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Biomedical subjects

S M Turner

Publications and source records attributed to S M Turner.

At least 19 recordsLinked to original sources
PubMed1999

Psychopathology of childhood social phobia.

OBJECTIVE: To describe the clinical syndrome of social phobia in preadolescent children. METHOD: Fifty children with DSM-IV social phobia were assessed with semistructured diagnostic interviews, self-report instruments, parental and teacher ratings, a behavioral assessment, and daily diary recordings. In addition, the behaviors of these children were compared with those of a sample of normal peers. RESULTS: Children with social phobia had a high level of general emotional over-responsiveness, social fear and inhibition, dysphoria, loneliness, and general fearfulness. Sixty percent suffered from a second, concurrent disorder. Socially distressing events occurred quite frequently and were accompanied by maladaptive coping behaviors. In addition, children with social phobia had significantly poorer social skills. There were few differences based on gender or race. CONCLUSIONS: Children with social phobia suffer pervasive and serious functional impairment. In addition, the clinical presentation suggests specific avenues for psychosocial interventions.

Adolescent↗
PubMed1997

Direction of temperature control in the thermal biofeedback treatment of vascular headache.

In order to test for the specific therapeutic effects of thermal biofeedback (TBF) for hand warming on vascular headache (HA), 70 patients with chronic vascular HA were randomly assigned to TBF for hand warming, TBF for hand cooling, TBF for stabilization of hand temperature, or biofeedback to suppress alpha in the EEG. Patients in each condition initially had high levels of expectation of therapeutic benefit and found the treatment rationales highly credible. Participants in each condition received 12 treatment sessions on a twice-per-week basis. Based on daily HA diary data gathered for 4 weeks prior to treatment and 4 weeks after treatment, HA Index was significantly (p = .003) reduced as was HA medication consumption. There were no differential reductions in HA Index or Medication Index among the four conditions. Global self-reports of improvement gathered at the end of the post-treatment monitoring period also did not differ among the four conditions. We were unable to demonstrate a specific effect of TBF for hand warming on vascular HA activity.

Adolescent↗
PubMed1997

At risk for anxiety: I. Psychopathology in the offspring of anxious parents.

OBJECTIVE AND METHOD: Children of parents with anxiety disorders, depressive disorders, mixed anxiety/depressive disorders, and no psychiatric disorder were assessed with semistructured interviews to determine rates of overall psychopathology and to determine specifically the presence of anxiety disorders. RESULTS: Children of the three "high-risk" groups were significantly more likely to have a diagnosable disorder (including anxiety disorders) than offspring of normal parents, but there were no differences among the children from the three parental diagnostic groups. However, when examined specifically for anxiety disorders, offspring of anxious parents were significantly more likely to have only anxiety disorders. Offspring of depressed or mixed anxious/depressed parents had a broader range of disorders and more comorbid disorders. Family socioeconomic status was related to the probability that a child would have a disorder. CONCLUSIONS: Anxiety disorders are common among offspring of anxious and depressed parents. However, when a parent has depression, children exhibit a broader range of psychopathology than when a parent has an anxiety disorder alone.

Anxiety Disorders↗
PubMed1996

Stability of anxious symptomatology in children.

The stability of anxiety states and symptoms was assessed in a sample of 150 anxious and nonanxious children. A number of assessment methods including a semistructured interview, self-report instruments, psychophysiological measures, and parental reports were used initially and at intervals up to 6 months later. The majority of children with a diagnosed anxiety disorder at the initial assessment still manifested significant symptomatology at the 6 month follow-up. However, stability of specific anxiety symptoms when assessed by self- and parental reports was mixed. With respect to psychophysiological assessment, stability of responses was evident at 2 weeks but not after 6 months. Results are discussed in terms of the stability of diagnoses and symptomatology, and the need for thematically relevant self-reports and behavioral assessment tasks. Recommendations are made for the development of a reliable, multimethod strategy to assess the multiple domains of childhood anxiety.

Anxiety Disorders↗
PubMed1996

Trauma management therapy: a preliminary evaluation of a multicomponent behavioral treatment for chronic combat-related PTSD.

The development and initial evaluation of a new, comprehensive and multicomponent behavioral treatment (Trauma Management Therapy, or TMT) for chronic combat-related Post-Traumatic Stress Disorder (PTSD) is described. The program utilizes elements of intensive exposure therapy, programmed practice, and structured social and emotional skills training to target the multiple aspects of chronic combat-related PTSD. The treatment was found to be effective in alleviating a broad spectrum of difficulties in combat veterans with chronic PTSD, most of whom had co-occurring Axis I and/or Axis II disorders. The results are discussed with respect to the implementation of the new treatment and the general need for a comprehensive approach to treating combat-related PTSD. Implications for the potential cost-effectiveness of the treatment program also are discussed.

Adult↗
PubMed1996

Clinical features affecting treatment outcome in social phobia.

Characteristics of social phobics were examined to determine their effect on treatment acceptance, drop-out rate and amount of improvement at post-treatment. The rate of treatment non-acceptance was low and those who entered treatment differed from those who did not only on ratings of social phobia severity. The drop-out rate also was relatively low, and there were no differences between those who dropped out and those who completed treatment. When patients were divided on the specific versus generalized subtype dichotomy, a number of interesting findings emerged. Response to treatment was similar, but the specific subtype was significantly more improved at post-treatment than the generalized subtype. When compared on composite indexes of overall improvement and endstate functioning, there was no difference between the number of specific and generalized social phobics achieving significant or moderate improvement. However, a greater number of the specific subtype were judged to have high or moderate endstate status than the generalized subtype. A similar outcome was found when social phobics with comorbid disorders were compared with those who were non-comorbid. The results are discussed in terms of factors affecting outcome in social phobia treatment.

Adult↗
PubMed1996

Panic, agoraphobia, and vestibular dysfunction.

OBJECTIVE: Otoneurological abnormalities have been reported in panic disorder. The purpose of this investigation was to determine the prevalence of such findings in panic disorder with and without agoraphobia and to discern whether vestibular dysfunction was associated with specific symptoms. METHOD: Clinical audiological and vestibular tests were administered to 30 patients with uncomplicated panic disorder (without agoraphobia or with only mild agoraphobia), 29 patients with panic disorder with moderate to severe agoraphobia, 27 patients with anxiety but no history of panic attacks, 13 patients with depressive disorders but no history of anxiety or panic attacks, and 45 normal comparison subjects. Evaluators were blind to subjects' diagnostic group. Quantitative measures of subjects' discomfort with space and motion and of the frequency of certain symptoms between and during panic attacks were obtained. Anxiety state levels were measured during the vestibular tests. RESULTS: Vestibular abnormalities were common in all the groups but most prevalent in the patients with panic disorder with moderate to severe agoraphobia. Vestibular dysfunction was associated with space and motion discomfort and with frequency of vestibular symptoms between, but not during, panic attacks. There were no major differences between the two panic groups in anxiety levels during vestibular testing. There were no significant differences between groups on the audiological component of the test battery. Exploratory data analysis indicated that the constellation of vestibular tests most specific for agoraphobia was one indicating compensated peripheral vestibular dysfunction. CONCLUSIONS: Subclinical vestibular dysfunction, as identified by clinical tests, may contribute to the phenomenology of panic disorder, particularly to the development of agoraphobia in panic disorder patients.

Adult↗
PubMed1996

Lung function in bronchiectasis: the influence of Pseudomonas aeruginosa.

Sputum isolation of Pseudomonas aeruginosa (PA) is associated with extensive disease in bronchiectasis. It is not known, however, whether infection with P. aeruginosa is the result or the cause of severe disease. We compared spirometry in patients with bronchiectasis before and after infection with P. aeruginosa, with that of patients infected by other organisms. All patients (n=12) with chronic colonization by P. aeruginosa (PA group) were studied. These were compared with other patients with bronchiectasis with no isolations of P. aeruginosa (n=37, non-PA group). In the PA group, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were lower than in the non-PA group. The PA group, however, also had lower values at the time of initial colonization with P. aeruginosa than the current values for the non-PA group. Change in FEV1 and FVC over time was faster in the PA group than in the non-PA group. Reduction of FEV1 and FVC over time in the PA group prior to P. aeruginosa colonization was intermediate, not being statistically different from either value above. Our results confirm the association of chronic P. aeruginosa colonization with poor lung function, but conclude that patients with bronchiectasis who become colonized by P. aeruginosa have poorer lung function when first colonized than those colonized by other organisms. Decline in lung function is faster in those chronically colonized by P. aeruginosa than in those colonized by other organisms. It is not clear whether chronic P. aeruginosa colonization causes an accelerated decline in lung function or whether it is simply a marker of those whose lung function is already declining rapidly.

Aged↗
PubMed1996

Socioecological and sociocultural variables in psychopharmacological research: methodological considerations.

Although a relatively small amount of work has been done, available evidence suggests that a host of variables, some of which are environmental, influence drug kinetics and likely dynamics as well. Recent evidence suggests that there are considerable differences in interethnic and racial responsiveness (including side effects) to various psychotropic drugs, and that understanding of differences is important for clinical and research studies as well as patient welfare. Some of the parameters of potential importance are presented, and strategies for controlling these variables in research studies are discussed.

Cultural Characteristics↗
PubMed1995

Two-year follow-up of social phobias treated with Social Effectiveness Therapy.

A 2-yr follow-up assessment was conducted with patients treated with Social Effectiveness Therapy (SET), a multi-component treatment for social phobia. Eight of the 13 patients who completed the treatment study were available for the follow-up. The results indicated that treatment gains were maintained over the 2-yr follow-up interval, and there was some indication of further improvement over that attained at posttreatment. The findings are discussed in terms of the efficacy of SET and the durability of behavioral treatment of social phobia.

Adult↗
PubMed1995

Social phobia: an analysis of possible developmental factors.

Sixty-eight individuals with specific or generalized social phobia and 25 normal controls were assessed for presence of a family history of anxiety, childhood shyness, traumatic conditioning experiences, neuroticism, and extraversion. Subtype differences emerged, including significantly greater neuroticism and a more frequent history of shyness in the generalized subtype. Those with the generalized subtype also had significantly lower extraversion scores, and those with the specific subtype had a significantly higher frequency of traumatic conditioning episodes. Together, traumatic conditioning and childhood shyness predicted the presence of social phobia, although other unidentified factors also appeared to be relevant. The results are discussed in terms of potentially different modes of onset for the subtypes of social phobia and the role of neuroticism and introversion in the development of the disorder.

Adult↗
PubMed1995

Assessing community violence: the children's report of exposure to violence.

OBJECTIVE: To describe the development and initial psychometric features of a brief self-report instrument for assessing exposure to community violence, the Children's Report of Exposure to Violence (CREV). METHOD: The CREV was administered to 228 schoolchildren between the ages of 9 and 15 years. A subset (n = 42) was retested 2 weeks later. RESULTS: The CREV has good test-retest reliability, internal consistency, and construct validity. Analyses performed by race and gender revealed no differences in frequency of exposure to community violence as assessed by the CREV. CONCLUSIONS: This initial report suggests that the CREV has promise as a self-report questionnaire, and its construction represents a significant advance in the development of psychometrically sound instruments for use in community violence research.

Adolescent↗
PubMed1995

Emotional impact of children's exposure to community violence: a preliminary study.

OBJECTIVE: To use multiple methods and measures to investigate preliminarily the emotional impact of children's exposure to community violence. METHOD: Thirty-seven schoolchildren between the ages of 7 and 12 years were categorized into groups with "high" or "low" frequency of exposure. RESULTS: Differing levels of exposure to community violence did not appear to have an impact on DSM-III-R diagnoses. Exposure to high levels of community violence was not related to internalizing behavior and disorders, but rather was associated with externalizing behavior. CONCLUSIONS: There appears to be an adverse relationship between high levels of exposure to community violence and emotional and conduct problems. Vicarious learning serves as an explanatory construct for these findings.

Child↗
PubMed1994

A multicomponent behavioral treatment for social phobia: social effectiveness therapy.

The development of a new, comprehensive and multicomponent treatment for social phobia is described. Initial results of a pilot study with the new treatment also are reported. The treatment was found to be effective with severe (generalized) social phobics, most of whom had co-occurring Axis I and/or II conditions. In addition to significant change on a host of outcome variables, a normative-based endstate functioning index was used to determine treatment efficacy. The results are discussed with respect to the implementation of the treatment and in terms of the need for a comprehensive approach to treating social phobia.

Adult↗
PubMed1994

A composite measure to determine improvement following treatment for social phobia: the Index of Social Phobia Improvement.

This article describes the development of a composite index to determine improvement in treatment outcome research with social phobia. The index is comprised of 5 individual outcome measures that tap various domains of social phobia and assess the disorder via multiple methods (e.g. self-report, clinical ratings, behavioral performance). The ability of the index to determine improvement over treatment, and its initial concurrent validity are discussed.

Adult↗