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Biomedical subjects

W T Roth

Publications and source records attributed to W T Roth.

At least 55 records · Page 3Linked to original sources
PubMed1990

Skin conductance habituation in panic disorder patients.

Skin conductance habituation was compared between 38 patients meeting DSM-III criteria for Panic Disorder and 29 normal controls. Approximately half of each group was randomly assigned to be given 100 dB SPL tones and the other half 75 dB tones. All indices pointed to slowed habituation in patients compared with normals: number of trials to response habituation, total number of responses, and slope of decline of skin conductance level. Patient-normal differences were not significantly larger for 100 dB than for 75 dB. In addition, patients compared with normals had more nonspecific fluctuations, higher skin conductance levels, and a shorter response latency to the first stimulus. Stepwise discriminant analyses classified patients and normals better in the 100 dB than in the 75 dB condition, and showed that the various skin conductancy variables were largely redundant at the higher intensity.

Acoustic Stimulation↗
PubMed1990

Motor activity and tonic heart rate in panic disorder.

Motor activity and tonic heart rate were monitored in 62 drug-free panic disorder patients and 40 normal control subjects. Mean daily activity, mean waking heart rate controlled for activity, and mean sleeping heart rate were determined. Panic disorder patients without phobic avoidance showed higher activity than control subjects or patients with limited or extensive avoidance. Similarly, an "inverted U", relationship between trait anxiety and activity was observed. On the other hand, neither mean waking nor sleeping heart rate showed significant differences between patients and controls, suggesting that the differences previously reported in laboratory studies result from anticipatory anxiety.

Adult↗
PubMed1990

Dietary and hormonal evaluation of men at different risks for prostate cancer: plasma and fecal hormone-nutrient interrelationships.

Relationships between dietary nutrients and plasma and fecal estrone, estradiol-17 beta, testosterone, and plasma prolactin concentrations were studied in young Seventh-day Adventist men: 18 nonvegetarians (NVs), 20 lactoovovegetarians (LOVs), and 15 vegans (V). Blood samples and 3-d dietary records were obtained. Contemporaneously collected diet composites and stool samples were analyzed for fiber. Vs and LOVs consumed significantly more fiber than did the omnivores, whereas NVs and LOVs consumed more saturated fatty acids than did Vs. Although plasma steroid-hormone status did not differ, Vs had significantly higher fecal estrogen concentrations than did NVs or LOVs. Plasma prolactin concentrations were significantly higher in NVs and LOVs than in Vs. Significant relationships were observed for the combined groups between dietary and fecal fiber components and fecal, but not plasma, steroid hormones. For the combined groups, prolactin concentrations were positively correlated with saturated fatty acid intake. Further research on the effects of dietary nutrients on endocrine homeostasis in other age groups is warranted.

Adult↗
PubMed1990

Cardiovascular and symptomatic reduction effects of alprazolam and imipramine in patients with panic disorder: results of a double-blind, placebo-controlled trial.

Seventy-nine patients with panic disorder were randomized to an 8-week double-blind treatment with alprazolam, imipramine, or placebo. Patients kept daily records of panic attacks, activity, anxiety, sleep, and medication use. Weekly measures of anxiety, depression, somatic symptoms, fears, avoidance, disability, and improvement were obtained. All patients underwent a symptom-limited exercise treadmill and other cardiovascular measures. By physician and patient global assessment, patients receiving alprazolam or imipramine were significantly better than patients on placebo. The alprazolam effects were apparent by week 1; the imipramine effects by week 4. All groups showed significant reductions in anxiety, depression, somatic measures, and panic attack frequency. At 8 weeks, patients in the alprazolam group reported significantly less fear than patients in the other two groups. Subjects in the imipramine group showed a significant increase in heart rate and blood pressure.

Adult↗
PubMed1990

Effects of stimulus repetition, duration, and rise time on startle blink and automatically elicited P300.

Intense auditory stimuli of sudden onset evoke not only startle blinks but also an event-related potential component resembling classic P300, even when subjects have no assigned task. To more closely examine the relationship of this P300 to startle, event-related potentials and eyeblink were recorded from 16 young adults in three paradigms designed to produce wide variation in startle amplitude: an Habituation series of 30-ms, 105dBA white noise bursts, a Duration paradigm which presented 105dB noise bursts for 3, 10, 30, or 90 ms, and a Rise Time paradigm which varied the rise/fall times (3, 15, 30, and 45 ms) of 110dBA, 1000-Hz tone bursts. Subjects received two runs of each paradigm. Only on the final Duration and Rise Time runs were stimuli explicitly task relevant; on those runs subjects rated verbally, midway in each 8.4-s interstimulus interval, the disturbingness of the prior sound. Although even the briefest noise bursts evoked parietal P300 as well as startle blink, P300 did not behave like startle. P300 habituated more slowly than did blink amplitude, was more responsive to sustained noise than were blink, N110, and P190, and most importantly, did not show the sensitivity to stimulus rise time manifested by these measures. These findings suggest that the amplitude of automatically elicited P300 is not governed by the same mechanisms as startle amplitude, but behaves more like a defense response.

Adolescent↗
PubMed1990

Guttman scaling in agoraphobia: cross-cultural replication and prediction of treatment response patterns.

The Fear and Avoidance Scales (FAS) is an 11-item questionnaire consisting of two subscales that measure features of agoraphobia and claustrophobia and that were demonstrated to be valid Guttman scales in a British clinical population. The purposes of the study reported here were to replicate the scale characteristics in the United States and to determine if improvement during treatment would follow the sequence predicted by the hierarchy implied in the scales. The FAS was given to 25 female agoraphobics before and after behavioural treatment. A principal components analysis replicated the agoraphobia and claustrophobia factors established in the British sample. Scalogram analyses showed that the Claustrophobia subscale of the FAS was a valid Guttman scale in the US sample whereas the Agoraphobia subscale yielded a high coefficient of reproducibility but a low coefficient of scalability. Treatment reduced the patients' fears and avoidances in the predicted sequence since for both scales the hierarchy of items remained unchanged following treatment.

Adult↗
PubMed1990

Surreptitious drug use by patients in a panic disorder study.

In a double-blind, placebo-controlled trial comparing alprazolam and imipramine for panic disorder, serum analysis revealed that a substantial proportion of the patients took explicitly prohibited anxiolytic medication. Excluding these patients changed the results.

Adult↗
PubMed1989

P3 in schizophrenia is affected by stimulus modality, response requirements, medication status, and negative symptoms.

Eighteen schizophrenics who were not taking medication, 13 schizophrenics who were taking medication, and 37 age-matched controls were tested with event-related potential paradigms designed to elicit P3 response automatically or effortfully (ie, with a choice reaction time task). Electroencephalograms were recorded from the 19 standard 10-20 electrode sites. Compared with controls, both groups of schizophrenics had reduced P3 amplitudes for both effortful and automatic paradigms. P3 latencies were delayed relative to controls for the medication-taking schizophrenics in the effortful paradigms. Negative symptoms derived from the Brief Psychiatric Rating Scale within 1 week of event-related potential testing correlated negatively with both auditory and visual P3 amplitude in the subjects who were not taking medication. There was no evidence that P3 is smaller over left temporal electrode sites in schizophrenics, as has been reported by others. P3 amplitude reduction in schizophrenia is a robust psychobiological phenomenon that is present regardless of medication status or task demands.

Adult↗
PubMed1989

Use of medication and in vivo exposure in volunteers for panic disorder research.

A survey of 794 subjects volunteering for studies of panic disorder with or without phobic avoidance revealed that fewer than 15% had received imipramine and fewer than 15% had undergone in vivo exposure, although the majority had engaged in some form of counseling and had used benzodiazepines. Subjects with spontaneous panic attacks reported more avoidance than subjects with situational attacks. One-half of the subjects were unemployed. The authors recommend wider use of the available effective treatments for panic disorder and phobic avoidance.

Adult↗
PubMed1989

Plasma lipid levels in patients with panic disorder or agoraphobia.

Plasma lipids were measured in 102 subjects with panic disorder or agoraphobia. In women, but not men, a significantly higher than expected number of subjects had cholesterol values that exceeded the 75th percentile of national reference values for their sex and age.

Adult↗
PubMed1989

Cognitive aspects of panic attacks. Content, course and relationship to laboratory stressors.

Twenty patients with panic attacks and ten controls were given a standardised interview about thoughts occurring during times of anxiety or panic attacks. The interviewer was blind to the subject's diagnosis. The 20 panic patients underwent a psychophysiological test battery which included a cold pressor test, mental arithmetic task, and 5.5% CO2 inhalation. More patients than controls reported thoughts centered on fears of losing control and shame when anxious. Panic patients rated their thoughts as stronger and clearer than did controls and they had more difficulty excluding them from their minds. A feeling of anxiety preceded anxious thoughts in patients. This suggests that 'faulty cognitions' are not the initial event in a panic attack, although anxious thoughts may exacerbate or maintain them. Significant correlations were found between the intensity of anxiety-related thoughts in anticipation of mental arithmetic and changes in diastolic blood pressure and heart rate during mental arithmetic.

Adult↗
PubMed1988

Autonomic changes after treatment of agoraphobia with panic attacks.

Twenty-three patients meeting DSM-III criteria for agoraphobia with panic attacks and 14 age-, race-, and sex-matched nonanxious controls were tested in the laboratory and on a test walk in a shopping mall. The patients were tested before and after about 15 weeks of treatment with placebo and exposure therapy, imipramine and exposure therapy, or imipramine and initial antiexposure instructions. Controls were tested twice at a similar interval, but without any treatment. On test day 1, patients compared to controls showed higher average heart rate and skin conductance levels and greater numbers of skin conductance fluctuations in the laboratory, and higher heart rates before and during the test walk. Between pretreatment and posttreatment tests, clinical ratings improved and skin conductance levels decreased in all treatment groups. Heart rate levels in the laboratory, on the other hand, decreased in patients on placebo and rose in patients on imipramine. Thus, imipramine compromises the usefulness of heart rate as a measure of emotional arousal. Higher pretreatment heart rates predicted greater clinical improvement.

Adult↗
PubMed1987

Treadmill exercise test and ambulatory measures in panic attacks.

Treadmill exercise test performance and ambulatory heart rate and activity patterns of 40 patients with panic attacks were compared with 20 age-matched controls (control group 1) and 20 nonexercising controls (control group 2). All patients underwent a symptom-limited exercise stress test. Panic attack patients and control group 1 wore an ambulatory heart rate/activity monitor for up to 3 days. Panic patients had a significantly higher heart rate at 4 and 6 METS than either control group. The max METS were 11.2 +/- 2.3, 13.5 +/- 2.3 and 11.2 +/- 1.8 for the panic attack patients and control groups 1 and 2, respectively. One panic patient had ischemia on the treadmill at 12 METS. Panic patients had a significantly higher standing heart rate than controls. Furthermore, 11 of 39 panic patients had tachycardia on standing compared with 3 of 40 controls. Panic attack patients had higher wake and sleep heart rates than control group 1, but the differences were not significant. These results are consistent with autonomic dysfunction in panic patients but may also be due to differences in physical conditioning. The treadmill can be useful for reassuring patients and for identifying the rare patient with ischemia on exercise.

Adult↗
PubMed1987

Serum phosphate and anxiety in major depression.

Serum inorganic phosphate was measured in 33 hospitalized patients with unipolar depression. As predicted, serum phosphate showed significant negative correlations with Minnesota Multiphasic Personality Inventory scales sensitive to anxiety (Psychasthenia: -0.33) and somatic concern (Hypochondriasis: -0.51). This is consistent with previous observations of relative hypophosphatemia in patients with panic disorder. Clinical consequences of relative hypophosphatemia and the possible roles of hyperventilation or elevated peripheral catecholamines as mediators of this effect are discussed.

Adult↗
PubMed1987

Panic attacks in the natural environment.

Despite much recent research, there is still little systematic information about the phenomenology of panic attacks, and their possible causes remain obscure. We investigated panic attacks in the natural environment using an event sampling approach. Twenty-seven panic attack patients and 19 matched normal controls kept panic attack and self-exposure diaries for 6 days and wore an ambulatory heart rate/physical activity recorder for 3 days. Patients reported 175 attacks, generally of moderate severity. The most frequent symptoms were palpitations, dizziness/lightheadedness, dyspnea, nausea, sweating, and chest pain/discomfort. The results did not support the classification of panic attacks recently proposed by Sheehan and Sheehan, which requires three symptoms as a cutoff for panic attacks. Panic attacks classified by the patients as situational (i.e., occurring in feared situations) were more severe and occurred in situational contexts different from spontaneous attacks, but were otherwise phenomenologically similar. Heart rates did not change during spontaneous attacks and were only mildly elevated during situational attacks or during the 15 minutes preceding these attacks. These heart rate changes were interpretable as effects of anxiety, although physical activity showed a similar pattern of changes. Some normal control subjects reported on the panic diary primarily situational anxiety episodes that were phenomenologically similar to, albeit less severe than, the patients' episodes. Panic patients may sometimes fail to perceive environmental triggers for their attacks because many attacks classified as spontaneous occurred in classical "phobic" situations. Furthermore, the comparison of concurrent diary and retrospective interview and questionnaire descriptions showed that panic patients have a tendency toward retrospective exaggeration. Implications for the assessment, definition, and classification of panic attacks are discussed.

Activities of Daily Living↗