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D K Winstead

Publications and source records attributed to D K Winstead.

At least 19 recordsLinked to original sources
PubMed1999

Subtyping obsessive compulsive patients by depressive symptoms: a retrospective pilot study.

Depression is a frequent comorbid condition in obsessive compulsive disorder (OCD) patients and may impact upon treatment prognosis. Identification of OCD "subtypes" might ultimately aid in treatment decision-making as it has in other psychiatric disorders. A retrospective pilot study was performed examining depressive and OCD symptomatology by analyzing the relation between factor scores on the Beck Depression Inventory (BDI) and the Maudsley Inventory (MOCI) in 41 OCD patients. Total BDI score was significantly correlated with total MOCI score (r = .36, p < .02). Checking was correlated with Retarded depression (r = .30, p < .05). Doubting correlated with both Guilty depression (r = .48, p < .002) and Retarded depression (r = .37, p < .02). None of the canonical correlations were significant. At p < .08, the first canonical correlation approached significance. The data were interpreted cautiously as suggesting that some OCD patients may exhibit symptoms of Doubting together with Guilty depression and Retarded depression symptoms. These data need replication in a larger, prospective study design.

Adult↗
PubMed1995

Smooth pursuit eye movement differences between familial and non-familial schizophrenia.

Disrupted smooth pursuit eye tracking characterizes a greater proportion of individuals with schizophrenia than in the normal population. The finding of a similar increased incidence of eye tracking abnormality in first degree relatives of schizophrenics implicates this disorder as a potential biological marker for schizophrenia. To test the assumption that the eye tracking dysfunction of schizophrenics is genetically related, left and right smooth pursuit gain and phase shift were compared between 20 schizophrenics with a family history of schizophrenia or schizophrenia-related disorders, 18 schizophrenics without a family history, as well as for 18 normal controls. Subjects tracked pendular targets on an LED light bar moving at frequencies of 0.2 and 0.7 Hz. Horizontal eye movements were recorded using DC-electro-oculography. Results indicate that schizophrenics with a positive family history had significantly reduced right pursuit gain compared with controls, while right gain for negative family history schizophrenics did not differ from either group. Schizophrenic subjects also were administered neuropsychological tests. Linear regression by groups analyses reveal that neuropsychological measures significantly predicted right gain to slower targets (0.2 Hz) for the positive family history schizophrenics, but not for negative family history schizophrenics.

Adolescent↗
PubMed1994

Visible persistence decay rates for schizophrenics and substance abusers.

Information-processing deficits are consistently reported for schizophrenics. The findings from the majority of psychophysical tasks indicate that the deficit is specific to schizophrenics and thus may represent a marker for schizophrenia. The present study evaluated for specificity of impairment by including controls using methadone. A two-pulsed forced choice information-processing task that required the detection of a line or a blank-field during an interstimulus interval (ISI) indexed efficiency of processing (i.e., visible persistence). There were 19 schizophrenic, 9 schizoaffective, 8 depressed, 12 on methadone, and 12 normal subjects. The visual stimuli were low and high spatial frequency gratings. Either a line of equivalent width to those of the gratings or a blank field was presented during the ISI. The gratings were presented for 150 msec prior to and following an ISI of 30, 60, 90, 120, 150, and 350 msec. The results support previous findings for impaired processing during a 90-150 msec interval for schizophrenics. Also, the methadone-using controls were not significantly different from schizophrenics. Normal and depressed controls' profiles did not differ from each other, however, they were significantly different from the other groups. The results support an early information-processing deficit in schizophrenic individuals and may implicate dysregulation of dopaminergic neuromodulation.

Adult↗
PubMed1994

Diagnosis, health beliefs, and risk of HIV infection in psychiatric patients.

OBJECTIVE: The study examined behavioral and cognitive factors that may place mentally ill persons at increased risk of infection by the human immunodeficiency virus (HIV). METHODS: Sixty-one patients consecutively admitted to a psychiatric inpatient unit of a public general hospital completed questionnaires focused on their knowledge about AIDS and their sexual practices. They also participated in a structured interview to assess how their beliefs about health related to changes in health behaviors. Responses of the psychiatric patients, of whom 54.5 percent were men and 61.5 percent were black, were categorized by diagnosis (schizophrenia, bipolar affective disorder, and depression) and were compared with responses of a control group of 32 patients with no identified psychiatric disorder who had been treated in the hospital's medical emergency room. RESULTS: Trends in the data suggested that the psychiatric patients were more likely than the control subjects to engage in high-risk sexual behaviors. Psychiatric patients with different diagnoses appeared to engage in different kinds of high-risk behaviors. Whereas control subjects seemed inclined to change their behaviors as their knowledge about HIV increased, schizophrenic patients appeared willing to change their behavior only if they believed their behavior could really make a difference in whether they would become infected. CONCLUSIONS: The relationship between specific psychiatric symptoms, knowledge about HIV, and factors influencing behavior need to be more thoroughly examined so that clinicians can develop interventions to reduce the risk of HIV infection in mentally ill persons.

Adult↗
PubMed1993

Risk of HIV infection in the homeless and chronically mentally ill.

Recent data suggest that the homeless and those with chronic mental illness may be at increased risk for HIV infection. A review of the recent literature reveals insufficient rigorously collected data to identify with confidence any particular subgroup of chronically mentally ill patients at increased risk. Nonetheless, it seems reasonable to suspect that those with acute psychosis, a history of substance abuse, or a history of sexual abuse may be at higher risk. Conversely, some data currently support the conclusion that homeless persons are at increased risk for infection due to human immunodeficiency virus (HIV). Clinicians of all disciplines should be aware of these findings and be particularly vigilant when patients are members of both aforementioned groups. Future research should focus upon improving service delivery to the homeless and mentally ill, particularly with regard to sex education and substance abuse intervention. Also, continued research into causal influences of homelessness will ultimately lead to more definitive intervention.

Adult↗
PubMed1993

Psychopathology and psychiatric diagnoses of World War II Pacific theater prisoner of war survivors and combat veterans.

OBJECTIVE: This study assessed current and long-term psychological and psychiatric sequelae of war trauma in World War II Pacific theater combat veterans, some of whom had been Japanese prisoners of war (POWs). METHOD: A group of 36 POW survivors and a group of 29 combat veterans, all of whom had seen fierce fighting and heavy unit casualties, were compared approximately 40 years later on psychological instruments assessing psychopathology constructs, negative mood states, and symptoms of posttraumatic stress disorder (PTSD) and on the computer-administered National Institute of Mental Health Diagnostic Interview Schedule. RESULTS: Although similar in personal backgrounds and in having suffered catastrophic war trauma, the two groups differed in the severity and type of psychiatric symptoms and in the occurrence of psychiatric disorders. Anxiety and depressive disorders were common in both groups, but there were differences in the frequency of PTSD diagnoses. Among the POW survivors, 70% fulfilled the criteria for a current diagnosis and 78% for a lifetime diagnosis of PTSD, compared to 18% and 29%, respectively, of the combat veterans. CONCLUSIONS: The findings point to the persistent nature of symptoms thought to be residuals of extraordinary stress and the relation between severity of psychiatric sequelae and characteristics of the stressors.

Aged↗
PubMed1992

Deficits in initial feature registration of schizophrenics and substance abusers.

Information processing deficits are consistently reported for schizophrenics. The present study evaluated if the longer duration required by schizophrenics to visually recognize a target may qualify, as proposed by previous studies, as a vulnerability and/or trait biological marker. Critical stimulus duration (CSD) was used as the index of initial target registration and recognition. The CSD is the minimal duration, in ms, to meet task criterion, which in the present study was seven consecutive identifications of the target letter 'T' or 'A'. There were 13 normal controls, 11 methadone maintenance experimental controls, 21 chronic schizophrenics and 12 subacute schizophrenics. Analysis of variance revealed that the CSDs of normal controls and subacute schizophrenics were not statistically different (p > 0.05); the CSDs of chronic schizophrenics were not statistically different from methadone controls (p > 0.05), while the chronic schizophrenics and the methadone controls' CSDs were statistically different from the normal controls and the subacute schizophrenics. The results support earlier reports of long target duration required by chronic schizophrenics for feature recognition. Since retarded CSDs were obtained for methadone control but not for acute schizophrenics, the CSD does not qualify as a specificity or a vulnerability index for schizophrenia. A neurophysiological explanation is proposed for the findings.

Adult↗
PubMed1992

Schizophrenic feature recognition deficits are independent of task criterion.

The present study determined the minimal exposure time (i.e., critical stimulus duration (CSD) necessary for feature registration and recognition by normals and chronic schizophrenics. Our interest was whether the longer exposure times required by schizophrenics than by normals could be attributed to an inability of schizophrenics to maintain attention when the task criteria were stringent as opposed to 'loose'. The present findings support previous findings of impaired feature recognition by chronic schizophrenics. Chronic schizophrenics' and normals' CSDs were not affected by task criterion. The consistent performance by these groups on the 'loose' and 'rigid' task criteria suggest that if attentional lapses occur then they are as likely to occur for chronic schizophrenics as for normals and they are independent of the task's criterion. It is concluded that impaired feature registration for chronic schizophrenics is a consequence of a deficit at the earliest stage of encoding.

Adult↗
PubMed1992

Behavioral aspects of trichotillomania.

Trichotillomania is characterized by an inability to resist urges to pull out hair. It is estimated to occur in at least 1 out of 200 persons by college age. The disorder usually begins in childhood or adolescence with a chronic course more likely in patients with a later onset. Some investigators hypothesize a relationship between trichotillomania and obsessive compulsive disorder, but this proposal has not yet been substantiated. Little rigorous treatment research has been done, but the current treatments of choice are clomipramine and behavior therapy (habit reversal training).

Adult↗
PubMed1991

Cognitive deficits and psychopathology among former prisoners of war and combat veterans of the Korean conflict.

OBJECTIVE: This study was conducted to describe the long-term psychological and psychiatric sequelae of prisoner of war (POW) confinement against the backdrop of psychiatric evaluations of Korean conflict repatriates more than 35 years ago. METHOD: A group of 22 POWs and a group of 22 combat veteran survivors of the Korean conflict were compared on measures of problem solving, personality characteristics, mood states, and psychiatric clinical diagnoses by means of a battery of psychometric instruments and structured clinical interviews. RESULTS: Although the two groups were similar in background and personal characteristics, they differed in reports of life adjustment problems, complaints of physical distress, proficiency on cognitive tests, objectively measured personality characteristics, and assigned psychiatric diagnoses. CONCLUSIONS: Illustrated by a case report which describes the prolonged brutality of the Korean conflict POW experience for one individual, the results suggest that the psychiatric symptoms documented more than three decades ago have persisted in severity and chronicity. In addition to problems with cognitive deficits and complaints of bodily discomfort, most common among POW survivors were symptoms of suspiciousness, apprehension, confusion, isolation, detachment, and hostility.

Affect↗
PubMed1990

Assessment of long-term psychosocial sequelae among POW survivors of the Korean Conflict.

Psychological and psychiatric assessments were performed among 20 prisoner-of-war (POW) Korean-Conflict survivors. Results revealed extraordinary biological and psychological abuse with weight losses exceeding 35% of preservice weights and long-term cognitive, emotional, and behavioral sequelae. The full range of posttraumatic stress disorder symptoms was seen in 90% to 100% of the cases with high prevalence of co-morbidity, specifically mood (75%), other anxiety (45%), and alcohol abuse (20%) disorders. Documented by clinical investigators at POW release and now more than 30 years later, symptoms of apprehensiveness, confusion, detachment, and depression reflect the persistence of psychiatric morbidity over time.

Adaptation, Psychological↗
PubMed1990

Obsessive compulsive patients: familial frustration and criticism.

Familial factors such as attitudes toward illness, knowledge of disease process, and criticism of patients often play an important role in patient compliance and outcome in general medical practice as well as in psychiatric settings. As part of the initial assessment in a psychoeducational group for obsessive compulsive disorder patients and their significant others, nonpatients completed the Relative's Reactions Questionnaire and the Control of Symptoms Schedule. The patients completed the Perceived Criticism Measure. Results suggest that significant others experience frustration with the symptomatic behavior of their friend or family member with obsessive compulsive disorder and may respond too frequently with verbal criticism. The patients themselves reported a moderately high level of criticism from significant others at home. Further research is needed on a larger sample size and with nonpsychiatric and nonobsessive compulsive disorder psychiatric controls.

Adult↗