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Biomedical subjects

T E Oxman

Publications and source records attributed to T E Oxman.

At least 37 records · Page 2Linked to original sources
PubMed1994

Assessment of object relatedness through a lexical content analysis of the TAT.

A variety of psychological tests and scoring systems have been developed to assess object representation, including schemata using Rorschach responses, the Thematic Apperception Test (TAT), Early Memories, and Loevinger's Sentence Completion Test for Ego Development. This article presents an alternative approach to assessing TAT responses for possible indices of self/other schemata. In this study, we explored a lexically based, quantitative approach for assessing object relations in a sample of hospitalized psychiatric patients for whom extensive clinical, psychological test, and behavioral data were available. To test the relationship between lexical choice and individuals' representational schemata, we subjected verbatim transcripts of TAT responses to a computerized content analysis and then correlated content profiles with independent assessments of object representation and interpersonal relations derived from other psychological test assessments and from behavioral and clinical observation. These included the Urist (1977) Mutuality of Autonomy score and Blatt, Brenneis, Schimek, and Glick's (1976) Developmental Analyses of the Concept of the Object, as well as ratings of clinical behavior as expressed in independently derived clinical case reports. The findings suggest that lexical choices in TAT narratives represent a highly reliable, valid means of assessing the quality of object relations, particularly unconscious or preconscious aspects of such representations.

Adolescent↗
PubMed1993

Language content and schizophrenia in acute phase Turkish patients.

The purpose of this study was to replicate and extend, in a Turkish sample, previous investigations of speech content in English-speaking schizophrenics. Computer content analytic procedures, which quantify thematic emphases in the subjects' free speech, have been shown to differentiate schizophrenic patients from other acutely ill psychiatric patients and from normal controls. We repeated the speech sampling procedure with hospitalized psychiatric patients in Turkey, and analyzed their responses using content analysis procedures with a translation of the dictionary or language classification system used in the original studies of English-speaking patients in the United States. Eighty subjects were included in the study: 20 schizophrenics, 20 depressives, 20 manics and 20 healthy controls. There were ten females and ten males in each group. After being diagnosed separately by two clinicians using the Turkish version of the Structured Clinical Interview for DSM-III-R (SCID), each subject's free speech was tape-recorded in a standardized session. The speech content of Turkish patients with schizophrenia exhibited considerable similarity to that previously observed in American subjects, but there were certain dissimilarities that appeared to reflect the impact of culture on the manifestations of the schizophrenic disorder. The phenomenological differences between the three psychiatric syndromes compared were also reflected in the results of the content analysis. The most dissimilar syndromes were mania and depression whereas the most similar were mania and schizophrenia. The particular word categories emphasized by specific groups also appeared to be consistent with the effects of their psychiatric disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Assessment of sleep in patients with lung cancer and breast cancer.

PURPOSE AND METHODS: We studied the sleep architecture and psychologic state of 32 patients with breast or lung cancer compared with 32 age- and sex-matched, normal-sleeping volunteers and 32 otherwise healthy insomniacs. RESULTS: Research findings indicate that lung cancer patients slept as poorly as did insomniacs, but underreported their sleep difficulties. Breast cancer patients slept similarly to normal-sleeping volunteers. No psychiatric disorders were detected in the cancer patients, and there were no significant differences in mood between lung and breast cancer patients. CONCLUSION: Lung cancer patients appear to be unique in underestimating an objectively verified sleep difficulty. The adaptive mechanism of denial in these patients is discussed.

Adult↗
PubMed1993

Issues in the comparison of techniques for eliciting source material in computerized content analysis.

Zeldow and McAdams (1993) recently presented artifactual explanations for our data showing dissimilarity between the content of speech elicited by the Thematic Apperception Test (Murray, 1943) and free speech tasks (Schnurr, Rosenberg, & Oxman, 1992). In particular, they alleged that our findings resulted from a lack of psychological meaning in our content categories and in the free speech task. We cite empirical and theoretical support to refute this allegation and provide additional analyses of our data that are consistent with our earlier suggestion that text samples elicited under different conditions may not be interchangeable.

Comment↗
PubMed1992

Social support and depressive symptoms in the elderly.

The purpose of this study was to examine the effect of characteristics of social networks and support on depressive symptoms in the elderly. The subjects were 1,962 noninstitutionalized persons 65 years and older from the New Haven Establishment of Populations for Epidemiologic Study of the Elderly in 1982, who were available to give a complete follow-up interview in 1985. Baseline depression, functional disability in 1982, and any change in disability by 1985 were considered as additional influences on 1985 depression, requiring adjustment along with sociodemographic variables. Multiple regression procedures were used to simultaneously examine the variables. Baseline depression, functional disability, and change in functional disability made the largest contribution to explaining the variance in depression. Among the social support and network characteristics, loss of a spouse, adequacy of emotional support, and its change during 1982-1985 made the largest contributions. Other significant characteristics in relative order of magnitude of effect, based on contrast tests, included tangible support adequacy and its change, loss of a confidant between 1982 and 1985, number of children making weekly visits and change in this number by 1985, and the absence of a confidant in both 1982 and 1985. For mental health outcomes, these findings emphasize the need to consider specific dimensions of social support and networks rather than global measures.

Aged↗
PubMed1992

Update on the dementia spectrum of depression.

OBJECTIVE: The primary focus of this review is to examine the usual dichotomy between depressive dementia as functional and reversible and degenerative dementia as organic and irreversible. METHOD: The authors propose viewing depression, cognitive impairment, and degenerative dementia as intersecting continua. They define five prototypical groups along these continua: 1) major depression without depressive dementia, 2) depressive dementia, 3) degenerative dementia without depression, 4) depression of degenerative dementia, and 5) independent co-occurrence of degenerative dementia and depression. Clinical, neuropsychological, and neurobiological studies comparing these groupings were identified by a computerized literature search covering the past 20 years. References were selected for review if they compared at least two groups. Degenerative dementia was limited to the Alzheimer type. RESULTS: No studies clearly included all five of the prototypical groups. There are methodological problems with each type of research reviewed, but the consensus of the research is that severe cognitive impairment of depression is associated with a variety of organic abnormalities. Depending on the length of follow-up, depressive dementia may not be as reversible as previously thought. CONCLUSIONS: The continuum viewpoint encourages longitudinal clinical follow-up for early detection and alleviation of incipient depressive and dementing symptoms. Hypotheses of overlapping pathophysiological mechanisms rather than differential diagnosis become an important research focus. The authors discuss three different types of relationships for future research: 1) interactions, 2) consequences of disease or treatment, and 3) necessary but not sufficient pathophysiology.

Alzheimer Disease↗
PubMed1992

Comparison of TAT and free speech techniques for eliciting source material in computerized content analysis.

We compared the free speech samples and Thematic Apperception Test (TAT) responses of 95 community-residing volunteers by using the General Inquirer content analysis computer program and the Harvard III Psychosociological Dictionary (Stone, Dunphy, Smith, & Ogitvie, 1966). Comparability was assessed by computing mean differences and correlations among techniques. The techniques were evaluated by assessing the ability of data derived from each to predict individual differences in developmental level, gender, depressive symptomatology, and personality. Results show highly discriminable profiles and low reliability among techniques. TAT data were superior in predicting individual, differences. We suggest that structured techniques like the TAT are preferable to standard free speech instructions for eliciting data in content analytic studies and discuss the possibility of computerized content analysis as a method of scoring the TAT.

Journal Article↗
PubMed1990

Symptomatology of late-life minor depression among primary care patients.

Patients of four general internists and four family physicians were interviewed by two psychiatrists to identify those suffering from depressive disorders. Nineteen elderly (60 years of age and older) patients and 22 younger (between 18 and 59 years of age) patients met Research Diagnostic Criteria (RDC) for minor depressive disorder, and 73 elderly and 79 younger patients had no psychiatric disorder. In general, the elderly depressed medical outpatients and the younger depressed medical outpatients had similar symptomatology, as did the elderly and nonelderly medical outpatients without psychiatric disorders.

Adult↗
PubMed1990

Content analysis: a comparison of manual and computerized systems.

Computerized content analysis is a technique for classifying texts. In personality research it has been used to make inferences about psychological states and traits of the speaker or writer. Whereas computerized techniques have been increasing in both sophistication and ease of use, questions remain regarding their validity compared to hand-scored scales. In this study, we compare a relatively simple computerized technique; a more sophisticated, context-sensitive computerized approach; and a context-sensitive, human-scored system. Seventy-one subjects, representing four diagnostic groups, provided free-speech samples which were scored according to all three methods. Data from each method were then submitted to discriminant and classification analyses. In comparing the classification performance of the three methods, we found that both computerized methods were more accurate than the human-scored method. The time and cost benefits of computerized systems are discussed.

Artificial Intelligence↗
PubMed1990

Assessment of social relationships in elderly patients.

This article provides an overview of measures for assessing the importance of social relationships to the outcome of illness in the elderly. Review of the evidence associating social relationships with the variability in health outcome emphasizes the need for separating social relationships into three components: Social network structure and composition; Type and amount of social support provided through the network; and, perceived adequacy of the social support. Because of physical and social changes during the life cycle, care must be exercised in selecting and interpreting social relationship measures for use with the elderly. Available measures relevant for assessing the three components of social relationships in the elderly are described.

Activities of Daily Living↗
PubMed1988

The prevalence of psychiatric disorders in a primary care practice.

Using a two-stage case identification process, patients from a rural primary care practice were assessed for psychiatric disorders (Research Diagnostic Criteria [RDC] categories) over a 15-month period. The prevalence of all psychiatric disorders was 26.5%; 10.0% were specific RDC depressive disorders, and 5.3% were disorders without depression, usually anxiety related. Another 11.2% of patients were thought to have a disorder with significant depressive symptomatology that could not be classified into a specific depressive disorder category, a finding that suggests restricted usefulness of specialty-based categories for the range of clinical presentations in primary care. The relationship of demographic variables to specific disorders was examined; there were age, sex, and marital status differences in the rates for certain disorders, although these findings need replication using large patient samples. The prevalence findings emphasize the need for research on outcome and treatment response for depression presentations in primary care.

Adolescent↗
PubMed1988

Somatization, paranoia, and language.

Somatization and paranoia are circumscribed distortions of reality that are impervious to the normative process of consensual validation. These distortions are often postulated as a means of bolstering lowered self-esteem. We used computerized content analysis of the free speech of patients with these disorders in order to identify and compare dimensions of self-concept reflected in their lexical choices. Interestingly, patients with these disorders differed in the themes prominent in their speech. The higher frequency categories used by the somatization disorder group conveyed an overwhelming sense of negativism, distress, and a preoccupation with an uncertain self-identity. In contrast, the categories used by the paranoid patients portrayed an artificially positive, grandiose self-image and a defensive abstractness. Our exploratory analysis suggests that circumscribed distortions of reality in somatization and paranoid disorders are not associated with the same common defensive style attempting to bolster self-esteem.

Adult↗
PubMed1988

The language of altered states.

To compare the subjective experience of different forms of altered states of consciousness, computerized content analysis was applied to 66 autobiographical accounts of schizophrenia, hallucinogenic drug states, or mystical ecstasy and to 28 autobiographical control accounts of important personal experiences. The patterns of lexical choice used by the four groups were significantly different in word frequencies from 49 of 83 lexical categories measured. When data from the 13 most statistically significant categories were used in discriminant and classification analyses, 84% of the samples were correctly identified by their word frequencies. These findings suggest that the subjective experiences of schizophrenia, hallucinogenic drug-induced states, and mystical ecstasy are more different from one another than alike.

Analysis of Variance↗
PubMed1988

Diagnostic classification through content analysis of patients' speech.

Speech samples from 71 patients in four diagnostic groups were analyzed by two quantitative methods of speech content analysis, the results of which were entered into a discriminant analysis to test whether patients could be accurately classified back into their appropriate diagnostic groups. These classifications were compared with classifications made by two psychiatrists, blind to the patients' diagnoses, who read transcripts of the speech samples. The results suggest that data from the systematic quantification of lexical choice can be used to classify patients into their respective diagnostic groups and that this classification compares favorably with that done by psychiatric raters.

Computers↗
PubMed1987

Psychiatric symptoms in the elderly in a primary care practice.

During a 15-month period in a rural group medical practice 1063 patients of four general internists completed a 49-item version of the Hopkins Symptom Check List (HSCL). This version of the HSCL measured symptoms of depression, anxiety, phobic anxiety, hostility, and interpersonal sensitivity. In comparison to younger groups, the elderly patients reported decreased symptomatology on all HSCL scales except the phobic anxiety scale. These differences could be due to a reporting effect, selective migration or mortality, a cohort effect, or they could reflect a true age effect, the view favored by the authors.

Aged↗
PubMed1987

Psychiatric aspects of cancer in the aged.

The greatest risk factor for cancer is ageing, yet little is known about the epidemiology and treatment of psychiatric disorders in the aged cancer population. This is particularly true for the group over 75 years of age. Four important areas of psychiatric treatment relevant to the aged cancer patient are: illness behaviour, cognitive disorders, depression and psychosocial adaptation. Within these areas the following four conclusions can be made: (a) Symptom presentation and health promoting practices are two important aspects of illness behaviour that affect the detection and prevention of cancer in the aged. (b) It is likely that there will be an increased co-occurrence of dementia and cancer, raising important issues of treatment and informed consent. (c) There appears to be evidence that depression in cancer patients does not increase with age. (d) Similar to depression, despite widely differing methods and age cutoffs, the results of several studies have shown that psychosocial adaptation to cancer is maintained with age. With respect to psychiatric treatment, no patient should be denied full use of appropriate therapy on grounds of old age alone, and more attention should be given to the systematic detection and evaluation of reversible cognitive disorders.

Adaptation, Psychological↗
PubMed1986

A methodological note on content analysis: estimates of reliability.

The reliability of measurements obtained from a dictionary-based form of content analysis was investigated in this experiment by tape-recording subjects as they spoke about a predetermined topic in two separate sessions 1 week apart. Subjects were randomly assigned to speak in one of two contexts. The content of transcripts of these sessions was analyzed using adaptations of the Harvard III Psychosociological Dictionary and the General Inquirer content analysis program (Stone, Dunphy, Smith, & Ogilvie, 1966). Reliability was high over time, both within and between sessions, and there were few differences observed between contexts. Results are discussed in terms of their implications for the use of content analysis in personality research.

Journal Article↗