Sources and determinants of social support for caregivers of persons with AIDS

Endocrine studies of captive strepsirrhine primates suggest that physical environment and social factors mediate inter-individual variations in testicular function and serum testosterone (sT) in males. While these studies have made major contributions to our understanding of the individual proximate mechanisms influencing androgen activity in male strepsirrhines, none have investigated how these mechanisms work coincidentally in free-ranging populations. In this study we used fecal steroid analysis to examine androgen-behavior interactions associated with reproduction in free-ranging male Propithecus verreauxi. Behavioral and hormone data were collected from two social groups during the 1990-91 and 1991-92 breeding seasons at Beza Mahafaly, Madagascar. Solid phase and radioimmunoassay techniques were used to quantify testosterone (T) in 105 desiccated fecal samples collected weekly from seven males. Results suggest that 1) solid phase extraction and radioimmunoassay techniques were reliable and accurate methods for quantifying T in sifaka feces; 2) fecal T (fT) elevations spanned a minimum of 4 months, peak levels occurring 1 month prior to the January onset of the breeding season; 3) fecal T concentrations were influenced by developmental factors and, among mature males, social factors associated with rank, intergroup aggression, and group instability.     

Family functioning in families of children with anxiety disorders.

The authors examined maternal and paternal reports of family functioning and their relationship with child outcomes as well as the association between anxiety and depression in family members and family functioning. Results reveal that maternal and paternal reports of family functioning were both significantly associated with worse child outcomes, including child anxiety disorder (AD) severity, anxiety symptoms, and child global functioning. Maternal and paternal anxiety and depression predicted worse family functioning, whereas child report of anxiety and depression did not. Parents of children with ADs reported significantly worse family functioning and behavior control, but only fathers reported worse problem solving and affective involvement compared with fathers of children with no psychological disorders. Findings from this study suggest that paternal as well as maternal anxiety and depression play a role in worse family functioning in children with ADs and that unhealthier family functioning is associated with worse child outcomes in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived social support and community adaptation in schizophrenia

Prompted by the continuing transition to community care, mental health nurses are considering the role of social support in community adaptation. This article demonstrates the importance of distinguishing between kinds of social support and presents findings from the first round data of a longitudinal study of community adaptation in 156 people with schizophrenia conducted in Brisbane, Australia. All clients were interviewed using the relevant subscales of the Diagnostic Interview Schedule to confirm a primary diagnosis of schizophrenia. The study set out to investigate the relationship between community adaptation and social support. Community adaptation was measured with the Brief Psychiatric Rating Scale (BPRS), the Life Skills Profile (LSP) and measures of dissatisfaction with life and problems in daily living developed by the authors. Social support was measured with the Arizona Social Support Interview Schedule (ASSIS). The BPRS and ASSIS were incorporated into a client interview conducted by trained interviewers. The LSP was completed on each client by an informal carer (parent, relative or friend) or a professional carer (case manager or other health professional) nominated by the client. Hierarchical regression analysis was used to examine the relationship between community adaptation and four sets of social support variables. Given the order in which variables were entered in regression equations, a set of perceived social support variables was found to account for the largest unique variance of four measures of community adaptation in 96 people with schizophrenia for whom complete data are available from the first round of the three-wave longitudinal study. A set of the subjective experiences of the clients accounted for the largest unique variance in measures of symptomatology, life skills, dissatisfaction with life, and problems in daily living. Sets of community support, household support and functional variables accounted for less variance. Implications for mental health nursing practice are considered.     

Quality of social support and associated social and psychological functioning in women with rheumatoid arthritis.

Investigated the relationship between health status, social integration, qualitative aspects of social support, and social and psychological functioning in 194 women (aged 21–65 yrs) with rheumatoid arthritis. Ss completed a telephone interview that included measures of these variables. Even after controlling for the influences of current physical limitations and social integration, qualitative dimensions of social support as measured by the Quality of Social Support Scale, a scale developed for this study, explained a significant proportion of the variance in home and family functioning and in depression. This demonstrates the importance of social support to both social and psychological functioning with a chronic, painful, and disabling disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fathers and mothers of school-age children with developmental disabilities: parental stress, family functioning, and social support

Thirty pairs of fathers and mothers who had school-age children with mental retardation and other disabilities were compared with each other and with 32 father and mother pairs of parents of children without disabilities. Responses to family scales indicated that fathers and mothers of children with developmental disabilities did not differ from each other nor from fathers and mothers of children without disabilities in parental stress, family social support, or family functioning. However, parents of children with disabilities experienced a disproportionately greater level of stress relating to their children than did those of children without disabilities. Fathers' and mothers' stress was associated with aspects of family functioning as perceived by themselves and their spouses.     

Victimization, social support, and psychosocial functioning among children of same-sex and opposite-sex couples in the United Kingdom.

To further develop an understanding of psychological and social functioning of children raised by lesbian couples, the authors compared 18 students ages 12-16 raised in families led by female same-sex couples, who were identified from a large school-based survey, with 18 matched students raised by opposite-sex couples and the general student sample. Comparisons were made on factors including victimization, social support, and psychological functioning. Results indicate that those students raised by female same-sex couples did not differ significantly from those raised by opposite-sex couples or the general student sample in terms of reports of victimization, psychological functioning, experience of common adolescent concerns, or prospective use of support outlets provided by family and peers. However, children of same-sex couples reported significantly less likelihood of using school-based support than did children of opposite-sex couples or the general student sample. Findings indicate the need for school administrators, teachers, and psychologists to be knowledgeable of and provide appropriate support and resources for these children. Additional implications for research and application are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting and social functioning of children with and without cerebral palsy.

Objective: To examine the associations between parenting dimensions and the social functioning of children with and without cerebral palsy (CP). The primary hypothesis was that controlling for cognitive ability, specific parenting dimensions would be associated with higher social functioning, including larger social networks, higher-quality friendships, and healthier social adjustment in children with and without CP. Participants: Forty-one children with cerebral palsy and 60 typically developing (TD) children, ages 6 to 12. Measures: Parenting Dimensions Inventory; Social Network Inventory for Children, Friendship Quality Questionnaire, Personality Inventory for Children-Second Edition, WISC-III Vocabulary. Results: Bivariate associations revealed that cognitive ability was associated with social functioning in both groups. In the group with CP, controlling for cognitive ability, parenting dimensions were not associated with social functioning, in contrast with findings in the TD sample. Conclusions: Findings suggest different parenting influences on the social development of children with and without CP. Theoretical and methodologic implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depiction of pain in the self-drawings of children with sickle cell disease

In an attempt to explore the perception of pain in children, 30 children with sickle cell disease were asked to make two drawings; one of themselves and one of themselves in pain. It was hypothesized that the cognitive ability and the emotional state of the child would be affected by the pain experience. Children and their parents were interviewed on the incidence of pain and on the child's control over it. The cognitive ability of the child was related to the kind of control he/she exercised over the pain. An analysis of the drawing concerning their thematic representations, colour and size is also presented. The mental age of the child dropped in the drawing of pain as compared to the non-pain drawing but it was found to be irrelevant to the kind of control the child exercised on the pain.     

Social anxiety in children with anxiety disorders: relation with social and emotional functioning

BACKGROUND: Oxygen radicals have been implicated as important mediators in the early pathogenesis of acute pancreatitis, but the mechanism by which they produce pancreatic tissue injury remains unclear. We have, therefore, investigated the effects of oxygen radicals on isolated rat pancreatic acinar cells as to the ultrastructure, cytosolic Ca2+ concentration and energy metabolism. METHODS: Acinar cells were exposed to an oxygen radical-generating system consisting of xanthine oxidase, hypoxanthine and chelated iron ions. Cell injury was assessed by LDH release and electron microscopy. Cytosolic Ca2+ levels and mitochondrial membrane potential were determined by flow cytometry; adenine nucleotide concentrations by HPLC. Mitochondrial dehydrogenase activity was measured by spectrophotometric assay. RESULTS: Oxygen radicals damaged the plasma membrane as shown by a 6-fold LDH increase in the incubation medium within 180 min. At the ultrastructural level, mitochondria were the most susceptible to oxidative stress. In correlation to the pronounced mitochondrial damage, the mitochondrial dehydrogenase activity declined by 70%, whereas the mitochondrial membrane potential was enhanced by 27% after 120 min. Together this may cause the 85% decrease in the ATP concentration and the corresponding increase in ADP/AMP observed in parallel. In addition, an immediate 26% increase in cytosolic Ca2+ was found, a change which could be inhibited by BAPTA, reducing cellular damage. CONCLUSION: Cytosolic Ca2+ synergizes with oxygen radicals causing alterations of the ultrastructure and energy metabolism of acinar cells which might contribute to the cellular changes found in early stages of acute pancreatitis.     

Going beyond social support: The role of social relationships in adaptation.

Discusses new directions for explicating relations among stress, support, and adaptational outcomes. Attention is drawn to the distinctiveness of marriage as a source of stress and support in adult life. In addition, the literature on marital and family therapy points to the potentially deleterious effects of overinvolvement in close relationships. It is suggested that if research and theory on social support are to become relevant to clinical intervention, the current emphasis on the benefits of perceived social support needs to be balanced by consideration of the costs constraints of participating in social relationships and by a concern for how such perceptions arise. (83 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment of mothers of children and adolescents with sickle cell disease: the role of stress, coping methods, and family functioning

Assessed the psychological adjustment of 78 mothers of children and adolescents (7-17 years of age) with sickle cell disease. Support was provided for a transactional stress and coping model in delineating the processes associated with maternal adjustment. In particular, poor maternal adjustment was associated with use of palliative coping methods and high levels of stress related to daily hassles. Variables of the model accounted for 55% of the variance in maternal psychological distress.     

Relationships between cognitive and social functioning in preschool children.

Examined short-term longitudinal relationships between test measures of cognitive processes and ratings of classroom behaviors observed during free play. Ss were 64 35–57 mo old middle-class preschoolers, 34 boys and 30 girls. Magnification of the same covariation pattern over time was used as an index of reciprocal influences between cognitive and social functioning. Analyses differentiated between the static (individually stable) and linear-change components of social attributes. Verbal-conceptual processes covaried positively with the static measures of socially outgoing and task-oriented behaviors and with positive vs negative affective expressions in girls, but not in boys. A nonverbal cognitive measure did not so relate to the social measures. The linear-change components of certain social attributes exhibited consistent though limited relationships with the cognitive measures. The study yielded little evidence for reciprocity between the cognitive and social domains. Certain cognitive processes facilitated social adaptation, but social adaptation did not influence cognitive growth. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nephrotic syndrome in Nigerian children with homozygous sickle cell disease

Two hundred and seventy two children with the nephrotic syndrome were seen and followed up at the Paediatric Renal Unit of the University of Nigeria Teaching Hospital, Enugu over 12 1/2 year period, between June 1983 and December 1995. Of these, there were nine (3.3%) children with homozygous sickle cell disease (SS). This latter group had a mean age of 9.6 +/- 3.2 years, male to female ratio of 1:2 and serum cholesterol of 3.13 +/- 1.48 mmol/l at the time of diagnosis. The mortality rate was 55.6% in these sicklers, death occurring within one and a half to five years of diagnosis. Causes of death were attributable to sickle cell disease in 60%, renal diseases in 20%, and other causes in 20%. Renal biopsy in two of the sicklers showed membrano-proliferative glomerulonephritis (MPGN) and focal glomerulosclerosis (FGS) respectively. Homozygous sickle cell disease does seem to predispose to the development of the nephrotic syndrome and those that do develop nephrotic syndrome exhibit some special characteristics, when compared to non-sicklers with nephrotic syndrome. These include older age of onset of the nephrotic syndrome, reverse sex ratios, lower serum cholesterol, higher mortality rate and sickle cell complications rather than chronic renal failure as the major cause of death.     

Protein C activity in Gabonese children with sickle cell disease

Protein C levels were determined in 40 Gabonese children with sickle cell disease, in the steady state and during vasoocclusive crisis. In comparison with 40 healthy controls matched for age and sex, there was a significant decrease in protein C activity in the patients, although no difference was found between protein C levels in the steady state and during crisis.     

Reversible splenic hypofunction in hypertransfused children with homozygous sickle cell disease

Functional hyposplenism, as documented by technetium 99 metastable sulfur colloid spleen scan and increased pocked erythrocyte count (also known as a pit count), is well described in children under 2 years of age with homozygous sickle cell anemia. We evaluated the clinical course and splenic function of 16 patients with sickle cell anemia (ages 3 to 20 years) on a hypertransfusion program for more than 6 months following a cerebrovascular accident. Patients were followed with simultaneous spleen scan and pitted erythrocyte count using direct interference contrast microscopy. Pit counts were taken prior to each transfusion and hemoglobin S level maintained at less than 20%. With the exception of two patients, splenic function was recovered only in those patients who were younger than 10 years of age at the time transfusion was initiated. There were no serious bacterial infections or other complications of sickle cell anemia documented in the hypertransfused group. Based on our results and the literature review, we conclude that some patients with sickle cell anemia receiving intensive hypertransfusion therapy for a cerebrovascular accident recover a normal splenic phagocytic function. Age and level at which the hemoglobin S is maintained are important factors in reestablishing splenic phagocytic function.     

Social problem-solving abilities, social support, and adjustment among family caregivers of individuals with a stroke.

ABSTRACT. Objective: To investigate the unique contributions of social problem solving abilities and social support in the prediction of aspects of caregiver adjustment. Study Design: Correlational procedures were used to determine the unique contributions of social problem-solving abilities and social support in the prediction of caregiver depression, health, and life satisfaction. Mediating factors were examined with correlational and regression analyses. Participants: Caregivers of individuals who had a stroke (20 African Americans and 20 Caucasians). Main Outcome Measures: The general health scale from the Short-Form Health Survey and measures of life satisfaction and depression. Results: Social support was the best predictor of caregiver life satisfaction. Perceived control over emotions when solving problems was the best predictor of caregiver depressive behavior and health. Social problem-solving abilities were associated with caregiver depressive behavior and health; social support did not mediate these relationships. Conclusions: Problem-solving interventions may be most appropriate for the treatment and prevention of caregiver depression and health problems. Social support programs may be indicated for caregiver life satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

National trends in the mortality of children with sickle cell disease, 1968 through 1992

OBJECTIVES: This paper describes national trends in mortality of children with sickle cell disease and the settings in which death occurred. METHODS: United States death certificate data from 1968 through 1992 were used to calculate mortality rates of Black children with sickle cell disease 1 to 14 years old. Deaths from trauma, congenital anomalies, and perinatal conditions were excluded. RESULTS: Between 1968 and 1992, mortality rates of Black children with sickle cell disease decreased 41% for 1- to 4-year-olds, 47% for 5- to 9-year-olds, and 53% for 10- to 14-year-olds. During 1986 through 1992, children who died before hospital admission accounted for 41% of deaths among 1- to 4-year-olds, 27% among 5- to 9-year-olds, and 12% among 10- to 14-year-olds. CONCLUSIONS: Survival of Black children with sickle cell disease has improved markedly since 1968. A substantial proportion of deaths continue to occur prior to hospital admission. Trends in sickle cell mortality can be monitored inexpensively with death-certificate data.