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John S. Brekke - One of the best experts on this subject based on the ideXlab platform.
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How family factors impact Psychosocial Functioning for African American consumers with schizophrenia.
Community mental health journal, 2010Co-Authors: Joseph Guada, Maanse Hoe, Reta Floyd, Jack Barbour, John S. BrekkeAbstract:There is a critical need to test how family contextual factors impact outpatient consumer Functioning in schizophrenia. This is the first study of two companion studies reported here that tests family factors’ influence on consumer Functioning. Ninety-three low income inner-city African American consumer-family dyads were tested to see the possible impact of family factors, based on the EE and family caregiver burden literatures, on consumer Psychosocial Functioning (work, social, and independent living). The results supported a model wherein greater amounts of family contact had a significant relationship with better consumer Psychosocial Functioning. Additionally, family dysfunction had a direct negative relationship to consumer Psychosocial Functioning while family pressures and resources had an indirect negative relationship to consumer Psychosocial Functioning. Results are in marked contrast to what impacted consumer clinical Functioning for the same sample. The findings appear to confirm that family factors differently impact the domains of clinical and Psychosocial Functioning. These findings are new for understanding the contextual factors that impact consumer Functioning, especially Psychosocial Functioning.
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The Prospective Relationships Among Intrinsic Motivation, Neurocognition, and Psychosocial Functioning in Schizophrenia
Schizophrenia bulletin, 2010Co-Authors: Eri Nakagami, Maanse Hoe, John S. BrekkeAbstract:To address significant gaps in our understanding about how neurocognition, intrinsic motivation (IM), and Psychosocial Functioning are interrelated in schizophrenia, this study investigated the following questions: Is IM stable or dynamic over time? Does neurocognition predict change in IM over time? What is the association between change in neurocognition, change in IM, and change in Psychosocial Functioning? Finally, what is the causal structure of the relationships among neurocognition, IM, and Psychosocial Functioning over time? One hundred and thirty individuals diagnosed with schizophrenia or schizoaffective disorder were recruited from 4 community-based Psychosocial rehabilitation programs in urban Los Angeles. Measures of neurocognition were taken at baseline and 12 months. Measures of IM, Psychosocial Functioning, and symptoms were taken at baseline, 6, and 12 months. Results of latent growth curve modeling analyses demonstrated that IM is dynamic over time. Baseline neurocognition was associated with the initial level of IM but did not predict the rate of change in motivation. However, baseline levels of IM predicted rates of subsequent improvement in neurocognition. Change in IM was strongly associated with change in Psychosocial Functioning, and change in neurocognition was associated with change in Psychosocial Functioning, but change in IM was not associated with change in neurocognition. Latent difference score analyses revealed that neurocognition caused changes in Psychosocial Functioning, and Psychosocial Functioning caused changes in IM. These findings improve our fundamental understanding of the relationships among these variables and contribute to intervention development for improving outcomes in schizophrenia.
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Intrinsic motivation, neurocognition and Psychosocial Functioning in schizophrenia: testing mediator and moderator effects.
Schizophrenia research, 2008Co-Authors: Eri Nakagami, Maanse Hoe, Bin Xie, John S. BrekkeAbstract:This study examined the nature of the relationships among neurocognition, intrinsic motivation, and Psychosocial Functioning for persons with schizophrenia. Hypotheses concerning both mediator and moderator mechanisms were tested. 120 individuals diagnosed with schizophrenia were recruited as they entered outpatient Psychosocial rehabilitation programs. Measures of Psychosocial Functioning and intrinsic motivation were administered at baseline. Measures of neurocognition were administered at baseline by testers blind to scores on other study variables. Data were analyzed using latent construct modeling to test for mediator and moderator effects. There were strong bivariate relationships between neurocognition, intrinsic motivation, and Psychosocial Functioning. The results demonstrated that intrinsic motivation strongly mediated the relationship between neurocognition and Psychosocial Functioning. This mediation was evidenced by: (i) the direct path from neurocognition to functional outcome no longer being statistically significant after the introduction of motivation into the model, (ii) the statistical significance of the indirect path from neurocognition through motivation to functional outcome. There was no support for the two moderation hypotheses: the level of neurocognition did not influence the relationship between intrinsic motivation and Psychosocial Functioning, nor did the level of intrinsic motivation influence the relationship between neurocognition and Psychosocial Functioning. Neurocognition influences Psychosocial Functioning through its relationship with intrinsic motivation. Intrinsic motivation is a critical mechanism for explaining the relationship between neurocognition and Psychosocial Functioning. Implications for the theoretical understanding and Psychosocial treatment of intrinsic motivation in schizophrenia are discussed.
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Intrinsic motivation, neurocognition and Psychosocial Functioning in schizophrenia: testing mediator and moderator effects.
Schizophrenia Research, 2008Co-Authors: Eri Nakagami, Maanse Hoe, Bin Xie, John S. BrekkeAbstract:Abstract Background This study examined the nature of the relationships among neurocognition, intrinsic motivation, and Psychosocial Functioning for persons with schizophrenia. Hypotheses concerning both mediator and moderator mechanisms were tested. Method 120 individuals diagnosed with schizophrenia were recruited as they entered outpatient Psychosocial rehabilitation programs. Measures of Psychosocial Functioning and intrinsic motivation were administered at baseline. Measures of neurocognition were administered at baseline by testers blind to scores on other study variables. Data were analyzed using latent construct modeling to test for mediator and moderator effects. Results There were strong bivariate relationships between neurocognition, intrinsic motivation, and Psychosocial Functioning. The results demonstrated that intrinsic motivation strongly mediated the relationship between neurocognition and Psychosocial Functioning. This mediation was evidenced by: (i) the direct path from neurocognition to functional outcome no longer being statistically significant after the introduction of motivation into the model, (ii) the statistical significance of the indirect path from neurocognition through motivation to functional outcome. There was no support for the two moderation hypotheses: the level of neurocognition did not influence the relationship between intrinsic motivation and Psychosocial Functioning, nor did the level of intrinsic motivation influence the relationship between neurocognition and Psychosocial Functioning. Conclusions Neurocognition influences Psychosocial Functioning through its relationship with intrinsic motivation. Intrinsic motivation is a critical mechanism for explaining the relationship between neurocognition and Psychosocial Functioning. Implications for the theoretical understanding and Psychosocial treatment of intrinsic motivation in schizophrenia are discussed.
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Neuropsychological Functioning as a moderator of the relationship between Psychosocial Functioning and the subjective experience of self and life in schizophrenia
Schizophrenia bulletin, 2001Co-Authors: John S. Brekke, Brandon A. Kohrt, Michael F. GreenAbstract:Psychosocial interventions and models of quality of life in schizophrenia are based on the notion that increases in Psychosocial Functioning will be related to improvements in subjective experience outcomes such as self-esteem and satisfaction with life. However, studies have repeatedly failed to demonstrate a direct relationship between Psychosocial Functioning and subjective experience in schizophrenia. This study of 40 individuals diagnosed with schizophrenia examined whether neurocognitive measures of executive Functioning moderated the relationship between Psychosocial Functioning and subjective experience. Subjective experience was represented by measures of satisfaction with life and self-esteem. The Global Assessment Scale measured Psychosocial Functioning, and the Wisconsin Card Sorting Test measured executive Functioning. Multiple regression and correlation analyses indicated that executive Functioning was a strong moderator. Specifically, individuals with schizophrenia with impaired executive Functioning displayed a positive and statistically significant association between Psychosocial Functioning and both measures of subjective experience (r = 0.55 and 0.61). However, among schizophrenia patients with intact executive performance, Psychosocial Functioning was negatively associated with self-esteem and satisfaction with life (r = -0.24 and -0.46). And the findings were internally replicated using two other neuropsychological measures relevant to executive Functioning. These findings indicate that executive Functioning plays a major role in moderating the relationship between subjective experience and Psychosocial Functioning in schizophrenia. Implications for biosocial models, Psychosocial interventions, and models of quality of life in schizophrenia are discussed.
Martin B. Keller - One of the best experts on this subject based on the ideXlab platform.
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Course of longitudinal Psychosocial Functioning in bipolar youth transitioning to adults.
Journal of affective disorders, 2020Co-Authors: Erica J. Lee, Tina R Goldstein, Boris Birmaher, Benjamin I Goldstein, Michael A Strober, Martin B. Keller, Heather Hower, Richard N. Jones, John Merranko, Lauren M. WeinstockAbstract:Abstract Objectives In a sample of participants diagnosed with Bipolar Disorder (BD) in youth, we aim: (1) to examine longitudinal Psychosocial Functioning; (2) to determine whether Psychosocial impairment remains in those who remitted from mood disorders during later periods of follow-up; (3) to examine predictors of Psychosocial impairment despite symptomatic remission. Method A Course and Outcome of Bipolar Youth subsample of 367 (≥ 4 years follow-up data) were grouped into mood trajectories: Class 1 Predominantly Euthymic; Class 2 Moderately Euthymic; Class 3 Ill with Improving Course; Class 4 Predominantly Ill. Psychosocial Functioning was assessed via Children's Global Assessment Scale (C-GAS) for those under age 22; Global Assessment of Functioning (GAF) scale after 22. Current school, employment, and disability status were examined. Established predictors of symptomatic impairment were analyzed. Results The Predominantly Euthymic Class had better Psychosocial Functioning, and were more likely to be in school/employed. The Persistently Ill Class had worse Psychosocial Functioning, and were more likely to receive disability. However, 44% of Predominantly Euthymic and 93% of Ill with Improving Course participants continued to experience current Psychosocial impairment. Early BD onset, low Socioeconomic Status (SES), and current comorbidity, predicted poor Psychosocial Functioning. Low SES, and current comorbidity, predicted no school enrollment/unemployment. Limitations The study does not have a healthy control group to compare Functioning findings. Conclusions In general, youth with persistent mood symptoms had worse Psychosocial Functioning, moreover, those with remitted symptoms still exhibited current Psychosocial Functioning deficits. High risk individuals with predictors of impairment should be targeted for Functioning interventions.
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predictors of longitudinal Psychosocial Functioning in bipolar youth transitioning to adults
Journal of Affective Disorders, 2019Co-Authors: Heather Hower, Tina R Goldstein, Boris Birmaher, Benjamin I Goldstein, Michael A Strober, Martin B. Keller, Erica J. Lee, Richard N. Jones, John Merranko, Lauren M. WeinstockAbstract:Abstract Objectives In a sample of participants diagnosed with Bipolar Disorder (BD) in youth, we aim: (1) to examine longitudinal Psychosocial Functioning; (2) to determine whether Psychosocial impairment remains in those who remitted from mood disorders during later periods of follow-up; (3) to examine predictors of Psychosocial impairment despite symptomatic remission. Method A Course and Outcome of Bipolar Youth subsample of 367 (≥ 4 years follow-up data) were grouped into mood trajectories: Class 1 Predominantly Euthymic; Class 2 Moderately Euthymic; Class 3 Ill with Improving Course; Class 4 Predominantly Ill. Psychosocial Functioning was assessed via Children's Global Assessment Scale (C-GAS) for those under age 22; Global Assessment of Functioning (GAF) scale after 22. Current school, employment, and disability status were examined. Established predictors of symptomatic impairment were analyzed. Results The Predominantly Euthymic Class had better Psychosocial Functioning, and were more likely to be in school/employed. The Persistently Ill Class had worse Psychosocial Functioning, and were more likely to receive disability. However, 44% of Predominantly Euthymic and 93% of Ill with Improving Course participants continued to experience current Psychosocial impairment. Early BD onset, low Socioeconomic Status (SES), and current comorbidity, predicted poor Psychosocial Functioning. Low SES, and current comorbidity, predicted no school enrollment/unemployment. Limitations The study does not have a healthy control group to compare Functioning findings. Conclusions In general, youth with persistent mood symptoms had worse Psychosocial Functioning, moreover, those with remitted symptoms still exhibited current Psychosocial Functioning deficits. High risk individuals with predictors of impairment should be targeted for Functioning interventions.
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Predictors of longitudinal Psychosocial Functioning in bipolar youth transitioning to adults.
Journal of affective disorders, 2018Co-Authors: Heather Hower, Tina R Goldstein, Boris Birmaher, Benjamin I Goldstein, Michael A Strober, Martin B. Keller, Erica J. Lee, Richard N. Jones, John Merranko, Lauren M. WeinstockAbstract:In a sample of participants diagnosed with Bipolar Disorder (BD) in youth, we aim: (1) to examine longitudinal Psychosocial Functioning; (2) to determine whether Psychosocial impairment remains in those who remitted from mood disorders during later periods of follow-up; (3) to examine predictors of Psychosocial impairment despite symptomatic remission. A Course and Outcome of Bipolar Youth subsample of 367 (≥ 4 years follow-up data) were grouped into mood trajectories: Class 1 Predominantly Euthymic; Class 2 Moderately Euthymic; Class 3 Ill with Improving Course; Class 4 Predominantly Ill. Psychosocial Functioning was assessed via Children's Global Assessment Scale (C-GAS) for those under age 22; Global Assessment of Functioning (GAF) scale after 22. Current school, employment, and disability status were examined. Established predictors of symptomatic impairment were analyzed. The Predominantly Euthymic Class had better Psychosocial Functioning, and were more likely to be in school/employed. The Persistently Ill Class had worse Psychosocial Functioning, and were more likely to receive disability. However, 44% of Predominantly Euthymic and 93% of Ill with Improving Course participants continued to experience current Psychosocial impairment. Early BD onset, low Socioeconomic Status (SES), and current comorbidity, predicted poor Psychosocial Functioning. Low SES, and current comorbidity, predicted no school enrollment/unemployment. The study does not have a healthy control group to compare Functioning findings. In general, youth with persistent mood symptoms had worse Psychosocial Functioning, moreover, those with remitted symptoms still exhibited current Psychosocial Functioning deficits. High risk individuals with predictors of impairment should be targeted for Functioning interventions. Copyright © 2018 Elsevier B.V. All rights reserved.
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Disparities in Psychosocial Functioning in a diverse sample of adults with anxiety disorders
Journal of anxiety disorders, 2014Co-Authors: Ethan Moitra, Roberto Lewis-fernández, Robert L. Stout, Erica Angert, Risa B. Weisberg, Martin B. KellerAbstract:Anxiety disorders are associated with Psychosocial functional impairments, but no study has compared how these impairments might vary by ethno-racial status. We examined whether minority status was uniquely associated with functional impairments in 431 adults with anxiety disorders. Functioning was measured in the rater-assessed domains of: Global Assessment of Functioning (GAF); global Psychosocial Functioning; work, relationship, and recreational Functioning; and, self-reported: life satisfaction, mental health Functioning, physical Functioning, and disability status. After controlling for demographic and clinical variables, results revealed evidence of disparities, whereby African Americans (AAs), particularly those with low income, had worse GAF, worse global Psychosocial Functioning, and were more likely to be disabled compared to non-Latino Whites. Latinos, particularly those with low income, had worse global Psychosocial Functioning than non-Latino Whites. Results suggest AAs and Latinos are at increased risk for functional impairments not better accounted for by other demographic or clinical variables.
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Research report Psychosocial Functioning among bipolar youth
2009Co-Authors: Tina R Goldstein, Boris Birmaher, David Axelson, Benjamin I Goldstein, Mary Kay Gill, Christianne Esposito-smythers, Neal D Ryan, Michael A Strober, Jeffrey Hunt, Martin B. KellerAbstract:Background: Evidence indicates that children and adolescents with bipolar disorder (BP) experience significant functional impairment. However, little is known about the association between Psychosocial Functioning and episodes of illness, demographic, and clinical variables in this population. Methods: Subjects included 446 patients aged 7 to 17 diagnosed with DSM-IV bipolar disorder via the K-SADS for the Course and Outcome of Bipolar Youth (COBY) study. The Psychosocial Functioning Schedule of the Adolescent Longitudinal Interval Follow-Up Assessment (A-LIFE) was administered at study intake. Results: Mild to moderate levels of Psychosocial impairment were evident in work (includes academics), interpersonal, and overall domains of Functioning among BP youth. Multivariate analyses indicated that the strongest predictors of Psychosocial impairment wereadolescence(regardlessofageofonset),currentmoodepisode,currentaffectivesymptomseverity,currentpsychoticsymptoms, and current comorbid conduct disorder. Bipolar youth in-episode were significantly more impaired than those in partial remission/ recovery in every functional domain examined and were less satisfied with their Functioning. Yet, BP youth in partial remission/ recovery reported significant Psychosocial impairment. Limitations: Limitations include the reliance on patient and parent retrospective report of Psychosocial Functioning. Additionally, we did not account for the impact of Psychosocial and pharmacological interventions on Functioning. Conclusions: Findings suggest pediatric BP is associated with significant impairment in Psychosocial Functioning during and between episodes, with greater impairment during mood episodes than during partial remission/recovery. Additionally, functional impairment in BP appears to increase during adolescence regardless of age of onset. Clinicians should carefully assess and address Psychosocial impairment during and between mood episodes, with particular attention to the Functioning of BP adolescents. © 2008 Elsevier B.V. All rights reserved.
Benjamin I Goldstein - One of the best experts on this subject based on the ideXlab platform.
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Course of longitudinal Psychosocial Functioning in bipolar youth transitioning to adults.
Journal of affective disorders, 2020Co-Authors: Erica J. Lee, Tina R Goldstein, Boris Birmaher, Benjamin I Goldstein, Michael A Strober, Martin B. Keller, Heather Hower, Richard N. Jones, John Merranko, Lauren M. WeinstockAbstract:Abstract Objectives In a sample of participants diagnosed with Bipolar Disorder (BD) in youth, we aim: (1) to examine longitudinal Psychosocial Functioning; (2) to determine whether Psychosocial impairment remains in those who remitted from mood disorders during later periods of follow-up; (3) to examine predictors of Psychosocial impairment despite symptomatic remission. Method A Course and Outcome of Bipolar Youth subsample of 367 (≥ 4 years follow-up data) were grouped into mood trajectories: Class 1 Predominantly Euthymic; Class 2 Moderately Euthymic; Class 3 Ill with Improving Course; Class 4 Predominantly Ill. Psychosocial Functioning was assessed via Children's Global Assessment Scale (C-GAS) for those under age 22; Global Assessment of Functioning (GAF) scale after 22. Current school, employment, and disability status were examined. Established predictors of symptomatic impairment were analyzed. Results The Predominantly Euthymic Class had better Psychosocial Functioning, and were more likely to be in school/employed. The Persistently Ill Class had worse Psychosocial Functioning, and were more likely to receive disability. However, 44% of Predominantly Euthymic and 93% of Ill with Improving Course participants continued to experience current Psychosocial impairment. Early BD onset, low Socioeconomic Status (SES), and current comorbidity, predicted poor Psychosocial Functioning. Low SES, and current comorbidity, predicted no school enrollment/unemployment. Limitations The study does not have a healthy control group to compare Functioning findings. Conclusions In general, youth with persistent mood symptoms had worse Psychosocial Functioning, moreover, those with remitted symptoms still exhibited current Psychosocial Functioning deficits. High risk individuals with predictors of impairment should be targeted for Functioning interventions.
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predictors of longitudinal Psychosocial Functioning in bipolar youth transitioning to adults
Journal of Affective Disorders, 2019Co-Authors: Heather Hower, Tina R Goldstein, Boris Birmaher, Benjamin I Goldstein, Michael A Strober, Martin B. Keller, Erica J. Lee, Richard N. Jones, John Merranko, Lauren M. WeinstockAbstract:Abstract Objectives In a sample of participants diagnosed with Bipolar Disorder (BD) in youth, we aim: (1) to examine longitudinal Psychosocial Functioning; (2) to determine whether Psychosocial impairment remains in those who remitted from mood disorders during later periods of follow-up; (3) to examine predictors of Psychosocial impairment despite symptomatic remission. Method A Course and Outcome of Bipolar Youth subsample of 367 (≥ 4 years follow-up data) were grouped into mood trajectories: Class 1 Predominantly Euthymic; Class 2 Moderately Euthymic; Class 3 Ill with Improving Course; Class 4 Predominantly Ill. Psychosocial Functioning was assessed via Children's Global Assessment Scale (C-GAS) for those under age 22; Global Assessment of Functioning (GAF) scale after 22. Current school, employment, and disability status were examined. Established predictors of symptomatic impairment were analyzed. Results The Predominantly Euthymic Class had better Psychosocial Functioning, and were more likely to be in school/employed. The Persistently Ill Class had worse Psychosocial Functioning, and were more likely to receive disability. However, 44% of Predominantly Euthymic and 93% of Ill with Improving Course participants continued to experience current Psychosocial impairment. Early BD onset, low Socioeconomic Status (SES), and current comorbidity, predicted poor Psychosocial Functioning. Low SES, and current comorbidity, predicted no school enrollment/unemployment. Limitations The study does not have a healthy control group to compare Functioning findings. Conclusions In general, youth with persistent mood symptoms had worse Psychosocial Functioning, moreover, those with remitted symptoms still exhibited current Psychosocial Functioning deficits. High risk individuals with predictors of impairment should be targeted for Functioning interventions.
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Predictors of longitudinal Psychosocial Functioning in bipolar youth transitioning to adults.
Journal of affective disorders, 2018Co-Authors: Heather Hower, Tina R Goldstein, Boris Birmaher, Benjamin I Goldstein, Michael A Strober, Martin B. Keller, Erica J. Lee, Richard N. Jones, John Merranko, Lauren M. WeinstockAbstract:In a sample of participants diagnosed with Bipolar Disorder (BD) in youth, we aim: (1) to examine longitudinal Psychosocial Functioning; (2) to determine whether Psychosocial impairment remains in those who remitted from mood disorders during later periods of follow-up; (3) to examine predictors of Psychosocial impairment despite symptomatic remission. A Course and Outcome of Bipolar Youth subsample of 367 (≥ 4 years follow-up data) were grouped into mood trajectories: Class 1 Predominantly Euthymic; Class 2 Moderately Euthymic; Class 3 Ill with Improving Course; Class 4 Predominantly Ill. Psychosocial Functioning was assessed via Children's Global Assessment Scale (C-GAS) for those under age 22; Global Assessment of Functioning (GAF) scale after 22. Current school, employment, and disability status were examined. Established predictors of symptomatic impairment were analyzed. The Predominantly Euthymic Class had better Psychosocial Functioning, and were more likely to be in school/employed. The Persistently Ill Class had worse Psychosocial Functioning, and were more likely to receive disability. However, 44% of Predominantly Euthymic and 93% of Ill with Improving Course participants continued to experience current Psychosocial impairment. Early BD onset, low Socioeconomic Status (SES), and current comorbidity, predicted poor Psychosocial Functioning. Low SES, and current comorbidity, predicted no school enrollment/unemployment. The study does not have a healthy control group to compare Functioning findings. In general, youth with persistent mood symptoms had worse Psychosocial Functioning, moreover, those with remitted symptoms still exhibited current Psychosocial Functioning deficits. High risk individuals with predictors of impairment should be targeted for Functioning interventions. Copyright © 2018 Elsevier B.V. All rights reserved.
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Neurocognition and Psychosocial Functioning in adolescents with bipolar disorder.
Journal of affective disorders, 2016Co-Authors: Michael W. Best, Christopher R. Bowie, Melanie R. Naiberg, Dwight F. Newton, Benjamin I GoldsteinAbstract:Abstract Background Adults with bipolar disorder demonstrate significantly poorer Psychosocial Functioning and neurocognition compared to controls. In adult bipolar disorder neurocognition predicts a substantial portion of variance in Functioning. Adolescents with bipolar disorder have reducedPsychosocial Functioning, but less is known about neurocognitive impairments, and no studies have examined the relationship between neurocognition and Functioning in an adolescent sample. Methods 38 adolescents with bipolar disorder and 49 healthy controls under 20 years of age completed assessments of Psychosocial Functioning, neurocognitive ability, and psychiatric symptoms. Results Adolescents with bipolar disorder had significantly poorer Psychosocial Functioning in domains of daily activities, social Functioning, and satisfaction with Functioning, ps Limitations Limited sample size did not allow for complex statistical analyses. Differences in demographic characteristics of the clinical and control groups may limit generalization of these results. Conclusions This adolescent sample with bipolar disorder experiences significantly poorer neurocognitive and Psychosocial Functioning compared to controls; however, Psychosocial Functioning appears to be more strongly related to mood symptoms than to neurocognition. Future work is needed to delineate the time course of neurocognitive Functioning and its relation to Psychosocial Functioning across the course of illness. Adolescence may provide an ideal time for cognitive enhancement and intensive Psychosocial intervention.
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Psychosocial Functioning IN OFFSPRING OF PARENTS WITH BIPOLAR DISORDER
Journal of Affective Disorders, 2011Co-Authors: Tolulope Bella, Tina R Goldstein, Benjamin I Goldstein, David A. Axelson, Mihaela Obreja, Kelly Monk, Mary Beth Hickey, Rasim Somer Diler, David A. Brent, David J. KupferAbstract:Background Offspring of parents with bipolar disorder are at increased risk for a range of psychopathology, including bipolar disorder. It is not clear if they also have impairments in their Psychosocial Functioning.
Lee Anna Clark - One of the best experts on this subject based on the ideXlab platform.
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interrelations between Psychosocial Functioning and adaptive and maladaptive range personality traits
Journal of Abnormal Psychology, 2013Co-Authors: Lee Anna ClarkAbstract:Decrements in one or more domains of Psychosocial Functioning (e.g., poor job performance, poor interpersonal relations) are commonly observed in psychiatric patients. The purpose of this study is to increase understanding of Psychosocial Functioning as a broad, multifaceted construct as well as its associations with both adaptive- and maladaptive-range personality traits in both nonclinical and psychiatric outpatient samples. The study was conducted in two phases. In Study 1, a nonclinical sample (N = 429) was administered seven Psychosocial Functioning and adaptive-range personality trait measures. In Study 2, psychiatric outpatients (N = 181) were administered the same Psychosocial Functioning measures, and maladaptive- as well as adaptive-range personality trait measures. Exploratory (both studies) and confirmatory (Study 2) factor analyses indicated a common three-factor, hierarchical structure of Psychosocial Functioning-Well Being, Social/Interpersonal Functioning, and Basic Functioning. These Psychosocial Functioning domains were closely--and differentially--linked with personality traits, especially strongly so in patients. Across samples, Well Being was associated with both Neuroticism/Negative Affectivity and Extraversion/Positive Affectivity, Social/Interpersonal Functioning was associated with both Agreeableness and Conscientiousness/Disinhibition, and Basic Functioning was associated with Conscientiousness/Disinhibition, although only modestly in the nonclinical sample. These relations generally were maintained even after partialing out current general dysphoric symptoms. These findings have implications for considering Psychosocial Functioning as an important third domain in a tripartite model together with personality and psychopathology.
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Psychosocial Functioning in the context of diagnosis: assessment and theoretical issues.
Psychological assessment, 2009Co-Authors: Lee Anna ClarkAbstract:Psychosocial Functioning is an important focus of attention in the revision of the Diagnostic and Statistical Manual of Mental Disorders. Researchers and clinicians are converging upon the opinion that psychometrically strong, comprehensive assessment of individuals' Functioning is needed to characterize disorder fully. Also shared is the realization that existing theory and research in this domain have critical shortcomings. The authors urge that the field reexamine the empirical evidence and address theoretical issues to guide future development of the construct and its measurement. The authors first discuss several theoretical issues relevant to the conceptualization and assessment of Functioning: (a) definitions of Functioning, (b) the role of Functioning in defining disorder, and (c) understanding Functioning within environmental contexts. The authors then present data regarding empirical domains of Psychosocial Functioning and their interrelations. Self-reported data on multiple domains of Psychosocial Functioning were collected from 429 participants. Factor-analytic results (promax rotation) suggest a 4-factor structure of Psychosocial Functioning: Well-Being, Basic Functioning, Self-Mastery, and Interpersonal and Social Relationships. Finally, the authors propose an integration of theory and empirical findings, which they believe will better incorporate Psychosocial Functioning into future diagnostic systems.
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Deterioration in Psychosocial Functioning predicts relapse/recurrence after cognitive therapy for depression.
Journal of affective disorders, 2008Co-Authors: Jeffrey R Vittengl, Lee Anna Clark, Robin B JarrettAbstract:Associations between major depressive disorder (MDD) and Psychosocial Functioning are incompletely understood across time and during continuation phase cognitive therapy (C-CT). We examined the validity of the Range of Impaired Functioning Tool (RIFT; [Leon, A.C., Solomon, D.A., Mueller, T.I., Turvey, C.L., Endicott, J., Keller, M.B., 1999. The Range of Impaired Functioning Tool (LIFE-RIFT): A brief measure of functional impairment. Psychol. Med. 29, 869-878.]) as a measure of Psychosocial Functioning and its relations to depressive symptoms in C-CT and assessment-only control conditions. Outpatients with recurrent MDD who responded to acute-phase cognitive therapy (A-CT) were randomized to 8 months of C-CT (n=41) or assessment-only (n=43) and followed 16 additional months [Jarrett, R.B., Kraft, D., Doyle, J., Foster, B.M., Eaves, G.G., Silver, P.C., 2001. Preventing recurrent depression using cognitive therapy with and without a continuation phase: A randomized clinical trial. Arch. Gen. Psychiatry 58, 381-388.]. Interviewers rated depressive symptoms and Psychosocial Functioning monthly. Patients completed additional self-reports. The RIFT converged appropriately with other measures of Psychosocial Functioning, depressive symptoms, cognitive content, and personality. About half (55%) of patients were Psychosocially "well" (RIFT< or =8) during the first month post-A-CT. C-CT improved Psychosocial Functioning only transiently compared to the assessment control. Examined prospectively, depressive symptom level did not predict monthly changes in Psychosocial Functioning significantly, whereas Psychosocial dysfunction level predicted monthly changes in depressive symptoms and relapse/recurrence. Findings may not generalize to other patient populations, treatments, and assessment methods. The cross-lagged correlational data structure allows only tentative conclusions about the causal effect of Psychosocial Functioning on depressive symptoms. The RIFT is a valid measure of Psychosocial Functioning among responders to A-CT for depression. After such response, deteriorations in Psychosocial Functioning may signal imminent major depressive relapse/recurrence and provide targets for change during treatments focused on relapse/recurrence prevention.
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Deterioration in Psychosocial Functioning predicts relapse/recurrence after cognitive therapy for depression
Journal of Affective Disorders, 2008Co-Authors: Jeffrey R Vittengl, Lee Anna Clark, Robin B JarrettAbstract:Abstract Background Associations between major depressive disorder (MDD) and Psychosocial Functioning are incompletely understood across time and during continuation phase cognitive therapy (C-CT). We examined the validity of the Range of Impaired Functioning Tool (RIFT; [Leon, A.C., Solomon, D.A., Mueller, T.I., Turvey, C.L., Endicott, J., Keller, M.B., 1999. The Range of Impaired Functioning Tool (LIFE-RIFT): A brief measure of functional impairment. Psychol. Med. 29, 869–878.]) as a measure of Psychosocial Functioning and its relations to depressive symptoms in C-CT and assessment-only control conditions. Methods Outpatients with recurrent MDD who responded to acute-phase cognitive therapy (A-CT) were randomized to 8 months of C-CT ( n = 41) or assessment-only ( n = 43) and followed 16 additional months [Jarrett, R.B., Kraft, D., Doyle, J., Foster, B.M., Eaves, G.G., Silver, P.C., 2001. Preventing recurrent depression using cognitive therapy with and without a continuation phase: A randomized clinical trial. Arch. Gen. Psychiatry 58, 381–388.]. Interviewers rated depressive symptoms and Psychosocial Functioning monthly. Patients completed additional self-reports. Results The RIFT converged appropriately with other measures of Psychosocial Functioning, depressive symptoms, cognitive content, and personality. About half (55%) of patients were Psychosocially “well” (RIFT ≤ 8) during the first month post-A-CT. C-CT improved Psychosocial Functioning only transiently compared to the assessment control. Examined prospectively, depressive symptom level did not predict monthly changes in Psychosocial Functioning significantly, whereas Psychosocial dysfunction level predicted monthly changes in depressive symptoms and relapse/recurrence. Limitations Findings may not generalize to other patient populations, treatments, and assessment methods. The cross-lagged correlational data structure allows only tentative conclusions about the causal effect of Psychosocial Functioning on depressive symptoms. Conclusions The RIFT is a valid measure of Psychosocial Functioning among responders to A-CT for depression. After such response, deteriorations in Psychosocial Functioning may signal imminent major depressive relapse/recurrence and provide targets for change during treatments focused on relapse/recurrence prevention.
Tina R Goldstein - One of the best experts on this subject based on the ideXlab platform.
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Course of longitudinal Psychosocial Functioning in bipolar youth transitioning to adults.
Journal of affective disorders, 2020Co-Authors: Erica J. Lee, Tina R Goldstein, Boris Birmaher, Benjamin I Goldstein, Michael A Strober, Martin B. Keller, Heather Hower, Richard N. Jones, John Merranko, Lauren M. WeinstockAbstract:Abstract Objectives In a sample of participants diagnosed with Bipolar Disorder (BD) in youth, we aim: (1) to examine longitudinal Psychosocial Functioning; (2) to determine whether Psychosocial impairment remains in those who remitted from mood disorders during later periods of follow-up; (3) to examine predictors of Psychosocial impairment despite symptomatic remission. Method A Course and Outcome of Bipolar Youth subsample of 367 (≥ 4 years follow-up data) were grouped into mood trajectories: Class 1 Predominantly Euthymic; Class 2 Moderately Euthymic; Class 3 Ill with Improving Course; Class 4 Predominantly Ill. Psychosocial Functioning was assessed via Children's Global Assessment Scale (C-GAS) for those under age 22; Global Assessment of Functioning (GAF) scale after 22. Current school, employment, and disability status were examined. Established predictors of symptomatic impairment were analyzed. Results The Predominantly Euthymic Class had better Psychosocial Functioning, and were more likely to be in school/employed. The Persistently Ill Class had worse Psychosocial Functioning, and were more likely to receive disability. However, 44% of Predominantly Euthymic and 93% of Ill with Improving Course participants continued to experience current Psychosocial impairment. Early BD onset, low Socioeconomic Status (SES), and current comorbidity, predicted poor Psychosocial Functioning. Low SES, and current comorbidity, predicted no school enrollment/unemployment. Limitations The study does not have a healthy control group to compare Functioning findings. Conclusions In general, youth with persistent mood symptoms had worse Psychosocial Functioning, moreover, those with remitted symptoms still exhibited current Psychosocial Functioning deficits. High risk individuals with predictors of impairment should be targeted for Functioning interventions.
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predictors of longitudinal Psychosocial Functioning in bipolar youth transitioning to adults
Journal of Affective Disorders, 2019Co-Authors: Heather Hower, Tina R Goldstein, Boris Birmaher, Benjamin I Goldstein, Michael A Strober, Martin B. Keller, Erica J. Lee, Richard N. Jones, John Merranko, Lauren M. WeinstockAbstract:Abstract Objectives In a sample of participants diagnosed with Bipolar Disorder (BD) in youth, we aim: (1) to examine longitudinal Psychosocial Functioning; (2) to determine whether Psychosocial impairment remains in those who remitted from mood disorders during later periods of follow-up; (3) to examine predictors of Psychosocial impairment despite symptomatic remission. Method A Course and Outcome of Bipolar Youth subsample of 367 (≥ 4 years follow-up data) were grouped into mood trajectories: Class 1 Predominantly Euthymic; Class 2 Moderately Euthymic; Class 3 Ill with Improving Course; Class 4 Predominantly Ill. Psychosocial Functioning was assessed via Children's Global Assessment Scale (C-GAS) for those under age 22; Global Assessment of Functioning (GAF) scale after 22. Current school, employment, and disability status were examined. Established predictors of symptomatic impairment were analyzed. Results The Predominantly Euthymic Class had better Psychosocial Functioning, and were more likely to be in school/employed. The Persistently Ill Class had worse Psychosocial Functioning, and were more likely to receive disability. However, 44% of Predominantly Euthymic and 93% of Ill with Improving Course participants continued to experience current Psychosocial impairment. Early BD onset, low Socioeconomic Status (SES), and current comorbidity, predicted poor Psychosocial Functioning. Low SES, and current comorbidity, predicted no school enrollment/unemployment. Limitations The study does not have a healthy control group to compare Functioning findings. Conclusions In general, youth with persistent mood symptoms had worse Psychosocial Functioning, moreover, those with remitted symptoms still exhibited current Psychosocial Functioning deficits. High risk individuals with predictors of impairment should be targeted for Functioning interventions.
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Predictors of longitudinal Psychosocial Functioning in bipolar youth transitioning to adults.
Journal of affective disorders, 2018Co-Authors: Heather Hower, Tina R Goldstein, Boris Birmaher, Benjamin I Goldstein, Michael A Strober, Martin B. Keller, Erica J. Lee, Richard N. Jones, John Merranko, Lauren M. WeinstockAbstract:In a sample of participants diagnosed with Bipolar Disorder (BD) in youth, we aim: (1) to examine longitudinal Psychosocial Functioning; (2) to determine whether Psychosocial impairment remains in those who remitted from mood disorders during later periods of follow-up; (3) to examine predictors of Psychosocial impairment despite symptomatic remission. A Course and Outcome of Bipolar Youth subsample of 367 (≥ 4 years follow-up data) were grouped into mood trajectories: Class 1 Predominantly Euthymic; Class 2 Moderately Euthymic; Class 3 Ill with Improving Course; Class 4 Predominantly Ill. Psychosocial Functioning was assessed via Children's Global Assessment Scale (C-GAS) for those under age 22; Global Assessment of Functioning (GAF) scale after 22. Current school, employment, and disability status were examined. Established predictors of symptomatic impairment were analyzed. The Predominantly Euthymic Class had better Psychosocial Functioning, and were more likely to be in school/employed. The Persistently Ill Class had worse Psychosocial Functioning, and were more likely to receive disability. However, 44% of Predominantly Euthymic and 93% of Ill with Improving Course participants continued to experience current Psychosocial impairment. Early BD onset, low Socioeconomic Status (SES), and current comorbidity, predicted poor Psychosocial Functioning. Low SES, and current comorbidity, predicted no school enrollment/unemployment. The study does not have a healthy control group to compare Functioning findings. In general, youth with persistent mood symptoms had worse Psychosocial Functioning, moreover, those with remitted symptoms still exhibited current Psychosocial Functioning deficits. High risk individuals with predictors of impairment should be targeted for Functioning interventions. Copyright © 2018 Elsevier B.V. All rights reserved.
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Psychosocial Functioning IN OFFSPRING OF PARENTS WITH BIPOLAR DISORDER
Journal of Affective Disorders, 2011Co-Authors: Tolulope Bella, Tina R Goldstein, Benjamin I Goldstein, David A. Axelson, Mihaela Obreja, Kelly Monk, Mary Beth Hickey, Rasim Somer Diler, David A. Brent, David J. KupferAbstract:Background Offspring of parents with bipolar disorder are at increased risk for a range of psychopathology, including bipolar disorder. It is not clear if they also have impairments in their Psychosocial Functioning.
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Research report Psychosocial Functioning among bipolar youth
2009Co-Authors: Tina R Goldstein, Boris Birmaher, David Axelson, Benjamin I Goldstein, Mary Kay Gill, Christianne Esposito-smythers, Neal D Ryan, Michael A Strober, Jeffrey Hunt, Martin B. KellerAbstract:Background: Evidence indicates that children and adolescents with bipolar disorder (BP) experience significant functional impairment. However, little is known about the association between Psychosocial Functioning and episodes of illness, demographic, and clinical variables in this population. Methods: Subjects included 446 patients aged 7 to 17 diagnosed with DSM-IV bipolar disorder via the K-SADS for the Course and Outcome of Bipolar Youth (COBY) study. The Psychosocial Functioning Schedule of the Adolescent Longitudinal Interval Follow-Up Assessment (A-LIFE) was administered at study intake. Results: Mild to moderate levels of Psychosocial impairment were evident in work (includes academics), interpersonal, and overall domains of Functioning among BP youth. Multivariate analyses indicated that the strongest predictors of Psychosocial impairment wereadolescence(regardlessofageofonset),currentmoodepisode,currentaffectivesymptomseverity,currentpsychoticsymptoms, and current comorbid conduct disorder. Bipolar youth in-episode were significantly more impaired than those in partial remission/ recovery in every functional domain examined and were less satisfied with their Functioning. Yet, BP youth in partial remission/ recovery reported significant Psychosocial impairment. Limitations: Limitations include the reliance on patient and parent retrospective report of Psychosocial Functioning. Additionally, we did not account for the impact of Psychosocial and pharmacological interventions on Functioning. Conclusions: Findings suggest pediatric BP is associated with significant impairment in Psychosocial Functioning during and between episodes, with greater impairment during mood episodes than during partial remission/recovery. Additionally, functional impairment in BP appears to increase during adolescence regardless of age of onset. Clinicians should carefully assess and address Psychosocial impairment during and between mood episodes, with particular attention to the Functioning of BP adolescents. © 2008 Elsevier B.V. All rights reserved.
