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PubMed1996

The effect of a history of conduct disorder in adult major depression.

This paper examines the impact of a history of conduct disorder on major depression in adulthood, including its symptomatology, comorbidity and response to tricyclic antidepressants. 103 subjects with DSM-III-R major depression were assessed for DSM-III-R axis I and II comorbidity, severity of depression, social functioning, general psychiatric symptomatology, early familial environment and family psychiatric history. 18 patients (17%) had a history of conduct disorder, 32 (31%) were subthreshold, and 53 (51%) had no childhood symptoms of conduct disorder. Depressed adults with a history of conduct disorder had significantly higher lifetime alcohol and drug dependence and virtually all (17/18, 94%) met criteria for a personality disorder. Despite this, the current episode of depression did not differ in severity, symptoms or response to treatment except that those with a history of conduct disorder were more likely to be agitated when depressed. The authors conclude that a history of conduct disorder is depressed patients predicts the presence of adult personality disorders and psychoactive substance dependence. In most other ways, depressed subjects with a history of conduct disorder were similar to other subjects.

Adolescent↗
PubMed1996

The subaffective-character spectrum subtyping distinction in primary early-onset dysthymia: a clinical and family study.

In 1983, Akiskal proposed that primary early-onset dysthymia should be divided into two subtypes: subaffective dysthymia, which is a subsyndromal form of major mood disorder; and character spectrum disorder, which is a form of personality disorder with secondary dysphoria. The present study attempted to validate this distinction. Akiskal's (1983) criteria were applied to a sample of 97 early-onset dysthymic outpatients, yielding groups of 41 subaffective and 56 character spectrum patients. Patients were evaluated using structured interviews for Axis I and II disorders, family history of psychopathology, and the early home environment, and a comprehensive battery of questionnaires. In addition, direct and family history interviews were conducted with their first-degree relatives. There was mixed support for Akiskal's typology. Consistent with the model, subaffectives exhibited higher rates of major depression, depressive symptoms, and a number of depressive personality and cognitive features. In addition, there was a higher rate of alcoholism among the relatives of character spectrum patients. However, contrary to Akiskal's model, the groups did not differ on gender, unstable personality disorders, family history of mood disorders, or the early home environment.

Adult↗
PubMed1991

Psychosocial risk factors distinguishing melancholic and nonmelancholic depression: a comparison of six systems.

We examined six systems or scales designed to distinguish melancholia from residual nonmelancholic depressive disorders in a sample of 305 patients. A count of the number of significant psychosocial risk factors showed that a clinical diagnosis was the most differentiating (19 significant risk factors), followed by the Newcastle index (13), DSM-III (10), and the CORE system (10)--the last essentially assessing psychomotor change; Research Diagnostic Criteria (RDC) (7) and an endogeneity symptom scale (2) were the least differentiating. A subsample of "composite melancholics" was derived, comprising 138 who met "melancholia" criteria for DSM-III, RDC, and CORE, and they were contrasted with residual depressives. The composite melancholics were older, had had a briefer depressive episode, and differed significantly on 12 risk factors, essentially being less likely to report deprivational experiences such as deficient parenting and dysfunctional marital relationships. We suggest that such a risk factor strategy is of potential use in refining the clinical definition of melancholia.

Adaptation, Psychological↗
PubMed1993

Psychosis proneness scales in schizophrenia spectrum personality disorders: familial vs. nonfamilial samples.

The authors evaluated the extent of overlap between DSM-III-R schizophrenia spectrum personality diagnoses (SSPD) and the Psychosis Proneness Scales of Chapman and his associates. The subjects were recruited from the family members of schizophrenic patients ("familial" subjects; n = 45) and members of the community with negative family histories for schizophrenia ("nonfamilial" subjects; n = 60). Clinical interviews were performed to obtain DSM-III-R Axis I and II diagnoses. In 105 individuals with no Axis I diagnosis, the five Chapman Scales were administered. The results suggest that the nonfamilial subjects with diagnoses of SSPD (n = 24) scored significantly higher on the Chapman Scales of Magical Ideation, Perceptual Aberration, and Impulsive Nonconformity compared with the familial SSPD subjects and the other non-SSPD groups. The familial SSPD subjects (n = 17) scored significantly higher than the nonfamilial, non-SSPD groups on the Physical Anhedonia Scale. Scores on the Social Anhedonia Scale were highest in the SSPD subjects, but only scores for the nonfamilial SSPD subjects were statistically different from those for the other non-SSPD groups. The data were reanalyzed by first dividing the scores from the Chapman Scales into high and low scores based on different cutoff points. Sensitivities, specificities, and predictive powers of the "high" Chapman scores for SSPD diagnoses were then calculated. These were done because the Chapman Scales are often used to identify individuals with schizophrenia-related personality disorders on the basis of scores that exceed arbitrary cutoff points. The results suggest that the Chapman Scales (other than the Physical Anhedonia Scale) and DSM-III-R criteria identified mostly the same subjects, when only nonfamilial subjects were considered (with sensitivities and specificities of about 0.70). However, the overlap between these two constructs was poor when only schizophrenia spectrum subjects recruited from the family members of schizophrenic patients were considered.

Adult↗
PubMed1990

Heavy drinking and its correlates in young men.

This study examined the drinking behavior of a sample of 98 college men and the relationship to drinking of a variety of subject variables. The subjects reported drinking an average of nearly eight days a month, about five drinks each time, and were intoxicated more than three times monthly. Nearly half reported having experienced two or more drinking-related adverse consequences within the past year and over a third were intoxicated four or more times monthly. Forty percent of the subjects could be described as problem drinkers. Illicit drug use and the disinhibition factor of the sensation seeking scale were the most consistent correlates of drinking behavior and its adverse consequences, although belonging to a fraternity, consuming alcohol/drugs before age 15, the Macandrew Alcoholism Scale score, and a family member having received alcoholism treatment were also found to be consistently associated with drinking in the subjects. Sociodemographic characteristics, physical health, mental health treatment, childhood behavior problems, adolescent antisocial behavior, and familial alcoholism were by and large not found to be related to drinking behavior. A stepwise multiple regression analysis revealed that five variables accounted for 51% of the total variance in drinking behavior. The significant predictors included a heavy drug use factor, a smoking factor, fraternity membership, drug/alcohol use before age 15, and having a family member who had received alcoholism treatment. Thus, four of the five significant predictor variables were reflective of drug use in the subject or his family. The findings underline the need for further prospective longitudinal research to understand the origins of problem drinking and its relationship to alcoholism.

Adolescent↗
PubMed1991

Personality and family features of adolescent girls with eating symptoms: evidence for restricter/binger differences in a nonclinical population.

Conflicting evidence exists concerning a "restricter/binger" dichotomy aligned with personality traits of obsessionality versus impulsivity, and family traits of enmeshment versus incohesion. The present study explored relationships among reported personality and family traits, on the one hand, and subtypes of eating symptoms, on the other, in a sample of 715 high-school girls. Symptomatic eaters (most displaying subclinical eating problems) consistently displayed more Mood Problems, Body Concerns, and Self-Criticism than did asymptomatic girls. Differences were observed between restrictive eaters and binge eaters on other variables: Restrictive types were more Perfectionistic, whereas bingers were more Impulsive and rated their families as more Incohesive. Results were discussed in the light of two views on restricter/binger differences. That they reflect: (a) premorbid features acting in predisposition to the eating disorders (EDs). (b) state-dependent features associated either with restrictive or binging phases of eating disturbances.

Adolescent↗
PubMedDate not supplied

Personal and parental alcohol abuse, and victimization in obese binge eaters and nonbingeing obese.

Current obesity research has begun to emphasize the importance of pretreatment assessment and more individually tailored treatment protocols. Obese binge eaters have been identified as a subgroup of the obese who do not respond well to standard behavioral treatment programs. We were interested in identifying variables that are important to consider when assessing and treating obese binge eaters. The present study assessed the prevalence of personal alcohol abuse, parental alcohol abuse, and victimization in 62 males and 274 females seeking treatment for obesity. Obese binge eaters (OBE) had significantly greater rates of personal alcohol abuse, parental alcohol abuse, and victimization than the nonbingeing obese (NBO) in our sample. Further studies of the OBE population are recommended.

Adolescent↗
PubMed1992

Personal and parental problem drinking: effects on problem-solving performance and self-appraisal.

This study examined the problem-solving performances and self-appraisals of problem-solving ability of college-age subjects with and without parental history of problem drinking. Contrary to our predictions, children of problem drinkers (COPDs) were rated as somewhat more effective in their problem-solving skills than non-COPDs, undermining prevailing assumptions about offspring from alcoholic households. While this difference was not large and was qualified by other variables, subjects' own alcohol abuse did exert a detrimental effect on problem-solving performance, regardless of parental history of problem drinking. However, a different pattern was evident for problem-solving self-appraisals. Alcohol-abusing non-COPDs saw themselves as effective problem-solvers while alcohol-abusing COPDs appraised themselves as poor problem-solvers. In addition, the self-appraisals of alcohol-abusing COPDs were consistent with objective ratings of solution effectiveness (i.e., they were both negative) while alcohol-abusing non-COPDs were overly positive in their appraisals, opposing the judgments of trained raters. This finding suggests that the relationship between personal alcohol abuse and self-appraised problem-solving abilities may differ as a function of parental history of problem drinking. Limitations on the generalizability of findings are addressed.

Adult↗
PubMed1990

Association between intravenous drug use and early misbehavior.

This investigation uses an epidemiologic strategy to examine a suspected association between misbehavior in early life and subsequent involvement in intravenous drug use. The 222 cases of i.v. drug use in this study were a subset of all persons recruited for a continuing study of drug use, HIV-1 infection, and the natural history of AIDS. It was possible to match these 222 i.v. drug users to 588 subjects from the NIMH Epidemiologic Catchment Area survey sample, for a total of 810 subjects in 60 matched sets. The matching factors were gender and census tract of residence. Conditional logistic regression models were used to estimate the degree of association between early misbehavior and i.v. drug use. The results showed a strong association between i.v. drug use and early misbehavior. For every unit increase in misbehavior score, the odds of being an i.v. drug user increased by a factor of 1.74 (P less than 0.001). Compared to subjects with low misbehavior scores, those with high scores were 24.67 times more likely to be i.v. drug users (P less than 0.001). Results of this study add to evidence now supporting field trials of public health strategies to modify the link between misbehavior in early life and later illicit drug use.

Adolescent↗
PubMed1991

Primary and secondary depression in alcoholism--clinical features and family history.

One hundred thirty-six alcoholic inpatients were studied with regard to the association between alcoholism and depression. They fell into three groups: primary depression, secondary depression and non-depressive alcoholism. The main results obtained are as follows: (1) Depression was found in 46 patients (33.8%) in the present or past history; 13 were regarded as primary depression and 33 as secondary depression. (2) The clinical symptoms and the background of the primary group resembled those of endogenous depression. (3) The clinical features, including the duration of depressive episodes in the secondary depression group differed from those in the primary group. (4) No statistically significant differences were noted as to the rates of family-history of alcoholism and depression among the three groups. Clinical and biological differences between the primary and secondary groups were discussed on the basis of these results.

Adult↗
PubMed1991

Psychological change during residence in a rehabilitation centre for female drug misusers. Part I. Drug misusers.

Fifty consecutive entrants to a year-long Christian residential rehabilitation programme for female drug misusers received a comprehensive psychological assessment on intake, 3 and 6 months later, and at completion of the programme. Significant changes were seen in emotional state, self-esteem, personality and attitudes to Christianity. Most of the changes occurred during the first 3 months, but changes in personality continued throughout the period of residence. The 11 women who completed the programme differed significantly from the others on their characteristics at intake; the 26 who dropped out during the first 3 months differed significantly from those who dropped out after that time. In both cases, the differences were at a clinically significant level. The importance of matching drug users to rehabilitation centres is discussed.

Adolescent↗
PubMed1992

Adolescent drug use, health and personality.

Four factors have confounded the association between drug use and morbidity: (a) known drug users may be less healthy than unknown drug users; (b) drug users are rarely compared to control subjects; (c) the socio-economic status of drug users predisposes them to ill-health; (d) the personality of drug users predisposes them to ill-health. Here, controlling for these confounds, in a study of 210 adolescent drug users it was found that subjective ill-health was more strongly related to drug use than was objective ill-health. Drug use was related to neuroticism and psychopathic deviance. Controlling for personality, drug use accounted for little additional variance in health. It is concluded that drug use and health are not strongly related amongst adolescent drug users, although, because of their personalities, drug users tend not to feel well. Implications are discussed for the self-treatment explanation of drug use and for the design of preventative programmes.

Adolescent↗
PubMed1979

Separation and reunion behaviors as criteria of attachment to mothers and fathers.

Twenty infants were observed 4 times between 7 and 13 months of age in a short-term longitudinal study. Responses to separations from and reunions with mothers and fathers are reported. None of the measures showed a preference for either parent at any age. Other studies confirm that even young infants are attached to both parents. It is argued that greater attention must be paid to the family's role in social and personality development.

Adult↗
PubMedDate not supplied

Chemical dissociation in adults sexually victimized as children: alcohol and drug use in adult survivors.

Using a structured diagnostic interview, 65.9% of a clinical group of adult survivors of childhood sexual abuse met DSM-III-R criteria for lifetime prevalence of drug or alcohol abuse or dependence. Only 4.6% of the total were still using drugs or alcohol at the time of testing. Childhood risk factors predicted those survivors who used drugs or alcohol with users coming from more chaotic home environments. The data supports the hypothesis that many adults sexually victimized as children use substances to "chemically dissociate."

Adolescent↗
PubMed1992

The HOME inventory: a new scale for families of pre- and early adolescent children with disabilities.

A preliminary form of a new version of the Home Observation for Measurement of the Environment (HOME) is presented. It is designed for use with families of children aged 10-15. The 80-item preliminary version of the Preadolescent HOME (PA-HOME) was field tested on 117 children with varying disabilities. The 80 items were selected from a pool of over 250 items by means of several field tests and accompanying item analyses. Both factor analyses and item analyses were used to help pare down items and produce a scale with acceptable psychometric properties. The psychometric properties of the PA-HOME are quite similar to those reported for the other three versions of the HOME Inventory. It appears to be a reasonably reliable scale with moderate correlations with other measures of the family environment, such as SES, social support, and marital stability. It has low to moderate correlations with measures of child competence in this sample of children with disabilities. The correlations are of the same general magnitude of correlations between the Infant-Toddler, Early Childhood, and Middle Childhood versions of HOME in samples of younger children with disabilities.

Adaptation, Psychological↗
PubMed1992

Characteristics of adult children of alcoholics.

Ninety-seven adult children of alcoholics (ACOAs), 36 adults with dysfunctional family histories, and 41 adults without identified dysfunctional family histories were compared on self-reports of 20 adult characteristics. Significant differences among the groups were found on 4 of the characteristics, with the ACOA group showing the highest frequency of occurrence on 17 of them. No differences due to gender of the alcoholic parent were found, and there was no group by gender interaction. The results suggested that the clinical characteristics attributed to ACOAs may have some empirical validity but the ACOAs seem fairly similar to adults with other types of dysfunctional family histories.

Adaptation, Psychological↗
PubMed1992

Alcohol use and personality relationships in U.S. and Polish adolescents.

To obtain information, which could be useful to the design of intervention and prevention programs for adolescent alcohol users and potential users, personality and alcohol use data were collected from over 300 Polish and U.S. 15-year-olds. Thirty percent of these subjects were already drinking on a more or less consistent basis. Users were angry, nonconforming, and impulsive-antisocial persons in both countries. Future research and potential intervention and prevention strategies are discussed.

Adolescent↗