Search PubMed⌕ Search

Biomedical subjects

T Lewin

Publications and source records attributed to T Lewin.

At least 37 records · Page 2Linked to original sources

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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗