缓解期精神分裂症患者生活质量及其与社会支持等因素的相关研究

目的了解缓解期精神分裂症患者的生活质量及其社会支持等因素对缓解期精神分裂症患者生活质量的影响。方法采用生活质量综合评定问卷（GQOL-74）对50例缓解期精神分裂症综合评定并与50名正常人进行对照，对缓解期精神分裂症患者同时施测社会支持评定量表（SSAS）、阳性与阴性症状量表（PANSS）和药物不良反应量表（TESS）。结果①生活质量总分和社会功能维度分研究组显著低于对照组；②社会支持与生活质量总分及躯体功能、心理功能和社会功能维度存在显著正相关；⑧药物副反应与生活质量总分及躯体功能和心理功能雄度存在显著负相关；④阳性症状与生活质量总分及心理功能维度存在显著负相关，阴性症状与生活质量总分及物质生活、躯体功能、心理功能和社会功能维度均存在显著负相关。结论缓解期精神分裂症患者的生活质量低于正常对照组，并且与社会支持、药物副反应和精神症状密切相关。     

Church support networks of African Americans: The impact of gender and religious involvement

We examined the sociodemographic and religious involvement correlates of church support networks in a nationally representative sample of African Americans across the adult life span. Data from the National Survey of American Life was used for analysis. Ordinary least squares regression was conducted to identify correlates of frequency of contact, subjective closeness, provision and receipt of overall support, receipt of emotional support, and negative interactions with church members. We also investigated differences in church support networks separately for men and women. Religious involvement was positively associated with church support network indicators (i.e., frequency of contact). Church support network indicators also varied by age, gender, education, family income, marital status, and region. The findings indicate that for many African Americans, church members are an integral component of their support networks and underscore the importance of social integration in church networks for social support exchanges. Moreover, these church support network characteristics are patterned by sociodemographic characteristics.     

Initiator status,family support,and adjustment to marital separation: A test of an interaction hypothesis

Fifty-six newly separated, volunteer participants (40 women, 16 men) were examined to determine if depressive symptomatology (as measured by the CES-D) was related to the respondent's active participation in the decision to separate from the spouse (initiator status) and the proportion of family members in their social support network. The relationship between initiator status and depressive symptomatology was marginally significant, F(l, 50) = 3.93, p = 0.053. There was an interaction between initiator status and the proportion of family members in the social network. For initiators, a low proportion of family members was related to increased depressive symptomatology (r = 0.15), whereas for noninitiators, a low proportion of family members was related to increased depressive symptomatology (r = - 0.37), a difference significant at p<.04. It is suggested that the functional ability of the network to be supportive is mediated both by aspects of the individual in need of support and by structural aspects of the network.     

Which factors explain information exchange and user referral among program implementers?

The Program for Psychosocial Care and Comprehensive Health for Victims serves, on a yearly basis, an average of 25,000 users in northern Colombia alone. The program is implemented by multidisciplinary teams comprised of psychologists, social workers, and community facilitators, who step in at the individual, family, and community levels. An attempt has been made to determine the effect generated by the timeframe through which professionals have been engaged with the program-filling positions of centrality and betweenness within the networks of information exchange and user referral, including the potential mediating effect from the structure of the egocentric network of implementers in the two aforementioned networks and the moderating effect of the sense of belonging to a team of professionals. Both centrality and betweenness are positional measures describing the location actors occupied within the network structure. Centrality reflects the nominations made and receipt by an actor in a network and is considered an individual indicator of prominence and power. Betweenness shows the times that an actor act as a bridge among two actors in a network and it is considered an indicator of strategic positioning in social networks. An egocentric network is the local structure of relationships that each implementer maintains with his or her direct contacts. In this study, 112 active implementers were included, mostly women (n = 97, 88.2%), who had been working on the program for 16.9 months on average (SD = 14.7). Through conditional process analysis, it has been shown that the time that the implementers have been working on the program and the sense of belonging to the task team are relevant factors that interact with each other toward explaining the level of centrality and betweenness of professionals in the information exchange and user referral networks.     

综合干预对精神分裂症缓解期生活质量的影响

目的了解精神分裂症患者在综合干预下的生活质量和社会支持状况,为科学干预和提高患者生活质量提供理论依据。方法采用生活质量综合评定问卷和领悟社会支持量表,对综合干预治疗和常规治疗的住院精神分裂症缓解期患者94人进行评估。结果①干预组的心理功能维度、社会功能维度和生活质量总分均显著高于对照组(t=3.146,3.206,2.375;P均0.05);②干预组的家庭支持,朋友支持,其他人支持及社会支持总分均显著高于对照组(t=3.789,2.649,3.257,3.671;P均0.01);③除物质生活与家庭支持无显著相关性外,生活质量的4个维度及总分与社会支持的3个维度及支持总分均呈显著正相关(r=0.226~0.505,P均0.05)。结论综合干预治疗可改善精神分裂症患者的生活质量;加强社会支持有助于改善精神分裂症患者的生活质量。     

Specificity of Social Support for Back Pain Patients: Do Patients Care Who Provides What?

This study examined low back pain patients’ (N=50) perceptions of what they considered to be helpful and unhelpful social support from various sources over the previous six months. Among types of social support, tangible support was most likely to be rated as helpful, whereas emotional support was the type of support most likely to be rated as unhelpful. Patients reported only rare instances of dissatisfaction with tangible support across various providers. Among support sources, instances of tangible support from physicians, and emotional support from friends, family, and spouses were recalled as most helpful. Physical therapists were named as providing the greatest amount of all three types of social support and were rated as rarely providing unhelpful social support. These findings suggest that the desirability of different types of social support varies as a function of the source of support and indicate that physical therapists are perceived by back pain patients as particularly helpful in their provision of social support.     

Online Social and Professional Support for Smokers Trying to Quit: An Exploration of First Time Posts From 2562 Members

Background

Both intratreatment and extratreatment social support are associated with increased rates of smoking cessation. Internet-based social support groups have the capability of connecting widely dispersed groups of people trying to quit smoking, making social support available 24 hours a day, seven days a week, at minimal cost. However, to date there has been little research to guide development of this particular feature of Web-assisted tobacco interventions (WATIs).

Objective

Our objectives were to compare the characteristics of smokers who post in an online smoking cessation support group with smokers who do not post, conduct a qualitative analysis of discussion board content, and determine the time it takes for new users to receive feedback from existing members or moderators.

Methods

Data were collected from StopSmokingCenter.net version 5.0, a WATI equipped with an online social support network moderated by trained program health educators that was operational from November 6, 2004, to May 15, 2007. Demographic and smoking characteristics for both users and nonusers of the online social support network were analyzed, and qualitative analyses were conducted to explore themes in message content. Posting patterns and their frequency were also analyzed.

Results

During the study period, 16,764 individuals registered; of these, 70% (11,723) reported being American. The mean age of registrants was 38.9 years and 65% (10,965) were female. The mean number of cigarettes smoked was 20.6 per day. The mean score for the 41% (6849) of users who completed the Fagerström Test for Nicotine Dependence was 5.6. Of all registered members, 15% (2562) made at least one post in the online social support network; 25% of first posts received a response from another member within 12 minutes, 50% within 29 minutes. The most frequent first posts were from recent quitters who were struggling with their quit attempts, and most responses were from members who had quit for a month or more. Differences in demographic and smoking characteristics between members who posted on the support group board at least once and those who did not post were statistically but not clinically significant.

Conclusions

Peer responses to new users were rapid, indicating that online social support networks may be particularly beneficial to smokers requiring more immediate assistance with their cessation attempt. This function may be especially advantageous for relapse prevention. Accessing this kind of rapid in-person support from a professional would take an inordinate amount of time and money. Further research regarding the effectiveness of WATIs with online social support networks is required to better understand the contribution of this feature to cessation, for both active users (posters) and passive users (“lurkers”) alike.     

The training of principals for school advisory council leadership

The effectiveness of a 2-day residential leadership training workshop for school principals designed to increase their ability to develop effective citizen participation on a School Advisory Council is reported. One hundred eight schools were included in this study. The experimental design included two trained groups and one waiting list control group. The major findings revealed that trained principals and their council members were significantly more satisfied with and involved in their councils and more likely to report that their councils benefited their schools' academic programs than were untrained principals and their council members. Council members of the former group were also more likely to express support for their school administrators' policies than were control group council members. Furthermore, perceived social climate variables were found to discriminate significantly as mediators between trained and untrained groups. This research exemplifies the application of psychology's knowledge base and methods to a new state-level educational policy and contributes to community psychology's knowledge about citizen participation in public education.     

Psychological effects and mediators of a group multi-component program for breast cancer survivors

This study evaluated the short-term impact of YWCA Encore, a mixed-modality group exercise and information support program for breast cancer patients situated in the community setting. Australian post-surgical breast cancer patients (N = 162) were assigned to either the 8-week Encore intervention or a Waitlist control. Intervention impact was assessed in terms of quality of life, cancer-specific distress, and social support. Changes in familiarity with exercise, self-efficacy and social support were tested as mediators of the intervention impact on quality of life. Overall adherence and satisfaction with the program were high. Significant enhancements at follow-up for quality of life and social support were evident for intervention compared with control participants. Familiarity with exercise and self-efficacy satisfied the requirements for mediation of quality of life. These findings provide evidence for psychosocial benefits of YWCA Encore multi-component program and support the use of such community-based programs for breast cancer survivors. The role of exercise familiarity and self-efficacy as probable mediators of the multi-component intervention is a critical finding and highlights the need for future investigations into the underlying mediating processes of similar interventions for cancer patients.     

Psychosocial empowerment and social support factors associated with the employment status of immigrant welfare recipients

We analyzed the role that psychosocial empowerment and social support factors play in the employment status of immigrants who participate in jobreadiness programs financed by the European Social Funds and the Welfare Services of Andalusia, a region in the south of Spain. The goal of these programs is to find new ways to improve immigrants' social–labor participation and community integration. By means of a logistical regression analysis applied to data obtained in interviews with 188 participants, a predictor model of psychosocial factors associated with employment status was obtained. Significant psychological empowerment factors included having a positive professional self‐concept, having an internal attribution of causality of employment, and having an active job search. Ability to depend on both compatriots and members of the host country in one's support network and the advice and information received from them was a significant factor in social support. Suggestions for future program development include increasing the use of psychosocial resources in interventions designed to improve immigrants' employment status. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 673–690, 2005.     

女性精神分裂症患者配偶生活质量与社会支持的相关性研究

目的 探讨女性精神分裂症患者配偶的生活质量,以及与社会支持的关系.方法 应用生活质量综合评定问卷(the Generic Quality of Life Inventory,GQOLI)及社会支持评定量表(SSAS)对60名女性精神分裂症患者的配偶(观察组)及60名正常女性的配偶(对照组)进行评定.结果 观察组GQOLI总分及躯体功能、心理功能、社会功能3个维度评分均显著低于对照组,其社会支持总分及客观支持、主观支持、支持利用度评分亦均显著低于对照组(P＜0.01).女性精神分裂症患者配偶的GQOLI总分及躯体功能、心理功能、社会功能3个雏度评分与社会支持总分及客观支持、主观支持、支持利用度评分均呈显著性正相关.结论 女性精神分裂症患者配偶的生活质量较差,与社会支持有关.     

Testing the association between the incidence of schizophrenia and social capital in an urban area

BACKGROUND: Social capital has been considered aetiologically important in schizophrenia but the empirical evidence to support this hypothesis is absent. We tested whether social capital, measured at the neighbourhood level, was associated with the incidence of schizophrenia (ICD-10 F20).MethodWe administered a cross-sectional questionnaire on social capital to 5% of the adult population in 33 neighbourhoods (wards) in South London (n=16 459). The questionnaire contained items relating to two social capital constructs: social cohesion and trust (SC&T) and social disorganization (SocD). Schizophrenia incidence rates, estimated using data from the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study, provided the outcome. We used multi-level Poisson regression to test our hypothesis while controlling for individual- and neighbourhood-level characteristics. RESULTS: We identified 148 cases during 565 576 person-years at-risk. Twenty-six per cent of the variation in incidence rates was attributable to neighbourhood-level characteristics. Response from the social capital survey was 25.7%. The association between SC&T and schizophrenia was U-shaped. Compared with neighbourhoods with medial levels of SC&T, incidence rates were significantly higher in neighbourhoods with low [incidence rates ratio (IRR) 2.0, 95% confidence interval (CI) 1.2-3.3] and high (IRR 2.5, 95% CI 1.3-4.8) levels of SC&T, independent of age, sex, ethnicity, ethnic density, ethnic fragmentation and socio-economic deprivation.ConclusionNeighbourhood variation in SC&T was non-linearly associated with the incidence of schizophrenia within an urban area. Neighbourhoods with low SC&T may fail to mediate social stress whereas high SC&T neighbourhoods may have greater informal social control or may increase the risk of schizophrenia for residents excluded from accessing available social capital.     

Social environment and longevity in schizophrenia

OBJECTIVE: The role of social support as a predictor of long-term survival among patients with schizophrenia was examined. METHODS: Social histories were abstracted from the medical records of a cohort of 133 deceased schizophrenic patients admitted for inpatient treatment between 1934 and 1944. Two independent raters assessed the quantity and quality of support available in each patient's social environment. RESULTS: Cox regression analysis revealed that higher quantity of social support was significantly related to survival time (p<.05) after controlling for marital status and quality of support. The Cox model indicated that a 1-point increase in the support quantity rating was associated with a proportional 25% decrease in the hazard rate. CONCLUSIONS: The present findings suggest that social environment, specifically the quantity of social support available to the patient, may impact longevity in psychiatric populations.     

Bereavement,stress, and social support in members of a self-help group

The relationship between demographic characteristics, social support, network orientation, and the stress response to the death of a family member was studied. Participants were members of a national self-help group for the bereaved, The Compassionate Friends (sample n =158), who completed a demographic questionnaire, and measures of stress response, social support, and orientation toward the helpfulness of others. Results indicated that time since the death was the strongest determinant of the severity of the stress response, followed by orientation toward the helpfulness of others. Satisfaction with social support was directly related to the number of people in the support network and participants' orientation toward others' helpfulness. Help-seeking behavior was directly related to number of people in the support network. These results are discussed relative to counseling practice and grief awareness.     

Rethinking approaches to risk reduction for injection drug users: differences in drug type affect risk for HIV and hepatitis C virus infection through drug-injecting networks

OBJECTIVE: To identify and compare the drug-injecting network characteristics of cocaine and heroin injectors associated with a risk of HIV and hepatitis C virus (HCV). METHODS: Active injectors were recruited from syringe exchange and methadone programs. Characteristics of all participants and their social networks were elicited. Regression analysis using generalized estimating equations examined the network characteristics of injection drug users (IDUs) relative to cocaine or heroin use in the past 6 months. RESULTS: Of 282 IDUs, 228 (81%) used cocaine and 54 (19%) used heroin as their primary injected drug. In analyses adjusted for age and gender, cocaine injectors compared with heroin injectors were more likely to live in unstable housing (odds ratio [OR] = 3.55, 95% confidence interval [CI]: 1.49 to 8.40), self-report HCV infection (OR = 4.69, 95% CI: 2.14 to 10.31), and have a greater number of IDUs in their social network (OR = 1.61, 95% CI: 1.14 to 2.28) and were less likely to be polydrug users (OR = 0.06, 95% CI: 0.02 to 0.16) and to have social support (OR = 0.97, 95% CI: 0.95 to 0.99). The injecting networks of cocaine users were more likely to have members who were older (OR = 1.08, 95% CI: 1.04 to 1.12), had a history of shooting gallery use (OR = 2.27, 95% CI: 1.08 to 4.76), and had shorter relationships with the subject (OR = 0.91, 95% CI: 0.85 to 0.97). CONCLUSIONS: Beyond personal behaviors, HIV and HCV infection risk seems to be linked to social network traits that are determined by drug type. Prevention efforts to control the spread of bloodborne viruses among IDUs could benefit from tailoring interventions according to the type of drug used.     

Collective action among US veterans: Understanding the importance of self-efficacy,collective efficacy,and social support

The purpose of this study was to examine the relationship between collective action, collective efficacy, self-efficacy, and social support among US veterans who formally volunteered in their communities upon their return from military service. The participants were 323 post-9/11/01-era veterans who completed a national nonprofit administered civic service program. Results from the structural equation model indicate that appraisal social support is negatively, directly associated with collective action, while belonging social support is positively, directly associated with collective action. In addition, appraisal social support is positively, indirectly associated with collective action via self-efficacy and collective efficacy. About 44% of the relationship between self-efficacy and collective action is associated via collective efficacy. The model accounts 19.9% of the variance in self-efficacy, 16.5% of the variance in collective efficacy, and 23.7% of the variance in collective action. The role of social support in the model provides additional evidence for the importance of strong social ties in facilitating collective action as veterans gather to volunteer in programs across the country. Results have implications for how national, nonprofit, and community volunteering programs may want to engage veterans and community members in collective action efforts.     

Characteristics and circumstances of homicidal acts committed by offenders with schizophrenia

BACKGROUND: While men with schizophrenia are at higher risk of displaying homicidal behaviours compared with the general population, very little is known about the circumstances related to the triggering of such violent acts among offenders with schizophrenia. The main goal of the present investigation was to describe the surrounding context, psychotic symptoms, target characteristics and other circumstantial factors associated with homicidal acts committed by men with schizophrenia, with or without an additional antisocial personality disorder (APD). METHOD: Comprehensive clinical and research interviews, as well as multiple sources of information including reports from social workers and police officers, criminal records, witness statements and questionnaires completed by friends, acquaintances and family members were used to determine specific characteristics surrounding the homicidal acts. RESULTS: Overall, a significant majority of homicides were considered as the consequence of psychotic symptoms; they mostly involved someone who knew the offender; and they usually occurred in a private residence. However, the subgroup of offenders with both schizophrenia and APD were less likely to be judged as responding to psychotic symptoms; they assaulted a non-relative more frequently, and they were more likely to have used alcohol and to be involved in an altercation with the victim prior to the incident than offenders without APD. CONCLUSION: Even for such extreme acts as homicides, the circumstances affecting the occurrence of violence among offenders with schizophrenia may differ when an additional APD diagnosis is present, which would have important implications for prevention and treatment programmes.     

北京地区精神分裂症患者家属情感表达方式及特征

目的：了解家属与患者之间的关系，探讨北京地区住院精神分裂症患者家属情感表达的种类，对患者的监护水平，对精神疾病认识和受歧视的体验等。方法：采用包括十个维度的费氏EFI－CV情感表达测评工具。对265位精神分裂症患者家庭中的427名亲属，在患者住院当时进行访谈和录音，访谈后由测评员按标准对各维度进行评分，并把被试者划分为高或低情感表达的种类。结果：427名家属中，61人（14．3％）对患者有高批评，26人（6．0％）表露敌对情感，172人（40．3％）有情感过分参人，总计200人（46．8％）有高情感表达，有情感过分参入和高度赞扬的女性明显多于男性，家属对患者在急性期与缓解期治疗的监护方式以被动为主，在日常生活和患者对外关系中以主动方式为主。结论：北京地区住院精神分裂症患者的家属中有高情感表达的比例。     

Effect of animal-assisted therapy on the psychological and functional status of elderly populations and patients with psychiatric disorders: a meta-analysis

Abstract

Animal-assisted therapy (AAT) may affect health via an increase in perceived social support and social interaction. A meta-analysis was conducted to determine its effects on selected populations with poor social functioning. Studies involving elderly participants and those with depression and schizophrenia were searched in Medline, PsycINFO and Cochrane up to January 2009. Matched or controlled trials incorporating pre- and post-test outcome measures and with at least five participants subjected to a multiple-day AAT intervention were selected (n=21). Participants' characteristics, study design, intervention features, outcome variables, reported effects and study quality were retrieved. Design-specific effect sizes were pooled using random-effects models. Heterogeneity of effects by study characteristics, including target population and intervention features, was explored through meta-regression. Pooled effect sizes were calculated for social functioning, depression, anxiety, behavioural disturbances, loneliness, daily living skills and cognitive status. As hypothesised, AAT improved social functioning (pooled effect size = 1.06, n=275). Moderate effects were found for depression (?0.34, n=447), anxiety (?0.29, n=291) and behavioural disturbances (?0.32, n=367). Effects on social functioning and depression were larger in individuals with psychiatric conditions while behavioural disturbances were reduced in patients with dementia. The inconsistent methodological characteristics of the studies meta-analysed suggest a conservative interpretation of these findings.     

Peer-Based Differences Among Boys With ADHD

Examined the peer interactions and peer acceptance of three groups of boys ages 8 to 11 1/2 years: attention deficit hyperactivity disorder (ADHD), predominantly inattentive type; ADHD, combined type; and nonclinical controls (N = 45). Peer nominations were obtained from each boy's classroom. Newly acquainted peers consisting of boys from each of the 3 groups were observed for 3 play sessions, after which peer nominations were obtained. Both ADHD groups were more likely than nonclinical controls to receive lower social preference scores from peers in the classroom but not in the play groups. In both settings, boys from the predominantly inattentive group were more likely to be nominated as very shy, whereas boys from the combined type group were more likely to be nominated for starting fights and arguments. Observations of the play group showed that boys from the predominantly inattentive group displayed a marked pattern of social withdrawal. The findings suggest that the peer rejection experienced by these 2 groups may result from very different social behavior patterns.