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Background: The changing cannabis legal climate in the United States has been associated with increased prevalence of use, more favorable general attitudes, and cultural norms toward its use among young adults. The purpose of this study was to conceptualize salient beliefs governing illicit cannabis use within a state where medical use is legal and adult use remains illegal. Methods: Following an initial qualitative pilot, a prospective study (baseline and a 30-day follow-up) that utilized an electronic survey design was conducted. Students at a large US university (N = 514) completed a baseline assessment of cannabis use and Theory of Planned Behavior (TPB) constructs, and 169 completed the follow-up assessing actual behavior. Results: Roughly 60% reported illicit cannabis use. Attitude and subjective norms accounted for 57% of the variation in intention for cannabis use in the next 30 days, while intention and perceived behavioral control (PBC) explained 51% of the variation in prospective use. The majority of salient beliefs identified exhibited moderate to strong correlations with intention and behavior among the larger sample. Close friends and partners were identified as important referents, outcome expectations of relaxation, improved social functioning, and more enjoyment, as well as environmental factors, such as proximity to use, safe utilization location, and continued illegality of adult use exhibited strong associations to intention and behavior. Conclusions: The practical utility of the salient belief measures identified herein presents a useful foundation for interventions aimed at reducing illicit cannabis utilization among young adults. [ABSTRACT FROM AUTHOR]

Background: This study included evaluation of the effectiveness of vortioxetine, a treatment for adults with major depressive disorder (MDD), using patient-reported outcome measures (PROMs) in a real-world setting. Methods: This retrospective chart review analyzed the care experiences of adult patients with a diagnosis of MDD from Parkview Physicians Group – Mind-Body Medicine, Midwestern United States. Patients with a prescription for vortioxetine, an initial baseline visit, and ≥ 2 follow-up visits within 16 weeks from September 2014 to December 2018 were included. The primary outcome measure was effectiveness of vortioxetine on depression severity as assessed by change in Patient Health Questionnaire-9 (PHQ-9) scores ~ 12 weeks after initiation of vortioxetine. Secondary outcomes included changes in depression-related symptoms (i.e., sexual dysfunction, sleep disturbance, cognitive function, work/social function), clinical characteristics, response, remission, and medication persistence. Clinical narrative notes were also analyzed to examine sleep disturbance, sexual dysfunction, appetite, absenteeism, and presenteeism. All outcomes were examined at index (start of vortioxetine) and at ~ 12 weeks, and mean differences were analyzed using pairwise t tests. Results: A total of 1242 patients with MDD met inclusion criteria, and 63.9% of these patients had ≥ 3 psychiatric diagnoses and 65.9% were taking ≥ 3 medications. PHQ-9 mean scores decreased significantly from baseline to week 12 (14.15 ± 5.8 to 9.62 ± 6.03, respectively; p < 0.001). At week 12, the response and remission rates in all patients were 31.0% and 23.1%, respectively, and 67% continued vortioxetine treatment. Overall, results also showed significant improvements by week 12 in anxiety (p < 0.001), sexual dysfunction (p < 0.01), sleep disturbance (p < 0.01), cognitive function (p < 0.001), work/social functioning (p = 0.021), and appetite (p < 0.001). A significant decrease in presenteeism was observed at week 12 (p < 0.001); however, no significant change was observed in absenteeism (p = 0.466). Conclusions: Using PROMs, our study results suggest that adults with MDD prescribed vortioxetine showed improvement in depressive symptoms in the context of a real-world clinical practice setting. These patients had multiple comorbid psychiatric and physical diagnoses and multiple previous antidepressant treatments had failed. [ABSTRACT FROM AUTHOR]

People with schizophrenia often experience impaired social functioning and low satisfaction with relationships. Existing measures of social impairment in schizophrenia primarily assess pleasure derived from social interactions, rather than examining impairments in social motivation, including effortful behavior. We conducted a validation study of a recently developed self-report measure of social effort in 31 participants with schizophrenia spectrum disorders, including tests of association with standard assessments of social functioning and behavior in daily life using ecological momentary assessment (EMA). We also assessed predictive validity of the scale, measuring the extent to which social effort at baseline predicted changes in social functioning over a 60-day smartphone-based social intervention. Higher social effort was associated with greater social functioning and lower negative symptom severity at baseline. Baseline social effort did not predict changes in social functioning over the intervention period, nor was it related to EMA-reported social experiences. Thus, tendencies toward social effort exertion may capture meaningful variance in gold-standard assessments of social functioning and negative symptoms, but may not track with social experiences in daily life. Further research should examine whether social effort is sensitive to change, and evaluate the utility of targeting social effort in evidence-based interventions for improving the social functioning in schizophrenia. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study is to describe the extent to which students with ADHD received school-based intervention services and identify demographic, diagnostic, and impairment-related variables that are associated with service receipt in a large, nationally drawn sample. Method: Parent-reported data were obtained for 2,495 children with ADHD aged 4 to 17 years from the National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA). Results: The majority (69.3%) of students with ADHD currently receive one or more school services. Educational support (62.3%) was nearly twice as prevalent as classroom behavior management (32.0%). More than 3 times as many students with ADHD had an individualized education program (IEP; 42.9%) as a Section 504 plan (13.6%). Conclusion: At least one in five students with ADHD do not receive school services despite experiencing significant academic and social impairment, a gap that is particularly evident for adolescents and youth from non-English-speaking and/or lower income families. [ABSTRACT FROM AUTHOR]

Background: The impact of culture on insight on illness and attitudes towards medication among patients with schizophrenia has not been well studied. We compared inpatients in the US and in China (a culture that numerous studies have shown heavily stigmatizes mental illness and psychosis), on measures of insight and acceptance of medication, controlling for overall severity of schizophrenia symptoms. Methods: Clinical antipsychotic treatment for intervention effectiveness (CATIE) was a large study of pharmacotherapy of people with schizophrenia across the US. Insight was measured using the insight and treatment attitudes questionnaire (ITAQ) and attitudes towards medication by the drug attitude inventory (DAI) and symptoms of schizophrenia by the Positive and Negative Syndrome Scale (PANSS). These measures were applied to a sample of hospitalized patients diagnosed with schizophrenia at the Guangzhou Psychiatric hospital, the largest psychiatric hospital in Southern China. Mean ITAQ and DAI scores, net of total schizophrenia symptoms and other differences were compared at the time of admission using analysis of covariance. Results: Both insight and favourable attitudes towards medication were significantly and substantially lower in the sample from Guangzhou on bivariate analysis even after adjusting for severity of overall schizophrenia symptoms on the PANSS. Conclusion: Inpatients in China had far lower scores on measures of insight and acceptance of their need for and benefits of medication, controlling for overall severity of schizophrenia symptoms, suggesting a significant impact of Chinese culture which is presumed to more heavily stigmatize mental illness and especially psychosis, although other explanations can not be ruled out. [ABSTRACT FROM AUTHOR]

The purpose of this study is to establish the psychometric properties of a noncommercial, publicly available, modular screening and assessment system for adolescents in substance abuse treatment. Data were collected in 2011-2012 from 1,189 adolescents admitted to eight residential treatment programs in urban and rural locations in the United States. Results from three sets of analyses documented the instruments to be reliable. Females reported more problems than males, and younger adolescents reported more problems than older youth. Implications and limitations are discussed, and suggestions for future research are provided. [ABSTRACT FROM AUTHOR]

Purpose: According to the World Health Organization, quality of life (QOL) includes physical and mental health, emotional well-being, and social functioning. Using an adaptation of Andersen's behavioral model, we examined the associations between the three dimensions of QOL and needs and health behaviors in a nationally representative sample of adults 65 years and older. Methods: A representative sample from the 2005-2006 National Health and Nutrition Examination Survey (NHANES) was used. NHANES over-samples persons 60 years and older, African Americans, and Hispanics. Frequencies and distribution patterns were assessed, followed by bivariate and multiple regression analyses. Results: These older adults reported high levels of QOL. However, associations between needs and health behaviors and QOL varied across dimensions. Activities of daily living (ADL) were associated with all three dimensions. Depression was associated with two dimensions and memory problems with one dimension. Physical activity was linked to social functioning, and health care utilization was linked to emotional well-being. Conclusions: The differences in associations with different dimensions of QOL confirm that this is a multidimensional concept. Since depression, memory problems, and ADL function were all associated with some dimension of QOL, future interventions to improve QOL in older adults should include screening and treatment for these problems. [ABSTRACT FROM AUTHOR]

Schizophrenia-related impairments impact functional status and health-related quality of life. The Social Integration Survey (SIS) measures social functioning outcomes in schizophrenia from patient and informant perspectives. A total of 129 patient/informant dyads at eight US sites participated. Patients were at least 18 years old, with schizophrenia or schizoaffective disorder for 1 year or more, residing in the community. Informants were at least 21 years old, cared for patient at least 1 month, with contact at least twice weekly. The SIS, PSP, PETiT, QLS, CGI-S, and PANSS were completed. Individual item performance, subscale development, reliability, and validity were examined. Items were easily understood and responses well-distributed for patients and informants. Four of five subscales identified were internally consistent (alphas ≥0.68) and stable over time. Inter-rater reliability was low. SIS scores were not strongly correlated with other measures, except PETiT Quality of Life. The SIS differentiated on social functioning at varying levels of symptom severity ( P < 0.05). Patient and informant-completed versions showed adequate internal consistency, test–retest reliability, and discriminant validity. Lack of correspondence between patient and informant responses and construct validity require further examination. Work-related items were inapplicable for most patients, but would be for those with higher functioning. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of depressed mood in institutionalized schizophrenia patients and its association with illness-related and functional variables. Methods: Out of 657 institutionalized schizophrenia patients, patients with depressed mood were identified and compared to non-depressed patients, matching for potential confounders. Results: Forty-eight (7.3%) patients had moderate to severe depressed mood. They were younger, more educated and had fewer years since their first hospitalization than non-depressed patients. After matching for these variables, depressed patients showed more positive symptoms and exhibited better social and cognitive functioning. When controlling for negative symptoms, the differences in social and cognitive functioning between the depressed and non-depressed patients disappeared, and depressed patients showed more positive symptoms and more impaired impulse control. Conclusions: Unlike the negative impact of depressed mood in other populations, this study shows that symptoms of depressed mood may identify a subgroup of institutionalized schizophrenia patients who show better functioning across a variety of indicators. Future studies should determine differential treatment responses and long-term outcomes of these patients. [ABSTRACT FROM AUTHOR]

This study investigated the social adjustment of female family members and significant others (FSOs) of illicit drug users in order to gain insight into the impact of drug use upon those close to the user. Using the Social Adjustment Scale-Self Report (SAS-SR), we examined the social adjustment self-ratings (overall and in seven specific role areas) of 41 female partners and 24 mothers of drug users. We compared these ratings to the ratings they reported for their drug-using partners or children, to each other, and to self-ratings drawn from community comparison samples. As expected, results showed that the female FSOs reported significantly better social adjustment than the drug users in most role areas. However, their social adjustment was compromised relative to the community samples. Partners of drug users reported poorer adjustment than parents of drug users overall and in the specific areas of marital and economic functioning. Further inquiry is needed to improve our understanding of the impact of drug use on the users'' family members. [ABSTRACT FROM AUTHOR]

Classroom quality throughout three Head Start programs in the southeastern United States was monitored. A random sample of classrooms was selected to represent high and low quality classrooms in urban and rural settings. Parents and teachers rated the social behaviors of 328 children who were nested within 40 classrooms. Maternal depression was associated with parent reports of fewer positive social behaviors and more problem behaviors. Parent-reported home violence was associated with fewer disruptive behaviors as reported by the teacher. Higher quality classrooms tended to have lower scores on a parent-reported measure of children's problem behaviors. Teachers who interacted less positively with children tended to rate the children in their classrooms as more compliant. The teacher's ability to individualize instruction tended to moderate the association between the child's age and prosocial behaviors while also moderating the association between maternal depression and parents' reports of their children's problem behaviors. [ABSTRACT FROM AUTHOR]

This article describes the findings of an exploratory study of six working class Gay/Bisexual Latino men residing in the United States. The author provides a description of the social, environmental, and cultural context relevant to understanding social functioning and sexual identity development issues faced by working class Gay/Bisexual Latino men. A list of recommendations provides a basis for the development and delivery of culturally competent human services to this population. [ABSTRACT FROM AUTHOR]

Difficulty using reparative behaviors (i.e., prosocial behaviors that individuals use after they have transgressed to cause another's distress) has been concurrently associated with poorer social functioning and both internalizing and externalizing disorders in children and adults. Despite these associations, no study has examined social and psychological outcomes of children who display consistently low levels of reparative behaviors across childhood. This study used established developmental trajectories of reparative behaviors that span preschool through early adolescence (low-stable, moderate-stable, and high-stable) to predict social and psychological outcomes in adolescence (N = 129). Membership in trajectories characterized by lower levels of reparative behaviors predicted greater social rejection, social withdrawal, aggression, and symptoms of depression in adolescence, even when controlling for baseline levels of each outcome. Membership in the low-stable reparative trajectory also significantly mediated the relationship between high levels of guilt in preschool and greater depression severity in adolescence. Findings suggest that children who display persistently low levels of reparative behaviors may be at-risk for a variety of poorer social and emotional outcomes. Further, preschoolers who display both high levels of guilt and low levels of reparative behaviors may be at particularly high risk for depression recurrence in adolescence. Thus, interventions that teach young children reparative skills and/or promote approach rather than avoidance after transgressions may have important implications for preventing a wide range of poorer social and emotional outcomes in adolescence.

Children with Tourette syndrome often have behavioral and social difficulties, which may be associated with co-occurring mental, emotional, or behavioral disorders. This study investigated social competence, including behavioral problems and social skills, and social activities between children with and without Tourette syndrome using a nationally representative sample. In the 2007 National Survey of Children's Health, parents reported on health care provider diagnosis of Tourette syndrome, co-occurring mental, emotional, or behavioral disorders, and indicators of social competence. Children aged 6-17 years with and without Tourette syndrome were compared. Most (78.7%) children with Tourette syndrome had a co-occurring mental, emotional, or behavioral disorder. Children with Tourette syndrome had significantly lower social competence, exhibited by higher levels of behavior problems (mean score 11.6 for Tourette syndrome and 9.0 for no Tourette syndrome) and lower levels of social skills (mean 15.3) than children without a Tourette syndrome diagnosis (mean 17.1); however, these associations were no longer significant after controlling for co-occurring mental, emotional, or behavioral disorders. Moderate to severe Tourette syndrome was associated with the highest ratings of behavioral problems and the lowest ratings of social skills. Children with and without Tourette syndrome were equally likely to participate in social activities; the difference for children with moderate to severe Tourette syndrome being less likely to participate in activities compared to children with mild Tourette syndrome had a chi-square test P value of .05. In conclusion, Tourette syndrome was associated with lower social competence, particularly for children with moderate to severe Tourette syndrome. Monitoring social functioning and co-occurring conditions among children with Tourette syndrome, and referral for evidence-based interventions when needed, may benefit overall health and functioning.