<p>Based on a biopsychosocial model of mammography pain, the current study assessed if specific biological and psychosocial factors were associated with higher reported mammography pain in early stage breast cancer survivors. One hundred and twenty-seven women completed questionnaires assessing demographic information, cancer treatment history, ongoing breast pain, mammography-related anxiety, and social support immediately prior to receiving a mammogram. They then completed questionnaires assessing mammography pain and mammography-related pain catastrophizing immediately following the mammogram. Using path modeling and mediation analyses, relations among these variables were examined. Results revealed that mammography-related pain catastrophizing was related to higher mammography pain directly, while ongoing breast pain, lower social support quantity, and lower perceived quality of social support related to higher mammography pain indirectly through mammography-related pain catastrophizing. Moderated mediation analyses found that the mediation effects of mammography-related pain catastrophizing were significantly different at varying levels of perceived quality of social support, with more pronounced negative effects for those with higher quality support than those with lower quality support. The theoretical, clinical, and research implications of these findings are discussed.</p> / Dissertation

Childhood obesity has been prevalent for a number of years despite programs designed to educate children and families on healthy diets and activities. Multiple disciplines have reported chronic stress can interfere with normal neuroendocrine functions in the body which include energy balance. Research into alternate mechanisms contributing to childhood obesity is just beginning to include psychosocial factors’ and their influence on biology. Healthy coping strategies can reduce the effects of stress and influence perceptions of what is stressful. Warm, secure relationships with parents, family connectedness, and a secure stable environment all contribute to the buffering of chronic stress as well as promote the ability to cope with stress. Through the years, changes in the family environment through divorce, single parenthood, and cohabitation may play a role in the child’s ability to cope with stress. Therefore, the purpose of this study was to explore relationships between the child’s perceptions of chronic stress, coping strategies, family connectedness, family characteristics, and weight in 4th and 5th grade children. This study used a cross sectional and correlational design. The conceptual framework guiding this study was the Bio-Psycho-Social Model for Health integrating the three dimensions (biological, psychological, and sociological) as they relate to obesity in children. Well established instruments were used to measure chronic stress, coping, family connectedness, and weight. Results did not reveal a relationship between chronic stress and children’s weights. The ‘frequency the family sat down to eat dinner together’ was significantly related to weight: the more dinners together the lower the body mass indices and accounted for 14.7% variance in children’s body mass indices. Frequency of family meals was also correlated with the frequency of cooking dinner and negative trending of both ‘frequency’ and ‘helpfulness’ of coping strategies: possibly suggesting less need for the coping strategies. Parents’ education was positively correlated with more sleep on school nights for children. The findings suggest the importance of family time together is related to lower body mass indices in children. / text

The objective of this study was to elucidate the possible importance of factors from the social environment for the development of depression. As a theoretical framework, Engel's biopsychosocial model (Engel, 1980), based on systems theory, has been applied. Proceeding from the single individual (characterized by experience, personality, behaviour) as the highest level of the organismic hierarchy the following system levels have been taken into account: dyads, family, community, culture-subculture. The depressive patients (n=lll) showed to be living in a narrowed social network and to lack confiding relationships compared with a non-psychiatric control sample (n=98). The personality characteristics (e.g. anxiety, detachment, suspicion) of the patients were related to experienced loneliness, contact difficulties, social network features and leisure activities. By means of a discriminant analysis 83% of the subjects could be correctly classified. In a study of perceived parental rearing, depressives showed to have experienced lack of emotional warmth. As regards social class an overrepresentation of social class III in the subgroups of unipolar, bipolar and unspecified depression was observed. Finally, implications for treatment are discussed in favour of a combination of drug and cognitive psychotherapy. Future research strategies are also suggested. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1985, härtill 8 uppsatser.</p> / digitalisering@umu

Due to the global push for deinstitutionalisation, the care of psychiatric patients has been transferred to their family members. Evidence worldwide however suggests that the rate of deinstitutionalisation has not been matched with the sufficient increase of community resources to support both the caregiver and the patient in the community where they reside (Lippi, 2016:1). The conducted study undertook to explore and describe the experiences of caregivers of Mental Health Care Users (MHCUs) with a diagnosis of Schizophrenia in the southern- western parts of Johannesburg. The goal of the present study was to explore the experiences of the caregivers of MHCUs with schizophrenia in the southern- western parts of Johannesburg. A qualitative research approach was utilised to conduct the study. The researcher made use of purposive sampling and semi-structured, face to face interviews were utilised to collect data. Ten interviews were conducted with caregivers of MHCUs in Lenasia South. The researcher however reports on 9 of the 10 interviews due to the fact that the recording device was stolen in the home of the researcher before the recording could be backed up. The findings of the study indicate that the caregivers of MHCUs often do not know the name of the diagnosis and do not understand the diagnosis. Many of the caregivers held the belief that the MHCU was bewitched. The social lives, health and finances of caregivers were negatively affected by the task of caregiving. The study found that caregivers are reluctant to leave the MHCU alone or in the care of other people, because they are constantly worried about their well-being. The study found that caregivers were stigmatised together with the MHCU in their communities. Community resources to support the caregiver and provide psychoeducation are non-existent in the experience of these caregivers. The study found that caregivers had minimal to no experience at all of receiving support from a social worker. The study concludes that the experiences of caregivers are difficult because of the lack of understanding of the illness, a lack of support and psycho-education and a lack of community resources that can aid the caregiver. Recommendations in the study include making a referral to be seen by a social worker mandatory for each case, social workers facilitating the start-up of peer support groups for the caregivers and being intentional about psycho-educating caregivers. / Mini Dissertation (MSW)--University of Pretoria, 2019. / Social Work and Criminology / MSW / Unrestricted

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Background: Pediatric chronic pain is prevalent and comes with diagnostic uncertainty and biopsychosocial complexity. The literature significantly lacks evidence and clinical guidance to inform triage decisions to interdisciplinary pediatric chronic pain programs, which likely impacts timely and appropriate access to much needed interdisciplinary care. Purpose: To methodically conduct foundational investigation into triage within interdisciplinary pediatric chronic pain programs to develop a preliminary series of Clinical Decision Support (CDS) triage tools grounded in evidence to facilitate nurses' triage decision-making. Methods: A pragmatic, multi-method study was conducted and fundamentally guided by the Knowledge to Action Framework (KTA). Included studies involved: 1) A modified Delphi study to attain expert consensus on the diagnostic expectations of pediatric patients referred to interdisciplinary chronic pain programs; 2) A systematic review of multidimensional biopsychosocial tools used in the pediatric chronic pain population, guided by the Multidimensional Biobehavioral Model of Pediatric Pain; and 3) An explorative descriptive qualitative study guided by the Cognitive Continuum Theory (CCT) and the Theoretical Domains Framework (TDF) to explore and describe the decision-making practices of and contextual influences on nurses triaging patients to interdisciplinary pediatric chronic pain programs. Findings: Following two survey rounds, the Delphi study demonstrated consensus on 84% of diagnostic items and general agreement regarding the diagnostic expectations of referred patients. The systematic review revealed six valid and reliable multidimensional biopsychosocial tools and highlighted 84 significant relationships between pain and functional interference across 11 biopsychosocial variables. The qualitative study emphasized the leading and complex triage role nurses lead in interdisciplinary pediatric chronic pain programs, and comprehensively described the triage process and determinants of the triage decision. Conclusions: Findings from the three studies have been integrated into the preliminary development of a series of CDS triage tools to be used in interdisciplinary pediatric chronic pain programs. This series offers decision guidance to accept or redirect care based on diagnostic clarity and a strategy to prioritize access to interdisciplinary care based on biopsychosocial needs. To determine clinical utility and validity of the tool, future research will target end-users to finalize tool development.

Emerging adulthood is often-overlooked in current gastrointestinal (GI) health research; however, epidemiological evidence suggests that GI disorders are increasing in this population. The purpose of this study was to first define common GI symptom subgroups within emerging adults and then to characterize these group differences with key biopsychosocial factors encompassing diet, depression and anxiety symptoms, as well as physical and social functioning related to quality of life. A total of 956 emerging adults from a southeastern US university were surveyed on GI symptoms, psychosocial factors, and demographics. Latent class analysis uncovered three statistically significant GI symptom patterns within the sample identified by the degree of severity: Normal (n=649), Mild (n=257), and Moderate (n=50). This study demonstrated that significant impairment in GI functioning emerges at much earlier ages that are commonly assumed. In addition, these GI symptom levels were associated with important biopsychosocial factors. Assessing GI functioning in emerging adults may provide important insights into understanding the development of FGIDs.

京都大学 / 新制・課程博士 / 博士(地域研究) / 甲第24117号 / 地博第306号 / 新制||地||119(附属図書館) / 京都大学大学院アジア・アフリカ地域研究研究科東南アジア地域研究専攻 / (主査)教授 古澤 拓郎, 准教授 坂本 龍太, 准教授 小坂 康之 / 学位規則第4条第1項該当 / Doctor of Area Studies / Kyoto University / DGAM

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Research shows that when a gender stereotype is made salient and the target of the stereotype is asked to perform in the stereotyped domain, targets of the stereotype often perform at a lower level compared to situations when the stereotype was not made salient (Spencer, Steele, & Quinn, 1999). Current models of stereotype threat show that increased physiological arousal and reduced working memory capacity partially explain this decrement in performance (Ben-Zeev, Fein, & Inzlicht, 2005; Schmader, Johns, & Forbes, 2008). Furthermore, the noticeable absence of female faculty and students in math and science departments at coed universities throughout the United States may increase the belief in gender stereotypes and discourage women from pursuing careers in these fields (Dasgupta & Asgari, 2004). Contact with counter-stereotypical exemplars, such as female science experts, decreases belief in gender stereotypes and increases women's motivation to pursue careers in science (Stout, Dasgupta, Hunsinger, & McManus, 2011). Thus, the present study examined whether imagining an interpersonal interaction with a counter-stereotypic exemplar removes the physiological and performance effects of stereotype threat. However, the stereotype threat manipulation failed to elicit a strong stereotype threat effect on performance or physiology. Only reaction time and high frequency heart rate variability were sensitive to the stereotype threat induction. The imagination manipulation significantly attenuated the physiological effects of stereotype threat, whereas the reaction time effects were only marginally significant. Limitations and future directions for stereotype threat and imagined contact are discussed. / Ph. D.