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We examined trajectories of affective balance (AB) among 488 individuals admitted to a metropolitan Level 1 trauma center for serious physical injury. AB was measured prior to hospital discharge, and at three, six, and 12 months post-discharge. Multilevel modeling (MLM) was used to investigate whether initial demographic variables, injury severity, the occurrence of a mild traumatic brain injury (TBI), self-reported resilience and social support predicted AB trajectories. Participants' change in resilience and social support over the 12-month period were also tested as predictors. The results revealed a large amount of between-individual variation in the first year post-injury. Initial resilience, resilience change, initial social support, and social support change predicted AB 1 year later. Changes in resilience and social support predicted the linear growth in AB over time. Demographic and injury-related variables did not significantly predict AB, nor did the diagnosis of a mild TBI. Participants' self-perceived resilience and social support scores changed substantially, for better or worse, over the 12-month period. AB was strongly associated with these changes, even when controlling for initial resilience and social support: Increases in either resilience or social support were significantly associated with increases in AB over time. The final model accounted for 33.2% of the between-individual variance in final scores and 46.9% of the variance in linear growth. These results provide additional evidence of the beneficial effects of existing levels of resilience and social support following traumatic injury, and these characteristics are better predictors of AB than injury severity, basic demographic data, and the presence of a mild head injury. Furthermore, changes that may occur in social support and self-perceived resilience are associated with significant changes in AB, and these factors should be considered in post-discharge plans to facilitate subsequent adjustment. [ABSTRACT FROM AUTHOR]

We studied the predictive impact of proxy 'outsider' reports, injury type, and functional independence on trajectories of happiness over the first 5 years following medical treatment for a traumatic spinal cord injury, brain injury, severe burns or inter-articular fractures (total N = 1,271). It was anticipated that lower functional independence and outsider status would predict lower happiness trajectories, with injury type having little effect over time. A measure of functional impairment and the life satisfaction index containing the items that assessed happiness were administered 12, 24, 48, and 60 months post-discharge. Trajectory modeling revealed that lower functional independence significantly predicted lower happiness, regardless of injury type. Outsider reports predicted significantly higher happiness scores than the insiders reported themselves. These differences persisted across time and injury type. Additional analyses found that insider/outsider status accounted for one percent of the variance in happiness scores and functional independence accounted for twenty percent of the variance. Moreover, for all injury groups, there was no evidence for changes in happiness trajectories over time. Outsider accounts differ significantly from insider estimations of variables of positive adjustment accounts but explain little variation in the reports of happiness overall and still have practical and clinical value as secondary sources of information about positive emotional experiences, particularly when reports from the 'insider' are not possible. [ABSTRACT FROM AUTHOR]

Ulcerative colitis is a common form of inflammatory bowel disease with a complex etiology. As part of the Wellcome Trust Case Control Consortium 2, we performed a genome-wide association scan for ulcerative colitis in 2,361 cases and 5,417 controls. Loci showing evidence of association at P < 1 × 10−5 were followed up by genotyping in an independent set of 2,321 cases and 4,818 controls. We find genome-wide significant evidence of association at three new loci, each containing at least one biologically relevant candidate gene, on chromosomes 20q13 (HNF4A; P = 3.2 × 10−17), 16q22 (CDH1 and CDH3; P = 2.8 × 10−8) and 7q31 (LAMB1; P = 3.0 × 10−8). Of note, CDH1 has recently been associated with susceptibility to colorectal cancer, an established complication of longstanding ulcerative colitis. The new associations suggest that changes in the integrity of the intestinal epithelial barrier may contribute to the pathogenesis of ulcerative colitis. [ABSTRACT FROM AUTHOR]

Cross-sectional, correlational analyses of data from two separate studies were conducted to examine the correlates of adjustment among family caregivers of women with disabilities. Participants included 40 caregivers of women with spinal cord injuries in the first study and 53 caregivers of women with cerebral palsy, traumatic brain injury, and other neuromuscular disabilities in the second study. It was hypothesized that a negative problem-solving style would be associated with greater caregiver distress in both studies, and that caregiver adjustment would be associated with care recipient depression in the second study. As expected, results indicated that a higher negative orientation toward solving problems was associated with caregiver depression and lower well-being. However, in the second study, caregiver characteristics were not associated with care recipient depression. These data indicate that considerable variability exists in caregiver adjustment. Methodological limitations and the implications for research, service, and policy formation are! discussed. [ABSTRACT FROM AUTHOR]

We examined the potentially mediating effects of negative affectivity (NA) on the hope–depression relationship among a sample of postpartum women. We also assessed the social support reported by these women and examined the possible mediating effects of NA on the social support–postpartum depression relationship. Correlational analyses of data obtained from women ( N = 98) who had given birth in the previous 6 months revealed that NA did not mediate either hope or social support in the prediction of postpartum depression. Hope accounted for a significant degree of variance in postpartum depression. These data suggest that hope has palliative effects among women following childbirth and these effects are not nullified or explained by emotional predispositions. [ABSTRACT FROM AUTHOR]

Family members have a considerable impact on the health and well-being of others in the family. The characteristics of family caregivers that relate to care recipients' positive and negative outcomes associated with chronic disease have received scant empirical attention. We reasoned that family caregiver social problem solving abilities would be associated with depression and life satisfaction reported by persons with congestive heart failure (CHF). Correlational analyses found that caregiver negative orientation toward solving problems was significantly predictive of higher depression and with decreased life satisfaction of persons with CHF. These findings indicate that family caregiver problem solving abilities are important factors in adjustment following CHF. Implications for clinical interventions and theoretical models of problem solving are discussed. [ABSTRACT FROM AUTHOR]

Individuals who provide ongoing care for family members who have a chronic disease or disability are likely to encounter a wide array of problems that can compromise their own health and their ability to function effectively in a caregiving role. Structured focus group meetings were conducted to elicit a comprehensive list of the problems that caregivers experienced during their first year of providing care to a person with a severe physical disability. A separate group of caregivers (N = 60) individually sorted problems into piles based on their similarity and assigned relative importance to each problem. The aggregated data were analyzed with multidimensional scaling and hierarchical cluster analysis. Results indicated that caregivers cognitively organize problems along three dimensions: I. Centeredness–caregiver versus patient-oriented; II. Relationship Demands–physical versus emotional; and III. Caregiver Burden–time versus emotional. Additionally, 6 clusters of substantively similar problems were identified and prioritized in terms of personal relevance: Basic Needs (lowest); Perceived Constraints; Caregiver Challenges; Patient Resentment; Patient Withdrawal; and Patient Intrapsychic Adjustment (highest). Further examination of the organization of problems identified by caregivers should provide important insights about the experience of caregivers and how more targeted interventions can be developed to address their specific needs. [ABSTRACT FROM AUTHOR]

Although many persons with spinal cord injuries (SCI) are at risk for preventable complications, very little research has examined the health behaviors of these individuals. In this study, we examined self-reported health behaviors of persons with recent-onset SCI. We also studied the association between health behaviors and social problem-solving abilities. The results indicated that positive problem-solving characteristics were associated with more adaptive wellness and accident prevention behaviors. A negative orientation toward problem solving and avoidant and impulsive/careless styles was associated with increased traffic and substance risk taking. Implications are discussed in terms of health education, research, and prevention programs. [ABSTRACT FROM AUTHOR]

Changes in health care have dramatically curtailed services to people with severe physical disability and their families. This has placed a greater burden of responsibility on those who live with these conditions and have ongoing care needs. Yet little is known about the subjective problems, challenges, and solutions reported by these people. We demonstrate how the nominal group technique can be used to obtain consumer-oriented information germane to these individuals and their concerns. We conducted nominal group technique meetings with 2 groups for persons with physical disability and a third with a group for family members in caregiving roles. We demonstrate how focus groups can be conducted with the nominal group technique to identify problems experienced by individuals who live with severe physical disability. Recommendations for using the nominal group technique with client populations are presented, and implications for clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Although social problem-solving abilities have been consistently associated with indicators of behavioral health, this work has been largely confined to tests of specific theoretical issues. Research has yet to demonstrate how the separate elements of the social problem-solving model relate to different patterns of adjustment, particularly among persons who live with chronic disease. We studied the occurrence of different profiles of social problem-solving abilities observed among persons living with diabetes mellitus. We then examined differences between clusters on measures of life satisfaction and depression. Results indicate that distinct profiles in problem-solving abilities do occur and these groupings can be distinguished by their different patterns of adjustment. Implications for theoretical models of problem solving and clinical assessment and interventions for persons with diabetes are discussed. [ABSTRACT FROM AUTHOR]

The current study employed a case-control design to examine the impact of marital status on adjustment among individuals with spinal cord injury (SCI) 1 year post-injury. Two groups of 53 individuals (i.e., single versus married individuals) were matched case-for-case on age (i.e., within 10 years), education, gender, race, and lesion level. Although not specifically matched, etiology of SCI, and number of rehospitalizations and days rehospitalized during the past year were not significantly different between groups. Outcome measures included the Satisfaction With Life Scale, the Craig Handicap Assessment and Reporting Technique (CHART), and the SF-12. Results indicated that overall self-reported QOL was significantly lower among single individuals as compared to their matched married counterparts. Similarly, self-reported handicap was significantly higher among single individuals, particularly in the areas of social integration and economic self-sufficiency. In contrast, overall physical and mental health were not different across groups. [ABSTRACT FROM AUTHOR]

A consecutive sample of 63 adventitiously blinded American military veterans in a interdisciplinary inpatient rehabilitation program participated in this study examining the relation of hope to self-reported functional ability level. Scores from a modified oral administration of the Hope Scale and the Millon Behavioral Health Inventory basic coping styles were used as predictor variables to test regression-based models of mediation and moderation relations to functional ability level. Results support a mediating role for hope in the relation between a proactive sociable style and perceived level of functional ability. [ABSTRACT FROM AUTHOR]

Recent and dramatic changes in the demand for and reimbursement of psychological services and expertise in health care delivery systems have radical implications for the preparation of psychologists at the predoctoral, internship, and postdoctoral levels. In order to respond to these changes effectively and advance the profession, training programs must realize the expanded and potential role of psychological expertise in evolving health care delivery systems. In this paper, we review several limitations and unfortunate consequences of traditional training programs that have confined the scope of research and practice to the realm of “mental health.” We propose that future psychologists be recognized and trained from a broader perspective as “behavioral scientists,” prepared to operate at the highest levels of health care delivery systems. Specific recommendations for training and education are discussed. [ABSTRACT FROM AUTHOR]

The Coprinus cinereus trp-2 gene which encodes a trifunctional protein of the tryptophan biosynthetic pathway was used to transform a trp-2 mutant of the secondarily homothallic species Coprinus bilanatus. Southern blot analysis confirmed the presence of transforming DNA in the genome of transformants and indicated the presence of tandemly duplicated copies of the plasmid in some of these. Although these two species of Coprinus are regarded as closely related, no cross-hybridisation between the homologous trp-2 genes was detected. [ABSTRACT FROM AUTHOR]