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Biomedical subjects

M J Goldstein

Publications and source records attributed to M J Goldstein.

At least 91 records · Page 5Linked to original sources
PubMed1982

Family interaction and the course of adolescent psychopathology: an analysis of adolescent and parent effects.

This study focused on evaluating the utility of three family measures for predicting outcome in a sample of disturbed but nonpsychotic adolescents: (a) the affective quality of the adolescents' voice tone when communicating with his/her parents; (b) the predominant affective quality of the parents' voice tones when communicating with the adolescent, and (c) the affective quality of the content of the parents' verbalizations to the adolescent. These measures were derived from 5-minute face-to-face discussions between parents and their disturbed adolescent. Results indicated that adolescents using positive or neutral voice tones during emotionally laden discussions with their parents tended to show relatively adequate levels of psychosocial adjustment as young adults, while adolescents using exclusively negative voice tones tended to show sufficient adjustment difficulties in early adulthood to warrant diagnoses within the extended schizophrenia spectrum. Although adolescent voice tone was associated with outcome, considering both adolescent and parent affective response led to improved prediction, with consideration of adolescent and parent variables leading to accurate prediction of outcome for 30 of the 33 sample cases.

Adolescent↗
PubMed1982

Family factors in the onset, course, and treatment of schizophrenic spectrum disorders: an update on current research.

Recent findings from several research projects on the role of family factors in the onset, course, and treatment of schizophrenia are discussed. The report emphasizes several key issues facing researches in this field such as how family characteristics associated with onset are related to the course of schizophrenia, replicability of findings on expressed emotion and relapse rates, and the construct validity of measures of familial characteristics. Ongoing studies employing neuroleptic treatment and family therapy are outlined, and the implications of these preliminary findings are discussed.

Adult↗
PubMed1981

Parental communication deviance and affective style. Predictors of subsequent schizophrenia spectrum disorders in vulnerable adolescents.

In an attempt to assess the contributory role of family factors to the development of schizophrenia-like disorders, measures of parental communication deviance and affective styles of communication were obtained for a sample of families of disturbed but nonpsychotic adolescents. Outcome was assessed five years later. Absence of a pathologic affective style was associated with a benign outcome, but neither parental variable alone allowed precise identification of the schizophrenia-spectrum cases. However, an index using a combination of both variables was statistically predictive of subsequent psychiatric status at follow-up. Thus, adolescents whose parents had both a pathologic affective style of communication and a high level of communication deviance had schizophrenia-like disorders develop in young adulthood. Adolescents of parents who had both lower levels of communication deviance and a benign affective style had offspring with healthier outcomes.

Adolescent↗
PubMed1981

Parental patterns of affective style and the development of schizophrenia spectrum disorders.

Measures of parental affective style of communication, based on direct family discussions, were obtained for a sample of 52 families of disturbed but nonpsychotic adolescents. When the variations of both parents on the measure for two different measurement contexts were combined, an accurate prediction of subsequent psychiatric status at follow-up occurred. Adolescents with at least one parent who consistently displayed a pathological affective style of communication in both a dyadic and triadic discussion developed schizophrenia-spectrum disorders as young adults. Conversely, adolescents with at least one parent who was consistently benign in affective style had healthier outcomes. Finally, more serious young adult psychopathology was noted where both parents were inconsistent in their affective style from dyadic to triadic interaction. Methodological implications for family interaction research are discussed.

Adolescent↗
PubMed1980

Cyclazocine in the treatment of opiate addiction: a review with recommendations.

The use of cyclazocine, a narcotic antagonist in the treatment of opiate addiction, is reviewed. Eleven investigations which have employed cyclazocine within addiction treatment programs have led to the conclusion that cyclazocine has yet to demonstrate its therapeutic efficacy due to low patient acceptance and the difficulty in maintaining effective blocking dosages. The use of naloxone to alleviate side effects during cyclazocine induction and technological advances in implantable sustained-release devices may facilitate the effectiveness of cyclazocine treatment of opiate addiction. Experimental designs are advocated as the best method for the evaluation of narcotic treatment programs.

Adolescent↗
PubMed1980

Effects of a postexercise sauna bath on ECG pattern and other physiologic variables.

In an attempt to determine the risk of sauna bathing after heavy exercise, the responses of 10 clinically normal adult males (mean age 44 years) were observed and recorded for 26 min. during recovery from a standard, heavy exercise task on two separate days. On one of the 2d, recovery was interrupted by a 10-min (min 6-16) exposure to intense, dry heat (70-74 degrees C, 3-6% R.H.). The higher heart rate and rectal temperature during the treatment (min 6-16) and post treatment (min 16-26) phases on the experimental day were indicative of the expected response to the heat stress. Systolic blood pressure did not differ on experimental and control days during either phase of recovery, while diastolic blood pressure decreased during the heat exposure. Double product was higher during treatment and post-treatment phases on the experimental day indicating an increased myocardial O2 need in response to the heat. ECG (CM5) changes were limited to increased J-point displacement during the treatment phase on the experimental day, with S-T segment flattening (0.08 s) in one case, and prolongation of the Q-T interval (corrected for rate) with reduction in T-wave amplitude. The prolongation of electrical systole and T-wave flattening were not observed during exercise at comparable and higher heart rates and may be associated with reduced subendocardial perfusion. We concluded that sauna bathing of short duration after exercise represents a tenable risk for clinically normal males.

Adult↗
PubMed1979

Therapist ratings of achievement of objectives in psychotherapy with acute schizophrenics.

Therapist ratings of patients' achievement of objectives in psychotherapy were used to examine the impact of drugs on psychotherapy, to identify attributes of patients who achieve therapy objectives, and to assess the importance of the implementation of a crisis-oriented model of therapy. Patients were part of a project investigating the long-acting phenothiazine fluphenazine enanthate and crisis-oriented family therapy in a 6-week program of aftercare treatment for briefly hospitalized first admission acute schizophrenics. The 44 patients in this study were randomly assigned to the psychotherapy condition and to either a high or low dosage of phenothiazines. Therapist ratings of the achievement of therapy objectives were significantly related to independent ratings on two outcome measures, the Global Assessment Scale and the Brief Psychiatric Rating Scale (BPRS) factor Thought Disorder, at 6-month followup. Analyses of predictors of the achievement of therapy objectives revealed significant interactions between drug level and Venables and O'Connor ratings of paranoid symptomatology among good permorbid patients and between drug level and BPRS ratings of Hostility for the entire sample.

Acute Disease↗
PubMed1978

Drug and family therapy in the aftercare of acute schizophrenics.

After a brief inpatient hospitalization, 104 acute, young schizophrenics, stratified by premorbid adjustment, were randomly assigned to one of four aftercare conditions for a six-week controlled trial. Conditions involved one of two dose levels of fluphenazine enanthate (1 ml or 0.25 ml) and presence or absence of crisis-oriented family therapy. Relapses during the six-week period and at six-month follow-up were least in patients who received both high-dose and family therapy (0%) and greatest (48%) in the low-dose-no therapy group. Brief Psychiatric Rating Scale symptom ratings disclosed a significant family therapy effect at six weeks that was sustained at six months only for therapy patients originally receiving the high drug dose. Numerous interactions were found between premorbid adjustment status and response to the two treatment conditions.

Acute Disease↗
PubMed1978

Further data concerning the relation between premorbid adjustment and paranoid symptomatology.

This study examines the relationship between premorbid adjustment and paranoid status in acute schizophrenia. In order to avoid limitations of previous studies, premorbid adjustment (based on the UCLA Social Attainment Scale) was considered at five levels instead of the usual binary classification (good vs. poor) and paranoid symptomatology (using the Venables and O'Connor Scale) was considered rather than paranoid diagnosis. In a sample of 112 first lifetime admission schizophrenics, a positive linear relationship was found between premorbid adjustment and paranoid symptoms. Definite paranoid symptomatology was largely absent at the lowest levels of premorbidity and increased progressively with more adequate premorbid adjustment. The one exception to this linear trend was noted for the highest (most superior) level of premorbid adjustment where an increase of nonparanoid cases was observed.

Adult↗
PubMed1977

Communication deviance in the families of schizophrenics: a comment on the misuse of analysis of covariance.

Serious contradictions in recent research programs concerning communication anomalies in parents of schizophrenics have been generated by invalid statistical analyses. The method of analysis used, the analysis of covariance, can lead to erroneous conclusions in the context of these studies, and thus, other means must be sought for bringing these important research programs into common focus.

Analysis of Variance↗
PubMed1977

Parental transactional style deviance as a possible indicator of risk for schizophrenia.

The presence of a pattern of parental transactional style deviance on the Thematic Apperception Test (TAT) (a significant attribute of parents of offspring with schizophrenia spectrum disorders) was used to identify a group of disturbed nonpsychotic adolescents hypothesized to be at high risk for subsequently developing schizophreniform psychopathology. High-risk male adolescents came from two symptom groups, withdrawn adolescents and adolescents in active family conflict, which are symptom patterns similar to the premorbid pictures of two schizophrenia subtypes. High-risk parents also tended to show transactional style deviance in direct interaction with their child and in a written statement describing their child's problem. The degree of risk was significantly related to the amount of therapy in which the family was subsequently engaged and, at a four-year follow-up, to the level of adjustment of the adolescents seen earlier in the project.

Adolescent↗
PubMed1977

Coping patterns of law enforcement officers in simulated and naturalistic stress.

Psychophysiological and self-report measures of reactivity were obtained from 135 police deputies exposed to a stressful film. Subjects categorized according to trait anxiety level and character defense pattern were encouraged to anticipate benign or threatening experiences or were given no preparatory information. In general, information abetted stress reduction; individual personality variables also influenced reactivity. The vigilant coper group uniformly demonstrated intolerance for uncertainty, whereas the responses of the neutral and avoider groups were separable according to anxiety level, in which lower anxiety facilitated adaptation to the stressor. The dramatic correspondence of supervisory ratings of field performance and the data for the no-warning condition suggests that the demands for success in law enforcement service were approximated by the simulated stress procedure.

Adaptation, Psychological↗
PubMed1976

Predicting individual responses to drug treatment in schizophrenia: a test dose model.

The literature and the findings from the Camarillo Schizophrenia Research Project reported in this paper indicate that a satisfactory method for predicting the response of an individual schizophrenic patient to antipsychotic drugs has yet to be devised. A test dose procedure is described which offers promise of a practical approach to selecting the most appropriate drug and dosage for a particular patient and tailoring blood concentrations to the needs of the individual case. Preliminary findings indicate that the test dose procedure is feasible; that detectable changes occur after a single test dose; and that measurements made during the test dose period may be predictive of eventual outcome. These findings are, of course, only a report of a preliminary pilot experiment, subject to important caveats about small number of cases, interpretation of large numbers of correlation coefficients, and need for cross-validation. Nevertheless, they are encouraging and suggest that the test dose approach has considerable potential for further research.

Antipsychotic Agents↗
PubMed1976

Radioautographic observations of a 19-month-old ileal conduit.

The influence of an altered environment of the cellular kinetics and histological appearance of ileal mucosa used as a urinary bladder was investigated in a patient with a conduit of 1 year and 7 months' duration. After injection of 10 mc of 3H-TdR, multiple biopsies were taken spanning a 3-day period. No increase in inflammatory cell numbers was seen and villous atrophy was minimal. A generation time or total cell cycle time of 36 hr was observed, with a G1 phase of 22 hr and an S phase of 11 hr. At 1 hr 2.4 3H-TdR-labeled cells per crypt column and a mitotic index of 1.4% were obtained. The complet labeled mitosis curve obtained on the epithelial cells of the 19-month-old ileal conduit mucosa demonstrated a retention of the kinetics and histological characteristics of normal ileal mucosa, contrary to previously documented findings.

Autoradiography↗