Peak oxygen uptake of 12-18-year-old boys living in a densely populated urban environment

The prevalence of self-reported alcohol and marijuana use, along with alcohol abuse as measured by the Short Michigan Alcoholism Screening Test, was assessed for a community-based sample (n = 123) of persons with spinal cord injury (SCI). Correlates of alcohol and marijuana use and alcohol abuse also were examined, including demographic variables, measures of impairment, disability, and handicap, SCI medical complications, and measures of subjective assessment such as health rating, health maintenance behaviors, depression, life satisfaction, perceived stress, pain, and social support. Prevalence of alcohol use (59%) and marijuana use (16%) in persons with SCI was less than that of comparison groups in the general population. However, prevalence of alcohol abuse (21%) exceeded that of general population studies. Participants who abused alcohol shared the following criteria: (1) perceived their overall health as worse than those who did not abuse alcohol; (2) were more depressed; and (3) experienced more stress in their lives than those who did not abuse alcohol. Participants who used marijuana were younger at the time of the study and were younger at injury. They were also more depressed and more stressed. The indications of alcohol abuse in one in five persons with SCI living in the community mandates that screening, treatment, and referrals be part of any rehabilitation treatment program.     

Psychosocial factors in children with idiopathic musculoskeletal pain: a prospective, longitudinal study

To explore the role of psychosocial factors in the development and persistence of idiopathic musculoskeletal pain (IMP) in children, 23 children with IMP and 52 children with juvenile chronic arthritis (JCA) were compared at first admission to hospital and at 9 y follow-up. Semistructured interviews were performed at both assessments. At first admission, the prevalence of psychiatric diagnoses was high both in patients with IMP and patients with JCA, but patients with IMP more often had pain models, reported more school stress and more often lived with one biological parent. At follow-up, overall psychosocial functioning and level of chronic family difficulties were improved in both groups, but patients with IMP had a higher prevalence of psychiatric diagnoses and more chronic family difficulties and life events than patients with JCA. The persistence of IMP at follow-up was related to pain models, school stress, less parental education and more chronic family difficulties at first admission. Findings support the association between psychosocial factors and childhood IMP.     

Stress appraisal in women with spinal cord injury: Supplementary findings through mixed methods.

A study was conducted to examine how women with spinal cord injury (SCI) perceive the stressors they encounter, and how cognitive appraisal is associated with coping and life satisfaction. Fifty women with SCI were interviewed regarding their experience with stress and coping. The interviews were then coded using a framework based on stress and coping theory (transactional model). The systematic application of quantitative methods to the coded interview data allowed for statistical analyses, which demonstrated that the context in which the women spoke about their experiences with various stressors was associated with coping strategies, time since injury, and life satisfaction. Although stress and coping are commonly seen as interacting constructs that influence quality of life outcomes, current findings suggest that appraisal of stressors in the context of loss (more common among women more recently injured) may have a direct impact on life satisfaction apart from any coping strategies put into effect. Interventions designed to facilitate coping with loss and enhance problem-solving skills, along with education about available resources, may foster a sense of empowerment after SCI and ultimately change how stressors are perceived and managed in order to dampen their negative impact on life satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Knee pain and disability in the Nottingham community: association with poor health status and psychological distress

OBJECTIVE: To assess the prevalence of knee pain, disability and health status in the community, and to examine the association of pain with psychological distress. METHODS: A postal survey was sent to 4057 men and women aged 40-79 yr in Nottingham. Health status was assessed using the SF-36 instrument, with the specific dimensions of physical function and mental health used to measure disability and psychological distress. RESULTS: The overall response rate was 81.9%. The prevalence of knee pain was 28.7%, rising with age. Disability was more common in those with knee pain compared to those without pain (P < 0.001). Subjects with knee pain had lower scores for all dimensions of health. When adjusted for potential confounders, low mental health scores associated with increased odds for pain and disability (2.1, 95% CI 1.7-2.6; and 4.7, 95% CI 3.7-6.1). CONCLUSIONS: Knee pain is common in this population and is associated with poor perceived health and significant disability. Psychological distress strongly associates with both pain and disability.     

Using exercise to enhance subjective well-being among people with spinal cord injury: The mediating influences of stress and pain.

Purpose: To assess exercise as a strategy for reducing pain and improving subjective well-being (SWB) among people with spinal cord injury (SCI). Design: Randomized controlled trial. Method and Participants: Thirty-four individuals with SCI. Exercisers performed aerobic and resistance training twice weekly, whereas wait-list controls maintained their usual level of activity. Results: Analyses of covariance indicated that after 3 months, exercisers reported less pain, depression, and stress, as well as greater perceived quality of life and better physical self-concept than controls (ps     

Pregnancy-specific stress, prenatal health behaviors, and birth outcomes.

Objective: Stress in pregnancy predicts earlier birth and lower birth weight. The authors investigated whether pregnancy-specific stress contributes uniquely to birth outcomes compared with general stress, and whether prenatal health behaviors explain this association. Design: Three structured prenatal interviews (N = 279) assessing state anxiety, perceived stress, life events, pregnancy-specific stress, and health behaviors. Main Outcome Measures: Gestational age at delivery, birth weight, preterm delivery (     

Stressful life events, social support, and mortality in men born in 1933

OBJECTIVE: To examine relations between stressful life events and mortality in middle aged men. DESIGN: Prospective population study. Data on stressful life events, social network, occupation, and other psychosocial factors derived from self administered questionnaires. Mortality data obtained from official registers. SETTING: City of Gothenburg, Sweden. SUBJECTS: 752 men from a random population sample of 1016 men aged 50. MAIN OUTCOME MEASURE: Mortality from all causes during seven years' follow up. RESULTS: Life events which had occurred in the year before the baseline examination were significantly associated with mortality from all causes during seven years' follow up. Of the men who had experienced three or more events during the past year 10.9% had died compared with 3.3% among those with no life events (odds ratio 3.6; 95% confidence interval 1.5 to 8.5). The association between recent life events and mortality remained true after smoking, self perceived health, occupational class, and indices of social support were controlled for. Many of the deaths were alcohol related, but the number of deaths was too small to allow for analyses of specific causes of death. The association between life events and mortality was evident only in men with low emotional support. CONCLUSION: Stressful life events are associated with high mortality in middle aged men. Men with adequate emotional support seem to be protected.     

Minority stress, masculinity, and social norms predicting gay men's health risk behaviors.

The authors examined the contributions of the minority stress model, traditional masculine gender roles, and perceived social norms in accounting for gay men's use of alcohol, tobacco, illicit drugs, and risky sexual practices. Three hundred fifteen gay men recruited from listserv communities completed measures assessing internalized homophobia, stigma, antigay physical attack, masculinity, and perceptions of normative health behaviors, along with health risk behaviors of alcohol use, illicit drug use, smoking, and high-risk sexual behaviors. Pearson correlations supported several hypotheses; social norms and masculinity variables were significantly related to health risk behaviors. Four multiple regression analyses indicated that masculinity and perceptions of social norms predicted health risk behaviors. Additionally, a significant interaction was found between minority stress and perceptions of social norms. The clinical implications of the findings, limitations, and suggestions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quality of life in adults with cystic fibrosis

BACKGROUND: Cystic fibrosis is an inherited condition with a high mortality and morbidity. The aims of this study were to assess quality of life in a population of adults with cystic fibrosis, to compare quality of life with published scores from a healthy population and other patient groups, and to examine the relation between quality of life and other measured clinical variables. METHODS: Patients over 16 years of age attending an adult cystic fibrosis outpatient clinic were surveyed at a time when they were clinically stable. A self-complete questionnaire was administered which comprised the Nottingham Health Profile (NHP) together with six additional questions related to cystic fibrosis. RESULTS: Completed questionnaires were obtained from 240 subjects (100 women) of median age 26 years (range 16-56). Mean (SD) forced expiratory volume in one second (FEV1) was 49 (26)% predicted, forced vital capacity (FVC) was 68 (26)% predicted, and the FEV1:FVC ratio was 59 (16)%. In this cross sectional study different patterns of perceived quality of life were seen in men and women. In part 1 of the NHP there was an age related trend compared with norms in men, with more distress/disability in the dimensions of emotion, sleep, and social isolation in the older age groups. In women there was no age related trend in the degree of distress/disability compared with norms. The mean score was different from norms in the dimensions of pain, emotion and sleep. For the patients with cystic fibrosis as a whole the scores in part 1 were comparable with published scores of patients with minor non-acute conditions. Scores in part 2 of the NHP for men were different from norms in six of the seven areas of daily living (all except home life). For women the scores were different from norms in the areas of looking after the home, social life, hobbies, and holidays. There were correlations between several of the quality of life dimensions and other measured variables such as FEV1, breathlessness score, and the time spent on home treatment. CONCLUSIONS: Men and women with cystic fibrosis have different patterns of perceived quality of life, and there is an age related trend of perceived quality of life in men in some dimensions. Quality of life scores in this group, as assessed by the NHP, are similar to those reported in subjects with minor non-acute conditions.     

Gender, quality of life, and mental disorders in primary care: results from the PRIME-MD 1000 study

BACKGROUND: Recently there has been increased interest in the special mental health needs of women. We used data from the PRIME-MD 1000 study to assess gender differences in the frequency of mental disorders in primary care settings, and to explore the potential impact of these differences on health-related quality of life (HRQL). SUBJECTS AND METHODS: One thousand primary care patients (559 women) were interviewed during the PRIME-MD study, which was conducted at four primary care clinics affiliated with university hospitals throughout the eastern United States. Patients completed a one-page questionnaire in the waiting room prior to being seen by the physician; patients and physicians then completed together a clinician evaluation guide that used DSM-III-R algorithms to diagnose mood, anxiety, somatoform, eating, and alcohol related disorders. Health-related quality of life was assessed with the Medical Outcomes Study SF-20 General Health Survey. RESULTS: Women were more likely than men to have at least one mental disorder (43% versus 33%, P < 0.05). Higher rates were particularly prominent for mood disorders (31% of women versus 19% of men, odds ratio [OR] = 1.9, 95% confidence interval [CI] 1.4 to 2.6), anxiety disorders (22% versus 13%, OR = 1.9, CI = 1.3 to 2.8), and somatoform disorders (18% versus 9%, OR = 2.2, CI = 1.5 to 3.4). Psychiatric comorbidity was also more common in women (26% of women had two or more mental disorders versus 15% of men, P < 0.05). Unadjusted HRQL scores, ranging from 0 to 100, with 100 = best health, were all significantly lower in women than in men (eg, physical function = 67 in women versus 76 in men, P < 0.0001; mental health = 69 in women versus 76 in men, P < 0.0001). Many HRQL differences persisted after controlling for age, education, ethnicity, marital status, and number of physical disorders; however, differences in HRQL were eliminated in 5 of 6 domains after controlling for number of mental disorders. When compared with female patients of male physicians, female patients of female physicians demonstrated similar satisfaction with care, health care utilization, HRQL, and recognition rate of mental disorders. CONCLUSIONS: In the 1,000 patients of the PRIME-MD study, mood, anxiety, and somatoform disorders and psychiatric comorbidity were all significantly more common in women than men. The HRQL scores were poorer in women than men, although most of this difference was accounted for by the difference in prevalence of mental disorders. These data suggest that one of the most important aspects of a primary care physician's care of female patients is to screen for and treat common mental disorders.     

Chronicity of back problems during working life

STUDY DESIGN: A follow-up study of a cohort of 444 patients aged 16 to 59 years who consulted with their general practitioners (GPs) in 1987-1988 for an incident episode of back pain. OBJECTIVES: To determine the proportion of patients with back pain in whom chronic back problems develop after a follow-up of 7 years, to compare health outcomes and labor force participation of patients with and without chronic back problems and to identify determinants of chronicity. SUMMARY OF BACKGROUND DATA: The incidence and prevalence of back pain are very high. A large proportion of the costs related to medical consumption, absence from work, and disability are probably caused by chronic back problems. It is unknown what proportion of back problems become chronic, especially after a long follow-up period, and which factors can predict chronicity. METHODS: Data on the course of the symptoms and medical consumption from the period between 1987-1988 and 1991 were gathered retrospectively. Data on several health outcomes, including LFP, and data on some work characteristics were collected prospectively in 1991. A more extensive data set on health outcomes including psychologic status and working situation was collected in 1994. RESULTS: Chronic back problems developed in 28% of the patients. These patients reported more pain, higher levels of medical resource consumption, worse health outcomes, and lower labor force participation. Episodes of back pain before 1987-1988, severe pain in 1991, and disability score in 1991 were positively associated with chronicity in 1994, difficulties with job performance in 1991, and frequent stooping in the subgroup of patients who held a paying job in the follow-up period. CONCLUSIONS: Even after a follow-up of 7 years, the proportion of people with chronic back problems was high. The consequences for quality of life, labor force participation, and consumption of medical resources are clear. Further research is necessary to examine determinants and ways to prevent chronicity.     

Girls with spinal cord injury: Social and job-related participation and psychosocial outcomes.

Objective: To examine social and job-related participation among girls with spinal cord injury (SCI) and relationships between participation, depression, and quality of life. Participants and Setting: This sample included 97 girls (aged 7–17 years) who had sustained SCI at least 1 year prior to interview, and who were receiving care at three pediatric SCI centers within a single hospital system. Measures: Participants completed the Children’s Assessment of Participation and Enjoyment, Children’s Depression Inventory, and Pediatric Quality of Life Inventory. Caregivers completed a demographics form. Results: Girls participated more often in social activities than in job-related activities and participated in social activities with a more diverse group and further from home. A broader context of social participation was related to lower depression, which in turn was related to higher quality of life. Higher frequency of job-related participation was related to lower depression, which in turn was related to higher quality of life. Conclusions: Social and job-related participation are related to psychosocial outcomes among girls with SCI. Participation in social and job-related activities should be a focus of rehabilitation for girls, because the skills gained from this involvement may help build resilience against future obstacles to socialization and employment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catastrophizing mediates associations between pain severity, psychological distress, and functional disability among persons with spinal cord injury.

Objective: To examine associations between pain severity, psychological distress, catastrophizing, and indices of functional disability in a sample of persons with spinal cord injury (SCI). Catastrophizing was examined as a potential mediator of associations between pain severity, psychological distress, and functional disability. Design and Participants: Questionnaires assessing pain severity, psychological distress, catastrophizing, pain interference, and community integration were completed by 237 persons with SCI. Results: Psychological distress and pain severity were associated significantly with greater functional disability. Moreover, the association between pain severity and functional disability was strongest among persons with high psychological distress. Catastrophizing appeared to mediate the associations between pain severity, psychological distress, and functional disability. Conclusions: Pain severity and psychological distress have the potential for both direct and interactive effects on functional disability, possibly through the mediating effects of catastrophizing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between spirituality and quality of life among individuals with spinal cord injury.

Objective: To determine how spiritual-based coping relates to quality of life in individuals with spinal cord injury (SCI). Design, Setting, & Participants: A telephone interview of 75 participants, primarily Caucasian single men aged 19 to 71 (enrolled in the Northern New Jersey Spinal Cord Injury Model System). Measures: Ellison's Spiritual Well-Being Scale, Duke Health Profile, Craig Handicap Assessment and Reporting Technique, Diener's Satisfaction With Life Survey. Results: Virtually all participants (98.7%) reported using some form of spiritual-based coping. Quality of life was highest among participants who use existential spiritual as opposed to religious spiritual coping. In particular, existential spirituality shared 27% variance with overall perceived life quality. Conclusions: Spiritual-based coping might be encouraged as a possible strategy to improve life quality. Clinicians should be cognizant of ongoing spiritual practices among persons with SCI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thyroid carcinoma in intrathoracic goiter

While research on spinal cord injury (SCI) is abundant, few studies focus on women. This population-based study investigates differences in the prevalence of secondary conditions between 128 women and 522 men. Case managers retrospectively interviewed 650 persons regarding medical and psychological conditions secondary to SCI, as well as other life issues. Overall, males and females show more similarities than differences in the ways in which they manage life with SCI. Differences were found, though, regarding etiology of initial injury, insurance coverage, caregiver use, transportation use, medication use, and in other medical and behavioral areas. Females are significantly involved in more automobile crashes than males, while males are involved in more galls than females. Females are more reliant on Medicaid, while males report more Medicare and Worker's Compensation coverage. Females are more likely to have a paid attendant as a caregiver while males are more likely to have their spouse or parents assist. Males report more independence in their use of transportation than females. Males and females also report significant differences in the use of medication. Females are more likely to use medication any time it is a treatment option. Males are more active, use tobacco more and have more arm fractures postinjury than females.     

Family health and mental health six years after economic stress and unemployment

This study is a follow-up of 39 working class couples who were interviewed after suffering economic stress or unemployment and again six years later. Repeated measures related to economics, stress, family functioning, anxiety, and depression were collected and analyzed for couples and for husbands and wives separately. A model of long-term coping was suggested for future testing. Initially stressed families appeared to grow stronger. Mental health correlated negatively to family problems. Depressed wives seemed to maintain their depression over time if they perceived family life as stressful. Irrespective of marital problems, husbands were less likely to stay depressed.     

Haredi women, haredi men, stress and distress

This report examines data from interviews with 179 strictly-orthodox Jews living in London. The impetus was a debate in this journal on the question whether men or women in the strictly-orthodox (haredi) community are more stressed. Many of the observations made in this journal on the quality of life among haredi men and women in Israel were borne out among the strictly-orthodox London Jews interviewed. Quantitatively, severe stress and clinical levels of depression and anxiety were similar among the men and women studied, but women had overall more eventful lives than men, and were more likely to suffer from borderline depression and anxiety--though these differences were only marginally significant. It is suggested that the London sample studied were probably similar to haredim in Israel, and that the findings might therefore be applicable.     

Associations and Predictors of Posttraumatic Stress Levels According to Person-Related, Disability-Related, and Trauma-Related Variables Among Individuals With Spinal Cord Injuries.

Objective: To examine the associations and predictors of posttraumatic stress among individuals with spinal cord injuries (SCI) in the framework of a Person x Disability x Traumatic Event model. Design: An exploratory study involving analyses of variance, correlations, and a hierarchical multiple regression of a cross-sectional sample. Participants: Three hundred twelve individuals with SCI using a veteran or a civilian SCI clinic. Main Outcome Measures: Purdue Posttraumatic Stress Disorder--Revised scale (PPTSD-R). Results: Four out of all the examined variables had significant regression coefficients: spiritual-religious coping, pain level, severity of SCI, and number of traumatic events. Severity of SCI was a significant predictor, but data suggested that severity of SCI had a curvilinear association with both total posttraumatic stress levels and hyperarousal scores. Conclusion: Treatment of an individual's pain may reduce posttraumatic stress symptoms. Clinicians also can evaluate for previous trauma unrelated to the onset of the SCI and can intervene with the goal of reducing the impact of previous trauma on the individual's present emotional state and reactions to SCI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Height, occupation and back pain in a national prospective study

Back pain is an important public health problem but there is a paucity of knowledge about risk factors and causal mechanisms. Previous studies have shown that tall men are more at risk of back pain, although observations in women have been less consistent. This paper presents findings from a national longitudinal study of 3262 men and women aged 43 yr. Standing height and sitting height were related to 18-month reported prevalence of 'sciatica, lumbago or severe backache' in both men and women. The paper investigates explanations for these findings using previously collected data on childhood growth and detailed lifetime occupational histories. Neither greater susceptibility of tall men to heavy lifting, nor the timing of growth, were able to account for these relationships. To assess further the association between height and back pain, information is needed on the relationship between stature and characteristics of spinal structure.     

The perceived stress reactivity scale: Measurement invariance, stability, and validity in three countries.

There is accumulating evidence that individual differences in stress reactivity contribute to the risk for stress-related disease. However, the assessment of stress reactivity remains challenging, and there is a relative lack of questionnaires reliably assessing this construct. We here present the Perceived Stress Reactivity Scale (PSRS), a 23-item questionnaire with 5 subscales and 1 overall scale, based on an existing German-language instrument. Perceived stress reactivity and related constructs were assessed in N = 2,040 participants from the United Kingdom, the United States, and Germany. The 5-factor structure of the PSRS was found to be similar in the 3 countries. In the U.S. sample the questionnaire was applied using 2 modes of administration (paper–pencil and computerized), and measures were repeated after 4 weeks. Measurement invariance analyses demonstrated full invariance across mode of administration and partial invariance across gender and countries. Scale scores differed between countries and genders, with women scoring higher on most scales. Overall, reliability analysis suggested good stability of PSRS scores over a 4-week period, and validation analysis showed expected associations with related constructs such as self-efficacy, neuroticism, chronic stress, and perceived stress. Perceived stress reactivity was also associated with depressive symptoms and sleep. These associations were particularly strong when individuals scoring high on perceived stress reactivity were exposed to chronic stress. In sum, our findings suggest that the PSRS is a useful and easy-to-administer instrument to assess perceived stress reactivity. (PsycINFO Database Record (c) 2011 APA, all rights reserved)