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Biomedical subjects

G Parker

Publications and source records attributed to G Parker.

At least 253 records · Page 14Linked to original sources
PubMed1990

Depressive type and state effects on personality measures.

We examine the hypothesis that the effect of mood state on personality questionnaire scores is more a function of diagnosis than of depression severity. Sixteen endogenous and 83 neurotic depressives completed a battery of personality questionnaires at a baseline assessment and again 20 weeks later. Scores on the personality measures changed significantly. Endogenous depressives were found to have more pronounced changes on measures of dependence and timidity, but when change in mood state was partialed out only one of the dependence measures and timidity remained significant. Thus the hypothesis only received partial support--change in mood state appears to be the major factor in elevating personality questionnaire scores.

Adolescent↗
PubMed1990

Personality differences between patients with remitted melancholic and nonmelancholic depression.

Seventy-five patients with remitted depression were categorized as having melancholic-endogenous or non-melancholic-nonendogenous depression according to DSM-III criteria, Research Diagnostic Criteria, and the Newcastle endogeneity scale. The patients' scores on four personality scales--the Eysenck Personality Inventory, the Interpersonal Dependency Inventory, locus of control, and the Interpersonal Sensitivity Measure--were then compared. Patients with nonmelancholic-nonendogenous depression were generally rated as having more vulnerable personality styles, but the differences were dependent on the particular diagnostic system used. A principal components analysis isolated three underlying personality constructs--dependency, introversion, and timidity. Patients with nonmelancholic-nonendogenous depression scored as significantly more dependent.

Adult↗
PubMed1990

The psychiatric status of patients with the chronic fatigue syndrome.

The prevalence of psychiatric disorder in 48 patients with chronic fatigue syndrome (CFS) was determined. Twenty-two had had a major depressive (non-endogenous) episode during the course of their illness, while seven had a current major (non-endogenous) depression. The pre-morbid prevalence of major depression (12.5%) and of total psychiatric disorder (24.5%) was no higher than general community estimates. The pattern of psychiatric symptoms in the CFS patients was significantly different to that of 48 patients with non-endogenous depression, but was comparable with that observed in other medical disorders. Patients with CFS were not excessively hypochondriacal. We conclude that psychological disturbance is likely to be a consequence of, rather than an antecedent risk factor to the syndrome.

Adolescent↗
PubMed1990

Classifying depression by mental state signs.

The possibility that separation of a categorical depressive disease ('melancholia') from remaining depressive disorders can be improved by assessment of mental state signs was examined in patients treated by representative Sydney psychiatrists and patients referred to a specialised mood disorders unit. A set of signs, principally assessing retardation, was derived within the two samples by principal-components and latent-class analyses. Scores were significantly correlated with clinical, DSM-III, and RDC diagnoses, and appeared independent of severity, suggesting that melancholia can be defined phenomenologically. Scores were also associated with several 'validating' factors. Comparative analyses of a refined list of melancholia symptoms suggested that ratings of defined signs are likely to have greater capacity than symptom ratings to differentiate melancholia from residual depressive disorders.

Adjustment Disorders↗
PubMed1990

Prediction of response to electroconvulsive therapy. Preliminary validation of a sign-based typology of depression.

In an open study of 35 depressed patients, psychomotor disturbance, assessed by the CORE rating system, significantly predicted response to ECT in patients with a 'retarded' but not those with an 'agitated' type of illness. In multivariate analyses, psychomotor disturbance was the sole predictor of response. This preliminary study suggests that the CORE system, which has been shown to differentiate endogenous and non-endogenous depressive disorders, has predictive validity in relation to ECT response.

Adult↗
PubMed1990

Hormonal responses to fenfluramine in depressive subtypes.

In order to study putative differences in central neurotransmitter function in depressive subtypes, serum cortisol and prolactin responses to the putative serotonin agonist fenfluramine were examined in 30 subjects with major depression. Patients with endogenous depression (melancholia) as defined by each of ICD-9, DSM-III, RDC and Newcastle scale demonstrated a reduced prolactin response to 60 mg oral fenfluramine when compared with non-endogenous subjects. This was independent of either prolactin or cortisol baseline levels, and indicates that there are differences in brain neurotransmitter function in the endogenous and non-endogenous subtypes of depression. Basal prolactin levels were reduced in bipolar compared with unipolar subjects, and delusional compared with non-delusional patients, although there were no differences in the prolactin responses to fenfluramine between these subgroups. Basal cortisol levels and cortisol response to fenfluramine did not distinguish between any of the subtypes.

Administration, Oral↗
PubMed1990

Reliability of the parental bonding instrument and intimate bond measure scales.

The long-term reliability of the Parental Bonding Instrument (PBI) and of the Intimate Bond Measure (IBM) are examined in a non-clinical group, with data being examined over eleven and five years for the two respective measures. Such reliability data are compared with reliability data on a number of personality measures within the same cohort. Results demonstrate considerable stability in the PBI over an extended period and moderate stability in IBM scores.

Adult↗
PubMed1989

Is sex necessarily a risk factor to depression?

To isolate and quantify possible determinants of any increased prevalence of depressive disorders in women we studied a select group of men and women, initially similar in terms of a number of putative social determinants of depression, and reviewed the sample five years later when social role diversity was anticipated. We used the Diagnostic Interview Schedule (DIS) to generate DSM-III and RDC diagnoses to estimate lifetime depressive disorders, and established (via corroborative reports) the likely accuracy of those data. Despite lifetime depression being a relatively common experience, no significant sex differences in depressive episodes were demonstrated, suggesting the possible irrelevance of biological factors in determining any sex difference. As there was not major social role divergence over the five year study, we interpret the lack of a sex difference as a consequence, and suggest that findings support the view that social factors are of key relevance in determining any female preponderance in depression described in general population studies.

Adult↗
PubMed1989

Factorial validity of the EE scales.

High 'expressed emotion' (EE) has been held to be predictive of a poor course in patients with schizophrenia, a finding that has emphasized the predictive validity of the EE measure. We review appropriate research examining properties of the EE measure to suggest that, in particular, little is known about the construct validity of the EE measure. We report a longitudinal study examining three measures of parental style (EE; Parental Bonding Instrument or PBI; and interviewer ratings). By comparing EE scale scores with ratings derived by an interviewer we find support for the accuracy of the process generating EE scale scores, and by factor analytic techniques we examine the factorial (construct) validity of the EE scales. A principal components analysis suggested two other dimensions of relevance in parents involved with a schizophrenic member (vigilance, and acceptance of illness in their child) which may be of value in predictive studies. We examined the capacity of interviewer-generated scores (as a simple clinical rating) and factor scores (as central constructs) to predict the course, and were unable to discriminate 'relapsers' and 'non-relapsers' with either predictor.

Adaptation, Psychological↗
PubMed1989

The life skills profile: a measure assessing function and disability in schizophrenia.

We review limitations of representative measures of function and disability associated with schizophrenia and specify requirements of a suitable measure for service evaluation: It should reliably and validly assess constructs relevant to survival, function, and adaptation in the community. Additionally, it should be brief, comprise specific and jargon-free items assessing distinct behaviors, and therefore be capable of completion by family members and community housing managers as well as by professional staff. The initial development of such a measure, the 39-item Life Skills Profile (LSP), with its five scales, is described. We report data to suggest that it is likely to be a measure of considerable utility both in research studies and in defining and assessing clinical services.

Activities of Daily Living↗
PubMed1989

Predicting the productive research psychiatrist.

Data were obtained for some 89 psychiatrists who were responsible for 372 first-author research publications over the period 1978-1984, to define predictors of productivity (rate of publishing in scientific journals). A principal components analysis suggested three key researcher dimensions, comprising 'track record', 'experience' and 'resource base' variables. The 'track record' dimension was the only significant predictor and was contributed to principally by the number of publications in the early part of the review period, number of citations to published work, rating by peers, and possessions of a research degree.

Adult↗
PubMed1989

Reliability of parental reports using the Katz Adjustment Scales: before and after hospital admission for schizophrenia.

We examined the interrater and test-retest reliability of the KATZ Adjustment Scale (Relative rated or R form) longitudinally in a sample of schizophrenic patients, assessing their function before hospital admission, as well as at 1 and 9 mo. after discharge. Changes in mean scores over those assessments suggested sensitivity to change while mothers and fathers both completed the measure with moderate consistency over time. Interrater reliability was moderate at best and quite poor at initial testing, when the subjects were most disturbed clinically, suggesting that the scales may be acceptable when the individual is stable but that ratings may be unreliable when there is an exacerbation in clinical state.

Adult↗
PubMed1989

Endogenous depression as a construct: a quantitative analysis of the literature and a study of clinician judgements.

We review the concept of endogenous depression historically and undertake quantitative analyses of representative factor analytic studies. We also report an empirical study, isolating symptoms and signs associated with a clinical diagnosis of psychotic/endogenous depression, made by a large number of clinical raters assessing 300 depressives. The quantitative analyses and the study of practising psychiatrists agreed in delineating depressive type and together suggest a more restricted construct of endogenous and psychotic depression than has been held historically. Key clinical features isolated were severity, retardation, delusions and paranoid features, non-reactivity and non-variability in mood, while vegetative features appeared to lack relevance.

Adjustment Disorders↗
PubMed1989

Standards of care for area mental health services.

A provisional set of standards of care was derived from a quality assurance strand of a wider research project, which reported the development of evaluation strategies for area integrated mental health services (AIMHS). In contrast to most published standards, they apply to all facets of care in a comprehensive catchment area mental health service, whether clinical or functional, community or hospital based, urban or rural, or managed by the public, private or voluntary sectors. We review briefly existing sets of standards of mental health services and report the process of development of standards of care, each with sub-sets of performance indicators and examples. While the AIMHS standards and a companion quality assurance manual are still undergoing refinement, they offer a guide for mental health professionals to the provision of services, and a checklist to service-users of services that should be available to them at every stage of care in a mental health system.

Accreditation↗
PubMed1989

The Parental Bonding Instrument: psychometric properties reviewed.

The Parental Bonding Instrument (PBI) was designed as a refined self-report measure of fundamental parental dimensions of care and protection. The utility of such a self-report measure is dependent on demonstration of robust psychometric characteristics, particularly the extent to which the PBI provides valid ratings of actual and not merely perceived characteristics. This paper reviews initial and more recently published studies assessing the psychometric properties of the PBI, and which suggest satisfactory reliability and validity.

Adult↗
PubMed1989

Development of a scale to measure interpersonal sensitivity.

We describe the development of a self-report measure (the Interpersonal Sensitivity Measure or IPSM). The IPSM generates a total score as well as five sub-scale scores: interpersonal awareness, need for approval, separation anxiety, timidity and fragile inner-self. Its reliability is demonstrated by high internal consistency in two separate groups, and by stability in scores over time in a non-clinical group. Studies of a clinical group of depressives showed change in scale scores following improvement in the depressive state, suggesting some sensitivity of the measure to mood state. The IPSM appears related to measures of neuroticism and to low self-esteem but not to a modified concept of neuroticism, emotional arousability. The constructs contributing to interpersonal sensitivity and their relevance to depression are considered. Some preliminary findings of higher scores in depressives compared to non-depressives are reported.

Adaptation, Psychological↗
PubMed1988

Parental 'expressed emotion' as a predictor of schizophrenic relapse.

Fifty-seven schizophrenic patients were initially assessed after admission to hospital, at which time their parents completed a Camberwell Family Interview, generating "expressed emotion" (EE) scores. Relapse over the next nine months was not predicted by household EE status or by individual EE scales. Multivariate analyses suggested that a poor course after hospitalization was best predicted by a poor course before admission and by living in a one-parent household. High household EE status was a predictor only in one multivariate analysis after course of illness and one-parent household status had been entered, suggesting an interaction effect. We query the causal proposition linking high EE and relapse and suggest instead that a poor illness course may elicit high EE in relatives, particularly in one-parent households, and, thus, may make the principal contribution to the proposed link.

Adult↗