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Biomedical subjects

R E Tarter

Publications and source records attributed to R E Tarter.

At least 55 records · Page 3Linked to original sources

Alcoholism: a developmental disorder.

Alcoholism etiology is discussed from a developmental behavior genetic perspective. At the outset point, temperament characteristics, by means of ongoing and reciprocal interaction with the social environment, shape the course of behavioral development. The behavioral characteristics successively acquired during development are vectors that determine the ontogenetic trajectory that culminates ultimately in the clinical disorder of alcoholism. The temperament features that appear to be associated with a heightened risk for alcoholism are examined. Their interactions with the environment during the course of development are considered within an epigenetic framework and, as discussed, have important ramification for improving the prevention and treatment of alcoholism.

Alcoholism↗

Individual, family, and peer affiliation factors predisposing to early-age onset of alcohol and drug use.

In this study, a multifactorial model of liability to early-age alcohol and drug use was elucidated on a sample of sons of substance-abusing fathers (n = 59) and sons of normal fathers (n = 71) at time 1 when the boys were 10-12 years of age. Three hierarchical regression analyses were computed to test models to identify salient risk characteristics associated with sons' perception of family dysfunction unconventional activities among peers, and affiliation with peers engaged in delinquent behaviors. The respective models explained 28% of the variance on sons' Dysfunctional Family Index scores, 21% of the variance on sons' Conventional Activities of Friends Scale scores, and 53% of the variance was accounted for on sons' Peer Delinquency Scale scores. In subsequent logistic regression analyses, a multifactorial model comprised of individual, family, and peer risk characteristics obtained at time 1 correctly predicted 83.7% of sons who had used alcohol and/or drugs by time 2 when they were 12-14 years old. The findings also suggest that temperament phenotype influences family interaction patterns that in turn influence the psychosocial development of the child.

Alcoholism↗

A neuropsychologic profile of adolescent alcoholics.

Male and female adolescents who qualified for a DSM-III-R diagnosis of Alcohol Abuse or Dependence and a control sample of nonalcohol-abusing male and female adolescents were administered a battery of intellectual, achievement, and neuropsychologic tests. Alcohol-abusing adolescents were found to have significantly lower verbal and full-scale IQ scores than controls. Furthermore, alcohol-abusing adolescents were found to have a trend toward lower age-standardized scores on achievement tests of reading ability and spelling. Surprisingly, alcohol-abusing adolescents made less perseverative errors and commission errors on a learning and memory task than controls. Control males performed worse on the Wisconsin Card Sort than alcoholic males, whereas alcohol-abusing females performed worse than control females. In addition, alcoholic subjects scored better than controls on a measure of visual memory sensitivity. The results indicate that adolescent alcohol abusers in general have poorer language skills than adolescents who do not abuse alcohol. However, in contrast to results obtained from studies of adult alcoholics, there is little evidence of significant brain damage as revealed by using neuropsychologic test performance.

Adolescent↗

Statistical approaches in alcohol research: a comparative survey of two major alcohol journals with four major psychiatric journals.

This study surveyed and compared the statistical methods used in two major alcohol journals with those used in four major psychiatric journals. The alcohol specialty journals were Alcoholism: Clinical and Experimental Research and Journal of Studies on Alcohol. The psychiatry journals studied were the American Journal of Psychiatry, British Journal of Psychiatry, Archives of General Psychiatry, and Acta Psychiatrica Scandinavica. The aim of this study was to examine the extent to which alcohol researchers use statistical methods and their level of statistical sophistication. A second aim focused on the extent to which alcohol researchers are attentive to design and sample size issues. Comparisons between papers published in the four psychiatry journals and the two alcohol specialty journals published in 1990 revealed that the percentage of articles without any numerical results was substantially different among the journals: 21% of the psychiatry journals and 7% in the alcohol journals. There was a significant difference in favor of the alcohol journals with respect to frequency of intermediate statistical techniques. The number of papers published in the two alcohol journals using 20 or fewer subjects was similar to the four psychiatric journals. However, the alcohol journals contained more articles in which > 400 subjects were studied.

Alcoholism↗

Fitting a two-parameter logistic item response model to clarify the psychometric properties of the Drug Use Screening Inventory for adolescent alcohol and drug abusers.

The suitability of fitting a two-parameter logistic item response model to the Drug Use Screening Inventory (DUSI) was assessed. In a sample of 846 adolescents, each of the 10 domains was found to be unidimensional. Invariance of the item parameters across different groups was also observed. The reliability coefficient, based on item response theory, was found to be superior. The results of these analyses indicate that the DUSI has sound psychometric properties.

Adolescent↗

SPECT scan and cognitive findings in subclinical hepatic encephalopathy.

The authors studied 6 patients with end-stage cirrhosis and 6 age- and sex-matched normal control subjects by using SPECT brain scans to determine whether subclinical hepatic encephalopathy (HE) altered regional cerebral blood flow (rCBF). In addition, cirrhosis patients performed a battery of standardized neuropsychological tests known to be sensitive to effects of liver disease, and these were compared with published norms. Results of cognitive tests that showed impairment were correlated with ratios of rCBF values. In cirrhosis patients, rCBF was decreased in bilateral frontotemporal and right basal ganglia regions as compared with control subjects. These defects were compatible with the cirrhosis patients' visuopractic neuropsychological deficits, which were consistent with known subclinical HE cognitive patterns.

Basal Ganglia↗

Sexual functioning of male anabolic steroid abusers.

The effects of anabolic steroid use on male sexual behavior were assessed using a structured clinical interview administered to male body builders currently using steroids, and to two comparison groups (body builders with a past but not current history of steroid use, and a group of "natural" body builders who had never used steroids). Current anabolic steroid users had a significantly higher coital and orgasmic frequency than did comparison athletes. They also reported a significantly higher incidence of erectile difficulties during the past month. Beliefs concerning the sexually stimulating effects of steroids did not correlate with the frequencies of specific sexual behaviors. The data support the contention that anabolic steroids, as androgenic compounds, enhance sexual desire.

Adult↗

Antisocial symptoms in preadolescent boys and in their parents: associations with cortisol.

Conduct disorder (CD) symptom counts in preadolescent boys, and antisocial personality disorder (ASP) and childhood conduct disorder symptom counts in their parents, were used as dimensional measures of behavioral deviation. A significant correlation was found for CD and ASP symptom counts between the two parents and between CD symptom counts of the children and parental CD and ASP symptom counts. Although socioeconomic level correlated negatively with parental symptom counts, no association was observed between parental socioeconomic status and children's CD symptom counts. Saliva cortisol level in the children was negatively associated with their CD symptom count and with their fathers' ASP count. Cortisol level was also lower among sons whose fathers had CD as children and subsequently developed ASP compared with the cortisol level in sons whose fathers either did not have any Axis I psychiatric disorder or did not develop ASP.

Antisocial Personality Disorder↗

Heightened motor activity level in male offspring of substance abusing fathers.

Heightened activity level has been implicated in the liability for substance abuse, but no prior research has directly examined motor activity in a sample of prepubertal boys at high-risk for substance abuse. The magnitude of behavioral activity of 10-12 year-old sons of substance abusing fathers (SA +) (n = 42) and controls (SA -) (n = 60) was assessed using a microprocessor-based activity monitor during tasks that demanded significant concentration, effort, and constraint on motor activity, and when no such demands were present. Psychiatric status, measures of temperament traits, and measures of internalizing and externalizing behaviors were also obtained on the boys. Although the groups did not differ during the lower demand task, SA + boys showed significantly greater motor activity than SA - boys during the tasks that required concerted effort, attention, and behavioral suppression. Multiple regression analysis indicated that under the low-demand condition, the presence of an anxiety disorder in the boy was the only significant predictor of activity level. However, under the conditions that demanded effort, concerted attention and behavioral suppression, SA + group membership, and having low rhythmicity (as a temperament trait) predicted heightened activity. Statistically controlling for rhythmicity, the SA + boys were estimated to have about 24% higher activity than control boys. The results suggest that heightened motor activity may be associated with susceptibility to substance abuse.

Attention↗

Comparison between treatment completers and noncompleters among dually diagnosed substance-abusing adolescents.

The psychiatric and demographic characteristics that may distinguish treatment completers from noncompleters among hospitalized adolescents with substance abuse and comorbid psychiatric disorders were examined. Affective and adjustment disorders were more prevalent among treatment completers whereas non-completers were more likely to be assigned a conduct disorder diagnosis. There were no differences between the groups with respect to demographic and legal status, education level and lifetime psychiatric diagnosis in the parents or caretakers, living arrangements, treatment history, and perception of treatment benefits. A higher percentage of treatment completers than noncompleters received psychotropic medications. The factors contributing to treatment termination as well as the clinical and research implications of the findings are discussed.

Adolescent↗

The psychiatric diagnosis of alcoholism: critique and proposed reformulation.

A taxonomy of alcohol problem involvement is proposed which encompasses categorical and dimensional approaches to classification. It is argued that contemporary nosology such as that described in DSM or ICD cannot, in principle, yield discrete categories containing homogeneous membership. Nor does current classification and diagnosis yield sufficient specific information necessary for effective treatment. These limitations are not resolvable by additional empirical research; rather, as discussed herein, a new conceptual framework and focus are required. The proposed new taxonomy comprises the first step in developing a comprehensive and clinically useful method for characterizing the alcohol consuming population.

Adult↗

Severity of hepatic encephalopathy before liver transplantation is associated with quality of life after transplantation.

BACKGROUND: Cirrhosis is associated with a chronic low-grade hepatic encephalopathy and disturbances in quality of life. This study investigated the extent to which severity of hepatic encephalopathy before orthotopic liver transplantation correlated with quality of life. METHODS: A battery of neuropsychological tests was administered to nonalcoholic patients to quantify severity of hepatic encephalopathy. The Sickness Impact Profile was administered before and after surgery to document quality of life across multiple health and psychosocial dimensions. RESULTS: There was substantial improvement from the pretransplant to the posttransplant periods across almost all dimensions of quality of life. Neuropsychological test scores explained up to 20% of the variance in magnitude of change from pre (before) to post (after) surgery. CONCLUSION: Severity of hepatic encephalopathy (particularly with respect to static ataxia and fine motor control) is associated with posttransplantation improvement in quality of life.

Adult↗

Subclinical hepatic encephalopathy: relationship between neuropsychological deficits and standard laboratory tests assessing hepatic status.

A multivariate analysis of the relationship between biochemical measures of hepatic function and neuropsychological assessments of specific cognitive domains was performed on data obtained from 74 patients with chronic liver disease and subclinical hepatic encephalopathy. Biochemical tests of hepatic protein synthesis correlated significantly with measures of impaired language efficiency, perceptual speed, and psychomotor efficiency. Biochemical indices of impaired processing of nitrogenous compounds correlated with visuopractic deficits. Hepatic blood flow indices correlated with language inefficiency. Interestingly, biochemical measures of hepatic injury did not demonstrate a significant association with any neuropsychological parameter assessed. These results suggest that subclinical hepatic encephalopathy is the consequence of a multifactorial hepatic dysfunction, and that acute hepatic injury, as assessed by elevation of aminotransferases, does not appear to be involved in the pathogenesis of subclinical hepatic encephalopathy.

Journal Article↗

Ulcerative colitis disease activity as subjectively assessed by patient-completed questionnaires following orthotopic liver transplantation for sclerosing cholangitis.

To assess whether or not liver transplantation and subsequent immunosuppression with cyclosporine and prednisone affect ulcerative colitis symptomatology, we surveyed by questionnaire all 23 surviving patients with pretransplant colonoscopy-documented ulcerative colitis who were transplanted for primary sclerosing cholangitis between June 1982 and September 1985. At follow-up [89.8 +/- 7.6 weeks (mean +/- SEM], all six patients who had had asymptomatic colonoscopy-documented ulcerative colitis reported continued ulcerative colitis quiescence. Among the 17 patients who had had symptomatic colonoscopy-documented ulcerative colitis at time of liver transplantation, 88.2% reported improvement in overall ulcerative colitis severity (P less than 0.001), with significant improvement in the frequency of bowel movements reported by 100%, in crampy abdominal pain by 87.5%, in bowel urgency by 75%, in the occurrence of pus or mucus in stool by 87.5%, in the incidence of ulcerative colitis flares by 81.8%, and in the number of days unable to function normally due to ulcerative colitis symptoms by 78.6% (all at least P less than 0.01). These data demonstrate that ulcerative colitis symptom severity significantly improves following liver transplantation with immunosuppression with cyclosporine and prednisone.

Adult↗

Impact of liver disease on daily living in transplantation candidates.

The impact of different types of liver diseases on life quality in transplantation candidates was assessed. For all disease types, psychosocial impairment exceeded physical impairment. Among the various disease conditions, differences on the pattern and severity of life quality disturbances were observed.

Activities of Daily Living↗

Multivariate comparison of adolescent offspring of substance abuse parents: community and treatment samples.

Adolescent offspring of substance abuse parents (SA+) were compared on the scales of the Drug Use Screening Inventory to offspring of control parents (SA-). Neither clinical nor community samples of SA+ subjects were different from controls. These findings indicate that parental substance abuse does not necessarily impart maladjustment to their offspring.

Adaptation, Psychological↗

Psychiatric comorbidity in alcoholism: importance of ascertainment source.

Although psychiatric comorbidity is often observed among individuals in treatment facilities for alcoholism, the prevalence and pattern of psychiatric comorbidity among alcoholic cirrhotics has not been well characterized. The present study aimed first to compare the prevalence of psychiatric comorbidity in cirrhotic individuals with alcoholism ascertained from a gastroenterology service with alcoholics ascertained from a treatment facility for alcoholism. Consistent with the findings of other investigators, the data suggest that there is a great degree of variability regarding the severity of alcoholism in alcoholic cirrhotic individuals. Furthermore, cirrhotics with alcoholism exhibited a less severe clinical picture of alcoholism as measured by less alcohol dependence and lower prevalence of psychiatric comorbidity than individuals in treatment for alcoholism. The main conclusion of this study is that ascertainment source is an important determinant of psychiatric comorbidity observed in alcoholic samples.

Adult↗