Psychosocial assessments with adults

The chapter covers the psychosocial assessment in detail, giving an approach to complex areas such as early life experiences and memories of sexual abuse. Advice is given on how to assess personality, including how to gain collateral history and navigate issues of negative judgement relating to personality disorder as well as issues to do with the separation of personality disorder from normality. The chapter aims to increase doctors’ confidence with how to assess family relationships, structures, and cycles and how to hold family interviews. A scheme for supplanting and extending information about the social state of the patient is given, including information on carers. The chapter ends by considering culture in psychiatric assessment and gives practical advice on enhancing communication and avoiding pitfalls in history taking and mental state examination across culture and on achieving cultural formulations..

Author(s):  
Bruce S. McEwen

The response to the social and physical environment involves two-way communication between the brain and the body and epigenetic adaptation (‘allostasis’) via mediators of the cardiovascular, immune, metabolic, neuroendocrine, and neural mechanisms. Chronic stress causes wear and tear on the brain and body (‘allostatic load and overload’), reflecting also the impact of health-damaging behaviours and lasting effects of early life experiences interacting with genetic predispositions. Hormonal and other mediators of allostasis promote adaptation in the short run but cause allostatic load/overload when they are overused or dysregulated. The brain is key because it determines what is threatening and the physiological and behavioural responses, while showing structural remodelling that affects its function. Besides pharmaceuticals, there are ‘top–down’ interventions, like physical activity, that engage ‘the wisdom of the body’ to change itself, as well as the impact of policies of government and business that encourage individuals to manage their own lives and promote increased ‘healthspan’.


2019 ◽  
Vol 35 (2) ◽  
pp. 105-203
Author(s):  
María G. León-Palacios ◽  
Miguel Garrido-Fernández ◽  
Cristina Senín-Calderón ◽  
Salvador Perona-Garcelán ◽  
Paul Gilbert ◽  
...  

Background: The Early Life Experiences Scale (ELES) evaluates the memory of threat and subordination perceived in childhood family relationships based on social rank theory. This scale was adapted to Spanish, its factor structure was tested by cross-validation, and its psychometric properties were explored. Method: 960 subjects participated (863 subjects from the general population and 97 patients). Results: Data confirm the factor structure of the original version by Authors (2003), obtaining a similar model with three factors: submission, threat, and devaluation, which explained 66.31% of the variance. The Spanish version of the ELES was comprised of the same number of items as in the original study and showed adequate indices of validity, internal consistency, retest and combined reliability. Conclusions: The Early Life Experiences Scale (ELES) can be a useful measure for evaluating early life experiences. Its application may be very relevant in studying the relationship between these experiences and psychopathological manifestations in constructing explanatory models.


PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10212
Author(s):  
Esther Ortega-Díaz ◽  
Jonatan García-Campos ◽  
José María Rico-Gomis ◽  
Carlos Cuesta-Moreno ◽  
Antonio Palazón-Bru ◽  
...  

Background A few papers studying healthy, first-degree relatives of people with borderline personality disorder (BPD) have found that this group presents attention and memory problems. However, current research has not analyzed their social cognition. Materials and Methods We designed an age-, gender- and education-level matched case-control study involving 57 people with BPD, 32 of their first-degree relatives, and 57 healthy controls in Spain in 2018–2019. All were assessed for social cognition and functioning using the Movie for Assessment of Social Cognition and the Social Functioning Scale; other potential confounders were also collected (marital status, occupation and household variables). Results There were differences in the social cognition domain of overmentalizing errors, with the BPD group scoring significantly higher than controls; however, there was no significant difference with relatives; in the social functioning domain of family relationships, with the controls showing the highest scores. Social engagement/withdrawal, interpersonal behavior, independence-competence, prosocial activities, full scale and categorization domains showed the same pattern: the BPD group had lower scores than their relatives and the controls. Relatives were significantly different from BPD patients in family relationships, social engagement/withdrawal and interpersonal behavior, as well as on the full Social Functioning Scale (both as a linear and categorical variable). However, only controls showed differences with relatives in family relationships. Conclusions All in all, relatives show similar levels of social cognition and functioning compared with controls, and people with BPD show some alterations in different domains of both social cognition and functioning.


2005 ◽  
Vol 21 (4) ◽  
pp. 216-225 ◽  
Author(s):  
William L. Cook

Abstract. In family systems, it is possible for one to put oneself at risk by eliciting aversive, high-risk behaviors from others ( Cook, Kenny, & Goldstein, 1991 ). Consequently, it is desirable that family assessments should clarify the direction of effects when evaluating family dynamics. In this paper a new method of family assessment will be presented that identifies bidirectional influence processes in family relationships. Based on the Social Relations Model (SRM: Kenny & La Voie, 1984 ), the SRM Family Assessment provides information about the give and take of family dynamics at three levels of analysis: group, individual, and dyad. The method will be briefly illustrated by the assessment of a family from the PIER Program, a randomized clinical trial of an intervention to prevent the onset of psychosis in high-risk young people.


2016 ◽  
Vol 3 (1) ◽  
pp. 5-28
Author(s):  
Efnan Dervişoğlu

Almanya’ya işçi göçü, neden ve sonuçları, sosyal boyutlarıyla ele alınmış; göç ve devamındaki süreçte yaşanan sorunlar, konunun uzmanlarınca dile getirilmiştir. Fakir Baykurt’un Almanya öyküleri, sunduğu gerçekler açısından, sosyal bilimlerin ortaya koyduğu verilerle bağdaşan edebiyat ürünleri arasındadır. Yirmi yılını geçirdiği Almanya’da, göçmen işçilerle ve aileleriyle birlikte olup işçi çocuklarının eğitimine yönelik çalışmalarda bulunan yazarın gözlem ve deneyimlerinin ürünü olan bu öyküler, kaynağını yaşanmışlıktan alır; çalışmanın ilk kısmında, Fakir Baykurt’un yaşamına ve Almanya yıllarına dair bilgi verilmesi, bununla ilişkilidir. Öykülere yansıyan çocuk yaşamı ise çalışmanın asıl konusunu oluşturmaktadır. “Ev ve aile yaşamı”, “Eğitim yaşamı ve sorunları”, “Sosyal çevre, arkadaşlık ilişkileri ve Türk-Alman ayrılığı” ile “İki kültür arasında” alt başlıklarında, Türkiye’den göç eden işçi ailelerinde yetişen çocukların Almanya’daki yaşamları, karşılaştıkları sorunlar, öykülerin sunduğu veriler ışığında değerlendirilmiş; örneklemeye gidilmiştir. Bu öyküler, edebiyatın toplumsal gerçekleri en iyi yansıtan sanat olduğu görüşünü doğrular niteliktedir ve sosyolojik değerlendirmelere açıktır. ENGLISH ABSTRACTMigration and Children in Fakir Baykurt’s stories from GermanyThe migration of workers to Germany has been taken up with its causes, consequences and social dimensions; the migration and the problems encountered in subsequent phases have been stated by experts in the subject. Fakir Baykurt’s stories from Germany, regarding the reality they represent, are among the literary forms that coincide with the facts supplied by social sciences. These stories take their sources from true life experiences as the products of observations and experiences with migrant workers and their families in Germany where the writer has passed twenty years of his life and worked for the education of the worker’s children; therefore information related to Fakir Baykurt’s life and his years in Germany are provided in the first part of the study.  The life of children reflected in the stories constitutes the main theme of the study.  Under  the subtitles of “Family and Home Life”, “Education Life and related issues”, “Social environment, friendships and Turkish-German disparity” and “Amidst two cultures”, the lives in Germany of children who have been  raised in working class  families and  who have immigrated from Turkey are  evaluated under the light of facts provided by the stories and examples are given. These stories appear to confirm that literature is an art that reflects the social reality and is open to sociological assessments.KEYWORDS: Fakir Baykurt; Germany; labor migration; child; story


Author(s):  
Roman Fedorov

The article is devoted to the problem of the social state as one of the fundamental constitutional principles of the state structure of modern developed countries. The course of historical development of philosophical and legal thought on this problem is considered. The idea of a close connection between the concept of the social state and the ideas of utopian socialism of Thomas More and Henri Saint-Simon is put forward. Liberals also made a significant contribution to the development of the idea of the social state, they argued that the ratio of equality and freedom is a key problem for the classical liberal doctrine. It is concluded that the emergence of the theory of the social state for objective reasons was inevitable, since it is due to the historical development of society.


Author(s):  
Svetlana Pirozhok

The relevance of determining the theoretical and methodological determinants of the Robert von Moll’s concept of the social state is due to the need to determine the patterns of evolution of ideas about the state and law, as well as the need to assess the ability to use the potential of the Robert von Moll’s theoretical and legal heritage, his predecessors and contemporaries to identify the optimal model of the social state. Modern Russia attempts to build such state. The proclamation and consolidation of Russia as a social state governed by the rule of law at the constitutional level requires attention both to the experiments carried out in social and legal development, and to the practices of social reform, and also to those ideas that have not yet been embodied. The ideas of European scholars regarding the evolution of the state-legal organization of society in the early modern period, based on which Robert von Mohl (1799–1875) developed original concepts of a social state and a state governed by the rule of law are discussed in the article. An analysis of the state of European political and legal thought and identification of the factors that have a significant impact on the development of Robert von Mohl’s doctrine of a social state governed by the rule of law are the purposes of the scientific article. The methodological basis of the study was the dialectical-materialistic, general scientific (historical, systemic) and special (historical-legal, comparativelegal) methods of legal research. The method of reconstruction and interpretation of legal ideas had great importance. As a result of the study, it was concluded that in the first half of the 19th century in European political and legal thought various approaches was formed to consider the problems of social protection and how to resolve them. The development trend of European political science became the transition from ideas and principles formed in the conditions of police states and enlightened absolutism to the ideas of a state governed by the rule of law (constitutional) that protects the rights and freedoms of a citizen. At the same time, it was a question of the rights and freedoms of only a part of the population: the proletariat growing in number and significance was not always evaluated as an independent social stratum. The axiological principles of state justification have also changed. Rights and utility principle became dominant principles. In the first half of the 19th century the social issue as an independent scientific problem of the European political and legal thought was not posed and not systematically developed. Questions about the social essence of the state, the specifics of the implementation of the state social function, the features of public administration in the new stage of socio-economic development of society predetermined the emergence of the idea of a social state. This idea was comprehensively characterized in the Robert von Mohl’s works. He went down in the history of political and legal thought as founder of the concepts of social and governed by the rule of law state.


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