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Biomedical subjects

A Spirito

Publications and source records attributed to A Spirito.

At least 73 records · Page 4Linked to original sources

Behavioral effects of corticosteroids in children with acute lymphoblastic leukemia.

We evaluated the behavior of 38 children with standard-risk and high-risk acute lymphoblastic leukemia who received corticosteroids as part of their antileukemia chemotherapy. Each patient was assessed on two occasions: 16 weeks following remission and 1 year thereafter. Parent reports on emotional lability, attention span/hyperactivity, sleep disturbance, listlessness, peer relations, and depressed mood were obtained for 4 consecutive weeks: week before, week during, and 2 weeks after treatment administration. At the 16 week evaluation, standard-risk (N = 17) and high-risk (N = 21) treatment differed by steroid dose and systemic chemotherapy, while at the 1 year testing, treatment differed only by steroid dose (prednisone 40 mg/m2 vs. 120 mg/m2). Statistically significant changes in all measures were observed during treatment as compared with before and after treatment for both risk groups and assessment times. High-risk patients exhibited greater behavioral effects than standard-risk patients only for emotional lability, listlessness, and depressed mood at the 16 week testing, when both steroid dose and chemotherapy differed. Girls had slightly greater behavioral effects than boys, while no influence of age was observed. At the doses tested, steroid dose per se does not appear to be the primary variable affecting behavioral changes.

Age Factors↗

Adolescent coping behavior when confronted with a friend with AIDS.

The coping strategies employed by adolescents (n = 871) when presented with a hypothetical situation of a friend with AIDS were examined. Adolescents reported a wide range of imagined responses that were generally adaptive. Girls more than boys and distressed students more than nondistressed students were likely to endorse adaptive coping items. Comparison of the students with a separate sample (n = 472) that responded to a hypothetical situation of a suicidal peer revealed more distress in girls for the AIDS problem and more distress in boys for the suicide problem, contrary to expectations. Adolescents were more distressed and endorsed a wider variety of coping strategies in response to the AIDS scenario than to the suicide problem. Implications for care of adolescents dealing with these significant issues are discussed.

Acquired Immunodeficiency Syndrome↗

Adolescent suicide attempts: outcomes at follow-up.

Adolescents seen in a general hospital emergency department or psychiatrically hospitalized were followed up at one month and three months following a suicide attempt. Findings included substantial drop-out rates for psychotherapy and high rates of repeated suicide attempts by three months. Implications for disposition planning and care of such adolescents are discussed.

Adolescent↗

The correlates of planning in adolescent suicide attempts.

Adolescent suicide attempts are often impulsive. It has been suggested that individuals who make nonimpulsive (premeditated) attempts have greater suicidal intent and are more hopeless than the impulsive attempters. Eighty-six adolescent suicide attempters were categorized according to the degree of premeditation of their attempt, as measured by two items of the Suicide Intent Scale. Sex, age, method of attempt, and the number of prior attempts were not useful discriminators between these groups. The nonimpulsive attempters were significantly more depressed and more hopeless than the impulsive attempters, as measured by several standardized scales. Measures of depression, hopelessness, and suicidal ideation were highly correlated in both groups. Anger turned inward and hopelessness were strongly correlated only in the premeditated group, suggesting that the nonimpulsive attempter's distress may bear a strong relationship to self anger.

Adolescent↗

Cognitive characteristics of adolescent suicide attempters.

The present study examined the relationship among psychiatric diagnosis, depression, attributional style, and hopelessness among 69 adolescent suicide attempters and 40 psychiatrically hospitalized adolescent controls. Contrary to predictions, the suicide attempters were more likely than the nonsuicidal group to attribute good events to global causes. No differences in attributional style were found across the depressed versus nondepressed subjects. However, there was a modest relationship between depression and attributional style. Results suggest that maladaptive cognitive characteristics are present in adolescent clinical samples but may be less specific to suicide attempters than is often suggested.

Adolescent↗

Adolescent risk-takers: a trauma center study of suicide attempters and drivers.

Adolescence is a developmental stage characterized by excessive risk-taking behavior that produces adverse health effects, typically in the form of injury. At issue is whether adolescent suicide attempters and injured adolescent motor vehicle drivers constitute a common risk group and are differentiated by the response of the emergency medical care system and by case disposition. Data originated in the medical records of a Rhode Island (USA) trauma center. The two study groups were not distinguished by religious preference, socioeconomic status or timing of the injury incident, but differed significantly by gender, race, emergency vehicle use, hospital admission rates, and seasonal injury patterns. Alcohol and drug involvement was examined, but serious data deficiencies were noted.

Accidents, Traffic↗

Encopresis: behavioral parameters associated with children who fail medical management.

The present study examined behavioral parameters such as parent management of encopresis and parental coping styles (active, cognitive, and avoidance) as predictors of success with medical management of encopresis. The results suggest that parents use a variety of management strategies and treatment success cannot be predicted using these variables. However, in line with previous research the presence of child behavior problems appeared to be a potential predictor variable.

Adolescent↗

Social adjustment of children successfully treated for cancer.

Compared 56 children between the ages of 5 and 12 years to a sample of healthy controls. All cancer patients had been treated between the ages of 2 and 5 years. Children completed the Self-Perception Profile for children and questionnaires assessing social adjustment. Parent and teacher ratings were also obtained. The cancer patients reported greater feelings of isolation than the controls but otherwise few differences were noted. There were few differences between cancer patients and controls in the teacher and parent report. Results are discussed in terms of the need to investigate behavioral sequelae of childhood illness and directions for future research.

Child↗

Group behavioral treatment of retentive encopresis.

Investigated the efficacy of behavioral group treatment for children with retentive encopresis who had previously failed medical management. Eighteen children between the ages of 4 and 11 years and their parents were seen in small treatment groups of 3 to 5 families over 6 sessions. The sessions focused on education about retentive encopresis, and the integration of behavioral parenting procedures with medical management. Parents and children were taught to deliver an enema clean-out, increase the children's dietary fiber, and appropriate toileting techniques. The results indicated that children significantly increased their fiber consumption by 40%, increased appropriate toileting by 116%, and decreased their soiling accidents by 83% pre- to posttreatment. Further, these treatment gains maintained or improved at the 6-month follow-up. The results are discussed in terms of cost-effective interventions and the interface between psychology and medicine in pediatric psychology.

Age Factors↗

Impact of social support and stress on compliance in women with gestational diabetes.

Compliance with medical recommendations is especially important for women with gestational diabetes because of the health implications for both mother and fetus. This study examined compliance with two daily self-management tasks, diet and insulin administration, in 98 women with gestational diabetes. Furthermore, the influence of stress and regimen-related social support on compliance was investigated. Results indicate that the level of reported compliance was high for both insulin administration and diet. Fewer minor stressors and greater social support were associated with greater compliance.

Adolescent↗

Screening measure to assess knowledge of diabetes in pregnancy.

The purpose of this study was to develop a brief measure to assess knowledge regarding diabetes in pregnancy (Diabetes in Pregnancy Knowledge Screen [DPKS]). A test-retest design was used for subjects enrolled in a diabetes in pregnancy program at a university hospital. There were 58 women with overt diabetes (OD; insulin dependent and non-insulin dependent) and 67 women with gestational diabetes (GD). Three forms of the DPKS scale were developed for use with women with OD and women with GD treated or not treated with insulin. Adequate readability, internal consistency (r = 0.71), and test-retest reliability (r = 0.76) were demonstrated with the DPKS. Initial support for the validity of the measure is suggested by its ability to differentiate women with GD versus OD, women on insulin versus those who are diet controlled, and women with shorter versus longer duration of illness. The DPKS may prove a useful clinical tool for diabetes educators working with pregnant women.

Adult↗

Social skills and depression in adolescent suicide attempters.

The relationship among depression, social skills, and suicidal behavior was examined in a sample of 41 adolescents hospitalized in a general medical setting following a suicide attempt. These subjects were compared to 40 nonsuicidal psychiatrically hospitalized adolescents. Level of depression, assessed using the Children's Depression Inventory (CDI), and social skills, assessed via the Matson Evaluation of Social Skills with Youngsters (MESSY), were evaluated for all subjects. The suicide attempters and psychiatrically hospitalized patients were not found to differ on either the CDI or MESSY. However, multiple regression analyses revealed the factor scores of the MESSY to be related to depression in both patient groups. The data provide support for the relationship between social skills and depression. Results are also discussed in terms of the similarities between adolescent suicide attempters and nonsuicidal psychiatrically disturbed adolescents.

Adolescent↗

Common problems and coping strategies. I: Findings with normal adolescents.

This study investigated problems commonly experienced by adolescents and the strategies they use to cope with these events. Coping strategies were examined across the subjects' emotional state and their evaluation of the problem. In general, adolescents reported four common stressors that were similar across age groups and gender. However, males differed from females in the frequency of these problems. Further, while the stressors were similar, the frequency with which the coping strategies were employed and the efficacy ascribed to them differed across sex and across problem type. These findings are discussed in terms of the stress and coping literature with adults and the implications for clinical assessment and treatment of adolescents.

Adaptation, Psychological↗

Common problems and coping strategies. II: Findings with adolescent suicide attempters.

This study investigated the most common precipitants of adolescent suicide attempts and the strategies used to cope with such problems. Adolescent suicide attempters were compared with both distressed and nondistressed nonsuicidal adolescents on problems reported and coping strategies utilized. All three groups reported four problems as occurring most frequently: school, parents, friends, or boyfriend/girlfriend. The suicide attempters and distressed controls reported problems with parents more frequently than did nondistressed controls, while this latter group reported problems at school more frequently than did suicide attempters or distressed controls. Suicide attempters used social withdrawal, problem solving, and emotional regulation more than did nondistressed controls, but not more frequently than distressed controls. Distressed controls used wishful thinking and resignation more than did suicide atempters. Results are discussed in terms of the similarities between suicide attempters and nonsuicidal distressed adolescents and the need to more closely investigate specific subgroups of suicide attempters.

Adaptation, Psychological↗

Suicide awareness programs in the schools: effects of gender and personal experience.

The present study evaluated the effects of gender and personal experience with suicide on the knowledge, attitudes, and behaviors of 471 high school students. Also, a suicide awareness curriculum was provided to 215 students and its impact was assessed. Results showed that having personal experience with a peer who had attempted suicide served to sensitize the student to the issues discussed in the curriculum, making it more likely that their knowledge regarding suicide would improve. However, this effect was overshadowed by the strong sex differences that emerged. Males were more likely than females to report maladaptive attitudes toward suicidal tendencies in their peers, display less adaptive coping styles, and exhibit less knowledge of suicidal behaviors. The role of sex differences in suicide prevention is discussed.

Adolescent↗

Psychological impact of the diagnosis of gestational diabetes.

The psychological impact of the diagnosis of gestational diabetes was examined in 68 pregnant women. No differences between the women with gestational diabetes and 50 non-diabetic pregnant controls, matched for gestational age, were found on the Profile of Mood States--Bipolar Form. Contrary to clinical lore, the prescription of insulin was not found to have an adverse effect on the emotional status of women with gestational diabetes. In this diabetic population whose blood glucose levels were well controlled, psychological status was not found to be related to blood glucose levels. The results suggest that the majority of pregnant women adapt readily to the unexpected diagnosis of gestational diabetes.

Adult↗

Psychosocial characteristics and coping skills in children maintained on chronic dialysis.

Psychosocial character traits and coping skills were examined in 12 children with end-stage renal failure. Six of the children were maintained on in-center hemodialysis and 6 were treated with home peritoneal dialysis. All of the patients felt a lack of ability to control their lives. The incidence of anxiety, depression, and hostility did not appear to vary from a population of healthy adolescents. Personal and social adjustment scores were, on average, on the 20th percentile. Coping skills appeared to be most influenced by the mode of dialysis treatment. Home peritoneal dialysis patients utilized self-reliance as a coping process more often than their counterparts on hemodialysis. We conclude that children maintained on chronic dialysis therapy demonstrate reasonable psychological adjustment with some differences in social and emotional functioning when compared with healthy children, and that the type of treatment chosen may influence the development of certain coping skills.

Adaptation, Psychological↗