Biomedical subjects

B J Cox

Publications and source records attributed to B J Cox.

At least 37 records · Page 2Linked to original sources

PubMed2000

Problem and probable pathological gambling: considerations from a community survey.

OBJECTIVE: To investigate the nature and extent of gambling problems in a region of Canada in which legalized gambling activities were expanded during the 1990s. METHOD: A standardized telephone interview was conducted with a random sample of 738 community-dwelling adults (response rate 74%) in Winnipeg, Manitoba. RESULTS: According to traditional classification criteria, the lifetime prevalence of "probable pathological gambling" was 2.6%. A further 3.0% of the sample met criteria for traditionally defined "problem gambling," and evidence suggests that both types of gamblers share several characteristics. Social or recreational gamblers significantly differed on several variables from individuals who reported gambling problems. CONCLUSIONS: The 2.6% prevalence figure is the highest yet reported in a Canadian epidemiological survey and was obtained in a region that developed a more liberal attitude toward gambling in the 1990s. Further, a continuum of severity was demonstrated by scores on the South Oaks Gambling Screen (SOGS), and a clear and consistent distinction between problem and probable pathological gambling was not apparent. Frequenting casinos and using video poker and slot machines, rather than buying lottery tickets, distinguishes problem or pathological gamblers from recreational gamblers.

Adult↗

PubMed1999

Gel-filtration chromatographic method for determining relative binding affinities: rat hepatic estrogen receptor as an example system.

We report a gel-filtration-based chromatographic method for separation of specific, nonspecific, and free radioligand in a protein receptor-ligand binding assay for the example of the estrogen receptor ERalpha. This assay affords relative binding affinities (RBAs) without the need for a separate determination of nonspecific binding. The probit method is recommended as the most satisfactory method of evaluating the data. The assay responds to both estrogen agonists and antagonists, mixtures respond additively, and the slopes of the probit plots indicate that all ligands bind to the same site on the estrogen receptor. RBAs obtained with rat and rainbow trout ERalpha were in good agreement, and also with those from other reported assays, consistent with the interspecies conservation of key regions of the ligand binding domain among estrogen receptors.

Amino Acid Sequence↗

PubMed1999

A comparison of people with and without nocturnal panic attacks.

This study examined differences in frequency and severity of diurnal panic attacks between patients with (n = 22) and without (n = 21) a history of nocturnal panic attacks. Subjects were assessed with a modified version of the SCID, and completed daily panic attack diaries, the Anxiety Sensitivity Index, and the Fear Questionnaire. No differences were found between the groups in the actual number of expected or unexpected diurnal panic attacks experienced. Subjects in the nocturnal panic group experienced significantly more symptoms during diurnal panic attacks than did the diurnal only group. More specifically, the nocturnal panic group experienced more symptoms during expected diurnal panic attacks, but not during unexpected/spontaneous diurnal panic attacks. A greater proportion of the nocturnal panic subjects reported "chest pain" during diurnal panic attacks and a trend toward greater "fear of dying". Otherwise, the two groups were very similar. Implications of the findings are discussed in relation to the findings of other recent studies of nocturnal panic.

Adult↗

PubMed1999

Fear of cognitive dyscontrol in relation to depression symptoms: comparisons between original and alternative measures of anxiety sensitivity.

Previous research has found that a facet of anxiety sensitivity (AS), referred to as fear of cognitive dyscontrol or fear of mental incapacitation, is associated with severity of depressed mood. Other research has extended the "fear of fear" concept to include fear of losing control over emotion in general (including depression). Because anxiety and depression share the common feature of general distress (Clark & Watson, 1991. Journal of Abnormal Psychology, 93, 19-30), the present study took a conservative approach and statistically controlled for the effect of trait anxiety and negative affectivity before contributions of AS to depression were examined. In a large college student sample (N = 348), facets of the original and alternative measures of AS were evaluated in attempts to predict severity of depression symptoms. Fear of cognitive dyscontrol facets from both measures of AS were significant predictors in the regression analyses. A new set of items reflective of control over emotions was also significant and both cognitive and emotional control added to the prediction of depression symptoms in a complementary fashion. Implications of these findings for identifying a proposed "depression sensitivity" are discussed.

Adolescent↗

PubMed1999

The nature of the depressive experience in analogue and clinically depressed samples.

The use of university students as analogue subjects in depression research remains a controversial one, because it is not clear if the depressive experience of analogue and clinical samples differs qualitatively or quantitatively. Accordingly, this study directly compared 101 adult outpatients with major depressive disorder to 175 analogue depressed university students on self-report severity ratings of DSM-IV symptoms of major depressive episode. Several goodness-of-fit indices revealed that the covariance matrices of the depression symptoms were very similar in the two samples. These and other results from the study supported a phenomenological continuity hypothesis. Further, although the two samples differed quantitatively, the nature of the depressive experience did not appear to be one of transient and mild distress for many individuals in the analogue sample.

Adolescent↗

PubMed1999

Anxiety sensitivity and the five-factor model of personality.

Relations between anxiety sensitivity (AS) and the higher-order and lower-order dimensions of the 'Big Five' model of personality were examined in 317 university students. AS was significantly associated with a number of personality domains and facets of the NEO-PI-R. Regression analyses indicated that only the higher-order domains of neuroticism and extraversion (negatively) and the lower-order N facets of anxiety and self-consciousness, significantly predicted AS. Three lower-order factors within AS were identified and were also compared to NEO-PI-R domains and facets. In a hierarchical regression, the three AS factors significantly predicted variance in a measure of panic-related anxiety after the effects of the six N facets were statistically controlled. Results are discussed in the context of previous work with a Big Three taxonomy of personality and implications for understanding the nature and possible origins of AS are outlined.

Adult↗

PubMed1999

Perfectionism and depression symptom severity in major depressive disorder.

In recent years it has been recognized that perfectionism is a multidimensional construct and two Multidimensional Perfectionism Scales have been developed and investigated in relative isolation [Frost, R.O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449-468; Hewitt, P.L., & Flett, G.L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470]. The present study sought to evaluate the association between various dimensions of perfectionism, higher-order personality dimensions, and self and observer rated depressive symptoms in a group of 145 patients with major depressive disorder. Only three of ten perfectionism dimensions (socially prescribed perfectionism, concern over mistakes and self-criticism) displayed medium to large correlations with depressive symptoms, especially self-report symptoms reflecting depressive cognitive distortions. The results are discussed in relation to the specificity of perfectionism dimensions to depression, adaptive versus maladaptive aspects of perfectionism, and in the context of previous research, much of which has relied on college student samples.

Adult↗

PubMed1999

Characteristics of problem gambling in a Canadian context: a preliminary study using a DSM-IV-based questionnaire.

OBJECTIVE: To develop a self-report instrument to assess diagnostic criteria and associated features of pathological gambling in order to learn more about the characteristics of individuals who seek treatment for gambling problems in a Canadian setting. METHOD: Fifty-seven adults seeking treatment for gambling problems at the Addictions Foundation of Manitoba were assessed. RESULTS: There was substantial variation in the endorsement of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptoms. Lying to family members or friends and "chasing" previous gambling losses were frequently reported, while more serious consequences (for example, relationship breakup, job losses) were less frequent. DSM-IV ratings were correlated (r = 0.59) with the South Oaks Gambling Screen. Many individuals reported gambling as a way to alleviate dysphoric mood, and 30% reported receiving mental health services in the past. Approximately 50% reported suicidal ideation, although recent suicide attempts were not common. CONCLUSION: These preliminary results of Canadian adults seeking treatment for gambling problems suggest a somewhat different profile from many United States studies, which often rely on older male pathological gamblers. More systematic investigation of the presence of major depression and other psychiatric disorders is warranted. Consistent with demographic data collected at the Addictions Foundation of Manitoba, it appears that video lottery terminals play a major role in the type of problem gambling experience seen in Canadian settings.

Adult↗

PubMed1998

Anxiety sensitivity: multiple dimensions and hierarchic structure.

Anxiety sensitivity (AS) is the fear of anxiety-related sensations, based on beliefs that these sensations have harmful consequences. AS is thought to play an important role as a diathesis for anxiety disorders, particularly panic disorder. Recent evidence suggests that AS has a hierarchical structure, consisting of multiple lower-order factors, which load on a single higher-order factor. If each factor corresponds to a discrete mechanism, then the results suggest that AS arises from a hierarchic arrangement of mechanisms. A problem with previous studies is that they were based on the 16-item Anxiety Sensitivity Index (ASI), which may not contain enough items to reveal the type and number of lower-order factors. Accordingly, we developed the 60-item Anxiety Sensitivity Profile, which was administered to 349 university students. Factor analyses revealed four lower-order factors: (1) Fear of respiratory symptoms, (2) fear of cognitive dyscontrol, (3) fear of gastrointestinal symptoms, and (4) fear of cardiac symptoms. These loaded on a single higher-order factor. The lower-order factors shared variance with the higher-order factor, but also contained unique variance. Thus, the results suggest that AS is the product of a general factor, with independent contributions from four specific factors.

Adolescent↗

PubMed1998

A retrospective study of the learning history origins of anxiety sensitivity.

Anxiety sensitivity (AS; the fear of anxiety-related sensations) has been proposed as a risk factor for the development of panic disorder. The present study involved a conceptual replication of Ehlers' (1993, Behaviour Research and Therapy, 31, 269-278) study on childhood learning experiences and panic attacks, but also extended her work by investigating the relationship between early learning experiences and the development of AS, in a non-clinical sample. A sample of 551 university students participated in a retrospective assessment of their childhood and adolescent instrumental and vicarious learning experiences with respect to somatic symptoms (i.e. anxiety and cold symptoms, respectively) using an expanded version of Ehler's (1993) Learning History Questionnaire. AS levels were assessed using the Anxiety Sensitivity Index, and panic history was obtained using the Panic Attack Questionnaire, Revised. Contrary to hypotheses, the learning experiences of high AS individuals were not found to be specific to anxiety symptoms, but involved parental reinforcement of sick-role behavior related to somatic symptoms in general. High AS subjects reported both more anxiety and cold symptoms prior to age 18 than individuals with lower levels of AS. In addition, both cold and anxiety symptoms elicited more special attention and/or instructions from parents for high AS individuals to take special care of themselves. These findings are contrasted with the results for self-reported panickers who reported more learning experiences (modeling and parental reinforcement) specific to anxiety-related symptoms, than the non-panickers. The results suggest that higher-than-normal levels of AS may arise from learning to catastrophize about the occurrence of bodily symptoms in general, rather than anxiety-related symptoms in particular.

Adult↗

PubMed1998

Confirmatory factor analysis of the Beck Anxiety and Depression Inventories in patients with major depression.

The Beck Anxiety Inventory (BAI; Beck, A.T., Epstein, N., Brown, G., Steer, R.A., 1988. An inventory for measuring clinical anxiety: psychometric properties. J. Consult. Clin. Psychol. 56, 893-897) is intended to assess clinical anxiety symptoms that are distinct from depressed mood, and there is some preliminary empirical support for this differential assessment. The BAI may serve a useful complementary role when used with the popular Beck Depression Inventory (BDI; Beck, A.T., Rush, A.J., Shaw, B.F., Emery, G., 1979. Cognitive Therapy of Depression: A Treatment Manual. Guilford Press, New York, NY; Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., Erbaugh, J., 1961. An inventory for measuring depression. Arch. Gen. Psychiatry 4, 561-571), in patients with mood and/or anxiety disorders. Accordingly, the present paper reports the results of the first confirmatory factor analysis of the Beck scales in a homogeneous, clinically depressed sample (137 outpatients with non-psychotic major depressive disorder). Results indicated that a multidimensional model of separate anxiety and depression factors had good fit to the data. However, the parameter estimate was very high (0.784) and a unidimensional, single-factor model of negative affectivity approached the criteria for good fit. It was concluded that the Beck Anxiety and Depression Inventories assess distinct anxiety and depression phenomena to a limited extent when used in a clinically depressed sample.

Adult↗

PubMed1998

A comparison of social phobia outcome measures in cognitive-behavioral group therapy.

This article reports the effects of a cognitive-behavioral group therapy program for social phobia (N = 25 outpatients) on several psychometric measures. It is the first study to simultaneously examine three newer and promising social-phobia measures: the Social Phobia Scale (SPS) and accompanying Social Interaction Anxiety Scale (SIAS), the Social Phobia and Anxiety Inventory (SPAI), and the Liebowitz Social Anxiety Scale (LSAS). More traditional measures of social phobia were also included, along with measures of anxious and depressed mood. Among the newer scales, the SPAI and SPS/SIAS were found to have good sensitivity to treatment. There was limited support for the LSAS. Intercorrelations among all of the outcome measures are presented both before and after cognitive-behavioral therapy. Strengths and weakness of each of the newer social-phobia measures are discussed.

Adult↗

PubMed1997

Suicide among Manitoba's aboriginal people, 1988 to 1994.

OBJECTIVE: To compare and contrast the characteristics of suicides among aboriginal and nonaboriginal people in Manitoba. DESIGN: Retrospective review of all suicides, based on a confidential analysis of records held by the Office of the Chief Medical Examiner. SETTING: Manitoba between 1988 and 1994. OUTCOME MEASURES: Standardized suicide rates, age- and sex-specific suicide rates, blood alcohol level at time of death, psychiatric help-seeking behaviour before suicide and residence on a reserve. RESULTS: Age-standardized suicide rates were 31.8 and 13.6 per 100,000 population per year among aboriginal and nonaboriginal people, respectively. The mean age of aboriginal people who committed suicide was 27.0 (standard deviation [SD] 10.8) years, compared with a mean age of 44.6 (SD 18.8) years for nonaboriginal people who committed suicide (p < 0.001). Blood alcohol levels at the time of death were a mean of 28 (SD 23) mmol/L among aboriginal people and 12 (SD 20) mmol/L among nonaboriginal people (p < 0.0001). Before their death, 21.9% of nonaboriginal suicide victims had sought psychiatric care whereas among aboriginal suicide victims 6.6% had sought care (p < 0.0001). Although the suicide rate was higher among aboriginal people living on reserve than among those living off reserve (52.9 v. 31.3 per 100,000 per year), both of these rates were substantially higher than the overall rates among nonaboriginal people. There were no significant differences in mean age, sex, blood alcohol level and previous psychiatric care among aboriginal people who committed suicide living on and off reserve. CONCLUSIONS: There was a high rate of suicide among Manitoba's aboriginal people between 1988 and 1994; this rate was comparable to earlier estimates of national suicide rates among aboriginal people. The reserve environment does not, by itself, account for the high suicide rate among Manitoba's aboriginal people. Further study of help-seeking behaviour and the association between alcohol abuse and suicide, particularly among aboriginal peoples, is indicated.

Adolescent↗

PubMed1997

Prevalence of anxiety disorders in elderly adults: a critical analysis.

The authors examined the prevalence of anxiety disorders in elderly adults as presented in a recent review of the topic (Flint, 1994) where it was concluded that these disorders are rare in this segment of the population. Considering that anxiety research with older adults often involves instruments and criteria that have not been validated with elders, it is suggested that results may lack validity and underestimate the occurrence of anxiety in this age group. Issues that should be considered in the assessment of anxiety in elderly adults are reviewed. In particular, elderly persons may tend to somatize anxiety symptoms and there is a large overlap between anxiety and other psychiatric symptoms among older persons. It is concluded that anxiety may present differently in elderly persons and estimates of prevalence should await more research in this area.

Age Factors↗

PubMed1997

Anxiety sensitivity and drug choice in individuals seeking treatment for substance abuse.

Sixty-four men and 49 women who applied for admission to outpatient substance abuse programs provided information on their preferred chemical (e.g., alcohol) and information on their alcohol and other chemical use. They also completed a package of self-report questionnaires including the Anxiety Sensitivity Index (ASI). The results showed that men who scored high on the ASI were more likely than low ASI subjects to prefer depressants, especially alcohol. Subjects who scored low on the ASI were more likely to prefer marijuana. ASI score did not predict chemical preference among women. All female ASI groups (high, medium and low) showed a preference for alcohol. The implications of these findings are discussed.

Adult↗

PubMed1997

Personality dimensions and depression: review and commentary.

OBJECTIVES: The relationship between dimensionally assessed personality and the onset, features, and course of depressive illness will be critically examined and considered in relation to 4 hypothesized models: predisposition or vulnerability: pathoplasty: complication or scar: and spectrum or continuity. METHOD: Studies that have used clinically depressed adult patients to explore the relationship between personality dimensions and depression will be reviewed. RESULTS: Higher-order personality factors that have shown a significant and consistent association with major depressive illness include neuroticism, extraversion (negative relationship), and the factors of Cloninger's Tridimensional Personality Model. Neuroticism appears to be the most powerful predictor of depression. Lower-order factors showing a significant and consistent relationship with depressive illness include dependency, self-criticism, obsessionality, and perfectionism. The links between depression and dependency and self-criticism have the strongest empirical support. CONCLUSIONS: Several personality dimensions are significantly associated with depressive illness, but the evidence that unequivocally demonstrates a true personality predisposition for depression is modest. Measures of personality may prove to be clinically useful for treatment selection.

Adult↗

PubMed1996

The nature and assessment of catastrophic thoughts in panic disorder.

This essay describes the current status of our conceptualization and assessment of catastrophic thoughts in panic disorder, an area that is more heterogeneous than may first appear. It is suggested that a heuristic approach would involve assessing both 'state' catastrophic cognitions (automatic thoughts) and the underlying 'trait' cognitive factors (beliefs). The cognitive symptoms listed in the DSM-IV and the self-report Anxiety Sensitivity Index serve as useful preliminary measures for assessing these respective domains. The trait cognitive domain is seen as multidimensional and congruence is required with internal or external stimuli in producing state catastrophic thoughts and accompanying panic attacks. Pressing challenges and controversies in this field are also highlighted and strategies for potentially resolving these issues are offered. Accordingly, several directions for future investigation are presented throughout the paper. Examples of innovative assessment techniques are briefly described.

Adolescent↗

PubMed1996

Anxiety sensitivity: confirmatory evidence for a multidimensional construct.

Anxiety sensitivity is a promising psychological construct in understanding the development of clinical anxiety, particularly panic disorder, and it has received a significant amount of research attention. Since the development of the 16-item Anxiety Sensitivity Index (ASI), there has been considerable controversy in the literature about whether it should be conceptualized as a unidimensional or multidimensional measure. ASI responses were collected from 216 panic disorder patients and 365 undergraduate students. Various ASI models identified in previous exploratory factor analytic studies were tested using confirmatory factor analysis (CFA) with multiple goodness-of-fit indicators. Separate CFA results for both the patient and student data strongly supported the view that the ASI is a multidimensional measure and the four-factor model originally identified by Peterson and Heilbronner (1987, Journal of Anxiety Disorders, 1, 117-121) provided the best fit to the data. It is recommended that the ASI be expanded to better assess the multiple dimensions.

Adult↗