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Biomedical subjects

M R Liebowitz

Publications and source records attributed to M R Liebowitz.

229 records · Page 13Linked to original sources

Is borderline a distinct entity?

There is no agreement in American psychiatry as to whether borderline should be regarded as a distinct entity. A review of the major viewpoints in the field reveals that borderline is variously used to designate: (1) a clinical disorder distinguishable by behavioral criteria; (2) a milder form of schizophrenia; (3) a nonspecific term encompassing several atypical affective disorders; (4) a psychostructural distinction. When the St. Louis approach to diagnostic validity is used as a guideline, the conclusion reached is that available data do not weigh conclusively for or against borderline's status as an independent entity. In particular, borderline, as defined by several investigators, appears distinct from schizophrenia, but requires further delimitation from the affective disorders.

Adjustment Disorders↗

Personality features of patients with primary affective disorder.

Personality variables were assessed in outpatients with primary affective disorder by use of the Maudsley Personality Inventory (MPI) and the Marke Nyman Temperament Scale (MNTS). Significant differences between diagnostic groups were initially noted for the extraversion and neuroticism scales of the MPI. However, when mood was more rigorously controlled for, these differences largely disappeared, while interdiagnostic differences for the solidity scale of the MNTS emerged. The findings suggest that these measured aspects of personality may be quite state (mood) dependent even when patients are given test instructions previously reported to minimize mood effects. This was born out in a follow-up study for the N scale, but not the E scale, of the MPI. These data indicate that assessment of neuroticism in affectively ill patients will be contaminated by the presence of even mild depressive symptoms, a finding that has important implications for studies of personality in affective disorder.

Adult↗

The relationship of social phobia subtypes and avoidant personality disorder.

The diagnoses of social phobia (SP) and avoidant personality disorder (APD) have evolved from different historical sources, but their criteria appear to converge in DSM-III-R. Fifty anxiety disorder clinic patients with DSM-III-R SP were evaluated for presence of DSM-III-R APD. APD was present in 89% of those with the generalized subtype of SP (GSP) and 21% of those with the discrete subtype of SP (DSP). The findings are discussed in conjunction with other recent reports showing substantial overlap between GSP and APD.

Adult↗

An investigation of gender differences in social phobia.

The present study was an exploratory investigation of gender differences in a large sample of persons with social phobia. Potential differences in demographic characteristics, comorbidity, severity of fear, and situations feared were examined. No differences were found on history of social phobia, social phobia subtype, or comorbidity of additional anxiety disorders, mood disorders, or avoidant personality disorder. However, women exhibited more severe social fears as indexed by several assessment instruments. Some differences between men and women also emerged in their report of severity of fear in specific situations. Women reported significantly greater fear than men while talking to authority, acting/performing/giving a talk in front of an audience, working while being observed, entering a room when others are already seated, being the center of attention, speaking up at a meeting, expressing disagreement or disapproval to people they do not know very well, giving a report to a group, and giving a party. Men reported significantly more fear than women regarding urinating in public bathrooms and returning goods to a store. Additionally, there were some differences in the proportion of men and women reporting fear in different situations. Specifically, more women than men reported fear of going to a party, and more men than women reported fear of urinating in a public restroom. Gender differences among patients with social phobia are discussed in the context of traditional sex-role expectations.

Adult↗

Factor structure of social fears: The Liebowitz Social Anxiety Scale.

In the assessment of social anxiety, investigators often differentiate between social interactional anxiety and performance anxiety. The Liebowitz Social Anxiety Scale (LSAS), a clinician-administered measure of social anxiety and avoidance, was originally developed with separate subscales for the assessment of fear and avoidance of situations involving social interaction and performance/observation by others. Separate confirmatory factor analyses of the LSAS fear and avoidance ratings demonstrated that this two-factor model did not provide an adequate fit to the data, suggesting the need to further investigate the underlying structure of the LSAS. Separate exploratory common factor analyses of the fear and avoidance ratings yielded four similar factors for each: (1) social interaction, (2) public speaking, (3) observation by others, and (4) eating and drinking in public, which demonstrated convergent and discriminant validity with other measures of social anxiety. These findings suggest that there are four global categories of social fear assessed by the LSAS, and that while social interaction anxiety appears to be unifactorial, fear of performance/observation situations may be multifactorial.

Adolescent↗

The mitral valve prolapse--panic disorder connection.

Whether mitral valve prolapse (MVP) is more common in patients with panic disorder (PD) and agoraphobia with panic attacks (AgP) than in the normal population is controversial. A related issue is whether the presence of MVP in such patients has any clinical or biological significance. Echocardiograms were performed on 36 patients with PD/AgP and 22 normal controls. MVP was found to be more common in PD/AgP patients than in normal controls. However, MVP in the patients was mild and not associated with thickened mitral leaflets or small left ventricular size. Moderate or severe prolapse was uncommon in both groups. Patients with MVP had trends to higher heart rate and prolonged QTc interval on EKG, and reported more respiratory difficulty during panic attacks compared to patients without MVP. Lactate infusion did not affect patients with MVP differently than patients without MVP. The authors conclude that MVP is more common in patients with PD or AgP than in normal controls, but is of doubtful clinical significance.

Adult↗