Low self-compassion in patients with bipolar disorder

BackgroundEmerging research suggests that low self-compassion may be linked to psychopathology and in particular depressive symptoms. To further elucidate this topic, the present study investigated self-compassion in patients with Bipolar Disorder (BD).MethodThirty remitted BD patients were compared to thirty age- and sex matched controls on the Self-Compassion Scale (SCS). The BD patients also completed the Altman Self-Rating Mania Scale (ASRM), the Major Depression Inventory (MDI), the Work and Social Adjustment Scale (WSAS), the Satisfaction With Life Scale (SWLS) and the Internalized Stigma of Mental Illness Scale (ISMI-10) and further reported their illness history on a survey sheet.ResultsThe BD patients were found to have significantly lower self-compassion than controls. In addition, self-compassion correlated positively and significantly with life-satisfaction but no significant correlations with functional impairment, internalized stigma or frequency of past affective episodes were found.LimitationsThe small sample size entailed reduced statistical power.ConclusionsBy suggesting that self-compassion is reduced and possibly linked to life-satisfaction in BD, the findings highlight a potential vulnerability meriting further investigations.     

Relationships Among History of Psychosis,Cognition and Functioning in Later-Life Remitted Major Depression

ObjectiveThis study tested the hypotheses that, in older adults with remitted major depression, a history of psychotic features and poorer neuropsychological performance would be independently associated with poorer everyday functioning, but that neuropsychological performance would explain more of the variance in functioning than history of psychotic features.MethodsThis cross-sectional study included 73 patients aged 50 years or older with remitted psychotic major depression or nonpsychotic major depression. The dependent variables were subjective and objective measures of function. The independent variables were history of psychotic features during one or more major depressive episodes in the previous 10 years and neuropsychological performance. Linear regression models examined the association of independent variables with function, controlling for pertinent covariates. Effect sizes were calculated for the magnitude of difference in function between the patient participants and an age- and gender-matched nonpsychiatric group, and distribution of functioning scores were compared between groups.ResultsIn separate models, history of psychotic features and poorer processing speed, executive function, and verbal learning were independently associated with poorer participant-reported functioning and performance-based functioning. However, the association of psychotic features with functioning was no longer statistically significant when tested in the same models as neuropsychological measures. Effect sizes of the difference in functioning between patients and the nonpsychiatric group were significantly larger for the remitted psychotic than the remitted nonpsychotic depression group; functioning scores were more heterogeneous in the remitted psychotic depression group.ConclusionPatients with remitted psychotic depression exhibit greater, and clinically important, impairment in everyday functioning than those with remitted nonpsychotic depression. Neuropsychological impairment appears to contribute to this relationship.     

Severe social anxiety in early psychosis is associated with poor premorbid functioning, depression, and reduced quality of life

ObjectiveThe main aim of the present study was to examine whether patients with first-episode psychosis (FEP) with severe social anxiety show poorer premorbid and current functioning, higher level of current clinical symptoms, and better “insight into illness.” Furthermore, we wanted to explore whether social anxiety is associated with reduced quality of life (QoL).MethodA sample of 144 individuals with an FEP was divided into 3 groups depending on current level of social anxiety symptoms measured by the Liebowitz Social Anxiety Scale. Analysis of variance was performed including measures of demographic and clinical characteristics. A hierarchical regression analysis was performed to explore possible predictors of QoL.ResultsThe most severe social anxiety group revealed poorer premorbid adjustment, lower social functioning, and higher levels of depression. Furthermore, this group revealed a higher awareness of illness and experienced reduced QoL. Overall, social anxiety was associated with reduced QoL even after adjusting for psychotic symptoms and depression.ConclusionSevere social anxiety in FEP is associated with poor premorbid functioning and distinct clinical characteristics, besides being a possible predictor of QoL.     

The Relationship between Impulsivity and Quality of Life in Euthymic Patients with Bipolar Disorder

Objective

Bipolar disorder (BD) is characterized by elevated impulsivity, even during periods of remission. Many recovered BD patients have functional impairments, which can lead to poor quality of life (QoL). The aim of this study was to investigate the association between impulsivity and QoL in euthymic BD patients.

Methods

A total of 56 remitted or recovered patients with type I or II BD, diagnosed based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, were recruited. Psychiatrists administered the Clinical Global Impression (CGI) for BD and the Global Assessment of Functioning (GAF) scales and then interviewed the subjects to assess clinical variables. Patients completed the Barratt Impulsiveness Scale (BIS-11) and the World Health Organization Quality of Life Assessment Instrument-Brief Form (WHOQoL-BREF). Pearson correlations, univariate regression analyses, and multiple linear regression analyses were performed.

Results

The BIS-11 total score was significantly correlated with the WHOQoL-BREF total score (r=-0.55, p<0.01) and with the WHOQoL-BREF subscales. After controlling for GAF score and other clinical variables, the BIS-11 total score (β=-0.43, p=0.001) was independently associated with overall QoL. Additionally, the BIS-11 total score was particularly strongly associated with the physical, psychological, and social domains of the multi-dimensional QoL scale.

Conclusion

Our results suggest that high impulsivity is related to low QoL in euthymic BD patients. Further studies are needed to examine whether interventions for high impulsivity effectively improve QoL in patients with BD.     

The association between insight and symptoms in bipolar inpatients: An Italian prospective study

ObjectiveTo evaluate potential differences in insight among bipolar manic, mixed and bipolar depressed inpatients and assess the role of clinical and demographic characteristics as possible predictors.MethodOne hundred and twenty consecutive inpatients divided into three diagnostic groups were studied on admission (T0), at discharge (T1) and at 18 weeks after hospitalization (T2). The Young Mania Rating Scale (YMRS), the Hamilton Rating Scale for Depression (HAMD) and the Scale to Assess Unawareness of Mental Disorder (SUMD) were used.ResultsPatients with mixed mania showed highest scores on the SUMD than patients with mania or bipolar depression. It was found a significant relationship between improvements in mania and in the insight. The level of insight at baseline was the only predictor of awareness in social consequences, moreover clinical and demographic characteristics were predictors of insight into mental illness. For what concerns insight about therapy benefits it was influenced by level of mania at baseline.ConclusionThe three general dimensions of insight revealed significant differences among the three groups. Regression models suggest that insight is a multidimensional concept in which some aspects are state-related, associated with psychopathology, whereas others are trait-like qualities, not directly associated with symptoms and predicted only by level at baseline.     

Lower subjective quality of life and the development of social anxiety symptoms after the discharge of elderly patients with remitted schizophrenia: a 5-year longitudinal study

ObjectivesRemitted schizophrenic patients living in the community often encounter difficulties in their daily lives, possibly leading to the development of social anxiety symptoms. Although several studies have reported the significance of social anxiety as a comorbidity in patients with schizophrenia, few longitudinal data are available on the development of social anxiety symptoms in patients with remitted schizophrenia, especially in association with the process of “deinstitutionalization.” The aims of this study were to assess the social anxiety symptoms in remitted outpatients with schizophrenia and to examine whether the development of social anxiety symptoms was associated with psychotic symptoms, social functioning, or subjective quality of life.MethodsFifty-six people with schizophrenia who were discharged through a deinstitutionalization project were enrolled in this longitudinal study and prospectively assessed with regard to their symptoms, social functioning, and subjective quality of life. The severity of social anxiety symptoms was measured using the Liebowitz Social Anxiety Scale (LSAS). Global/Social functioning and subjective quality of life were evaluated using the Global Assessment of Functioning Scale, the Social Functioning Scale, and the World Health Organization–Quality of Life 26 (WHO-QOL26).ResultsThirty-six patients completed the reassessment at the end of the 5-year follow-up period. The mean LSAS total score worsened over time, whereas other symptoms improved from the baseline. The mean WHO-QOL26 score in the worsened LSAS group was significantly lower than that in the stable LSAS group. At baseline, WHO-QOL26 scores were associated with an increase in the severity of social anxiety symptoms.ConclusionIn community-dwelling patients with remitted schizophrenia, a lower subjective quality of life might lead to the development of social anxiety symptoms, both concurrently and prospectively. To achieve a complete functional recovery, additional interventions for social anxiety may be needed.     

Personality disorders: patient characteristics and level of outpatient treatment service

Background: In this naturalistic study, patients with personality disorders (N?=?388) treated at Stolpegaard Psychotherapy Center, Mental Health Services, Capital Region of Denmark were allocated to two different kinds of treatment: a standardized treatment package with a preset number of treatment hours (basic hospital service) and 2: a specialized treatment program for the most severely affected patients without a predetermined restricted number of treatment hours and significantly more individual psychotherapy (regional specialized hospital services).

Aims: To investigate patient characteristics associated with clinicians’ allocation of patients to the two different personality disorder services.

Methods: Patient characteristics across eight domains were collected in order to study whether there were systematic differences between patients allocated to the two different treatments. Patient characteristics included measures of symptom severity, personality pathology, trauma and socio-demographic characteristics. Significance testing and binary regression analysis were applied to identify important predictors.

Results: Patient characteristics on fifteen variables differed significantly, all in the expected direction, with patients in regional specialized hospital services showing more pathology and psychosocial problems. In the regression model, only age and two variables capturing psychosocial functioning remained significant predictors of allocation.

Discussion: The finding that younger age was the most significant predictor of longer treatment replicates an earlier finding of allocation to treatment for personality disorder. Overall, this study therefore lends further support to the importance of demographic and social contextual factors in clinicians’ allocation of patients to different treatment services for personality disorder.     

Perception of stigma among patients with schizophrenia

Abstract. Background: Many individuals with schizophrenia are stigmatized by society. It is necessary to understand the factors contributing to stigma. This study investigated the relation of symptoms and other patient characteristics with perceived stigmatization in patients with schizophrenia. Method: Sixty patients with schizophrenia were included in the study. Symptomatology was assessed with the Positive and Negative Syndrome Scale.Perceived stigmatization was measured by several questions which were included in the World Health Organization-Disability Assessment Schedule-II (WHODAS-II). Patients were grouped as positive or negative for perceived stigmatization. Characteristics of patients and severity of symptoms were compared between the two groups. Results: The results showed that patients who reported to perceive stigmatization had more severe symptoms than the patients who did not perceive stigmatization. Positive symptoms and general psychopathology scores were significantly higher in the group perceiving stigmatization. Patients reporting stigmatization were significantly more disabled than the group negative for perceived stigmatization. Demographic variables were not different between the two groups. Stepwise regression analysis showed that depression and active social avoidance were the items which could predict the perception of stigmatization. Conclusion: The relation between perception of stigmatization and symptoms is a vicious circle in which the elements reinforce each other. Interruption of this circle will increase the adaptive abilities and decrease the disability of these patients.     

Quality of life in family caregivers of schizophrenia patients in Spain: caregiver characteristics,caregiving burden,family functioning,and social and professional support

Objective: Caregivers experience physical and mental stress that ends up lowering their quality of life (QoL). Our goal was to research (a) the level of caregivers QoL; (b) the relationships between the demographic characteristics of the caregivers, their caregiving burden, their family functioning, their social and professional support and their QoL and (c) the best predictors of caregivers QoL.

Methods: 100 key caregivers (70% parents, 8% spouses, 17% siblings and 5% children) were studied using the world health organization quality of life-Bref (WHOQOL-BREF) to research their QoL, the Zarit Scale to assess their perception of their caregiving burden, the Social Network Questionnaire to examine their social support, the Family APGAR to assess the satisfaction with social support from the family and a professional support scale (Escala de Apoyo Profesional) to determine the professional support received by caregivers was performed.

Results: Scores on the WHOQOL-BREF in the Physical, Psychological, Social and Environment domains were 15.0 (SD?=?3.7), 13.3 (SD?=?4.2), 11.0 (SD?=?4.7) and 13.5 (SD?=?3.1), respectively. Through bivariate analysis, the dimensions that showed a positive significant association with QoL were being a young male caregiver who was a working father with a high educational level and help from other family members. Caregivers of patients who were older and had a later onset of the illness, a lower score on the Zarit Scale and a high score on the Social Network Questionnaire, Family APGAR and Escala de Apoyo Profesional showed higher QoL. Many of these variables made a unique contribution in the multivariate analysis.

Conclusions: There is a significant association between the caregiver’s burden and their QoL. Regression analysis showed that the best predictors of QoL were caregiving burden, social support and professional support.     

Impulsivity, personality and bipolar disorder

BackgroundIncreased impulsivity is a diagnostic feature of mania in bipolar disorder (BD). However it is unclear whether increased impulsivity is also a trait feature of BD and therefore present in remission. Trait impulsivity can also be construed as a personality dimension but the relationship between personality and impulsivity in BD has not been explored. The aim of this study was to examine the relationship of impulsivity to clinical status and personality characteristics in patients with BD.MethodsWe measured impulsivity using the Barratt Impulsiveness Scale (BIS-11) and personality dimensions using Eysenck Personality Questionnaire in 106 BD patients and demographically matched healthy volunteers. Clinical symptoms were assessed in all participants using the Clinical Global Impressions Scale, the Montgomery-Asberg Depression Rating Scale and the Young Mania Rating Scale. Based on their clinical status patients were divided in remitted (n = 36), subsyndromal (n = 25) and syndromal (n = 45).ResultsThere was no difference in BIS-11 and EPQ scores between remitted patients and healthy subjects. Impulsivity, Neuroticism and Psychoticism scores were increased in subsyndromal and syndromal patients. Within the BD group, total BIS-11 score was predicted mainly by symptoms severity followed by Psychoticism and Neuroticism scores.ConclusionsIncreased impulsivity may not be a trait feature of BD. Symptom severity is the most significant determinant of impulsivity measures even in subsyndromal patients.     

Insomnia among current and remitted common mental disorders and the association with role functioning: results from a general population study

Objective and backgroundInsomnia is a neglected topic in psychiatric epidemiological studies. Despite the fact that insomnia is a common phenomenon and usually co-occurs with mental disorders, it remains to be addressed to what extent insomnia is associated with remitted and current common mental disorders and with impaired functioning in the population, after considering a wide variety of confounders.Patients and methodsData were used from three waves of the Netherlands Mental Health Survey and Incidence Study-2 (N = 4618), a nationally representative face-to-face survey of the general population. Insomnia was assessed at the third wave with the Women's Health Initiative Insomnia Rating Scale. Mental disorders were assessed at all waves with the Composite International Diagnostic Interview version 3.0. Confounders included sociodemographic characteristics, physical health, and psychotropic medication use. Role functioning was assessed with the Medical Outcomes Study Short Form Health Survey and work loss with the World Health Organization Disability Assessment Schedule.ResultsForty-two per cent of the population reported none to mild insomnia, 35% moderate insomnia, and 23% severe insomnia. Both current and remitted anxiety disorder and current mood disorder were significantly associated with severe insomnia with adjusted odds ratios ranging from 1.8 to 3.3. Current and remitted substance use disorders were associated with moderate insomnia (adjusted OR range: 1.3–1.8). Moderate and severe insomnia were significantly associated with impaired role functioning and work loss after adjustment for confounders.ConclusionInsomnia is a prevalent problem across different categories of mental disorders, even in the remitted phase. As insomnia has a high impact on daily functioning, insomnia deserves wide clinical attention.     

Suicide attempts are associated with worse quality of life in patients with bipolar disorder type I

BackgroundThe association between suicidal behavior and quality of life (QoL) in bipolar disorder (BD) is poorly understood. Worse QoL has been associated with suicide attempts and suicidal ideation in schizophrenic patients, but this relationship has not been investigated in BD. This study tested whether a history of suicide attempts was associated with poor QoL in a well-characterized sample of patients with BD, as has been observed in other psychiatric disorders and in the general population.MethodsOne hundred eight patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition BD type I (44 with previous suicide attempts, 64 without previous suicide attempts) were studied. Quality of life was assessed using the World Health Organization's Quality of Life Instrument–Short Version. Depressive and manic symptoms were assessed using the Hamilton Depression Rating Scale–17 items and the Young Mania Rating Scale.ResultsPatients with BD and previous suicide attempts had significantly lower scores in all the 4 domains of the World Health Organization's Quality of Life Instrument–Short Version scale than did patients with BD but no previous suicide attempts (physical domain P = .001; psychological domain P < .0001; social domain P = .001, and environmental domain P = .039). In the euthymic subgroup (n = 70), patients with previous suicide attempts had significantly lower scores only in the psychological and social domains (P = .020 and P = .004).LimitationsThis was a cross-sectional study, and no causal associations can be assumed.ConclusionsPatients with BD and a history of previous suicide attempts seem to have a worse QoL than did patients who never attempted suicide. Poorer QoL might be a marker of poor copying skills and inadequate social support and be a risk factor for suicidal behavior in BD. Alternatively, poorer QoL and suicidal behavior might be different expressions of more severe BD.     

An integrative model of internalized stigma and recovery-related outcomes among people diagnosed with schizophrenia in rural China

Purpose

Internalized stigma, an adverse psychological process, severely impedes the lives of people diagnosed with schizophrenia and restricts them from social integration and recovery. The aim of this study was to empirically evaluate an integrative model of relationship between internalized stigma and patients’ recovery-related outcomes among people diagnosed with schizophrenia in a rural Chinese community.

Method

A total of 232 people diagnosed with schizophrenia in Xinjin, Chengdu, participated in this study and completed measures of internalized stigma, social interaction, perceived social support, social functioning, and symptoms. The internalized stigma of mental illness scale (ISMI) was used to measure the internalized stigma. Path analysis was used to test the association between internalized stigma and recovery-related outcomes.

Results

There were no significant differences in mean scores of ISMI by gender, age (18–64 years and ≥ 65 years), education, marital status, or economic capacity. Internalized stigma was negatively associated with perceived social support and social interaction. Furthermore, higher level of internalized stigma was associated with impaired social functioning, and a lower level of social functioning was significantly associated with more severe symptoms.

Conclusion

Internalized stigma is associated with poor social interaction and weakened perceived social support in people diagnosed with schizophrenia, and is linked negatively to outcomes in their recovery. It is essential to tailor interventions related to reducing internalized stigma within a Chinese context and evaluate the effectiveness of anti-stigma intervention on recovery for people diagnosed with schizophrenia.

     

Predictors of depressive symptoms in older veterans with heart failure

Objectives: This study collected data on demographic factors, heart failure physical limitations, perception of heart failure intrusiveness, coping mechanisms, locus of control, self-efficacy and social support for 104 older veterans with heart failure (HF) to determine the factors’ relative importance in predicting depressive symptoms.

Method: Participants were veterans at least 60 years of age with HF who were screened for depression and anxiety with the Geriatric Depression Scale and Geriatric Anxiety Inventory, respectively, so that the final sample consisted of equal numbers with and without significant levels of anxiety and depression. Other measures included the Kansas City Cardiomyopathy Questionnaire, Heart Failure Illness Intrusiveness Rating Scale, Brief-COPE, Multidimensional Health Locus of Control Scale, Chronic Disease Self-Efficacy and Multidimensional Scale of Perceived Social Support.

Results: Correlational analyses indicated that depressive symptoms were significantly associated with physical limitations from HF, HF perceptions of intrusiveness, maladaptive coping, attributing locus of control to chance and HF self-efficacy. Including these variables in one regression equation predicting depressive symptoms indicated that perceptions of intrusiveness from HF and attributing locus of control to chance were the only variables to predict depressive symptoms independent of the influence of other significant bivariate predictors.

Conclusion: Even if physical limitations, maladaptive coping and self-efficacy are held constant, decreasing perceptions of HF intrusiveness and locus of control to chance reduce depressive symptoms. These two cognitive/perceptual factors may play a salient role in treatment of depression among older HF patients.     

Prospective Study of Perceived Stress in Cardiac Patients

Background: Psychological stress is known to have a negative effect on the health andwell-being of coronary artery disease (CAD) patients. Although the study of stress CAD samples has received considerable attention, few studies have examined the effects of gender and age, hadmultiple follow-ups over an extended period, and had extensive baseline assessment batteries.Purpose: In this study, demographic, clinical, social, and personality variables were evaluated as predictors of nine repeated assessments of stress over a 2-year period in 322 CAD patients (33.2% female).Methods: At baseline, perceived social support, coping style, and social conflict were associated with stress ratings. Mixed models were used to evaluate predictors of reported stress during the subsequent 2 years.Results: The results showed that higher stress was present in patients who were female and young. Follow-up stress was also found in patients with moderate income, congestive heart failure, high social conflict, low social support, and negative coping style.Conclusions: These findings may help clinicians identify patients who are likely to experience higher levels of stress over a prolonged period following a diagnosis of CAD and may also suggest which patients may benefit most from stress reduction interventions. This research was supported in part by Grants P01 HL36587, R01 HL45702, and R01 HL54780 from the National Heart, Lung and Blood Institute: Grant R01 AG12458 from the National Institute on Aging; and Grants T32 MH19109 and R05 MH70482 from the National Institute of Mental Health     

Ett nytt försök till empirisk analys av Sjöbrings personlighetspsykologiska modell)

Background: Violence is a significant clinical and public concern and is a frequent occurrence in patients with schizophrenia. The relationship between insight and violence remains controversial. In addition, there is a lack of research on insight, cognitive insight, demographic and psychopathologic variables in violent versus nonviolent schizophrenia patients. Aim: We aimed to compare insight, cognitive insight, psychopathological and demographic variables in violent and nonviolent subjects suffering from schizophrenia. In addition, we aimed to determine the demographic and clinical predictors of violent behaviour in patients with schizophrenia. Method: We recruited 133 schizophrenic patients without concomitant substance abuse or axis II disorder. Diagnoses were based on the SCID-I and SCID-II. Violent behaviours were assessed using the Overt Aggression Scale. Insight and cognitive insight were assessed with the Scale to Assess Unawareness of Mental Disorder and the Beck Cognitive Insight Scale, respectively. Results: We compared 47 patients with violent schizophrenia with 86 nonviolent patients. Non-violent patients had more severe depression, lower scores on positive symptoms, better clinical insight, more self-reflectivity and higher R-C index scores than did violent patients. In addition, history of violence, lower self-reflectiveness, worse clinical insight and delusion severity were significant predictors of violence in schizophrenia. Conclusion: The present study suggests that the inclusion of insight and cognitive insight may increase the prediction of violence in this population. In addition, clinicians should consider using non-pharmacological techniques that are based on cognitive behaviour therapy and enhance insight, particularly cognitive insight, among patients with schizophrenia who exhibit violent behaviour.     

Factors involved in the level of functioning of patients with schizophrenia according to latent variable modeling

PurposeThis study aimed at using latent variable modelling to explore the significantly contributing variables to functioning in schizophrenia patients.MethodsThe study cohort comprised 296 schizophrenia patients evaluated once for demographic characteristics, functioning (FROGS, SWN-K, QLS) and symptomatology (Positive and Negative Syndrome Scale [PANSS]). First exploratory multivariate analyses were conducted and then a model with functioning as a latent variable was proposed and tested with the data.ResultsSymptomatology as negative, cognitive and excitation factor are significant predictors of functioning assessed through FROGS (P < 0.0001), SWN-K and QLS (P < 0.001). The model was constructed with functioning defined as a latent variable, indicators are subscores on FROGS, SWN-K, QLS and exogenous variable included symptomatology, Duration of Untreated Psychosis (DUP) and educational level.ConclusionUsing the five clinical dimensions of the PANSS, (Positive, Negative, Cognitive, Anxiety/Depression and Excitation) the negative and cognitive dimensions are highly correlated via the latent variable to the three dimensions of functioning evaluated by the FROGS: “daily life”, “social functioning” and “treatment” and the QLS subscores (interpersonnal, common object, instrumental role). Educationnal level is positively linked to functioning but not DUP. The model emphasizes the need for treatment strategies that have an effect on cognitive-factors, to improve functioning in schizophrenia.     

Factors Increasing Suicidal Risk in Young Argentinean College Students With and Without Suicide Attempt History

Predicting suicidal behavior is one of the most challenging tasks in mental health-related disciplines. We addressed this noteworthy issue in young Argentinean people, since suicidal behavior is an increasing albeit meagerly studied phenomenon throughout this country. We aimed to compare mental health-related variables, impulsivity-related traits, and main demographic variables between groups with and without suicide attempt history and to assess potentially affecting factors related to increasing suicidal risk in each group. A cross-sectional sample of 451 young college students (M_age?=?21.74) answered online self-reported questionnaires. Differences and multiple linear regression analyses were performed. The group with suicide attempt history had worst scores in all mental health-related variables (suicidal risk, psychological discomfort, social functioning and coping, depression, anxiety, and alcohol-related consequences), higher positive urgency and (lack of) premeditation, and higher frequency of mental disorder history, than their counterparts without suicide attempt history. The best-fitted model to predict suicidal risk for this group included the following: psychological discomfort, social functioning and coping, depression, anxiety, negative alcohol-related consequences, positive urgency, and (lack of) premeditation. In the group without suicide attempt history, the best-fitted model included the following: sex, age, psychological discomfort, social functioning and coping, depression, anxiety, negative urgency, and (lack of) premeditation. Both depression and anxiety demonstrated to be the most relevant predictors of suicidal risk irrespective of suicide attempts. In addition to depression and anxiety, other predictors seem to act upon producing or restraining such outcomes. Our findings suggest that such predictors may be negative alcohol-related consequences and the positive and negative urgency impulsivity-related traits.

     

Self-esteem,social support,and life satisfaction in Chinese parents of children with autism spectrum disorder

PurposeThe current study examined self-esteem, social support, and life satisfaction in Chinese parents of children with autism spectrum disorder (ASD), and observed the mediation effects of social support on the relationship between self-esteem and life satisfaction.MethodsWe compared 118 Chinese parents of children with ASD to 122 demographic-matched parents of typically developing children on measures of self-esteem, social support, and life satisfaction using the Rosenberg Self-Esteem Scale (SES), Multidimensional Scale of Perceived Social Support (MSPSS), and Satisfaction with Life Scale (SWLS), respectively.ResultsParents of children with ASD scored significantly lower on self-esteem, social support, and life satisfaction than the controls (ps < 0.01), and social support partly mediated the relationship between self-esteem and life satisfaction in both groups. Hierarchical regressions indicated that after controlling for demographic variables, social support and self-esteem were significant predictors of life satisfaction in both groups but explained more variance in life satisfaction for the parents of children with ASD.ConclusionsSocial support and self-esteem play a more important role in life satisfaction for parents of children with ASD than those of typically developing children. Life satisfaction is positively related to higher household income, higher self-esteem, and stronger social support for parents. Self-esteem is likely to be associated with greater life satisfaction by means of greater social support. Future research and interventions should focus on fostering a more positive climate of social support for ASD families in China.