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Biomedical subjects

T Lewin

Publications and source records attributed to T Lewin.

At least 19 recordsLinked to original sources
PubMed1992

Changes in ego defenses with recovery from depression.

This study aimed to determine whether patterns of ego defense change with short-term treatment of psychiatric illness. The subjects were 37 inpatients and outpatients with a DSM-III-R diagnosis of major depressive disorder being treated using standard clinical methods. Ego defenses before and 7 to 9 weeks after commencement of treatment were measured using a shortened version of the Defense Style Questionnaire. There was a significant decline in the use of immature defenses with symptomatic recovery, but no change in the neurotic or mature defenses. Patients with additional axis I diagnoses and/or abnormal personality traits (N = 15) used more neurotic defenses than their counterparts with major depression alone (N = 22), but this pattern did not change with time. The study demonstrates the short-term mutability of immature defenses in relation to an episode of psychiatric illness and provides empirical support for the concept of temporary regression in the context of psychiatric illness episodes.

Ambulatory Care↗
PubMed1992

A high-risk community study of paternal alcohol consumption and adolescents' psychosocial characteristics.

A prospective community study looked at drinking behavior and biopsychosocial correlates of adolescents (in years 9 and 10 and again in years 11 and 12 at 23 high schools) and their parents. Heavy drinkers were compared to nil/low drinkers. Sons were more likely to drink heavily if fathers drank heavily and mothers who drank heavily were more likely to cohabit with heavy drinkers. Differences in psychological characteristics and home environment were defined in regard to heavy drinking fathers and drinking sons. Difficulty in settling disagreements and reduced time spent with family were the main correlates associated with drinking by both boys who did not necessarily have a heavy drinking father and those who did.

Adolescent↗
PubMed1992

Work-related chronic neck impairment. Neck motion analysis in female traverse crane operators.

Twenty-one female steel industry traverse crane operators with long-term sick-leave (3 (1-8) years) due to chronic neck disability underwent careful analysis of case history, physical status and electrogoniometric three-dimensional recordings of active neck motion. Results were compared with those from working female crane operators having identical work posture and tasks and, further, with a group of working female clerks. The sick-listed crane operators had previous frequent contacts with the primary health care because of complaints from the neck and back. In comparison with the reference groups, the sick-listed crane operators showed tenderness of the trapezius and levator scapulae muscles and a short neck stature in combination with impaired active neck motion range with reduced motion speed. The motion pattern was however unchanged. The findings are consistent with the clinical picture of chronic neck myalgia that persisted despite long-term absence from the previous exposure to high static work load upon the neck-shoulders.

Adult↗
PubMed1991

Antenatal prediction of mother-infant difficulties.

A prospective study of 143 "low risk" pregnant women expecting their first baby was conducted in Newcastle, Australia. The study was designed to examine the contribution of a woman's perception of her own childhood experiences, her trait anxiety level, socioeconomic status, and social support network to difficulties in her relationship with her baby during the baby's first year. The women were initially interviewed during pregnancy and followed up 3 and 12 months postpartum. Follow-up measures included the Dimensions of Perinatal Adjustment, the Neonatal Perception Inventory, the Ainsworth Strange Situation, and information from hospital records, family doctors, and baby health centre sisters. Women who perceived their social network as less supportive during pregnancy were likely to see their one-year-old babies (p less than .05) as more difficult. The other antenatal measures were not significantly predictive of outcome.

Adolescent↗
PubMed1991

A community screening test for high alcohol consumption using biochemical and haematological measures.

A discriminant function based on a number of biochemical and haematological tests from an extended multiple biochemical analysis and full blood count, together with weight, smoking status and systolic blood pressure is developed. The function was far more effective at detecting high alcohol use (greater than 40 g ethanol per day) than serum gamma-glutamyl transpeptidase (GGT) or the Short Michigan Alcoholism Screening Test (SMAST) in a community sample of adult males. When classifying high alcohol consumption by GGT only, several division criteria were considered, the most effective being at 40 i.u./l. In terms of identifying high alcohol consumers, rather than alcoholics, the SMAST was no better than GGT, and both had unacceptably low sensitivity (49%, 51%) and poor performance on other measures, thus limiting their use as community screening tools. The discriminant function, however, had an estimated community sensitivity of 78%, was similarly high on other performance measures, and would perform satisfactorily as a community screening tool, particularly in situations where there was a tendency for individuals to under-report their alcohol consumption.

Adult↗
PubMed1990

Mood changes, obstetric experience and alterations in plasma cortisol, beta-endorphin and corticotrophin releasing hormone during pregnancy and the puerperium.

The relationships between mood change, obstetric experience and alterations in plasma cortisol, beta-endorphin (beta-EP) and corticotrophin-releasing hormone (CRH) were examined in a prospective study of 97 primiparous Australian women. Psychological measures were administered between the 28th week of pregnancy and the 3rd postnatal month, including the Profile of Mood States (POMS) and the Montgomery Asberg Depressive Rating Scale (MADRS). Blood samples were collected for cortisol, beta-EP and CRH assay on most of these occasions and during labour. Factor analysis was used to identify key subsets of psychological variables for use in the subsequent analyses. 'Mood disturbance' and 'tiredness' factors peaked at 38 weeks' gestation, while 'difficulty falling asleep' was greatest around the time of birth. Cortisol, beta-EP and CRH concentrations rose significantly as pregnancy advanced and peaked at birth; plasma CRH correlated with plasma cortisol (r = 0.54) and beta-EP (r = 0.32). Women with the highest 'mood disturbance' and MADRS depression scores at 28 weeks' gestation received significantly more pain relief during labour. Those women whose mood deteriorated from 38 weeks' gestation to postnatal day 2 had larger falls in plasma beta-EP after delivery (p less than 0.01) than those women whose mood improved or remained constant. Women in this mood-deteriorated subgroup also had significantly higher MADRS depression scores at 3 months (p less than 0.01). Mild antenatal depression (MADRS greater than 13) occurred in 5.2% of women and mild postnatal depression in 4.7%. Overall, these data suggest a role for circulating CRH in the regulation of maternal cortisol secretion and significant relationships between maternal postnatal mood states and beta-EP and between antenatal mood states and obstetric events.

Adult↗
PubMed1990

Firearms and suicide in Australia.

Australia has a moderate overall suicide rate but an extremely high male firearm suicide rate. Using data covering the years 1961-1985, a series of multiple regression based analyses were performed. During this period, overall suicide rates fell but firearm suicides remained constant with a resulting increase in the proportion of suicides by firearms. There has been an increase in suicides in the young offset by a decline in the elderly. Young males showed the greatest proportional increase in the use of firearms. A limited regional analysis supported the hypothesis that lack of legislative restrictions on long guns in Queensland with a greater household prevalence of such weapons and different cultural attitudes were associated with higher overall and firearm suicide rates. Such findings are consistent with reports from North America, although trends in Australia are more modest. Reducing the availability and cultural acceptance of firearms is likely to decrease suicide rates, especially in males.

Adult↗
PubMed1990

The impact of parental loss on adolescents' psychosocial characteristics.

This study examined ten measures of personality, self-image, and emotional and family problems in a sample of 2,158 Australian adolescents, some of whom had suffered parental loss. The data reveal a pattern of poorer adjustment in adolescents who have lost a parent, but clearly demonstrate that type of loss and family reconstitution have no differential effects on psychosocial development. Implications for future research are discussed.

Achievement↗
PubMed1989

General practitioners' recognition and management of psychiatric illness.

All 53 of the general practitioners from one community health area of the Hunter region of New South Wales were interviewed about patients with psychiatric illnesses who had presented to their practices. Four main themes were covered: personal data which included details of medical and psychiatric training and experience; attitudes to psychiatric illness; pharmacological management; and the effectiveness of existing services. Ninety-four per cent of the general practitioners felt that dealing with psychiatric problems was an integral part of their role as a general practitioner and 60% of the general practitioners believed that their management of these problems was adequate. Patients with personality problems and those with hypochondriasis were identified as their most difficult patient groups, while inability to refer quickly was cited as the major obstacle to successful psychiatric treatment. An increased awareness of the hazards of psychotropic drugs and of the proper uses of these agents existed. Finally, private psychiatrists and the mental hospitals were criticized for not providing an adequate back-up service for this group of general practitioners.

Adult↗
PubMed1989

Australian adolescents' perceptions of their parents.

We examined the characteristics of a self-report measure for assessing perceptions of parents, the Parental Bonding Instrument (PBI), in an adolescent community sample (N = 2,147; mean age = 15.4 years). Using factor analysis, three PBI dimensions were identified--the original Care factor and two Protection factors: perceived social control and personal intrusiveness. Important sex differences were found which were not evident in the two factor structure recommended by Parker [1,2]. Relative to sons, daughters saw their fathers as more personally intrusive and their mothers as less socially controlling and much more caring. Overall, adolescents perceived mothers as more caring but more personally intrusive than fathers. Adolescents who saw their father as uncaring and their mother as controlling tended to have the least positive psychosocial profiles.

Adolescent↗
PubMed1987

Postnatal disappearance of the pregnancy-associated reduced sensitivity of plasma cortisol to feedback inhibition.

We recently observed that the characteristic insensitivity of the pituitary-adrenal system in women to feedback inhibition during pregnancy persists for at least four days postnatally. We therefore examined women during the first five weeks after delivery to assess when the sensitivity of plasma cortisol to glucocorticoid inhibition returns to normal. Dexamethasone (DEXA, 1 mg) was ingested at 11 pm by normal healthy women, once between the 3rd and 27th postnatal days, and again on day 35. Blood plasma was collected at 4 pm on the following day for cortisol assay. Plasma cortisol levels (nmol/L, mean +/- sem [n]) after DEXA in the first two weeks (216 +/- 28, [47]) were higher (p less than 0.001) than in nonmedicated nonpregnant women (47.4 +/- 8.9 [12]) and were normal by the 35th day after delivery (41.7 +/- 4.8 [74]). A negative association was found between post-DEXA cortisol and time after delivery in the first 4 post-partum weeks (r = -0.46, p less than 0.001). The study confirms that insensitivity of plasma cortisol to feedback inhibition persists beyond normal pregnancy in a significant proportion of healthy women for two to three weeks, and is absent by the 5th postnatal week.

Dexamethasone↗
PubMed1987

Minor psychiatric morbidity in a casualty population: identification, attempted intervention and six-month follow-up.

The prevalence of minor psychiatric morbidity (MPM) was investigated in 523 adults presenting to the casualty section of an Australian public hospital. Relationships between subject characteristics and the level of MPM were also examined, together with the acceptability of an offer of short-term intervention and the effectiveness of this intervention in reducing distress. Threshold morbidity on initial presentation to casualty was 41% (using the GHQ-12 with the customary 1/2 cut-off point) and the probable prevalence was estimated to be about 27%. The intervention was initially offered to a random sample of those identified as being 'under stress' (GHQ of three or above), but as there was a 90% rejection rate, it was offered to all symptomatic subjects. Overall, 26% accepted our offer of intervention. Those who accepted intervention and those who rejected it did not differ in their improvement in MPM during the subsequent six months. However, these groups improved slightly more than the group that was eligible for intervention but to whom it was not offered. Forty-seven per cent of subjects who were 'under stress' on initial presentation to casualty fell below the GHQ-12 threshold at the six-month follow-up; this compared with a shift of only 26% in the opposite direction (i.e., non-stressed to stressed). Regression to the mean offered the most parsimonious explanation for these GHQ changes.

Adult↗
PubMed1985

Peripartum concentrations of beta endorphin and cortisol and maternal mood states.

Nineteen women were studied before, during and after labour by assessment of their mood using a variety of psychological tests and by measurement of their plasma concentrations of beta-endorphin and cortisol. Beta-endorphin and cortisol concentrations rose markedly during labour and were influenced by the type of analgesia used. A deterioration in cognitive performance between days 2 and 4 postpartum correlated positively with the fall in beta-endorphin concentrations from those in labour to those on the fourth day postpartum. The women were more anxious and depressed at 38 weeks' gestation than on days 1-4 postpartum and the elevation of mood on day 2 postpartum correlated with a measure of depression 8 weeks later. It is postulated that the phenomenon of postpartum blues is a reaction to the euphoria of delivery which in turn is a response to endorphin release during labour. Whilst these changes may have a role in promoting maternal-infant attachment it is at the expense of maternal depression some weeks later.

Anxiety↗
PubMed1983

Predictors of initial and final work capacity in a chronic obstructive airways disease rehabilitation program.

A study was conducted to determine the predictors of initial and final work capacity in men with chronic obstructive airways disease attending an outpatient rehabilitation program in a veterans' hospital. Baseline psychological, ergometric and respiratory physiological data were collected on a sample of 27 patients and ergometric and physiological data were collected again after eight weeks. The study demonstrated that respiratory impairment as measured by vital capacity was predictive of initial work capacity and that knowledge of the patients' psychological state added little to this prediction. In addition, it demonstrated that work capacity could be improved considerably by such a rehabilitation program despite a lack of improvement in respiratory parameters. Such improvement in work capacity as did occur was greatest for those who were less affectively disturbed, had a more positive general psychological state, were less preoccupied with their symptoms and saw their problems as being more under their control.

Adult↗
PubMed1976

Relation between functional disturbances of the masticatory system and some anthropometric, physiological and psychological variables in young Swedish men.

The relation between functional disturbances of the masticatory system and anthropometric, physiological and psychological variables was studied in 248 Swedish men, aged 18-25 years. No physiological variables and only a few anthropometric variables were found to be correlated with symptoms of functional disorders or to the state of the dentition. Thus, for example, face height was greater in the presence than in the absence of disturbances of the occlusion (mainly occlusal interferences). The psychological variables were found to be most closely correlated with symptoms of functional disorders and the state of the dentition. Men with clinical dysfunction had a lower general level of intelligence than men without. Social adaptation at school was poor in those who reported parafunctions. Men with parafunctions, frequent headache, general muscle and joint symptoms and balancing side interferences had low emotional stability compared with those without such symptoms. Individuals completely free from symptoms of functional disturbances had high emotional stability.

Adolescent↗