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Invariance of SCL-90-R dimensions of symptom distress in patients with peri partum pelvic pain (PPPP) syndrome
- Authors:
- ARRINDELL W. A., et al
- Journal article citation:
- British Journal of Clinical Psychology, 45(3), September 2006, pp.377-391.
- Publisher:
- Wiley
There are no studies available that have examined the factorial invariance of dimensions underlying the Symptom Checklist-90-Revised (SCL-90-R) across at least three distinct samples. In the following study, we wished to determine whether a dimensional model comprising eight primary factors previously identified in psychiatric out-patients, phobics and the general population (Arrindell & Ettema, 2003) could be extended to a homogeneous sample of pain patients comprising females suffering from peri partum pelvic pain (PPPP) syndrome (N=413). The internal consistency and discriminant validity of the dimensions were also examined. The SCL-90-R and measures of disability, pain-related fear, pain intensity and fatigue were administered to the participants. The multiple group method was used to determine factorial invariance. Pearson correlations were determined between the SCL-90-R and aforementioned measures. The factorial invariance of an 8-dimensional model of primary factors underlying the SCL-90-R, namely, agoraphobia, anxiety, depression, somatization, cognitive-performance deficits, interpersonal sensitivity-mistrust, acting-out hostility and sleep difficulties, was extended with success to the present sample of PPPP patients. In spite of substantial correlations between the internally consistent SCL-90-R symptom dimensions, some evidence of discriminant validity was reported in that specific subscales showed different patterns of correlations with measures of disability, pain-related fear, pain intensity and fatigue. The 8-dimensional system based on the work of Arrindell and Ettema (2003) was invariant across psychiatric patients, phobics, the general population and pain patients. The invariance of the SCL-90-R hostility dimensions may have implications for a re-formulation of Watson and Clark's tripartite model of general distress, specific anxiety and specific depression.
The contribution of working conditions and social support to the onset of depressive and anxiety disorders among male and female employees
- Authors:
- PLAISIER Inger, et al
- Journal article citation:
- Social Science and Medicine, 2(64), January 2007, pp.401-410.
- Publisher:
- Elsevier
Poor working conditions may be an important source of stress and may therefore contribute to the development of depressive and anxiety disorders. Social support may act as a buffer and protect against the development of depression or anxiety in the face of poor working conditions. With longitudinal data from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), the effect of working conditions and social support on the incidence of depressive and anxiety disorders was examined among 2646 working men and women, aged 18 through 65 years. Three dimensions of self reported working conditions were assessed: psychological demands, decision latitude and job security. Social support was assessed through validated scales for daily emotional support. About 10.5% of working women and 4.6% among working men developed an incident depressive and/or anxiety disorder over 2 years. Psychological demands predicted the incidence of depressive and anxiety disorders in both men and women (RR per score increase=2.29, 95% CI: 1.44–3.63), whereas decision latitude and job security did not. Social support protected against the incidence of depressive and anxiety disorders. This effect was stronger for men compared to women. Social support did not buffer the unfavorable mental effect of working conditions. Women were more likely to report low levels of decision latitude, whereas men reported higher psychological demands. Working conditions did not explain sex differences in the incidence of depressive and anxiety disorders.
Premature termination of short-term inpatient psychotherapy: client's perspectives on causes and effects
- Authors:
- THUNNISSEEN Moniek, REMANS Yole, TRIJSBERG Wim
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 27(2), Summer 2006, pp.265-273.
- Publisher:
- Emerald
This study investigates what motivated patients to end their treatment prematurely, and to give recommendations for changes in the policy. Between May 1999 and December 2001, 24 patients were dropouts from a three-month in-patient psychotherapy programme in the Netherlands. The authors held interviews with 16 of them. The aim was to find out what they experienced during the treatment, which factors (from the patient's point of view) led to their leaving and how they functioned after they left the institution. Nearly half of the dropouts reported that they ended treatment in the first two weeks because of very high levels of anxiety. The remaining dropout patients reported more diffuse motives. Most patients recommended more supportive elements in the treatment to prevent dropout. As a result of the study, staff changed its attitude and endorsed a more supportive approach, especially in the first weeks of the treatment. In the next period from January 2002 till May 2003 the dropout rate was reduced from 16% to 8%.
Quality of diagnosis and treatment plans after using the ‘diagnostic guideline for anxiety and challenging behaviours’ in people with intellectual disabilities: a comparative multiple case study design
- Authors:
- PRUIJSSERS Addy, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 29(4), 2016, pp.305-316.
- Publisher:
- Wiley
Background: People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. Materials and Methods: A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. Results: The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. Conclusions: Working with the ‘Diagnostic Guideline for Anxiety and CB’ leads to improved diagnoses and treatment plans compared with care as usual. (Publisher abstract)
Factors associated with depression and anxiety in older adults with intellectual disabilities: results of the healthy ageing and intellectual disabilities study
- Authors:
- HERMANS Heidi, EVENHUIS Heleen M.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(7), 2013, pp.691-699.
- Publisher:
- Wiley
The objective of this article is to study which factors are associated with depression and anxiety in older adults with intellectual disabilities (ID). Depressive and anxiety symptoms were studied in 990 participants with borderline to profound ID, aged ≥ 50 years, using self-report and informant-report screening questionnaires. Participants were drawn from three large Intellectual Disability services in the Netherlands. In 290 participants, major depression and anxiety disorders were assessed with a standardised psychiatric interview. Associations with personal, medical and psychosocial factors, which were collected through questionnaires and participants' medical and psychological records, were studied using multiple logistic regression analysis. Increased depressive symptoms were positively associated with increased anxiety symptoms, number of life events during the past year and chronic diseases (heart failure, stroke, chronic obstructive pulmonary disease, coronary artery disease, diabetes mellitus and malignity in the previous 5 years) and negatively with instrumental activities of daily living (IADL) abilities. Major depression was positively associated with chronic diseases and negatively with IADL abilities. Increased anxiety symptoms were positively associated with borderline or mild ID and increased depressive symptoms and negatively associated with Down syndrome, epilepsy and social contacts. Anxiety disorders showed no significant associations. To develop effective prevention and treatment policies, factors associated with depression and anxiety in older adults with ID should be further examined in longitudinal research. (Publisher abstract)
The association between regulatory focus and distress in patients with a chronic disease: the moderating role of partner support
- Authors:
- SCHOKKER Marike C., et al
- Journal article citation:
- British Journal of Health Psychology, 15(1), February 2010, pp.63-78.
- Publisher:
- Wiley
This article details distress in four hundred and seventy seven patients in the Netherlands, with chronic illnesses such, as diabetes, asthma and heart disease which require self-management. It explores whether the presence or absence of partner support, and the type of support, ranging from little active engagement to high levels of protective buffering and overprotection, affects patients’ distress levels. Particularly looking at regulatory focus, consisting of two types of regulatory systems, self-regulation with either a promotion (obtaining positive outcomes) or prevention focus (avoiding negative outcomes), which can be determined in individuals as far back as interactions with caregivers in childhood, the patients were sent several questionnaires - a Regulatory Focus Questionnaire, questionnaires measuring active engagement (supportive behaviour), protective buffering and overprotection (unsupportive behaviour) by their partners - as perceived by the patients, and a General Health Questionnaire-12 to measure their distress levels. Results showed a promotion focus was negatively associated with distress, but only when patients reported partner support with relatively low levels of active engagement or relatively high levels of protective buffering/overprotection. In addition, the positive association between prevention focus and distress was not consistently found to be moderated by partner support. The authors conclude that active engagement buffers against distress in patients with low promotion focus, while protective buffering/overprotection aggravate distress in these patients.
Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial
- Authors:
- van’t VEER-TAZELAAR Petronella, et al
- Journal article citation:
- British Journal of Psychiatry, 196(4), April 2010, pp.319-325.
- Publisher:
- Cambridge University Press
An urgent need exists for the development of cost-effective preventive strategies to reduce the onset of mental disorders. This paper, aiming to establish the cost-effectiveness of a stepped care preventive intervention for depression and anxiety disorders in older people at high risk of these conditions, compared with standard primary care, evaluated the financial implications of stepped care preventive intervention in comparison to a randomised controlled trial. One hundred and seventy consenting individuals, aged 75 years or greater, with sub-threshold levels of depressive or anxiety symptoms were randomly assigned to a preventive stepped care programme or to routine primary care. Results showed that the intervention was successful in halving the incidence rate of depression and anxiety at 563 Euros (£412) per patient and 4367 Euros (£3196) per disorder-free year gained, compared with routine primary care, the latter representing good value for money if there is a willingness to pay for a disorder-free year at levels of at least 5000 Euros. In conclusion, the prevention programme generated depression and anxiety-free survival years in the older population at affordable cost.