Self-esteem in schizophrenia: Relationships between self-evaluation, family attitudes, and symptomatology.

Participants with schizophrenia (N=59) were assessed on self-evaluation, symptomatology, and positive and negative affect (expressed emotion) from significant others. An interview-based measure of self-evaluation was used and two independent dimensions of self-esteem were derived: negative and positive evaluation of self. As predicted, negative self-evaluation was strongly associated with positive symptoms, a more critical attitude from family members was associated with greater negative self-evaluation, and analyses supported a model whereby the impact of criticism on patients' positive symptoms was mediated by its association with negative self-evaluation. The interview-based method of self-esteem assessment was found to be superior to the questionnaire because its predictive effects remained after depressed mood was accounted for. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A sociocultural stress, appraisal, and coping model of subjective burden and family attitudes toward patients with schizophrenia.

A sociocultural stress, appraisal, and coping model was developed to understand relatives' burden of care and negative affective attitudes toward patients with schizophrenia. Ninety-two African American and 79 White patients and a significant other (80% mothers) completed 2 10-min family problem-solving discussions. In addition, the Kreisman Rejection Scale and a global self-report rating of family burden were administered to relatives, and a self-report rating of substance use was administered to patients. Results indicated that subjective burden of care and patients' odd and unusual thinking during the family discussion each independently predicted relatives' attitudes toward patients, suggesting that negative attitudes are based in part on both patients' symptoms and perceived burden of care. African American relatives' perceived burden was also predicted by patients' substance abuse. Finally, White family members were significantly more likely than African Americans to feel burdened by and have rejecting attitudes toward their schizophrenic relative suggesting that cultural factors play an important role in determining both perceived burden and relatives' attitudes toward patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family burden and family stigma in major mental illness.

Discusses the stresses and burdens on families of mentally ill (MI) individuals, including stigmatization, and problems in dealing with mental health (MH) professionals. Converging historical events, new biogenetic research findings; widening recognition of the dimensions of family burden; deinstitutionalization, have led to a reconceptualization of the family role. The growth and influence of the National Alliance for the Mentally Ill have also been part of the historical process and have contributed to the new respect for families of MI individuals. The new and collaborative model of clinician–family relationships has done much to destigmatize families, to reorient the thinking of many MH professionals, and to alleviate the burden of families of MI individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anhedonia, positive and negative affect, and social functioning in schizophrenia

This study examines the relationship between anhedonia and the trait dimensions of positive affect (PA) and negative affect (NA) in schizophrenia. The relationship between poor social functioning in schizophrenia and these individual differences in affectivity is also examined. Schizophrenia outpatients (n = 37) and normal controls (n = 15) were assessed at a baseline evaluation and again approximately 90 days later. Consistent with the hypothesized decrease in hedonic capacity in schizophrenia, patients reported significantly greater physical and social anhedonia and less PA than controls. However, the schizophrenia group also reported significantly greater NA and social anxiety than did controls. In support of the dispositional view of these individual differences in affectivity, trait measures demonstrated test-retest reliability, and group differences between the schizophrenia group and controls were stable over the 90-day followup period. Within the schizophrenia group, physical and social anhedonia were comparably negatively correlated with trait PA; however, social but not physical anhedonia was significantly positively correlated with NA and social anxiety. Poor social functioning in the schizophrenia group was associated with greater physical and social anhedonia and greater NA and social anxiety. Alternatively, greater trait PA was related to better social functioning. These findings indicate that schizophrenia is characterized by both low PA and elevated NA and that these affective characteristics are a stable feature of the illness. The results also suggest important links between affect and social functioning in schizophrenia.     

Family routines and rituals--The importance of family functioning: Comment on the special section.

This diverse collection of papers highlights routines and rituals in family life. Just as individual family members bring unique styles and perspectives to the family table, to be incorporated into a family framework, so do each of these papers present rich and varied research questions, designs, and measurement strategies that enrich our understanding of family routine behavior patterns and ritual meanings. This series adds to our conceptualization of family routines and rituals within a systems perspective highlighting: 1) families are comprised of multiple levels that operate individually; interact with each other; and as a whole, reveal properties distinct from separate parts; 2) families tend toward stability in meaningful patterns of functioning; and 3) family functioning has meaning for individual outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family systems and alcohol misuse: Research on the effects of alcoholism on family functioning and effective family interventions.

This article reviews the most prominent research at the interface between studies of alcohol addiction and family systems psychology. The review addresses the general effects of alcohol misuse on family functioning as determined in empirical studies comparing healthy families, alcohol afflicted families, and otherwise troubled families. Three factors ("dry" vs "wet" families, family development and the progression of alcoholism, and family structure) are identified as particularly relevant to understanding the treatment needs of families affected by alcohol misuse. Research examining the general efficacy of family interventions in the treatment of alcoholism and specific treatment considerations unique to treating families coping with alcohol misuse are reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Commitment to family roles: Effects on managers' attitudes and performance.

The authors tested the premise that family role commitment (i.e., marital role commitment, parental role commitment) has simultaneous negative and positive effects on managers' (N = 346) life satisfaction, career satisfaction, and performance through family-to-work interference and enhancement. The authors also explored whether psychological strain mediates the effects of interference and enhancement on outcomes. The authors expected family role commitment to reduce the favorability of outcomes by increasing interference. To the contrary, they found that neither marital nor parental role commitment was associated with increased interference. The authors expected family role commitment to improve outcomes by increasing enhancement. As expected, marital role commitment was associated with increased enhancement, which, in turn, seemed to reduce strain and strengthen outcomes. Parental role commitment was also associated with increased enhancement. However, parental role commitment had direct positive effects on outcomes that were more substantial than its indirect effects through enhancement. Overall, marital and parental role commitment had more benefits than costs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in neuropsychological performance and social functioning in schizophrenia and bipolar disorder.

Objective: To investigate sex differences in neurocognition and social functioning in schizophrenia and bipolar disorder and the possible role of sex as a moderator of this relationship. Method: Participants with schizophrenia (60 women/94 men), bipolar I disorder (55 women/51 men), and healthy controls (158 women/182 men) were assessed with an extensive neuropsychological test battery and a social functioning questionnaire. Results: We found significant main effects of sex for neuropsychological tests (p     

Effects of Zen meditation on anxiety reduction and perceptual functioning.

Assigned 72 Ss (undergraduates and volunteer university employees) to 3 treatment groups: Zen meditation, antimeditation (control), or no-treatment (control). Cells were balanced for locus of control, sex, and volunteer-S pool status. Training took place over a 1-wk period in the laboratory to ensure compliance. Daily logs suggested that appropriate experiences were achieved. Measures of self-reported anxiety, the Trait Anxiety scale of the State–Trait Anxiety Inventory, and the Epstein-Fenz Manifest Anxiety Scale showed a decrease after meditation, but no more of a decrease than the 2 control groups. State anxiety after stress showed no effect of meditation. Measures of perceptual functioning from the Holtzman Inkblot Test and the Embedded Figures Test showed no differential improvement as a result of meditation. Locus of control and sex were not related to outcome but volunteer status was, suggesting a personality or motivational influence. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Addressing executive functioning and cognitive rehabilitation in the treatment of schizophrenia.

ABSTRACT. Schizophrenia spectrum disorders are currently viewed as having a neuropsychological basis included in the etiology. Cognitive deficits that occur in schizophrenia are primarily observed in the areas of attention–concentration, memory, and planning. These abilities are commonly viewed under the broader spectrum of executive functioning. Research has shown that these executive functioning skills can be improved through the use of cognitive rehabilitation interventions. This article includes a case study documenting the use of cognitive rehabilitation strategies with a patient diagnosed with schizophrenia who possessed documented deficits in executive functioning. The discussion illustrates the possible progress that may be made in the treatment of schizophrenia when this additional tier of intervention is used. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist attitudes as influenced by A-B therapist type, patient diagnosis, and social class.

Attempted to clarify a number of inconsistent and contradictory findings regarding interactions between patient diagnosis (schizophrenic vs. neurotic) and the A-B therapist variable. 37 psychiatric residents completed Kemp's version of the A-B scale. The 10 highest and 10 lowest scorers then rated 4 patient vignettes on likability, discomfort, interest in treating, and prognosis. Patient social class as well as diagnosis were systematically controlled. Results support some of the previous research on likability but provided no support for other A-B * Patient Type interactions. A number of main effects for diagnosis and social class indicate that, in general, residents of both types hold more favorable attitudes toward neurotic and middle-class patients than they do toward schizophrenic and lower-class patients. (23 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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.     

Family cohesion, family adaptability, social support, and adolescent depressive symptoms in outpatient clinic families.

The relationships among adolescent depressive symptoms and self-reported family cohesion, adaptability, satisfaction with family functioning, family structure, and social support received from family and friends were investigated in a sample of 93 families attending family therapy at an outpatient clinic. Results were in keeping with previous studies of nonclinical samples, in that family cohesion and family social support were inversely related to depression. In contrast to nonclinical samples, family characteristics were more strongly associated with depression among boys than among girls, and social support from friends did not act as a buffer against depression. The strongest predictor of depressive symptoms was adolescents' levels of satisfaction with the cohesiveness and adaptability in their families, suggesting the importance of subjective cognitive appraisal in the link between family functioning and depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of parental marital status, income, and family functioning on African American adolescent self-esteem.

This study examined the effects of marital status, family income, and family functioning on African American adolescents' self-esteem. One hundred sixteen adolescents participated, 64% of whom were female. Compared with boys with nonmarried parents, boys with married parents had higher overall self-esteem, even when family income and family functioning were controlled. Parental marital status had no effect on girls' self-esteem. Family functioning was a very strong predictor of self-esteem for both sexes. However, family relational factors were more important to girls' self-esteem, whereas structural and growth factors were more important for boys. It was concluded that African American adolescent boys with nonmarried parents are at risk for developing low self-esteem compared with other African American adolescents, but a more controlled and structured environment may buffer the effects of having nonmarried parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beliefs and attitudes about bupropion: Implications for medication adherence and smoking cessation treatment.

Beliefs about medication are associated with treatment adherence and outcome. This is a secondary analysis of the role of beliefs and attitudes about bupropion in treatment adherence and smoking cessation outcomes using data from a smoking cessation trial of open-label sustained-release (SR) bupropion therapy reported previously (Toll et al., 2007). Positive beliefs and attitudes were positively correlated with intentions, desire, confidence, and motivation to quit smoking; expectation of quitting success; perceived benefits of quitting; and perceived disadvantages of smoking. Positive beliefs were also associated with greater medication adherence, an increased likelihood of completing treatment and being continuously abstinent, and a delayed latency to smoking lapse. These findings provide preliminary support that positive beliefs and attitudes about bupropion are associated with positive attitudes toward quitting, better treatment adherence, and potentially better treatment response. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress, family functioning, and social support in survivors of childhood leukemia and their mothers and fathers.

Psychological sequelae are examined in 130 former childhood leukemia patients and 155 comparison participants and their parents. The major dependent variables are symptoms of anxiety and posttraumatic stress, family functioning, and social support. Multivariate analyses of covariance indicated significantly more posttraumatic stress symptoms in mothers and fathers of childhood leukemia survivors (p?     

Depression, schizophrenia, and social attraction.

J. C. Coyne (see PA, Vol 56:02455 and 61:1146) has shown that after interacting with depressed patients, Ss report feeling depressed themselves and rejecting toward the depressed person. In the present study, measures (e.g., Mood Adjective Check List, Interpersonal Check List) were obtained from 216 undergraduates who listened to tapes of interviews with either hospitalized depressive, hospitalized schizophrenics, or normal hospital staff. Results show that schizophrenics aroused dysphoric feelings similar although not identical to those feelings aroused by depressives, and in the case of males they were equally rejected. In addition, the schizophrenics and, to a lesser extent, the depressives were seen as weak, submissive, and less capable of offering a positive relationship. Modifications of the Coyne position are suggested. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding attitudes toward use of medication in substance abuse treatment: A multilevel approach.

Individual and organizational variables influence attitudes toward use of naltrexone, methadone, and buprenorphine for the treatment of alcohol and drug disorders. Previous research has not considered both sets of influences simultaneously. Hierarchical linear modeling tested the contribution of individual and organizational variables with data from the National Drug Abuse Treatment Clinical Trials Network treatment unit and workforce surveys (n = 2,269 staff nested within 247 treatment units). Individual-level variables consistently had more influence on attitudes, but a unique blend of variables existed for each medication. One predictor, support for psychiatric medications, influenced attitudes across all medications. Staff attitudes toward addiction medications varied significantly between treatment units. Implications for increasing the appropriate use of addiction medications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autonomic functioning in process and reactive schizophrenia.

Compared the autonomic functioning of male process schizophrenics, reactive schizophrenics, and normal ss (n = 30) under rest and arousal conditions. Ss were exposed to 6 arousal conditions: (a) white noise, (b) electric shock, (c) paired associate learning, (d) word activity test, (e) finger dexterity task, and (f) pursuit rotor task. Rest periods preceded each arousal condition. Heart rate, skin resistance, respiration rate, diastolic and systolic blood pressures were recorded under all 6 conditions. Results show that under stress the levels of physiological functioning for normal ss and reactive schizophrenics were similar on skin resistance and blood pressure, with process schizophrenics showing a higher level of arousal on skin resistance and a lower level on blood pressure. Reactive schizophrenics had the fastest heart rate, with process schizophrenics next, and normals the lowest. Respiration did not reliably differentiate among the groups. Reactive schizophrenics and normals generally showed greater increments to the arousal conditions (compared with prestress base lines) than the process schizophrenics in all measures except heart rate and skin resistance. In those 2 measures, reactive and process schizophrenics were similar in their reactions to the stress conditons, and both groups showed less reactivity in general than normals. (french summary) (31 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)