Kiran Rao

The Social Occupational Functioning Scale (SOFS): A brief measure of functional status in persons with schizophrenia

The social functioning of persons with schizophrenia contributes to their overall functional outcome and ability to live in the community. Enhancing the level of social functioning is an important treatment goal. The present study describes the development of the Social Occupational Functioning Scale (SOFS), a brief, yet comprehensive, easy to administer measure of social functioning for use in busy clinical settings. It has adequate psychometric properties in terms of reliability and validity. Exploratory factor analysis revealed a three-factor structure comprising of adaptive living skills, social appropriateness and interpersonal skills, accounting for 59% of the variance in total SOFS score.

Coping and Subjective Wellbeing in Women with Multiple Roles

Background: Married, working women experience a considerable amount of strain from their multiple roles. At the same time, studies indicate that they enjoy a high level of wellbeing. While the nature of employment and the level of spousal support have been examined in relation to wellbeing, the role of coping styles has not received much attention. Aim: To examine the role of work-related factors, availability of support and coping styles as predictors of wellbeing. Method: Sixty married, working women were individually interviewed with regard to reasons for employment and support availability, and administered the Coping Checklist and Subjective Wellbeing Inventory. Results: On stepwise multiple regression analysis, greater use of social support seeking and less use of denial as coping styles, absence of multiple role strain, working to be financially independent, availability of support and refusal of job promotion were significant predictors of wellbeing. Conclusion: In working women with multiple roles, enhancing problem and emotion focused coping by strengthening the use of the support network is important for wellbeing.

Validation of Social Cognition Rating Tools in Indian Setting (SOCRATIS): A new test-battery to assess social cognition

Social cognition is a cognitive domain that is under substantial cultural influence. There are no culturally appropriate standardized tools in India to comprehensively test social cognition. This study describes validation of tools for three social cognition constructs: theory of mind, social perception and attributional bias. Theory of mind tests included adaptations of, (a) two first order tasks [Sally-Anne and Smarties task], (b) two second order tasks [Ice cream van and Missing cookies story], (c) two metaphor-irony tasks and (d) the faux pas recognition test. Internal, Personal, and Situational Attributions Questionnaire (IPSAQ) and Social Cue Recognition Test were adapted to assess attributional bias and social perception, respectively. These tests were first modified to suit the Indian cultural context without changing the constructs to be tested. A panel of experts then rated the tests on likert scales as to (1) whether the modified tasks tested the same construct as in the original and (2) whether they were culturally appropriate. The modified tests were then administered to groups of actively symptomatic and remitted schizophrenia patients as well as healthy comparison subjects. All tests of the Social Cognition Rating Tools in Indian Setting had good content validity and known groups validity. In addition, the social cure recognition test in Indian setting had good internal consistency and concurrent validity.

Psychosocial support in disaster-affected communities

The paper outlines psychosocial interventions in providing care and support to disaster-affected communities. Any impact of disaster can be looked at in two ways: firstly by ascertaining the characteristics of the event itself, and secondly, how that event is appraised by those affected. Depending on different phases of the impact of the disaster, individuals will respond in different styles. Psychosocial interventions must be tailored to address the needs of the target population, with special attention paid to vulnerable groups such as children, women and the elderly. These should also be modulated according to the phase of recovery following the event occurrence because each phase will highlight different needs. The four phases of intervention, although determined separately, may show an overlap. In the initial phases, the emphasis is on social intervention that can be delivered by community-level workers. In the later phases, the psychological issues that emerge necessitate the services of trained professionals. Initial social care will need to give way to psychological care, and on occasion both will need to be combined for a considerable period. Since psychosocial care is a long-term, continuous process, disaster management and preparedness programmes must invest in training for capacity building by training community workers and primary care health professionals.

Lessons learnt in mental health and psychosocial care in India after disasters.

Different phases of intervention after any disaster bring with them specific issues that policy-makers as well as healthcare deliverers must take into account. There are some specific issues related to aid with dignity and dead-body identification that need to be taken into account. The human and material resources are important in planning and delivering mental healthcare. In India, with each successive disaster, the immediate response in the rescue and relief phase has improved and the administration is able to mobilize a large amount of resources from different sectors quickly, efficiently and in a co-ordinated manner in the immediate and short-term periods after a disaster. That psychological first aid will reduce psychiatric morbidity is now generally accepted as a key principle in interventions immediately after a disaster. In the recent events, large numbers of community-level volunteers have received short-term training and been able to provide effective psychosocial care and support. The paper presents the authors observations and provides an overview of some of the lessons learnt in mental health and psychosocial support care across the several natural and human-made disasters that have taken place in India. While significant progress has been made with respect to the rescue and relief response, there is still a lot to be achieved in the rehabilitation and rebuilding phases that follow a disaster. Disaster prevention and mitigation need global vision combined with local action. Building capacity through careful planning and training potential workers is an important step. The stakeholders must take into account local cultural and social needs.

Lycanthropy in depression: two case reports.

Two cases of lycanthropy presenting as part of a depressive disorder are described. The patients responded favorably to pharmacotherapy. In both cases, a positive history of dog bite influenced the presentation of symptoms. The authors speculate whether the defense of identification with the aggressor was operative.