The Importance of Self-Perceptions to Psychosocial Adjustment in Adolescents With Heart Disease

IntroductionThis study examined the importance of self-perceptions as determinants of psychosocial adjustment reported by adolescents with heart disease and compared adolescents with heart disease to healthy norms.MethodsNinety-two adolescents with heart disease from a single Midwestern institution provided reports of self-perceptions (health, self-worth, competence, and importance), internalizing behavior problems (IPs; e.g., anxiety and depression) and externalizing behavior problems (EPs; e.g., attention problems and aggression), and health-related quality of life (HRQOL). Hierarchical linear regression was used to assess the impact of self-perceptions, as well as clinical factors (e.g., illness severity, time since last hospitalization, and medications) and demographic characteristics on outcomes.ResultsSelf-perceptions explained the most variance in behavioral and HRQOL outcomes (R²_adj = 0.34 for IP, 0.24 for EP, and 0.33 for HRQOL, p < .001). Male gender and lower household income were associated with more behavior problems. Clinical variables were only related to HRQOL. Compared with healthy norms, IPs were significantly more common in male adolescents and HRQOL was lower (p < .001).DiscussionAdolescents with heart disease are at risk for internalizing behavior problems and reduced HRQOL; however, positive self-perceptions appear to be protective. Self-perceptions are critical and should be addressed by clinicians.     

Maternal-fetal attachment and its correlates in a sample of Italian women: a study using the Prenatal Attachment Inventory

Background: Maternal–fetal attachment (MFA) is considered to be related to the quality of subsequent maternal care of the infant and maternal health behaviour during pregnancy. Objective: The aims of the present study were to investigate the internal structure of a questionnaire used for assessing MFA, the Prenatal Attachment Inventory (PAI), and to address the role of gestational age, couple adjustment and depressive symptomatology on MFA, on a sample of women from suburban areas. Method: A cross-sectional study using self-report questionnaires was conducted to address these two aims on 130 women attending prenatal care services. Results: A five-factor solution emerged for the PAI questionnaire. MFA levels were comparable to those found in previous studies using PAI, whereas depressive symptoms were higher than those reported in previous studies with normative pregnant women. Couple adjustment and gestational age significantly increased MFA. Among the MFA dimensions, Affect and Interaction were mainly affected by gestational age; Maternal–fetal differentiation was associated with gestational age and couple adjustment. Depressive symptoms were associated with an increase in Fantasy and Sensitivity factor scores. Conclusion: Prenatal attachment increased as gestational age advanced and as mothers perceived greater levels of couple adjustment, which promoted MFA strength, positive affect and MFA interaction and differentiation. The internal structure of PAI and its association with specific correlates are discussed.     

Predicting healthcare expenditure by multimorbidity groups

Objectives

This article has two main purposes. Firstly, to model the integrated healthcare expenditure for the entire population of a health district in Spain, according to multimorbidity, using Clinical Risk Groups (CRG). Secondly, to show how the predictive model is applied to the allocation of health budgets.

AN EDUCATIONAL AND COUNSELING PROGRAM FOR PHENYLKETONURIC ADOLESCENT GIRLS AND THEIR PARENTS

Since adolescent girls with phenylketonuria are in need of informed counseling, parents and their phenylketonuric daughters were invited to five successful group meetings at Children's Hospital Medical Center in Boston. During these sessions the staff reviewed general aspects of the disorder, dealth with particular problems of adolescence, and focused primarily on the complexities relating to maternal phenylketonuria. Subsequent lively discussions allowed the participants to express their feelings and concerns relative to these issues. The information conveyed will assist parents and their daughters in realistic planning for the future.     

Relations Between Depression Level and Conflict Resolution Styles,Marital Adjustments of Patients With Major Depression and Their Spouses

The objective of this study was to determine to relations between the depression level and the conflict resolution styles, marital adjustments of the depressed patients and to analyze the conflict resolution styles, marital adjustments of both the patients and their spouses as the possible predictors of depression levels. The research comprised 113 patients with major depression and their spouses. While there was a negative correlation between depression scores and positive and subordination conflict resolution styles subscales of the patients, there was a positive correlation between the depression scores and negative conflict resolution style subscale. Negative correlation was observed between the depression and marital adjustment scores of patients (p < 0.05). The conflict resolution styles and marital adjustment of depressed patients and their spouses are predictors of depression in patients.     

Daily life,experience and needs of persons suffering from homozygous familial hypercholesterolaemia: Insights from a patient survey

Homozygous familial hypercholesterolaemia (HoFH) is a rare and severe hereditary lipid disorder that is typically associated with high serum levels of low-density lipoprotein cholesterol (LDL-C). Excessive exposure to high levels of LDL-C puts affected individuals at very high risk of premature onset coronary heart disease, and this considerably limits life expectancy. Although the clinical features and treatment of HoFH have been extensively researched, societal and socio-psychological impacts of the disease have not been reported to date. The current study was conducted to investigate the burden of disease and treatment from the patient's perspective by means of semi-structured interviews with 24 HoFH patients. The findings of the survey indicate that HoFH represents a considerable burden for patients, not only due to physical signs and limitations caused by the disease but also a number of psychosocial factors, treatment-related issues and impact on their education and employment situation.     

Impaired Theory of Mind and psychosocial functioning among pediatric patients with Type I versus Type II bipolar disorder

Deficits in Theory of Mind (ToM) have been documented among pediatric patients with Bipolar Disorder (BD). However, fewer studies have directly examined differences between type I and type II patients and whether or not ToM deficits are related to psychosocial difficulties. Therefore, the aim of this study was to compare type I versus type II pediatric bipolar patients and matched Healthy Controls (HC) on ToM and interpersonal functioning tasks. All participants completed the Revised Mind in the Eyes Task (MET), the Cognitive and Emotional Perspective Taking Task (CEPTT), and the Index of Peer Relations (IPR). Type I BD patients reported greater peer difficulties on the IPR compared to HC, and also performed more poorly on the MET and the cognitive condition of the CEPTT, but did not differ significantly on the emotional condition. There were no significant group differences between type II BD patients and HC. More impaired ToM performance was associated with poorer interpersonal functioning. Type I BD patients show deficits in the ability to understand another's mental state, irrespective of emotional valence. Deficits in understanding others' mental states could be an important treatment target for type I pediatric patients with BD.