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Biomedical subjects

Keith Humphreys

Publications and source records attributed to Keith Humphreys.

41 records · Page 3Linked to original sources
PubMed2002

Social networks as mediators of the effect of Alcoholics Anonymous.

AIMS: This study tested the hypothesis that the relationship between Alcoholics Anonymous (AA) involvement and reduced substance use is partially explained (or 'mediated') by changes in social networks. DESIGN: This is a naturalistic longitudinal study of the course of alcohol problems. SETTING: Study sites were the 10 largest public and private alcohol treatment programs in a northern California county. PARTICIPANTS: Three hundred and seventy-seven men and 277 women were recruited upon seeking treatment at study sites. MEASUREMENTS: At baseline and 1-year follow-up, we assessed alcohol consequences and dependence symptoms, consumption, social support for abstinence, pro-drinking social influences and AA involvement. FINDINGS: In the structural equation model, AA involvement was a significant predictor of lower alcohol consumption and fewer related problems. The size of this effect decreased by 36% when network size and support for drinking were included as mediators. In logistic regression models predicting abstinence at follow-up, AA remained highly significant after including social network variables but was again reduced in magnitude. Thirty-day abstinence was predicted by AA involvement (OR=2.9), not having pro-drinking influences in one's network (OR=0.7) and having support for reducing consumption from people met in AA (versus no support; OR=3.4). In contrast, having support from non-AA members was not a significant predictor of abstinence. For alcohol-related outcomes other than abstinence, significant relationships were found for both AA-based and non-AA-based support. CONCLUSIONS: The type of social support specifically given by AA members, such as 24-hour availability, role modeling and experientially based advice for staying sober, may help to explain AA's mechanism of action. Results highlight the value of focusing on outcomes reflective of AA's goals (such as abstinence) when studying how AA works.

Adult↗
PubMedDate not supplied

Does writing affect asthma? A randomized trial.

OBJECTIVE: Nonpharmacologic treatments for asthma may act as useful adjuncts to pharmacotherapy but should be recommended to patients only after several well-controlled studies provide evidence of efficacy. Research demonstrating that written emotional expression can improve pulmonary function in patients with asthma consists of one impressive yet unreplicated study. Our main objective was to test and extend previous research finding that written emotional expression improves pulmonary function in patients with asthma compared with writing on neutral topics. METHODS: We conducted a randomized, controlled trial of outpatient asthmatics recruited from hospitals and the community. Of the 137 adult patients with asthma who were randomized, 117 began and 114 completed the study. Patients were randomly assigned to write for 20 minutes, once per week, for 3 weeks about stressful experiences (n = 41), positive experiences (n = 37), or neutral experiences (n = 36; control group). At baseline, postintervention, and 2-month follow up, patients were assessed by spirometry. RESULTS: The mean change from baseline to 2-month follow up in percentage of predicted forced expiratory volume in 1 second (FEV1) was 4.2% in the stress-writing group, 1.3% in the positive-writing group, and 3.0% in the control group. In forced vital capacity (FVC), there was 3.1% improvement in the stress-writing group, 3.6% in the positive-writing group, and 2.4% in the control group. These changes were not statistically or clinically significant. CONCLUSIONS: The present study reduces confidence in the ability of written emotional expression to benefit the disease status of asthma patients.

Adolescent↗
PubMedDate not supplied

Depression increases diabetes symptoms by complicating patients' self-care adherence.

PURPOSE: This study evaluated whether diabetes patients with depressive symptoms are more likely than other diabetes patients to report symptoms of glucose dysregulation, and whether this relationship is mediated by the impact of depressive symptoms on patients' adherence to their diabetes self-care regimen. METHODS: Participants were English- and Spanish-speaking adults with type 2 diabetes. Interviewers assessed participants' depressive symptoms and diabetes-related symptoms at baseline. Self-care behaviors and diabetes symptoms were measured at a 1-year follow-up. Structural equation models were used to determine whether depression affected diabetes symptoms by limiting patients' ability to adhere to self-care recommendations. RESULTS: An initial model identified direct effects of baseline depressive symptoms on self-care and diabetes symptoms at follow-up. The relationship between self-care behaviors and physical symptoms of poor glycemic control were assessed using a second model. Results explained the relationship between depressive symptoms at baseline and diabetes symptoms at 1 year. CONCLUSIONS: Depressive symptoms impact subsequent physical symptoms of poor glucose control by influencing patients' ability to adhere to their self-care regimen. More aggressive management of depression among patients with diabetes may improve their physical health as well as their mental health.

Adult↗