Karen Wohlheiter

Obesity among individuals with serious mental illness

Objective:  To study the distribution and correlates of body mass index (BMI) among individuals with serious mental illness.

Effects of Videogame Distraction and a Virtual Reality Type Head-Mounted Display Helmet on Cold Pressor Pain in Young Elementary School-Aged Children

OBJECTIVE This study examined the effects of videogame distraction and a virtual reality (VR) type head-mounted display helmet for children undergoing cold pressor pain. METHODS Fifty children between the ages of 6 and 10 years underwent a baseline cold pressor trial followed by two cold pressor trials in which interactive videogame distraction was delivered via a VR helmet or without a VR helmet in counterbalanced order. RESULTS As expected, children demonstrated significant improvements in pain threshold and pain tolerance during both distraction conditions. However, the two distraction conditions did not differ in effectiveness. CONCLUSIONS Using the VR helmet did not result in improved pain tolerance over and above the effects of interactive videogame distraction without VR technology. Clinical implications and possible developmental differences in elementary school-aged childrens ability to use VR technology are discussed.

Quality of Life in Individuals With Serious Mental Illness and Type 2 Diabetes

Diabetes is a pervasive metabolic disease that disproportionately affects persons with serious mental illness. The authors studied the effect of diabetes on quality of life in a sample of 369 adult outpatients with schizophrenia or major mood disorder, 201 of whom had type 2 diabetes. Patients with diabetes reported greater impairment in both physical and mental-health quality of life than those without diabetes. The diabetes patients also reported less satisfaction with health but not with other life domains. Medical providers need to be attentive to the burden of disease experienced by patients with both serious mental illness and diabetes.

Consumer satisfaction with inpatient psychiatric treatment among persons with severe mental illness

Consumer satisfaction with inpatient care is an important component of quality of care and a recovery-oriented system of care. This study assessed association of patient, demographic and process of care variables with inpatient satisfaction focusing on modifiable service delivery factors. Participants were 136 people with psychotic or affective disorders recruited from VA inpatient units who were interviewed with an extensive assessment. Staff teaching efforts regarding medication, illness management, substance abuse, outpatient treatment and living skills were significantly associated with greater levels of satisfaction with care, controlling for demographic and clinical variables. This may reflect value consumers place on staff time, attention and communication. Teaching may enhance self-efficacy and hope thereby facilitating recovery.

The Effects of Interactive and Passive Distraction on Cold Pressor Pain in Preschool-aged Children

OBJECTIVE Using a mixed model design, this study examined the effects of interactive versus passive distraction on healthy preschool-aged childrens cold pressor pain tolerance. METHODS Sixty-one children aged 3-5 years were randomly assigned to one of the following: interactive distraction, passive distraction, or no distraction control. Participants underwent a baseline cold pressor trial followed by interactive distraction trial, passive distraction trial, or second baseline trial. One or two additional trials followed. Children originally assigned to distraction received the alternate distraction intervention. Controls participated in both interactive and passive distraction trials in counterbalanced order. RESULTS Participants showed significantly higher pain tolerance during both interactive and passive distraction relative to baseline. The two distraction conditions did not differ. CONCLUSIONS Interactive and passive video game distraction appear to be effective for preschool-aged children during laboratory pain exposure. Future studies should examine whether more extensive training would enhance effects of interactive video game distraction.

Interactive Versus Passive Distraction for Acute Pain Management in Young Children: The Role of Selective Attention and Development

OBJECTIVE To examine whether age and developmental differences in selective attention influence young childrens differential responses to interactive and passive distraction. METHODS 65 3- to 6-year-old children underwent three cold-pressor trials while receiving no intervention, playing a video game (interactive distraction), or watching a video game (passive distraction). In addition, children completed a test of selective attention, and parents completed ratings of attention. RESULTS Consistent with neurocognitive models of pain, children benefited more from interactive distraction than from passive distraction. Although older children demonstrated superior pain tolerance overall, age and selective attention skills did not moderate childrens responses to the distraction intervention. CONCLUSIONS These findings suggest that younger preschoolers can benefit from interactive distraction to manage acute pain, provided that the distraction activity is developmentally appropriate. Research is needed to determine whether developmental issues are more important moderators of childrens responses to distraction when faced with more challenging task demands.

Correlates of religious service attendance and contact with religious leaders among persons with Co-occurring serious mental illness and type 2 diabetes

The purpose of this study was to examine the prevalence and correlates of religious participation among persons with co-occurring serious mental illness and type 2 diabetes. Among 201 outpatients, 53% attended religious services, 36% had regular contact with a religious leader, and 15% received assistance from a religious leader. Persons with schizophrenia and African Americans were more likely to attend services and have contact with religious leaders. Both attendance at religious services and regular contact with a religious leader were linked to higher quality of life in selected domains, but not associated with global health ratings or glycosylated hemoglobin (HbA1c) levels. Results indicate that there are important diagnostic and racial differences in religious participation, and that religious participation may be a resilience factor that supports enhanced quality of life for persons with serious mental illness and diabetes.

Predictors of quality of life in type 2 diabetes patients with schizophrenia, major mood disorder, and without mental illness.

PurposeThe aim of the current study is to compare the predictors of health-related quality of life in individuals with schizophrenia, major mood disorder, and no mental illness, all with type 2 diabetes.MethodsA total of 100 individuals with schizophrenia, 101 with a major mood disorder, and 99 without mental illness, all with type 2 diabetes, rated their health-related quality of life on the Medical Outcomes Survey, Short Form-12; physical and mental composite scores (PCS and MCS) were calculated. We performed a hierarchical multiple regression on PCS and MCS in each sample starting with a basic set of predictors and then adding diabetes-related variables. We compared the regression weights and incremental variance explained within each group.ResultsThe number of co-occurring medical conditions was significantly associated with lower PCS in all three groups and with lower MCS in the no mental illness group. Diabetes-related variables added significant incremental variance to the prediction of PCS in the no mental illness group but not in either psychiatric group.ConclusionsFor persons with diabetes and mental illness, as well as with no mental illness, additional medical conditions exert a strong effect on physical well-being. The impact on quality of life of diabetes-related factors may be lower in persons with diabetes and serious mental illness compared to those with diabetes and no mental illness.