1
|
Feliu J, Custodio AB, Pinto-Marín A, Higuera O, Pérez-González M, del Pino L, Ruiz-Jiménez L, Sánchez-Cabero D, Viera I, Jurado A, Espinosa E. Predicting Risk of Severe Toxicity and Early Death in Older Adult Patients Treated with Chemotherapy. Cancers (Basel) 2023; 15:4670. [PMID: 37760638 PMCID: PMC10526243 DOI: 10.3390/cancers15184670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Determining the risk of grade 3-5 toxicity and early death (ED) is important to plan chemotherapy in older adult patients with cancer. Our objective was to identify factors predicting these complications at the time of treatment initiation. METHODS 234 patients aged ≥70 were subjected to a geriatric assessment and variables related to the tumor and the treatment were also collected. Logistic regression multivariable analysis was used to relate these factors with the appearance of grade 3-5 toxicity and ED. Predictive scores for both toxicity and ED were then developed. RESULTS Factors related to grade 3-5 toxicity were hemoglobin, MAX2 index, ADL, and the CONUT score. Factors related to ED were tumor stage and the GNRI score. Two predictive scores were developed using these variables. ROC curves for the prediction of toxicity and ED were 0.71 (95% CI: 0.64-0.78) and 0.73 (95% CI: 0.68-0.79), respectively. CONCLUSIONS Two simple and reliable scores were developed to predict grade 3-5 toxicity and ED in older adult patients with cancer. This may be helpful in treatment planning.
Collapse
Affiliation(s)
- Jaime Feliu
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
- Cátedra UAM-AMGEN de Oncología Médica y Medicina Paliativa, Facultad de Medicina, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red del Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ana Belén Custodio
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
- Centro de Investigación Biomédica en Red del Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alvaro Pinto-Marín
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
| | - Oliver Higuera
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
| | - Miriam Pérez-González
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
| | - Laura del Pino
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
| | - Leticia Ruiz-Jiménez
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
| | - Darío Sánchez-Cabero
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
| | - Isabel Viera
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
| | - Ana Jurado
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
| | - Enrique Espinosa
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain; (A.B.C.); (A.P.-M.); (O.H.); (M.P.-G.); (L.d.P.); (L.R.-J.); (D.S.-C.); (I.V.); (A.J.); (E.E.)
- Cátedra UAM-AMGEN de Oncología Médica y Medicina Paliativa, Facultad de Medicina, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red del Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| |
Collapse
|
2
|
Bouldin ED, Delgado R, Peacock K, Hale W, Roghani A, Trevino AY, Viny M, Wetter DW, Pugh MJ. Military Injuries-Understanding Posttraumatic Epilepsy, Health, and Quality-of-Life Effects of Caregiving: Protocol for a Longitudinal Mixed Methods Observational Study. JMIR Res Protoc 2022; 11:e30975. [PMID: 34989689 PMCID: PMC8771349 DOI: 10.2196/30975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background Veterans with posttraumatic epilepsy (PTE), particularly those with comorbidities associated with epilepsy or traumatic brain injury (TBI), have poorer health status and higher symptom burden than their peers without PTE. One area that has been particularly poorly studied is that of the role of caregivers in the health of veterans with PTE and the impact caring for someone with PTE has on the caregivers themselves. Objective In this study, we aim to address the following: describe and compare the health and quality of life of veterans and caregivers of veterans with and without PTE; evaluate the change in available supports and unmet needs for services among caregivers of post-9/11 veterans with PTE over a 2-year period and to compare support and unmet needs with those without PTE; and identify veteran and caregiver characteristics associated with the 2-year health trajectories of caregivers and veterans with PTE compared with veterans without PTE. Methods We conducted a prospective cohort study of the health and quality of life among 4 groups of veterans and their caregivers: veterans with PTE, nontraumatic epilepsy, TBI only, and neither epilepsy nor TBI. We will recruit participants from previous related studies and collect information about both the veterans and their primary informal caregivers on health, quality of life, unmet needs for care, PTE and TBI symptoms and treatment, relationship, and caregiver experience. Data sources will include existing data supplemented with primary data, such as survey data collected at baseline, intermittent brief reporting using ecological momentary assessment, and qualitative interviews. We will make both cross-sectional and longitudinal comparisons, using veteran-caregiver dyads, along with qualitative findings to better understand risk and promotive factors for quality of life and health among veterans and caregivers, as well as the bidirectional impact of caregivers and care recipients on one another. Results This study was approved by the institutional review boards of the University of Utah and Salt Lake City Veterans Affairs and is under review by the Human Research Protection Office of the United States Army Medical Research and Development Command. The Service Member, Veteran, and Caregiver Community Stakeholders Group has been formed and the study questionnaire will be finalized once the panel reviews it. We anticipate the start of recruitment and primary data collection by January 2022. Conclusions New national initiatives aim to incorporate the caregiver into the veteran’s treatment plan; however, we know little about the impact of caregiving—both positive and negative—on the caregivers themselves and on the veterans for whom they provide care. We will identify specific needs in this understudied population, which will inform clinicians, patients, families, and policy makers about the specific impact and needs to equip caregivers in caring for veterans at home. International Registered Report Identifier (IRRID) PRR1-10.2196/30975
Collapse
Affiliation(s)
- Erin D Bouldin
- Department of Health and Exercise Science, Appalchian State University, Boone, NC, United States
| | - Roxana Delgado
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Kimberly Peacock
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Willie Hale
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX, United States
| | - Ali Roghani
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Amira Y Trevino
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Mikayla Viny
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - David W Wetter
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Mary Jo Pugh
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States.,Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, United States
| |
Collapse
|
3
|
Feliu J, Espinosa E, Basterretxea L, Paredero I, Llabrés E, Jiménez-Munárriz B, Antonio-Rebollo M, Losada B, Pinto A, Custodio AB, del Mar Muñoz M, Gómez-Mediavilla J, Torregrosa MD, Soler G, Cruz P, Higuera O, Molina-Garrido MJ. Prediction of Chemotoxicity, Unplanned Hospitalizations and Early Death in Older Patients with Colorectal Cancer Treated with Chemotherapy. Cancers (Basel) 2021; 14:cancers14010127. [PMID: 35008291 PMCID: PMC8749992 DOI: 10.3390/cancers14010127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/15/2021] [Accepted: 12/23/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Chemotoxicity, unplanned hospitalizations (Uhs) and early death (ED) are common among older patients with cancer who receive chemotherapy. Our objective was to determine factors predicting these complications. A predictive score for these three complications based on geriatric, tumor and laboratory variables was developed in a series of 215 older patients with colorectal carcinoma receiving chemotherapy. The use of this score may reliably identify patients at risk to have excessive toxicity with chemotherapy, UH or ED, thus helping to plan treatment, implement adaptive measures, and intensify follow-up. Abstract Purpose: To identify risk factors for toxicity, unplanned hospitalization (UH) and early death (ED) in older patients with colorectal carcinoma (CRC) initiating chemotherapy. Methods: 215 patients over 70 years were prospectively included. Geriatric assessment was performed before treatment, and tumor and treatment variables were collected. The association between these factors and grade 3–5 toxicity, UH and ED (<6 months) was examined by using multivariable logistic regression. Score points were assigned to each risk factor. Results: During the first 6 months of treatment, 33% of patients developed grade 3–5 toxicity, 31% had UH and 23% died. Risk factors were, for toxicity, instrumental activities of daily living, creatinine clearance, weight loss and MAX2 index; for UH, Charlson Comorbidity Score, creatinine clearance, weight loss, serum albumin, and metastatic disease; and for ED, basic activities in daily living, weight loss, metastatic disease, and hemoglobin levels. Predictive scores were built with these variables. The areas under receiver operation characteristic (ROC) curves for toxicity, UH and ED were 0.70 (95% CI: 0.64–0.766), 0.726 (95% IC: 0.661–0.799) and 0.74 (95% IC: 0.678–0.809), respectively. Conclusion: Simple scores based on geriatric, tumor and laboratory characteristics predict severe toxicity, UH and ED, and may help in treatment planning.
Collapse
Affiliation(s)
- Jaime Feliu
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
- Correspondence: ; Tel./Fax: +3-491-727-7118
| | - Enrique Espinosa
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Laura Basterretxea
- Oncology Department, Donostia University Hospital, 20014 Donostia, Spain; (L.B.); (J.G.-M.)
| | - Irene Paredero
- Oncology Department, Doctor Peset University Hospital, 46017 Valencia, Spain; (I.P.); (M.-D.T.)
| | - Elisenda Llabrés
- Oncology Department, Insular University Hospital of Gran Canarias, 35016 Las Palmas, Spain;
| | | | - Maite Antonio-Rebollo
- Oncohematogeriatrics Unit, Institut Català d’Oncologia, IDIBELL Hospitalet, 08908 Barcelona, Spain; (M.A.-R.); (G.S.)
| | - Beatriz Losada
- Oncology Department, University Hospital of Fuenlabrada, 28942 Madrid, Spain;
| | - Alvaro Pinto
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Ana Belén Custodio
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - María del Mar Muñoz
- Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain; (M.d.M.M.); (M.-J.M.-G.)
| | | | | | - Gema Soler
- Oncohematogeriatrics Unit, Institut Català d’Oncologia, IDIBELL Hospitalet, 08908 Barcelona, Spain; (M.A.-R.); (G.S.)
| | - Patricia Cruz
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Oliver Higuera
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | | |
Collapse
|
4
|
Blakey SM, Halverson TF, Evans MK, Patel TA, Hair LP, Meyer EC, DeBeer BB, Beckham JC, Pugh MJ, Calhoun PS, Kimbrel NA. Experiential avoidance is associated with medical and mental health diagnoses in a national sample of deployed Gulf War veterans. J Psychiatr Res 2021; 142:17-24. [PMID: 34314990 PMCID: PMC8429252 DOI: 10.1016/j.jpsychires.2021.07.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/17/2021] [Accepted: 07/21/2021] [Indexed: 12/14/2022]
Abstract
A substantial minority of deployed Gulf War veterans developed posttraumatic stress disorder (PTSD), depression, and several chronic illnesses. Although military combat and exposure to certain nuclear, biological, and chemical agents (NBCs) increase risk for post-deployment health problems, they do not fully explain many Gulf War veteran health diagnoses and are not viable treatment targets. Experiential avoidance (EA; one's unwillingness to remain in contact with unpleasant internal experiences) is a modifiable psychosocial risk factor associated with PTSD and depression in veterans as well as pain and gastrointestinal diseases in the general population. In this study, we recruited a national sample of deployed Gulf War veterans (N = 454) to test the hypothesis that greater EA would be significantly associated with higher lifetime odds of PTSD, depression, "Gulf War Illness" (GWI/CMI), and other chronic illnesses common in this veteran cohort. Participants completed a self-report battery assessing demographic, military-related, and health-related information. Multivariate analyses showed that after adjusting for age, sex, race, combat exposure, and NBC exposure, worse EA was associated with higher lifetime odds of PTSD, depression GWI/CMI, gastrointestinal problems, irritable bowel syndrome, arthritis, fibromyalgia, and chronic fatigue syndrome (ORs ranged 1.25 to 2.89; effect sizes ranged small to large), but not asthma or chronic obstructive pulmonary disease. Our findings suggest medical and mental health providers alike should assess for EA and potentially target EA as part of a comprehensive, biopsychosocial approach to improving Gulf War veterans' health and wellbeing. Study limitations and future research directions are also discussed.
Collapse
Affiliation(s)
- Shannon M Blakey
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA.
| | - Tate F Halverson
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
| | - Mariah K Evans
- Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Tapan A Patel
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
| | - Lauren P Hair
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Eric C Meyer
- University of Pittsburgh Department of Rehabilitation Science and Technology, 4028 Forbes Tower, Pittsburgh, PA, 15260, USA.
| | - Bryann B DeBeer
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center, 1700 N Wheeling St, G-3-116M, Aurora, CO, 80045, USA; Department of Physical Medicine and Rehabilitation, Anschutz Medical Campus, University of Colorado, 12631 E 17th Ave, Aurora, CO, 80045, USA.
| | - Jean C Beckham
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Mary J Pugh
- VA Salt Lake City Healthcare System, 500 Foothill Dr, Salt Lake City, UT, 84148, USA; University of Utah School of Medicine Department of Medicine, 30 N. 1900 E, Salt Lake City, UT, 84132, USA.
| | - Patrick S Calhoun
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Nathan A Kimbrel
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| |
Collapse
|
5
|
Feliu J, Pinto A, Basterretxea L, López-San Vicente B, Paredero I, Llabrés E, Jiménez-Munárriz B, Antonio-Rebollo M, Losada B, Espinosa E, Gironés R, Custodio AB, Muñoz MDM, Díaz-Almirón M, Gómez-Mediavilla J, Torregrosa MD, Soler G, Cruz P, Higuera O, González-Montalvo JI, Molina-Garrido MJ. Development and Validation of an Early Mortality Risk Score for Older Patients Treated with Chemotherapy for Cancer. J Clin Med 2021; 10:jcm10081615. [PMID: 33920250 PMCID: PMC8070509 DOI: 10.3390/jcm10081615] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 01/17/2023] Open
Abstract
Background: Estimation of life expectancy in older patients is relevant to select the best treatment strategy. We aimed to develop and validate a score to predict early mortality in older patients with cancer. Patients and Methods: A total of 749 patients over 70 years starting new chemotherapy regimens were prospectively included. A prechemotherapy assessment that included sociodemographic variables, tumor/treatment variables, and geriatric assessment variables was performed. Association between these factors and early death was examined using multivariable logistic regression. Score points were assigned to each risk factor. External validation was performed on an independent cohort. Results: In the training cohort, the independent predictors of 6-month mortality were metastatic stage (OR 4.8, 95% CI [2.4–9.6]), ECOG-PS 2 (OR 2.3, 95% CI [1.1–5.2]), ADL ≤ 5 (OR 1.7, 95% CI [1.1–3.5]), serum albumin levels ≤ 3.5 g/dL (OR 3.4, 95% CI [1.7–6.6]), BMI < 23 kg/m2 (OR 2.5, 95% CI [1.3–4.9]), and hemoglobin levels < 11 g/dL (OR 2.4, 95% CI (1.2–4.7)). With these results, we built a prognostic score. The area under the ROC curve was 0.78 (95% CI, 0.73 to 0.84), and in the validation set, it was 0.73 (95% CI: 0.67–0.79). Conclusions: This simple and highly accurate tool can help physicians making decisions in elderly patients with cancer who are planned to initiate chemotherapy treatment.
Collapse
Affiliation(s)
- Jaime Feliu
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
- Correspondence: ; Tel./Fax: +3-491-727-7118
| | - Alvaro Pinto
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
| | - Laura Basterretxea
- Oncology Department, OSI Donostialde, Donostia Unibertsitate Ospitalea, Donostialde, Donostia, 20014 Gipuzkoa, Spain; (L.B.); (J.G.-M.)
| | | | - Irene Paredero
- Oncology Department, Hospital Universitario Dr. Peset, 46017 Valencia, Spain; (I.P.); (M.D.T.)
| | - Elisenda Llabrés
- Oncology Department, Hospital Universitario Insular de Gran Canarias, 35016 Las Palmas, Spain;
| | | | - Maite Antonio-Rebollo
- Oncohematogeriatrics Unit, Institut Català d’Oncologia, IDIBELL, Hospitalet, 08908 Barcelona, Spain; (M.A.-R.); (G.S.)
| | - Beatriz Losada
- Oncology Department, Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain;
| | - Enrique Espinosa
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
| | - Regina Gironés
- Oncology Department, Hospital Universitari y Politécnic La Fé, 46026 Valencia, Spain;
| | - Ana Belén Custodio
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
| | - María del Mar Muñoz
- Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain; (M.d.M.M.); (M.J.M.-G.)
| | - Mariana Díaz-Almirón
- Biostatistics Department, Hospital La Paz, Universidad Autónoma de Madrid, 28046 Madrid, Spain;
| | - Jenifer Gómez-Mediavilla
- Oncology Department, OSI Donostialde, Donostia Unibertsitate Ospitalea, Donostialde, Donostia, 20014 Gipuzkoa, Spain; (L.B.); (J.G.-M.)
| | | | - Gema Soler
- Oncohematogeriatrics Unit, Institut Català d’Oncologia, IDIBELL, Hospitalet, 08908 Barcelona, Spain; (M.A.-R.); (G.S.)
| | - Patricia Cruz
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
| | - Oliver Higuera
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
| | | | | |
Collapse
|
6
|
Feliu J, Espinosa E, Basterretxea L, Paredero I, Llabrés E, Jiménez-Munárriz B, Losada B, Pinto A, Custodio AB, Muñoz MDM, Gómez-Mediavilla J, Torregrosa MD, Cruz P, Higuera O, Molina-Garrido MJ. Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy. Cancers (Basel) 2021; 13:1437. [PMID: 33809852 PMCID: PMC8004134 DOI: 10.3390/cancers13061437] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To determine the incidence of unplanned hospitalization (UH) and to identify risk factors for UH in elderly patients with cancer who start chemotherapy. METHODS In all, 493 patients over 70 years starting new chemotherapy regimens were prospectively included. A pre-chemotherapy geriatric assessment was performed, and tumor and treatment variables were collected. The association between these factors and UH was examined by using multivariable logistic regression. Score points were assigned to each risk factor. RESULTS During the first 6 months of treatment, 37% of patients had at least one episode of UH. Risk factors were the use of combination chemotherapy at standard doses, a MAX2 index ≥1, a Charlson comorbidity score ≥2, albumin level <3.5 g/dL, falls in the past 6 months ≥1, and weight loss >5%. Three risk groups for UH were established according to the score in all patients: 0-1: 17.5%; 2: 34%; and 3-7: 57% (p < 0.001). The area under receiver operation characteristic (ROC) curve was 0.72 (95% CI: 0.67-0.77). CONCLUSION This simple tool can help to reduce the incidence of UH in elderly patients with cancer who are scheduled to initiate chemotherapy treatment.
Collapse
Affiliation(s)
- Jaime Feliu
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Enrique Espinosa
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Laura Basterretxea
- Oncology Department, Hospital Universitario de Donostia, 20014 Donostia, Spain; (L.B.); (J.G.-M.)
| | - Irene Paredero
- Oncology Department, Hospital Universitario Dr. Peset, 46017 Valencia, Spain; (I.P.); (M.D.T.)
| | - Elisenda Llabrés
- Oncology Department, Hospital Universitario Insular de Gran Canarias, 35016 Las Palmas, Spain;
| | | | - Beatriz Losada
- Oncology Department, Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain;
| | - Alvaro Pinto
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Ana Belén Custodio
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - María del Mar Muñoz
- Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain; (M.d.M.M.); (M.J.M.-G.)
| | | | | | - Patricia Cruz
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Oliver Higuera
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | | |
Collapse
|
7
|
Feliu J, Espinosa E, Basterretxea L, Paredero I, Llabrés E, Jiménez-Munárriz B, Antonio-Rebollo M, Losada B, Pinto A, Gironés R, Custodio AB, Muñoz MDM, Gómez-Mediavilla J, Torregrosa MD, Soler G, Cruz P, Higuera O, Molina-Garrido MJ. Undertreatment and overtreatment in older patients treated with chemotherapy. J Geriatr Oncol 2020; 12:381-387. [PMID: 33109485 DOI: 10.1016/j.jgo.2020.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/02/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Inconsistent doses and schemes are commonly used in older patients receiving cancer chemotherapy. We performed this study in patients with cancer and age ≥ 70 years to determine the frequency of undertreatment and overtreatment as well as factors influencing the decision to modify chemotherapy doses. PATIENTS AND METHODS Patients aged ≥70 years starting new chemotherapy regimens were prospectively included in a multicentre study. The schedule and drug doses were determined by the treating oncologist. Pre-chemotherapy assessment included sociodemographics, treatment details and geriatric assessment (GA) variables. Association between these factors and undertreatment (use of less intensive cancer treatment [LICT] in a fit patient) or overtreatment (use of standard cancer treatment in an unfit older patient) were examined by multivariate logistic regression. RESULTS Three- hundred ninety-seven patients were included, 43% of whom received LICT. If not adjusted for GA, toxicity did not differ between those receiving LICT (38%) or standard doses of chemotherapy (37%). If the dose of chemotherapy was analyzed according to the results of GA 61 (15%) patients had been undertreated and 133 (34%) had been overtreated. Undertreatment was related with increasing age and decreased renal function. Factors related with overtreatment were younger age, curative intention of treatment, prescription of G-CSF as primary prophylaxis and adequate cognitive status. Overtreated patients had more grade 3-4 toxicity than those receiving treatment adapted to fragility (42% vs 31%; p < 0.05). CONCLUSIONS The use of chemotherapy without considering GA leads to overtreatment more commonly than undertreatment in older patients with cancer. Oncologists should take into account the results of GA to stratify patients and to avoid under or overtreatment.
Collapse
Affiliation(s)
- Jaime Feliu
- Oncology department, Hospital Universitario La Paz, Madrid, Spain; Cátedra UAM-AMGEN, CIBERONC, Spain.
| | - Enrique Espinosa
- Oncology department, Hospital Universitario La Paz, Madrid, Spain
| | | | - Irene Paredero
- Oncology department, Hospital Universitario Dr. Peset. Valencia, Spain
| | - Elisenda Llabrés
- Oncology department, Hospital Universitario Insular de Gran Canarias, Spain
| | | | - Maite Antonio-Rebollo
- Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL, Hospitalet, Barcelona, Spain
| | - Beatriz Losada
- Oncology department, Hospital Universitario de Fuenlabrada, Spain
| | - Alvaro Pinto
- Oncology department, Hospital Universitario La Paz, Madrid, Spain
| | - Regina Gironés
- Oncology department, Hospital Universitari y Politécnic La Fé, Valencia, Spain
| | | | | | | | | | - Gema Soler
- Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL, Hospitalet, Barcelona, Spain
| | - Patricia Cruz
- Oncology department, Hospital Universitario La Paz, Madrid, Spain
| | - Oliver Higuera
- Oncology department, Hospital Universitario La Paz, Madrid, Spain
| | | |
Collapse
|
8
|
Jukić M, Lukinac AM, Požgain I, Talapko J, Jukić M, Filaković P. The Role of Perceived Social Support in Assessing Posttraumatic Stress Disorder and Mental Health-Related Quality of Life in Veterans. Healthcare (Basel) 2020; 8:E396. [PMID: 33053836 PMCID: PMC7711990 DOI: 10.3390/healthcare8040396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/30/2020] [Accepted: 10/09/2020] [Indexed: 01/22/2023] Open
Abstract
This study aims to establish the effect of self-perceived social support on the intensity of Post-Traumatic Stress Disorder (PTSD) symptoms and Mental Health-Related Quality of Life (MHRQoL) in veterans more than two decades after exposure to trauma in the Homeland War in Croatia, which took place from 1990 to 1995. The sample comprised 259 Croatian Homeland War veterans diagnosed with PTSD, with at least 6 months of combat experience. Among them, 90 subjects had also experienced imprisonment in enemy prison camps (at least 1 month of captivity). The subjects were evaluated using the questionnaire on self-perceived social support, sociodemographic questionnaire, PTSD self-report checklist (PCL-5) and Short Form (SF-36) Health Survey questionnaire. A general regression model analysis was performed to determine whether social support affected patients' MHRQoL and intensity of the PTSD symptoms. The obtained results showed that veterans who had a more positive perception of social support after the events of the war had less intense PTSD symptoms and better MHRQoL. Furthermore, captivity and socioeconomic status were shown to be important predictors of PTSD and MHRQoL. The nonimprisoned veteran group was more likely to develop more severe PTSD symptoms and have poorer MHRQoL compared to the group of former prisoners of war (ex-POWs). This could be due to better post-war care and social support, which ex-POWs received after their release from captivity.
Collapse
Affiliation(s)
- Melita Jukić
- Department of Psychiatry, County General Hospital Vukovar and Croatian Veterans’ Hospital, 32000 Vukovar, Croatia;
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Ana Marija Lukinac
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
- Department of Rheumatology, Clinical Immunology and Allergology, University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Ivan Požgain
- Psychiatric Clinic, University Hospital Center Osijek, 31000 Osijek, Croatia;
| | - Jasminka Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (J.T.); (P.F.)
| | - Marko Jukić
- Faculty of Food Technology Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Pavo Filaković
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (J.T.); (P.F.)
| |
Collapse
|
9
|
Umucu E, Reyes A, Carrola P, Mangadu T, Lee B, Brooks JM, Fortuna KL, Villegas D, Chiu CY, Valencia C. Pain intensity and mental health quality of life in veterans with mental illnesses: the intermediary role of physical health and the ability to participate in activities. Qual Life Res 2020; 30:479-486. [PMID: 32974882 PMCID: PMC7515555 DOI: 10.1007/s11136-020-02642-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2020] [Indexed: 01/14/2023]
Abstract
Purpose The purpose of this study was to examine the intermediary role of physical health quality of life and ability to participate social roles and activities in the relationship between pain intensity and mental health quality of life in veterans with mental illnesses. Methods This is a cross-sectional correlational design study. Our participants are 156 veterans with self-reported mental illness (Mage = 37.85; SDage = 10.74). Descriptive, correlation, and mediation analyses were conducted for the current study. Results Pain intensity was negatively correlated with physical health QOL, ability to participate in social roles and activities, and mental health QOL. Physical health QOL and ability to participate in social roles and activities were positively associated with mental health QOL, respectively. Physical health QOL was positively correlated with a ability to participate in social roles and activities. Study results indicate that the effect of pain intensity on mental health QOL can be explained by physical health QOL and ability to participate. Conclusions Specific recommendations for practitioners include implementing treatment goals that simultaneously focus on physical health and ability to participate in social roles and activities for clients who present with both physical pain and low mental health QOL.
Collapse
Affiliation(s)
- Emre Umucu
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA.
| | - Antonio Reyes
- Division of Special Education and Counseling, CA State University - Los Angeles, Los Angeles, CA, USA
| | - Paul Carrola
- Department of Educational Psychology and Special Services, The University of Texas at El Paso, El Paso, TX, USA
| | - Thenral Mangadu
- Department of Public Health Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Beatrice Lee
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
| | - Jessica M Brooks
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Karen L Fortuna
- The Geisel School of Medicine at Dartmouth, Dartmouth College, Concord, NH, USA
| | - Diana Villegas
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
| | - Chung-Yi Chiu
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Carolina Valencia
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
| |
Collapse
|
10
|
|
11
|
Feliu J, Jiménez-Munárriz B, Basterretxea L, Paredero I, Llabrés E, Antonio-Rebollo M, Losada B, Espinosa E, Gironés R, Custodio AB, Del Mar Muñoz M, Díaz-Almirón M, Gómez-Mediavilla J, Pinto A, Torregrosa MD, Soler G, Cruz P, Higuera O, Molina-Garrido MJ. Predicting Chemotherapy Toxicity in Older Patients with Cancer: A Multicenter Prospective Study. Oncologist 2020; 25:e1516-e1524. [PMID: 32329131 DOI: 10.1634/theoncologist.2019-0701] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 03/24/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Standard oncology tools are inadequate to distinguish which older patients are at higher risk of developing chemotherapy-related complications. MATERIALS AND METHODS Patients over 70 years of age starting new chemotherapy regimens were prospectively included in a multicenter study. A prechemotherapy assessment that included sociodemographics, tumor/treatment variables, and geriatric assessment variables was performed. Association between these factors and the development of grade 3-5 toxicity was examined by using logistic regression. RESULTS A total of 551 patients were accrued. Chemotherapy doses (odds ratio [OR] 1.834; 95% confidence interval [CI] 1.237-2.719) and creatinine clearance (OR 0.989; 95% CI 0.981-0.997) were the only factors independently associated with toxicity. Only 19% of patients who received reduced doses of chemotherapy and had a creatinine clearance ≥40 mL/minute had grade 3-4 toxicity, compared with 38% of those who received standard doses or had a creatinine clearance <40 mL/minute (p < .0001). However, no satisfactory multivariate model was obtained using different selection approaches. CONCLUSION Chemotherapy doses and renal function were identified as the major risk factors for developing severe toxicity in the older patient. These factors should be considered when planning to initiate a new chemotherapy regimen and should also lead to a closer follow-up in these patients. IMPLICATIONS FOR PRACTICE Older patients are more vulnerable to chemotherapy toxicity. However, standard tools are inadequate to identify who is at higher risk of developing chemotherapy-related complications. Chemotherapy doses (standard vs. reduced) and renal function were identified as the major risk factors for developing severe toxicity in the elderly. These factors should be considered when planning to initiate a new chemotherapy regimen and should also lead to a closer follow-up.
Collapse
Affiliation(s)
- Jaime Feliu
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | | | | | - Irene Paredero
- Oncology Department, Hospital Universitario Dr. Peset, Valencia, Spain
| | - Elisenda Llabrés
- Oncology Department, Hospital Universitario Insular de Gran Canarias, Las Palmas, Spain
| | - Maite Antonio-Rebollo
- Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL Hospitalet, Barcelona, Spain
| | - Beatriz Losada
- Oncology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Enrique Espinosa
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | - Regina Gironés
- Oncology Department, Hospital Lluis Alcanyis de Xátiva, Valencia, Spain
| | - Ana Belén Custodio
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | | | - Mariana Díaz-Almirón
- Biostatistics Department, Hospital La Paz, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Alvaro Pinto
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | | | - Gema Soler
- Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL Hospitalet, Barcelona, Spain
| | - Patricia Cruz
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | - Oliver Higuera
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | | |
Collapse
|
12
|
Sippel LM, Watkins LE, Pietrzak RH, Hoff R, Harpaz-Rotem I. Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination. Eur J Psychotraumatol 2019; 10:1646091. [PMID: 31489133 PMCID: PMC6713134 DOI: 10.1080/20008198.2019.1646091] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 11/21/2022] Open
Abstract
Elucidating whether PTSD symptoms predict poorer social connectedness over time (i.e. social erosion) and/or that poor social connectedness contributes to maintenance of PTSD (i.e. social causation) has implications for PTSD treatment and relapse prevention. Most extant research has been cross-sectional and examined overall PTSD symptoms. Evidence of longitudinal associations among heterogeneous PTSD symptom clusters and social connectedness could provide insight into more nuanced targets for intervention. Using data from 1,491 U.S. military veterans in residential treatment for PTSD at 35 Department of Veterans Affairs facilities, we evaluated a two-wave cross-lagged panel model including a five-factor model of PTSD and two aspects of social connectedness. PTSD, quality of connectedness (i.e. degree of distress related to interpersonal conflict), and structural social support (i.e. number of days of contact with supportive loved ones) in the past 30 days were assessed at baseline and 4 months after discharge. The largest effect was greater severity of PTSD dysphoric arousal symptoms (i.e. irritability/anger, poor concentration, and sleep problems) at baseline predicting more conflict-related distress at follow-up (β = 0.43). Post-hoc symptom-level analyses indicated that irritability/anger drove this association. In addition, conflict-related distress predicted greater PTSD symptom severity across all five clusters (β's = 0.10 to 0.14, p's < 0.01). More days of contact predicted lower severity of avoidance and numbing symptoms (β's = -.05 and -.07, p's < 0.01), along with individual symptoms within these clusters, plus flashbacks. Results support both social erosion and social causation models. Engaging loved ones in veterans' treatment and targeting dysphoric arousal symptoms, particularly anger and irritability, may improve long-term PTSD and relationship outcomes, respectively.
Collapse
Affiliation(s)
- Lauren M Sippel
- National Center for PTSD Executive Division, White River Junction, VT, USA.,Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Laura E Watkins
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Robert H Pietrzak
- National Center for PTSD Clinical Neurosciences Division, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Rani Hoff
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,National Center for PTSD Evaluation Division, West Haven, CT, USA
| | - Ilan Harpaz-Rotem
- National Center for PTSD Clinical Neurosciences Division, West Haven, CT, USA.,National Center for PTSD Evaluation Division, West Haven, CT, USA
| |
Collapse
|
13
|
Monteith LL, Smith NB, Holliday R, Pietrzak RH. Psychiatric and Interpersonal Correlates of Suicide Ideation in Military Sexual Trauma Survivors: The National Health and Resilience in Veterans Study. CHRONIC STRESS 2018; 2. [PMID: 31218269 PMCID: PMC6583800 DOI: 10.1177/2470547018815901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Veterans who experience military sexual trauma are at increased risk for experiencing suicidal ideation, suicide attempt, and suicide. Yet few studies have attempted to discern factors that relate to suicidal ideation and suicide attempts among survivors of military sexual trauma. The present study aimed to identify psychiatric and interpersonal correlates of suicidal ideation (primary aim) and suicide attempt (secondary aim) among survivors of military sexual trauma. Methods This cross-sectional analysis included 115 veterans (56 females; mean age = 53.24) who participated in the National Health and Resilience in Veterans Study and reported experiencing military sexual trauma. Self-report measures assessed psychological distress, hazardous alcohol use, social support, loneliness, social acknowledgment following one's worst trauma, suicidal ideation, and suicide attempts. Results Military sexual trauma survivors who reported more severe psychological distress (OR = 2.88), hazardous alcohol use (OR = 1.14), and perceived general disapproval from others (OR = 1.14) were significantly more likely to report experiencing suicidal ideation in the past two weeks. Hazardous alcohol use (OR = 1.19) and perceived general disapproval from others (OR = 1.36) were associated with being more likely to report attempting suicide in adulthood. Conclusions Addressing alcohol misuse, psychological distress, and perceived general disapproval from others in relation to one's worst traumatic event is recommended when assessing and managing suicide risk among veterans who have experienced military sexual trauma. Findings also contribute to a growing literature highlighting the importance of understanding perceptions of the interpersonal response to trauma. Considering the cross-sectional design, longitudinal research is needed to further elucidate the roles of these constructs in predicting suicidal ideation and suicide attempt following military sexual trauma.
Collapse
Affiliation(s)
- Lindsey L Monteith
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, CO, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Noelle B Smith
- VA Northeast Program Evaluation Center, West Haven, CT, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ryan Holliday
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, CO, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,National Center for Posttraumatic Stress Disorder, West Haven, CT, USA
| |
Collapse
|
14
|
Sippel LM, Watkins LE, Pietrzak RH, Hoff R, Harpaz-Rotem I. The Unique Roles of Emotional Numbing and Arousal Symptoms in Relation to Social Connectedness Among Military Veterans in Residential Treatment for PTSD. Psychiatry 2018; 81:271-282. [PMID: 30015602 DOI: 10.1080/00332747.2017.1395313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE While poor social connectedness is often a consequence of living with posttraumatic stress disorder (PTSD) symptoms, little is known about whether PTSD symptom clusters may be uniquely related to different aspects of social connectedness. This information can inform case conceptualization and treatment planning to potentially facilitate sustained recovery for individuals with PTSD. METHOD We examined associations among a five-factor model of PTSD and two aspects of social connectedness-distress related to problems getting along with others and days of contact with supportive loved ones in the past 30 days-in a sample of 2,600 U.S. military veterans seeking residential treatment for PTSD. RESULTS A large proportion of veterans reported experiencing distress related to problems getting along with others (66.2%) and few days of contact with supportive people (43.5%). Ordinal regression models controlling for intercorrelations among PTSD symptom clusters revealed that emotional numbing symptoms were independently associated with greater distress (β = 0.130, p < 0.001) and fewer days of contact (β = -0.159, p < 0.001); dysphoric arousal symptoms were associated with more distress (β = 0.236, p < 0.001), while anxious arousal was associated with more days of contact (β = 0.058, p < 0.05). CONCLUSIONS Findings reveal high rates of difficulties in social connectedness and distinct associations among these difficulties with emotional numbing, dysphoric arousal, and anxious arousal symptoms in veterans receiving residential treatment for PTSD. Future studies should examine whether targeting poor social connectedness during treatment improves interpersonal functioning and supports sustained trauma recovery, which may be particularly beneficial to veterans with more severe emotional numbing and dysphoric arousal symptoms.
Collapse
|
15
|
Moderating Effect of Marital Status on the Association Between Combat Exposure and Post-Deployment Mental Health in Canadian Military Personnel. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
16
|
Landes SD, Wilder J, Williams D. The effect of race and birth cohort on the veteran mortality differential. Soc Sci Med 2017; 179:36-44. [DOI: 10.1016/j.socscimed.2017.02.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 01/11/2017] [Accepted: 02/21/2017] [Indexed: 01/18/2023]
|
17
|
Fried DA, Passannante M, Helmer D, Holland BK, Halperin WE. The Health and Social Isolation of American Veterans Denied Veterans Affairs Disability Compensation. HEALTH & SOCIAL WORK 2017; 42:7-14. [PMID: 28395067 DOI: 10.1093/hsw/hlw051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/11/2016] [Indexed: 06/07/2023]
Abstract
Authors comparatively analyzed health and social isolation between U.S. military veterans denied Veterans Affairs (VA) disability compensation and veterans awarded VA disability compensation. The 2001 National Survey of Veterans was used to create a sample of 4,522 veterans denied or awarded VA disability compensation. Using the Andersen health services utilization model as a conceptual framework, multivariate logistic regression was applied to assess relationships between VA disability compensation award status, three separate domains of health, and correlates of social isolation. Results indicate that denied applicants were more likely than those awarded to have poor overall health (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.23, 1.70), and limitations in activities of daily living (OR = 1.12, 95% CI: 1.03, 1.21). Denied applicants' physical functioning (40.3) and mental functioning (41.2) composite summary scores were not clinically different from those of awarded applicants (39.0 and 40.1, respectively), indicating that both were comparably impaired. Veterans denied VA disability compensation had poor health and functional impairments. They also experienced poverty and isolation, suggesting that they may be in need of additional supportive services. Connecting veterans to community resources could be a vital service to provide to all veterans applying for disability compensation.
Collapse
Affiliation(s)
- Dennis Adrian Fried
- Postdoctoral fellow, War Related Injury and Illness Study Center (WRIISC), U.S. Department of Veterans Affairs (VA), East Orange, NJ, USA
| | - Marian Passannante
- Professor, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA
| | | | - Bart K Holland
- Professor, New Jersey Medical School, State University of New Jersey, Newark, USA
| | - William E Halperin
- professor, School of Public Health, Rutgers, State University of New Jersey, Newark, USA
| |
Collapse
|
18
|
Posttraumatic Stress and Physical Health Functioning: Moderating Effects of Deployment and Postdeployment Social Support in OEF/OIF/OND Veterans. J Nerv Ment Dis 2017; 205:93-98. [PMID: 27660993 PMCID: PMC5272856 DOI: 10.1097/nmd.0000000000000571] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Research indicates that posttraumatic stress disorder (PTSD) is strongly associated with physical health difficulties, and that social support may be protective for both problems. Social support, however, is often broadly conceptualized. The present analysis explores how Veteran-specific social support (during military deployment and postdeployment) may moderate the relationship between PTSD and physical health functioning. Participants were recruited from a VA Medical Center. Self-report data were analyzed from 63 Veterans (17.46% female; 42.86% white) who had been deployed in support of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND). Data indicate that military deployment social support moderated the relationship between PTSD and pain (β = 0.02, p = 0.02) whereas postdeployment social support moderated the relationship between PTSD and general health perceptions (β = 0.03, p = 0.01). These findings may be used to better understand the role of support in influencing psychological and physiological processes.
Collapse
|
19
|
Yang MS, Burr JA. Combat exposure, social relationships, and subjective well-being among middle-aged and older Veterans. Aging Ment Health 2017; 20:637-46. [PMID: 25928024 DOI: 10.1080/13607863.2015.1033679] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study described the association of subjective well-being with combat exposure and social relationships among middle-aged and older Veteran men in the USA. The stress-buffering hypothesis, which predicts social relationships may moderate the association between combat exposure and subjective well-being, was also examined. METHOD Data from the 2008 Health and Retirement Study (N = 2961) were used to estimate logistic regression models, focusing on three measures of subjective well-being: depression, life satisfaction, and self-reported health. RESULTS In the fully adjusted models, there were no statistically significant relationships between combat exposure and the three indicators of subjective well-being. However, compared to Veterans who had lower scores on the social relationship index, Veterans who had higher scores were less likely to be depressed and less likely to report poor or fair health. Veterans who had higher scores on the social relationships index reported higher levels of life satisfaction than those Veterans who had lower scores. There was no evidence for a social relationships buffering effect. CONCLUSION The results of this study demonstrated that combat exposure did not have a long-term relationship with subjective well-being. Longitudinal research designs with more comprehensive indicators of combat exposure may help researchers better understand some of the underlying complexity of this relationship. Complementary research with samples of women Veterans, as well as samples of Hispanic, and non-Black, non-White Veterans, is also needed.
Collapse
Affiliation(s)
- Mai See Yang
- a Department of Gerontology , McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston , Boston , MA , USA
| | - Jeffrey A Burr
- a Department of Gerontology , McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston , Boston , MA , USA
| |
Collapse
|
20
|
Chumbler NR, Neugaard B, Kobb R, Ryan P, Qin H, Joo Y. Evaluation of a Care Coordination/Home-Telehealth Program for Veterans with Diabetes. Eval Health Prof 2016; 28:464-78. [PMID: 16272426 DOI: 10.1177/0163278705281079] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We evaluated a Veterans Health Administration (VHA) care coordination/ hometelehealth (CC/HT) programon the utilization of health care services and health-related quality of life (HRQL) in veterans with diabetes. Administrative records of 445 veterans with diabetes were reviewed to compare health care service utilization in the 1-year period before and 1-year period postenrollment and also examined self-reported HRQL at enrollment and 1 year later. Multivariate analyses indicated a statistically significant reduction in the proportion of patients who were hospitalized (50% reduction), emergency room use (11% reduction), reduction in the average number of bed days of care (decreased an average of 3.0 days), and improvement in the HRQL role-physical functioning, bodily pain, and social functioning. The results need to be interpreted with caution because we used a single-group study design that may be influenced by regression to the mean. Ideally, future research should use a randomized controlled trial design.
Collapse
Affiliation(s)
- Neale R Chumbler
- Veterans Affairs Health Services Research and Development/Rehabilitation Research and Development, Rehabilitation Outcomes Research Center, & Veterans Affairs Health Services Research and Development Stroke QUERI, North Florida.
| | | | | | | | | | | |
Collapse
|
21
|
Gros DF, Flanagan JC, Korte KJ, Mills AC, Brady KT, Back SE. Relations among social support, PTSD symptoms, and substance use in veterans. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2016; 30:764-770. [PMID: 27786511 DOI: 10.1037/adb0000205] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Social support plays a significant role in the development, maintenance, and treatment of posttraumatic stress disorder (PTSD). However, there has been little investigation of social support with PTSD and its frequent comorbid conditions and related symptoms. Substance use disorders (SUDs) are 1 set of conditions that have yet to be investigated in combination with PTSD and social support. As compared with civilians, veterans are at increased risk for developing both PTSD and SUD. In this study, veterans (N = 171) with symptoms of PTSD (76% met diagnostic criteria) and SUD (83% met diagnostic criteria for any dependence) were recruited and completed clinician-rated and self-report measures of PTSD, SUD, and social support. Overall, low social support was reported in the sample. When controlled for the other disorder's symptoms, PTSD symptoms demonstrated a significant negative relation and SUD symptoms demonstrated a significant positive relation to social support. The PTSD findings are consistent with previous studies on PTSD and social support without SUD comorbidity. However, the SUD findings are inconsistent with previous studies, which focused primarily on older veterans. Together, these findings highlight the significance of social support in individuals with PTSD and SUD and promote future research within comorbid presentations. (PsycINFO Database Record
Collapse
Affiliation(s)
- Daniel F Gros
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center
| | | | - Kristina J Korte
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center
| | - Adam C Mills
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center
| | - Kathleen T Brady
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center
| | - Sudie E Back
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center
| |
Collapse
|
22
|
Kim JE, Nesselroade JR. Relationships among social support, self-concept, and wellbeing of older adults: A study of process using dynamic factor models. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2016. [DOI: 10.1080/01650250244000010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Intra-individual patterns of time-lagged relationships among self-reports of social support, self-concept, and physical and psychological wellbeing were investigated. Participants were older adults (mean age = 77 years) who were measured weekly on some scales and biweekly on others, covering a total of 25 weeks. Dynamic factor models were fitted to multivariate repeated measures data pooled over subsets of participants. The results indicate significant time-lagged, cross-factor relationships showing that negative social support has both a direct effect and an indirect effect, through less positive self-concept, on physical health measures. For the measures of negative social support, self-concept, subjective health, and physical performance (gait), there are substantial autoregressive effects indicating persisting factor scores over 1 or 2 weeks. How intra-individual perspectives and methods can facilitate the study of complex developmental processes is discussed.
Collapse
|
23
|
Abstract
Purpose: The purpose of this article is to explore how kin and nonkin social support networks influence health behaviors among older Samoan women. Method: Using a cross-sectional survey design, 290 Samoan women who were age 50 years and older were interviewed. Using separate logistic regressions, each health behavior was regressed on age and kin and nonkin social support networks after controlling for background characteristics and health status. Results: In multivariate analyses, higher scores on kin increased the likelihood of never salting food, getting screened for diabetes in the past year, and having had a mammogram in the past 2 years, whereas higher scores on nonkin increased the likelihood of exercising at all and ever trying to lose weight. Discussion: Kin networks positively affect mostly chronic disease-related health behaviors, whereas nonkin networks positively affect mostly lifestyle-related health behaviors.
Collapse
Affiliation(s)
- Lené Levy-Storms
- University of California, Los Angeles, and Jewish Home for the Aging of Greater Los Angeles, USA
| | | |
Collapse
|
24
|
Shallcross SL, Arbisi PA, Polusny MA, Kramer MD, Erbes CR. Social Causation Versus Social Erosion: Comparisons of Causal Models for Relations Between Support and PTSD Symptoms. J Trauma Stress 2016; 29:167-75. [PMID: 27077494 DOI: 10.1002/jts.22086] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Social support is a robust correlate of posttraumatic stress disorder (PTSD) symptoms and of general psychological distress (Ozer, Best, Lipsey, & Weiss, 2003). The nature of the causal relationship between support and PTSD remains the subject of debate, with 2 models, social erosion and social causation, often used to explain findings. Despite extensive research using these models, no studies of which we are aware have included tests of both models within the same series of analyses, across more than 2 time points, in veterans. These competing models were tested in a sample of National Guard soldiers (N = 521) who completed measures of perceived social support and the PTSD Checklist-Military version (Weathers, Litz, Herman, Huska, & Keane, 1993) at 3 months, 15 months, and 27 months following a combat deployment to Iraq. Analyses were run separately for overall PTSD symptoms and the PTSD components of intrusion, trauma-avoidance, dysphoria, and hyperarousal. Both the social erosion (βs ranging from -.10 to -.19) and social causation (βs ranging from -.08 to -.13) hypotheses were supported. Results suggested PTSD-specific symptom dimensions may both erode and be influenced by social support, whereas general psychological distress erodes social support. Implications for clinical intervention and research are discussed.
Collapse
Affiliation(s)
- Sandra L Shallcross
- Psychology Department, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
| | - Paul A Arbisi
- Psychology Department, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.,University of Minnesota, Medical School, Minneapolis, Minnesota, USA
| | - Melissa A Polusny
- Psychology Department, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.,University of Minnesota, Medical School, Minneapolis, Minnesota, USA.,Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Mark D Kramer
- University of Minnesota, Medical School, Minneapolis, Minnesota, USA.,Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Christopher R Erbes
- University of Minnesota, Medical School, Minneapolis, Minnesota, USA.,Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| |
Collapse
|
25
|
Quinones C, Kakabadse NK. Self-concept clarity and compulsive Internet use: The role of preference for virtual interactions and employment status in British and North-American samples. J Behav Addict 2015; 4:289-98. [PMID: 26690624 PMCID: PMC4712763 DOI: 10.1556/2006.4.2015.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Compulsive Internet Use (CIU) describes a maladaptive relationship with the Internet characterised by loss of control and conflict. Although also affecting adults, most studies use teenage samples, and theoretical development on risk factors is scarce. According to Davis (2001), the social connectivity function of the Internet is key in identifying traits associated with CIU. Since Self-Concept Clarity (SCC) is strongly related to social anxiety, and virtual interactions allow "self-edition", we hypothesized that individuals low in SCC could choose virtual interactions as safer alternative to satisfy their social needs. This could in turn increase the risk of CIU. Building on a previous study, we also expected CIU to be more harmful in the unemployed. METHODS We collected samples from the U.K. (N = 532) and U.S. (N = 502) with equal distribution of employed and unemployed individuals. We ran Measurement Invariance tests to confirm that the constructs were equivalent across countries. Subsequently, we conducted mediation and moderation analysis to test our hypothesis with Multigroup Confirmatory Factor Analysis. RESULTS Measurement Invariance was confirmed. The relationship between SCC and CIU was partially mediated by preference of virtual interactions in both countries. This preference was significantly related to lower social support. Short term unemployment seemed to accentuate the negative impact of CIU on life satisfaction in both countries, although only marginally significantly in the U.S. The unemployed reported significantly lower levels of life satisfaction. CONCLUSION We demonstrated that SCC is a key vulnerability factor to CIU in adults, and confirmed the additional risks for the unemployed.
Collapse
Affiliation(s)
- Cristina Quinones
- Open University Business School, Walton Hall, Milton Keynes, UK,Corresponding author: Cristina Quinones; Open University Business School, Walton Hall, Milton Keynes, MK7 6AA, UK; Phone: +4401908 632763; E-mail:
| | | |
Collapse
|
26
|
Hajek A, Brettschneider C, Lange C, Posselt T, Wiese B, Steinmann S, Weyerer S, Werle J, Pentzek M, Fuchs A, Stein J, Luck T, Bickel H, Mösch E, Wolfsgruber S, Heser K, Maier W, Scherer M, Riedel-Heller SG, König HH. Gender differences in the effect of social support on health-related quality of life: results of a population-based prospective cohort study in old age in Germany. Qual Life Res 2015; 25:1159-68. [DOI: 10.1007/s11136-015-1166-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2015] [Indexed: 11/25/2022]
|
27
|
Choi NG, DiNitto DM, Marti CN. Social participation and self-rated health among older male veterans and non-veterans. Geriatr Gerontol Int 2015; 16:920-7. [PMID: 26338088 DOI: 10.1111/ggi.12577] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2015] [Indexed: 11/25/2022]
Abstract
AIM To examine self-rated health (SRH) and its association with social participation, along with physical and mental health indicators, among USA male veterans and non-veterans aged ≥65 years. METHODS The two waves of the National Health and Aging Trend Study provided data (n = 2845 at wave 1; n = 2235 at wave 2). Multilevel mixed effects generalized linear models were fit to test the hypotheses. RESULTS Despite their older age, veterans did not differ from non-veterans in their physical, mental and cognitive health, and they had better SRH. However, black and Hispanic veterans had lower SRH than non-Hispanic white veterans. Formal group activities and outings for enjoyment were positively associated with better SRH for veterans, non-veterans and all veteran cohorts. CONCLUSIONS Aging veterans, especially black and Hispanic veterans, require programs and services that will help increase their social connectedness. Geriatr Gerontol Int 2016; 16: 920-927.
Collapse
Affiliation(s)
- Namkee G Choi
- The University of Texas at Austin, Austin, Texas, USA
| | | | | |
Collapse
|
28
|
Quinones C, Kakabadse NK. Self-concept clarity, social support, and compulsive Internet use: A study of the US and the UAE. COMPUTERS IN HUMAN BEHAVIOR 2015. [DOI: 10.1016/j.chb.2014.11.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
29
|
Longitudinal trajectory patterns of social support: correlates and associated mental health in an Australian national cohort of young women. Qual Life Res 2015; 24:2075-86. [DOI: 10.1007/s11136-015-0946-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 10/23/2022]
|
30
|
Prevalence of mental health symptoms in Dutch military personnel returning from deployment to Afghanistan: a 2-year longitudinal analysis. Eur Psychiatry 2014; 30:341-6. [PMID: 25195152 DOI: 10.1016/j.eurpsy.2014.05.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 05/14/2014] [Accepted: 05/19/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Recent studies in troops deployed to Iraq and Afghanistan have shown that combat exposure and exposure to deployment-related stressors increase the risk for the development of mental health symptoms. The aim of this study is to assess the prevalence of mental health symptoms in a cohort of Dutch military personnel prior to and at multiple time-points after deployment. METHODS Military personnel (n=994) completed various questionnaires at 5 time-points; starting prior to deployment and following the same cohort at 1 and 6 months and 1 and 2 years after their return from Afghanistan. RESULTS The prevalence of symptoms of fatigue, PTSD, hostility, depression and anxiety was found to significantly increase after deployment compared with pre-deployment rates. As opposed to depressive symptoms and fatigue, the prevalence of PTSD was found to decrease after the 6-month assessment. The prevalence of sleeping problems and hostility remained relatively stable. CONCLUSIONS The prevalence of mental health symptoms in military personnel increases after deployment, however, symptoms progression over time appears to be specific for various mental health symptoms. Comprehensive screening and monitoring for a wide range of mental health symptoms at multiple time-points after deployment is essential for early detection and to provide opportunities for intervention. DECLARATION OF INTEREST This project was funded by the Dutch Ministry of Defence.
Collapse
|
31
|
Lee MH, Choi KS, Lee YY, Suh M, Jun JK. Relationship between Social Network and Stage of Adoption of Gastric Cancer Screening among the Korean Population. Asian Pac J Cancer Prev 2014; 14:6095-101. [PMID: 24289632 DOI: 10.7314/apjcp.2013.14.10.6095] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Few studies have examined the relationship between social support and stages of adoption of cancer screening. Here we investigated associations between both structural and functional aspects of social support and stages of adoption of gastric cancer screening in the general population of Korea. The study population was derived from the 2011 Korean National Cancer Screening Survey (KNCSS), an annual cross-sectional survey that uses nationally representative random sampling to investigate cancer screening rates. Data were analyzed from 3,477 randomly selected respondents aged 40-74 years. Respondents were classified according to their stage of adoption of gastric cancer screening: precontemplation (13.2%), contemplation (18.0%), action/maintenance (56.1%), relapse risk (8.5%), and relapse stage (4.1%). Respondents with larger social networks were more likely to be in the contemplation/action/maintenance, or the relapse risk/relapse stages versus the precontemplation stage (OR=1.91, 95%CI: 1.52-2.91; p for tend=0.025). Emotional and instrumental supports were not associated with any stage of adoption of gastric cancer screening. However, respondents who reported receiving sufficient informational support were more likely to be in the relapse risk/relapse stages versus the precontemplation, or the contemplation/action/maintenance stage (p for trend=0.016). Interventions involving interactions between social network members could play an important role in increasing participation in gastric cancer screening.
Collapse
Affiliation(s)
- Myung Ha Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea E-mail :
| | | | | | | | | |
Collapse
|
32
|
Longitudinal analysis of relationships between social support and general health in an Australian population cohort of young women. Qual Life Res 2014; 24:485-92. [PMID: 25099200 DOI: 10.1007/s11136-014-0774-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The influence of social support on health and quality of life has been well documented. There is less evidence on whether health status affects social support, and little is known about longitudinal relationships between social support and health in early adulthood. This study investigates these associations using both concurrent and time-lagged measures at 5 time-points over 12 years during early adulthood. METHODS A population-based cohort of 9,758 young women from the Australian Longitudinal Study on Women's Health was used. Women were aged 22-27 in 2000 and 35-39 in 2012. The General Health subscale of the SF-36 and the MOS Social Support Survey 6-item Scale were used, with scores standardised to a range of 0-100. Longitudinal tobit models were used, because both social support and general health data were left skewed, with marked ceiling effects. All models were adjusted for status of the outcome of interest at the immediately previous survey. RESULTS With both concurrent and time-lagged measures, there was a statistically significant difference in mean general health scores across social support quintiles after adjusting for demographic and behavioural covariates: lower general health was associated with lower social support. In reverse, social support mean scores were also significantly different across general health quintiles in both concurrent and time-lagged fully adjusted models. CONCLUSION Social support is significantly associated with both current and subsequent general health in early adulthood. The significance of the reverse associations indicates that the two mutually influence each other. This study highlights the importance of social support as a health-related quality of life issue.
Collapse
|
33
|
Patulny R, Siminski P, Mendolia S. The front line of social capital creation--a natural experiment in symbolic interaction. Soc Sci Med 2014; 125:8-18. [PMID: 24836279 DOI: 10.1016/j.socscimed.2014.04.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 04/15/2014] [Accepted: 04/17/2014] [Indexed: 11/17/2022]
Abstract
This paper offers theoretical and empirical contributions to understanding the micro-sociological processes behind the creation of social capital. Theoretically, we argue that the emotional and shared experience of participating in symbolic interaction rituals may affect social capital in four different ways, via: (i) a 'citizenship' effect, connecting participants symbolically to the broader, civic society; (ii) a 'supportive' effect, bonding participants with each other; (iii) an exclusive 'tribal' effect, which crowds-out connections with other groups and the wider society; and (iv) an 'atomising' effect, whereby intense experiences create mental health problems that damage social capital. We illustrate this with a case study of Australian veterans of the Vietnam War. The randomness of the National Service conscription lotteries of that era translates into a high-quality natural experiment. We formulate several hypotheses about which of the four effects dominates for veterans who participated in the 'symbolic interaction' of training and deployment. We test these hypotheses using data from the 2006 Australian Census of Population and Housing, and the NSW 45 & Up Study. We found that war service reduced 'bonding' social capital, but increased 'bridging' social capital, and this is not explained completely by mental health problems. This suggests that while the combined 'tribal' and 'atomizing' effects of service outweigh the 'supportive' effects, the 'citizenship' effect is surprisingly robust. Although they feel unsupported and isolated, veterans are committed to their community and country. These paradoxical findings suggest that social capital is formed through symbolic interaction. The emotional and symbolic qualities of interaction rituals may formulate non-strategic (perhaps irrational) connections with society regardless of the status of one's personal support networks.
Collapse
|
34
|
Compulsive internet use in adults: A study of prevalence and drivers within the current economic climate in the UK. COMPUTERS IN HUMAN BEHAVIOR 2014. [DOI: 10.1016/j.chb.2013.08.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
35
|
Suicidality among older male veterans in the United States: results from the National Health and Resilience in Veterans Study. J Psychiatr Res 2013; 47:1766-75. [PMID: 23992768 DOI: 10.1016/j.jpsychires.2013.07.015] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 07/14/2013] [Accepted: 07/18/2013] [Indexed: 11/20/2022]
Abstract
Older men have a higher rate of suicide than the general population, but little is known about the prevalence and correlates of suicidality among older male veterans. In this study, we evaluated the prevalence, and risk and protective factors associated with current suicidal ideation (SI) and past suicide attempt (SA) in a contemporary, nationally representative sample of older male veterans. We analyzed data from 1962 male veterans aged 60 or older who participated in the National Health and Resilience Veterans Survey (NHRVS) between October and December 2011. Bivariate analyses and multivariate logistic regression were used to evaluate risk and protective factors associated with current SI and past SA in the full sample, and separately among combat and non-combat veterans. Six percent of the sample reported past 2-week SI, and combat veterans were more likely to contemplate suicide (9.2%) than non-combat (4.0%) veterans. Lifetime SA was reported by 2.6% of respondents. Major depression and physical health difficulties were the strongest risk factors for SI in combat veterans, while generalized anxiety disorder (GAD) was the strongest risk factor for SI in non-combat veterans. Posttraumatic stress disorder (PTSD) was independently associated with SI in both groups of veterans, and social connectedness was negatively related to SI in both groups. These results suggest that a significant proportion of older male veterans in the United States contemplates suicide, with higher rates of SI among combat than non-combat veterans. Interventions designed to mitigate psychological distress and physical difficulties, and to promote social connectedness may help mitigate suicidality risk in this population.
Collapse
|
36
|
Hatch SL, Harvey SB, Dandeker C, Burdett H, Greenberg N, Fear NT, Wessely S. Life in and after the Armed Forces: social networks and mental health in the UK military. SOCIOLOGY OF HEALTH & ILLNESS 2013; 35:1045-1064. [PMID: 23356827 DOI: 10.1111/1467-9566.12022] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study focuses on the influence of structural aspects of social integration (social networks and social participation outside work) on mental health (common mental disorders (CMD), that is, depression and anxiety symptoms, post-traumatic stress disorder (PTSD) symptoms and alcohol misuse). This study examines differences in levels of social integration and associations between social integration and mental health among service leavers and personnel still in service. Data were collected from regular serving personnel (n=6,511) and regular service leavers (n=1,753), from a representative cohort study of the Armed Forces in the UK. We found that service leavers reported less social participation outside work and a general disengagement with military social contacts in comparison to serving personnel. Service leavers were more likely to report CMD and PTSD symptoms. The increased risk of CMD but not PTSD symptoms, was partially accounted for by the reduced levels of social integration among the service leavers. Maintaining social networks in which most members are still in the military is associated with alcohol misuse for both groups, but it is related to CMD and PTSD symptoms for service leavers only.
Collapse
Affiliation(s)
- Stephani L Hatch
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, London UK Department of War Studies, King's College London, UK King's Centre for Military Health Research, King's College London, UK Academic Centre for Defence Mental Health, King's College London, UK School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | | | | | | | | | | |
Collapse
|
37
|
Meyer OL, Zane N. THE INFLUENCE OF RACE AND ETHNICITY IN CLIENTS' EXPERIENCES OF MENTAL HEALTH TREATMENT. JOURNAL OF COMMUNITY PSYCHOLOGY 2013; 41:884-901. [PMID: 25400301 PMCID: PMC4228688 DOI: 10.1002/jcop.21580] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Clinicians and researchers have pointed to the need for culturally sensitive mental health interventions. Yet it has not been determined if the inclusion of cultural elements affects the way mental health clients experience services. This study examined 102 clients who had received mental health treatment from outpatient mental health clinics to investigate whether culturally related elements involving race and ethnicity were important to clients and whether they were related to client satisfaction and perceived treatment outcomes. Ethnic minority clients generally felt that issues regarding race and ethnicity were more important than did White clients. When these elements were considered important but were not included in their care, clients were less satisfied with treatment. Consistent with the notion of cultural responsiveness, these findings provide empirical evidence that culturally relevant aspects of the mental health service experience are salient to ethnic minority clients and can affect how they respond to services.
Collapse
Affiliation(s)
- Oanh L Meyer
- University of CA, San Francisco and University of CA, Davis
| | | |
Collapse
|
38
|
McAndrew LM, D'Andrea E, Lu SE, Abbi B, Yan GW, Engel C, Quigley KS. What pre-deployment and early post-deployment factors predict health function after combat deployment?: a prospective longitudinal study of Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) soldiers. Health Qual Life Outcomes 2013; 11:73. [PMID: 23631419 PMCID: PMC3704953 DOI: 10.1186/1477-7525-11-73] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 04/04/2013] [Indexed: 11/18/2022] Open
Abstract
Background Physical and mental function are strong indicators of disability and mortality. OEF/OIF Veterans returning from deployment have been found to have poorer function than soldiers who have not deployed; however the reasons for this are unknown. Methods A prospective cohort of 790 soldiers was assessed both pre- and immediately after deployment to determine predictors of physical and mental function after war. Results On average, OEF/OIF Veterans showed significant declines in both physical (t=6.65, p<.0001) and mental function (t=7.11, p<.0001). After controlling for pre-deployment function, poorer physical function after deployment was associated with older age, more physical symptoms, blunted systolic blood pressure reactivity and being injured. After controlling for pre-deployment function, poorer mental function after deployment was associated with younger age, lower social desirability, lower social support, greater physical symptoms and greater PTSD symptoms. Conclusions Combat deployment was associated with an immediate decline in both mental and physical function. The relationship of combat deployment to function is complex and influenced by demographic, psychosocial, physiological and experiential factors. Social support and physical symptoms emerged as potentially modifiable factors.
Collapse
Affiliation(s)
- Lisa M McAndrew
- Department of Veterans Affairs, NJ War Related Illness & Injury Study Center, East Orange, NJ 07018, USA.
| | | | | | | | | | | | | |
Collapse
|
39
|
Adolescent social stress does not necessarily lead to a compromised adaptive capacity during adulthood: a study on the consequences of social stress in rats. Neuroscience 2013; 249:258-70. [PMID: 23305766 DOI: 10.1016/j.neuroscience.2012.12.050] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 12/21/2012] [Accepted: 12/28/2012] [Indexed: 11/22/2022]
Abstract
Childhood bullying or social stress in adolescent humans is generally considered to increase the risk of developing behavioral disorders like depression in adulthood. Juveniles are hypothesized to be particularly sensitive to stressors in their environment due to the relatively late maturation of brain areas that are targeted by stress such as the prefrontal cortex and hippocampus. In our study male adolescent rats were subjected to repeated social defeat on postnatal day (PND) 28, 31 and 34 (experiment 1) or to daily social defeats between PND 35 and 42 (experiment 2). Adolescent rats in experiment 1 were socially housed in pairs with a male of similar age during and after the social defeat. In experiment 2 adolescents were housed either alone or with an age-mate for 7 days (PND 35-42) next to either a highly aggressive or a non-aggressive adult male neighbor with whom a repeated physical interaction was allowed. In experiment 1 the adolescent defeats affected subsequent play behavior with the cage mate. Socially stressed rats more frequently initiated play behavior but also adopted more frequently submissive postures during the play fights. As adults, they seemed to cope behaviorally and physiologically better with a similar exposure to a residential aggressive male rat than unstressed controls. In experiment 2 acute effects of adolescent social stress were studied on neuroplasticity markers like hippocampal cell proliferation and neurogenesis as well as hippocampal brain-derived neurotrophic factor (BDNF) levels. The 2nd experiment also studied long-term effects of the adolescent stress in the response to an adult social defeat. A few acute but minor changes in brain plasticity markers and behavior were observed but these were transient and no behavioral or physiological effects persisted into adulthood. The results from both experiments support the theory developed in the so-called "match-mismatch hypothesis" which claims that the final consequence of childhood adversity depends on how well the early life environment matches the challenges in later life. Socially stressed adolescents are rather resilient to the lasting behavioral and physiological effects of the stress exposure if they are socially housed afterward and have the ability to recover.
Collapse
|
40
|
Mahmood MA, Bauze AE, Lokhorst JT, Bi P, Saniotis A. Influence of living arrangements on health services utilisation in Australia. AUST HEALTH REV 2012; 36:34-8. [PMID: 22513017 DOI: 10.1071/ah10920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Accepted: 04/12/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND The number of people living alone is increasing markedly. Others live as couples only, couples with child(ren) and single adult with child(ren). Health service utilisation could differ for people in different living arrangements as a result of varying levels of risk factors, health status, access to informal care and decision-making for accessing care. OBJECTIVE To identify the association between living arrangements and health service use. METHODS The Australian Bureau of Statistics' National Health Survey 2001 data for people 18-65 years old were analysed for household composition and service use. RESULTS People in various household types differ in terms of their overall use of health services and their use of services by general practitioners. Sex, rurality, socioeconomic status and status of heart condition significantly influenced the use of health services. CONCLUSION There are implications for health services provision and planning within the context of rapid changes in living arrangements. Additional research is required to explore the reasons to such differences, level of access to informal care, healthcare decision-making processes and consequences of under- or over-utilisation of services.
Collapse
|
41
|
Abstract
OBJECTIVE To investigate the association between US Navy individual augmentee (IA) deployers, who may lack the protective effects of unit cohesion and social support, and newly reported mental health. METHODS Responses from the Millennium Cohort Study questionnaires were examined for 2086 Navy deployers in this prospective exploratory study. Multivariable logistic regression was used to evaluate IA deployment and newly reported mental health symptoms. RESULTS After adjusting for covariates, IA deployment was not significantly associated with newly reported posttraumatic stress disorder (odds ratio = 1.02; 95% confidence interval: 0.53-1.95) or mental health symptoms (odds ratio = 1.03; 95% confidence interval: 0.66-1.60) compared with non-IA deployment. CONCLUSION IA deployment was not associated with increased risk for posttraumatic stress disorder or mental health symptoms following deployment. It is likely that social isolation was not highly influential among Navy IAs in this study.
Collapse
|
42
|
Cao Y, Hwang SS, Xi J. Project-induced displacement, secondary stressors, and health. Soc Sci Med 2012; 74:1130-8. [PMID: 22341203 DOI: 10.1016/j.socscimed.2011.12.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 11/15/2011] [Accepted: 12/14/2011] [Indexed: 11/19/2022]
Abstract
It has been estimated that about 15 million people are displaced by development projects around the world each year. Despite the magnitude of people affected, research on the health and other impacts of project-induced displacement is rare. This study extends existing knowledge by exploring the short-term health impact of a large scale population displacement resulting from China's Three Gorges Dam Project. The study is theoretically guided by the stress process model, but we supplement it with Cernea's impoverishment risks and reconstruction (IRR) model widely used in displacement literature. Our panel analysis indicates that the displacement is associated positively with relocatees' depression level, and negatively with their self-rated health measured against a control group. In addition, a path analysis suggests that displacement also affects depression and self-rated health indirectly by changing social integration, socioeconomic status, and community resources. The importance of social integration as a protective mechanism, a factor that has been overlooked in past studies of population displacement, is highlighted in this study.
Collapse
Affiliation(s)
- Yue Cao
- Medical University of South Carolina, Charleston, SC, USA.
| | | | | |
Collapse
|
43
|
Van Der Lugt CMC, Rollman A, Naeije M, Lobbezoo F, Visscher CM. Social support in chronic pain: development and preliminary psychometric assessment of a new instrument. J Oral Rehabil 2011; 39:270-6. [PMID: 22115492 DOI: 10.1111/j.1365-2842.2011.02269.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Satisfaction with social support (pain-relevant social support) may influence pain experience and behaviour in patients with chronic pain. Prior studies on measurement of social support, however, have been limited by the use of general, rather than of pain-specific assessment instruments. In this study, a new pain-relevant social support instrument, the Social support and Pain Questionnaire (SPQ), is presented together with an evaluation of its psychometric properties. A literature search was performed to establish different aspects of social support. For each of the six aspects found, one item was selected for inclusion in the new questionnaire. The draft version of the questionnaire was field tested. Thereafter, the psychometric properties of the SPQ were assessed in 250 patients with oro-facial pain. Principal component analysis (n=250) showed that the SPQ had a one-factor structure. The test-retest reliability of the SPQ (in a subsample of 54 patients) was fair-to-good (R=0·70; P<0·000). Convergent validity, as compared with a non-specific social support instrument, was good (n=140; R=0·54; P<0·000). The SPQ is a valid and reliable instrument, which offers the possibility to explore the patient's satisfaction with pain-related social support. With the SPQ, a useful tool to assess the influence of social support in patients with various types of pain is provided.
Collapse
Affiliation(s)
- C M C Van Der Lugt
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute MOVE, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | | | | | | | | |
Collapse
|
44
|
Amstadter AB, McCauley JL, Ruggiero KJ, Resnick HS, Kilpatrick DG. Self-rated health in relation to rape and mental health disorders in a national sample of women. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2011; 81:202-210. [PMID: 21486262 DOI: 10.1111/j.1939-0025.2011.01089.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Overall health status is associated with long-term physical morbidity and mortality. Existing research on the correlates of mental health effects of rape suggests that rape victims are at higher risk for poor overall health status. Little is known, however, about how different rape tactics may relate to health status in rape victims. Our aim was to examine prevalence and correlates of self-rated health in a community sample of women, with particular emphasis on lifetime rape history (distinguishing between rape tactics), psychopathology, and substance use outcomes. A nationally representative sample of 3,001 U.S. women (age range: 18-86 years) residing in households with a telephone participated in a structured telephone interview. Poor self-rated health was endorsed by 11.4% of the sample. Final multivariable models showed that poor self-rated health was associated with older age (p<.001), lower educational attainment (p=.01), African American ethnicity (p=.03), lifetime posttraumatic stress disorder (PTSD; p<.001), lifetime major depressive episode (MDE; p=.01), and history of forcible rape (p=.01). Self-rated health was associated with three potentially modifiable variables (forcible rape, PTSD, and MDE). Therefore, trauma-focused interventions for rape victims should include collaboration on treatment or prevention modules that specifically address both mental and physical health.
Collapse
Affiliation(s)
- Ananda B Amstadter
- National Crime Victims Research and Treatment Center, Medical University of South Carolina, USA.
| | | | | | | | | |
Collapse
|
45
|
Murray JA. LOSS AS A UNIVERSAL CONCEPT: A REVIEW OF THE LITERATURE TO IDENTIFY COMMON ASPECTS OF LOSS IN DIVERSE SITUATIONS. JOURNAL OF LOSS & TRAUMA 2011. [DOI: 10.1080/108114401753201679] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
46
|
Zinzow HM, Amstadter AB, McCauley JL, Ruggiero KJ, Resnick HS, Kilpatrick DG. Self-rated health in relation to rape and mental health disorders in a national sample of college women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2011; 59:588-94. [PMID: 21823953 PMCID: PMC3206265 DOI: 10.1080/07448481.2010.520175] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. PARTICIPANTS A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. METHODS Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. RESULTS Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). CONCLUSIONS These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.
Collapse
Affiliation(s)
- Heidi M Zinzow
- Department of Psychology, Clemson University, Clemson, South Carolina 29634, USA.
| | | | | | | | | | | |
Collapse
|
47
|
Prevalence and correlates of poor self-rated health in the United States: the national elder mistreatment study. Am J Geriatr Psychiatry 2010; 18:615-23. [PMID: 20220579 PMCID: PMC2893408 DOI: 10.1097/jgp.0b013e3181ca7ef2] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Despite its subjective nature, self-report of health status is strongly correlated with long-term physical morbidity and mortality. Among the most reliable predictors of self-reported poor health is older age. In younger adult populations, the second reliable predictor of reported poor health is the experience of domestic and other interpersonal violence. However, very little research exits on the connection between elder mistreatment and self-reports of poor health. The aim of this study was to examine the level of, and correlates for, poor self-rated health in a community sample of older adults with particular emphasis on elder mistreatment history, demographics, and social dependency variables. DESIGN Random digit dialing telephone survey methodology. SETTING A national representative phone survey of noninstitutionalized U.S. household population. PARTICIPANTS Five thousand seven hundred seventy-seven U.S. adults, aged 60 years and older. MEASUREMENTS Individuals participated in a structured interview assessing elder mistreatment history, demographics, and social dependency variables. RESULTS Poor self-rated health was endorsed by 22.3% of the sample. Final multivariable logistic regression models showed that poor self-rated health was associated with unemployment, marital status, low income, low social support, use of social services, needing help in activities of daily living, and being bothered by emotional problems. Secondary analyses revealed a mediational role of emotional symptoms in the association between physical maltreatment and poor health. CONCLUSIONS Results suggest that poor health is common among older adults. This study also identified correlates of poor health that may be useful in identification of those in need of intervention.
Collapse
|
48
|
Coventry WL, Medland SE, Wray NR, Thorsteinsson EB, Heath AC, Byrne B. Phenotypic and discordant-monozygotic analyses of stress and perceived social support as antecedents to or sequelae of risk for depression. Twin Res Hum Genet 2010; 12:469-88. [PMID: 19803775 DOI: 10.1375/twin.12.5.469] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The associations between social support and depression, and between stress and depression have been the subject of considerable research, and although this has included longitudinal designs, these have rarely controlled for genetic effects that mediate these associations. The sample comprised 7,356 female and 4,882 male participants aged 18-95 from the Australian NHMRC Twin Registry (ATR). Of these, between 100 and 324 female pairs and between 41 and 169 male pairs, depending on the measure, were monozygotic (MZ) pairs discordant for depression. We use the co-twin control design in combination with prospective analyses to explore the association between a composite of predictors (perceived social support, stress, and support x stress) and depression. With familial effects included, both perceived support and stress were antecedents to, and sequelae of, depression, but no stress-buffering occurred. With familial effects controlled, stress was a sequela of a prior depressive episode, and neither lack of support nor stress were antecedents to depression, though their interaction approached significance for males. The male twin who later became depressed had previously reported lower perceived support in the face of multiple stressors compared to his co-twin who did not become depressed. We show that associations commonly observed with prospective designs are partly due to familial factors.
Collapse
Affiliation(s)
- William L Coventry
- School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, Australia.
| | | | | | | | | | | |
Collapse
|
49
|
Smith-Osborne A. Mental health risk and social ecological variables associated with educational attainment for gulf war veterans: implications for veterans returning to civilian life. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2009; 44:327-337. [PMID: 19838786 DOI: 10.1007/s10464-009-9278-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study examines how post-secondary educational attainment among young veterans of the first gulf war affects their mental health status. The all-volunteer military attracts recruits by offering them veterans' educational benefits. Education should help veterans adjust to civilian life. Few studies have shown whether education following military service helps improve veterans' mental health, however. Viewing resiliency, life span and life course, and social geography theories through the lens of social ecology, it is hypothesized that selected contextual factors in the personal, interpersonal, and organizational domains could mediate or moderate the relationship between education and veterans' mental health. Informational social networks showed an association with obtaining mental illness treatment. Recent treatment for post-traumatic stress disorder (PTSD) showed an association with use of veterans' educational benefits. Residing with a small nuclear family in conjunction with having higher levels of health and educational benefits and a higher family income was associated with higher educational attainment.
Collapse
Affiliation(s)
- Alexa Smith-Osborne
- University of Texas at Arlington, 211 S. Cooper Street, Box 19129, Arlington, Texas 76019-0129, USA.
| |
Collapse
|
50
|
Okamoto K, Harasawa Y. Emotional support from family members and subjective health in caregivers of the frail elderly at home in Japan. Arch Gerontol Geriatr 2009; 49:138-41. [DOI: 10.1016/j.archger.2008.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Revised: 05/30/2008] [Accepted: 06/03/2008] [Indexed: 10/21/2022]
|