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Biomedical subjects

D B Clark

Publications and source records attributed to D B Clark.

At least 73 records · Page 4Linked to original sources
PubMed1971

The clinical approach to neurologic disorders.

The role of the clinician in the study of genetically determined disorders of the nervous system is to detect and describe clinical syndromes. His tools are the history and the physical examination. His task is to recognize those striking signs or symptoms, or those significant collections of lesser findings, which suggest a new disease state. His greatest responsibility is to weigh the significance of such findings against the effects of human variation, growth, maturation and senescence, and the life situation of the patient or his family. His unique contribution is his ability to recognize and pursue the uncertain entity, until chance observation, the evolution of the illness, or new technics of study make its exegesis possible.

Aged↗
PubMedDate not supplied

Correlates of mental health service utilization and unmet need among a sample of male adolescents.

The authors sought to identify the correlates of mental health services utilization and unmet need for these services among a sample of adolescent males. We hypothesized that our findings would replicate and extend those of the recent Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, which found that parental factors play a major role in their children's unmet mental health care needs. Our study involved an evaluation of mental health service utilization and unmet need during the prior 2 years, as reported by the subjects at a follow-up assessment at age 16. Four factors were found to predict increased mental health services utilization, including attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) among the adolescent males, the father's alcohol use disorder, and the mother's amphetamine use disorder. One factor was found to predict decreased utilization, the father's cannabis use disorder. Four factors significantly predicted unmet treatment need, including conduct disorder, the mother's amphetamine use disorder, a higher number of siblings, and a parental history of having had a childhood anxiety disorder. The results of this study suggest that parental psychopathology, parental substance abuse, the presence of conduct disorder, and an increased number of siblings act as barriers to adequate mental health treatment among adolescents. These findings confirm the crucial role that parental factors play in the treatment utilization and the unmet treatment need of their children, and also suggest that an increased number of siblings can also be associated with unmet treatment need.

Adolescent↗
PubMedDate not supplied

Clinical correlates of heavy tobacco use among adolescents.

The primary aim of this study was to determine the clinical factors differentiating adolescents with heavy smoking (> or = 10 cigarettes/day) from adolescents with light smoking. This study involved a study group of 812 adolescents recruited from adolescent alcoholism treatment centers and from the community. Logistic regression analyses demonstrated that adolescents with heavy smoking, compared with adolescents with light smoking, were significantly more likely to demonstrate Caucasian American ethnicity, drug-use disorders, alcohol-use disorders, and conduct disorder. Our findings suggest that the clinical correlates of heavy smoking among adolescents are generally similar to those for smoking at any level (vs. nonsmokers), except that heavy smoking is more strongly associated with Caucasian American ethnicity. Also, depressive disorders were associated with smoking at any level in our sample, but depressive disorders were not associated with heavy smoking.

Adolescent↗
PubMedDate not supplied

Early adolescent gateway drug use in sons of fathers with substance use disorders.

This study determined the relevance of preadolescent psychopathology and substance use for predicting early adolescent alcohol and cannabis involvement in boys of fathers with and without substance use disorders (SUD). Fathers of preadolescent boys (ages 10 through 12 years) were recruited to represent families of boys with paternal SUD (High Risk or HR: N = 102) and boys without paternal SUD (Low Average Risk or LAR: n = 166). These boys and a parental informant participated in semistructured diagnostic interviews at baseline and 2-year follow-up assessments (ages 12 through 14 years). Preadolescent tobacco experimentation and early adolescent regular alcohol use were more prevalent in HR than in LAR subjects. Logistic regression analyses were utilized to develop prediction equations. The presence of oppositional defiant disorder and the absence of anxiety disorders predicted preadolescent tobacco use. Preadolescent conduct disorder predicted early adolescent regular alcohol use. Preadolescent tobacco use and conduct disorder were highly predictive of early adolescent cannabis use, achieving 100% sensitivity with 76% specificity. Children with tobacco use prior to adolescence, as well as those with disruptive behavior disorders, may be important to target for interventions to prevent cannabis use.

Adolescent↗
PubMedDate not supplied

Reliability and validity of the Hamilton Anxiety Rating Scale in an adolescent sample.

OBJECTIVE: Although generalized anxiety is an important clinical problem among adolescents, there are no interview procedures to provide a global anxiety rating that have demonstrated reliability and validity for this population. The Hamilton Anxiety Rating Scale (HARS) is a general measure of anxiety that was developed for adults. The purpose of this study was to determine the reliability and validity of the HARS when used with adolescents. METHOD: The sample consisted of 257 adolescents aged 12 to 18 years from both clinical and community sources. The HARS interviews and ratings were conducted as part of an extensive psychiatric and medical assessment. Psychiatric diagnoses were determined by structured interview. Other questionnaire measures of anxiety were also obtained. RESULTS: The interrater reliability and internal consistency of the HARS were acceptable in this adolescent sample and were comparable to results reported for adults. The HARS exhibited good construct validity, showing statistically significant relationships with independent self-report measures of generalized anxiety and other anxiety variables. The factor structure of the HARS also was found to be similar to that found earlier with adults. CONCLUSIONS: These results demonstrate that the HARS is a reliable and valid measure for the assessment of global anxiety in the adolescent population.

Adolescent↗
PubMedDate not supplied

Hypertension and neurofibromatosis. Case report.

A 14-year-old girl with neurofibromatosis presented with severe hypertension. She was subsequently found to have a cerebellar glioblastoma multiforme and vascular lesions producing coarctation of the abdominal aorta and 50% and 95% stenosis of the left and right renal arteries respectively. No evidence of pheochromocytoma was found. After removal of the cerebellar tumor, marked amelioration of the hypertension suggested that the tumor had a major role in the pronounced elevation of her blood pressure. Patients who have both neurofibromatosis and hypertension should be carefully evaluated for these several potential lesions.

Adolescent↗