Biomedical subjects

C Muntaner

Publications and source records attributed to C Muntaner.

At least 55 records · Page 3Linked to original sources

PubMed1995

Occupational stress and the risk of alcohol abuse and dependence.

Using prospective data, we examined the relationship between occupational stress and risk for alcohol disorders. Consistent with the Demand/Control model for psychosocial work environments, we hypothesized that individuals working in high-strain occupations (jobs with high demands and low control) would be at increased risk for alcohol abuse-dependence relative to those in low-strain occupations (jobs with low demands and high control). We classified high occupational strain into two categories: (1) jobs with high psychological demands and low control, and (2) those with high physical demands and low control. A total of 18,571 study subjects were selected in 1980-1984 by taking probability samples of adult household residents at five sites of the Epidemiologic Catchment Area Program. At baseline, participants completed standardized interviews that measured sociodemographic variables and assessed whether they had met diagnostic criteria for currently or formerly active alcohol abuse-dependence syndromes. The interviews were readministered 1 year later to identify cases among the participants. Subjects were sorted into risk sets by age and residence census tract, and persons with a previous history of alcohol abuse or dependence, as well as those who were over 64 years or had no history of full-time employment, were excluded. Among the 507 participants included in the risk sets, there were 126 incident cases of alcohol abuse-dependence and 381 age and residence-matched noncases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1995

Differences in social class among psychotic patients at inpatient admission.

A cross-sectional assessment of differences in social class and other sociodemographic variables at hospital admission for patients with psychotic disorders was carried out through a systematic survey of psychotic patients admitted to greater Baltimore psychiatric facilities between 1983 and 1989. Female patients, first-admission patients, and patients with bipolar disorder or other, nonschizophrenic psychosis were more likely to have been admitted to community, university, and private hospitals than to state hospitals. Patients in medium and higher social class categories were 1.29 to 2.57 times more likely to be admitted to community, university, and private hospitals than to state hospitals.

Adolescent↗

PubMed1994

Impulsiveness and subjective effects of intravenous cocaine administration in the laboratory.

Cardiovascular and subjective responses to placebo and 40-mg intravenous (iv) cocaine injections were measured in 29 male iv cocaine users: most subjects received each of these injections on two separate occasions. Most of the subjects also completed various measures of psychopathology and personality. Although the small sample size made any conclusions tentative, an expected significant association between impulsivity and subjective euphoria following 40-mg cocaine administration was obtained, whereas associations of personality measures with cardiovascular responses to cocaine administration were inconsistent.

Adult↗

PubMed1994

Psychotic inpatients' social class and their first admission to state or private psychiatric Baltimore hospitals.

Social class differences were investigated among patients admitted to public and private psychiatric hospitals. Participants included first admission White psychotic men admitted to Baltimore metropolitan area hospitals between 1983 and 1989. After adjusting for age and diagnosis, patients with low levels of skills/credentials were found to be more likely than patients with higher levels to be admitted to state psychiatric hospitals. These findings underscore the persistence of social class as a determinant of differences in the use of psychiatric care.

Adolescent↗

PubMed1994

Psychosocial work environment and health in U.S. metropolitan areas: a test of the demand-control and demand-control-support models.

The authors use confirmatory factor analysis to investigate the psychosocial dimensions of work environments relevant to health outcomes, in a representative sample of five U.S. metropolitan areas. Through an aggregated inference system, scales from Schwartz and associates' job scoring system and from the Dictionary of Occupational Titles (DOT) were employed to examine two alternative models: the demand-control model of Karasek and Theorell and Johnson's demand-control-support model. Confirmatory factor analysis was used to test the two models. The two multidimensional models yielded better fits than an unstructured model. After allowing for the measurement error variance due to the method of assessment (Schwartz and associates' system or DOT), both models yielded acceptable goodness-of-fit indices, but the fit of the demand-control-support model was significantly better. Overall these results indicate that the dimensions of Control (substantive complexity of work, skill discretion, decision authority), Demands (physical exertion, physical demands and hazards), and Social Support (coworker and supervisor social supports) provide an acceptable account of the psychosocial dimensions of work associated with health outcomes.

Adolescent↗

PubMed1993

Work environment and schizophrenia: an extension of the arousal hypothesis to occupational self-selection.

The present study investigated a possible mechanism underlying the occupational self-selection of future schizophrenic patients prior to their first admission. More precisely, we explored whether schizophrenic patients are more likely than other psychotic patients to work in environments with a low potential for arousal (low complexity environments) in the last full-time job that preceded their hospitalization. All first admissions with psychotic symptoms to 15 hospitals providing inpatient psychiatric services in the Baltimore-Washington area were surveyed during a 6-year period. Patients diagnosed with schizophrenia were compared to patients diagnosed with bipolar disorder and other psychotic disorders to evaluate the suspected association. Study participants were assessed with a modified version of the Diagnostic Interview Schedule. Standard survey questions were used to assess occupational background. A measure based on the dictionary of occupational titles (DOT) was used to estimate the degree of complexity to which patients had been exposed in their last full-time occupation. Data were analyzed using multinomial logistic regression. After adjustment for age, gender, marital status, unemployment, socioeconomic status, hospital type, and physical demands and hazards on the job, patients with schizophrenia were more likely to have been working in low complexity environments in their last full-time jobs (e.g., janitors, gardeners, guards) than patients with bipolar disorder or with other psychotic disorders. Alternative explanations and potential implications regarding which work environments might be best suited to the social behavior of patients with schizophrenia are examined.

Adolescent↗

PubMed1993

A critical appraisal of the demand/control model of the psychosocial work environment: epistemological, social, behavioral and class considerations.

During the last decade the demand/control model has emerged as the dominant model to explain the relationship between the psychosocial features of work organization and health. Although originating from the field of occupational social epidemiology, the conceptual and methodological basis of the demand/control model parallel construct based models used in social psychology. Using behavioral and sociological perspectives the current paper discusses the model's limitations. Recommendations regarding incorporation of social levels of analysis, the relationship between self-report and behavior, worker vs expert knowledge, and the generalized effects of stress on mental health are discussed to provide a positive heuristic to the demand/control model.

Health↗

PubMed1992

Test-retest stability of cardiovascular and subjective responses to intravenous cocaine in humans.

Sixteen male i.v. cocaine users were measured on their cardiovascular and subjective responses to placebo followed on a separate day by 40 mg i.v. cocaine injections. They were retested within 2 weeks, again receiving placebo and 40 mg i.v. cocaine injections in a random order on separate days. Significant increases in baseline (pre-injection) heart rates during the later sessions were interpreted as possibly reflecting conditioning effects. There were no significant differences in post-injection increases in cardiovascular or subjective responses between the initial and later 40 mg conditions, which might have been indicative of tolerance or sensitization development. Test-retest correlations, indicative of response stability, were moderate to high for any particular timepoint for blood pressure, heart rate, and subjective responses, but pre- vs. post-injection change scores were stable across testings on these measures only under placebo. With the possible exception of some subjective responses, there was little evidence of test-retest stability in responses (change scores) to the 40 mg cocaine injection.

Adult↗

PubMed1991

Occupational characteristics and the occurrence of psychotic disorders.

This study was undertaken to investigate whether individuals working under various occupational stressors are at increased risk of three forms of psychotic conditions. This paper presents prospective analyses of antecedent occupational stressors in psychotic conditions with interview data from a community sample in five US metropolitan areas--the NIMH Epidemiologic Catchment Area Program. Three non-overlapping conditions were defined using DSM-III definitions as assessed by the Diagnostic Interview Schedule (DIS): (1) DSM-III schizophrenia criterion A; (2) full schizophrenia; and (3) criterion A and affective episode. Artistic (RR = 3.32, 95% CI 1.08-10.14) and construction trades occupations (RR = 2.58, 95% CI 1.15-5.77), "noisome working conditions" occupations (RR = 1.20, 95% CI 0.99-1.47) and physically demanding occupations (RR = 1.39, 95% CI 1.05-1.72) were associated with increased risk of developing DIS/DSM-III schizophrenia criterion A, even after adjustment for sociodemographic and psychopathology factors including alcohol and marijuana use. Psychologically demanding occupations (RR = 0.85, 95% CI 0.75-0.95) were associated with decreased risk of developing DIS/DSM-III schizophrenia. This finding is supported by results from experimental studies on the arousability of pre-schizophrenics. Finally, teachers (RR = 11.35, 95% CI 2.56-50.38), sales occupations (RR = 4.16, 95% CI 1.00-21.30) and occupations characterized by low control over work were associated with increased risk of developing DIS criterion A and affective episode, resembling previous findings on occupational stressors and depression. Overall, our results replicate and extend previous work on occupational stressors and psychotic conditions through use of prospective data, several psychotic conditions, multiple assessment of occupational stressors and adjustment for potential confounders.

Adolescent↗

PubMed1991

Effects of nifedipine pretreatment on subjective and cardiovascular responses to intravenous cocaine in humans.

The effects of oral nifedipine pretreatment on subjective and cardiovascular responses to intravenous cocaine infusions were studied in cocaine-using volunteers. Nifedipine, 10 mg or placebo, was administered 20-25 min before placebo, 20 mg, or 40 mg cocaine, using a repeated measures randomized double-blind design. The variables measured were self-reported subjective effects, general behavior rated by two observers, blood pressure and heart rate. Cocaine produced the expected dose-related effects on subjective and cardiovascular measures. Nifedipine pretreatment attenuated some subjective effects of cocaine. Nifedipine directly reduced blood pressure but did not antagonize the effects of cocaine on blood pressure. These findings suggest that dihydropyridine calcium channel modulators may be useful compounds in the clinical management of cocaine users.

Adult↗

PubMed1991

Methohexital and cocaine self-administration under fixed-ratio and second-order schedules.

Behavior maintained by either cocaine or methohexital was compared under two different schedules of drug delivery. Under a fixed-ratio 10 schedule, each tenth response produced an injection and responding was characterized by pauses alternating with high rates that were sustained until the drug injection. Under a second-order schedule, each tenth response produced a brief visual stimulus, and the first sequence of ten responses emitted after the lapse of a ten-minute interval produced the stimulus and the drug injection. Responding under the second-order schedule was characterized by an overall positive acceleration in responding that consisted of fixed-ratio response patterns terminating in the presentation of a brief stimulus. Under either schedule, each drug maintained maximal rates of responding at intermediate doses. In most respects, rates and patterns of responding depended more on the schedule of drug delivery than on the particular drug maintaining responding.

Animals↗

PubMed1990

Self-report vs. laboratory measures of aggression as predictors of substance abuse.

Measures of aggressive behavior, antisocial personality, criminality, and impulsivity were obtained on a sample of 85 drug abusing volunteers for studies at the Addiction Research Center in Baltimore. Measures included the Buss-Durkee Hostility Inventory, Diagnostic Interview Schedule Antisocial Personality Disorder diagnosis, Elliott-Huizinga Lifetime Events Scale, Eysenck's Impulsiveness-Venturesomeness-Empathy scales, and a laboratory measure of aggression patterned after the Buss 'aggression machine'. All of the self-report measures of aggression and antisocial personality were moderately correlated with each other, but did not correlate with the laboratory aggression measure. This laboratory measure, nevertheless, made a significant contribution to the prediction of certain substance abuse diagnoses over and above the contributions of the other measures.

Adult↗

PubMed1990

Effects of self-reported drug use and antisocial behavior on evoked potentials in adolescents.

From a sample of 35 adolescents, 17 were chosen who represented extremes of self-reported drug use and delinquent behavior. Three comparison groups were derived: Group 1, n = 7, high drug use/high delinquency; Group 2, n = 4 no drug use/high delinquency; Group 3, n = 6, no drug use/no delinquency. The three groups were similar for age, IQ, race and neighborhood characteristics. Group 1 showed significantly more drug use than Groups 2 and 3; Groups 1 and 2 had comparable levels of delinquency which were significantly greater than Group 3. The subjects performed the auditory oddball task under conditions of low and high background noise. In the high background noise condition, Group 1 had longer latency P300 responses than Groups 2 and 3, while Group 2 had smaller N100 amplitude than Groups 1 and 3. Performance was similar for each group and no group differences occurred in the low background noise condition. The results support and extend previous research on the relationship between attentional and cognitive processes, and delinquent and drug using behaviors.

Adolescent↗

PubMed1990

The prediction of drug dependence from expectancy for hostility while intoxicated.

Three hundred seventy-one male substance-abusing volunteers for drug studies were administered the Buss-Durkee Hostility Inventory (B-D). One hundred nineteen of these subjects were readministered the B-D with the instruction to answer the items in terms of their behavior while drinking alcohol, with 67 of these subjects also completing a heroin use condition. Expectancies for hostility under alcohol or heroin were generally uncorrelated with other measures of personality, psychopathology, antisocial personality, impulsiveness, or criminality; but expectancies for hostility under alcohol were predictive of diagnoses of alcohol, opioid, and marijuana abuse and dependence over and above the influence of these other measures.

Adult↗

PubMed1989

Cardiovascular responses to cocaine placebo in humans: a preliminary report.

Cardiovascular responses after placebo-cocaine injections were in the same direction as the effect of cocaine iv in 22 male volunteers. Subjects received iv placebo in a room where they had been given repeated doses of iv cocaine. The placebo response consisted of an increase from baseline values of systolic and diastolic blood pressure and pulse rate. The control group, 8 subjects, which was not exposed to a conditioning phase, showed a smaller increase in the pulse rate and systolic blood pressure after the placebo injection. The results, in accordance with animal literature, suggest the existence of cocaine-conditioned effects in humans.

Adult↗

PubMed1989

Placebo responses to cocaine administration in humans: effects of prior administrations and verbal instructions.

Subjective and physiological responses of eight male cocaine-using research volunteers were studied after a double-blind saline infusion (placebo) was given when subjects were instructed that a cocaine infusion might be given. Cardiovascular and subjective responses to placebo were similar in pattern and direction, though of lesser magnitude, than after a 40 mg cocaine infusion. These placebo responses were compared to responses after an earlier saline infusion condition in which subjects were instructed prior to the infusion that they would receive saline (instructed placebo). The design was thus meant to test for the effects of instructions on placebo responses to cocaine. Heart rates at baseline (pre-infusion) were significantly higher in the placebo than in the instructed placebo condition. Similar trends were found for elevated baseline placebo responses on two subjective effects measures. A comparison with an initial placebo session prior to the placebo and instructed placebo conditions described above provided evidence for conditioning of placebo responses on diastolic blood pressure and heart rate. The present results suggest that verbal instructions, as well as conditioning in the laboratory, could contribute to the observed placebo responses to cocaine infusions.

Adult↗

PubMed1989

Intravenous cocaine infusions in humans: dose responsivity and correlations of cardiovascular vs. subjective effects.

Eight experienced IV cocaine users were intravenously administered 0, 10, 20, and 40 mg of cocaine hydrochloride on separate days in a pseudo-randomized ascending dose series, such that the 20 mg dose always preceded the 40 mg dose. They were subsequently administered 0, 20, and 40 mg of cocaine in a fully randomized presentation order. Cardiovascular effects of cocaine were significantly different from placebo for the 20 mg, but not the 10 mg dose, in contrast to subjective responses which differed from placebo for the 10 mg dose. Cardiovascular and subjective effects of cocaine did not differ between the 20 and 40 mg dose conditions for the pseudo-randomized trials, but did differ in the fully randomized trials. This lack of difference in responsivity between the 20 and 40 mg dose in the earlier trials may possibly have been due to contrast effects. Cardiovascular responses were not consistently correlated with subjective responses, either within a cocaine dose condition or across doses.

Adult↗

PubMed1989

Correlates of self-reported early childhood aggression in subjects volunteering for drug studies.

The construct validity of a retrospective self-report measure of early childhood aggression, the Early Experience Questionnaire (EEQ), was assessed in a sample of substance abusing volunteers for drug studies at a research center in Baltimore. In contrast to the diagnosis of Antisocial Personality Disorder (APD), EEQ scores were not only associated with adult aggression, criminality, and substance abuse, but were also highly correlated with a cluster of measures reflecting emotionally reactive impulsivity. Correlations of the EEQ with the Minnesota Multiphasic Personality Inventory confirmed earlier findings obtained on a sample of alcoholics. Over and above the predictive influence of APD, early childhood aggression had some predictive influence on the incidence and severity of substance abuse but a substantial influence on the prediction of criminality.

Adult↗