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Biomedical subjects

J M Swanson

Publications and source records attributed to J M Swanson.

At least 73 records · Page 4Linked to original sources

Clinical features and psychosocial factors in young adults with genital herpes.

Clinical features of genital herpes, perceived causes, stress symptoms, treatments, and psychosocial factors in 70 young adults as compared to normative data for non-patient controls are described. The clinical features of the disease were congruent with those of other groups studied. Stress was viewed as the major cause of recurrence, headaches the major stress symptom, and acyclovir (an antiviral drug), was the major treatment. Statistically significant differences were found between scores obtained from the sample of young adults with genital herpes on three of four standardized psychological instruments when compared with normative data for non patient controls. Young adults with genital herpes had a lower self concept, more psychopathology, a greater frequency of daily hassles, and less intensity of uplifts. No differences were found, however, between the two groups in scores on depression.

Adult↗

Hemispheric processing and methylphenidate effects in attention-deficit hyperactivity disorder.

To advance our understanding of attention-deficit hyperactivity disorder and medication effects we draw upon the evidence for (1) a neurotransmitter imbalance between norepinephrine and dopamine in attention-deficit hyperactivity disorder and (2) an asymmetric neural control system that links the dopaminergic pathways to left hemispheric processing and links the noradrenergic pathways to right hemispheric processing. It appears that attention-deficit hyperactivity disorder may involve a bihemispheric dysfunction characterized by reduced dopaminergic and excessive noradrenergic functioning. In turn, favorable medication effects may be mediated by a restoration in neurotransmitter balance and by increased control over the allocation of attentional resources between hemispheres.

Attention↗

Illicit drug use among young adults with genital herpes.

Although an association exists between illicit drug use and sexually transmitted diseases (STDs) in known high-risk populations such as prostitutes, gay men, and intravenous drug users, little is known with respect to middle-class, heterosexual populations thought to be at less risk. We examined findings related to illicit drug use among young adults with genital herpes from a larger study of young adults' adaptation to chronic disease. In this cross-sectional retrospective study, 70 subjects age 18 to 35 years were interviewed and asked to fill out questionnaires. The sample was predominantly white, heterosexual, employed, and college educated. Responses to open-ended questions related to illicit drug use were coded and compared with findings from two other surveys: a national household survey, Pacific region, metropolitan areas; and a household survey of a San Francisco Bay area county. All but eight subjects (88.6%) reported that they had used an illicit drug at some time in the past. The median number of drugs used was 4; the maximum number was 11. Only six drug-using subjects reported that they had restricted their use to marijuana. Those with genital herpes were more likely to report ever using an illicit drug at some time in the past, and, more specifically, in the past year, than subjects in the two comparison surveys. Such findings suggest that programs screen for illicit drug use as a risk factor in middle-class young adults with genital herpes and other STDs, and for STDs in persons referred for drug abuse treatment.

Adolescent↗

Effects of methylphenidate on impulsive responding in children with attention-deficit hyperactivity disorder.

The present investigation examined the effects of methylphenidate on impulsivity in children with attention-deficit hyperactivity disorder (ADHD). A task was designed to measure empirically the ADHD child's proclivity to blurt out incorrect answers before giving a final and/or correct response. Twenty-six ADHD children referred for double-blind placebo-controlled assessment of medication responsiveness and 14 non-ADHD controls were given a visual search word-matching task to assess impulsive responding. An analysis of covariance showed that ADHD children on methylphenidate made fewer impulsive errors than ADHD children on placebo. The control group made fewer impulsive errors than the ADHD children in the placebo condition, but the performance of the ADHD children on medication approximated the performance of the children without ADHD. These preliminary findings suggest that the word-matching task may be a useful tool for assessing impulsive responding and determining the benefits of stimulant medication on impulsivity.

Adolescent↗

Genital herpes: clinical features, sources of information, recurrences, and treatment in young adults.

A descriptive study of 252 young adults with genital herpes recruited from newspaper advertisements in a metropolitan area on the West coast revealed gender differences in clinical features of the disease, perceived causes of recurrences, and treatments used. Stress was the most frequently perceived cause of recurrences. Although 68% of participants perceived nurses to be a source of information about the disease, only 25% perceived nurses as a source of the best information they had received. Development of nursing interventions based on the experience and perceptions of patients is needed.

Adolescent↗

Lateralized deficits in visual attention in males with developmental dopamine depletion.

Children with early treated phenylketonuria (ETPKU), a disorder associated with developmental dopamine depletion, were tested with a visual orienting paradigm to determine the existence of lateralized deficits in specific attentional operations. Male ETPKU subjects showed a right visual field impairment in disengaging attention, indicating left hemisphere dysfunction, and overall slowed reaction times. Female ETPKU and normal subjects did not differ. The results suggest that for males, dopamine depletion disrupts left hemisphere function. This finding has important implications for disorders with suspected developmental dopamine abnormalities, and may also illustrate how sex differences in functional lateralization develop in the normal brain.

Attention↗

Stimulant medication and reading performance: follow-up on sustained dose in ADHD boys with and without conduct disorders.

The study examined the sustained effects of methylphenidate on reading performance in a sample of 42 boys, aged 8 to 11, with attention deficit-hyperactivity disorder (ADHD). Two subgroups were formed based on the presence or absence of co-occurring conduct disorders. Subjects were selected on the basis of their positive response to methylphenidate as determined in a series of original medication trials (Forness, Cantwell, Swanson, Hanna, & Youpa, 1991). For the purpose of this study, subjects were placed on their optimal dose of medication for a 6-week period and then tested on measures of oral reading and reading comprehension equivalent to those used in the original trials, retested after a week without medication (placebo), then tested again the following week after return to medication. Only the subgroup with conduct disorders responded, and this response was limited to reading comprehension improvement in only those subjects who also demonstrated improvement in oral reading on original trials. No response differences were found between subjects with or without learning disabilities.

Achievement↗

Auditory attention switching in hyperactive children.

The ability to rapidly reorient attention in the auditory modality was studied in hyperactive children. Hyperactive and nonhyperactive subjects matched on age, sex, and IQ listened to dichotically presented lists for prespecified targets. Reorientation was studied by comparing performance on trials requiring subjects to reorient their attention during a list to performance on trials requiring no switching of attention. The results indicate that although nonhyperactive children were temporarily disrupted by the switch, they eventually reoriented to the cued ear. In contrast, once hyperactive children were disrupted by the switch, they did not reorient to the cued ear. As the pattern in performance comparing hyperactive and nonhyperactive subjects resembles the pattern previously found in comparing younger and older subjects, these results are consistent with the hypothesis that the auditory reorientation skills of hyperactive children are developmentally immature.

Acoustic Stimulation↗

A divided attention analysis of the effects of methylphenidate on the arithmetic performance of children with attention-deficit hyperactivity disorder.

Thirteen boys with Attention-Deficit Hyperactivity Disorder (ADHD) completed 80 arithmetic problems presented on a computer screen by typing a two digit answer. On half the trials, a foot press was required to terminate a computer-generated tone presented 2 seconds before, 1 second before, 1 second after, and 2 seconds after arithmetic problem presentation. Compared to placebo, methylphenidate resulted in significantly faster reaction times (RTs) to tone probes and faster answers to arithmetic problems when the two tasks did not overlap in time, but not when simultaneous processing was required when the probe was presented 2 seconds after arithmetic problems. When dual processing taxed cognitive capacity, methylphenidate still improved accuracy on the primary arithmetic task relative to placebo, but at the expense of speed of performance on the secondary RT task. When ADHD children fail to allocate available resources to a primary cognitive task, treatment with methylphenidate may result in reallocation of existing cognitive capacity from a secondary task to the primary task.

Attention↗

Effects of stimulant medication on learning in children with ADHD.

It is well established that stimulant medication improves classroom manageability and attention in terms of time on task, but does stimulant medication improve learning or long-term academic achievement in children with ADHD? There is no clear evidence that it does, but there are at least two reasons why beneficial effects may be obscured in research studies and clinical practice: (1) Higher-than-optimal doses may be prescribed if behavioral response (rather than cognitive response) is used to titrate the dose, and (2) treatment may be overinclusive if diagnostic groups are targeted in which a significant proportion of cases do not have favorable cognitive responses to medication. This article addresses these two issues and describes a large clinical series of patients who were evaluated using a double-blind medication assessment protocol designed to overcome some of the theoretical deficiencies suggested by these issues.

Achievement↗

Differential effects of stimulant medication on reading performance of boys with hyperactivity with and without conduct disorder.

Controversy surrounding stimulant medication, particularly its effects on reading performance, continues to obscure the issue of the use of this drug in classroom situations. The present study emphasized careful differential diagnosis, double-blind and placebo approaches, and curriculum-based dependent measures to address these concerns. Methylphenidate was administered to two groups of boys, ages 8 through 11. The two groups included 27 subjects meeting criteria for attention deficit-hyperactivity disorder but not conduct disorder, known as hyperactive disorder (HD), and 28 subjects meeting criteria for both diagnostic categories, known as hyperactive-aggressive (HA). Only four subjects in each group met a discrepancy criterion for learning disabilities (LD). Methylphenidate was administered to both groups at three levels of dosage, along with baseline and placebo conditions. Dependent measures involved both reading recognition and reading comprehension, equivalent across all conditions. No significant results were found for the group with HD in either reading recognition or comprehension, due largely to unusual placebo reactions. Results were generally in the direction predicted for the group with HA, but only significantly so in reading comprehension, and no dose effect was found on this variable. Implications for reading as a dependent measure of medication effects are discussed.

Achievement↗

Activating tasks for the study of visual-spatial attention in ADHD children: a cognitive anatomic approach.

The clinical label attention deficit hyperactivity disorder (ADHD) suggests that this syndrome is a disorder of attention. However, the presumed attentional deficits have not been linked either to specific cognitive operations or to specific neural systems. To provide this link, theories of the cognitive anatomy of attention were used to generate hypotheses about specific visual-spatial attentional deficits in children with ADHD. A cued reaction-time test was used to assess covert and overt shifts of attention theoretically linked to two neuroanatomically defined attentional systems in the posterior and anterior parts of the human brain. The early, posterior-based covert shift of attention was found to be normal in ADHD children, but a later, anterior-based overt shift of attention was abnormal as reflected by a significant lateral difference in reaction time. This was interpreted as a failure to sustain focused attention.

Analysis of Variance↗

Readability of commercial versus generic health instructions for condoms.

Despite the fact that condoms are increasingly recommended for the prevention of acquired immune deficiency syndrome (AIDS) and other sexually transmitted diseases (STDs) and have long been used as a barrier method of contraception, little is known about the readability of the range of materials that have been written exclusively for consumers on how to use a condom. The authors described and compared the reading comprehension levels of condom patient package inserts (PPIs) prepared commercially and those generic instructions (GIs) prepared by health care providers. Fifteen sets of PPIs and 30 sets of GIs were analyzed using six standard readability formulas (Fry, Fog, Dale-Chall, Flesch, Flesch-Kincaid, SMOG). Readability levels of the instructions ranged from grade 6.3 to 13.7. The PPIs required a significantly higher grade level for comprehension (mean 10.32) than the GIs (mean 8.69). This study suggests that instructions prepared by both sources may require a reading level above that of many consumers who need information on how to use a condom.

Contraceptive Devices, Male↗

Genetic latent structure analysis of dysmorphology in attention deficit disorder.

Dysmorphology--in the form of minor physical anomalies--has been frequently reported in children with attention deficit disorder (ADD). The authors report an overrepresentation of minor physical anomalies in both ADD probands and their first-degree relatives. Further, ADD probands who are not dysmorphic have non-ADD relatives who are dysmorphic; this familial pattern suggests that a single underlying factor may influence transmission of both traits. A genetic latent structure model was fit to these data to describe the factor's mode of transmission. In this analysis, an autosomal dominant model emerged. Successfully fitting this model is not equivalent to testing the validity of the model itself. Meaningful tests of the model will require larger samples than available at present, and would benefit from diagnostic refinement of the ADD and dysmorphic phenotypes.

Attention Deficit Disorder with Hyperactivity↗

Family factors associated with aggressive symptomatology in boys with attention deficit hyperactivity disorder: a research note.

This study tested whether parent and child affective attitudes and interactional behavior co-varied with the presence or absence of associated aggressive symptomatology in families with an attention deficit hyperactivity disorder (ADHD) child. Affective attitudes of both parents and their ADHD sons were studied using a modified measure of expressed emotion, the five minute speech sample (FMSS-EE), in 29 families. A direct interaction task was also used to measure verbal and non-verbal communication. FMSS-EE status predicted parental interactional behavior, but the degree of child aggressiveness did not. The child's behavior towards parents, however, was highly correlated with their aggressiveness but not their EE status regarding their parents, despite the fact that child and parent EE were highly correlated. The study supports the notion that aggressiveness and a negative family climate may be independent factors in determining the long-term course of ADHD children.

Adolescent↗

Psychosocial aspects of genital herpes: a review of the literature.

Understanding the psychosocial aspects of genital herpes will enable community health nurses to be aware of the range of responses by young adults to the disease and of interventions suggested by research. Reviewed are the epidemiology of genital herpes infection; the knowledge, attitudes, and behavior related to it; the psychosocial consequences of and techniques for coping and adaptation to living with the disease; responses to treatment; and implications for community health nursing.

Adaptation, Psychological↗