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Biomedical subjects

G Parker

Publications and source records attributed to G Parker.

At least 127 records · Page 7Linked to original sources
PubMed1999

Characteristics of depressed patients who report childhood sexual abuse.

OBJECTIVE: Depressed patients who had and had not been exposed to childhood sexual abuse were studied to determine differences in severity of depressed mood, lifetime histories of anxiety and depression, childhood environment, and disordered personality function. METHOD: Data were obtained from 269 inpatients and outpatients with major depression (171 women and 98 men) by means of structured clinical interviews and self-report questionnaires. RESULTS: Forty-six of the 269 patients reported childhood sexual abuse; 40 of these were women. These 40 women were compared with the 131 who did not report childhood sexual abuse. The patients who experienced abuse did not differ from those who had not on psychiatrist-rated mood severity estimates, but they did have higher self-report depression scores. They also evidenced more self-destructive behavior, more personality dysfunction, and more overall adversity in their childhood environment. Childhood sexual abuse status was associated with more borderline personality characteristics independently of other negative aspects of the patients' earlier parenting. Childhood sexual abuse status was linked strongly to adult self-destructiveness, as was early exposure to maternal indifference. CONCLUSIONS: Multivariate analyses suggest that depression is unlikely to be a direct consequence of childhood sexual abuse. Childhood sexual abuse appears to be associated with a greater chance of having experienced a broadly dysfunctional childhood home environment, a greater chance of having a borderline personality style, and, in turn, a greater chance of experiencing depression in adulthood.

Adult↗
PubMed1999

Double-blind controlled investigation of transcranial magnetic stimulation for the treatment of resistant major depression.

OBJECTIVE: The efficacy and safety of left prefrontal repetitive transcranial magnetic stimulation (rTMS) for treating resistant major depression were examined in a double-blind, controlled study. METHOD: Eighteen medication-resistant depressed subjects were randomly assigned to 2 weeks of real or sham rTMS, then permitted up to 4 weeks of real rTMS. Effects on mood, neuropsychological function, EEG, and hearing were assessed. RESULTS: The groups receiving real and sham rTMS improved in mood significantly over the 2-week double-blind period, but there was no significant difference between groups. CONCLUSIONS: Repetitive transcranial magnetic stimulation did not provide significantly greater improvement than did sham treatment. A 4-week course of rTMS, as administered in this study, was safe.

Affect↗
PubMed1999

An exploration of links between early parenting experiences and personality disorder type and disordered personality functioning.

Reports of early parenting were assessed using two measures, the Parental Bonding Index (PBI) and the Measure of Parenting Style (MOPS), in a sample of 265 patients with DSM-defined major depressive disorder. Psychiatrists then rated the extent to which sample members evidenced the personality "styles" underpinning 15 separate personality disorders, returning personality vignette scores. The extent of disordered functioning was also assessed across "parameters" and "domains" by psychiatrists, referrers, and family members, using a range of measures. Those with higher scores on vignettes measuring borderline, anxious, depressive, and self-defeating personality style rated parents as uncaring, overcontrolling, and abusive. When vignettes were consolidated into scores akin to the DSM clusters, the most consistent links between perceived dysfunctional parenting were with the Cluster C (anxious), and Cluster B (dramatic) styles and were nonsignificant for Cluster A (eccentric) style. Meeting criteria for an increasing number of personality disorder clusters was associated with increasing levels of adverse parenting. Multiple regression analyses indicated that disordered functioning (as assessed by the three independent rater groups) was most distinctly associated with paternal indifference and maternal overcontrol.

Adult↗
PubMed1999

Risk and the welfare state.

The British welfare state developed as a state-centred response to the problem of handling the risks encountered in a typical life-course. The influential work of Giddens and others implies that the traditional welfare state is under attack from two directions: a changing international politico-economic environment limits the freedom of national governments to pursue independent policies involving relatively high taxation to finance social spending. At the same time, changes in the experience of risk and declining confidence in the expertise of welfare state planners and professionals undermine support for state-centred solutions. This approach fails to acknowledge that available non-state services are often inadequate to meet many everyday life risks and that the authority of private sector advisers, insurers and professionals is also increasingly open to question. This article discusses whether people reject welfare state solutions to problems of risk in the context of research on the perceptions and behaviour of people buying or selling their homes, considering provision for long-term care needs and defrauding social security carried out by the ESRC's Economic Beliefs and Behaviour programme. Individual responses endorse the continued provision of state welfare in order to meet unprovided risks alongside disenchantment with the record of both state and private professionals and planners and awareness that state retrenchment requires greater individual responsibility for meeting one's own needs. The theory of risk society requires development to recognize that citizens are not necessarily alienated from state welfare.

Attitude to Health↗
PubMed1998

p53 mutation with frequent novel condons but not a mutator phenotype in BRCA1- and BRCA2-associated breast tumours.

The status of p53 was investigated in breast tumours arising in germ-line carriers of mutant alleles of BRCA1 and BRCA2 and in a control series of sporadic breast tumours. p53 expression was detected in 20/26 (77%) BRCA1-, 10/22 (45%) BRCA2-associated and 25/72 (35%) grade-matched sporadic tumours. Analysis of p53 sequence revealed that the gene was mutant in 33/50 (66%) BRCA-associated tumours, whereas 7/20 (35%) sporadic grade-matched tumours contained p53 mutation (P<0.05). A number of the mutations detected in the BRCA-associated tumours have not been previously described in human cancer databases, whilst others occur extremely rarely. Analysis of additional genes, p16INK4, Ki-ras and beta-globin revealed absence or very low incidence of mutations, suggesting that the higher frequency of p53 mutation in the BRCA-associated tumours does not reflect a generalized increase in susceptibility to the acquisition of somatic mutation. Furthermore, absence of frameshift mutations in the polypurine tracts present in the coding sequence of the TGF beta type II receptor (TGF beta IIR) and Bax implies that loss of function of BRCA1 or BRCA2 does not confer a mutator phenotype such as that found in tumours with microsatellite instability (MSI). p21Waf1 was expressed in BRCA-associated tumours regardless of p53 status and, furthermore, some tumours expressing wild-type p53 did not express detectable p21Waf1. These data do not support, therefore, the simple model based on studies of BRCA-/- embryos, in which mutation of p53 in BRCA-associated tumours results in loss of p21Waf1 expression and deregulated proliferation. Rather, they imply that proliferation of such tumours will be subject to multiple mechanisms of growth regulation.

BRCA1 Protein↗
PubMed1998

Mammalian glycophosphatidylinositol anchor transfer to proteins and posttransfer deacylation.

The glycophosphatidylinositol (GPI) anchors of proteins expressed on human erythrocytes and nucleated cells differ with respect to acylation of an inositol hydroxyl group, a structural feature that modulates their cleavability by PI-specific phospholipase C (PI-PLC). To determine how this GPI anchor modification is regulated, the precursor and protein-associated GPIs in two K562 cell transfectants (ATCC and .48) exhibiting alternatively PI-PLC-sensitive and resistant surface proteins were analyzed and the temporal relationship between GPI protein transfer and acquisition of PI-PLC sensitivity was determined. Nondenaturing PAGE analyses demonstrated that, whereas in .48 transfectants the GPI anchors in decay accelerating factor (DAF) and placental alkaline phosphatase (PLAP) were >95% acylated, in ATCC transfectants, they were 60 and 33% unsubstituted, respectively. In contrast, TLC analyses revealed that putative GPI donors in the two lines were identical and were >/=95% acylated. Studies of de novo DAF biosynthesis in HeLa cells bearing proteins with >90% unacylated anchors showed that within 5 min at 37 degreesC (or at 18 degreesC, which does not permit endoplasmic reticilum exit), >50% of the anchor in nascent 44-kDa proDAF protein exhibited PI-PLC sensitivity. In vitro analyses of the microsomal processing of miniPLAP, a truncated PLAP reporter protein, demonstrated that the anchor donor initially transferred to prominiPLAP was acylated and then progressively was deacylated. These findings indicate that (i) the anchor moiety that initially transfers to nascent proteins is acylated, (ii) inositol acylation in mature surface proteins is regulated via posttransfer deacylation, which in general is cell-specific but also can be protein-dependent, and (iii) deacylation occurs in the endoplasmic reticulum immediately after GPI transfer.

Acylation↗
PubMed1998

Depressed mood states and their inter-relationship with clinical depression.

A study was conducted to contrast depressed mood states in those positive and negative for lifetime depressive syndromes. A non-clinical cohort of 156 subjects was assessed on four occasions over 15 years, with 35% having had a major depression and 22% a minor depression at the most recent assessment. At 5-yearly reviews, estimates were obtained of episode frequency, duration and symptom patterns during depressed mood states. Such characteristics were then contrasted across the three groups of those who had experienced major depression, those who had suffered minor depression and lifetime non-cases. Depressive states were affirmed by at least 96% of subjects at each assessment, with the mean number of episodes per assessment year ranging from 8.6 to 21.2. Those who had experienced a lifetime episode of major depression differed from the two contrast groups (i.e. those with minor depression: non-cases) in having more episodes and more features during episodes. By contrast, there was a gradient across the three groups for two other examined features, with those having major depression being more likely than those with minor depression, who in turn were more likely than the non-cases to have longer episodes and a greater number of symptoms. The greater frequency, severity and duration of depressed mood states in those who met lifetime criteria for a major depressive episode suggest that their threshold to onset and persistence of a variety of depressive experiences is lowered, so supporting a general vulnerability hypothesis.

Adult↗
PubMed1998

Sex differences in the experience of depressed mood state over fifteen years.

A study was conducted to examine sex differences in frequency, duration and severity of experience of depressed mood state in a non-clinical group and to consider how such findings contribute to the understanding of sex differences in depressive experience. A cohort of 156 subjects, assessed initially in 1978 in their last year of teacher training, was reassessed at 5-yearly intervals over 15 years. On each occasion, the subjects completed self-report ratings of experience of "normal depression" and measures of neuroticism, trait depression, self-esteem and sex role. The study found no sex differences in the number or duration of episodes. Women reported more symptoms per episode and some specific symptoms (including tearfulness, appetite and weight gain) more often. The number of symptoms was correlated with neuroticism, self-esteem and trait depression scores, and with gender but not sex role. The number of episodes was related to trait depression and self-esteem but not neuroticism. The results showed that there are links between female gender, neuroticism and number of symptoms experienced during depressed mood state episodes. These links are related more to female gender than to feminine sex role or premenstrual problems, and are reflected in the severity of affective change (and some specific symptoms) but not in the number of episodes.

Adult↗
PubMed1998

Development of a measure profiling problems and needs of psychiatric patients in the community.

We argue the advantages of a measure profiling common problems faced by psychiatric patients in the community and indicating a likely need for service recognition, review and possible assistance. We describe the development of such a measure, the 35-item Profile of Community Psychiatry Clients (PCPC), and the identification of four relevant domains. Component scales assess coping limitations, behavioural problems, levels of social support and organic problems. High test-retest reliability was established, and a number of tests of the measure's validity were undertaken. Discriminant validity was established by demonstrating that those case managed by a community mental health service returned significantly higher scale scores than a comparison group who, while having a similar diagnostic profile, were not case managed. Additionally, scale scores were associated with a number of categorical and dimensional validators reflecting aspects of service need, and distinctly with service costs. We demonstrate that PCPC scores correspond with scores generated by the Life Skills Profile (LSP), a measure of disability, and examine the extent to which PCPC scales correspond to those contained in the Health of the Nation Outcome Scales (HoNOS). We argue for the scale's capacity to provide both a profile of central problems faced by patients and their likely need for community-based service assistance.

Adult↗
PubMed1998

Disordered personality style: higher rates in non-melancholic compared to melancholic depression.

OBJECTIVE: We test whether there is differential representation of disordered personality function across melancholic and non-melancholic depressive sub-types, with levels of differentiation examined against differing sub-typing measures. METHOD: In a sample of 245 subjects meeting criteria for a non-psychotic major depressive episode lasting less than 2 years, we examine for differential rates of disordered personality style across melancholic and non-melancholic depression, using four differing sub-typing measures (i.e., DSM-III-R and DSM-IV criteria, Newcastle Index, and the CORE measure). Disordered personality was assessed by psychiatrist ratings of 15 differing personality styles underpinning disorder classes, and several parameters and domains that reflect the arenas whereby disordered personality may be manifested. RESULTS: However defined, those with non-melancholic depression were distinctly more likely to rate as showing disordered personality function, with over-representation to an avoidant personality disorder style being the most consistently and strongly identified personality disorder class. Because of limitations to several of the sub-typing measures, we focus on the DSM-IV system. Discriminant function analyses indicated that those so identified as having non-melancholic depression were significantly more likely to rate as having avoidant and schizoid personality styles. A principal components analysis of our 15 differing personality disorder classes identified three molar classes corresponding to the three-cluster DSM system. Again, non-melancholic (compared to melancholic) subjects were more likely to return higher scores: in order, an 'anxious and fearful' (Cluster C) personality style, then an 'eccentric' Cluster A, and somewhat less clearly, a 'dramatic' Cluster B personality disorder style. Specificity to the non-melancholic depressive class was again suggested in relation to a large number of the parameters and domains measuring disordered personality function. CONCLUSIONS: Disordered personality function appears distinctly more likely in non-melancholic, compared to melancholic depression.

Adolescent↗
PubMed1998

Examining sex differences in the impact of anticipated and actual life events.

To examine for sex differences in anticipated and actual impact of pleasant and unpleasant life events in a non-clinical group, a cohort of 164 subjects was initially assessed in 1978 in their last year of teacher training. They were asked to participate in the life events study in 1979, and 97 subjects complied, providing us with ratings of impact of 'anticipated' life events. In 1983, the original cohort assessed the 'actual' impact of events experienced over the previous year. They also completed measures of neuroticism, state and trait depression, self-esteem, parental bonding and dependency in 1978, and gender roles in 1983. Some analyses for sex differences were undertaken for the entire cohort, with more extensive analyses for the 97 who had completed the 1979 (as well as 1978 and 1983) assessments. There were no sex differences in the scores for 'anticipated' or 'actual' impact of pleasant life events, or for 'anticipated' unpleasant life events. However, there was a statistically significant sex difference between 'actual' unpleasant life event scores, with females rating events as being either more pleasurable or unpleasant than males at both collection points. The actual impact of pleasant events was associated with higher dependency and masculinity scores, whilst unpleasant events was associated with higher dependency for females and higher parental overprotection and dependency scores for males.

Affective Symptoms↗
PubMed1998

The SSRI antidepressants: exploring their "other" possible properties.

BACKGROUND: Anecdotal reports suggest that the SSRIs may have important properties in addition to their antidepressant effects, possibly modifying mediating variables that dispose to and maintain depression. This preliminary study seeks to identify any such potential variables. METHODS: Fifty three subjects who had reported substantial general benefit to their clinician after treatment with an SSRI were requested to retrospectively rate change across a range of constructs assessed by questionnaire. RESULTS: Differential effects were identified. Irritability, trait depression, worry and neuroticism scores showed the most marked improvement, with cognitive style components also showing significant positive change. Equally importantly, there was no evidence of a positive response bias across all constructs. CONCLUSION: We suggest that the SSRIs may act as "antiworry" agents and reduce irritability, neuroticism and dysfunctional attributions. LIMITATIONS: Our study was retrospective and relied on self-report by volunteer patients who had been previously depressed. The study design cannot exclude the possibility that improvement reported on a number of measures may have been due to the amelioration of residual depression. CLINICAL RELEVANCE: The SSRIs, recognised as having antidepressant and anti-obsessional properties, may also have the capacity to lower irritability, worrying and neuroticism. This capacity could be useful per se but may, in addition, reduce the occurrence and duration of depressive episodes, particularly by reducing "anxious worrying".

1-Naphthylamine↗
PubMed1998

Non-melancholic depression: the contribution of personality, anxiety and life events to subclassification.

BACKGROUND: We sought to develop a clinically useful subtyping system for the non-melancholic depressive disorders, and here we assess one weighted to central aetiological factors. METHODS: We studied 185 patients meeting DSM-III-R and/or clinical criteria for non-melancholic depression. Data were obtained by self-report, interview of patients and from corroborative witnesses. We developed a set of variables for class definition, assessing: (i) 'P', disordered personality as a vulnerability factor; (ii) 'A', meeting criteria for a lifetime anxiety disorder or positive on probe questions about trait anxiety characteristics, so assessing anxiety as a vulnerability factor; and (iii) 'L', psychiatrist and consensually-rated life event stress prior to depression onset. RESULTS: A latent class analysis generated a four-class solution for the P-A-L variables. Life event stressors had similar item probabilities across all four classes, and did not influence the four-class 'P-A' solution when deleted from the analysis, suggesting that life event stress may act more as a general provoking agent, rather than constituting any distinct 'reactive' or 'situational' depression class. Three classes generated clinically meaningful groupings, reflecting varying contributions of anxiety and disordered personality functioning, and with evidence of differential outcome over the following 12 months. CONCLUSIONS: We suggest that a refined aetiologically-weighted model may assist definition of the non-melancholic depressive disorders, and provide the logic for exploring the comparative utility of differing treatments to identified vulnerability-based classes.

Adult↗
PubMed1998

Qualitative and quantitative analyses of a 'lock and key' hypothesis of depression.

BACKGROUND: We examine a 'lock and key' ('L-K') hypothesis to depression which posits that early adverse experiences establish locks that are activated by keys mirroring the earlier adverse experience to induce depression. METHODS: Two-hundred and seventy clinically depressed patients were examined with open-ended and pre-coded interview questions to ascertain both early adverse experiences and precipitating life events. Qualitative and quantitative data analyses examined for any associations between developmental 'locks' and precipitating 'keys'. RESULTS: Qualitative assessment suggested 'L-K' links in almost one-third of the sample, and examples are provided. While quantitative analyses indicated significant associations between several identical 'lock' and 'key' constructs, evidence of specificity was rare. When individual 'locks' and 'keys' were consolidated into three higher-order constructs, variable models were suggested, including a non-specific link, a specific link and absence of any link. 'L-K' links appeared more likely in those with 'non-melancholic' (versus 'melancholic') depression, with the seemingly greater relevance to 'reactive' (versus 'neurotic') depression in the quantitative analyses inviting speculation that that 'disorder' may be more a reaction to a salient rather than a severe stressor. CONCLUSIONS: This exploratory study suggests that early adverse experiences may variably establish specific and non-specific patterns of vulnerability to having depression triggered by exposure to salient mirroring life event stressors.

Adjustment Disorders↗
PubMed1998

Incident monitoring in psychiatry.

Critical Incident Monitoring (CIM) as an instrument of quality assurance (QA) has received increasing attention in recent years. The present study was developed to explore a potential role for CIM in QA for clinical psychiatry. A questionnaire was sent to psychiatrists and requested retrospective reporting of clinical incidents, and a pilot study of an inpatient-based incident reporting system was performed. All Fellows of the Royal Australian and New Zealand College of Psychiatry (RANZCP) were sent a questionnaire. Eight psychiatric inpatient services were invited to participate in the pilot study. The returns of the questionnaires were aggregated and analysed to reveal a relatively small number of separate incident types, with little difference between the 'adverse outcome' and 'near-miss' categories. Similar results were found with the pilot study. It was concluded that the development of a unified incident reporting system for use by psychiatric clinicians and psychiatric services may add usefully to existing quality improvement processes.

Antidepressive Agents↗
PubMed1998

Characterization and chromosomal localization of human hair-specific keratin genes and comparative expression during the hair growth cycle.

During anagen, cell proliferation in the germinative matrix of the hair follicle gives rise to the fiber and inner root sheath. The hair fiber is constructed from structural proteins belonging to four multigene families: keratin intermediate filaments, high-sulfur matrix proteins, ultra high-sulfur matrix proteins, and high glycine-tyrosine proteins. Several hair-specific keratin intermediate filament proteins have been characterized, and all have relatively cysteine-rich N- and C-terminal domains, a specialization that allows extensive disulfide cross-linking to matrix proteins. We have cloned two complete type II hair-specific keratin genes (ghHb1 and ghHb6). Both genes have nine exons and eight introns spanning about 7 kb and lying about 10 kb apart. The structure of both genes is highly conserved in the regions that encode the central rod domain but differs considerably in the C-terminal coding and noncoding sequences, although some conservation of introns does exist. These genes have been localized to the type II keratin cluster on chromosome 12q13 by fluorescence in situ hybridization. They, and their type I partner ghHa1, are expressed in differentiating hair cortical cells during anagen. In cultured follicles, ghHa1 expression declined in cortical cells and was no longer visible after 6 d, whereas the basal epidermal keratin hK14 appeared in the regressing matrix. The transition from anagen to telogen is marked by downregulation of hair cortical specific keratins and the appearance of hK14 in the epithelial sac to which the telogen hair fiber is anchored. Further studies of the regulation of these genes will improve our understanding of the cyclical molecular changes that occur as the hair follicle grows, regresses, and rests.

Base Sequence↗
PubMed1998

On modelling personality disorders: are personality style and disordered functioning independent or interdependent constructs?

Current descriptors of personality disorder (PD) are an amalgam of two constructs, personality style and/or disorder. We seek to determine whether their intrinsic personality style descriptors are proxy measures of, or independent of, disordered personality functioning. In a sample of depressed patients, psychiatrists rated 16 differing PD personality style vignettes and assessed eight differing manifestations of disordered functioning. When "personality" vignettes and identified personality clusters were intercorrelated with "disorder" variables, interdependence was generally evident, suggesting that the personality descriptors underpinning current definition of the PDs actually act as proxy criteria for assessing disorder because they are, in and of themselves, descriptors of pathological functioning. The obsessional personality vignette provided an exception, seeming to be independent of disordered function. Such results assist consideration of how best to model, define and measure the personality disorders.

Adolescent↗