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Biomedical subjects

P Marton

Publications and source records attributed to P Marton.

At least 19 recordsLinked to original sources
PubMed1996

The effects of sexual abuse on 3- to 5-year-old girls.

This study examined the initial effects of sexual abuse on 70 girls aged 3 to 5 years. They were compared to a control group of 42 nonabused nonclinical girls matched for age. Of the 70 girls in the abused group, the 42 who had experienced intrafamilial abuse were also compared to the 28 who had experienced extrafamilial abuse. Evaluation of effects was based on maternal reports and very importantly, given this young age group, on direct observation. Children from both abuse groups displayed more evidence of distress on all measures. In particular, more sexual behaviors and more internalizing problem behaviors were reported and observed. Girls who were abused by a member of their family demonstrated some elevations in symptomatology, but generally there was not a significant difference between the two abuse groups. Poorer outcome was associated with a more noxious family environment and with repeated, more invasive abuse. The association of abuse and family characteristics that exacerbated the effects of sexual abuse on the child underscores the need for early detection and careful clinical assessment of the family as well as the child.

Child Abuse, Sexual↗
PubMed1996

Characteristics of psychogeriatric patient visits to a general hospital emergency room.

OBJECTIVE: This study describes psychogeriatric patients who visit the Emergency Room (ER) in a teaching hospital with a comprehensive psychogeriatric service. METHOD: A survey assessing demographic and clinical characteristics was completed for every psychiatric ER patient during a 2-year period. RESULTS: One hundred and seventy-three ER patients aged over 60 (mean age 71.2) were assessed. Fifty-three percent were previously known to the psychogeriatric service. The majority of these previously known psychogeriatric patients who used the ER suffered from mood disorders. The majority of new psychogeriatric patients seen in the ER had an organic brain syndrome (OBS). CONCLUSIONS: Few OBS patients who visited the ER were previously known to the psychogeriatric service, but many new OBS patients accessed the psychogeriatric service via the ER. For patients with mood disorders, particularly if suicidal, the ER was used as part of their service delivery system.

Adult↗
PubMed1995

The prevalence of cognitive distortion in depressed adolescents.

This study examined the prevalence of cognitive distortion in depressed adolescents. Ninety-four consecutive depressed adolescent psychiatric outpatients were administered the Beck Depression Inventory, the Dysfunctional Attitude Scale, the Interpersonal Dependency Inventory and the Maudsley Personality Inventory. Depressed patients who scored above a threshold for cognitive distortion were compared to those who fell below the threshold. Of the depressed patients, 47.4% were found to meet the severity criteria for cognitive distortion, while the remaining 52.6% were found to be below the severity threshold. Cognitive distortion was associated with more severe symptoms of depression, lack of social self confidence and greater introversion. These results do not support the hypothesis that cognitive distortion is universal in clinical depression. However, they do suggest that cognitive distortion is associated with more severe depression.

Adolescent↗
PubMed1994

Response to desipramine treatment in adolescent depression: a fixed-dose, placebo-controlled trial.

OBJECTIVE: To determine the efficacy and tolerability of the tricyclic antidepressant desipramine (DMI) in the treatment of DSM-III-R-diagnosed major depressive disorder in adolescents. METHOD: Sixty adolescents (42 female, 18 male; aged 15 to 19 years) diagnosed with major depressive disorder using clinical interview and Schedule for Affective Disorders and Schizophrenia for School-Age Children were randomized to receive either DMI (200 mg daily in divided doses) or placebo for six consecutive weeks following a 1-week placebo period. Treatment outcome was determined using the Hamilton Depression Rating Scale and the Beck Depression Inventory. Tolerability was determined using a symptom side effects scale. In addition, a variety of laboratory and cardiovascular monitoring was performed. RESULTS: No significant differences in treatment outcome between DMI- and placebo-treated groups were determined. Neither DMI, nor its metabolite 2-hydroxy-DMI, nor their ratio, was positively correlated to treatment outcome. The DMI group endorsed more side effects but there were no significant between-group differences in any laboratory, electrocardiographic, or other cardiovascular parameters apart from heart rate, which was increased in the DMI-treated group (p = .03). CONCLUSIONS: Given the findings of this study and our review of previously published reports of tricyclic antidepressant treatment in this population, the routine use of short-term (6 weeks) DMI in the treatment of adolescent depression is not supported by the data on hand. Further investigations into what constitutes optimal psychopharmacological treatment of adolescent depression are warranted.

Adolescent↗
PubMed1994

Familial risk factors associated with intrafamilial and extrafamilial sexual abuse of three to five year old girls.

This study intended to identify familial risk factors which differentiate sexually abused young girls from nonabused girls and, further, young victims of intrafamilial from those of extrafamilial sexual abuse. The subjects were 112 girls aged three to five years and their families. Forty-two were the victims of intrafamilial sexual abuse and 28 were victims of extrafamilial sexual abuse while 42 girls were not the victims of abuse. The three groups of girls were matched for age. Comparisons indicated that the families of abused girls had less harmony and stability in the marital unit and were headed by less competent parents. Mothers in both abuse groups were significantly more likely to have experienced sexual abuse as children. For all comparisons, the intrafamilial group showed greater disadvantage and dysfunction than the extrafamilial group. The intrafamilial group was differentiated from the extrafamilial group by worse spousal relationships, inadequate boundaries in parent-child behaviour, father's history of physical abuse as a child and violent behaviour as an adult and maternal disapproval of the child victim. These findings suggest that child sexual abuse is related to a longstanding collection of interconnected adult personal and relational deficiencies which result in inadequate parenting for the young victim.

Child Abuse, Sexual↗
PubMed1994

The relationship between life events during adolescence and affect and personality functioning.

Bowlby's concept of the internal working model is useful in conceptualizing how a child develops a sense of self and security through the availability of significant relationships. The lack of secure attachments may lead to dysphoric moods and poor personality functioning. We have shown that a proportion of teenagers develop dysphoria as well as personality disturbance during adolescence. A study sample of 59 youths was examined at early, middle and late adolescence. Ratings were made of affect, attitudes and personality functions. At the same time, information was obtained about family status and functioning. Results showed that certain family and life events were more strongly correlated with changes in affect in early adolescence. These affects were both internalized and externalized. Middle adolescence appeared to be quiescent, without any correlations with affect or personality problems. In late adolescence, there were correlations between family changes and personality dysfunction as well as dysphoria. This shows that family changes which threaten the availability of significant attachment figures are linked to emotional and behavioural disturbance in early adolescence and personality and emotional disturbance in late adolescence.

Adolescent↗
PubMed1993

Cognitive social skills and social self-appraisal in depressed adolescents.

OBJECTIVE: This study was undertaken to determine whether the social cognitive skills and social self-appraisal of depressed adolescents differed from those of other adolescents with nonaffective psychiatric disorders or of adolescents free from disorder. METHOD: Within the age range of 15 to 19, 38 depressed adolescent outpatients (14 boys, 24 girls); 31 nondepressed adolescent outpatients (17 boys, 14 girls); and 34 normal high-school students (18 boys, 16 girls) were assessed using the following dependent measures: Interpersonal Negotiation Interview, Adolescent Social Problem Solving Measure, Adolescent Self Perception Profile, and Interpersonal Dependency Inventory. RESULTS: Depressed adolescents were found to have significantly more negative self-concepts and significantly less social self-confidence than either comparison group. They did not differ from the other adolescents in either social problem-solving ability or interpersonal understanding. CONCLUSIONS: These results indicate that depressed adolescents have unique deficits in social self-evaluation which contribute to ineffective social behavior and the maintenance of dysphoric affect. Treatment of social skill deficits should be based on a careful assessment of the patient's functioning in this area.

Adolescent↗
PubMed1993

Family factors in adolescent unipolar depression.

This paper reviews the current literature on the contribution of family factors to unipolar depression among adolescents. Research which examined the following factors was reviewed and evaluated: genetic transmission, parental depression, parental death, quality of attachment and family interaction. Studies had to meet the following criteria to be included: publication must have been between the years 1985 and 1992; the evaluation had to be empirical with some form of control; a dependent measure of family characteristics or functioning; the adolescent had to be between the ages of 13 to 19; and the adolescent had to meet the recognizable criteria for unipolar depression. Recent literature suggests that adolescents suffering from depression share a number of risk factors: a family history of affective disorder, inept or inadequate parenting, abrasive interactions within the family and insecure attachments. At this time, there is no evidence that these aversive interactions predate the disorder. Weaknesses in the current literature are identified and strategies for improving future research are proposed.

Adolescent↗
PubMed1993

Cognitive distortion in depressed adolescents.

Cognitive theories of the etiology of depression in adulthood have received widespread acceptance. To date there is little evidence of the role of cognitive distortion in the etiology of depression among adolescents. This study was conducted to determine whether or not cognitive distortion differentiates depressed adolescents from non-depressed adolescents. The Dysfunctional Attitude Scale, a measure of cognitive distortion, was administered to three groups of adolescents: clinically depressed; non-depressed with non-psychotic psychiatric disorders; and a non-clinical group of adolescents without psychiatric disorders. A subset of the depressed patients was re-administered the scale after they had clinically recovered from the depressive episode. The depressed adolescents had significantly greater cognitive distortion than the non-depressed adolescents. Remission of the depressive disorder was associated with a significant reduction in cognitive distortion, although the level of cognitive distortion was still significantly higher than normal.

Adolescent↗
PubMed1992

Specificity of psychoanalytic hypotheses regarding the onset of adolescent psychoses: an empirical test of a psychodynamic model.

The specificity of psychodynamic hypotheses regarding the onset of adolescent psychosis was assessed in a group of rigorously diagnosed psychotic (N = 75) and depressed (N = 53) adolescents. None of the four operationally defined psychodynamic hypotheses purported to be etiologically specific in the onset of adolescent psychotic illness: success and its opportunities; intimacy and its attempts; intent to act autonomously; or involved in insight-oriented psychotherapy was more commonly observed in the psychotic than the depressed group, thereby not supporting the hypotheses. The consequences of this finding are discussed.

Adolescent↗
PubMed1992

Substance abuse among adolescents with chronic mental illnesses: a pilot study of descriptive and differentiating features.

Twenty-six adolescents with a chronic mental illness (schizophrenia or schizoaffective disorder of at least 1.5 years' duration) were assessed for the presence or absence of comorbid substance abuse. The two groups were compared on a number of variables believed to identify or predict substance abuse. The substance abusing subgroup were significantly different in levels of social functioning, school achievement, premorbid substance abuse, having parents or siblings who abused substances, dysfunctional families, cigarette smoking, number of hospital admissions, and emergency room visits. These findings are discussed in the context of clinical issues regarding the management of adolescents with chronic mental illnesses.

Adolescent↗
PubMed1992

REM latency in endogenously depressed adolescents.

Twenty-three adolescents with DSM-III major depressive disorder (endogenous subtype) and 23 normal controls were studied polysomnographically (PSG). The depressed group showed significantly shortened REM latencies (P = 0.005) and longer sleep latencies (P = 0.04). No other PSG measures differentiated the two groups. The implications of these findings for adolescent depression are discussed.

Adolescent↗
PubMed1991

On the dynamic organization of memory. A mathematical model of associative free recall.

The interaction of memory structures and retrieval dynamics is discussed. A mathematical model for associative free recall is presented to support the view that the organization of simple processing units plays an important role in the retrieval of memory traces. Computer simulations show that "flexibility" and "fidelity" of the dynamics strongly depend on the network structure, the amplification and decay parameters, and the noise term.

Association Learning↗
PubMed1991

Affective disorders in first-degree relatives of adolescent onset bipolars, unipolars, and normal controls.

Two hundred and fifty-nine first-degree relatives of 23 adolescent bipolars (81 relatives); 26 unipolars (95 relatives); and 24 normal controls (83 relatives) were assessed for the presence of affective disorders, using the family history method. First-degree relatives of bipolar probands were significantly more likely to have a bipolar illness than those of unipolar probands (p = 0.03) and normal controls (p = 0.001). Rates of unipolar depression in first-degree relatives of bipolars and unipolars were not significantly different but differed significantly between bipolars and normals (p = 0.002) and unipolars and normals (p = 0.006). The implications of these findings for clinical work, diagnosis, and research in adolescents with affective disorders are discussed.

Adolescent↗
PubMed1991

Nocturnal cortisol, thyroid stimulating hormone, and growth hormone secretory profiles in depressed adolescents.

Twelve depressed adolescents and 12 controls matched for age, sex, Tanner stage, time of menstrual cycle (females), weight, and time of year assessed were studied over 3 nights. Measurements for cortisol, thyroid stimulating hormone, and growth hormone were made on serum collected at 10 P.M., 12 midnight, 1 A.M., 2 A.M., 3 A.M., 4 A.M., and 6 A.M. in eight pairs and every 20 minutes from 8 P.M. to 7 A.M. in four pairs. Cortisol secretion did not significantly differentiate the groups. Thyroid stimulating hormone secretion was significantly elevated in the depressed group at one time point. Growth hormone secretion significantly differentiated the two groups at most time points, and the depressed adolescents significantly hypersecreted growth hormone (area under the curve). Implications for the diagnosis, etiology, and treatment of adolescent depression are discussed.

Adolescent↗
PubMed1991

Consistency and change in personality characteristics and affect from middle to late adolescence.

Non clinical adolescents in a longitudinal study were examined at ages 16 and 18 to see whether or not there were changes in personality functioning, attitudes and affect over time, and whether or not these were related to each other. Personality functioning remained fairly consistent at both ages, with marked personality problems occurring in about one out of seven. As a group, the older adolescents demonstrated more anxiety and depression, as well as changes in certain attitudes such as more curiosity and interest in people. For individual adolescents it was found that there was considerable predictability of affect and attitudes at age 18 from the presentation at age 16. Furthermore, a relative increase in the amount of anger in middle adolescence was a predictor of personality problems in late adolescence.

Adaptation, Psychological↗
PubMed1991

Diagnostic utility of the Beck Depression Inventory with adolescent psychiatric outpatients and inpatients.

The utility of the Beck Depression Inventory (BDI) for differentiating adolescents with depressive disorders from adolescents with non affective psychiatric disorders was examined using a sample of 93 psychiatric outpatients and 26 inpatients. The Diagnostic Interview for Children and Adolescents (DICA) was administered to establish the patients' diagnosis. Psychiatric diagnoses were made by experienced clinicians who used all available information on the patient. The BDI scores discriminated between patients with depressive disorders and patients with non affective psychiatric disorders. This differentiation was true for boys and girls, outpatients and inpatients. The classification accuracy of the instrument was 75% at thresholds of 11 and 16 on the scale. The results indicate that the BDI is a useful instrument for screening for depression in adolescents, and can also be used in conjunction with other tests. However, the BDI by itself is inadequate to establish a diagnosis of depression.

Adolescent↗