Leitenberg et al (1992) conducted a retrospective study of long term coping methods with having a sexually abusive childhood. Their hypothesis was that since the psychological effects of many other stressful and traumatic life events have been shown to be influenced by different coping methods, (Garmezy and Rutter, 1983) it seems reasonable to expect that this would be the case as well for childhood sexual abuse. They found that "denial" and "emotional suppression" were the coping methods most commonly employed by women recalling experiencing CSA. Although women reported these strategies as being helpful at the time, the research demonstrated that these coping strategies were associated with poorer adult psychological outcome. Ebata and Moos (1991) conducted a study focusing on avoidance and confrontive coping strategies in clinical population adolescents. They found that depressed adolescents and adolescents with conduct disorder use more avoidance coping than rheumatic disease and healthy adolescents. Their results suggest that efforts to change, manage or positively reappraise a problematic situation actively, are important for good long term adjustment. Ebata and Moos (1991) conclude that adolescents who engage in more avoidance coping may be at greater risk for poorer adjustment to subsequent life stressors and crises.
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Stress and Post Traumatic Stress Disorder (PTSD): The intensive care units are intended to treat patients of a medical specialty or the sufferer of diseases or conditions, such as cardiac, neurological, surgical and traumatic, among others. However, despite being an environment with complex technological apparatus aimed at better patient care, most ICUs are environments that generate stress (Manpreet Kaur, 2016). Some triggers include lack of natural light, disruption of sleep- wake patterns, absence of clocks and lack of contact with family and friends, in addition to the several clinical procedures that cause patients to experience different types of physical and psychological discomfort (Biancofiore, 2005). Stressful conditions may trigger an inflammatory response in the brain and other systems, which is characterized by the complex release of inflammatory mediators. This response can exhibit different symptoms that depend on the intensity and quality of stressors. The stressors of critical illness are so numerous and severe that people become overwhelmed. In a review article by Mette Ratzeret. al. the prevalence range for PTSD/PTSS post ICU from the 38 articles ranged from 0% to 52% with a mean prevalence rate of 17% (n=7943) (Mette Ratzer, 2014).
Despite this, whether a coping strategy is efficacious (i.e., facilitates healthy psychological functioning), is far from straightforward (Somerfield & McCrae, 2000). That is, the efficacy of a particular coping strategy is partially determined by the interaction of personal resources, preferences, and situational factors (Zeidner & Saklofske, 1996). Moreover, a coping strategy that is efficacious for one outcome may simultaneously detract from another (Zeidner & Saklofske, 1996). However, in general, when perceived stressors are appraised as changeable task-oriented coping is efficacious and associated with lower levels of psychopathology and higher levels of positive characteristics such as self-esteem, sense of mastery, and self-efficacy (Causey &
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Figure 1 and Table 2 show that GD and body image dif ﬁ culties persisted through puberty suppression (at T0 and T1) and remitted after the administra- tion of CSH and GRS (at T2) (signi ﬁ cant linear effects in 3 of 4 indicators, and signi ﬁ cant quadratic effects in all indi- cators). Time by sex interactions re- vealed that transwomen reported more satisfaction over time with primary sex characteristics than transmen and a continuous improvement in satisfac- tion with secondary and neutral sex characteristics. Transmen reported more dissatisfaction with secondary and neu- tral sex characteristics at T1 than T0, but improvement in both from T1 to T2. Age was a signi ﬁ cant covariate with second- ary sex characteristics (the only signi ﬁ - cant demographic covariate with any outcome indicator in the study), indi- cating that older individuals were more dissatis ﬁ ed at T0, but the age gap in body satisfaction narrowed over time (F(1, 42) = 8.18; P , .01).
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At first, each patient was referred to a neurosurgeon for neurological evaluations. If the patient had met the inclusion criteria, a demographic questionnaire was then employed to record information such as age, gender, ed- ucation level, and GCS. Participation in our study was vol- untary with given written informed consent. For the 6 months follow-up, the patients were invited by the trauma research center in Shahid Beheshti hospital, Kashan, Iran, via phone calls for psychological assessments by a clinical psychologist. If the individuals were illiterate, a psychol- ogist would help him/her completing the questionnaire. The information obtained from the neurological evalua- tion, organic brain pathology, and psychological assess- ments were blinded to the psychologist to reduce any non- blinded outcome assessment bias or diagnostic suspicion bias. Also, we recruited 50 healthy subjects during a period of 6 months, all matched for sex and education. If there was missing of the follow-up, phone calls were repeated two times with 2 weeks interval. To persuade the cases, they were told that they are examined by the neurosurgeon for free.
In some studies (e.g. Mazonson et al. 1994 ; Rubenstein et al. 1995), feedback of outcome results was combined with an active educational programme and the provision of standardized best practice guidelines on the management. For example, in the study by Mazonson et al. (1994), the active educational programme involved sessions on the importance of deficits in health related quality of life and untreated anxiety, together with a description of the psychometric instruments and their interpretations. Results of profiles from three of their own patients were then discussed in detail and educational materi- als on the management of anxiety were provided in the form of audiotapes and articles. Ad- ditionally, a toll free telephone number was provided so that further questions could be answered by a study team physician.
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The numbers and complexity of maxillofacial^ operations are increasing all the time (Kocabalkan, Leblebicioglu, Erk and Enacar, 1995). Surgery of this kind is usually motivated by the belief that improved facial appearance will have a positive effect on psychological functioning. Shalhoub (1994) writes, “Surgical procedures usually are followed not only by changes in facial appearance but also in changes in function. These changes often lead to psychological effects on patients in addition to changes in their social life” (p i81). Several assumptions are made by this statement. First, that facial disfigurement causes psychological distress. Second, that surgery is able to improve facial appearance. Third, that improving facial appearance automatically improves psychological adjustment. An associated belief which follows from the last assumption, is that early surgery will produce better psychological results. The following literature review looks at the evidence for each of these assumptions in turn, to examine the value of surgery for individuals with facial disfigurements. While it appears to be true that these individuals are at a higher risk of psychological distress, it is not clear that surgery is the most effective means of resolving these difficulties.
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Only eight children showed symptoms of cerebellar ataxia in this series and all of them had prenatal onset of CH and were treated after seven months of age. Children with prenatal onset of CH treated before seven months and all those with a bone age equivalent to the newborn or later did not show any evidence of cerebellar dysfunction. In general, other indications of neurological dysfunction such as fine motor coordination disability, slow motor performance, short attention span, impaired spatial orien tation, slow ideation were more frequent in the 'prenatal' group. These symptoms did not appear to be affected by the age at start of treatment although the small numbers in the study make it difficult to assess this association more fully than just a description of individual cases. The study also reported the presence of hyperkinesis, enuresis and a specific mathematics learning disability in children with CH. However, there were difficulties in interpreting the findings without a control group when many of the observed behaviours were poorly defined. Nevertheless the study was important in two ways. It suggested the impor tance of prenatal processes in determining outcome and that bone age at diagnosis provided a useful predictor of longer term psychological outcome.
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Like in other parts of the world, the extent of psychological distress among young adults in the Nigerian universities is worrisome with over 31.9% likely to have a severe mental disorder. It is a fact that a number of factors contribute to the problem. This article presents the results of a study designed to investigate the effects of sleep hours and academic performance on psychological distress among University students. The correlational research design was used and three hundred and eighty-five students (385 [male=200 and female= 185]) participated in the study. The data collected through questionnaire was analyzed using one-way analyses of variance at p<.05. The analysis was done using JMP version. 13.2. The results revealed significant effects of sleep hours on the psychological distress F (3,381) = 17.750, p<.001, with students sleeping an average of ≤ 4 hrs reporting significant distress level, t = 6.16, p<.001. Academic performance was found to predict psychological distress F (3,381) 381 = 6.864, p<.001, with performance below average predicting psychological distress positively, t = 4.09, p<.001. The study concludes that poor sleep quantity and academic performance below average may significantly predict psychological distress among the study sample. The outcome of this study, therefore, provides psychologists,
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This study aimed to test the feasibility and acceptability of a novel, scalable psychological intervention with Kenyan women exposed to a range of adverse life events. Although the study was not powered to detect clinically significant differences on outcome measures, the find- ings revealed that PM+ had the potential to improve mental health, particularly a reduction in PTSD symp- toms for women affected by adversity, including GBV. The intervention did not have a significant effect on measures of general distress (GHQ) or functional im- pairment (WHO-DAS) compared with ETAU. This may be because the concepts measured by these instruments by comparison to the PCL are too heterogeneous to de- tect effects in a small sample size.
Whilst one of the strengths of this project is its natural- istic nature, this also presents some challenges in terms of the analysis of outcome data. In large scale randomised controlled trials that compare efficacy of different therap- ies, or medication vs therapy, manualised therapy is often used. Therapists in such studies will be supervised more closely than in standard practice, will be less free to vary sessions and will have their skills monitored. This project will involve therapists from different backgrounds includ- ing but not limited to; trained CBT therapists; clinical psy- chologists with IAPT high intensity therapy training and psychological well-being practitioners both pre- and post- qualification. These therapists will also have different amounts of experience and bring their own styles and ways of working to their patients. All of this will contrib- ute to the variance in non-specific therapeutic factors in- fluencing outcomes. At this point, we have not identified an efficient way of measuring these important ‘therapist factors’ but we will be working with team leaders in order to capture this in future research.
Because this is a low-risk intervention adding to stand- ard care and not involving any known side effects, we anticipate that most eligible women with chronic disease will be interested in participating in the trial, and we do not expect a high number of dropouts. Measures to monitor and enhance adherence to the intervention will be taken. The two self-reported questionnaires, one at 33–37 weeks of pregnancy and one at 2 months postpar- tum, will be followed by reminders if not completed within the time frame, and text message reminders will be sent in advance; adherence to all planned activities of the interventions will be monitored and recorded. The primary outcome (LOS) data are collected from medical records and do not rely on patient self-reporting. To reduce the risk of selection bias, eligible women will be offered the choice between a face-to-face meeting and a telephone conversation for information about the study, informed consent, and randomization, accommodating women living farther from the hospital.
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Ever since the inception of the PEG-tube, there is a consid- erable debate about the health issues related to the quality of life (HRQoL) of the patients who have undergone feed- ing via PEG tube with underlying chronic illnesses [6,7]. Quantitative assessment of the HRQoL is a difficult task. Most researchers measure HRQoL by asking specific ques- tions pertaining to its most important components that include physical, psychological and social domains of health. Although, the objective dimensions are very much important in defining a patient's degree of health; none- theless, it is the patient's subjective perceptions and expec- tations that translate the assessment into the actual quality of life experienced [8,9].
Result suggested that, individual psychological well-being such as autonomy, positive relationship, environmental mastery, purpose in life, personal growth and self-acceptance direct students to gain realize their innate potential and enhance self-confidence to perform challenging task. Poor psychological well-being ended in depression, severe anxiety and helplessness and unable to stay consistent in their life challenges. Secondary school education is very critical part in student’s life. That level of education result determined students capability to pursue their further studies in university or college. Therefore, achieving success academically being a key goal of their life. During their schooling time, students exposed to various obstacles and responsibilities such as an individual assignment, group project, and summative examination, interpersonal and intrapersonal conflicts. It would be the prime cause for their stress and psychological maladjustment. Student’s with psychological maladjustment shows unsatisfactory attendance and behavior delinquency. While there are many students able to cope with difficulties but number of cases these difficulties may have a grave effect on the young person’s psychological well-being. This poor psychological well-being leads them to the destructive effect such as poor academic achievement, unable to comprehend individual capability and social interaction challenges.
Setting: Eligible pregnant women were recruited from nine family healthcare centres in Nigde between September 2013 and July 2014. Participants: A total of 242 women completed questionnaires at both time points. Measures: PTS symptoms were measured using the Impact of Event Scale-Revised (IES-R) 6-8 weeks after birth. Potential protective or risk factors of childbirth self-efficacy, fear of childbirth, adaptation to pregnancy/motherhood, and perceived social support were measured in pregnancy and after birth. Perceived support and control during birth was measured after birth. Demographic and obstetric information was collected in pregnancy using standard self-report questions. Findings: PTS symptoms were associated with being multiparous, having a planned pregnancy, poor psychological
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The definition of mental and physical components of mental, behavioural, and physical health problems into mutually exclusive categories can be challenging, particularly as some components are symptomatic of multiple disorders, and there is a high probability of comorbidity between certain problems. For the purpose of this systematic review, the inclusion criteria for mental health problems was derived from the ICD-10. Eligible mental health problems, and their key diagnostic symptoms, were in the following classifications: (a) F20-29: schizophrenia, schizotypal and delusional disorders; (b) F30-39: mood (affective) disorders; (c) F40-48: neurotic, stress-related and somatoform disorders; (d) F60-69: disorders of adult personality and behaviour; and, (e) F90-97: behavioural and emotional disorders with onset usually occurring in childhood and adolescence. As such, organic mental disorders, disorders due to psychoactive substance abuse, behavioural syndromes associated with physiological disturbances and physical factors, intellectual disability, disorders of psychological development (e.g. childhood autism and specific developmental disorders), as well as other
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Three studies of anxiety fail to meet one or more APA stan- dards. An RCT of psychological conditions in participants in a weight loss program found reductions in anxiety that closely approached significance (p < .053) but did not meet the re- quired p < .05 threshold (APA criterion #2; Stapleton, Church, Sheldon, Porter, & Carlopio, 2013). Benor, Ledger, Toussaint, Hett, and Zaccaro (2010) found significant reductions in anxi- ety in university students, but class scheduling conflicts among participants prevented true randomization (APA criterion #1). Waite and Holder (2003) compared EFT to two sham tapping interventions and a non-tapping control group. However, the RCT failed to use valid and reliable assessments (APA Crite- rion #4), failed to apply EFT with fidelity to the manual (APA criterion #6), and failed to recognize that the “sham” points selected by the investigators were in fact actual acupressure points (APA criterion #6). These errors resulted in all three tapping groups improving relative to the non-tapping group.
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The main purpose of this study was to validate a newly developed psychological therapy outcome measure designed for use with people with intellectual disabilities. Analysis of the PTOS-ID identified a 29-item, self-report measure which assesses: a) Emotional and Behavioural Discomfort, b) Positive Well-being, and c) Anxiety. The factors that were identified were unexpected in relation to the item pool and the five proposed scales of depression, anxiety, anger, interpersonal well-being and psychological well-being. However, all identified factors had a Cronbach’s alpha of greater than 0.7 suggesting good levels of reliability. The sample size also satisfied statistical power for the exploratory analysis and the overall psychological distress score correlated significantly with the GSI of the BSI. Taken together, this suggests that the PTOS-ID has good levels of construct and concurrent validity.
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Using the diagnostic cut-offs and reliable change indices for each outcome measure (described above), we applied Jacobson and Truax (1991) criteria to report the proportions of cases with reliable and clinically significant improvement (RCSI) and reliable deterioration during their stepped care treatment episode . RCSI rates, treatment dropout rates and total cases classed as NOT were compared between cohorts using case -mix adjusted logistic regression. Supplementary outcome metrics commonly used in IAPT services were also estimated and described, including reliable improvement rates (Jacobson & Truax, 1991) for each measure and IAPT recovery rates (Clark et al., 2009).
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Although the usefulness of outcome feedback has been demonstrated in specialist counselling and psychotherapy centres, these methods have not yet been tested in stepped care psychological services such as those linked to the IAPT (Improving Access to Psychological Therapies) model applied in England (Clark, 2011) and Australia (Cromarty, Drummond, Francis, Watson, & Battersby, 2016). IAPT services are particularly well placed to apply OF methods since they routinely collect standardised outcome measures at every session to monitor clinical outcomes (Clark, 2011). However, the high volume of work and time pressures typical of public healthcare settings may limit therapists ’ ability to consistently and meaningfully reflect on the results of outcome measures within their treatment sessions. Furthermore, research suggests that IAPT clinicians do not necessarily consider symptom measures in their decisions about treatment planning and some tend to rely on subjective beliefs and attitudes when making decisions about the treatment of non-improving patients (Delgadillo, Gellatly, & Stephenson-Bellwood, 2015). Therefore, there are plausible contextual and attitudinal barriers that may limit the effective utilization of outcome feedback in this setting.
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