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Biomedical subjects

J A Neff

Publications and source records attributed to J A Neff.

At least 37 records · Page 2Linked to original sources
PubMed1987

Psychiatry and medicine in the US: interpreting trends in medical specialty choice.

An integrated model of change in knowledge, highlighting the role of technologic and organizational paradigms and the activities of professional and extra-professional groups, is used to clarify the historical development of psychiatry and to account for current specialty choice trends. American psychiatry and medicine stem from disparate scientific/philosophical roots. A review of events leading to the establishment of psychiatry as a medical specialty indicates that the merger of psychiatry and neurology may have stemmed as much from professional competition as from technological or paradigmatic convergence. Recent perceived declines in the choice of psychiatry as a medical specialty are examined in light of this sociology of knowledge perspective. Declining choice of psychiatry as a specialty reflects both underlying paradigmatic conflicts with medicine as well as declining federal support for psychiatric training. Solutions proposed for the perceived problem within psychiatry are designed to solidify ties with medicine, increase political power and prestige, and retain federal support.

Career Choice↗
PubMed1986

Alcohol consumption and psychological distress among U.S. Anglos, Hispanics and Blacks.

Data from the Health and Nutrition Examination Survey Augmentation Component of the U.S. National Center for Health Statistics were analysed to assess differences between Anglos (N=5546), Blacks (N=872), less-acculturated Hispanics (N=182), and more-acculturated Hispanics (N=58) with regard to alcohol use, psychological distress, and alcohol consumption-psychological distress relationships. Alcohol consumption differences were more notable for quantity rather than frequency, with Hispanics reporting significantly higher quantity than Anglos or Blacks. Drinkers were more depressed than non-drinkers among Anglos and Blacks; an opposite, though insignificant, pattern emerged among Hispanics. Higher quantity of alcohol use was generally associated with greater depressive symptomatology and lower well-being. More frequent drinking was generally associated with lower depressive symptoms and higher well-being. Additional findings that pointed to negative relationships between quantity and both reported nervous breakdowns and help-seeking for emotional problems among less-acculturated Hispanics suggest a greater use of alcohol as a coping mechanism in this group.

Black or African American↗
PubMed1985

Race and vulnerability to stress: an examination of differential vulnerability.

In this article the possibility of race differences in vulnerability to stress is considered. Structural models linking socioeconomic status, age, and life-change events to psychological distress are fit to blacks' and whites' data, which were obtained in a community survey of 829 Florida residents to evaluate differences in vulnerability. Life-change-distress paths were slightly larger among blacks than among whites, though not significantly so. The possible adaptive or coping resources provided by supportive social ties and by fatalistic responses to chronic stress are suggested as topics for further research with regard to psychological well-being among disadvantaged groups.

Adaptation, Psychological↗
PubMed1985

Evaluating the stress-buffering role of alcohol consumption: variation by type of event and type of symptom.

The possible stress-buffering properties of alcohol consumption are examined. Data on psychological symptoms from 1270 rural adults supported both symptom dimension (affective/somatic) and type of event (catastrophic/noncatastrophic) as possible influences upon buffering properties. Non-catastrophic events showed the greatest buffer effects from alcohol use. For depressive symptoms the greatest buffer effect was produced by occasional drinking; moderate drinking had a less pronounced effect. For somatic symptoms, buffer effects were suggested for both moderate and heavy drinkers. No buffer effects from alcohol were observed for catastrophic events.

Adolescent↗
PubMed1984

Race differences in psychological distress: the effects of SES, urbanicity, and measurement strategy.

Studies of race differences in psychological distress show that controls for demographic variables typically attenuate or reverse race differences. Variability in findings is interpreted in terms of the urbanicity of the population studied, the distress dimension considered, and measurement focus upon "presence" or "persistence" of symptoms. Data from 826 Florida residents indicated that race differences in urban and rural samples were generally attenuated by adjustments for SES and age. However, blacks reported significantly more persistent depressive symptoms after adjustment in the rural sample. Implications of these findings for future research on race differences in psychological distress are considered.

Depression↗
PubMed1984

The stress-buffering role of alcohol consumption: the importance of symptom dimension.

This paper examines the possibility of the existence of stress-buffering properties of alcohol consumption suggested by a recent study in which life events were related to depressive symptoms for abstainers and heavy drinkers but not for moderate drinkers. Survey data on affective and somatic symptoms from 364 urban and 333 rural Florida residents indicated some support for the buffering argument. Moderate and heavy drinkers manifested significantly lower levels of symptoms than did abstainers only with regard to somatic symptoms. Life event-drinking pattern interactions did not reach statistical significance, although trends consistent with the buffering hypothesis were obtained with the somatic symptom measure. Implications of the data are explored.

Adaptation, Psychological↗
PubMed1983

Urbanicity and depression reconsidered. The evidence regarding depressive symptomatology.

Evidence regarding the recent suggestion of greater prevalence of depressive symptoms in urban than in rural communities is evaluated. National data are reviewed which indicate that, whereas depressive symptoms may be less prevalent in rural than in urban communities, mean depression scores of residents of rural farm areas outside of standard metropolitan statistical areas are almost as high as scores of center city residents. Further data are presented from a study of urban and rural Florida residents which indicate a significantly higher mean number of depressive symptoms in urban than rural areas, though this difference was eliminated by controls for income, education, age, and sex. When persistent depressive symptoms were examined, urban-rural differences were not significant. The implications of the present findings for urban-rural differences in depressive disorder are considered and the need to examine the urbanicity hypothesis on a data base allowing appropriate controls for socioeconomic status-related variables and migration is emphasized.

Age Factors↗
PubMed1981

Social class and depressive symptomatology. The role of life change events and locus of control.

This paper considers the hypothesis that the relationship between social class and impairment may be accounted for by the greater prevalence of life events among lower-class individuals. This hypothesis was evaluated on data from 713 rural Tennessee adults. The data indicated that, although social class indices were inversely related to psychiatric impairment as expected there was no significant tendency for lower-class individuals to report a greater number of life events. For total number of events, as well as total number report a greater number of life events. For total number of events, as well as total number of undesirable, unexpected, or unpreventable events, middle- and upper-class individuals tended to report more events. Controls for the event indices did not affect the relationship between social class and symptomatology as the stress hypothesis would predict. However, locus of control was positively related to social class and was found to influence the event-impairment relationship. These data raise questions regarding the etiological role of life events in the relationship between social class and psychiatric impairments. The data suggest that observed social class differences in impairment may arise from the coping styles of certain social classes (as measured by locus of control) rather than from the differential prevalence of life events.

Adult↗
PubMed1980

Characteristics of life events and psychiatric impairment in rural communities.

This household survey of a random sample of 713 rural adults (ages 18 to 60) examined the influence of event characteristics upon the relationship between life change events and impairment. Data were obtained on the occurrence of events, event characteristics, demographic characteristics, and psychiatric impairment (using the General Well-Being Schedule and the Center for Epidemiologic Studies Depression Scale). Analysis indicated that individuals experiencing higher proportions of undesirable, unanticipated, unpreventable, and disruptive events or events having minimal social support manifested higher levels of psychiatric symptomatology. Although total number of events was consistently the best predictor of impairment, it did not diminish the effects of the event characteristics on impairment. The independent effects of these event characteristics are discussed.

Adolescent↗
PubMed1979

Psychiatric impairment in rural communities.

This household survey of 713 adults residing in nine rural Middle Tennessee counties was conducted to estimate the prevalence of psychiatric impairment in the rural population, to determine which groups in the population are characterized by higher levels of impairment, and to assess the validity of three indices of psychiatric impairment (HOS, CES-D, and GWB). The data indicate that approximately 12% of the rural population may be impaired and that impairment is most likely among females, the divorced, widowed, or separated, and those in lower socioeconomic strata. While depression was more common among the young, physical and psychosomatic complaints were more common among older respondents. Further, respondents classified as impaired by the indices tended to view themselves as having "substantial" or "major" problems and were likely to feel that they might require professional help. While the GWB appeared to discriminate between users and non-users of services, the other indices were less effective as predictors of service utilization.

Female↗
PubMedDate not supplied

Older persons' opinions about life-sustaining procedures in the face of dementia.

OBJECTIVE: To investigate the attitudes of cognitively normal older adults toward various life-sustaining procedures in the face of dementia. METHODS: Participants were 84 cognitively normal men and women (70% response rate), 65 years and older, from a variety of urban and suburban settings, including private homes, assisted-living apartments, transitional care facilities, and nursing homes. In-person interviews were conducted with each participant to obtain information about demographic characteristics, life and health, and desire for various life-sustaining procedures for 4 hypothesized levels of dementia. RESULTS: Approximately three fourths of participants said they would not want cardiopulmonary resuscitation, use of a respirator, or parenteral or enteral tube nutrition with the milder forms of dementia, and 95% or more of participants would not want these procedures with severe dementia. In addition, only one third or fewer participants thought they would want to be hospitalized or given antibiotics if they were severely demented. Logistic regression analysis showed a relationship between participants' desire for life-sustaining procedures and having less education, greater independence, and a higher perceived quality of life. CONCLUSIONS: Most surveyed individuals did not desire life-sustaining treatments with any degree of dementia, and the proportion of individuals not desiring such treatments increased with the projected severity of dementia. These findings indicate a need for including dementia in advance directives planning.

Advance Directives↗