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Biomedical subjects

J F Clarkin

Publications and source records attributed to J F Clarkin.

At least 37 records · Page 2Linked to original sources
PubMed1995

Caregiver burden.

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Adaptation, Psychological↗
PubMed1994

Construct validity of the Three-Factor Eating Questionnaire: flexible and rigid control subscales.

This study investigated the construct validity of two dietary restraint subscales, flexible control (FC) and rigid control (RC), identified by Westenhoefer (1991; Appetite, 16, 45-55) as a subset of the restraint scale items from the Three-Factor Eating Questionnaire (TFEQ, Stunkard & Messick. [1985]. Journal of Psychosomatic Research, 29, 71-83). The subjects were 31 women on long-term personality disorder units. Based on the Structured Clinical Interview for DSM-III-R (SCID), 68% has past anorexia and/or bulimia diagnoses and 94% were borderline. The subjects completed the TFEQ and supplied weight and height data for body mass index (BMI) calculations. The results supported the validity of the two restraint constructs by showing that FC was inversely related to BMI and predicted an anorexia diagnosis. In contrast, RC directly predicted BMI when tested concurrently with FC. RC was also more associated with a history of bulimia and problems with weight fluctuations than FC was. Thus, the FC-RC distinction was valid and useful in this population of women.

Adolescent↗
PubMed1994

A high-risk screen for psychiatric discharge planning.

This article tests the hypothesis that psychiatric inpatients at high risk for presenting difficulties in aftercare planning can be accurately identified on admission to an inpatient unit. A 16-item high-risk screening list is presented that was developed through an earlier analysis of discharge-delayed cases in a psychiatric hospital. The capacity of the list to accurately predict high-risk status was tested by comparing admission and discharge high-risk scores for 448 patients with a range of psychiatric disorders. Sixty-six percent of the patients rated high risk at admission were identically rated at discharge. Differences among risk groups were also found with respect to key demographic variables. The high-risk screen permits early identification of patients who will require immediate and intensive environmental interventions. Such data are critical to psychiatric social work in preventing overstays and in deploying department resources with maximum effectiveness.

Adolescent↗
PubMed1993

Time series analysis of intervention effects. Fluoxetine therapy as a case illustration.

This paper illustrates the advantages of time series analysis in documenting treatment effects through a case study of a trial of fluoxetine in a borderline woman being treated in a long-term inpatient unit for severe personality disorders. Data consisted of weekly self-reports of symptomatology over 58 weeks of hospitalization. Intervention analysis carried out after the patient was discharged documented the effectiveness of the medication and the differential timing of response in individual symptoms.

Adult↗
PubMed1993

Treatment response of borderline inpatients. A growth curve analysis.

This study examined the course of 40 hospitalized female borderline personality disorder patients over 25 weeks of inpatient treatment. Course was measured through weekly administration of the SCL-90-R. Level of identity and interpersonal problems, hypothesized by Kernberg to be at the center of the borderline patient's pathology, were found to be powerful predictors of treatment course. Patients with the most severe identity and interpersonal problems reported more symptoms throughout treatment and increasing symptom levels over time. This was very different from patients with the lowest level of identity and interpersonal problems, who reported fewer symptoms overall and decreasing symptoms over time.

Adult↗
PubMed1993

Subtypes of self-injurious patients with borderline personality disorder.

Twenty-seven female inpatients with borderline personality disorder were assigned to two groups on the basis of whether they did (N = 14) or did not (N = 13) report experiencing pain during self-injurious episodes. Ratings of depression, anxiety, impulsiveness, dissociation, and trauma symptoms were higher in the women who did not experience pain while injuring themselves, as were the number of suicide attempts and the prevalence of childhood sexual abuse.

Adolescent↗
PubMed1993

Clinical significance of inpatient family intervention: conclusions from a clinical trial.

OBJECTIVE: To test whether the statistically significant results of a randomized clinical trial of an inpatient family intervention were clinically significant for hospital practice, the authors reanalyzed outcome data using a measure of clinical significance based on the extent to which patients had recovered during the course of the intervention. METHODS: A total of 169 hospitalized subjects and their families were randomly assigned to a psychoeducational inpatient family intervention or to a comparison group. Patient and family outcome measures were assessed at admission, discharge, and six and 18 months after admission. Analyses of statistically significant differences in outcome suggested that inpatient family intervention was effective for certain patient subgroups identified by gender and diagnosis. Global Assessment Scale scores two or more standard deviations above the pretreatment (admission) mean were used as indicators for clinically significant improvement. RESULTS: The reanalysis confirmed that inpatient family intervention was associated with clinically significant improvement at discharge, especially for female patients and patients with chronic schizophrenia and bipolar disorder. These effects were maintained six months after admission before attenuating at 18 months. CONCLUSIONS: Inpatient family intervention results in clinically meaningful outcomes for certain subgroups of patients and their families.

Adult↗
PubMed1992

Comorbidity and treatment planning: summary and future directions.

This summary blends the commentaries from the 6 articles in the special section on comorbidity. Included is a discussion of various definitions of comorbidity, the merits and demerits of a hierarchical diagnostic system, and consideration of the extent, patterning, and nature of comorbidity. Directive comments with reference to future intervention planning mention both assessment (distinguishing overlapping constructs) and treatment (sequencing and treatment manuals) issues.

Adult↗
PubMed1991

A randomized clinical trial of inpatient family intervention: VI. Mediating variables and outcome.

In a randomized clinical trial of Inpatient Family Intervention (IFI) for 169 inpatients with schizophrenia, affective disorder, and a residual group of other diagnoses, results suggested significant effects favoring IFI for patients and their families. The treatment effects were limited to females and to two diagnostic groups: chronic schizophrenia patients and the bipolar subgroup of affective disorders.

Analysis of Variance↗
PubMed1991

Group and family treatments for borderline personality disorder.

The authors review clinical and empirical studies on the effectiveness of group treatments and family-marital treatments for borderline patients. These studies support the use of the group format in treating borderline patients, but no empirical study has examined whether group treatment combined or sequenced with individual treatment, or individual treatment alone, is better than group treatment alone. Empirical studies of family interventions with borderline patients are lacking, but further research is warranted, since many studies have shown that family pathology, especially physical and sexual abuse, is related to the development of borderline pathology.

Adolescent↗
PubMed1990

A randomized clinical trial of inpatient family intervention. V. Results for affective disorders.

This paper reports the results at follow-up of a randomized clinical trial of combining family intervention with drug treatment during hospitalization for patients with affective disorder. The results suggest that female bipolar patients and their families benefited from family intervention, whereas unipolar patients and families did not. Patient outcome was positively correlated with the achievement of the goals of family intervention.

Adolescent↗
PubMed1990

An examination of the stability of the MMPI Personality Disorder Scales.

Recently, a set of Minnesota Multiphasic Personality Inventory (MMPI) scales for the diagnosis of personality disorders have attracted research attention. As personality disorders are thought to represent long-standing trait disturbances, any measure of these disorders should be stable over time and relatively free from state influences. This study investigated the stability of the MMPI scales in 67 subjects across a brief inpatient treatment for substance abuse. The results indicated high levels of stability across the 3-week treatment period.

Adult↗
PubMed1990

Gender and schizophrenia outcome: a clinical trial of an inpatient family intervention.

Several studies document sex differences in premorbid and intermorbid role functioning, showing less functional deficit among females. The specific nature of sex differences in role functioning is still poorly understood. The purpose of the present study was to investigate sex differences in symptomatology and role functioning in a sample of 92 inpatients hospitalized for an episode of DSM-III-diagnosed schizophrenic disorder. Patients were randomized at hospital admission to either of two treatment conditions: (1) multimodal hospital treatment with the addition of an inpatient family intervention (IFI) or (2) multimodal hospital treatment without IFI. Results indicated (1) sex differences in levels of substance abuse and antisocial behavior (worse for males both at admission and followup)--dimensions of psychopathology unrelated to the core features of schizophrenia; (2) superior family and occupational functioning in females at followup; and (3) superior clinical response of females to IFI. Data on family response to IFI suggest some ameliorative effects of IFI on critical family attitudes toward female patients as well as greater family compliance with IFI treatment among the families of females. Sex differences in intermorbid family and occupational functioning and response to a family-based psychosocial intervention are discussed in light of data on rejecting family attitudes toward the patient and sex differences in symptomatology. The possible influence of sex-differentiated social role demands on response to IFI is also discussed.

Adult↗