighborhoods experience more physical health problems than elderly people who dwell in more favorable living environments. The purpose of this study is to see whether the deleterious effects of run-down neighborhoods are reduced for older people who use religious coping responses. Data from a nationwide longitudinal survey of elderly people suggest that the noxious impact of living in a dilapidated neighborhood on changes in self-rated health over time is offset completely for older adults who rely heavily on religious coping strategies. In contrast, significant stress-buffering effects failed to emerge when functional disability served as the outcome measure.     

Examining functional content in widely used Health-Related Quality of Life scales.

Purpose: Assess extent to which generic Quality of Life (QOL) and Health-Related Quality of Life (HRQOL) scales include function in assessment of health, and identify health assessment items that are free of functional content. Methods: An expert panel on measurement of health and disability reached consensus on definitions of health, disability, and function. They assessed all items of all generic (non-condition-specific) scales in the 2006 ProQolid database for being important to measuring health as distinct from function. Ratings were summarized as content validity ratios. Retained items were written into standard format and reviewed again by the expert panel and a validity panel with expertise in specific disabilities. Results: Of 85 scales, 21 were retained as containing items important for assessing health. Scales ranged from 100% (BRFSS HRQOL, WHO-5) to only 4% of items rated as important. In further review of “important” items, functional content was identified in many of the items, particularly with regard to mental functioning. Conclusions: Popular generic scales of QOL and HRQOL vary greatly in the degree to which they include content on function. A pool of items can be identified that are relatively free of function. Distinguishing measurement of function and health is particularly important for people with long-standing functional limitations and for assessing the relationship of health with function. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Research on Gossip: Taxonomy, Methods, and Future Directions.

A half century of gossip research from multiple disciplines is reviewed. Discussed are definitions of the construct: social, evolutionary, and personal functions of the practice; and data collection methods. Though people engage in the practice frequently, there has been relatively little psychological research on gossip. The layperson's understanding of the term is included in, but insufficient to encompass, definitions used by researchers. Most data are ethnographic and discursive, and few parametric data exist. The area could benefit from better experimental methods and instruments. Neurobiological and social network analysis methods are promising foundations for further study. There are real-world implications for understanding gossip. Strengthening gossip theory and research methods will beneficially inform the way we view the practice in context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking, nicotine dependence, and depressive symptoms in the CARDIA Study. Effects of educational status

We propose that two related sources of variability in studies of caregiving health effects contribute to an inconsistent pattern of findings: the sampling strategy used and the definition of what constitutes caregiving. Samples are often recruited through self-referral and are typically comprised of caregivers experiencing considerable distress. In this study, we examine the health effects of caregiving in large population-based samples of spousal caregivers and controls using a wide array of objective and self-report physical and mental health outcome measures. By applying different definitions of caregiving, we show that the magnitude of health effects attributable to caregiving can vary substantially, with the largest negative health effects observed among caregivers who characterize themselves as being strained. From an epidemiological perspective, our data show that approximately 80% of persons living with a spouse with a disability provide care to their spouse, but only half of care providers report mental or physical strain associated with caregiving.     

Disability among Canada's aboriginal peoples in 1991

In 1991, disability rates among adults were high for Aboriginal people, compared with the total Canadian population: 31% versus 13%. For all ages and levels of education, Aboriginal disability rates were much higher than those of Canadians overall. While most younger Aboriginal persons with a disability were only slightly disabled and did not need help with their daily activities, at age 55 and over, more than half of Aboriginal persons with a disability were either moderately or severely disabled and required such help. Nonetheless, most of the Aboriginal population with disabilities who needed help received it, so only a small proportion of them had unmet needs for assistance. The need for assistance, however, increased with the severity of disability. Recent improvements in survivorship mean that more Aboriginal people will live to older ages, at which disability rates are higher. This has implications for their need for health and social services, and the associated costs. Statistics Canada's 1991 Aboriginal Peoples Survey (APS) was used to examine the prevalence and severity of disability and the degree of dependence in the Aboriginal population. Where possible, these results are compared with data for the total Canadian household population from the 1991 Health and Activity Limitation Survey (HALS).     

Neurorehabilitation outcome in moyamoya disease

OBJECTIVE: To assess the contribution of emotional health problems to the burden of disability affecting people of working age. DESIGN: Analysis of data collected in a postal questionnaire survey of a random sample of people aged 18-64 years. SETTING: The four counties of the old Oxford region in 1991. SUBJECTS: 9332 people who responded to a questionnaire survey mailed to 14,000 people randomly selected from the Family Health Service Authority registers of the four counties of Berkshire, Buckinghamshire, Oxfordshire, and Northamptonshire. OUTCOMES MEASURES: Interference with work or other regular daily activity as reported in questions 4 and 5 of the health status measure SF-36. RESULTS: In this population the prevalence of disability attributable to emotional health problems was greater than that attributable to all physical health problems combined. People reporting that their work or other regular daily activity was affected by their emotional health were much less likely to report a long-standing illness, consultation with a GP or consultation with a hospital doctor than people reporting a physical health problem. CONCLUSIONS: Emotional health problems are a more important cause of disability in adults of working age than all physical health problems put together. Their importance is underestimated in health needs assessment exercises, which are based on NHS consultation rates or reporting of chronic illness. Research into the causes, prevention, and management of emotional health problems should be a national priority for the health service.     

How Changes in Population Demographics Will Impact Health Psychology: Incorporating a Broader Notion of Cultural Competence Into the Field.

U.S. population demographics are undergoing striking changes that will impact health care and the research and practice of health psychology. An increase in the number of people who are older; belong to an ethnic minority group; have disabilities; identify as lesbian, gay, bisexual, or transgendered; or live in poverty will influence definitions of aging, health, and illness, and will challenge current psychological and medical treatment models. The authors argue that health psychologists need to become context competent for the field to be relevant and viable over the course of this new century. Health psychologists need to become aware of the multiple, overlapping contexts in which people live and apply this knowledge on a regular basis to research, practice, education and training, and policy in health psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence and recognition of anxiety syndromes in five European primary care settings. A report from the WHO study on Psychological Problems in General Health Care

BACKGROUND: This study explored the prevalence, socio-demographic characteristics and severity of different anxiety syndromes in five European primary care settings, as well as medical help-seeking, recognition by general practitioners (GPs) and treatment prescribed. METHOD: The data were collected as part of the WHO study on Psychological Problems in General Health Care. Among 9714 consecutive primary care patients, 1973 were interviewed using the Composite International Diagnostic Interview. Reason for contact, ICD-10 diagnoses, severity and disability were assessed. Recognition rates and treatment prescribed were obtained from the GPs. RESULTS: Anxiety syndromes, whether corresponding to well-defined disorders or to subthreshold conditions, are frequent in primary care and are associated with a clinically significant degree of severity and substantial psychosocial disability. Their recognition by GPs as well as the proportion treated are low. CONCLUSIONS: Since people with subthreshold anxiety show a substantial degree of disability and suffering, GPs may consider diagnostic criteria to be insufficient. However, their awareness of specific definitions and treatment patterns for anxiety disorders still needs a lot of improvement both for patients' well-being and for the cost resulting from non-treatment.     

Major mental illness, housing, and supports: The promise of community integration.

Providing housing and supports for people with psychiatric disabilities, particularly those who are homeless, is a major public policy challenge. This article summarizes the ways in which the concept of these needs is rapidly shifting in the mental health field. The article is based on research on the effectiveness of non-facility-based community support and rehabilitation approaches, the findings of other disability fields, and the emergence of mental health consumers' own preferences for expanded choices, normal housing, and more responsive services, including consumer-operated services. These new sources of knowledge are facilitating a paradigm shift in which people with psychiatric disabilities are no longer seen as hopeless, or merely as service recipients, but rather as citizens with a capacity for full community participation and integration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes toward persons with a disability: An examination of demographic factors, social context, and specific disability.

Attempted to replicate the findings of S. A. Grand et al (see record 1983-08199-001) concerning the multidimensional nature of attitudes toward persons with a disability, and examined the relationship between attitudes toward persons with a disability and salient demographic and contact variables. 214 university faculty and staff (aged 19–73 yrs) completed a disability social relationship scale that examined attitudes about members of specific disability groups (people with cerebral palsy, epileptics, amputees, and blind people) in various situations (work, dating, marriage), and a demographic data form assessing age, education level, SES, gender, and religion. Results support the multidimensionality hypothesis, and a hierarchical regression analysis revealed that increased contact with persons with a disability, younger age, and higher levels of education were the best predictors of more favorable scores. However, demographic variables accounted for limited variance in attitudes. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging, health risks, and cumulative disability

BACKGROUND: Persons with lower health risks tend to live longer than those with higher health risks, but there has been concern that greater longevity may bring with it greater disability. We performed a longitudinal study to determine whether persons with lower potentially modifiable health risks have more or less cumulative disability. METHODS: We studied 1741 university alumni who were surveyed first in 1962 (average age, 43 years) and then annually starting in 1986. Strata of high, moderate, and low risk were defined on the basis of smoking, body-mass index, and exercise patterns. Cumulative disability was determined with a health-assessment questionnaire and scored on a scale of 0 to 3. Cumulative disability from 1986 to 1994 (average age in 1994, 75 years) or death was the measure of lifetime disability. RESULTS: Persons with high health risks in 1962 or 1986 had twice the cumulative disability of those with low health risks (disability index, 1.02 vs. 0.49; P<0.001). The results were consistent among survivors, subjects who died, men, and women and for both the last year and the last two years of observation. The onset of disability was postponed by more than five years in the low-risk group as compared with the high-risk group. The disability index for the low-risk subjects who died was half that for the high-risk subjects in the last one or two years of observation. CONCLUSIONS: Smoking, body-mass index, and exercise patterns in midlife and late adulthood are predictors of subsequent disability. Not only do persons with better health habits survive longer, but in such persons, disability is postponed and compressed into fewer years at the end of life.     

The Boulder Model: History, rationale, and critique.

Although the current philosophy of education in clinical psychology allows for the existence of a program of training clinical psychologists who primarily want to be practitioners in conjunction with the more traditional scientist-practitioner (Boulder model) program, the controversy over the value of the 2 types of program continues. The criticism of the Boulder model is that the rationale for requiring clinical psychology students to learn to do research as well as train to be clinicians was spurious; the Boulder model trains students as researchers, a role that is incompatible with their interests and abilities. The history of the development of the Boulder model is reviewed together with data regarding the personality traits, interests, and abilities of people interested in research as opposed to service work. Findings indicate that the objections of the critics are well founded. (6 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health professionals, disability, and assisted suicide: An examination of relevant empirical evidence and reply to Batavia (2000).

Prominent disability rights groups have adopted positions opposing the legalization of assisted suicide. That physicians and other health professionals would assist in suicides of persons with incurable conditions while offering suicide prevention to "healthy" individuals is, they maintain, evidence of social discrimination and an unwarranted devaluation of the quality of life of people with disabilities. This article examined empirical literature relevant to the question: Is there evidence that disability affects life in a manner that justifies an exception to the general practice of preventing rather than endorsing suicide? Research findings are discussed in terms of their bearing on the disability rights opposition to physician-assisted suicide and the need for research addressing the dynamics of death requests of persons with disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Burden of disease in the aged, Mexico, 1994

OBJECTIVE: To estimate the disability adjusted life years lost (DALYs) in population over 60 years of age in Mexico during 1994. MATERIAL AND METHODS: Years of life lost due to premature mortality (YLL) and years lived with disability (YLD) were estimated for 108 diseases, both sexes, and 32 states of the Mexican Republic divided in rural and urban areas in the population over 60 years of age, using the methodology originally proposed by Murray and López adapted to specific local characteristics. The inputs used were: mortality statistics for 1994 (after corrections of under-registration and misclassification), statistics on incidence and prevalence from local epidemiological studies, national health surveys and estimates by the authors. RESULTS: During 1994 the Mexican population over 60 years of age lost 1.8 million DALYs, 59% of which were YLL while 41% were YLD. Most of the burden of disease is due to noncommunicable diseases. The principal health needs of the elderly in Mexico can be divided in two groups: a) those that traditionally are frequent in this age group, such as ischaemic heart disease, diabetes, stroke and b) disabling diseases such as dementia, falls and arthritis as the most important. CONCLUSIONS: The use of composite indicators such as DALYs to assess health needs in older adult can help decision-makers and planners to incorporate disabling and lethal diseases within the list of priority needs, thereby achieving greater equity in the assignment of resources to different health care, prevention and rehabilitation programs.     

Prevalence of human papillomavirus in squamous cell carcinoma of the head and neck determined by polymerase chain reaction and Southern blot hybridization: proposal for optimized diagnostic requirements

OBJECTIVE: To develop Canadian projections for the prevalence and numbers of people with arthritis and arthritis disability, overall and in major age groups. METHODS: Age and sex specific data from the 1991 General Social Survey and the 1994 National Population Health Survey on the prevalence of arthritis and arthritis disability were applied to population projections for Canada for every 5 years between 1991 and 2031. RESULTS: Between 1991 and 2031 we project that the prevalence of arthritis diagnosed by a health professional as a longterm condition in Canada will increase from 10.7 to 15.7%, an increase of 46.7%, and the number of people with arthritis will increase from 2.9 to 6.5 million, an increase of 124%. Comparable changes in prevalence and numbers of people with self-reported arthritis are 17.1% (4.7 million) to 23.6% (9.7 million). Most of the increase will be in the population aged 45+, and not until after 2020 will the comparative increase in the 65+ age group be greater than that for the 45-64 age group. Disability attributed to arthritis in the population aged 15+ is projected to increase from a prevalence of 2.3% (595,000) in 1991 to 3.3% (1.13 million) in 2031. CONCLUSION: There are large projected increases in both the prevalence and numbers of people with arthritis and arthritis related disability that, at least in the next 20 years, will be split between the older half of the working population and those aged 65 and older.     

Assessing environmental factors that affect disability: Establishing a baseline of visitability in a rural state.

Purpose: The homes in which people live are one element of the shared built environment. The concept of visitability describes features of private homes that provide a minimal level of accessibility, allowing a person with mobility impairments to visit the homes of family and friends. This study's aim was to establish a baseline rate of basic home visitability in Montana. Method: A visitability question was included as part of the 2004 Montana Behavioral Risk Factor Surveillance System (BRFSS) Questionnaire, a random-digit-dialed telephone survey of 5,005 Montana adults. Results: Nearly 1 in 5 respondents (19.3%) said "a person who uses special equipment such as a wheelchair...could get into [their] house without being carried up steps or over other obstacles." Respondents with a disability who reported living in a visitable house were less likely than those who did not live in a visitable house to report any days of poor mental health in the past month. Conclusion: The BRFSS affords the opportunity to measure elements of the community environment important to the health and life quality of people with disabilities. Here, BRFSS data provided a baseline rate for visitable homes in the state. Strategies to increase this number are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meta-analysis of psychological interventions for chronic low back pain.

The purpose of this meta-analysis of randomized controlled trials was to evaluate the efficacy of psychological interventions for adults with noncancerous chronic low back pain (CLBP). The authors updated and expanded upon prior meta-analyses by using broad definitions of CLBP and psychological intervention, a broad data search strategy, and state-of-the-art data analysis techniques. All relevant controlled clinical trials meeting the inclusion criteria were identified primarily through a computer-aided literature search. Two independent reviewers screened abstracts and articles for inclusion criteria and extracted relevant data. Cohen's d effect sizes were calculated by using a random effects model. Outcomes included pain intensity, emotional functioning, physical functioning (pain interference or pain-specific disability, health-related quality of life), participant ratings of global improvement, health care utilization, health care provider visits, pain medications, and employment/disability compensation status. A total of 205 effect sizes from 22 studies were pooled in 34 analyses. Positive effects of psychological interventions, contrasted with various control groups, were noted for pain intensity, pain-related interference, health-related quality of life, and depression. Cognitive-behavioral and self-regulatory treatments were specifically found to be efficacious. Multidisciplinary approaches that included a psychological component, when compared with active control conditions, were also noted to have positive short-term effects on pain interference and positive long-term effects on return to work. The results demonstrated positive effects of psychological interventions for CLBP. The rigor of the methods used, as well as the results that reflect mild to moderate heterogeneity and minimal publication bias, suggest confidence in the conclusions of this review. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The homeless assessment program: A service-training model for providing disability evaluations for homeless, mentally ill individuals.

Many of the nation's homeless people suffer from unrecognized mental illnesses and do not have access to the kind of disability benefits they would be entitled to when properly assessed. The current system of disability evaluations for Social Security income claims is frequently inadequate and leaves these individuals without any source of income, health insurance, and mental health treatment. This article introduces a model of providing psychological assessments for homeless, mentally ill individuals by supervised student examiners, a model that could be replicated by other psychologists and training institutions. The authors argue that there may be a large number of homeless adults who suffer from disabling mental conditions but who are not properly diagnosed and, therefore, do not qualify for benefits. The authors propose that the model presented can help to fill a gap in services and may serve as a model of socially relevant clinical training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validation of the Lifestress Inventory for people with a mild intellectual disability

The Subjective Stress Scale (SSS; Bramston & Bostock, 1994) was developed to measure stress in people with a mild intellectual disability. In previous research, the SSS was found to measure two broad dimensions of stress (a) a General Worry factor and (b) a factor that tapped concerns about Negative Interpersonal Relations (Bramston & Fogarty, 1995). The present study sought to continue this line of research by introducing a slightly modified form of the SSS, to be known as the Lifestress Inventory (LI) and examining the psychometric properties of the scale when administered to a new sample of 221 people with mild intellectual disabilities. Confirmatory factor analysis indicated that three underlying factors corresponding to General Worry, Negative Interpersonal Relations, and Coping were sufficient to account for the correlations among the items in the LI. Rasch analysis indicated some improvements to the scoring format for the LI and also showed that the most easily experienced stressors were associated with the Negative Interpersonal Relations dimension. The refinements introduced by the LI and the further demonstration that some of the broad stress dimensions identified in the general population can also be found in people with an intellectual disability represent important milestones for researchers interested in exploring reactions to stress among this population.     

Religion among disabled and nondisabled persons II: attendance at religious services as a predictor of the course of disability

What is the relationship between religious involvement and functional disability among elderly people? Is being disabled different for those who frequently attend religious services? Does religious involvement have an effect on subsequent change in disability? Deriving our hypotheses from traditional theories in the sociology of religion, these questions are explored in these two related articles. Both employ data from the New Haven site of the Established Populations for the Epidemiologic Study of the Elderly (N = 2812). In the first, cross-sectional correlates of religious involvement and disability are examined at the baseline of the study, including multiple indicators of health practices, social activities, and subjective well-being. We test for interactions between religious attendance and disability. Findings are (a) that religious involvement in 1982 is tied to a broad array of behavioral and psychosocial resources, (b) that these resources are associated primarily with attendance at services, and not with subjective feelings of religiousness, and (c) that some of these associations are especially pronounced among disabled respondents.