The Journal of nervous and mental disease
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J. Nerv. Ment. Dis. · Mar 2009
Multicenter StudyEarly stage assessment and course of acute stress disorder after mild traumatic brain injury.
Although it has been established that acute stress disorder (ASD) and posttraumatic stress disorder occur after mild traumatic brain injury (MTBI) the qualitative differences in symptom presentation between injury survivors with and without a MTBI have not been explored in depth. This study aimed to compare the ASD and posttraumatic stress disorder symptom presentation of injury survivors with and without MTBI. One thousand one hundred sixteen participants between the ages of 17 to 65 years (mean age: 38.97 years, SD: 14.23) were assessed in the acute hospital after a traumatic injury. ⋯ Those with a MTBI and ASD had longer hospital admissions and higher levels of distress associated with their symptoms. Although many of the ASD symptoms that the MTBI group scored significantly higher were also part of a postconcussive syndrome, higher levels of avoidance symptoms may suggest that this group is at risk for longer term poor psychological adjustment. Mild TBI patients may represent a injury group at risk for poor psychological adjustment after traumatic injury.
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J. Nerv. Ment. Dis. · Nov 2008
Validity and reliability of the brief COPE in carers of people with dementia: the LASER-AD Study.
The Brief COPE is a self-completed questionnaire measuring coping strategies. It comprises 14 subscales for which psychometric properties are described. Three composite subscales measuring emotion-focused, problem-focused, and dysfunctional coping have proved useful in clinical research and have content validity. ⋯ Regression analyses indicated convergent and concurrent validity: emotion-focused coping was predicted by secure attachment (beta = 0.23) and by problem-focused coping (beta = 0.68); dysfunctional coping by burden (beta = 0.36) and less secure attachment (beta = -0.25) and problem-focused coping (beta = 0.31;all p < 0.05). The model predicting problem-focused coping included avoidant attachment (beta = 0.22; p = 0.014), social support (beta = 0.10; p = 0.25), care recipient activities of daily living impairment (beta = 0.12; p = 0.14) and less secure attachment (beta = -0.25; p = 0.011) and emotion-focused (beta = 0.53; p < 0.001) and dysfunctional coping (beta = 0.25, p = 0.006). These subscales are potentially useful in clinical research as they reflect possible components of interventions to change coping, although more information about sensitivity to change of the emotion-focused subscale is needed.
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J. Nerv. Ment. Dis. · Oct 2008
Comparative StudyImplicit and explicit stigma of mental illness: links to clinical care.
This study examined implicit and explicit measures of bias toward mental illness among people with different levels of mental health training, and investigated the influence of stigma on clinically-relevant decision-making. Participants (N = 1539) comprised of (1) mental health professionals and clinical graduate students, (2) other health care/social services specialists, (3) undergraduate students, and (4) the general public self-reported their attitudes toward people with mental illness, and completed implicit measures to assess mental illness evaluations that exist outside of awareness or control. ⋯ Compared with people without mental health training, individuals with mental health training demonstrated more positive implicit and explicit evaluations of people with mental illness. Further, explicit (but not implicit) biases predicted more negative patient prognoses, but implicit (and not explicit) biases predicted over-diagnosis, underscoring the value of using both implicit and explicit measures.
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J. Nerv. Ment. Dis. · May 2008
The Epworth sleepiness scale in the identification of obstructive sleep apnea.
The Epworth sleepiness scale (ESS) is often used clinically to screen for the manifestations of the behavioral morbidity associated to obstructive sleep apnea (OSA). The purpose of this study was to assess the sensitivity of the ESS in the identification of OSA, as defined by an elevated apnea-hypopnea index. ⋯ The results of the study showed only fair discriminatory ability of the ESS as a screener for OSA. A score of 8 (instead of 10) is suggested as the cutoff among clinic populations being screened for a sleep disorder.
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J. Nerv. Ment. Dis. · May 2008
Metacognition in schizophrenia: associations with multiple assessments of executive function.
Deficits in metacognitive capacity, or the abilities to think about thinking, are thought to be a key barrier to functioning in schizophrenia. Although metacognitive function may be linked to executive function, it is unclear how the different domains of each phenomenon are related to one another. Accordingly, we assessed 4 domains of metacognition on the basis of a self-generated narrative using the Metacognition Assessment Scale. ⋯ Participants were 49 men with schizophrenia spectrum disorders in a postacute phase of illness. Spearman Rho correlations revealed awareness of one's thoughts and feelings were more closely linked to performance on tests which required mental flexibility while recognizing others' needs, and independent relationships were more closely linked to performance on tasks which required inhibitory control. Results suggest different domains of metacognition may be influenced by and influence different neurocognitive processes.