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Biomedical subjects

T E Smith

Publications and source records attributed to T E Smith.

At least 37 records · Page 2Linked to original sources
PubMed1999

Symptoms and neurocognition as rate limiters in skills training for psychotic patients.

OBJECTIVE: This study aimed to replicate findings that neurocognitive capacity in schizophrenia is more predictive of acquisition of social skills than are symptoms. METHOD: Thirty-two hospitalized patients with chronic psychotic disorders were randomly assigned to community reintegration skills training or supportive group therapy. Neurocognitive functioning was assessed before treatment, and symptoms and skill levels were measured before and after treatment. RESULTS: The skills training group showed significantly greater skill acquisition. In a regression model, skill acquisition was predicted by group membership and verbal memory capacity and not by symptoms. CONCLUSIONS: With methodological advances, the authors replicated findings regarding the importance of neurocognition in determining treatment outcome in schizophrenia.

Cognition Disorders↗
PubMed1999

Development of a vertically integrated program of services for persons with schizophrenia.

Economic pressures are changing the nature and quality of services available to individuals with chronic psychiatric disorders. Vertical integration of services has been proposed as a strategy for cost-effective merging of resources. This report describes the integration of inpatient, continuing day treatment, and ambulatory clinic services over an 18-month period into a service line for patients with schizophrenia. Key principles in implementing the integrated program included an open admission policy, continuity of care, use of criteria for level of care that were set by external review agencies, rapid transfers between services, and maintenance of the integrity of the treatment plan. Steps toward integration included evaluating and securing treatment resources, establishing core treatment approaches, fostering staff development, implementing outcomes assessment, and presenting the new program to clients, family members, and the community. The integrated program was 15 percent more productive than the combined services before integration, and inpatient length of stay dropped by 66 percent. Vertical integration of services is cost-effective and offers the potential for significant clinical benefits.

Continuity of Patient Care↗
PubMed1999

Ethanol feeding selectively impairs the spreading of rat perivenous hepatocytes on extracellular matrix substrates.

BACKGROUND: Hepatocytes require attachment and subsequent spreading on an extracellular matrix for their proper growth, function and survival. Our previous studies have shown that ethanol feeding selectively impairs perivenule hepatocyte attachment to various extracellular matrices. This study was undertaken to determine whether zonal differences in hepatocyte spreading in response to ethanol feeding occurs and to ascertain the influence of ethanol consumption on the zonal expression of the beta1 subunit of integrins, which are the major surface receptors responsible for matrix binding and subsequent interactions. METHODS: Hepatocytes from the perivenous and periportal regions of the liver were isolated by digitonin/collagenase perfusion from rats that were pair-fed for 2 to 3 weeks with a liquid diet containing either ethanol or isocaloric carbohydrate. The ability of perivenous and periportal hepatocytes to spread on plates coated with either type IV collagen, laminin, fibronectin or polylysine was determined. In addition, the isolated cells were used for the analysis of total cellular and surface beta1 integrin expression. RESULTS: With all of the matrix substrates tested, the spreading of perivenous hepatocytes isolated from the ethanol-fed animals was markedly impaired, while the spreading of periportal hepatocytes was essentially unaffected by ethanol feeding. Both the total cellular as well as the surface expression of the beta1 integrin subunit in perivenous cells from the ethanol-fed rats were significantly higher than from the perivenous control cells, whereas the total and surface expression of the beta1 integrin in periportal cells isolated from ethanol-fed and control rats were not significantly different. CONCLUSIONS: The results indicated that in addition to impairing hepatocyte attachment, ethanol feeding also impairs another critical step of the adhesion process, that of hepatocyte spreading on extracellular matrix substrates. This defect occurred preferentially in perivenous cells and not periportal cells and was associated with an increase in beta1 integrin expression, suggesting that a compensatory mechanism occurs as an attempt by the perivenous cells to overcome impaired cell-matrix interactions caused by ethanol. Overall, these alterations in extracellular matrix-hepatocyte interactions could lead to alterations of hepatocyte structure and function and potentially play a role in alcoholic liver injury.

Animals↗
PubMed1998

The relationship between symptoms and insight in schizophrenia: a longitudinal perspective.

It has been suggested that deficits in symptom awareness and attribution in schizophrenia are relatively independent of core symptoms of the disorder. Many studies report conflicting findings, however, which may be explained by differences in study design and target population. In this study 33 individuals with schizophrenia or schizoaffective disorder were assessed longitudinally using standard symptom and insight measures, with analyses focusing on associations with psychotic, depression and anxiety symptoms. Both cross-sectional and longitudinal analyses showed significant but only moderate associations between insight and symptoms of depression and disorganization, with no consistent relationships with positive and negative symptoms. Higher levels of depression were associated with improved awareness and attribution, whereas higher levels of disorganized symptoms were associated with deficits in awareness and attribution. The results are compared with the previous literature, and it is suggested that insight deficits in schizophrenia may vary depending on factors such as course and phase of illness.

Adult↗
PubMed1998

Behavioral discrimination between circumgenital odor from peri-ovulatory dominant and anovulatory female common marmosets (Callithrix jacchus).

Social peer groups of callitrichid monkeys [marmosets and tamarins] exhibit intrasexual dominance hierarchies in captivity. This laboratory study employed two-choice behavioral discrimination bioassys to test the hypothesis that scent from female common marmosets contains chemical cues that permit discrimination between dominant females in the periovulatory versus luteal phase of the ovarian cycle and females holding dominant versus subordinate status. When scent from only dominant females was presented, marmosets directed significantly greater amounts of investigatory behavior toward peri-ovulatory scent versus scent collected during the luteal phase of the ovarian cycle. Animals of both sexes demonstrated significant discriminatory behavior between scent deposited by dominant versus subordinate females, but only when the dominant female was in the peri-ovulatory phase of the ovarian cycle. Test animals directed equal amounts of investigative behavior toward scent from luteal-phase dominant females and subordinate females. Female test subjects deposited significantly more scent marks over presented scents than did male subjects, particularly when the scent had been donated by a peri-ovulatory female. Chemical odors specific to the periovulatory and luteal phases of the ovarian cycle may play a role in mediating behavioral interactions among marmosets.

Animals↗
PubMed1998

Close proximity of the heterosexual partner reduces the physiological and behavioral consequences of novel-cage housing in black tufted-ear marmosets (Callithrix kuhli).

The present studies assessed the extent to which heterosexual pairmates could buffer marmosets (Wied's black tufted-ear marmoset, Callithrix kuhli) against stress. Six male and six female marmosets from established groups were exposed to two experimental manipulations together with a control condition. Each condition lasted a total of 4 days. For the two experimental conditions, animals were removed from the family group and housed in a novel cage for 48 h in either the presence or the absence of the heterosexual pairmate. During the 48-h novel-cage housing period and for 48 h upon reunion of the subjects with the family group, concentrations of urinary cortisol were measured in the first void sample of the day and behavioral observations were conducted. When animals were housed alone in a novel cage they exhibited significant elevations in levels of urinary cortisol after 24 and 48 h of novel-cage exposure. In contrast, when marmosets were housed in the novel cage in the presence of the pairmate, levels of urinary cortisol did not change across the 4-day period. The presence of the social partner also reduced the behavioral manifestations of exposure to novelty. Upon reunion with the family group, animals that had been housed in the novel cage alone spent significantly more time in close proximity to the pairmate than animals that had been housed with the partner. A second experiment was conducted to determine the effect that separation from the pairmate, only (independent of any effects of novelty), had on levels of cortisol. Concentrations of urinary cortisol were measured in subjects housed in the familiar home cage, but in the absence of the pairmate, over a 48-h period and compared to concentrations of excreted cortisol immediately prior to separation. Separation from the pairmate did not elevate cortisol levels when the subject was housed in the home cage, suggesting that elevated cortisol levels in animals housed alone in the novel cage were in response to novelty exposure rather than to separation from the pairmate. Since the physical presence of the heterosexual partner reduced the physiological and behavioral effects of novel-cage housing, social attachments might function as homeostatic regulators of HPA function in marmosets.

Animals↗
PubMed1998

Standards of care and clinical algorithms for treating schizophrenia.

Health care changes and improved understanding of the course and management of schizophrenia have provided the propitious environment to develop guidelines for treating patients with schizophrenia. This article describes two recent guidelines and highlights how these may be used to enhance clinical practice. Although still at a nascent stage that is awaiting more widespread acceptance by clinicians, the introduction of guidelines represent a significant advance in mental health care.

Algorithms↗
PubMed1997

Post-hospitalization treatment adherence of schizophrenic patients: gender differences in skill acquisition.

A cohort of acutely ill, hospitalized patients with chronic psychotic disorders participated in a study of a manualized community reintegration skills training program. Initial data analyses revealed that skill levels improved significantly over the course of treatment, and that higher post-training skill levels were associated with better post-discharge functioning for the group as a whole. Post-discharge treatment adherence rates were dramatically better in females, and analyses were conducted to determine the role of gender. Males and females had different predictors of post-training skill level and post-discharge treatment adherence. In males, who as a group were at higher risk for poor post-discharge outcome, there was a positive association between post-training skill level and post-discharge treatment adherence. Females, on the other hand, showed good post-discharge treatment adherence regardless of post-training skill or symptom levels. This report is consistent with prior studies suggesting that male and female individuals with schizophrenia show differential patterns of social skill, skill improvement, and social adjustment.

Female↗
PubMed1997

Cognitive and symptom correlates of participation in social skills training groups.

In a study of 19 hospitalized chronic schizophrenic patients participating in a manualized skills training program, neuropsychological functioning was found to be an important mediating variable. Executive functioning capacity was positively associated with level of participation in the training groups, and deficits in sustained attention together with negative symptoms correlated negatively with overall program attendance. Neuropsychological functioning should be considered as an important assessment domain when identifying patients with minimal requirements to begin skills training.

Adult↗
PubMed1997

Social and reproductive conditions modulate urinary cortisol excretion in black tufted-ear marmosets (Callithrix kuhli).

The links between psychosocial stress, social status, reproductive function, and urinary cortisol were assessed in social groups of black tufted-ear marmosets (Callithrix kuhli). Urinary cortisol excretion was monitored in cases of intrafamily conflict ("sibling fights") and in daughters in four distinct social contexts: in the family group, while housed singly or in same-sex pairs, and while paired with a male pairmate. Cortisol excretion was elevated in participants in intra-family conflict on the day of and the day following the conflict, relative to concentrations a week prior to or following the conflict. Daughters in natal family groups had concentrations of cortisol that did not differ from reproductively active adult females. This finding held for daughters who were either anovulatory or undergoing ovulatory cycles while in the natal family group. Natal family members and male pairmates exerted buffering effects on levels of activity in the hypothalamic pituitary adrenal axis (HPA) in female C. kuhli. Placing females in solitary housing led to significantly increased cortisol excretion. In the 2 months subsequent to pairing with a male partner, excreted cortisol concentrations in females declined significantly. Daughters removed from their natal family group and housed with a sister did not exhibit increased cortisol levels. These data reveal that activity in the (HPA) axis in marmosets is sensitive to psychosocial stressors, and that urinary cortisol can provide a useful quantitative measure of HPA reactivity. As in other callitrichids, delayed breeding in daughters and reproductive anomalies in C. kuhli appear to be mediated by mechanisms other than elevated HPA activity.

Aggression↗
PubMed1997

Social and developmental influences on reproductive function in female Wied's black tufted-ear marmosets (Callithrix kuhli).

Although marmoset social groups may contain multiple adult females, reproduction is typically limited to one breeding female. A variety of endocrine and behavioral mechanisms have been identified that regulate fertility among female marmosets. In the present study, we assessed the mechanism(s) by which fertility is regulated in female black tufted-ear marmosets, Callithrix kuhli. The reproductive status of 10 daughters aged 2-24 months was evaluated by measuring concentrations of urinary pregnane-diol 3 alpha glucuronide (PdG) and luteinizing hormone (LH). Concentrations of the two hormones were typically low in daughters less than 12 months of age, and the profiles suggested anovulation (mean PdG < 2 micrograms/mg Cr and mean LH < 6 ng/mg Cr). Concentrations of PdG rose dramatically in females older than 12 months. Eight subadult daughters commenced ovulatory function while still living with their family, and the remaining two failed to ovulate. The onset of ovarian function coincided with a change in the social environment in two females, but the remaining six females commenced spontaneous ovarian activity that was not associated with any social or environmental factor (mean age: 15.6 +/- 1.6 months). Ovulatory function was monitored in five daughters while housed in their natal family group, while removed from the natal family group and housed singly, and while paired with an unrelated and unfamiliar male. The ovarian cycles of these females housed in the natal group were characterized by significantly shorter luteal phases and reduced PdG concentrations, relative to when the females were housed on their own, and relative to adult breeding females (n = 6). Stimulatory cues from unfamiliar males were not necessary to trigger regular ovarian function in females. In this species, the regulation of fertility in daughters is a complex combination of behavioral and endocrine factors.

Animals↗
PubMed1997

Combined olfactory contact with the parent colony and direct contact with nonbreeding animals does not maintain suppression of ovulation in female naked mole-rats (Heterocephalus glaber).

The study investigated the role of odor cues from two naked mole-rat colonies, in conjunction with behavioral cues from nonbreeding colony members, in maintaining suppression of ovulation in subordinate female naked mole-rats isolated from the two parent colonies. Four high ranking nonbreeding female naked mole-rats were removed from their respective parent colonies and singly housed in separate burrow systems. For a 64-day period, the removed females were maintained in daily odor contact with their parent colony by daily rotating soiled bedding material between the parent colony and the burrow systems of removed females. In addition, subsets of nonbreeding animals from the respective parent colony were regularly moved into the burrow systems of removed females for 2-day periods during this 64-day period. Removed females were therefore in continual social contact with subsets of parent colony animals except for the breeding pair. All four removed females exhibited raised levels of urinary progesterone (< 2 ng/mg Cr) indicative of the onset of ovarian function within 3 days of being separated from the parent colony. Removed females exhibited a normal ovulatory cycle with levels of progesterone remaining elevated for 25-35 days (mean concentration of progesterone +/- SEM; 16.2 +/- 2 ng/mg Cr). Initiation of aggression and sexual behavior by removed females increased significantly when they were isolated from the parent colony. The results demonstrated that odor cues from the complete colony in conjunction with behavioral/tactile/vocal cues from the nonbreeding colony members were not the major cues maintaining reproductive suppression in nonbreeding female naked mole-rats. Instead, our results suggest that female reproductive suppression in naked mole-rats is caused by a dominance-related behavioral mechanism requiring direct contact with the breeding female.

Aggression↗
PubMed1997

Psychosocial stress and urinary cortisol excretion in marmoset monkeys (Callithrix kuhli).

Activation of the hypothalamic-pituitary-adrenal (HPA) axis is one of the hallmarks of the physiological responses to psychosocial stressors. The most common method of assessing HPA function is via the measurement of plasma cortisol levels. However, venipuncture involves capture and restraint, which can modify HPA function. We validated a noninvasive procedure for monitoring HPA responses to stressors by measuring excretion of free urinary cortisol. Samples collected throughout the day displayed marked circadian variation, with low cortisol values in first-void samples, followed by a mid-morning peak in cortisol excretion. Concentrations of excreted cortisol declined throughout the day. Exposing marmosets to mild and moderate stressors (11 h isolation in a small cage and manual restraint) increased excreted cortisol concentrations in a dose-dependent fashion: isolation in a small cage led to elevated cortisol in afternoon samples, while manual restraint and isolation produced elevated cortisol in both morning and afternoon samples. The marmoset HPA is differentially sensitive to rather subtle variations in stressors, and these results show that urinary cortisol excretion is a valid and sensitive index of the HPA response to these stressors.

Animals↗
PubMed1997

The relationship between personality and quality of life in persons with schizoaffective disorder and schizophrenia.

The goal of this study was to examine the effects of personality traits as measured by the NEO-PI on the quality of life (QOL) of persons with schizoaffective disorder and schizophrenia. The premise of this research is that personality traits may be important in shaping one's outlook and satisfaction with life. In a prior pilot study, personality traits were measured in persons with schizoaffective disorder and schizophrenia. In this study, the relationship between QOL and specific personality domains as assessed by the NEO-PI were studied in 21 patients. Global QOL as measured by the Lehman QOL instrument was positively correlated with Extroversion (E) and Agreeableness (A), and negatively correlated with the domain of Neuroticism (N). Global satisfaction scores were not correlated with ratings of psychoticism, paranoia or depression. These data suggest that even in psychotic conditions such as schizoaffective disorder or schizophrenia, intrapsychic factors influence one's sense of QOL. In addition, these data suggest that personality variables may differentially affect patients' satisfaction and QOL with different treatment settings.

Adult↗
PubMed1997

Stability of personality traits in schizophrenia and schizoaffective disorder: a pilot project.

This study was performed in an effort to begin characterization of personality traits in schizophrenia. Specific concerns included personality profiles relative to normal adults, personality profile stability over time, and trait-state issues. The authors administered the NEO Personality Inventory as well as symptom ratings at two time points to 21 patients. Patients were all stabilized outpatients attending an adult continuing day treatment program and diagnosed with either schizophrenia or schizoaffective disorder. Personality profiles were determined for all patients. Compared with a normal adult sample, this sample's scores on three out of five of the personality domains assessed were not distinguishable from normal adults. Test-retest correlations were highly significant over an average 28.2-week time interval. In general, the presence of positive symptoms did not appear related to NEO-PI stability, while negative symptoms did show a relationship to the stability of personality profiles. These data suggest that personality profiles can be looked at in schizophrenia, that these profiles do appear stable over time, and that negative symptoms have a strong influence on profile stability and appear to be "trait-like."

Adult↗
PubMed1997

Adolescent gender differences in time alone and time devoted to conversation.

On the basis of past theory and research, it is hypothesized that adolescent females will spend more time in conversation and less time alone than their male counterparts. The hypotheses are tested in data from 2,004 seventh and ninth grade students in a southeastern metropolitan area. With a number of potentially relevant variables taken into account, self-reports of average number of hours per week spent alone and spent in conversation are both substantially higher among girls than among boys contradicting the time alone hypothesis but supporting the conversation time hypothesis and the generalizability of an earlier finding of an adolescent gender difference in time spent in conversation. The findings are tentatively interpreted in terms of males' orientation toward sports, encouraging nonconversation time with others, and females' orientation toward close interpersonal relationships, encouraging talk with intimates. In additional nonhypothesized findings, black students report significantly more conversation time and time alone than do white students.

Adolescent↗
PubMed1996

Axis II diagnoses and treatment refractoriness in schizophrenia.

In a previous medical record review study we identified a subset of chronic schizophrenic patients with comorbid Axis II personality disorder diagnoses, who had significantly longer lengths of inpatient stay as compared to schizophrenic patients without Axis II diagnoses. This study describes a detailed review of a subset of these records. Eighteen records of schizophrenic patients with comorbid Axis II diagnoses were matched with records of patients without comorbid diagnoses. Demographic and premorbid data revealed no differences between the groups, indicating that the Axis II diagnoses were markers for current as opposed to past psychopathology. Negative symptoms were lower in the cohort with comorbid Axis II personality disorder diagnoses on admission only, while affective symptomatology was increased in this group throughout treatment. Ratings of personality pathology showed a trend towards significance, with the comorbid group demonstrating greater amounts of maladaptive personality traits. These data support the notion that personality traits may be independent of Axis I symptomatology in chronic schizophrenia, and can influence the course of treatment.

Adult↗