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Biomedical subjects

A Spiro

Publications and source records attributed to A Spiro.

At least 55 records · Page 3Linked to original sources
PubMed1994

Vulnerability and resilience to combat exposure: can stress have lifelong effects?

The purpose of this study was to examine whether appraisals of desirable and undesirable effects of military service mediated the effect of combat stress on posttraumatic stress disorder (PTSD) symptoms in later life in 1,287 male veterans, aged 44-91 years (M = 63.56, SD = 7.46), 40% of whom had been in combat. The men reported more desirable effects of military service (e.g., mastery, self-esteem, and coping skills) than undesirable ones; both increased linearly with combat exposure (r = .17 and .33, p < .001, respectively). Path analysis revealed that the appraisals were independent and opposite mediators, with undesirable effects increasing and desirable effects decreasing the relationship between combat exposure and PTSD, even controlling for depression and response style. Although lifelong negative consequences of combat exposure were observed, perceiving positive benefits from this stressful experience mitigated the effect.

Adaptation, Psychological↗
PubMed1993

Construct validation of optimism and pessimism in older men: findings from the normative aging study.

Validation of Scheier and Carver's (1985) Life Orientation Test (LOT) has identified associations between bipolar optimism and several external constructs. However, optimism and pessimism may be not bipolar, but rather separate constructs. Furthermore, these constructs may be indistinguishable from personality traits, such as neuroticism and extraversion. This study examined the associations of separate optimism and pessimism measures with self-reports of hassles, psychological symptoms, and illness severity, controlling for personality. Ss were 1,192 men from the Normative Aging Study. Findings suggest that optimism and pessimism are separate and that their relations to external criteria remain, although attenuated, when neuroticism and extraversion are controlled.

Age Factors↗
PubMed1993

Change in social support after retirement: longitudinal findings from the Normative Aging Study.

Although retirement is generally thought to lead to a decline in social support due to a loss of social contacts with coworkers, the evidence for this is at best contradictory. This longitudinal study examined change in social support among 1,311 men, participants in the Veterans Administration Normative Aging Study, over a 3-year period. In general, long-term retirees reported the least quantitative social support, and the continuing full-time workers the most; however, change in workforce status produced no apparent effect on quantitative support over the duration of this study. In general, qualitative support showed no retirement effects. We also examined more specific patterns of coworker friendship and again found a pattern similar to that of general quantitative support. The findings support our earlier suggestion of a distinction between retirement as a transition and retirement as a state, and also support the convoy model of social support in late life and the selectivity theory of developmental adaptation to aging.

Adult↗
PubMed1992

Supporting parents who wish to breastfeed twins.

Parents expecting twins need special support from health visitors to prepare them for the changes to their lives. A sound knowledge of the mechanics of breastfeeding and an empathetic understanding of their hopes and fears will prepare them for the months ahead, writes Alison Spiro. Health visitors may also be able to mobilise statutory and voluntary resources in the community to provide extra practical or emotional help.

Adaptation, Psychological↗
PubMed1991

Thymic peptides, stress, and depressive symptoms in older men: a comparison of different statistical techniques for small samples.

Thymic peptides play an important role in aging and immune regulation, but little is known about their relationship to psychosocial factors. One thymic fraction, thymosin-alpha 1 (TSN-alpha 1) may be of particular interest given its hypothesized role in the differentiation of immature T cells into functional, mature T cells. We examined the relationships among stress, psychological symptoms, and TSN-alpha 1 levels in two conditions; before and after a glucose challenge test. The sample consisted of 18 men, aged 48-80, participants in the Normative Aging Study. While none of the correlations reached significance in the baseline condition, life events and depressive symptoms were significantly correlated with TSN-alpha 1 in the postchallenge condition (r's = .57, and .62, respectively). Hierarchical regression analyses with cross-product interaction terms suggested that individuals who were high in both life events and depression showed the highest levels of postchallenge TSN-alpha 1, with the psychosocial variables accounting for 65% of the variance. Given the small sample size, we replicated these analyses using jackknife and bootstrap techniques, which generally confirmed these findings. Thus, these preliminary results suggest that psychosocial factors may be related to abnormal TSN-alpha 1 responses to a challenge.

Aged↗
PubMed1991

Personality and aging: a study of the MMPI-2 among older men.

We examined whether separate norms for older men are necessary for the revised Minnesota Multiphasic Personality Inventory (MMPI-2). Scores from 1,459 men in the Normative Aging Study (NAS) (age: M = 61.27, SD = 8.37) were contrasted with those from 1,138 men from the MMPI Restandardization Study (age: M = 41.71, SD = 15.32). Results showed that scores on the MMPI-2 validity, clinical, and content scales for the NAS men were highly similar to those from the MMPI-2 Restandardization sample. There were also few differences between the two groups at the item level. Within-sample analyses revealed some differences between age groups. However, the magnitudes of these differences were small and may represent the single or combined effects of cohort factors and age-related changes in physical health status rather than age-related changes in psychopathology per se. We concluded that special, age-related norms for the MMPI-2 are not needed for older men.

Adolescent↗
PubMed1990

Longitudinal findings from the Normative Aging Study: II. Do emotionality and extraversion predict symptom change?

We investigated the relationship between the personality traits of emotionality and extraversion and symptom-reporting, both cross-sectionally and longitudinally. The sample consisted of 1,034 men, initially screened for good health, who completed both the 16PF and at least two CMIs, (M = 5, range = 2-8) over an average period of 17 years (range = 2-25). Using a two-stage growth model, we obtained a predicted baseline and slope for each man for self-reported physical and psychological symptoms. Correlations revealed that emotionality was positively related to the numbers of both physical and psychological symptoms reported at baseline, while extraversion was negatively related. However, regression analyses including age and both personality variables indicated that only emotionality was associated with level of symptom-reporting. Longitudinal analyses revealed that emotionality was unrelated to physical symptom slopes and only weakly related to psychological slopes. We interpret these results as showing that, while personality and symptom-reporting are related cross-sectionally, personality does not predict changes in symptom reporting.

Adult↗
PubMed1989

Does emotionality predict stress? Findings from the normative aging study.

Investigated whether emotionality, assessed in 1975, predicted the reporting of both objective stress (life events) and subjective stress (hassles) 10 years later, and how emotionality affected the relation between both objective and subjective stress and mental health. The sample consisted of 1,159 older men, participants in the Normative Aging Study. Path analysis revealed that the reporting of stress was confounded with personality: Individuals higher in emotionality reported both more life events and more hassles. Furthermore, individuals higher in emotionality exhibited slightly higher levels of symptoms under stress than did individuals lower in emotionality. Nonetheless, both stress measures contributed independent variance to the prediction of psychological symptoms, even controlling for prior levels of emotionality. Implications for the assessment of stress are discussed.

Adaptation, Psychological↗
PubMed1989

Longitudinal findings from the normative aging study: 1. Does mental health change with age?

Longitudinal changes in self-reported symptoms were investigated using the Cornell Medical Index (CMI) in a sample of 2,041 men. The average man completed 5 CMIs (range = 2-8) over 17 (range = 2-25) years. Using a two-stage growth model, we first regressed symptoms against time on study for each man. The average slope of physical symptoms showed a moderate increase over time, but the average slope of psychological symptoms showed little change. Next, individual differences in change were examined using age at entry as an explanatory variable. Age accounted for 50% of the variance in physical symptoms at entry and 7% of the variance in slopes, but explained neither baseline level nor change in psychological symptoms. Rather, a U-shaped curve described the relation between age and psychological symptom change. These results, in concert with a developmental perspective, may help reconcile conflicting findings on aging and mental health.

Adult↗
PubMed1989

Utilization management in the small group insurance market.

Small businesses are the most rapidly growing segment of the economy, providing one half of all jobs in the United States. The health insurance industry must address issues which are unique to this market. The health insurance product for small businesses must have simple administration for the owners and easy access to quality medical care for the employees. Small businesses have been adversely affected by the high cost of health care. Numerous studies have shown that a major factor contributing to the high cost of health care is inappropriate and unnecessary utilization of health care. Until recently, techniques of utilization management have been difficult to adapt to the small group market. The Celtic Life Insurance Company has been using a managed care fee for service arrangement for the past three years. Celtic has been able to tailor a program for small businesses and maintain complete administrative coordination, instead of contracting with a private utilization review company. Our program maintains freedom of choice of providers and easy access to health care, without limiting access to specialists. Cost containment features have assisted insureds in selecting appropriate health care, in the appropriate setting while not interfering with the doctor-patient relationship.

Economic Competition↗
PubMed1988

Cumulative and reversible effects of lifetime smoking on simple tests of lung function in adults.

Data from a random sample of 8,191 men and women from 6 U.S. cities are used to fit a model describing the effects of cumulative and current cigarette smoking on pulmonary function. The data show that smokers suffer an irreversible loss of FVC and FEV1, which is described by a linear function of their cumulative cigarette smoking as measured in pack-years. For a typical male 173 cm tall, the estimated loss of FEV1 is 7.4 ml for each pack-year smoked. For a typical woman, 161 cm tall, the estimated effect is 4.4 ml per pack-year. Current cigarette smoking adds an acute deficit over and above the cumulative effect of lifetime smoking. For any lifetime pack-years, exsmokers have higher levels of FEV1, 123 ml for a typical man, 107 ml for a typical woman, than do current smokers of a pack per day (p less than 0.001). A man who starts smoking one pack of cigarettes per day at 25 yr of age would at age 60, after 35 pack-years of exposure, have an expected FEV1 equal to that of a man 69.4 yr of age who had never smoked. If he stopped smoking at 60 yr of age, his expected level would increase to that of a 66.5-yr-old never-smoker. This model therefore estimates how much lung function is irreversibly lost by smoking, estimates how much could be regained with cessation of smoking, and predicts the future loss of lung function in both cases.

Adult↗
PubMed1988

Respiratory muscle dysfunction in hereditary motor sensory neuropathy, type I.

Pulmonary function tests were performed on ten patients who were shown to have hereditary motor sensory neuropathy, type I. Mean values for spirometry, static lung volumes, and diffusion capacity were all greater than 80% of the predicted normal values for the group. In contrast, both inspiratory and expiratory muscle testing showed substantial reductions in function for the group. These abnormalities have not previously been reported, and they may be important in the management of these patients and in patients with other neuromuscular diseases.

Adolescent↗
PubMed1986

Explaining discrepancies between longitudinal and cross-sectional models.

Data from longitudinal studies may be analyzed both cross-sectionally and longitudinally. Discrepancies between estimates obtained from these analyses pose questions about the validity of cross-sectional estimates of change. In some cases these discrepancies are the result of period effects, cohort effects, or selective dropout. In others, they are the result of incomplete modeling of the process and are spurious rather than substantive. In this report, we show that when the true relation between a dependent variable and age is non-linear (e.g. quadratic), but is modeled as linear, the estimated age effect will be a function of the age distribution. In a continuous-time idealization, if the age distribution is Gaussian, the estimated age effects agree. If the age distribution is symmetric and the non-linearity is quadratic, cross-sectional and longitudinal results agree. Otherwise they do not. We illustrate these points by analysis of the relation between aging and pulmonary function in middle and old age using data from a large, prospective, longitudinal study.

Adult↗
PubMed1986

Some biophysical properties of the erythrocyte membrane in Duchenne muscular dystrophy.

Inasmuch as prior authors have suggested a 'generalized membrane defect' in patients with Duchenne muscular dystrophy, this study was undertaken to examine some biophysical properties of the erythrocytes in affected individuals. Using the micropipette technique we investigated the rheological properties of erythrocytes from 11 Duchenne muscular dystrophy patients (boys 3-14 years old) and 5 carriers (mothers 20-42 years old). The mean elastic modulus and membrane viscosity of the patient's erythrocytes were not significantly different from those of a group of 8 unaffected age-matched boys. The carrier group did not differ significantly from the adult control group in any of the rheological parameters. A significant increase in the number of stomatocytes was observed in the patient group, and a similar trend (not statistically significant) was observed in the carrier group. The membrane lipid fluidity of erythrocytes from patients, carriers, and normal controls was assessed with three different probes by fluorescence depolarization, and no significant differences were found. Our results indicate that there is a progressive elevation of the membrane elastic modulus with increasing age of the patients: the younger patients have a lower elastic modulus than their age-matched controls, while the older patients have a higher elastic modulus than their age-matched controls.

Adolescent↗