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Biomedical subjects

J W Greene

Publications and source records attributed to J W Greene.

At least 19 recordsLinked to original sources

Relation of alcohol expectancies to changes in problem drinking among college students.

OBJECTIVE: To evaluate the relation between alcohol expectancies and problem drinking during 3 years of college. DESIGN: Cohort with 3-year follow-up. SETTING: Private university campus. PARTICIPANTS: A random sample of 260 students entered a longitudinal study of alcohol use at the beginning of their freshman year. One hundred eighty-four students completed follow-up measures at the end of their junior year. Respondents were 90% white, with a mean (+/-SD) age of 17.9 +/- 0.5 years. INTERVENTIONS: None. MAIN OUTCOME MEASURES: A standardized measure of expectations and subjective evaluations of outcomes associated with drinking, quantity and frequency of alcohol use, and a composite measure of alcohol-related problems. RESULTS: Students were divided into nondrinking, low-risk, and high-risk groups for problem drinking. A repeated-measures multivariate analysis of variance indicated significant interaction effects for risk group by expectancy scale (P < .009) and for expectancy scale by time (P < .001). The three risk groups differed significantly from each other on positive outcome expectations at entry into college and positive expectations and negative outcome evaluations at the end of the junior year. Students who became problem drinkers during college had significantly higher positive outcome expectation scores at both times and developed less concern for negative outcomes by the end of their junior year. The few initial problem drinkers who moderated their drinking during college demonstrated an increased concern for negative outcomes by their junior year. CONCLUSIONS: Alcohol expectancies are associated with differing patterns of alcohol use and are longitudinally related to subsequent changes in alcohol use and problem drinking.

Adolescent

Relationship of alcohol expectancies to problem drinking among college women.

PURPOSE: To evaluate the stability of expectancies about alcohol and their ability to prospectively explain drinking patterns and the occurrence of alcohol-related problems among college freshman women. METHODS: College women (n = 120) completed a standardized measure of expectations and subjective evaluations of positive and negative outcomes associated with drinking and a questionnaire assessing drinking patterns and common alcohol-related problems at both the beginning and end of the school year. Ninety percent of the students were Caucasian with a mean age of 17.9 years (SD = 0.5). RESULTS: Students' positive and negative outcome expectations and their subjective evaluations at the beginning of the year were significantly correlated with drinking patterns at the end of the year (p's < .05). During the year, students at low risk for problem drinking developed stronger positive attitudes toward the effects of alcohol upon courage, became less concerned about potential behavioral impairment, and perceived less negative effects upon self-perception. High risk students showed a significant decline in their positive attitudes toward the effects of alcohol upon their sociability. Expectancies about alcohol at the beginning of the school year explained 33% of variance in subsequent drinking (F = 6.17; p < .0004) and 20% of the variance in alcohol-related problems occurring during the year (F = 3.26; p < .02). Outcome evaluation scales at the beginning of the year explained more variance in subsequent drinking and alcohol-related problems than did outcome expectation scales. CONCLUSIONS: Alcohol outcome expectations and their subjective evaluations were relatively stable across the freshman year for these college women. Alcohol expectancies on entry into college explained significant amounts of variability in drinking behavior and the occurrence of alcohol-related problems during the subsequent freshman year. Students' attitudes toward perceived outcomes may be more important than the perceived likelihood of the outcomes themselves.

Adolescent

Long-term health outcomes in patients with recurrent abdominal pain.

Investigated somatic and emotional symptoms, functional disability, and health service utilization in 31 former RAP patients and 31 former well patients who had originally been interviewed 5 to 6 years earlier. Both former patients and their mothers were interviewed for this follow-up study. Medical records were obtained for those patients who reported receiving new diagnoses for abdominal pain since their initial assessment. Results indicated that only one of the former RAP patients was later diagnosed with organic disease that clearly accounted for his earlier abdominal pain. Nonetheless, at follow-up former RAP patients reported significantly higher levels of abdominal pain, other somatic symptoms, and functional disability (including school/work absence) than did former well patients. Mothers reported higher levels of internalizing emotional symptoms in former RAP patients than in former well patients.

Abdominal Pain

Longitudinal evaluation of a screening measure for problem drinking among female college freshmen.

OBJECTIVE: A previous study suggested that combining the CAGE (cutting down of drinking, feeling annoyed by criticisms of drinking, feeling guilty about something that happened because of drinking, having an eye-opener) questionnaire with the Perceived-Benefit-of-Drinking Scale, an adolescent's use of tobacco, the age at which an adolescent first started drinking, and an adolescent's best friend's drinking pattern is a useful composite screening measure for problem drinking among adolescents. The present study was undertaken to evaluate prospectively this composite screening measure as a predictor of subsequent problem drinking among college women during their freshman year. DESIGN: Cross-sectional. SETTING: Private university student health service. PARTICIPANTS: A random sample of 248 college freshman women entered a longitudinal study of alcohol use at the beginning of their freshman year. One hundred twenty (48%) completed follow-up measures of alcohol use at the end of the year. Respondents were 90% white, with a mean age of 17.9 years (SD = 0.5 years). MAIN OUTCOME MEASURES: An index of the quantity and frequency of alcohol use and a composite measure of specific alcohol-related problems. RESULTS: The CAGE questionnaire score, the Perceived-Benefit-of-Drinking Scale score, the student's tobacco use, the student's best friend's drinking pattern, and the age at which the student first started drinking as reported at the beginning of the year together explained 38% of the variance in subsequent drinking habits and 26% of the variance in alcohol-related problems reported during the freshman year. Use of the composite screening measure significantly increased sensitivity and specificity beyond that obtained with the CAGE questionnaire or the Perceived-Benefit-of-Drinking Scale alone for problem drinking. CONCLUSIONS: The CAGE questions, the Perceived-Benefit-of-Drinking Scale, the student's tobacco use, the student's best friend's drinking pattern, and the age at which the student first started drinking may together constitute a clinically useful screening measure for subsequent problem drinking among female college freshmen.

Adolescent

Screening for problem drinking among college freshmen.

PURPOSE: This study identified predictors of older adolescents at risk for problem drinking. METHODS: College freshmen (n = 492) completed a questionnaire that addressed drinking patterns, risk factors for problem drinking, the CAGE questions, the Perceived-Benefit-of-Drinking Scale (PBDS), and the Children of Alcoholics Screening Test (CAST). They also responded to questions regarding alcohol-related problems including blackouts; alcohol-related injury, illness, violence, or legal problems; driving under the influence; and missing class. 50% of students were male with a mean age of 17.9 years (SD = 0.5). RESULTS: Higher scores on the CAGE and PBDS, use of tobacco, best friend's drinking pattern, and younger age at first drinking were associated with higher scores on a quantity/frequency drinking index and with reports of significantly more alcohol-related problems. Regression models using these variables explained 40% to 51% of the variance in drinking habits and alcohol-related problems. CONCLUSION: A composite screening measure had significantly better sensitivity and specificity than either the CAGE or PBDS alone in identifying older adolescents at high risk for problem drinking.

Adolescent

Somatic complaints in pediatric patients: a prospective study of the role of negative life events, child social and academic competence, and parental somatic symptoms.

This prospective study of 197 pediatric patients with chronic abdominal pain examined the role of negative family life events and several potential moderator variables (child social and academic competence, parental somatic symptoms, and child sex) in child somatic complaints 1 year after a clinic visit. Results indicated that (a) among children low in social competence at the time of the initial clinic visit, higher levels of subsequent negative life events predicted higher levels of somatic complaints at follow-up; (b) among boys in families with high levels of negative life events, those whose mothers were characterized by high levels of somatic symptoms had higher levels of somatic complaints at follow-up; and (c) children whose fathers were characterized by high levels of somatic symptoms showed higher levels of somatic complaints at follow-up, regardless of the level of life events. Possible mechanisms accounting for these findings are discussed.

Abdominal Pain

Alcohol expectancies, problem drinking, and adverse health consequences.

This study evaluated a measure of positive and negative expected effects of alcohol and their subjective evaluation in the identification of college freshmen at high risk for problem drinking and associated morbidities. It was hypothesized that greater expectations of positive outcomes and fewer negative evaluations of negative outcomes would be associated with reports of heavier drinking and more alcohol-related health problems. College freshmen (n = 328) completed a standardized measure of expectations and subjective evaluations of positive and negative outcomes associated with drinking, and a questionnaire assessing drinking patterns and common alcohol-related health problems. Fifty-two percent of students were male and the mean age was 17.9 years (SD = 0.5). Students' expectations of positive outcomes and their subjective evaluations of both positive and negative outcomes from drinking were significantly correlated with drinking and alcohol-related health problems indices (p < 0.001). Gender, expectation of positive outcomes, and evaluation of negative outcomes explained 29% of the variance in drinking and 15% of the variance in alcohol-related health problems indices. Heavier-drinking students and those reporting more health problems expected more positive effects on their sociability and sexuality (p < 0.03) and were less concerned about cognitive and behavioral impairment as a result of drinking (p < 0.001). Students with more health problems were less concerned that drinking would lead to risk-taking or aggressive behavior (p < 0.003). Positive and negative outcome expectancies and their subjective evaluations accounted for a significant portion of the variability in drinking and alcohol-related health problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Psychosocial correlates of recurrent childhood pain: a comparison of pediatric patients with recurrent abdominal pain, organic illness, and psychiatric disorders.

Pediatric patients with recurrent abdominal pain (RAP) were compared with patients with peptic disease, patients with emotional disorders, and well children with regard to (a) emotional and somatic symptoms and (b) theoretically derived variables, including negative life events, competence, family functioning, and the modeling and encouragement of illness behavior. RAP patients had levels of emotional distress and somatic complaints higher than those of well children and lower than those of psychiatric patients, but not different from those of patients with peptic disease. RAP patients had fewer negative life events, better family functioning, and higher competence than children with emotional disorders. In comparison with well children and psychiatric patients, both RAP and peptic disease patients had a higher incidence of illness in other family members and perceived greater parental encouragement of illness behavior for abdominal symptoms.

Abdominal Pain

Exercise-induced menstrual irregularities.

Exercise of sufficient rigor, particularly when coupled by weight loss and dietary restriction, is capable of producing reversible disturbances of reproductive function in many otherwise healthy women. However, it is clear that there are many health benefits for women who exercise regularly and in moderation. These include improved cardiovascular status, increased bone mineral content, improvement of dysmenorrhea and premenstrual syndrome symptoms, and general stress reduction. In addition, the inclusion of young women in high school and college athletics has provided many new opportunities. With these new opportunities, however, have come new challenges for physicians in assisting these women in maintaining optimal health.

Adult

Problem drinking among college freshmen.

Entering college freshmen (n = 308) completed a questionnaire which assessed drinking behaviors and identified students at risk for problem drinking as defined by the CAGE (focuses on Cutting down on drinking, Annoyance by criticism by others about drinking, Guilty feelings about drinking, and the use of an Eye opener) questionnaire and Perceived-Benefit-of-Drinking Scale (PBDS). Students were 50% male with a mean age of 17.9 years. In the past month, 17% had drunk on 10 or more occasions, and 18% had binged on 6 or more occasions. CAGE scores of 2 or greater were obtained by 21% and PBDS scores of 3 or greater by 29%, reflecting high risk for problem drinking. High-risk CAGE and PBDS scores were associated with frequent drinking and binging. Student reports of parental problem drinking were not associated with high risk for problem drinking. Intent to join a fraternity or sorority (the Greek system) was associated with frequent drinking, binging, and high-risk CAGE and PBDS scores. Approaches to screening for problem drinking which emphasize attitudes and beliefs may be useful. The Greek system appears to be attractive to high-risk students and should be a focus of prevention programming.

Adolescent

Somatization symptoms in pediatric abdominal pain patients: relation to chronicity of abdominal pain and parent somatization.

Symptoms of somatization were investigated in pediatric patients with recurrent abdominal pain (RAP) and comparison groups of patients with organic etiology for abdominal pain and well patients. Somatization scores were higher in RAP patients than well patients at the clinic visit, and higher than in either well patients or organic patients at a 3-month followup. Higher somatization scores in mothers and fathers were associated with higher somatization scores in RAP patients, but not in organic or well patients. Contrary to the findings of Ernst, Routh, and Harper (1984), chronicity of abdominal pain in RAP patients was not significantly associated with their level of somatization symptoms. Psychometric information about the Children's Somatization Inventory is presented.

Abdominal Pain

Endomyocardial ultrastructural findings in preeclampsia.

Ultrastructural findings in endomyocardial biopsy specimens obtained during cardiac catheterization in a patient with severe preeclampsia are described. Intramyocardial vessels revealed prominent swelling of the endothelial cell cytoplasm. In addition, cardiac myocyte mitochondria showed swelling and clearing within the matrix. Endomyocardial ultrastructural injury occurs in severe preeclampsia.

Adult

The functional disability inventory: measuring a neglected dimension of child health status.

Described the development and validation of the Functional Disability Inventory (FDI) for school-age children and adolescents. Results provide support for construct, concurrent, and predictive validity. FDI scores also demonstrated stability over a 3-month period in patients with a chronic condition, and the instrument was sensitive to changes in patient status subsequent to medical treatment. There was some evidence that gender played a role in disability, particularly in adolescence. The instrument may be used (a) in studying individual differences in pediatric disability, (b) in examining the relation of disability to psychosocial functioning in the child and other family members, or (c) as an outcome measure in assessing the impact of interventions on patient functioning.

Adolescent

Negative life events and symptom resolution in pediatric abdominal pain patients.

Investigated relation of negative life events (NLE) to initial symptom severity and symptom resolution at 3 months in 2 patient groups: (a) recurrent abdominal pain (RAP) without identifiable organic etiology, (b) abdominal pain with organic diagnosis. Symptoms assessed were abdominal pain, somatization symptoms, anxiety, depression. Number of NLE was positively correlated with anxiety and depression in both groups at clinic visit. NLE predicted resolution of abdominal pain for RAP patients only; RAP patients with more NLE prior to or following the clinic visit were more likely to maintain their abdominal pain. More NLE following clinic visit was associated with maintenance of anxiety and somatization symptoms at follow-up in RAP patients. Results suggest a measure of NLE is not useful in differential diagnosis of patients with and without organic findings, but is useful in predicting outcome in patients without organic findings.

Abdominal Pain