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Biomedical subjects

Gil G Noam

Publications and source records attributed to Gil G Noam.

15 recordsLinked to original sources
PubMed2005

White matter hyperintensities and their association with suicidality in depressed young adults.

INTRODUCTION: Researchers and clinicians have increasingly recognized that biological markers may help identify patients who are at risk for suicide. The objective of this retrospective, cross-sectional study was to compare the prevalence and location of white matter hyperintensities (WMH) in young inpatients with major depressive disorder (MDD) with and without histories of suicide attempts. METHODS: T2-weighted magnetic resonance images (MRI) of 102 young psychiatric inpatients with MDD were rated for the presence of WMH. Medical charts were reviewed to ascertain history of suicide attempt, demographic and clinical variables. Fisher's Exact Tests and logistic regression modeling were used to test the association between WMH and suicidality. RESULTS: Bivariate analysis showed that the prevalence of periventricular WMH was significantly higher in subjects with past suicide attempts (Fisher's Exact Test, p=0.02). Logistic regression analyses controlling for age, sex, and several clinical risk factors supported this finding (odds ratio=5.7; 95% confidence interval: 1.6, 21.2). LIMITATIONS: Due to the retrospective, cross-sectional design of our study, we are unable to determine if the WMH preceded or followed past suicide attempts. The generalizability of our findings is limited since this group of inpatients is more severely ill than the general psychiatric population. CONCLUSIONS: The increased prevalence of periventricular WMH in young adults with MDD and a history of suicide attempt, compared to similarly depressed adults without such a history, is consistent with our findings in children and youth, and suggests there might be neurobiological in addition to psychosocial risk factors for suicide.

Adolescent↗
PubMed2004

Relationships across multiple settings: an overview.

It is not the method of interaction but the quality of the interaction between patient and therapist, student and teacher, mentee and mentor, or youth and youth worker that is the most critical determinant of success in a myriad of fields.

Adolescent↗
PubMed2004

Achieve Boston: a citywide innovation in professional development.

Achieve Boston is a broad-based collaborative effort to improve the overall quality of programs for children and youth by establishing a professional development infrastructure that supports those who work with young people during the out-of-school-time hours.

Adolescent↗
PubMed2004

Aggressive behavior in the adolescent psychiatric patient: a clinical-developmental perspective.

OBJECTIVE: This study examined the relationship between ego development and psychological defenses to aggressive behavior in a group of psychiatrically hospitalized adolescents. METHOD: Subjects were 245 adolescents ages 12-16, who were assessed for aggressive behaviors, assaultive incidents, ego development and defenses. RESULTS: Aggressive behavior was found to be negatively associated with ego development, regardless of age, gender or IQ. Defense styles which located the source of conflict outside of the self were associated with higher levels of self-reported aggressive behaviors. Hospital incidents of assault were associated with a lack of cognitively based defenses. CONCLUSION: Aggressive behavior is tied to the development of critical psychological processes which shape the adolescent's ability to understand themselves and their environment. The results are discussed in the context of a clinical-developmental approach to adolescent aggressive behavior.

Adolescent↗
PubMed2004

White matter hyperintensities and their associations with suicidality in psychiatrically hospitalized children and adolescents.

OBJECTIVE: Increasingly, researchers and clinicians are recognizing that there may be biological markers associated with increased risk of suicide. The objective of this study was to compare white matter hyperintensities in psychiatrically hospitalized children and youth with and without a history of suicide attempt while controlling for other variables. METHOD: White matter hyperintensities of 153 child and adolescent psychiatry inpatients were rated on T2-weighted magnetic resonance imaging scans using a modified Coffey scale. DSM-IV diagnosis, history of suicide attempt, and control variables such as gender, age, comorbid medical illnesses, developmental disorder, substance abuse, severity of mental illness, head injury, and possible cerebral hypoxia were obtained from discharge medical records. RESULTS: Within the unipolar depression group (n = 48), white matter hyperintensities were significantly associated with a higher prevalence of past suicide attempts (Fisher exact test, p =.03). Logistic regression analysis confirmed this relationship, indicating that none of the control variables confounded our results and suggesting a specificity of 0.94. CONCLUSIONS: This is the first report of an increased prevalence of white matter hyperintensities in children and youth with unipolar depression and a history of suicide attempt. Replication and expansion of our preliminary findings could be of great clinical interest.

Adolescent↗
PubMed2003

Threat and trauma: an overview.

Common responses after exposure to threat include reexperiencing the event, intrusive thoughts and images, hyperarousal, avoidance and numbing, a sense of a foreshortened future, and shattered assumptions about control and safety.

Adaptation, Psychological↗
PubMed2003

Subanalysis of the location of white matter hyperintensities and their association with suicidality in children and youth.

Our previous research with psychiatrically hospitalized children and youth indicates that white matter hyperintensities (WMH) on T2-weighted MRI images are associated with a history of suicide attempt. This subanalysis of the specific locations of the WMH suggests that youth with deep WMH in the parietal lobe but not in the frontal lobe have a significantly higher prevalence of reported past suicide attempt.

Adolescent↗
PubMed2002

Where education and mental health meet: developmental prevention and early intervention in schools.

There is growing recognition that traditional strategies, such as pullout special education programs and on-site casework and guidance, are no longer sufficient to address the staggering needs of a growing number of troubled children entering U.S. schools. This paper introduces a school-based prevention and intervention method for young adolescents called Responsive Advocacy for Life and Learning in Youth (RALLY). Prevention practitioners, a new role developed by the program, work in classrooms and after-school settings to provide nonstigmatizing support to students. Using a three-tiered prevention model, practitioners integrate a mental health and educational focus to foster students' academic, social, and emotional success. The intervention involves all children of an age cohort in middle schools. The practitioners are developmental specialists who create relationships with youth, teachers, and families in high-risk environments and serve triage functions to existing community and health care institutions. The RALLY intervention builds on normative developmental and developmental psychopathology theory, especially a risk and resilience framework. The paper describes the principles behind the practice and how the work in this field has created innovations in theory and a new impetus for research.

Adolescent↗
PubMedDate not supplied

White matter hyperintensities on magnetic resonance imaging of the brain in children with psychiatric disorders.

The current study sought to determine the prevalence, severity, and location of white matter signal hyperintensities (WMH) on brain magnetic resonance imaging assessments of children and adolescents with psychiatric disorders. Seventy-one percent (N = 934) of children admitted to the McLean Hospital Child and Adolescent inpatient treatment unit were evaluated with the Diagnostic Interview Schedule for Children (DISC) within 7 days of admission during the period 1988 to 1993 (total, 1,308 admissions). Four hundred eight of these subjects (43.7%) were referred for brain magnetic resonance imaging (MRI) scans and became our study subjects (mean age, 12.4 years [SD = 2.7]; male/female, 230/178). Study subjects were grouped according to a hierarchical diagnostic system as follows: schizophrenia (n = 42), bipolar disorder (n = 56), unipolar depression (n = 94), conduct disorder/attention deficit disorder (n = 103), and other neurotic disorders (n = 30). Subjects without any level 2 diagnosis on DISC (n = 83) constituted the comparison group. Bipolar disorder, unipolar depression, and conduct disorder/attention deficit disorder groups were significantly more likely to have severe levels of WMH than the comparison group (prevalence rates: 17.9%, 13.8%, 13.6% v 1.2%). In addition, the bipolar disorder group was significantly more likely to have severe levels of WMH than the schizophrenia group (prevalence rates: 17.9% v 2.4%). The frontal lobes were the predominant locations of WMH in the bipolar disorder and unipolar depression groups (76.9% and 60.0%, respectively) and also the most frequent location for the conduct disorder/attention deficit disorder group (35.7%). The current study reports an increased prevalence and severity of WMH in children with bipolar disorder, unipolar depression, and conduct disorder/attention deficit disorder relative to the comparison group and in children with bipolar disorder compared to those with schizophrenia. The development of brain WMH, especially in the frontal lobes, may play a role in the pathophysiology of affective disorders in children and adolescents.

Adolescent↗