Microbicidal activity of eosinophils is associated with activation of the arginine-NO pathway

The burden, the coping strategies and the social network of a sample of 236 relatives of patients with schizophrenia, living in five European countries, were explored by well-validated assessment instruments. In all centres, relatives experienced higher levels of burden when they had poor coping resources and reduced social support. Relatives in Mediterranean centres, who reported lower levels of social support, were more resigned, and more often used spiritual help as a coping strategy. These data indicate that family burden and coping strategies can be influenced by cultural factors and suggest that family interventions should have also a social focus, aiming to increase the family social network and to reduce stigma.     

Care of stroke patients by relatives--social support and coping strategies

OBJECTIVE: To assess the coping ability and the social support of relatives looking after patients who have had a stroke. Of special interest was to ascertain how coping behaviour and social support differed between short-term (caring period of 3-6 months) and long-term (caring period longer than 2 years) carers. Differences in social networking between relatives and a control group (no caring tasks) were also assessed. SUBJECTS AND METHODS: A questionnaire based on the well-established "Berne coping forms" and another on social support were filled in by 20 relatives (18 women, two men; mean age 50.6 years) after a short-term caring period of up to 6 months and 20 relatives after a caring period longer than 2 years (14 women, six men; mean age 64.9 years) and a control group (27 women, 10 men; mean age 57.8 years). RESULTS: Among the total group of relatives the coping strategies (listed by order of importance) were: "passive cooperation", "acceptance", and "lending a hand". The short- and long-term carers showed no significant differences in these strategies. However, there were significant deficits in social support between the relatives and the controls as to practical support (P < 0.05), social integration (P < 0.01), social support received (P < 0.01), social burden (P < 0.01) and the caring persons (P < 0.05). There was no difference regarding social support between the short- and long-term carers. CONCLUSIONS: The results confirm the importance of social support for relatives who look after stroke patients. Every form of psychosocial help should be given at the time the patient is discharged to home care. This would require day clinics and short-term places in nursing homes.     

Stability of expressed emotion in relatives of those with schizophrenia and its relationship with burden of care and perception of patients' social functioning

BACKGROUND: There is evidence that high expressed emotion (EE) in relatives of patients with schizophrenia is associated with higher levels of burden of care, and with worse perception of patient's social functioning. However, it is not clear whether changes in EE levels over time are associated with changes in relatives' burden of care and their perception of patients' social functioning. METHODS: Fifty patients with a diagnosis of schizophrenia and 50 relatives were included in the study soon after patients' admission to hospital. Thirty-six relatives and 31 patients were re-assessed 9 months after patients' discharge. Both assessments included patients' symptomatology and relatives' EE levels, burden of care, and perception of patients' social functioning. RESULTS: Twenty-three relatives (64%) had the same EE level in both assessments, nine (25%) had changed from high to low EE, and four (11%) from low to high EE. Improvement in burden and perception of patients' social role performance were significantly more accentuated among relatives who changed from high to low EE than among relatives who had a stable EE level. Variables that best predicted changes in EE levels were changes in burden scores and number of hours of contact between patients and relatives at follow-up. CONCLUSIONS: Change in EE is associated with change in circumstances and burden. Findings support the idea that EE is better understood in an integrative model.     

People living with HIV infection who attend and do not attend support groups: a pilot study of needs, characteristics and experiences

People living with Human Immunodeficiency Virus (HIV) confront a myriad of stressors over the course of their infection. Social support groups offer a means of addressing the support needs of people living with HIV. In the present study, 34 persons who had attended HIV support groups and 29 who had not attended groups completed measures of distress, coping, and social connectedness, and participated in open-ended interviews concerning their support group experiences. Results showed that those who attended support groups knew they were HIV-seropositive for a longer time, reported less emotional distress, and had more social contact than did non-attenders. However, non-attenders endorsed avoidant coping strategies to a greater extent. Analyses showed that time since testing positive accounted for differences between groups in social connectedness but not differences in anxiety, depression, or avoidance coping. Thus, HIV-seropositive persons become socially reconnected with time, but individuals with avoidant coping styles experience greater emotional distress and are unlikely to seek support groups. A sizeable proportion of people with HIV may therefore need supportive interventions, particularly nearer to the time that they test HIV-seropositive.     

Coping with job stress and burnout in the human services.

Conducted a mail survey of 141 human service workers (aged 25–65 yrs) to investigate the effects of coping on psychological strain and burnout produced by job stress. The survey assessed job stressors and coping strategies with open-ended questions and measured strain using closed-ended alienation, satisfaction, and symptom scales. Because previous research suggested that individual coping responses do not alleviate strain produced by job stress, the survey elicited information on group coping (social support) and on coping strategies initiated by agencies. Job stress was associated with high levels of strain, and group coping with low levels, but individual responses had little effect. Although Ss identified many strategies that agencies could use to reduce stress and strain, actual use of such strategies was slight. Because men and women worked in the same jobs, no sex differences in individual coping were predicted and none were found; women, however, reported more social support than men. There was no evidence for moderating (interaction) effects of stress and coping on strain. Results suggest that social service agencies should take actions to reduce stress among employees. (57 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial predictors of life satisfaction among persons living with HIV infection and AIDS

As AIDS becomes a more chronic but manageable illness, understanding quality of life issues among persons living with this disease has become an important goal of health care researchers. However, most quality of life investigations of persons living with HIV disease have relied heavily on clinical samples (e.g., hospitalized patients, psychiatric outpatients). The present study sought to identify psychosocial predictors of general life satisfaction in a community sample of 275 persons living with HIV/AIDS in a large midwestern state. Principal components and multiple regression analyses revealed that improved physical/functional well-being, increased social support, more frequent use of active coping strategies, and fewer incidents of AIDS-related discrimination and stigma predicted higher levels of general life satisfaction (R2 = 39). Intervention strategies likely to produce higher levels of life satisfaction among persons living with HIV disease are discussed.     

Three-year trials of personal therapy among schizophrenic patients living with or independent of family, I: Description of study and effects on relapse rates

OBJECTIVE: The study of individual psychotherapeutic approaches to the treatment of schizophrenia has yielded equivocal findings, partly because of methodologic problems. Further, the ability of psychosocial treatments to prevent psychotic relapse appears to lessen over time. The authors' goal was to develop and test a demonstrably effective individual therapy for schizophrenia. METHOD: Using a study design that addressed previous methodologic issues, the authors evaluated personal therapy specifically designed to forestall late relapse in patients with schizophrenia. They evaluated the effectiveness of personal therapy over a period of 3 years after hospital discharge among 151 patients with schizophrenia or schizoaffective disorder diagnosed according to Research Diagnostic Criteria. The patients were randomly assigned to receive either personal therapy or contrasting therapies in one of two concurrent trials. One trial studied patients who were living with family (N = 97); the other studied patients who were living independent of family (N = 54). RESULTS: All of the patients had extensive psychiatric histories, but only 44 (29%) experienced recurrent psychotic episodes over the 3-year study period, and only 27 (18%) prematurely terminated the study; most of those who left the study were in the no-personal-therapy conditions. Among patients living with family, personal therapy was more effective than family and supportive therapies in preventing psychotic and affective relapse as well as noncompliance. However, among patients living independent of family, those who received personal therapy had significantly more psychotic decompensations than did those who received supportive therapy. CONCLUSIONS: Personal therapy had a positive effect on adverse outcomes among patients who lived with family. However, personal therapy increased the rate of psychotic relapse for patients living independent of family. The application of personal therapy might best be delayed until patients have achieved symptom and residential stability.     

Anhedonia as a phenotype for the Val1??Met COMT polymorphism in relatives of patients with schizophrenia.

The Val1??Met polymorphism of the catechol-O-methyltransferase (COMT) gene has been associated with aspects of schizophrenia that are possibly related to the disorder's pathogenesis. The present study investigated the Val1??Met polymorphism in relation to anhedonia--a construct central to negative schizotypy. Anhedonia and other schizotypal characteristics were assessed in relatives of patients with schizophrenia, relatives of patients with bipolar disorder, and nonpsychiatric controls using the Chapman schizotypy scales and the Schizotypal Personality Questionnaire. Compared with controls, relatives of individuals with schizophrenia had elevated scores on Chapman scales for social anhedonia and physical anhedonia, while relatives of patients with bipolar disorder exhibited only increased scores on the Social Anhedonia Scale. As a group, relatives of patients with schizophrenia who were homozygous for the val allele of the COMT polymorphism showed the highest elevations in self-reported social and physical anhedonia. Associations with the COMT polymorphism were absent in relatives of patients with bipolar disorder and control participants. Findings suggest that anhedonia is manifest in individuals who carry genetic liability for schizophrenia and is associated with the Val1??Met polymorphism of the COMT gene. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between adjustment to HIV and both social support and coping.

This study examined the relationships between HIV stage, social support, coping strategies, and adjustment to HIV. Ninety-six HIV-infected gay men and 33 seronegative comparison group participants participated in the study. In general, coping strategies and social support did not differ according to HIV stage. As predicted, adjustment was related to social support and coping strategies. Coping strategies were linked to psychosocial adjustment, whereas social support was more strongly associated with health-related variables. There was little evidence of buffering effects of either coping strategies or social support. Four coping strategies were related to low levels of psychological distress. Contrary to expectation, the relationships between coping strategies and adjustment did not vary as a function of HIV stage. However, the relationship between adjustment and some elements of social support varied as a function of HIV stage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support for elderly patients with chronic wounds

Few attempts have been made to measure the social support received by elderly patients with chronic wounds. To focus research on these issues, an established model integrating the various roles played by social support in the adaptation of patients to stressful situations was applied. Two questionnaires were used to measure perceived social support and coping in a sample of patients with leg ulcers (N = 15, mean age 70.4 years) or diabetic foot ulcers (N = 15, mean age 63.6 years) at two time-points over a four-month period. The results indicate that there were no statistical differences between the groups. The overall levels of social support were low, with emotional support recorded most frequently. The standardised scores for types of coping indicate no unusual patterns, although the scores for logical analysis were low. However, there was considerable variation in the types of coping strategies used by individuals.     

Detection of serum transforming growth factor-alpha in patients of primary epithelial ovarian cancers by enzyme immunoassay

OBJECTIVE: To survey the social outcome of patients with schizophrenia attending State mental health facilities in southern Tasmania. METHOD: Using the Statewide Mental Health Register, patients using inpatient and outpatient facilities who received a diagnosis of schizophrenia between 1981 and 1988 were identified (n = 771), and demographic and illness measures, and admissions and length of inpatient stay were compiled. The Life Skills Profile (LSP) was completed by mental health personnel for the 247 who were regular attenders or inpatients in 1991. RESULTS: Social morbidity as indexed by the LSP was highest in psychiatric hospital inpatients and patients in long-term rehabilitation programs, and lower in patients attending community centres. The majority of patients in suburban settings and attending community centres lived with their families, whereas patients in the inner city or in the rehabilitation service were mainly in hostel accommodation or living alone. Patients with schizophrenia attending State services were of a similar age range but had a longer duration of illness and more admissions, and had spent more days in hospital than patients who were not in regular contact with the service. CONCLUSIONS: The distribution of social morbidity in schizophrenia confirms that the public health system is supporting a group with high social morbidity. Patients with the highest morbidity are receiving the highest levels of care and intervention.     

Personal and contextual determinants of coping strategies.

This study examined personal and contextual predictors of active and avoidance coping strategies in a community sample of over 400 adults and in a sample of over 400 persons entering psychiatric treatment for unipolar depression. Sociodemographic factors of education and income (except for active-cognitive coping), personality dispositions of self-confidence and an easy-going manner, and contextual factors of negative life events and family support each made a significant incremental contribution to predicting active and avoidance coping. Among both healthy adults and patients, active and avoidance coping were positively associated with negative life events. Individuals who had more personal and environmental resources were more likely to rely on active coping and less likely to use avoidance coping. Moreover, for both groups, most of the predictors continued to show significant relations with active and avoidance coping strategies even after the stable component in coping was controlled in a longitudinal design. A comprehensive framework to understand the determinants of coping can be of practical value in suggesting points for therapeutic interventions aimed at fostering more adaptive coping efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When should we send in our rads to bat alone?

The families of 26 patients with Ebstein's anomaly were examined. There were 120 first-degree relatives, 100 of whom were living, and 93 of these were examined. Information was available on 14 of the 20 who had died. No case of Ebstein's anomaly was found among the first-degree relatives, but 2 had ventricular septal defects and another, who died at 7 months, was said to have had congenital heart disease. In more distant relatives there were 6 with congenital heart disease, including 2 with ventricular septal defects and 2 with Fallot's tetralogy.     

Family treatment and medication dosage reduction in schizophrenia: Effects on patient social functioning, family attitudes, and burden.

The effects of 2 family intervention programs (supportive family management [SFM], including monthly support groups for 2 years; or applied family management [AFM], including 1 year of behavioral family therapy plus support groups for 2 years), and 3 different neuroleptic dosage strategies (standard, low, targeted) on social functioning of patients with schizophrenia, their relatives' attitudes, and family burden were examined. AFM was associated with lower rejecting attitudes by relatives toward patients and less friction in the family perceived by patients. Patients in both AFM and SFM improved in social functioning but did not differ, whereas family burden was unchanged. Medication strategy had few effects, nor did it interact with family intervention. The addition of time-limited behavioral family therapy to monthly support groups improved family atmosphere, but did not influence patient social functioning or family burden. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping--status of knowledge in the 90's

After a brief historical introduction the literature that has appeared on coping since the middle eighties is reviewed. Theoretically Lazarus' concept of transactional coping has been developed with focus on emotions. Antonovsky's salutogenesis is considered to be innovative. Methodology is discussed in view of instruments, observers time and perspective and need for qualitative evaluation. Clinically it must be concluded from the many cross-sectional comparisons that diseases with comparable demands call for similar coping. Only in long-term studies can stage-dependent differences of efficacy be detected. Active, tackling coping based on social and emotional resources and problem-analysis is significantly superior to passive coping with social withdrawal, ruminating, resignation and self-accusation. More recently interest in coping is extended to families and caretakers of patients. It is concluded that more corresponding with stress-research is needed, methodology should be adjusted and in view of important intervention strategies evaluation of efficacy is necessary.     

Effects of psychosocial and situational variables on substance abuse among homeless adults.

Finding direct and indirect influences of salient psychosocial and situational variables on problem substance use among homeless people is important in designing evidence-based, effective, and relevant interventions for this special population. A stress-coping paradigm in conjunction with situational items specialized for homeless people was used to explore predictive relationships in a sample of homeless adults (N = 664) among (a) psychosocial variables of self-esteem, social support, positive and negative coping, and emotional distress, (b) situational variables of homelessness history and quality of recent housing, and (c) outcomes of alcohol use, injection drug use (IDU), and non-IDU. Lower self-esteem predicted greater emotional distress, lower positive coping, greater negative coping, and more alcohol use. Social support predicted less emotional distress and more positive coping. Chronic homelessness predicted more emotional distress, less positive coping, greater alcohol use, and IDU. Poor housing was associated with more alcohol use and IDU. Substance abuse interventions among the homeless should have a dual focus that includes attention to psychological issues and negative coping patterns while also addressing situational, environmental factors, including encouraging provision of permanent supportive housing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Approach and avoidance coping responses among older problem and nonproblem drinkers.

The Coping Responses Inventory (CRI) was used to study coping among older problem and nonproblem drinkers. The CRI organizes coping efforts according to their focus (approach or avoidance) and method (cognitive or behavioral). Compared with nonproblem drinkers, older problem drinkers were more likely to use cognitive and behavioral avoidance responses to manage life stressors. Problem drinkers who experienced more negative life events and more severe stressors used both more approach and more avoidance coping. Those who had more financial and social resources relied more on approach and less on avoidance coping. Problem drinkers who relied more on avoidance coping tended to have more drinking problems and to report more depression and physical symptoms and less self-confidence. Positive reappraisal was associated with less depression and more self-confidence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of social support receipt.

Psychological correlates of social support receipt were examined in an investigation of stress and coping among 150 middle-aged community residents. Subjects were interviewed monthly for 6 months, each time concerning a specific stressful situation in the previous month. Social support received and methods of coping were assessed each time, as well as other variables. Factors hypothesized to be associated with support receipt were person predispositions, appraisal patterns with regard to specific stressful encounters, and coping strategies used. Each was most strongly associated with a particular type of social support. Person predispositions related most strongly to emotional support received, appraisal factors related most strongly to aid, and coping strategies related most to informational support received. Furthermore, of the three sets of variables, the individual's ways of coping appeared to be most strongly associated with all types of social support received. Two implications are explored. First, we suggest that the three types of social support studied represent different constructs with different antecedents and consequences. Second, we argue that coping behavior provides interpersonal cues regarding what is wanted or needed in a stressful situation and that the members of the social environment respond accordingly. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Thanks for sharing that": Ruminators and their social support networks.

Receiving positive social support after a trauma generally is related to better adjustment to the trauma. The personality of trauma survivors may affect the extent to which they seek social support, their perceived receipt of social support, and the extent to which they benefit from social support. The authors hypothesized that people with a ruminative coping style, who tended to focus excessively on their own emotional reactions to a trauma, compared to those without a ruminative coping style, would seek more social support, and would benefit more from social support, but would report receiving less social support. These hypotheses were confirmed in a longitudinal study of people who lost a loved one to a terminal illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Regulation of cytochrome P450 enzymes by aryl hydrocarbon receptor in human cells: CYP1A2 expression in the LS180 colon carcinoma cell line after treatment with 2,3,7,8-tetrachlorodibenzo-p-dioxin or 3-methylcholanthrene

The Food Research and Action Center estimates that approximately 12% of all families with children younger than 12 years old experience food insufficiency in the United States. The authors conducted 16 focus groups with 141 participants, who were either at risk or experienced food insufficiency, to learn about coping strategies. Individual and network-level coping mechanisms were used to manage insufficient food supply. Social networks included family, friends, and neighbors. The assistance provided included food aid, information, and emotional support. Not all networks were relied on or accessed by everyone. Most participants reported that they relied on family members first, followed by friends, and then neighbors. Parents found reliance on anyone as stressful and often threatening. In conclusion, as the social welfare system becomes constrained, more and more households may experience food insufficiency. Responsive policies are therefore needed to assist low-income families.