Women and autonomy: using structural analysis of social behavior to find autonomy within connections

Antisocial behavioral syndromes and 3-year quality-of-life outcomes in United States adults

OBJECTIVE

To examine 3-year quality-of-life (QOL) outcomes among United States adults with Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) antisocial personality disorder (ASPD), syndromal adult antisocial behavior without conduct disorder (CD) before age 15 [adulthood antisocial behavioral syndrome (AABS), not a DSM-IV diagnosis], or no antisocial behavioral syndrome at baseline.

METHOD

Face-to-face interviews (n = 34 653). Psychiatric disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule - DSM-IV Version. Health-related QOL was assessed using the Short-Form 12-Item Health Survey, version 2 (SF-12v2). Other outcomes included past-year Perceived Stress Scale-4 (PSS-4) scores, employment, receipt of Supplemental Security Income (SSI), welfare, and food stamps, and participation in social relationships.

RESULTS

Antisocial personality disorder and AABS predicted poorer employment, financial dependency, social relationship, and physical health outcomes. Relationships of antisociality to SSI and food stamp receipt and physical health scales were modified by baseline age. Both antisocial syndromes predicted higher PSS-4, AABS predicted lower SF-12v2 Vitality, and ASPD predicted lower SF-12v2 Social Functioning scores in women.

CONCLUSION

Similar prediction of QOL by ASPD and AABS suggests limited utility of requiring CD before age 15 to diagnose ASPD. Findings underscore the need to improve prevention and treatment of antisocial syndromes.

An emerging theory of human relatedness

Theory of human relatedness addresses a pervasive human concern, establishing and maintaining relatedness to others, objects, environments, society and self. This theory, derived from a series of inductive and deductive strategies, views relatedness as a functional, behavioral system rooted in early attachment behaviors. Individuals move through different states of relatedness including connectedness, disconnectedness, parallelism and enmeshment. Social processes that contribute to this movement are sense of belonging, reciprocity, mutuality and synchrony. Disruptions in clients' relatedness contribute to biological, psychological, and social disturbances.

Sense of belonging: a vital mental health concept

Sense of belonging is a concept that has not been researched in psychiatric nursing practice. Using a concept-analysis strategy proposed by Walker and Avant, the authors present a detailed description of the concept that evolved from a series of inductive and deductive strategies. Sense of belonging is defined as the experience of personal involvement in a system or environment so that persons feel themselves to be an integral part of that system or environment. Sense of belonging has important applicability for clinical use as well as continued theory development in psychiatric nursing.