Search PubMed⌕ Search

Biomedical subjects

A Spirito

Publications and source records attributed to A Spirito.

At least 55 records · Page 3Linked to original sources
PubMed1997

Affect regulation and suicide attempts in adolescent inpatients.

OBJECTIVE: To examine the relationship between affect dysregulation and self-destructive behaviors in adolescent suicide attempters. METHOD: Measures of affect dysregulation, number of risk-taking behaviors in past year, presence of self-mutilative behaviors in past year, and number of different types of self-mutilative behaviors in past year were individually administered to adolescents admitted to an inpatient unit who were either suicide ideators (n = 25) or suicide attempters (n = 35). RESULTS: Suicide attempters reported significantly higher levels of affect dysregulation and a greater number of different types of self-mutilative behaviors in the past year than suicide ideators. In addition, the number of different types of self-mutilative behaviors in the past year had the strongest relationship to suicide attempts. CONCLUSION: Suicidal behavior among adolescent psychiatric patients is related to poor affect regulation. A risk factor for suicidal behavior in adolescents is a broad range of self-mutilative acts in the year preceding the suicide attempt.

Adolescent↗
PubMed1997

Child temperament, parenting discipline style, and daytime behavior in childhood sleep disorders.

Fifty-two children without significant sleep disturbance seen at a primary care clinic for well-child care were compared on measures of temperament, parenting style, daytime behavior, and overall sleep disturbance to three diagnostic subgroups identified in a pediatric sleep clinic: children with obstructive sleep apnea (n = 33), parasomnias (night terrors, sleepwalking, etc.) (n = 16), and behavioral sleep disorders (limit-setting disorder, etc.) (n = 31). The mean age of the entire sample was 5.7 years. Temperamental emotionality in the behavioral sleep disorders group was associated with a higher level of sleep disturbance (p < .001); parenting laxness was associated with sleep disturbance in the general pediatric population (p < .01); and intense and negative temperament characteristics seemed to be associated with clinically significant behavioral sleep disturbances. Ineffective parenting styles and daytime disruptive behaviors were more likely to be associated with the milder sleep disturbances found in children in a primary care setting.

Analysis of Variance↗
PubMed1997

Incidence of parasomnias in children with obstructive sleep apnea.

The incidence of parent-reported parasomnias in children with obstructive sleep apnea (OSA) is increased in comparison with a normative age-matched sample of children but is not higher than that for a similar clinical sample of children with a diagnosed behavioral sleep disorder.

Child↗
PubMed1996

Synthesis and activity of the glutathione analogue gamma-(L-gamma-oxaglutamyl)-L-cysteinyl-glycine.

An efficient synthesis of the backbone modified glutathione analogue gamma-(L-gamma-oxaglutamyl)-L-cysteinyl-glycine (7), characterized by the presence of an urethane O-CO-NH linkage replacing the gamma-glutamylic CH2CO-NH fragment is described. The new analogue has been fully characterized by 1H- and 13C-NMR, and FAB-MS. Compound 7 was tested for inhibition of gamma-glutamyl-transferase activity and was found to be a non-competitive inhibitor of hog kidney gamma-glutamyltransferase (EC 2.3.2.2).

Animals↗
PubMed1996

Conceptual and methodologic issues in quantifying perceptual accuracy in childhood asthma.

Delineated methodologic issues in the study of symptom perception in childhood asthma. A review of past and recent psychophysiological and clinical studies of both adults and children presents the methodologic and analytic approaches that have been applied to quantify perceptual accuracy. Peak expiratory flow rate, forced expiratory volume in the first second, and force expiratory flow can serve as objective measures of asthma. A visual analog scale, a numerical guess, and a categorical description as subjective measures all have clear strengths and weaknesses. Correlational analysis of subjective-objective data, arithmetic differences between subjective guess and objective value, and an error grid categorization can each be applied to calculate an accuracy index on an individual subject. Illustrative examples reveal that the same data lead to different indices depending on the method chosen. Empirical research is needed to standardize various methodologic approaches. Given the increasing prevalence, severity, and morbidity of pediatric asthma, the study of symptom perception may be a critical component in our understanding of asthma management, and will likely lead to useful clinical interventions.

Adolescent↗
PubMed1996

Symptom perception in pediatric asthma: relationship to functional morbidity and psychological factors.

OBJECTIVE: Perception of changes in respiratory symptoms is a critical element in the self-management of pediatric asthma. The purpose of this study was to quantify perceptual accuracy in childhood asthma, to investigate links between symptom perception and functional morbidity, and to examine relationships between psychological variables and perceptual accuracy. METHOD: Eighty-six children, aged 8 to 15 years, attending an asthma camp made subjective estimates of asthma severity immediately prior to spirometry an average of 31 times at camp. The correlation coefficient between these measures (the child's accuracy index) was analyzed in relation to morbidity data and to scores on instruments that assessed trait anxiety, repressive coping style, intelligence, behavior problems, and parental symptom-reporting patterns. RESULTS: A wide range of perceptual ability was found, as children's subjective-objective r ranged from-.39 to .88. Greater perceptual accuracy was significantly related to fewer days missed from school and fewer emergency medical visits. Of the psychological variables assessed, only intelligence was significantly related to accuracy. CONCLUSIONS: Symptom perceptual ability is an important psychosomatic factor affecting the course of asthma for some children. Further study is indicated to understand psychological variables in addition to intelligence that may determine a child's perceptual accuracy.

Adaptation, Psychological↗
PubMed1996

Physical and sexual abuse and their relation to psychiatric disorder and suicidal behavior among adolescents who are psychiatrically hospitalized.

Adolescents who were psychiatrically hospitalized (N = 105) were classified as sexually abused, physically abused, both sexually and physically abused, or not abused, and studied to determine the prevalence of suicidal behavior and psychiatric disorders. Self-reports of hopelessness, depression, coping, and self-concept were also examined. No difference in suicidal behavior or psychiatric disorder, based on abuse history, was found, with one exception. Adolescents who were sexually abused, particularly those who experienced the most severe sexual abuse, used negative coping strategies more often than those not sexually abused. Findings suggest that symptomatology of adolescents who are psychiatrically hospitalized does not differ markedly based on history of abuse.

Adaptation, Psychological↗
PubMed1996

Factor analysis of the suicide intent scale with adolescent suicide attempters.

Examined the factor structure of the Suicide Intent Scale (SIS; Beck, Schuyler, & Herman, 1974) when used with adolescent suicide attempters as well as the validity of these factors. Participants consisted of 190 hospitalized adolescent suicide attempters evaluated within 36 hr of the attempt. They responded to multiple self-report measures as part of a standard battery administered in the hospital that included the Suicide Ideation Questionnaire (Reynolds, 1987b), Reynolds Adolescent Depression Scale (Reynolds, 1987a), and the Hopelessness Scale for Children (Kazdin, French, Unis, Esveldt-Dawson, & Sherrick, 1983). A clinician rated suicide intent on the SIS. A common factor analysis, using the items of the SIS, revealed a three-factor solution. Factors were labeled Isolation Behaviors, Expected Outcome, and Planning Activities. The latter two factors correlated modestly with measures of depression, hopelessness, and suicidal ideation. Isolation Behaviors did not correlate with these measures. Results suggest that the Expected Outcome and Planning Activities factors may be more useful with adolescent suicide attempters than the total score.

Adolescent↗
PubMed1995

A multisystems analysis of adolescent suicide attempters.

The present study tested an ecologically based model, which predicted that hopelessness (individual level) mediates the effects of family dysfunction (interpersonal level) and socioeconomic status (sociocultural level) on both suicidal intent and suicidal ideation, within a sample of attempters. Subjects included adolescent males and females presenting at a general hospital emergency room following suicide attempts. Baron and Kenny's (1986) criteria for testing mediation models through multiple-regression analyses were employed. Little evidence of mediation was found. Hopelessness proved to be the best predictor of suicidal intent and ideation within a sample of attempters.

Adolescent↗
PubMed1995

Coping with everyday and disease-related stressors by chronically ill children and adolescents.

OBJECTIVE: This study examines those aspects of disease that chronically ill children find stressful and the coping strategies they report using to manage these stressors. In particular, we examined whether a state or trait conceptualization of coping was most applicable to this population. METHOD: A total of 177 children with varying chronic illnesses were asked to complete a coping checklist in response to a self-generated illness-related problem and an everyday problem. RESULTS: Analyses of coping strategy stability revealed gender but not age effects. Some coping strategies were used equally across varying illness-related stressors, but others, e.g. distraction, blaming others, and emotional regulation, varied by type of stressor. Moderately consistent patterns were found across illness-related and non-illness-related situations for the same individual. CONCLUSIONS: The results suggest that coping strategies used by chronically ill children have some stability but do vary across situations. Clinicians might benefit from routine screening of coping in chronically ill children.

Adaptation, Psychological↗
PubMed1994

Emergency department assessment of adolescent suicide attempters: factors related to short-term follow-up outcome.

Empirical data to help gauge risk for repeat suicide attempts and noncompliance with outpatient psychiatric care among adolescent suicide attempters discharged from emergency departments is scarce. In this study, 62 adolescent suicide attempters discharged from a regional trauma center serving an urban/suburban area with a broad range of social classes were followed up at three months after their attempts to assess treatment compliance and repeat attempts. Information regarding suicidal intent and characteristics of the attempt were collected by emergency physicians at the time of the attempt. Parental ratings of adolescent functioning were also collected. At three-month follow-up, none of the adolescents had completed suicide; 7% made a repeat suicide attempt, 16% never followed through with outpatient psychiatric appointments, 15% attended one session, and 21% went to only two appointments. A prior suicide attempt, alcohol use at the time of the attempt, and greater planning of the suicide attempt were associated with better compliance with outpatient psychiatric treatment. None of the variables predicted repeat attempts. Parental reports of an adolescent's physical fighting and health problems of a family member were related to referral failure. Clinical implications are discussed.

Adolescent↗
PubMed1994

Stressful life events associated with adolescent suicide attempts.

This study was designed to examine the types of stressful events that are related to adolescent suicidal behaviour. Adolescent inpatients who attempted suicide and a control group of high school students were compared on various types of stressors. The stressors were categorized according to their type (for example, discrete events versus chronic strains) and source (for example, family or friends). Compared to high school controls, adolescents who attempted suicide reported elevated levels of major negative events and exit events. Both chronic strains and discrete stressors were related to an increased severity of depression and suicidal ideation. The results support the notion that increased stress is related to adolescent suicidal behaviour. Different approaches to categorizing stress may improve the understanding of the relationship between stressful life events and suicide. Also, sex differences may influence the relationship between life stress and suicidal feelings.

Adolescent↗
PubMed1994

A pictorial visual analog scale for rating severity of childhood asthma episodes.

The purpose of this study was to determine whether the use of pictorial anchors improved a visual analog scale (VAS) designed to assess asthma episodes. The sample consisted of 77 children with moderate to severe asthma attending a summer camp. They rated one of two VASs, either nonpictorial (39 subjects in year 1) or pictorial (38 subjects in year 2), three times a day for 2 weeks to report the severity of their asthma symptoms. Immediately after the subjects rated the VAS, pulmonary function testing was obtained. The mean VAS scores increased 64% using the pictorial VAS while the mean PEFRs in the 2 years were almost identical, suggesting that changes on the VAS were not due to differences in pulmonary functioning. For boys, the increase in individual mean VAS score in year 2 using the pictorial VAS was 44%; for girls, the increase in individual mean VAS scores was 112%. Use of a pictorial VAS increases the range of severity of symptoms reported by children with asthma. The instrument may be a useful tool in the systematic quantifiable assessment of subjective symptomatology in pediatric asthma.

Adolescent↗
PubMed1993

Self-reported compliance with diabetes self-management during pregnancy.

OBJECTIVE: The current study examined regimen compliance in pregnant women with pre-existing (overt) diabetes across multiple self-care tasks at three times during the pregnancy: mid-second, early third, and late third trimesters. METHOD: Forty-nine pregnant women with Type I (68%) or Type II (32%) diabetes completed measures to assess compliance with the diabetic regimen, major and minor life stressors, and social support for the diabetic regimen. RESULTS: Pregnant women with overt diabetes generally reported being compliant with their self-care regimen. There were, however, notable differences in reported compliance levels across different regimen tasks. Specifically, 74 to 79 percent of women reported being always compliant with dietary recommendations compared to 86 to 88 percent for insulin administration, 85 to 89 percent in managing insulin reactions, and 94 to 96 percent for glucose testing. Furthermore, stress in the form of major and minor life events and regimen-related social support were significantly related to self-reported compliance with dietary recommendations. There was no relationship between compliance and blood glucose levels. CONCLUSIONS: These findings suggest that psychiatric consultants focus on ways to increase social support as one means of improving compliance in pregnant women with diabetes.

Adolescent↗
PubMed1993

Gender differences among adolescent suicide attempters.

When males attempt suicide, they often use more lethal and violent methods than females. However, this article suggests that gender alone is not especially useful in assessing the seriousness of adolescent suicide attempts. In the study discussed here, the sociodemographic and psychological characteristics of female and male suicide attempters seen in a pediatric hospital are compared. There were no sociodemographic differences between the groups. Boys and girls were similar when assessed regarding suicidal ideation, depression, and hopelessness. More males than females were diagnosed with conduct disorders. Some items on the Suicide Intent Scale indicated that boys exhibited more serious intentionality than girls. Division of the sample based on suicide intentionality resulted in differences in the level of reported depression.

Adolescent↗