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Biomedical subjects

A Ostfeld

Publications and source records attributed to A Ostfeld.

24 records · Page 2Linked to original sources
PubMedDate not supplied

Depressions of bereavement.

The clinical significance of the depressions of bereavement is controversial. Although evidence suggests that most of these depressions remit spontaneously, some of them do require professional attention. Using a trained, non-professional screener, a study to screen for depressions of bereavement at 6 and 12 months after loss of a spouse was performed to determine the rate of depression and its characteristics. The relative value of using a dimensional assessment of depression (20-item Center for Epidemiologic Studies Depression [CES-D] Scale) and a structured diagnostic schedule for depression (Structured Clinical Interview for the DSM [SCID]) as telephone screening measures was evaluated. We found that while the CES-D overestimated, the SCID more precisely reflected the true rate of depression as determined in a subsample. The criterion for depression in this analysis was a diagnostic interview by a psychiatrist using DSM-III criteria and the Hamilton Rating Scale for Depression (HRSD). The study confirmed the existing literature on the high rate of depressions at 6 months (32% of bereaved spouses) and 12 months (27% of bereaved spouses) after a loss. These depressions were more common in widows than widowers. Past personal history (PPH) of depression and family history (FH) of depression were common among bereaved spouses, but did not enhance the risk of depression. Most of these depressions lasted considerably longer than 1 month. Anxiety, restlessness, and psychomotor retardation were prominent; melancholia was occasionally observed; and intense grief was associated with the depression.

Adaptation, Psychological↗
PubMedDate not supplied

An epidemiological review of the mortality of bereavement.

Epidemiological literature revealing excess mortality in the newly widowed is reviewed. The risk varies by age and sex. Younger persons and men are at higher risk. There are manifold specific causes of death characterized by conditions manifest in middle and late life. Cause specificity also varies by sex. Methodological problems in this literature are mitigated by application of varied methodology and replication of basic findings. Socioeconomic status and "social" stress are not well controlled as independent variables. Nevertheless, they probably do not explain the large relative risk of mortality among the bereaved. Pathogenetic mechanisms resulting from a loss are probably twofold: physiologic changes associated with the loss response and behavioral changes that comprise health maintenance or chronic disease management. Because of its important as a health problems, as a fundamental human reaction, and as a research strategy for the basic psychosomatic hypothesis, bereavement is a prime target of investigation.

Adult↗
PubMedDate not supplied

Urinary-free cortisol excretion in relation to age in acutely stressed persons with depressive symptoms.

We examined the relationship between age and urinary excretion of free cortisol in acutely stressed middle-aged and elderly persons. We observed that elderly persons under stress excreted larger amounts of urinary-free cortisol than did middle-aged persons; Pearson's r between age and cortisol = 0.38, p less than 0.05. When the sample was stratified by severity of depressive symptoms, the relationship between age and cortisol excretion was strongly accentuated among those with severe depressive symptoms (r = 0.62, p = 0.01) and diminished among those with milder symptoms (r = 0.25, N.S.). Potentially confounding factors such as diet, use of medications, and physical stature were controlled and did not explain the observations. The high depression scores in this acutely stressed sample were indicative of a higher severity of stress response and also a higher risk of occurrence of depressive syndromes. The depressive syndromes did not resemble depressive disorder of an endogenous nature.

Adjustment Disorders↗
PubMedDate not supplied

Conscious and unconscious coping with loss.

Sixty-seven persons were identified 1 to 2 months after the death or life-threatening illness of their spouse and followed for 25 months. Intake measures included a) a revised Ways of Coping Scale, a structured assessment of ego defenses, sociodemographic information, and other baseline variables. Fifty-six completed follow-up. Outcome measures included deaths, hospitalization, self-rated health, depressive symptoms, symptoms of anxiety, and separation distress. In our analyses, bereavement was used as a covariate and found to be unrelated to outcome. Low self-ratings on coping by making a change and problem-focused planning predicted higher scores on separation distress at 13 months (p < or = .05). Participants who used less problem-focused planning were at risk for higher depression scores 13 months after the stressful event (p < or = .05). Low ego-defensive work and high neurotic ego-defensive ratings predicted high depression scores at 13 months (p < or = .05). At 25 months, coping by self-blame was inversely related to scores on separation distress (p < or = .05). Coping variables predicted neither scores on anxiety symptom scales nor the outcomes of hospitalization or death over the 25-month study period. These observations counter some prevailing clinical assumptions about coping with a loss and emphasize the value of empirical studies of coping as a mediator of outcome during the stress of a loss.

Adaptation, Psychological↗
PubMedDate not supplied

Borderline hypertensives volunteering for follow-up and biofeedback. A preliminary study: locus of control characteristics.

We compared the locus of control scores of the following groups: (1) 19 male borderline hypertensives volunteering for biofeedback treatment; (2) 100 consecutive males who were screened for hypertension; (3) 30 male cancer patients receiving radiation therapy, and (4) the normative data from college students. The biofeedback volunteer group was significantly more internal in locus of control as compared to all other groups. The locus of control of the borderline hypertensives within the screened population did not differ from the normotensives, but the screened population as a whole had a relatively internal locus of control. Our findings imply that the 'internals' may be more attracted to self-control treatments like biofeedback, and data generated from this particular population may have limited generalizability, especially in regard to 'externals'.

Biofeedback, Psychology↗