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Biomedical subjects

I Grant

Publications and source records attributed to I Grant.

At least 217 records · Page 12Linked to original sources
PubMed1986

Influence of premorbid risk factors on neuropsychological performance in alcoholics.

This report provides new evidence that neuromedical risk factors influence levels of behavioral impairment in alcoholics. Using a factorial model, the effects of age, neuromedical risk history, and duration of sobriety were studied in relation to neuropsychological performance. The data showed a consistent interaction between duration of abstinence and risk status: Recently detoxified alcoholics (sober 1 month) with a positive premorbid risk history had worse neuropsychological performance than did those without such historical risk events. By contrast, long-term abstinent alcoholics (sober 4 years) did not demonstrate the interaction between alcohol history and positive premorbid risk history. The present results are held to mean that neuromedical risk factors may exert a differential influence on test scores of recently detoxified men, suggesting a source of variance in neurobehavioral studies of alcoholism requiring attention by investigators.

Adult↗
PubMed1985

Relationship of neuropsychological status to everyday functioning in healthy and chronically ill persons.

Three hundred and three patients with chronic obstructive pulmonary disease and concomitant neuropsychological impairment plus 99 healthy control subjects matched on the basis of socio-demographic variables were administered an expanded version of the Halstead-Reitan Battery and a battery of instruments measuring the quality of everyday-life functioning. The results indicated that neuropsychological measures can be used to predict everyday-life functioning in impaired persons, but few significant relationships were observed in the normals. Neuropsychological status was more consistently related to activities of daily living and basic social role performance than to emotional status. Complex, multifunctional neuropsychological tasks were found to be the best overall predictors of life functioning, whereas more specific tasks served as better predictors of specific dimensions of life functioning.

Activities of Daily Living↗
PubMed1985

Use of demographic variables to predict full scale IQ: a replication and extension.

The evaluation of current level of neuropsychological functioning is handicapped by the lack of validated actuarial methods for estimating premorbid intellectual functioning. The present study cross-validated and attempted to improve the one existing method of using demographic variables in a systematic way to predict WAIS Full Scale IQ (Wilson et al., 1978). A sample of 491 neurologically normal subjects was used. The results generally supported the IQ prediction equation, but did reveal systematic differences in accuracy of prediction and direction of prediction error for IQs in the high and low ranges. Also, a simpler IQ prediction formula that uses only years of education was developed and compared with the 5-variable Wilson et al. formula.

Adolescent↗
PubMed1985

Analysis of covariance as a remedy for demographic mismatch of research subject groups: some sobering simulations.

Analysis of Covariance (ANCOVA) is often used in neuropsychological studies to effect ex-post-facto adjustment of performance variables amongst groups of subjects mismatched on some relevant demographic variable. This paper reviews some of the statistical assumptions underlying this usage. In an attempt to illustrate the complexities of this statistical technique, three sham studies using actual patient data are presented. These staged simulations have varying relationships between group test performance differences and levels of covariate discrepancy. The results were robust and consistent in their nature, and were held to support the wisdom of previous cautions by statisticians concerning the employment of ANCOVA to justify comparisons between incomparable groups. ANCOVA should not be used in neuropsychological research to equate groups unequal on variables such as age and education or to exert statistical control whose objective is to eliminate consideration of the covariate as an explanation for results. Finally, the report advocates by example the use of simulation to further our understanding of neuropsychological variables.

Adult↗
PubMed1985

The social environment and neurological disease.

This chapter has reviewed some of the methodological and theoretical issues in research linking the social environment to medical illnesses. The second part of the chapter has focused on three specific neurological entities to examine evidence for a possible association between neurological illness and life stress. There is some suggestion that certain vulnerable epileptic patients can experience convulsions in response to acute emotional upheaval or certain types of cognitive challenges. More commonly, it is probable that social stress and emotional tension can produce lowering of seizure threshold by increasing levels of fatigue and disrupting sleep. The latter factor, in particular, is known to lower seizure threshold. In the case of stroke, several dramatic cases of intracranial hemorrhage have been related to disastrous life circumstances. A general association between life stress and stroke has yet to be established. The case for a link between life events and onset of exacerbation of multiple sclerosis seems stronger. Events which produce emotional upset seem capable of worsening symptoms in patients with existing disease, and several studies have reported unusual life stresses in the period preceding onset of symptoms in this disorder.

Affect↗
PubMed1984

Aging, abstinence, and medical risk factors in the prediction of neuropsychologic deficit among long-term alcoholics.

Halstead-Reitan assessments were conducted with 71 male alcoholics sober for four weeks, 65 alcoholics sober for four years, and 68 nonalcoholics. Recently detoxified alcoholics showed learning and problem-solving difficulties, as did older persons in all groups. Aging, not alcoholism, was related to psychomotor slowing. There were no age-alcohol interactions for any neuropsychologic test. Time since last drink predicted neuropsychologic performance modestly, as did head injury, age, and education. Long-term sober alcoholics were indistinguishable from controls. Our results suggest that alcoholics abstinent one month suffer a subacute alcohol-related organic mental disorder that might resolve with prolonged abstinence, that the neuropsychologic findings in such alcoholics are more consistent with an "independent decrements" rather than "premature aging" hypothesis, and that neuromedical and other risk factors must be considered before permanent neuropsychologic deficit among alcoholics can be attributed solely to neurotoxic effects of alcohol.

Adult↗
PubMed1984

Interaction of life events and symptoms in psychiatric patient and nonpatient married couples.

Many studies have related life events to various symptoms, but there has been little effort to examine how life events and symptoms experienced by a spouse might contribute to health change in the partner. On 3 bimonthly occasions, 115 husbands and wives completed the Schedule of Recent Experiences and a Symptom Checklist. In 40 of the couples, husbands were psychiatric outpatients, and in 75 they were nonpatients. Among nonpatient couples, symptoms in either partner were significantly predicted by the level of each one's own life events (especially undesirable events) and by the levels of symptoms in the spouse during the preceding 2 months. Among couples in which the husband was a patient, the most important predictor of symptoms in either spouse was that person's self-report of life events. Future research on the social origins of psychiatric symptoms should consider the possible contributions of a spouse's symptom state to the health of the individual under study.

Adult↗
PubMed1984

Deficient learning and memory in early and middle phases of multiple sclerosis.

Forty-three patients with multiple sclerosis showed disturbances in short-term memory, learning, and delayed recall which were associated with years of active disease (average was 4.5 years), age, presence of flareup, but not steroid/ACTH treatment. Unrecognised memory loss might be prevalent early in the natural history of multiple sclerosis and deserves neuropsychological assessment.

Adrenocorticotropic Hormone↗
PubMed1984

Failure of nonlinear models of drinking history variables to predict neuropsychological performance in alcoholics.

To test whether the relationship between drinking parameters and cognitive functioning can be visualized as a curvilinear surface (rather than as a line, which more traditional regression equations presuppose), the authors tested 84 recently detoxified and 72 longer-term abstinent alcoholic men with the Halstead-Reitan battery. Quadratic statistical models did not predict test performance in the first group; a few predictions were found in the second. When the multiple correlation was adjusted for number of cases and variables, the "nonlinear" results were statistically no more significant than those of simpler linear models. It is concluded that drinking history does not readily explain cognitive findings among sober alcoholics and that polynomial models can produce inflated correlation coefficients.

Adult↗
PubMed1983

Psychologic effects of continuous and nocturnal oxygen therapy in hypoxemic chronic obstructive pulmonary disease.

The Nocturnal Oxygen Therapy Trial (NOTT) showed previously that patients with hypoxemic chronic obstructive pulmonary disease (COPD) frequently suffered from neuropsychologic deficit and experienced disturbed mood, personality, and life quality. The present study has followed up 150 NOTT patients six months after they were randomized to continuous oxygen treatment (COT) or nocturnal oxygen treatment (NOT). Tested off oxygen, 42% showed modest neuropsychologic improvement after six months of therapy, and the rates for COT and NOT were comparable. A subsample (n = 37) was examined a third time, after 12 months of treatment. At this point patients receiving COT registered better neuropsychologic performance than those receiving NOT. Concurrently, the COT group began showing improved survival. Despite mild neuropsychologic improvement, patients reported little change in emotional status or life quality. It is concluded that prolonged oxygen treatment is associated with small but definite improvement in brain functioning among patients with hypoxemic COPD, and that COT might have some advantage over NOT in enhancing neuropsychologic functioning as well as survival.

Cognition↗
PubMed1982

Life events and symptoms: Fourier analysis of time series from a three-year prospective inquiry.

In a three-year prospective study in which life events and psychiatric symptoms were assessed every two months, Fourier analyses led to the classification of event-symptom relationships into five typologies. Only one event-symptom typology, representing 9% of subjects, was consistent with the commonly held causal model. The results indicate that further progress in life-events research will require prospective designs, more sophisticated methods for gathering life-events data than the Schedule of Recent Experiences, focus on qualitative features of events (eg, undesirability or threat), and identification of personal characteristics and coping styles that might augment or attenuate the health impacts of life happenings.

Adult↗
PubMed1982

Life quality of patients with chronic obstructive pulmonary disease.

Two hundred three patients with hypoxemic chronic obstructive pulmonary disease (COPD) and 73 healthy control subjects matched for age, sex, race, and neighborhood of residence were administered three self-report inventories concerned with the following four dimensions of life quality: emotional functioning, social-role functioning, activities of daily living, and recreational pastimes. An additional inventory was administered to a spouse or another close relative of each patient. The life quality of patients with COPD was found to be impaired relative to healthy subjects on all dimensions. Depression was the preponderant emotional disturbance reported; difficulties with home management and reduction in social interaction were the primary social-role deficits. Ambulation, mobility, sleep and rest, and a variety of recreational pastimes were also severely affected. Life quality exhibited moderate but significant relationships to neuropsychological, pulmonary, and cardiac functioning and to exercise capability. Age and socioeconomic status were found to be possible moderators of the relationship of COPD to life quality. A model to integrate these findings is proposed. Implications for the management of COPD and for the evaluation of medical treatments of chronic disabling conditions are described.

Activities of Daily Living↗
PubMed1982

Neuropsychologic findings in hypoxemic chronic obstructive pulmonary disease.

As part of a six-center clinical trial of the effectiveness of continuous v nocturnal oxygen in the management of hypoxemic chronic obstructive pulmonary disease (COPD), we performed detailed neuropsychologic assessments of these patients prior to their beginning treatment. The 203 patients (age, 65 years; Pao2, 51 mm Hg; forced expiratory volume in 1 s, 0.74 L) performed significantly worse than controls on virtually all neuropsychologic tests. Moderate to severe test impairment suggestive of cerebral dysfunction was found in 42% of the patients, as compared with 14% of controls. Higher cognitive functions (abstracting ability, complex perceptual-motor integration) were most severely affected, although half the patients also showed decrements in motor speed, strength, and coordination. Low-order significant inverse correlations were found between neuropsychologic impairment and Pao2, resting arterial oxygen saturation and hemoglobin levels and maximum work. It is concluded that cerebral disturbance is common in hypoxemic COPD and may be related in part to decreased availability of oxygen to the brain.

Adult↗
PubMed1981

Quality of life events in relation to psychiatric symptoms.

This prospective study explored the relationship of life changes to psychiatric symptom changes in psychiatric outpatients (N = 196) and a comparison group of nonpatients (N = 194). Subjects completed the Schedule of Recent Experiences and a symptom checklist bimonthly for 18 months. At all reporting intervals, symptoms and events were strongly correlated. Undesirable and uncontrollable events related positively and desirable events negatively to symptoms. Among symptoms, those of a dysphoric and somatic nature were most strongly associated with event change. Psychiatric patients also reported more undesirable, more uncontrollable, and fewer desirable events than the comparison group. We conclude that the relationship of life events to symptoms depends on the specific qualities of both events and symptoms. Undesirable and uncontrollable events appear to have a direct, and desirable events an inverse, association with dysphoric and somatic symptoms.

Adult↗
PubMed1981

Life event reports by psychiatric patients, nonpatients, and their partners.

The Schedule of Recent Experience (SRE) was completed for three separate two-month periods by groups of male psychiatric patients, male nonpatients, and their partners (primarily spouses). Each partner completed the SRE for life events believed to have occurred to the index person. For both patient and nonpatient pairs, perfect agreement was reported for only about one third of the responses where at least one pair member reported an occurrence. With disagreements, index persons were little more likely than their partners to report that an event occurred. Agreement was higher for clearly worded than for vaguely worded items in both patient and nonpatient groups. Among nonpatient pairs only, agreement was higher for events that would be difficult to hide from a partner than for those that could be kept hidden. Agreement for undesirable events for either group.

Female↗