Psychosocial functioning in patients with alcohol-related liver disease post liver transplantation

Emotional and role functioning difficulties are associated with chronic alcohol use and liver disease. Little is known about prospective changes in psychological and psychosocial functioning following orthotopic liver transplantation (OLT) amongst patients with alcoholic liver disease (ALD). We aimed to assess the functioning of this patient group post liver transplantation. Comprehensive psychosocial assessment of depression (Beck Depression Inventory [BDI]), anxiety (State-Trait Anxiety Inventory-Form X [STAI]) and psychosocial adjustment (Psychosocial Adjustment to Illness Scale-Self-Report version [PAIS-SR]) was conducted with 42 ALD patients available for pre and post OLT testing. Dependence severity was assessed by the Brief Michigan Alcoholism Screening Test (bMAST). Significant reductions in average anxiety and depression symptoms were observed 12-months post-OLT. Significant improvements in psychosocial adjustment to illness were also reported. Patients with higher levels of alcohol dependence severity pre transplant assessment improved comparably to those with lower levels of dependence. In summary, the study found that OLT contributed to reducing overall levels of mood and anxiety symptoms in ALD patients, approximating general (non-clinical) population norms. Psychosocial adjustment also improved significantly post liver transplantation.

The impact of the developmental timing of trauma exposure on PTSD symptoms and psychosocial functioning among older adults.

The present study examined the impact of the developmental timing of trauma exposure on posttraumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (N = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas experienced during childhood, adolescence, young adulthood, midlife, or older adulthood. Each of these developmental periods is characterized by age-related changes in cognitive and social processes that may influence psychological adjustment following trauma exposure. Results revealed that older adults who experienced their currently most distressing traumatic event during childhood exhibited more severe symptoms of PTSD and lower subjective happiness compared with older adults who experienced their most distressing trauma after the transition to adulthood. Similar findings emerged for measures of social support and coping ability. The differential effects of childhood compared with later life traumas were not fully explained by differences in cumulative trauma exposure or by differences in the objective and subjective characteristics of the events. Our findings demonstrate the enduring nature of traumatic events encountered early in the life course and underscore the importance of examining the developmental context of trauma exposure in investigations of the long-term consequences of traumatic experiences.

Predicting family caregiver psychosocial functioning in palliative care

Health professionals are expected to support family caregivers of patients requiring palliative care. However, there is a dearth of empirical evidence to help clinicians identify caregivers who might be at risk of poor psychosocial functioning.

A Longitudinal Examination of Bidirectional Associations between Subjective Sleep Characteristics and Psychosocial Functioning among University Students

A number of studies have found a significant link between sleep and psychosocial functioning among university students. A critical examination of this literature, however, indicates that one important gap within the literature is the need for longitudinal studies that specifically test for bidirectional associations between these two constructs. The main purpose of my dissertation was to address this gap by conducting three studies that examined bidirectional associations between sleep and psychosocial functioning among a sample of university students. Participants were 942 (71.5% female) undergraduate students enrolled at a Canadian university, who completed survey assessments annually for three consecutive years, beginning in their first year of university. In the first study, I assessed bidirectional associations between two sleep characteristics (sleep quality and sleep duration) and three psychosocial functioning variables (academics, friendship quality, and intrapersonal adjustment). Results based on cross-lagged models indicated a significant bidirectional association between sleep quality and intrapersonal adjustment, such that more sleep problems predicted more negative intrapersonal adjustment over time, and vice versa. Unidirectional associations indicated that both higher academic achievement and more positive friendship quality were significant predictors of less sleep problems over time. In the second study, in which I examined bidirectional associations between sleep and media use, results provided support only for unidirectional associations; such that more sleep problems predicted increases in both time spent watching television and time spent engaged in online social networking. In the third study of my dissertation, in which I examined social ties at university and sleep quality, results indicated a significant bidirectional association, such that more positive social ties predicted less sleep problems over time, and vice versa. Importantly, emotion regulation was a significant mediator of this association. Findings across the three studies, highlight the importance of determining the direction of effects between different sleep characteristics and various aspects of university students’ psychosocial functioning, as such findings have important implications for both methodology and practice. A better understanding of the nature of the associations between sleep and psychosocial functioning will equip students, parents and university administrators with the tools necessary to facilitate successful adjustment across the university years.

Adolescent body image and psychosocial functioning

Researchers have highlighted the significance of a poor body image in the development of dysfunctional eating but have systematically investigated few other outcomes. The authors examined the relationships between different aspects of body image and psychosocial functioning. Participants were 245 boys and 173 girls from Grades 8 and 9 (M age = 13.92 years, SD = 0.69 years). Respondents completed measures of physical attractiveness, body satisfaction, body image importance, body image behaviors, appearance comparison, social physique anxiety, self-esteem, depression, anxiety, and same-sex and opposite-sex relations. Whereas girls tended to report a more negative body image than did boys, the relevance of body image to self-esteem was similar for boys and girls. Concern about others' evaluation of their bodies was especially important in understanding low female self-esteem, whereas for boys, ratings of general attractiveness most strongly predicted self-esteem. The authors found a negative body image to be unrelated to symptoms of negative affect but to be strongly associated with poor opposite-sex peer relationships, especially among boys. A negative body image also affected same-sex relations among girls.

Oxidative stress markers, cognitive functions, and psychosocial functioning in bipolar disorder: an empirical cross-sectional study

This study aimed to evaluate the relationship between oxidative stress markers and cognitive functions and domains of psychosocial functioning in bipolar disorder.

The effects of parental nurturance and involvement on peer relationships and psychosocial functioning of young adults

This study examined peer relationships and psychosocial functioning as a function of maternal and paternal involvement and nurturance along with the moderating effects of gender, family form, and ethnicity. Prior research has shown the influence of mother’s involvement on peer relationship quality but not of fathers. Further, previous studies did not examine moderation by family form, gender, or ethnicity. The sample consisted of 1359 students who identified their biological mother and father as the most influential parental figures in their lives. Their ages ranged from 18 to 26; Sixty-one percent of the sample was Hispanic, 13% non-Hispanic Black, 25% non-Hispanic White; 76% female and 70% from intact families. The analytical strategy included using bivariate correlations and structural equation modeling to examine these relationships. ^ All dimensions of maternal and paternal nurturing and involvement were positively related to positive characteristics of peer relationships, self-esteem and life satisfaction consistent with the multicultural findings of PARTheory (Rohner, Khalique, & Cournoyer, 2005). A structural model was developed that was able to adequately account for the relationship between parental influence, peer relationships, and psychosocial functioning. These effects of both maternal and paternal influence were strongly moderated by culture, family form, and gender. Finally, a differential effect was found among parental influence with fathers having a greater influence on friendship quality and importance than mothers, despite greater maternal involvement. ^ These findings have theoretical, clinical, and social implications as they call for a socially based theoretical perspective within which to study these relationships. Such a perspective would better inform clinicians when using impaired social functioning as indicative of axial diagnosis, and for the implementation of social policy to encourage paternal involvement. ^

Psychosocial Functioning in Women with Symptoms of Persistent Genital Arousal

Persistent genital arousal disorder (PGAD) is characterized by physiological sexual arousal (vasocongestion, sensitivity of the genitals and nipples) that is described as distressing, and sometimes painful. Although awareness of PGAD is growing, there continues to be a lack of systematic research on this condition. The vast majority of published reports are case studies. Little is known about the symptom characteristics, biological factors, or psychosocial functioning associated with the experience of persistent genital arousal (PGA) symptoms. This study sought to characterize a sample of women with PGA (Study One); compare women with and without PGA symptoms on a series of biopsychosocial factors (Study Two); and undertake an exploratory comparison of women with PGA, painful PGA, and genital pain (Study Three)—all within a biopsychosocial framework. Symptom-free women, women with PGA symptoms, painful PGA, and genital pain, completed an online survey of biological factors (medical history, symptom profiles), psychological factors (depression, anxiety) and social factors (sexual function, relationship satisfaction). Study One found that women report diverse symptoms associated with PGA, with almost half reporting painful symptoms. In Study Two, women with symptoms of PGA reported significantly greater impairment in most domains of psychosocial functioning as compared to symptom-free women. In particular, catastrophizing of vulvar sensations was related to symptom ratings (i.e., greater severity, distress) and psychosocial outcomes (i.e., greater depression and anxiety). Finally, Study Three found that women with PGA symptoms reported some overlap in medical comorbidities and symptom expression as those with combined PGA and vulvodynia and those with vulvodynia symptoms alone; however, there were also a number of significant differences in their associated physical symptoms. These studies indicate that PGA symptoms have negative consequences for the psychosocial functioning of affected women. As such, future research and clinical care may benefit from a biopsychosocial approach to PGA symptoms. These studies highlight areas for more targeted research, including the role of catastrophizing in PGA symptom development and maintenance, and the potential conceptualization of both PGA and vulvodynia (and potentially other conditions) under a general umbrella of ‘genital paraesthesias’ (i.e., disorders characterized by abnormal sensations, such as tingling and burning).