Search PubMed⌕ Search

Biomedical subjects

P J Brantley

Publications and source records attributed to P J Brantley.

At least 37 records · Page 2Linked to original sources
PubMed1995

The relation of stress and depression to interdialytic weight gain in hemodialysis patients.

Nonadherence to fluid restrictions is a common problem with serious health consequences for patients with end-stage renal disease (ESRD). For the present study, the authors evaluated psychological variables of stress, as measured by major and minor life events, and depression. They sought to determine the role of these events in patients' failure to adhere to fluid restrictions as measured by increased interdialytic weight gain. Forty-two hemodialysis patients completed inventories assessing major life events, daily stressful events, and depression on three consecutive dialysis sessions. Fluid adherence was measured by interdialytic weight gain. A path analysis model found daily minor stress to have a direct effect on nonadherence, whereas there was a direct inverse effect of depression on nonadherence. Possible mechanisms and implications for future studies are discussed.

Depressive Disorder↗
PubMed1995

Ozone level effect on respiratory illness: an investigation of emergency department visits.

This project examined the relationship of daily ozone (O3) levels to the number of respiratory-related emergency department (ED) visits. The confounding effects of temperature, humidity, mold, and pollen counts were examined, as were the effects of day of the week on numbers of ED visits. The design is a time-series relating concurrently measured variables that are repeatedly measured over time. Respiratory-related ED visits at three hospitals in a southern city were examined. Visits were analyzed separately for pediatric, adult, and geriatric patients. A significant association was found between elevated O3 levels and respiratory-related visits for adults. The same association was not found for pediatric or geriatric ED visits. Days with higher ozone were accompanied by higher numbers of adults going to the emergency department because of respiratory complaints. However, the effect was not large and does not appear to hold for pediatric or geriatric ED visits.

Adolescent↗
PubMed1994

Stress, depression, and anxiety predict average symptom severity and daily symptom fluctuation in systemic lupus erythematosus.

Forty-one subjects diagnosed with systemic lupus erythematosus (SLE) were recruited from across the United States. Regressions were conducted to evaluate the relation among stress, depression, anxiety, anger, and SLE symptom complaints. Negative weighting of major life events predicted symptom history. Significant hierarchical regressions using negative weighting of major life events, impact of daily stress, depression, anxiety, and anger were found for severity of joint pain, abdominal distress, and rash. Analyses using 1-day-lagged predictors yielded similar results. Within-subject analyses suggested that there was much individual variability in the strength of the stress-illness relation. Thus, some individuals appeared to be stress responders, while others did not. Findings for impact of minor life events and depression were consistent across the different levels of analyses. It was concluded that stress, depression, anxiety, and anger are associated with, and may exacerbate, self-reported symptomatology of SLE patients.

Adult↗
PubMed1994

Subsyndromal ("mixed") anxiety--depression in primary care.

OBJECTIVE: To determine in primary care settings the prevalence, clinical characteristics, and functional status of patients who have anxious and depressive symptoms who did not meet diagnostic criteria for major mood and anxiety diagnoses. DESIGN: Patients were screened with the General Health Questionnaire and interviewed if they exceeded the cutoff score of 5. Also, one patient whose score was below the cutoff was interviewed for every two patients whose scores were above the cutoff. SETTING: Five primary care sites in the United States, France, and Australia. PATIENT: Two hundred sixty-seven patients presenting to their primary care physicians for general medical care and follow-up. METHODS: Structured diagnostic interviews were conducted and ratings of anxiety, depression, and functional impairment were obtained by trained interviewers. RESULTS: After adjustments for sampling, 5% of the patients had symptoms of anxiety, depression, and functional impairment, without meeting formal criteria for a major DSM-III-R mood or anxiety disorder. This was comparable to the prevalence of diagnosable DSM-III-R mood disorders but only one-fourth the prevalence of diagnosable anxiety disorders. These patients who had subsyndromal symptoms had rates of lifetime psychiatric disorders and prior psychiatric treatment comparable to those of patients meeting criteria for major mood and anxiety disorders. CONCLUSION: The comparable rates of symptomatic distress, functional impairment, and prior psychiatric illness and treatment suggest that patients with subsyndromal anxiety and depressive symptoms warrant clinical recognition and possibly specific treatment.

Anxiety↗
PubMed1993

Contingent social reinforcement for fluid compliance in a hemodialysis patient.

Two approaches, (a) patient education and (b) compliance-contingent social reinforcement, were employed to improve compliance with fluid restrictions in a chronically noncompliant hemodialysis patient of borderline intellectual functioning. Results indicated that only social reinforcement led to improved compliance (i.e., decreased intersession weight gain). Treatment effects were well maintained at both 3- and 6-month follow-ups. Contingency management strategies are recommended as a potentially cost effective treatment for noncompliance in hemodialysis patients.

Adult↗
PubMed1992

The relation between stress and disease activity in rheumatoid arthritis.

This study investigated the relation between stress and current disease activity in rheumatoid arthritis (RA). During a routine clinic appointment, subjects were given ratings of global disease status by their physicians and completed self-report measures of major stress and minor stress. In addition, each subject's erythrocyte sedimentation rate was taken. After controlling for disease severity and major stress, minor stress accounted for a significant amount of the variance in inflammation level. These results suggest that minor stress is associated with current disease activity in RA.

Adaptation, Psychological↗
PubMed1992

Stress and social support as predictors of dietary compliance in hemodialysis patients.

This study examined the effects of minor stress on variations in biochemical indices of dietary compliance in hemodialysis patients. Subjects completed the Schedule of Recent Events, the Weekly Stress Inventory, and the Social Support Questionnaire. In addition, two biochemical measures of dietary compliance were obtained from the patients' medical charts. Multiple regression analysis, with baseline levels of compliance and the relatively stable influence of major life events and social support controlled for, revealed that minor stress was significantly predictive of changes in dietary compliance. The results suggest that minor stress may affect health status in the chronically ill by reducing compliance behaviors.

Adaptation, Psychological↗
PubMed1991

The relation between daily stress and Crohn's disease.

This study examined the effect of minor daily stressors on the primary indices of Crohn's disease in 10 adult volunteers from a support group for individuals with inflammatory bowel disease. All subjects monitored the occurrence of daily stress concurrently with the signs and symptoms of their disease for 28 days. The results of the regression and between-subject analyses indicate a relation between daily stress and self-rated disease severity in Crohn's disease. The effects of daily stress on signs and symptoms of Crohn's disease were significant even after controlling for the effects of major life events. Individual within-subject correlations, however, indicated that stress and indicators of disease were highly related for only three subjects. The results of the current study therefore suggest that at least for some individuals with Crohn's disease, daily stress is related to self-reported indicators of the illness.

Adaptation, Psychological↗
PubMed1990

Efficacy of behavioral management and patient education on vascular access cleansing compliance in hemodialysis patients.

Compared four treatment conditions to test their ability to enhance compliance with vascular access cleansing (VAC) procedures in a group of 56 hemodialysis patients. The conditions were patient education, behavioral management with monetary incentive, patient education/behavioral management, and attention control. Behavioral observers rated VAC behavior at pretreatment, posttreatment 1-month follow-up, and 1-year follow-up. Knowledge of VAC procedures was also assessed via a questionnaire at pretreatment and posttreatment. Data were analyzed using repeated-measures multivariate analyses of variance. Results indicated that the patients in the education/behavioral, behavioral, and education groups gave significantly more correct answers on our VAC knowledge questionnaires at posttreatment than did patients in the attention control group. Further, patients in the education/behavioral and behavioral groups completed significantly more VAC steps at posttreatment and 1-month follow-up than did patients in the education group and in the attention control group. Differences were not maintained at 1-year follow-up, although more than 50% of the patients were lost to follow-up. Implications of the present findings for behavioral and educational interventions are discussed.

Adult↗
PubMed1989

Pseudocyesis and depression. Etiological and treatment considerations.

Pseudocysesis, or false pregnancy, is generally classified as a conversion symptom and is usually treated as such with little success. Depression, however, is a commonly associated phenomenon and is typically neglected in the formulation and treatment of this disorder. This report presents a case study in which the patient was referred for evaluation of pseudocyetic symptoms, but depression was judged to be the underlying problem. Antidepressant therapy was instituted and found to be effective in ameliorating the pseudocyetic symptoms. Treatment implications of pseudocyesis as an artifact or concomitant of depression are discussed.

Adult↗
PubMed1987

Cluster analysis of Minnesota Multiphasic Personality Inventory (MMPI) profiles in a chronic headache population.

Minnesota Multiphasic Personality Inventory (MMPI) profiles from 123 chronic headache sufferers (48 migraine, 47 muscle contraction, 28 mixed) were cluster analyzed in order to replicate results from other pain populations and to examine differences among the clusters along headache parameters and demographic variables. Four homogeneous subgroups were obtained and a multiple discriminant analysis was successful in correctly classifying 97.56% of the headache subjects. Obtained clusters closely resembled those evidenced in previous pain research. Results indicated that diagnostic category was unrelated to cluster membership; however, frequency of headache occurrence was a differentiating factor. Implications for headache treatment and future research are discussed.

Adolescent↗
PubMed1987

A Daily Stress Inventory: development, reliability, and validity.

This article describes the development of the Daily Stress Inventory, a measure introduced to provide researchers and clinicians with a psychometrically sound self-report instrument for the daily assessment of the sources and individualized impact of relatively minor stressful events. It was designed to assess sources of stress not typically assessed by major life-event scales. Generalizability coefficients indicate that the scale has significant homogeneity and a useful degree of stability. Several studies investigating the concurrent and construct validities suggest that the scale measures the construct commonly referred to as "stress." Implications for uses in theoretical and basic research as well as clinical assessment are discussed.

Adolescent↗
PubMed1985

Blepharospasm: a case study comparison of trihexyphenidyl (Artane) versus EMG biofeedback.

Blepharospasm is a chronic condition characterized by involuntary spasmodic closure of the eyelid(s). The present investigation empirically evaluated the relative efficacies of a current pharmacological and a psychological approach in the treatment of blepharospasm. An A-B-A-C-A single-case design was used to compare trihexyphenidyl [Artane] with EMG biofeedback. EMG activity in the frontalis muscle and number of eyeblinks were the dependent variables. The results indicated that Artane had no effect on either dependent measure and that biofeedback had a dramatic treatment effect on both dependent variables. Treatment gains were maintained at a 42-week follow-up. These results are discussed in light of the methodological considerations, the efficacy of psychological intervention, and the need for future research.

Biofeedback, Psychology↗